Disputes between patients and providers regarding life-sustaining medical treatment (LSMT) are universal across all U.S. states, yet policies regarding these disputes differ significantly. This dissertation determines that all 50 states have advance directive laws that protect a patient’s right to refuse LSMT even when a healthcare provider objects, yet only some states have policies that protect the patient’s right to choose to continue LSMT when a healthcare provider objects (a dispute known as medical futility). Some states have pro-patient laws that protect the patient’s right to make the final decision, while other states have enacted pro-provider medical futility policies that explicitly grant the provider authority to remove LSMT against the patient’s wishes. Finally, in one state, the law delegates the final decision to a third-party: institutional healthcare ethics committees. This dissertation studies the innovation and adoption of these 17 state medical futility policies, examining the theory that values determine both whether the state adopts a medical futility policy as well as what type of medical futility policy a state will adopt- as the policy actors that represent these values: policy entrepreneurs and interest groups. A comparative case study of successful third-party policy adoption in Texas contrasted against a failed effort …

Undergraduate thesis studying preparedness policies and mechanisms in place for the special population of juvenile delinquents housed in facilities during disasters. The author examines day-to-day functioning and assesses gaps in resources arising during and after a disaster by interviewing emergency managers, a representative from a major school district, and key personnel from a facility housing juvenile delinquents. Results suggest a lack of research regarding this population and the need for closer examination of the unique needs of juvenile delinquent populations during disasters and how agencies can work collaboratively to address them.