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Marijuana Localism, Robert A. Mikos
Marijuana Localism, Robert A. Mikos
Vanderbilt Law School Faculty Publications
The states have wrested control of marijuana policy from the federal government, but they risk losing some of their newfound power to another player: local governments. Hundreds of local communities are now seeking to establish their own marijuana policies, from legalization to prohibition and a variety of idiosyncratic regulatory schemes in between. These local efforts raise one of the most important and unresolved questions surrounding marijuana law and policy: What authority, if any, should states give local governments to regulate marijuana? This Article provides some guidance on this question. It starts by identifying two competing considerations that help determine whether …
Patient Awareness And Approval For An Opt-Out Genomic Biorepository, Ellen Wright Clayton, Kyle B. Brothers, Matthew J. Westbrook, M. Francis Wright, John A. Myers, Daniel R. Morrison, Jennifer L. Madison, Jill M. Pulley
Patient Awareness And Approval For An Opt-Out Genomic Biorepository, Ellen Wright Clayton, Kyle B. Brothers, Matthew J. Westbrook, M. Francis Wright, John A. Myers, Daniel R. Morrison, Jennifer L. Madison, Jill M. Pulley
Vanderbilt Law School Faculty Publications
Aim: In this study, we sought to assess patient awareness and perceptions of an opt-out biorepository. Materials & methods: We conducted exit interviews with adult patients and parents of pediatric patients having their blood drawn as part of their clinical care at Vanderbilt University Medical Center (TN, USA). Results: 32.9% of all patients and parents of pediatric patients report having heard of the opt-out biorepository, while 92.4% approve of this research effort based on a brief description. Awareness that leftover blood could be used for research increased among adult patients during the study period, from 34.3 to 50.0%. Conclusion: These …
Seeking Genomic Knowledge: The Case For Clinical Restraint, Ellen Wright Clayton, Wylie Burke, Susan Brown Trinidad
Seeking Genomic Knowledge: The Case For Clinical Restraint, Ellen Wright Clayton, Wylie Burke, Susan Brown Trinidad
Vanderbilt Law School Faculty Publications
Genome sequencing technology provides new and promising tests for clinical practice, including whole genome sequencing, which measures an individual's complete DNA sequence, and whole exome sequencing, which measures the DNA for all genes coding for proteins. These technologies make it possible to test for multiple genes in a single test, which increases the efficiency of genetic testing. However, they can also produce large amounts of information that cannot be interpreted or is of limited clinical utility. This additional information could be distracting for patients and clinicians, and contribute to unnecessary healthcare costs. The potential for genomic sequencing to improve care …
The Benefits Of Mortality Risk Reduction: Happiness Surveys Vs. The Value Of A Statistical Life, W. Kip Viscusi
The Benefits Of Mortality Risk Reduction: Happiness Surveys Vs. The Value Of A Statistical Life, W. Kip Viscusi
Vanderbilt Law School Faculty Publications
A principal component of many benefit-cost analyses (BCAs) of health, safety, and environmental regulations is the valuation of the fatality risk effects of the underlying policy. Government agencies currently value these expected effects using estimates of the value of a statistical life (VSL), that is, the tradeoff rate between money and very small risks of death. This measure corresponds to BCA's theoretically appropriate benefits measure, which is society's willingness to pay for the risk reduction. Here, I will review the VSL approach, compare it to suggested alternatives that use happiness measures of well-being, and address some of the misunderstandings that …
An Investigation Of The Rationality Of Consumer Valuations Of Multiple Health Risks, W. Kip Viscusi, Wesley A. Magat, Joel Huber
An Investigation Of The Rationality Of Consumer Valuations Of Multiple Health Risks, W. Kip Viscusi, Wesley A. Magat, Joel Huber
Vanderbilt Law School Faculty Publications
After developing a conceptual analysis of consumer valuation of multiple risks, we explore both economic and cognitive hypotheses regarding individual risk-taking. Using a sample of over 1,500 consumers, our study ascertains risk-dollar tradeoffs for the risks associated with using an insecticide and a toilet bowl cleaner. We observe the expected positive valuation of risk reductions andfind empirical supportfor a diminishing in the valuation of risk reduction as the extent of the risk reduction increases. We also find evidence of certainty premiums for the total elimination of one risk, but no strong evidence of additional certainty premiums for the elimination of …
"Sell's" Conundrums: The Right Of Incompetent Defendants To Refuse Anti-Psychotic Medication, Christopher Slobogin
"Sell's" Conundrums: The Right Of Incompetent Defendants To Refuse Anti-Psychotic Medication, Christopher Slobogin
Vanderbilt Law School Faculty Publications
The Supreme Court's 2003 decision in Sell v. United States declared that situations in which the state is authorized to forcibly medicate a criminal defendant to restore competency to stand trial "may be rare." Experience since Sell indicates that this prediction was wrong. In fact, wittingly or not, Sell created three exceptions to its holding (the dangerousness, treatment incompetency, and serious crime exceptions) that virtually swallow the right to refuse. Using the still-on-going case of Jared Loughner as an illustration, this essay explores the scope of these exceptions and the dispositions available in those rare circumstances when none of them …
The Right To Voice Reprised, Christopher Slobogin
The Right To Voice Reprised, Christopher Slobogin
Vanderbilt Law School Faculty Publications
This article appears in a symposium issue of Seton Hall Law Review on courtroom epistemology. In Proving the Unprovable: The Role of Law, Science and Speculation in Adjudicating Culpability and Dangerousness, I argued that criminal defendants ought to be able to present speculative psychiatric testimony if the expert has followed a routinized evaluation process that addresses the relevant legal criterion, an argument based in part on the position that the Constitution can be read to entitle defendants to tell their exculpatory mental state stories. In a recent essay, Professor Lillquist takes aim at this latter rationale, which I called the …
Policy Challenges Of The Heterogeneity Of The Value Of Statistical Life, W. Kip Viscusi
Policy Challenges Of The Heterogeneity Of The Value Of Statistical Life, W. Kip Viscusi
Vanderbilt Law School Faculty Publications
Economic research has developed estimates of the heterogeneity of the value of statistical life (VSL) on dimensions such as individual age, income, immigrant status, and the nature of the risk exposure. This paper examines the empirical evidence on the heterogeneity of VSL and explores the potential implications for the valuation of regulatory policies. Previously, the U.S. Environmental Protection Agency (EPA) unsuccessfully sought to adopt a simple age discount percentage for VSL based on survey evidence. However, labor market estimates of VSL indicate a pattern that tracks lifetime consumption trajectories, as the VSL rises with age and eventually tapers off but …
Mental Illness And Self-Representation: Faretta, Godinez And Edwards, Christopher Slobogin
Mental Illness And Self-Representation: Faretta, Godinez And Edwards, Christopher Slobogin
Vanderbilt Law School Faculty Publications
In the recent decision of Indiana v. Edwards the Supreme Court held that the right to represent oneself may be denied to defendants who are competent to stand trial if they "still suffer from severe mental illness to the point where they are not competent to conduct trial proceedings by themselves." Edwards was a surprise, given the Court's holding 15 years earlier in Godinez v. Moran that Nevada courts did not err when they permitted a mentally ill person who had been found competent to stand trial to waive the right to counsel, plead guilty and waive the presentation of …
Ten Fingers, Ten Toes: Newborn Screening For Untreatable Disorders, Ellen Wright Clayton
Ten Fingers, Ten Toes: Newborn Screening For Untreatable Disorders, Ellen Wright Clayton
Vanderbilt Law School Faculty Publications
This movie makes two important points despite its admitted unreality. The first, which the screen writer probably did not fully appreciate at the time, is that genetic testing cannot now and probably will never be able to predict with complete certainty the occurrence and course of complex diseases. It is not true that "Genes-R-Us." Rather, we are the products of complex interactions of our genes, the genomes of other organisms (many of which we live in relation with), and the environment, broadly understood to include the air we breathe, the water we drink, the food we eat, the drugs we …
Do Citizens Care About Federalism? An Experimental Test, Robert Mikos, Cindy D. Kam
Do Citizens Care About Federalism? An Experimental Test, Robert Mikos, Cindy D. Kam
Vanderbilt Law School Faculty Publications
The ongoing debate over the political safeguards of federalism has essentially ignored the role that citizens might play in restraining federal power. Scholars have assumed that citizens care only about policy outcomes and will invariably support congressional legislation that satisfies their substantive policy preferences, no matter the cost to state powers. Scholars thus typically turn to institutions-the courts or institutional features of the political process-to cabin congressional authority. We argue that ignoring citizens is a mistake. We propose a new theory of the political safeguards of federalism in which citizens help to safeguard state authority. We also test our theory …
Allocating Responsibility For The Failure Of Global Warming Policies, W. Kip Viscusi, Joni Hersch
Allocating Responsibility For The Failure Of Global Warming Policies, W. Kip Viscusi, Joni Hersch
Vanderbilt Law School Faculty Publications
A recent series of climate change lawsuits has sought to mimic the "regulation through litigation" approach of the claims brought by the states against cigarette manufacturers. What is distinctive about the cigarette cases relative to conventional tort claims is that they were not brought on behalf of individual smokers, but rather sought to recoup the Medicaid-related costs of smoking. A parallel climate change litigation approach seeks payments from public utilities, energy producers, and other parties responsible for greenhouse gas emissions to reflect the long-term societal damages that the plaintiffs claim will be caused by this pollution. While environmental litigation of …
Patients And Biobanks, Ellen Wright Clayton
Patients And Biobanks, Ellen Wright Clayton
Vanderbilt Law School Faculty Publications
The question about the privacy of medical information can be stated simply: To what extent can and should patients control what the medical record contains and who has access to it and for what purposes? Patients often have apparently conflicting views on this subject. On the one hand, we, as patients, say that we prize privacy and that we fear that information will be used to harm us. On the other hand, we value the benefits that come from improved communication among providers, such as having our visits covered by third party payers and advances in medical science, which often …
The Civilization Of The Criminal Law, Christopher Slobogin
The Civilization Of The Criminal Law, Christopher Slobogin
Vanderbilt Law School Faculty Publications
This article explores the jurisprudential and practical feasibility of a "preventive" regime of criminal justice. More specifically, it examines an updated version of the type of government intervention espoused four decades ago by thinkers such as Barbara Wooton, Sheldon Glueck, and Karl Menninger. These individuals, the first a criminologist, the latter two mental health professionals, envisioned a system that is triggered by an antisocial act but that pays no attention to desert or even to general deterrence. Rather, the sole goal of the system they proposed is individual prevention through assessments of dangerousness and the provision of treatment designed to …
Is Atkins The Antithesis Or Apotheosis Of Anti-Discrimination Principles? Sorting Out The Groupwide Effects Of Exempting People With Mental Retardation From The Death Penalty, Christopher Slobogin
Is Atkins The Antithesis Or Apotheosis Of Anti-Discrimination Principles? Sorting Out The Groupwide Effects Of Exempting People With Mental Retardation From The Death Penalty, Christopher Slobogin
Vanderbilt Law School Faculty Publications
In "Atkins v. Virginia", the U.S. Supreme Court held that people with mental retardation may not be executed. z Many advocates for people with disability cheered the decision, because it provides a group of disabled people with protection from the harshest punishment imposed by our society. But other disability advocates were dismayed by "Atkins", not because they are fans of the death penalty, but because they believe that declaring disabled people ineligible for a punishment that is accorded all others denigrates disabled people as something less than human. If people with disability are to be treated equally, these dissenters suggest, …
What Atkins Could Mean For People With Mental Illness, Christopher Slobogin
What Atkins Could Mean For People With Mental Illness, Christopher Slobogin
Vanderbilt Law School Faculty Publications
This article, written for a symposium on Atkins v. Virginia - the Supreme Court decision that prohibited execution of people with mental retardation - argues that people with severe mental illness must now also be protected from imposition of the death penalty. In labeling execution of people with mental retardation cruel and unusual, the Atkins majority stressed that mentally retarded people who kill are less blameworthy and less deterrable than the average murderer, an assertion that can also be made about people with severe mental illness. As it had in previous eighth amendment cases, however, the Court also relied heavily …
Rethinking Legally Relevant Mental Disorder, Christopher Slobogin
Rethinking Legally Relevant Mental Disorder, Christopher Slobogin
Vanderbilt Law School Faculty Publications
The law insists on maintaining mental disorder as a predicate for a wide array of legal provisions, in both the criminal justice system and the civil law. Among adults, only a person with a "mental disease or defect" can escape conviction for an intentional, unjustified crime on grounds of cognitive or volitional impairment.' Only people with "mental illness" or "mental disorder" may be subjected to indeterminate preventive commitment based on dangerousness. Under the laws of many states, only people with a mental disorder are prevented from making decisions about treatment, criminal charges, wills, contracts, and a host of other important …
The Market Value Of Reducing Cancer Risk: Hedonic Housing Prices With Changing Information, W. Kip Viscusi, Ted Gayer, James T. Hamilton
The Market Value Of Reducing Cancer Risk: Hedonic Housing Prices With Changing Information, W. Kip Viscusi, Ted Gayer, James T. Hamilton
Vanderbilt Law School Faculty Publications
In this paper, we use housing price changes occurring after the release of a regulatory agency's environmental risk information to estimate the value people place on cancer risk reduction. Using a large original data set on the repeat sales of houses, matched with detailed data on hazardous waste cancer risk and newspaper publicity, we find that housing prices respond in a rational manner to changes in information about risk. Since the new information indicated that the sites in our sample pose relatively low cancer risk, the informational release led residents to lower their risk beliefs, resulting in an average housing …
Safety At Any Price, W. Kip Viscusi
Safety At Any Price, W. Kip Viscusi
Vanderbilt Law School Faculty Publications
After three decades of experience with extensive government regulation and oversight of health, safety and environmental matters, we have reason to believe that those measures have largely failed to fulfill their initial promise, but many of the initial promises were infeasible goals of a "zero-risk" society. Economic findings with respect to risk-risk tradeoffs highlight the fallacies inherent in government's zero-risk mentality. Agencies that make an unbounded financial commitment to safety frequently are sacrificing individual lives. There continues to be major opportunities to improve regulatory performance by targeting existing inefficiencies and using market mechanisms (rather than strict command-and-control mechanisms) to achieve …
Cigarette Smokers As Job Risk Takers, Joni Hersch, W. Kip Viscusi
Cigarette Smokers As Job Risk Takers, Joni Hersch, W. Kip Viscusi
Vanderbilt Law School Faculty Publications
Using a large data set, the authors find that smokers select riskier jobs, but receive lower total wage compensation for risk than do nonsmokers. This finding is inconsistent with conventional models of compensating differentials. The authors develop a model in which worker risk preferences and job safety performance lead to smokers facing a flatter market offer curve than nonsmokers. The empirical results support the theoretical model. Smokers are injured more often controlling for their job's objective risk and are paid less for these risks of injury. Smokers and nonsmokers, in effect, are segmented labor market groups with different preferences and …
Doubts About Daubert: Psychiatric Anecdata As A Case Study, Christopher Slobogin
Doubts About Daubert: Psychiatric Anecdata As A Case Study, Christopher Slobogin
Vanderbilt Law School Faculty Publications
In Daubert v. Merrell Dow Pharmaceuticals Inc., the Supreme Court sensibly held that testimony purporting to be scientific is admissible only if it possesses sufficient indicia of scientific validity. In Kumho Tire Co. v. Carmichael, the Court more questionably held that opinion evidence based on "technical" and "specialized" knowledge must meet the same admissibility threshold as scientific testimony. This Article addresses the implications of these two decisions for opinion evidence presented by mental health professionals in criminal trials.
The Criminal Defense Lawyer's Fiduciary Duty To Clients With Mental Disability, Christopher Slobogin, Amy Mashburn
The Criminal Defense Lawyer's Fiduciary Duty To Clients With Mental Disability, Christopher Slobogin, Amy Mashburn
Vanderbilt Law School Faculty Publications
This Article has argued that the defense attorney has a multifaceted fiduciary duty toward the client with mental disability. That duty requires, first and foremost, respect for the autonomy of the client. The lawyer shows that respect not only by heeding the wishes of the competent client but by refusing to heed the wishes of the incompetent client. A coherent approach to the competency construct is therefore important. Following the lead of Professor Bonnie, this Article has broken competency into two components: assistance competency and decisional competency. It has defined the former concept in traditional terms, as an understanding of …
An End To Insanity: Recasting The Role Of Mental Disability In Criminal Cases, Christopher Slobogin
An End To Insanity: Recasting The Role Of Mental Disability In Criminal Cases, Christopher Slobogin
Vanderbilt Law School Faculty Publications
This article argues that mental illness should no longer be the basis for a special defense of insanity. Instead, mental disorder should be considered in criminal cases only if relevant to other excuse doctrines, such as lack of mens rea, self-defense and duress, as those defenses have been defined under modern subjectively-oriented codes. With the advent of these subjectively defined doctrines (a development which, ironically, took place during the same period that insanity formulations expanded), the insanity defense has outlived its usefulness, normatively and practically. Modern official formulations of the defense are overbroad because, fairly construed, they exculpate the vast …
The Governmental Composition Of The Insurance Costs Of Smoking, W. Kip Viscusi
The Governmental Composition Of The Insurance Costs Of Smoking, W. Kip Viscusi
Vanderbilt Law School Faculty Publications
The estimated health risks from smoking have significant external financial consequences for society. Studies at the national level indicate that cigarettes are selffinancing since external costs such as those due to illnesses are offset by cost savings associated with premature death, chiefly pension costs. This paper extends this analysis to all 50 states and considers the costs considered in the state attorneys general suits against the cigarette industry. Cigarettes are always self-financing from the standpoint of costs to each state. The extent of the cost savings is less than at the federal level. However, smokers' higher medical costs are outweighed …
Constructive Cigarette Regulation, W. Kip Viscusi
Constructive Cigarette Regulation, W. Kip Viscusi
Vanderbilt Law School Faculty Publications
Professor W. Kip Viscusi argues for a move away from the adversarial approach to tobacco regulation, an approach that is currently embodied in class action lawsuits and the proposed broadening of FDA regulatory power over cigarettes. In this Article, he suggests that the FDA should take a constructive role in fostering technological innovations to promote cigarette safety, in much the same way that the government currently fosters safety improvements in motor vehicles and jobs. Professor Viscusi claims that the objective of government policy should be to promote informed consumer risk taking-an approach which recognizes that adult consumers have a right …
Psychiatric Evidence In Criminal Trials: To Junk Or Not To Junk?, Christopher Slobogin
Psychiatric Evidence In Criminal Trials: To Junk Or Not To Junk?, Christopher Slobogin
Vanderbilt Law School Faculty Publications
This Article begins, in Part I, with a brief review of the past four decades" of psychiatric and psychological testimony in criminal trials (henceforth referred to simply as "psychiatric testimony"). Although this review cannot be called comprehensive, it does make clear that, contrary to what the popular literature would have us believe, psychiatric innovation is neither at an all time high nor the prevalent form of opinion testimony by mental health professionals. At the same time, such "nontraditional" expert opinion from clinicians, on those rare occasions when it does occur, has changed over the past few decades in both content …
Teen Smoking Behavior And The Regulatory Environment, Joni Hersch
Teen Smoking Behavior And The Regulatory Environment, Joni Hersch
Vanderbilt Law School Faculty Publications
Professor Hersch argues that most state regulations aimed at fighting teen smoking have had little or no effect. She provides evidence that despite widespread age restrictions on purchasing tobacco, most teens do not consider it difficult for minors to purchase tobacco products within their community. She also presents evidence demonstrating a strong correlation between smoking rates and perceptions about the addictive nature of smoking. These findings suggest that facilitating greater awareness of the addictive power of cigarettes could be effective in curbing teen smoking. She explores the potential for parental restrictions on limiting teen smoking, but provides indications that parents …
From Cash Crop To Cash Cow, W. Kip Viscusi
From Cash Crop To Cash Cow, W. Kip Viscusi
Vanderbilt Law School Faculty Publications
The 1990s have witnessed a blizzard of antismoking efforts. Hillary Clinton and a variety of supporters of the Clinton health care plan urged dramatically higher cigarette taxes to pay for expanded health insurance efforts. And many state and local governments have imposed smoking restrictions or have undertaken antismoking ad campaigns. Those antismoking efforts recently culminated with a pro posed $368.5 billion settlement to address many liability and regulatory issues. The focal point of the bargain was the settlement of a series of lawsuits filed by the states against cigarette companies to recoup smoking-related Medicaid costs. Several state attorney generals composed …
Carcinogen Regulation: Risk Characteristics And The Synthetic Risk Bias, W. Kip Viscusi
Carcinogen Regulation: Risk Characteristics And The Synthetic Risk Bias, W. Kip Viscusi
Vanderbilt Law School Faculty Publications
In this paper, I will explore the decision to regulate natural and synthetic chemicals. To what extent are regulatory decisions driven by the severity of the risk as opposed to the character of the risk exposure? The striking result is that the risk severity plays a very small role. Instead.it is whether the chemical is synthetic or natural that is the driving force behind regulatory decisions.
Human Health Risk Assessments For Superfund, W. Kip Viscusi, James T. Hamilton
Human Health Risk Assessments For Superfund, W. Kip Viscusi, James T. Hamilton
Vanderbilt Law School Faculty Publications
The Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) is scheduled for reauthorization in the spring of 1995, and Congress must decide either to continue the Superfund program in its current form or to modify it in some manner. Congress cannot sensibly decide how to reauthorize CERCLA without understanding the program's progress toward one of its fundamental missions: the reduction of risks to human health and the environment from uncontrolled hazardous waste sites... This article is structured in six sections. Section I provides background on how risk assessment data are used at Superfund sites.Section II details the construction and organization …