Law Commons^™

State Abortion Restrictions And The New Supreme Court: Women’S Access To Reproductive Health Services, Rebecca Reingold, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The US Supreme Court’s landmark 1973 ruling in Roe v Wade established a privacy right to choose abortion. In 1992, Planned Parenthood of Southeastern Pennsylvania v Casey reaffirmed Roe with the Supreme Court calling reproductive decisions “the most intimate and personal choices a person may make…central to personal dignity.” Casey allows abortion regulations, but states cannot impose an “undue burden,” where the law’s “purpose or effect” places a substantial obstacle in a woman’s path in accessing an abortion previability.

State abortion restrictions—meaning laws that restrict whether, when, and under what circumstances a woman may obtain an abortion—increased in the aftermath …

Artificial Intelligence In The Medical System: Four Roles For Potential Transformation, Will Nicholson Price Ii

Articles

Artificial intelligence (AI) looks to transform the practice of medicine. As academics and policymakers alike turn to legal questions, a threshold issue involves what role AI will play in the larger medical system. This Article argues that AI can play at least four distinct roles in the medical system, each potentially transformative: pushing the frontiers of medical knowledge to increase the limits of medical performance, democratizing medical expertise by making specialist skills more available to non-specialists, automating drudgery within the medical system, and allocating scarce medical resources. Each role raises its own challenges, and an understanding of the four roles …

The Public Charge Rule As Public Health Policy, Medha D. Makhlouf

Faculty Scholarly Works

A recent Gallup poll found that health care, the economy, and immigration are the top three most important political issues for U.S. voters. Public charge policy—which relates to the admission of noncitizens based on the likelihood that they will not become dependent on the U.S. government for support—lies at the intersection of these three topics. At the same time, immigration and welfare reform are prominent agenda items for the current administration. On October 10, 2018, the Department of Homeland Security (DHS) released a Notice of Proposed Rulemaking that would transform public charge policy that has existed for more than a …

Legal Remedies To Address Stigma-Based Health Inequalities In The United States: Opportunities And Challenges, Valarie K. Blake, Mark L. Hatzenbuehler

Faculty & Staff Scholarship

Stigma is an established driver of population-level health outcomes. Antidiscrimination laws can generate or alleviate stigma and, thus, are a critical component in the study of improving population health.

Currently, antidiscrimination laws are often underenforced and are sometimes conceptualized by courts and lawmakers in ways that are too narrow to fully reach all forms of stigma and all individuals who are stigmatized.

To remedy these limitations, we propose the creation of a new population-level surveillance system of antidiscrimination law and its enforcement, a central body to enforce antidiscrimination laws, as well as a collaborative research initiative to enhance the study …

The Lancet Commission On Global Health Law: The Transformative Power Of Law To Advance The Right To Health, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

A new report by The Lancet-O’Neill-Georgetown University Commission on Global Health and the Law shows how law can fulfill the global pledge of the human right to health, while “leaving no one behind.” I call this “global health with justice.” We need both health and justice. By global health, I mean ever increasing indicators of good health and increased longevity in all countries around the world. By justice I mean that the global “good” of health must be fairly distributed both within and among countries. The Lancet Commission report offers a comprehensive roadmap towards realizing the law’s power to make …

Who Takes Action To Promote The Health Of Refugees And Migrants, Lawrence O. Gostin, Ibrahim Abubakar, Ranieri Guerra, Sabina F. Rashid, Eric A. Friedman, Zsuzsanna Jakab

Georgetown Law Faculty Publications and Other Works

Migration is a defining issue of our time, with 1 billion migrants globally, of whom 258 million have crossed borders. Climate change and political instability propel ever-greater displacement, with major detriments to health. Policies that fail to prevent human trafficking or guarantee essential services undermine Universal Health Coverage (UHC) and the global pledge to “leave no one behind.” The World Health Assembly should robustly implement WHO’s Global Action Plan (GAP) on the Health of Refugees and Migrants.ugees and Migrants.

What A Long Strange Trip It’S Been For The 3.8% Net Investment Income Tax, Ausher M.B. Kofsky, Bryan P. Schmutz

Maryland Law Review Online

No abstract provided.

The Legal Determinants Of Health: Harnessing The Power Of Law For Global Health And Sustainable Development, Lawrence O. Gostin, John T. Monahan, Jenny Kaldor, Mary Debartolo, Eric A. Friedman, Katie Gottschalk, Susan C. Kim, Ala Alwan, Agnes Binagwaho, Gian Luca Burci, Luisa Cabal, Katherine Deland, Timothy Grant Evans, Eric Goosby, Sara Hossain, Howard Koh, Gorik Ooms, Mirta Roses Periago, Rodrigo Uprimny, Alicia E. Yamin

Georgetown Law Faculty Publications and Other Works

Health risks in the 21st century are beyond the control of any country. In an era of globalization, promoting public health and equity requires cooperation and coordination both within and among states. Law can be a powerful tool for advancing global health, yet it remains significantly underutilised and poorly understood. Working in partnership, public health lawyers and health professionals can become champions for evidence-based laws to ensure the public’s health and safety.

The O'Neill Institute/Georgetown University Lancet Commission on Law and Global Health articulates the vital role of law – through legal instruments, legal capacities, and institutional reforms, as well …

Congress Prescribes Preemption Of State Tort-Reform Laws To Remedy Healthcare "Crisis": An Improper Prognosis?, Jason C. Sheffield

Student Scholarship

Say what you want about the tort-reform debate, but it has staying power. Over the last half-century, legislators and commentators have extensively debated every aspect of tort reform and the litigation "crisis" arguably giving rise to it, without resolving much of anything. Despite this ideological stalemate, tort-reform proponents have managed to push measures through every state legislature. With fifty tries come fifty results, and for the most part, fifty failures. But have all these efforts been in vain? As of yet, no. Although the healthcare system does not appear to be improving, the numerous tort-reform measures states have adopted provide …

Columbia Law Scholars Respond To New Hhs Rule, "Protecting Statutory Conscience Rights In Health Care", Law, Rights, And Religion Project

Center for Gender & Sexuality Law

During his National Day of Prayer remarks, President Trump announced a finalized rule that creates expansive legal protections for healthcare providers with specific religious beliefs, including opposition to abortion, sterilization, end-of-life care, and healthcare for LGBTQ persons. The final rule does not offer similarly broad protections to healthcare providers who feel religiously obligated to provide comprehensive sexual and reproductive healthcare to their patients.

Epilogue: Health Care, Federalism, And Democratic Values, Nicole Huberfeld

Faculty Scholarship

Is the United States experiencing a “crisis of democracy in health care”? This symposium's central question can only begin to be addressed here. The answer depends, in part, on where we look and how we measure democracy.

Democracy is a complex ideal often said to be promoted by federalism. In health care, each level of government exercises power because federalism is a default choice in health reform efforts. This default enables state governments and the federal government to create, enforce, and adjudicate health law and policy - democratic operations at the national and the subnational levels. But on each democratic …

Flushed And Forgotten: Sanitation And Wastewater In Rural Communities In The United States, Alabama Center For Rural Enterprise (Acre), Human Rights Institute, Institute For The Study Of Human Rights

Human Rights Institute

This report seeks to bring attention to the unique plight of rural U.S. communities struggling to secure basic sanitation and wastewater. The problem of inadequate and unaffordable water services has received increasing coverage in recent years, and the focus here is on bringing attention to less well-known structural challenges that impede access to sanitation, and the unique ways they impact rural residents.

American Democratic Deficit In Assisted Reproductive Technology Innovation, Myrisha S. Lewis

Faculty Publications

In many areas of innovation, the United States is a leader, but this characterization does not apply to the United States' position in assisted reproductive technology innovation and clinical use. This article uses a political science concept, the idea of the "democratic deficit" to examine the lack of American public discourse on innovations in ART. In doing so, the article focuses on America's missing public consultation in health care innovation. This missing discourse is significant, as political and ethical considerations may impact regulatory decisions. Thus, to the extent that these considerations are influencing the decisions of federal agency employees, namely …

“Big” Food, Tobacco, And Alcohol: Reducing Industry Influence On Noncommunicable Disease Prevention Laws And Policies, Belinda Reeve, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The food, tobacco and alcohol industries have penetrated markets in low- and middle-income countries (LMICs), with a significant impact on these countries’ burden of noncommunicable diseases (NCDs). Tangcharoensathien and colleagues describe the aggressive marketing of unhealthy food, alcohol and tobacco in LMICs, as well as key tactics used by these industries to resist laws and policies designed to reduce behavioural risk factors for NCDs. This commentary expands on the recommendations made by Tangcharoensathien and colleagues for preventing or managing conflicts of interest and reducing undue industry influence on NCD prevention policies and laws, focusing on the needs of LMICs. A …

Biobanks As Innovation Infrastructure For Translational Medicine, W. Nicholson Price Ii

Book Chapters

Biobanks represent an opportunity for the use of big data to drive translational medicine. Precision medicine demands data to shape treatments to individual patient characteristics; large datasets can also suggest new uses for old drugs or relationships between previously unlinked conditions. But these tasks can be stymied when data are siloed in different datasets, smaller biobanks, or completely proprietary private resources. This hampers not only analysis of the data themselves, but also efforts to translate data-based insights into actionable recommendations and to transfer the discovered technology into a commercialization pipeline. Cross-project technological innovation, development, and validation are all more difficult …

Deploying Mindfulness To Gain Cognitive Advantage: Considerations For Military Effectiveness And Well-Being, Amishi P. Jha, Scott L. Rogers, Eric Schoomaker, Edward Cardon

Articles

Mindfulness involves paying attention to present moment experience without discursive commentary or emotional reactivity. Mindfulness training (MT) programs aim to promote this mental mode via introduction to specific mindfulness exercises, related in-class discussion, and ongoing engagement in mindfulness exercises. MT is being increasingly offered to high-demand, high-stress military/uniformed and civilian cohorts with a wide array of reported benefits. Herein, we begin by discussing recent theoretical models regarding MT’s mechanisms of action from a cognitive training/cognitive neuroscience perspective, which propose that MT engages and strengthens three key processes [e.g., 1]. These are: 1) attentional orienting, which is the ability to select …

Achieving The Goals Of The Value-Based Purchasing Program: Defining A Standard For External Data Use, Svetlana Makoviy

Student Award Winning Papers

In our society, artificial intelligence technology has permeated through every aspect of human life. By the end of 2019, more than 60 million Americans will use some kind of smartwatch, whether a Fitbit or an Apple Watch as a part of their daily routine. Further, over 58% of people currently use a healthcare-related mobile application, such as MyFitnessPal or Nike+ Running. Health and fitness application usage increased by over 330% in the last three years. Unsurprisingly, healthcare-related data is one of the fastest growing and financially valuable data pools in the country, if not worldwide. The volume of data generated …

Does Va Medicaid Expansion Change The Landscape For Copn?, Megan E. Italiano

Student Award Winning Papers

The Paper will proceed in five parts. Part I will present the history of COPN, both nationally and in Virginia. Next, Part II will detail Virginia’s COPN program and its State Medical Facilities Plan. Part III will discuss the current debate for and against the COPN program. In Part IV, this Paper will discuss the market irregularities that the health care industry faces and how Virginia’s COPN program helps insulate hospitals from these market imbalances. Lastly, Part V will focus on the impact that the Medicaid expansion has on the COPN program, focusing particularly on the effects of the program’s …

Disclosing Deviations: Using Guidelines To Nudge And Empower Physician-Patient Decision Making, Melissa Ballengee Alexander

Faculty Articles

Americans fail to receive recommended care roughly half the time, reflecting poor decision making that threatens their health. This Article offers an innovative solution: require physicians to disclose clinical practice guideline recommendations to patients during informed consent. Behavioral economics suggest that insisting physicians and patients discuss guidelines, before deviating from them, could be surprisingly effective at nudging more rational care choices. At the same time, such disclosure should also educate and empower patients, serving autonomy.

Previous scholarship on unwarranted variances in care has focused primarily on malpractice reforms, largely ignoring the role of cognitive bias and the importance of patients …

Law & Health Care Newsletter, Spring 2019

Law & Health Care Newsletter

No abstract provided.

Data Re-Use And The Problem Of Group Identity, Leslie Francis, John G. Francis

Utah Law Faculty Scholarship

Reusing existing data sets of health information for public health or medical research has much to recommend it. Much data repurposing in medical or public health research or practice involves information that has been stripped of individual identifiers but some does not. In some cases, there may have been consent to the reuse but in other cases consent may be absent and people may be entirely unaware of how the data about them are being used. Data sets are also being combined and may contain information with very different sources, consent histories, and individual identifiers. Much of the ethical and …

Deputizing Family: Loved Ones As A Regulatory Tool In The "Drug War" And Beyond, Matthew J.B. Lawrence

Faculty Scholarly Works

Many laws use family members as a regulatory tool to influence the decisions or behavior of their loved ones, i.e., they deputize family. Involuntary treatment laws for substance use disorder are a clear example; such laws empower family members to use information shared by their loved ones to petition to force their loved ones into treatment without consent. Whether such deputization is helpful or harmful for a patient’s health is a crucial and dubious question discussed in existing literature, but use of family members as a regulatory tool implicates important considerations beyond direct medical impacts that have not been as …

Women's Rights, Human Rights And The Criminal Law Or, Feminist Debates And Responses To [De]Criminalization And Sexual And Reproductive Health, Aziza Ahmed

Faculty Scholarship

My comments today seek to highlight how social and economic rights advocates, particularly those concerned with the right to health, engage with ongoing debates about the role of criminal law in human rights. In particular, I emphasize how many “right to health” campaigns fight for the decriminalization of laws that result in the arrest of marginalized communities or health workers. This trend within right to health advocacy complicates what has been called the anti-impunity turn in human rights. In other words, although many scholars have correctly highlighted the rise of a carceral agenda in human rights, there is also ongoing, …

The Cost Of Novelty, W. Nicholson Price Ii

Law & Economics Working Papers

Patent law tries to spur the development of new, better, innovative technology. But it focuses much more on “new” than “better” — and it turns out that “new” carries real social costs. I argue that patent law promotes innovation that diverges from existing technology, either a little (what I call “differentiating innovation”) or a lot (“exploring innovation”), at the expense of innovation that tells us more about existing technology (“deepening innovation”). Patent law’s focus on newness is unsurprising, and fits within a well-told narrative of innovative diversity accompanied by market selection of the best technologies. Unfortunately, innovative diversity brings not …

Cannabis For Medical Use: Fda And Dea Regulation In The Hall Of Mirrors, Rebecca S. Eisenberg, Deborah B. Leiderman

Articles

A majority of Americans now live in states that purport to authorize medical use of cannabis, although federal law continues to prohibit both recreational and medical use. The current legal regime for cannabis is unstable and may be more effective at deterring research than it is at deterring medical use. Lack of data on medical cannabis products poses public health risks as well as policy and legal challenges. Modified regulatory approaches for other kinds of products provide alternative models for encouraging safety and effectiveness research and providing better information about cannabis products already in clinical use.

Artificial Intelligence In The Medical System: Four Roles For Potential Transformation, W. Nicholson Price Ii

Articles

Artificial intelligence (AI) looks to transform the practice of medicine. As academics and policymakers alike turn to legal questions, including how to ensure high-quality performance by medical AI, a threshold issue involves what role AI will play in the larger medical system. This Article argues that AI can play at least four distinct roles in the medical system, each potentially transformative: pushing the frontiers of medical knowledge to increase the limits of medical performance, democratizing medical expertise by making specialist skills more available to non-specialists, automating drudgery within the medical system, and allocating scarce medical resources. Each role raises its …

Supervised Injection Facilities: Legal And Policy Reforms, Lawrence O. Gostin, James G. Hodge, Chelsea L. Gulinson

Georgetown Law Faculty Publications and Other Works

The US Centers for Disease Control and Prevention reported that more than 70 000 deaths from drug overdoses occurred in 2017, including prescription and illicit opioids, representing a 6-fold increase since 1999. Innovative harm-reduction solutions are imperative. Supervised injection facilities (SIFs) create safe places for drug injection, including overdose prevention, counseling, and treatment referral services. Supervised injection facilities neither provide illicit drugs nor do their personnel inject users. Supervised injection facilities are effective in reducing drug-related mortality, morbidity, and needle-borne infections. Yet their lawfulness remains uncertain. The Department of Justice (DOJ) recently threatened criminal prosecution for SIF operators, medical personnel, …

Fighting Novel Diseases Amidst Humanitarian Crises, Lawrence O. Gostin, Neil R. Sircar, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

Humanitarian crises are becoming more prevalent and, frequently, more complex, in zones of mis-governance, lack of government presence, and even active conflict, marked by public mistrust and insecurity. The WHO and other health emergency responders lack the capacities and mandate to adequately respond. The current Ebola outbreak in an area of an active insurgency in the Democratic Republic of the Congo is just such a crisis. The State Department has banned U.S. personnel from the outbreak zone due to safety concerns, leaving the population feeling abandoned, potentially increasing the threat to the few brave health workers who remain.

We need …

Wealthy Countries Should Share Vaccine Doses Before It Is Too Late: The Greater Good Depends On Ending The Pandemic Everywhere, Lawrence O. Gostin, Eric A. Friedman, Suerie Moon

Georgetown Law Faculty Publications and Other Works

The world is on the brink of failing a critical test, which is whether the international community is willing or able to end a global pandemic without leaving anyone behind. Wealthy countries have bought up vast vaccine supplies, leaving poorer ones with extreme scarcity. An international initiative known as the COVID-19 Global Vaccine Access Facility (COVAX) aims to distribute vaccines widely and equitably, but is not only short of funds. Even if it reaches its 2021 target, COVAX will reach only a small portion of lower-income countries’ populations this year.

Along with moral demands of equitable global distribution, wealthy countries …

Living, Aging, And Dying In Healthy And Just Societies: Life Lessons From My Father, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

My father passed away at 102 years old. He lived, aged, and died well. But that is rare in the United States and globally. The World Health Organization defines palliative care “throughout the life course” as improving quality of life for patients and families and relieving pain and suffering, while paying special attention to physical, psychosocial, and spiritual functioning. That’s the global vision, but then there’s the reality. Palliative care, in practice, has been little more than pain relief at life’s end—and in much of the world, not even that.

We need to reimagine palliation, embracing a communal or relational …