Law Commons^™

Between The Scalpel And The Lie: Comparing Theories Of Physician Accountability For Misrepresentations Of Experience And Competence, Heyward H. Bouknight, Iii

Washington and Lee Law Review

No abstract provided.

Is There Light At The End Of The Tunnel? Balancing Finality And Accuracy For Federal Black Lung Benefits Awards, Brian L. Hager

Washington and Lee Law Review

No abstract provided.

Wic Reauthorization: Opportunities For Improving The Nutritional Status Of Women, Infants, And Children, Harriette Fox, Margaret Mcmanus, Harry Schmidt

National Health Policy Forum

This paper examines the main reform issues affecting the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which is coming up for reauthorization this year. The paper provides background information on the WIC program, including its dramatic growth in participation and funding. It also reviews WIC’s link to health care and its impact on health outcomes. A series of considerations for WIC’s future are raised, including food package and program eligibility changes, nutrition education strategies to reduce obesity, financial risks and health consequences of relying on infant formula rebates, and new opportunities for research and demonstration.

Hatch–Waxman Reform And Accelerated Market Entry Of Generic Drugs: Is Faster Necessarily Better?, Sarah E. Eurek

Duke Law & Technology Review

Recently there has been a considerable amount of pressure to accelerate consumer access to generic drugs, which are significantly less expensive than their brand-name counterparts. One way to bring generic drugs on to the market sooner is through revision of the existing law relating to pharmaceutical patents. This iBrief describes recent regulatory changes to the Drug Price Competition and Patent Term Restoration Act (the Hatch-Waxman Act), which governs the patenting process for new drug products, as well as current legislative efforts to speed generic access through Hatch-Waxman reform. This iBrief also assesses whether these changes will be beneficial to consumers …

Dr. Jekyll's Waiver Of Mr. Hyde's Right To Refuse Medical Treatment: Washington's New Law Authorizing Mental Health Care Advance Directives Needs Additional Protections, Nick Anderson

Washington Law Review

Mental health care advance directives are gaining popularity nationwide. Following a growing trend, the Washington State Legislature has recently passed a law allowing patients to draft mental health care advance directives that could be irrevocable. Patients who sign an irrevocable directive essentially waive their fundamental right to refuse treatment in the future. The United States Supreme Court has held that waivers of fundamental rights must be made knowingly, voluntarily, and intelligently. However, as passed, Washington's new law contains insufficient safeguards to guarantee such a waiver. This Comment proposes that the Washington State Legislature amend this law to require two additional …

Following The Man On The Clapham Omnibus: Social Science Evidence In Malpractice Litigation, Richard O. Lempert

Law & Economics Working Papers Archive: 2003-2009

This article responds to proposals to admit statistical evidence from empirical studies of actual health care practices to prove prevailing health practice standards in malpractice litigation by arguing that the case for doing so has numerous weaknesses that advocates of admitting such data commonly ignore. A fundamental concern is that the standard of practice defense co-evolved with prevailing modes of proof and might have been different had proof through experts not allowed for an aspirational as well as an empirical element to reach the jury. The article also argues that generating reliable statistical evidence of standard medical practice can be …

Obesity In America: A Growing Threat, Eileen Salinsky, Wakina Scott

National Health Policy Forum

This background paper seeks to clarify the nature and causes of the obesity epidemic in the United States and provides an overview of the associated economic and health costs. The paper summarizes existing federal programs and policies that address obesity and examines new and emerging policy strategies to battle the bulging American silhouette. Topics explored include population-based prevention, federal food- and nutrition-assistance programs, Medicare and Medicaid payment policies, school health initiatives, and publicly funded biomedical research.

The Geography Of Medicare: Explaining Differences In Payment And Costs, Nora Super

National Health Policy Forum

This issue brief examines the sources of variation in Medicare payment and costs across different geographic areas and different sites of care. It discusses the payment policies that address variation in the cost of providing care, such as input price adjustments and special payments to hospitals. It also considers differences due to beneficiaries’ health status and in physician practice patterns. Finally, it explores policy options to address Medicare geographic variation.

Mid-Atlantic Ethics Committee Newsletter, Summer 2003

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Unmanaged Care: Towards Moral Fairness In Health Care Coverage, Sharona Hoffman

Indiana Law Journal

Health insurers are generally guided by the principle of "actuarial fairness," according to which they distinguish among various risks on the basis of costrelated factors. Thus, insurers often limit or deny coverage for vision care, hearing aids, mental health care, and even AIDS treatment based on actuarial justifications. Furthermore, approximately forty-two million Americans have no health insurance at all, because most of these individuals cannot afford the cost of insurance. This Article argues that Americans have come to demand more than actuarial fairness from health insurers and are increasingly concerned about what I call "moral fairness." This is evidenced by …

Understanding The Terrorist Mindset, Randy Borum

Mental Health Law & Policy Faculty Publications

No abstract provided.

Border Patrol, Carl E. Schneider

Articles

Recently, the Supreme Court has encountered cases that concern perhaps our weightiest bioethical issue-how medical care is to be rationed. But this does not mean that the Court must therefore assess the justice of rationing, as many people incited by many journalists now fondly and firmly believe. In explaining why, we begin with a story about how Learned Hand remembered saying one day to Justice Holmes, "Well, sir, goodbye. Do justice!" Holmes turned quite sharply and said: "That is not my job. My job is to play the game according to the rules." If the Court doesn't do justice, what …

Reviving Informed Consent: Using Risk Perception In Clinical Trials, Dana Ziker

Duke Law & Technology Review

The current doctrine of informed consent falls far short of its potential to serve as a valuable safeguard for human research subjects. Instead of providing a channel of communication between physician and subject, informed consent is a lifeless entity responsible for a large portion of the misunderstanding existing between these parties. Acknowledging risk perception principles may help transform the informed consent process into an effective communication of health risks.

Accumulation Of Tissue Factor Into Developing Thrombi In Vivo Is Dependent Upon Microparticle P-Selectin Glycoprotein Ligand 1 And Platelet P-Selectin, Shahrokh Falati, Qingde Liu, Peter Gross, Glenn Merrill-Skoloff, Janet Chou, Erik Vandendries, Alessandro Celi, Kevin Croce, Barbara C. Furie, Bruce Furie

Articles & Chapters

Using a laser-induced endothelial injury model, we examined thrombus formation in the microcirculation of wild-type and genetically altered mice by real-time in vivo microscopy to analyze this complex physiologic process in a system that includes the vessel wall, the presence of flowing blood, and the absence of anticoagulants. We observe P-selectin expression, tissue factor accumulation, and fibrin generation after platelet localization in the developing thrombus in arterioles of wild-type mice. However, mice lacking P-selectin glycoprotein ligand 1 (PSGL-1) or P-selectin, or wild-type mice infused with blocking P-selectin antibodies, developed platelet thrombi containing minimal tissue factor and fibrin. To explore the …

Statewide Penetration And Standard Costs Of Psychotropic Medications, Mary R. Murrin

Mental Health Law & Policy Faculty Publications

This study will examine differences in pharmaceutical utilization rates relative to financial risk arrangements of differing insurance plans. During the last four years we have noted consistent differences in utilization of expensive, psychotropic medications between individuals enrolled in Health Maintenance Organizations (HMOs), which are at financial risk for the provision of pharmaceuticals, and the MediPass program in which the state bears the risk of pharmacy expenses. Persons in HMOs had lower levels of utilization.

Welfare Reform: Adolescent Girls In Transition: A One-Year Follow-Up Study, Roger A. Boothroyd, Mary I. Armstrong, Angela Gomez, Haynes Diane

Mental Health Law & Policy Faculty Publications

The report summarizes the findings from a one-year follow-up study examining the current well-being and predictors of future hopes and aspirations of adolescent girls living in families receiving TANF. This mixed-method study includes two phases. Phase 1 involved face-to-face interviews using various standardized measures with 125 mothers who were receiving TANF in 2002 and their daughters while Phase 2 included in-depth qualitative interviews with a random sample of 20 adolescent girls participating in Phase 1. One year re-interview rates were 92% for Phase 1 interviews and 90% for Phase 2 interviews.

The Effect Of Abortion Legalization On Sexual Behavior: Evidence From Sexually Transmitted Diseases, Jonathan Klick, Thomas Stratmann

All Faculty Scholarship

Unwanted pregnancy represents a major cost of sexual activity. When abortion was legalized in a number of states in 1969 and 1970 (and nationally in 1973), this cost was reduced. We predict that abortion legalization generated incentives leading to an increase in sexual activity, accompanied by an increase in sexually transmitted diseases (STDs). Using Centers for Disease Control data on the incidence of gonorrhea and syphilis by state, we test the hypothesis that abortion legalization led to an increase in sexually transmitted diseases. We find that gonorrhea and syphilis incidences are significantly and positively correlated with abortion legalization. Further, we …

Unrelated Living Organ Donation: Ultra Needs To Go, Sujit Choudhry, Abdallah S. Daar

Sujit Choudhry

Doing It Rite: Exploring A Decade Of Health Coverage Innovation (Rhode Island), Jennifer Ryan, Ginger P. Parra

National Health Policy Forum

This site visit to the state of Rhode Island provided an opportunity to experience and understand the decade of health coverage innovation that has resulted in near universal coverage for children. Site visitors had the opportunity to interact with health care providers, state officials, and consumer advocates, as well as other leaders in health care community. The group also visited the Thundermist Health Center in Woonsocket; a school based health clinic at Woonsocket High School; the HELP Lead Safe Center in South Providence; and a local provider, St. Joseph’s Hospital for Specialty Care, that houses several preventive care clinics and …

Disease Management To Population-Based Health: Steps In The Right Direction?, Lisa Sprague

National Health Policy Forum

This issue brief reviews the evolution of the disease management model and the ways it relates to care coordination and case management approaches. It also looks at examples of population-based disease management programs operating in both the private and public sectors and reviews the evidence of their success. Finally, the paper considers the policy implications of adapting this model to a Medicare fee-for-service population.

Medicaid Prescription Drug Coverage: State Efforts To Control Costs, Dawn Gencarelli

National Health Policy Forum

This paper provides a brief summary of the Medicaid prescription drug benefit. It explains the mechanisms being used by states to control their prescription drug spending within the Medicaid program. The paper also highlights some of the concerns that have been expressed with these mechanisms and the litigation that has been initiated in several states as a result of these efforts. It takes a closer look at three states with cost containment strategies that have been the focus of increased scrutiny.

Most Favored Nation Clauses, Jonathan Baker, William Kopit, Thomas Overstreet, Robert Mcnair, Jr., Steven Snow

Presentations

Event descriptionThe Federal Trade Commission and Department of Justice will commence public hearings in Washington, D.C. on February 26, 2003 on the implications of competition law and policy for health care financing and delivery. The hearings will broadly consider the impact of competition law and policy on the cost, quality, and availability of health care, and the incentives for innovation in the field.Specific subjects to be considered include hospital mergers, the significance of non-profit status, vertical integration, quality and efficiencies, the boundaries of the state action and Noerr-Pennington doctrines, monopsony power, the adequacy of existing remedies for anticompetitive conduct, and …

Affixing Blame: Ideologies Of Hiv/Aids In Thailand, Tarik Abdel-Monem

San Diego International Law Journal

This Article focuses on ideologies of the HIV/AIDS epidemic in Thailand, one of many nations where the HIV/AIDS pandemic has reached alarming levels. Not unlike other nations struggling with HIV/AIDS, an epidemic of stigma and blame has developed in Thailand with increasing rates of infection among the population. Understandings of whom to blame for the epidemic, and how to realize appropriate solutions, have likewise developed as the epidemic continues to persist and spread. This Article examines these ideologies and how they are mediated through the lens of popular culture in contemporary Thailand. It attempts to examine the reasoning of such …

Conundrums With Penumbras: The Right To Privacy Encompasses Non-Gamete Providers Who Create Preembryos With The Intent To Become Parents, Lainie M.C. Dillon

Washington Law Review

To date, five state high courts have resolved disputes over frozen preembryos. These disputes arose during divorce proceedings between couples who had previously used assisted reproduction and cryopreserved excess preembryos. In each case, one spouse wished to have the preembryos destroyed, while the other wanted to be able to use or donate them in the future. The parties in these cases invoked the constitutional right to privacy to argue for dispositional control over the preembryos; two of the five cases were resolved by relying on this right. The constitutional right to privacy protects intimate decisions involving procreation, marriage, and family …

Toward A More Communitarian Future? Fukuyama As The Fundamentalist Secular Humanist, June Carbone

Michigan Law Review

With The End of History and the Last Man, Francis Fukuyama established himself as the prophet of liberal democracy and free markets, heralding their triumph as the only form of governance capable of commanding legitimacy. Asked to reflect on his predictions a decade later, Fukuyama concluded that the greatest threat to liberalism comes from biotechnology because it alone has the potential to remake the human nature that liberal democracy was designed to serve. Fukuyama makes a compelling case that biotechnology may produce developments that should concern us; he is ironically less persuasive in articulating a liberal-democratic framework for governing the …

The U.S. Health Workforce: Definitions, Dollars, And Dilemmas, Karen Matherlee

National Health Policy Forum

This background paper provides a comprehensive view of the structure of the health workforce. It explores public and private insurance coverage and payment policies, as well as discretionary grant programs, that govern it. The paper also looks at health workforce concerns: supplies of certain types of physicians, health workforce mix, challenges from complementary and alternative medicine, shortages of nurses and pharmacists (and some other practitioners), maldistribution issues, and lack of diversity in response to demographic changes. It presents proposals that are on the table to reform the health workforce, at a time when it is demanding greater attention from health …

Reauthorizing Head Start: The Future Federal Role In Preschool Programs For The Poor, Jane Koppelman

National Health Policy Forum

This paper describes the implications of President Bush’s proposal to devolve authority for running the Head Start program to the states and to alter the organization and funding of all government early childhood programs—with the goal of improving the school readiness skills of low-income children. The administration plan to allow states to mix Head Start funds with state-funded preschool money and, if desired, child care monies to create a more uniform early childhood care system with an educational focus raises numerous questions. This paper addresses questions raised by this plan, including the potential quality of these new systems, the extent …

A Matter Of Priority: Transplanting Organs Preferentially To Registered Donors, Adam Kolber

Faculty Scholarship

No abstract provided.

Physician Liability And Managed Care: A Philosophical Perspective, Dionne L. Koller

All Faculty Scholarship

Despite the emergence of managed health care and the resulting dramatic change in the role of the third-party payer in the physician-patient relationship, the liability standards applied to physicians largely have remained unchanged. This has created a tension between physicians' legal and ethical obligations, and the requirements imposed on the physician by managed health care. Specifically, the issue confronts the physician in the context of malpractice liability. Managed Care Organizations impose a significant amount of control over the way physicians practice medicine, often forcing physicians to ration care. Notwithstanding any beneficial cost savings that might result, this approach subjects the …

Mid-Atlantic Ethics Committee Newsletter, Spring 2003

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.