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Bioethics And The Family: The Cautionary View From Family Law, Carl E. Schneider

Articles

For many years, the field of bioethics has been specially concerned with how the authority to make medical decisions should be allocated between doctor and patient. Today the patient's power-indeed, the patient's right-is widely acknowledged, at least in principle. But this development can hardly be the last word in our thinking about how medical decisions should be made. For one thing, sometimes patients cannot speak for themselves. For another, patients· make medical decisions in contexts that significantly include more participants than just the patient and doctor. Now, as this conference demonstrates, bioethics is beginning to ask what role the patient's …

Cumulative Trauma Disorders: Osha's General Duty Clause And The Need For An Ergonomics Standard, David J. Kolesar

Michigan Law Review

This Note argues that neither the Act nor its underlying policies supports OSHA's current use of the general duty clause to prosecute alleged ergonomics violations and that the only way to protect workers from CTDs fairly and effectively is through the promulgation of an ergonomics standard. Part I examines the purposes of the Act, as well as the function of the Act's general duty clause. Part II analyzes the four requirements of the general duty clause in the context of CTDs and finds that the clause does not apply to CTDs. Part III argues that the Act's intended policies support …

Patent Rights In The Human Genome Project, Rebecca S. Eisenberg

Book Chapters

The various research efforts that comprise the Human Genome Project will inevitably both draw on and yield a multitude of patentable inventions. The broad subject matter of the patent laws potentially reaches every phase of the Genome Project, from the discovery of new research technologies, such as techniques and equipment for DNA sequencing, through the ultimate development of new products, such as screening tests for genetically transmitted diseases. Even bits and pieces of the human genome itself may be, and sometimes have been, patented.' Nor does the fact that the public is paying for the Genome Project through federal funding …

Tales Of Two Cities: Aids And The Legal Recognition Of Domestic Partnerships In San Francisco And New York, David L. Chambers

Articles

Here are two stories. They are of the quite different ways that domestic partnerships of lesbian and gay couples have come to be recognized, for some purposes, in San Francisco and New York City. I tell the stories for their own sake, but with a particular focus on the role that AIDS played in the political process in each city.

Paradox And Pandora's Box: The Tragedy Of Current Right-To-Die Jurisprudence, Cathaleen A. Roach

University of Michigan Journal of Law Reform

Part I of this Article examines the trilogy of recent right-to-die cases and contrasts the results of those cases with recent national opinion polls and statistical surveys of the issue. Part II examines federal and state legislative responses to the debate. It suggests that both the courts and legislatures are out of sync with an emerging national consensus on the death-with- dignity debate. In fact, the federal legislative response may only exacerbate the problem. Instead of creating new rights, it feeds individuals into the existing state network, which is a quagmire of confusing and inequitable statutory provisions. Part III examines …

The Impact Of Public Abortion Funding Decisions On Lndigent Women: A Proposal To Reform State Statutory And Constitutional Abortion Funding Provisions, Carole A. Corns

University of Michigan Journal of Law Reform

This Note argues that state legislatures should relax funding restrictions on abortions for indigent women and proposes specific mechanisms to ensure the equal protection of indigent women in the abortion context. Part I briefly recounts the history of federal funding for abortions, from the liberal post-Roe funding scheme to the restrictive funding arrangements that have prevailed since the early 1980s. Part II surveys the existing literature and discusses patterns of state funding and the impact of funding restrictions on indigent women seeking abortions. This literature shows that the tightening of state funding policies subsequent to the federal Medicaid restrictions has …

Final Frontier: Life, Death And Law, Yale Kamisar

Book Chapters

[T]o call Nancy Cruzan's case a matter of the right to die seems strained, if not contrived. The situation is a tragic one. Cruzan has been in a persistent vegetative state since 1983, when, at the age of 25, she was in a severe car accident. Although she is able to breathe on her own, she receives all her nutrition and fluids through a feeding tube inserted into her stomach. When her parents sought to halt this life support, they were rebuffed, first by officials of the Missouri state hospital where Cruzan is a patient and ultimately by the Missouri …

In The Regulation Of Manmade Carcinogens, If Feasibility Analysis Is The Answer, What Is The Question?, Christopher H. Schroeder

Michigan Law Review

A Review of Environmentally Induced Cancer and the Law by Frank B. Cross

Shattered Mirrors: Our Search For Identity And Community In The Aids Era, William J. Aseltyne

Michigan Law Review

A Review of Shattered Mirrors: Our Search for Identity and Community in the AIDS Era by Monroe E. Price

The Right To Die: Green Lights And Yellow Lights, Yale Kamisar

Articles

In the long-awaited and much-discussed Nancy Cruzan case, a 5-4 Supreme Court majority ruled that absent "clear and convincing evidence" that a once but no longer competent patient wishes to discontinue her life support (in this instance artificial nutrition and hydration) a state is not constitutionally compelled to terminate that support.

Nancy's situation is tragic. Since suffering severe injuries in 1983, she has been in a persistent vegetative state. Yet medical experts testified that if her feeding tube were not removed she could linger on in her present condition for many years.

But the first thing to keep in mind …

Aids And Government: A Plan Of Action?, Taunya Lovell Banks

Michigan Law Review

A Review of Report of the Presidential Commission on the Human Immunodeficiency Virus Epidemic by Washington: U.S. Government Printing Office

A Need For Caring, Judith Areen

Michigan Law Review

A Review of AIDS and the Law: A Guide for the Public edited by Harlon L. Dalton, Scott Burris and the Yale AIDS Law Project

A Response To "Two Puzzles", Carl E. Schneider

Book Chapters

In his stimulating paper, Professor Mnookin suggests that the legal issue of neonatal euthanasia may be seen in terms of two puzzles: First, what accounts for the ''striking dichotomy between the law on the books, which apparently outlaws such conduct, and the law in action, which apparently permits it"? Second, why has "the treatment of severely handicapped newborns . . . evoked such a violent storm in the last few years"? Professor Mnookin resolves the first puzzle by suggesting that the ''dichotomy between the law on the books and the law in action may serve as a pragmatic, although not …

Rights Discourse And Neonatal Euthanasia, Carl E. Schneider

Articles

Hard cases, they say, make bad law. Hard cases, we know, can also make revealing law. Hard cases identify the problems we have not found a way of solving. They reveal ways the law's goals conflict. They force us to articulate our assumptions and to examine our modes of discourse and reasoning. If there was ever a hard case for the law, it is the question of whether, how, and by whom it should be decided to allow newborn children who are severely retarded mentally or severely damaged physically to die. For many years, the law has not had to …

On The Human Body As Property: The Meaning Of Embodiment, Markets, And The Meaning Of Strangers, Thomas H. Murray

University of Michigan Journal of Law Reform

For as long as I can recall, newspapers have published brief items in which someone has calculated what the human body is "worth" on the open market. The value of the body-as reduced to its chemical components-was never more than a few dollars. A more accurate accounting, though, would include the market value of transplantable organs and tissues, as well as the potential bonanza to be had should a cell line cultured from that body prove valuable to the biotechnology industry. The bottom line could be anywhere from tens of thousands to perhaps millions of dollars.

Both moral and legal …

Special Care: Medical Decisions At The Beginning Of Life, Jonathan H. Margolies

Michigan Law Review

A Review of Special Care: Medical Decisions at the Beginning of Life by Fred M. Frohock

How To Argue About Health Care, Don Herzog

Articles

Despite the aggressive title of this article, my goals are modest. I begin by explaining briefly what should at any rate be obvious: that health care policies inescapably raise moral and political difficulties, difficulties that no technical fix could resolve. I move on to puzzle over the connections between some of the more abstract issues of moral and political theory and medical policy: here I urge that we develop a more sustained taste for exploring the moral conflicts embedded in our current practices. Finally, I suggest a strategy for making nitty-gritty facts-from the concrete world of third-party payment, expensive technology, …

Abusing The Patient: Medicare Fraud And Abuse And Hospital-Physician Incentive Plans, Kathryn A. Krecke

University of Michigan Journal of Law Reform

Part I provides a background discussion of the PPS, DRGs, and incentive plans. Part II focuses on the fraud and abuse provisions of the Medicare statute and argues that incentive plans violate the plain language · of the statute, which prohibits any knowing and willful remuneration for the inducement of referrals. Part III concentrates on the fraudulent and abusive practices that incentive plans encourage. The plans frustrate legislative intent because they encourage practices that subvert the cost-containment purposes of the PPS and have an adverse effect on patient care.

The Medicare Rx: Prospective Pricing To Effect Cost Containment, H. Lynda Kugel

University of Michigan Journal of Law Reform

This Note analyzes the impact of changing hospital reimbursement while maintaining charge-based reimbursement for physicians on hospital-physician relationships and on cost and quality of care. This Note contends that if the stated goals of redirecting incentives and containing costs are to be realized, physicians must be drawn into the revised reimbursement scheme. An indirect, aggregate approach is advocated to maintain the integrity of the physician-patient relationship and to avoid a direct financial impact upon the physician regarding patient care decisions. Part I will briefly examine the reasons for changing hospital reimbursement from retrospective cost-based reimbursement to prospective fixed rates. Part …

From Coitus To Commerce: Legal And Social Consequences Of Noncoital Reproduction, Joan Heifetz Hollinger

University of Michigan Journal of Law Reform

This paper argues that there is an urgent need for the creation and clarification of a legal framework within which contemporary efforts to produce or procure children can take place. State legislatures should act now in order to avoid the kind of crisis that confronts Great Britain, where an infant girl, the product of a breached surrogacy contract, has been impounded by a British court. While the court ponders how to determine the legal parentage of this particular child, Parliament considers criminal penalties for those who arrange surrogacy contracts and general regulations to constrain IVF and ET research and practice. …

Beyond State Intervention In The Family: For Baby Jane Doe, Martha Minow

University of Michigan Journal of Law Reform

Newspapers and broadcasters gave major billing to the story. Headlines announced: "The Life or Death Question of Baby Doe;" and "Baby Doe's Parents Call U.S. Action Intimidating." The medical care decisions about this infant born with spina bifida, microcephaly, and other severe disabilities, not only attracted mass media attention, but also led to both state and federal court proceedings. Legislative hearings raised the issue of her care. Many commentators debated what should happen to this infant of Long Island parents. This article instead will ask: what was all the attention about?; why are cases like this so riveting?; and might …

Selective Nontreatment Of Handicapped Newborns, Michigan Law Review

Michigan Law Review

A Review of Selective Nontreatment of Handicapped Newborns by Robert Weir

Of Foxes And Hen Houses: Licensing And The Health Professions, Michigan Law Review

Michigan Law Review

A Review of Of Foxes and Hen Houses: Licensing and the Health Professions by Stanley J. Gross

Making Health Care Decisions: A Report On The Ethical And Legal Implications Of Informed Consent In The Patient-Practitioner Relationship, Volume 1, Michigan Law Review

Michigan Law Review

A Review of Making Health Care Decisions: A Report on the Ethical and Legal Implications of Informed Consent in the Patient-Practitioner Relationship, Volume 1 by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research

The Hardest Drug: Heroin And Public Policy, Michigan Law Review

Michigan Law Review

A Review of The Hardest Drug: Heroin and Public Policy by John Kaplan

Equality, "Anisonomy," And Justice: A Review Of Madness And The Criminal Law, Andrew Von Hirsch

Michigan Law Review

A Review of Madness and the Criminal Law by Norval Morris

The Insanity Plea: The Uses And Abuses Of The Insanity Defense, Michigan Law Review

Michigan Law Review

A Review of The Insanity Plea: The Uses and Abuses of the Insanity Defense by William J. Winslade and Judith Wilson Ross

The Theory And Practice Of Civil Commitment, Andrew Scull

Michigan Law Review

A Review of The Court of Last Resort: Mental Illness and the Law by Carol A.B. Warren, contributions by Stephen J. Morse and Jack Zusman

The Propriety Of Denying Entry To Homosexual Aliens: Examining The Public Health Service's Authority Over Medical Exclusions, Robert Poznanski

University of Michigan Journal of Law Reform

This Note defends the position that the PHS has the authority to define homosexuality for the purpose of the section 212(a)(4) exclusion, and that the PHS definition is binding upon the INS. Therefore, the PHS's decision to refuse to examine aliens for homosexuality precludes the INS from excluding aliens on that basis. Part I of this Note traces the history of the policy of excluding homosexual aliens. Part II maintains that, regardless of the psychiatric profession's interpretation of ''psychopathic personality,'' Congress intended the expression to encompass homosexuality. Part III contends that Congress intended to empower the PHS to change its …

Employee Selection Base On Susceptibility To Occupational Illness, Mark A. Rothstein

Michigan Law Review

This Article attempts to compile the latest information available concerning this difficult problem. Part I reviews the scientific literature, explaining the biological basis of increased risk of occupational disease. Part II explores the efforts of various employers to incorporate this research into their personnel practices. Part III surveys the legal response to these practices. Employees may challenge medical screening on a variety of theories, most of which were not designed to deal with the problem of susceptibility to occupational disease. Not surprisingly, none of the approaches offers an entirely satisfactory response to the problem. This Article offers no clear answers. …