Law Commons^™

Carrying A Big Carrot: Linking Multilateral Disarmament And Development Assistance, David A. Koplow, Philip G. Schrag

Georgetown Law Faculty Publications and Other Works

This article proposes, as a new element of the "liberal internationalism" that should characterize the post-Cold War world, a simultaneous solution to these three problems. The nations of the world should negotiate a series of multilateral agreements to stop the spread of advanced weaponry, and include in each of them, as an overt incentive for developing states to accept the disarmament and verification obligations, provisions that explicitly require the affluent, developed states to make specified monetary and in-kind transfers to the third world parties. The new regime should also provide stronger-than-customary treaty procedures for clarifying ambiguities, adjudicating claims, and resolving …

The Interconnected Epidemics Of Drug Dependency And Aids, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Drug dependence and human immunodeficiency virus (HIV) are America's two most pressing epidemics, interconnected by a cycle of urban poverty, physical dependence and a culture of sharing needles and syringes. Extant political strategies to curb these interconnected epidemics involve two traditional approaches. The first--law enforcement and interdiction--is designed to limit the supply of illicit drugs to the marketplace. This strategy is advanced by broad criminal sanctions against importing, selling, distributing, medically prescribing, or possessing illicit drugs or drug paraphernalia. The second strategy to combat the drug and HIV epidemics involves reducing the demand for illicit drugs. Education, counseling, and treatment …

Ethical Principles For The Conduct Of Human Subject Research: Population-Based Research And Ethics, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This paper provides a halting first step in organizing a set of ethical guidelines for the conduct of population-based research, surveillance and practice. These principles are not distinct from, but an expansion of, traditional ethics. Research ethics, which matured significantly from the Nuremberg Code through to the Helsinki IV and the Council for International Organizations of Medical Sciences (CIOMS) guidelines, nourished the individual human spirit. Ethical principles should have a similarly profound impact in the development of science and the protection of human populations in the 1990s and beyond.

Genetic Discrimination: The Use Of Genetically Based Diagnostic And Prognostic Tests By Employers And Insurers, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This paper analyzes the law, ethics and public policy concerning "genetic discrimination," defined as the denial of rights, privileges or opportunities on the basis of information obtained from genetically based diagnostic and prognostic tests. The Human Genome Initiative will enhance the ability to gather and organize information that may predict a person's future potential and disabilities. Enormous human benefits may ensue from understanding the etiology and pathophysiology of genetic disorders, including disease prevention through genetic counseling, and treatment of the disorders through genetic manipulation. This information will help clinicians understand and eventually treat many of the more than 4,000 diseases …

A Decade Of A Maturing Epidemic: An Assessment And Directions For Future Public Policy, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The author's goal in this article, is not merely to propose public health strategies for the future, but also to examine why government has been so slow, so equivocal, in its public health response to the acquired immune deficiency syndrome (AIDS) epidemic. He argues that there has been a fundamental ambivalence in perceptions of the epidemic. For some, AIDS is perceived as a disease, with sympathy for sufferers. Once AIDS is viewed as a disease, like other catastrophic diseases, it follows that public policy will be based upon science and epidemiology--health education, research and treatment.

For others, AIDS is caused …

The Politics Of Aids: Compulsory State Powers, Public Health, And Civil Liberties, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This article argues that compulsory public powers are justified only if they meet the following criteria: there is a significant risk of transmission of the acquired immune deficiency syndrome (AIDS) virus; the public health response is efficacious in preventing a primary mode of transmission of the virus; the economic, practical, or human rights burdens are not disproportionate to the public health benefits; and the public health power is the least restrictive alternative that would prevent viral transmission.

The author carefully examines the levels of risk posed by behavior which can potentially transmit human immunodeficiency virus (HIV), and demonstrates that compulsory …

Hospitals, Health Care Professionals, And Aids: The "Right To Know" The Health Status Of Professionals And Patients, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This article addresses why patients and health care professionals (HCPs) with human immunodeficiency virus (HIV) should have autonomy and privacy rights to choose whether to consent to an HIV test and to disclose their serologic status. It also demonstrates that the risk of HIV transmission in health care settings is exceedingly low, that it is probably lower than other well-accepted risks taken by patients and professionals, and that there are other less intrusive ways to further reduce the risk. The article concludes that knowledge of a patient's serologic status is unlikely to reduce risk, since no effective action could be …

Policy, Procedures, And People: Governmental Response To A Privately Initiated Nuclear Test Monitoring Project As A Case Study In National Security Decision-Making, Philip G. Schrag

Georgetown Law Faculty Publications and Other Works

This article applies the Allisonian framework to the U.S. Government's response to a private arms control initiative undertaken in 1986 by the Natural Resources Defense Council (NRDC), an environmental organization. This case lends itself to fruitful analysis for several reasons. First, while it fits the criteria for second-level decisions, it also involves a critical area of international relations-the control of nuclear weapons. Second, the involvement of numerous government agencies in the project presents ample opportunity to examine processes within and among agencies. Third, the reaction of the United States appears, at first blush, to have been ambivalent or inconsistent, for …

The Future Of Public Health Law, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Developments in medicine and constitutional law dictate modification of public health legislation in the United States. Traditionally overlooked by legislators, present public health laws provide inadequate decision-making criteria and inappropriate procedures for dealing with issues. Revised legislation should provide health care officials and agencies with the tools to balance individual rights against public health necessities. This article makes four recommendations for legislative reform: (1) remove artificial legislative distinction between venereal and other communicable diseases; (2) provide criteria defining "public health necessity" to limit discretionary exercise of police power by health officials; (3) provide strong confidentiality protections in the collection and …

The Nucleus Of A Public Health Strategy To Combat Aids, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Since acquired immune deficiency syndrome (AIDS) was first identified in I98I, its rate of spread among a primarily young and vibrant population has chilled the medical and lay communities. Today, the public response is sober and oriented toward the examination of specific policies that could lessen the impact of the disease. After six years' experience it is now feasible to propose a strategy for combating AIDS. Consensus around the policies outlined in this article should form the nucleus of the public health strategy to combat AIDS before the intervention of an effective vaccine or treatment.

A Moment In Human Development: Legal Protection, Ethical Standards And Social Policy On The Selective Non-Treatment Of Handicapped Neonates, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Selective non-treatment decisions involving severely handicapped neonates have recently come under renewed judicial and legislative scrutiny. In this article, the author examines the legal, ethical and social considerations attendant to the non-treatment decision. In Part II he discusses the predominant ethical viewpoints relating to this issue and proposes a new moral standard based on personal interests. Part III presents a survey of the jurisprudence relating to selective non-treatment decisions. Parts IV and V of this article provide a critical examination of the recently enacted Child Abuse Amendments of 1984, a federal legislative initiative designed to regulate treatment decisions relating to …

Contemporary Social Historical Perspectives On Mental Health Reform, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The argument presented in this article is that a new role has been developing in law which can and should be used as a strategy in the provision of services. It will be further argued that there is an important place for the law in setting limits on established psychiatric measures relating, for example, to compulsory admission and treatment, and even to particularly hazardous measures taken with the consent of the patient. The final role of law is to ensure the civil status of those who are the consumers of psychiatric services. One must accept the fact that pernicious legal …

Compulsory Treatment In Psychiatry: Some Reflections On Self-Determination, Patient Competency And Professional Expertise, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

In this article the author examines the rationale, in legal and policy terms, of the inextricable association traditionally formed between certification and incompetency. He argues that forming categories of people in which the law automatically dispenses with the requirement of seeking consent is fraught with conceptual inconsistencies and practical difficulties. He further argues that clinical judgments made without the consent of the patient should be made subject to an independent statutory review. Such a review procedure could also be adopted for treatments which are unusually hazardous, irreversible or not fully established even if the doctor purports to proceed with the …

Workers' Health And Safety: Whose Costs, Whose Benefits?, Joseph A. Page

Georgetown Law Faculty Publications and Other Works

Health and safety on the job remain sources of bitter controversy in the public forums. Businessmen rail against the Occupational Safety and Health Administration (OSHA) for its "dictatorial" enforcement of "oppressive" regulations, leading President Ford in early 1976 to demonstrate sympathy for their concerns. Labor leaders deplore the failure of industry and government to stem the toll of death and disablement from work-related disease. Members of' Congress, responsive to pressures from constituents, fill pages of the Congressional Record with reports of both employer vexations and employee tragedies.

Like ships passing in the night, advocates on both sides tend to regard …

A Mental Patient's Right To Vote: An Analysis Of The Wild Case, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This article is an analysis of the Wild case that was heard on 15 June 1976 by Judge Lloyd Jones of the County Court, Warrington.

In order to vote, the person's name must appear on the register of electors as a resident of a particular locality. Any place where the elector legitimately resides (even a hostel, a general hospital or a university) may be used as an address which qualifies a person for entry onto the register. The one exception is found in section 4(3) of the Representation of the People Act 1949, as amended by the Mental Health Act, …

The Constitutional Right To Free Communication Of The Institutionalized Resident, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This article comes from the notes and comments section of the North Carolina Central Law Journal from 1973.

Justified by the generic first amendment protection to unabridged expression and association, a United States citizen cannot be unreasonably denied the right to communicate by mail; by telephone; with legal counsel; with the opposite sex; with others. In most states where such a citizen becomes "mentally ill," the person may be involuntarily civilly committed. Although there is no justification for such a commitment beyond the fact that the individual is sick and is in need of care, often the individual's first amendment …