Health Law and Policy Commons^™

Preserving A Precious Resource: Rationalizing The Use Of Antibiotics, Eric Kades

Eric A. Kades

No abstract provided.

Liberty Without Capacity: Why States Should Ban Adolescent Driving, Vivian E. Hamilton

Vivian E. Hamilton

No abstract provided.

Genetic Discrimination: Why Bragdondoes Not Ensure Protection, Laura F. Rothstein

Laura Rothstein

No abstract provided.

Constructing 'Health', Defining 'Choice': Legal And Policy Perspetives On The Post-Pgd Embryo In Four Jurisdictions, Estair Van Wagner, Roxanne Mykitiuk, Jeff Nisker

Estair Van Wagner

Through Preimplantation Genetic Diagnosis, embryos created by IVF are selected for transfer to a woman based on particular characterisations, including the presence of genetic markers or a tissue match for a sibling. In this paper we examine the precise language used in the recent policy and regulatory documents of four jurisdictions (the United Kingdom, Australia, Canada and New Zealand) that in any way characterises the post-PGD embryo. We then explore the mutually constructed relationship between how that embryo is characterised and the purposes for which PGD is applied, as well as the types of uses to which the post-PGD embryo …

Guantánamo Bodies: Law, Media, And Biopower, Cary Federman, Dave Holmes

Cary Federman

The idea of the Guantánamo detainee as a Muselmann, the lowest order of concentration camp inmates, contains within it important implications for the new understanding of sovereignty in the era of Guantánamo, in an age of exception. The purpose of this article is to explain the status of those who are detained at Guantánamo Bay. Stated broadly, in assessing that status, we will emphasize the connection between the altered meaning of sovereignty that has accompanied the placing of prisoners in an American penal colony in Cuba and the biopolitical status of the prisoners who reside there. More particularly, we …

Biting The Hands That Feed “The Alligators”: A Case Study In Morbid Obesity Extremes, End-Of-Life Care, And Prohibitions On Harming And Accelerating The End Of Life, Michael J. Malinowski

Michael J. Malinowski

Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention (“CDC”), American Heart Association (“AHA”), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of “extreme morbid obesity” (“EMO”)—situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success. Bariatric surgeries themselves are very high risk for EMO patients. …

The U.S. Science And Technology “Triple Threat”: A Regulatory Treatment Plan For The Nation’S Addiction To Prescription Opioids, Michael J. Malinowski

Michael J. Malinowski

No abstract provided.

Hospital Mergers And Public Accountability: Tennessee And Virginia Employ A Certificate Of Public Advantage, Erin C. Fuse Brown

Erin C. Fuse Brown

No abstract provided.

Intellectual Property And Public Health – A White Paper, Ryan G. Vacca, Jim Chen, Jay Dratler Jr., Tom Folsom, Timothy Hall, Yaniv Heled, Frank Pasquale, Elizabeth Reilly, Jeff Samuels, Kathy Strandburg, Kara Swanson, Andrew Torrance, Katharine Van Tassel

Katharine Van Tassel

On October 26, 2012, the University of Akron School of Law’s Center for Intellectual Property and Technology hosted its Sixth Annual IP Scholars Forum. In attendance were thirteen legal scholars with expertise and an interest in IP and public health who met to discuss problems and potential solutions at the intersection of these fields. This report summarizes this discussion by describing the problems raised, areas of agreement and disagreement between the participants, suggestions and solutions made by participants and the subsequent evaluations of these suggestions and solutions.

Led by the moderator, participants at the Forum focused generally on three broad …

Actavis And Error Costs: A Reply To Critics, Aaron S. Edlin, C. Scott Hemphill, Herbert J. Hovenkamp, Carl Shapiro

Aaron Edlin

The Supreme Court’s opinion in Federal Trade Commission v. Actavis, Inc. provided fundamental guidance about how courts should handle antitrust challenges to reverse payment patent settlements. In our previous article, Activating Actavis, we identified and operationalized the essential features of the Court’s analysis. Our analysis has been challenged by four economists, who argue that our approach might condemn procompetitive settlements.As we explain in this reply, such settlements are feasible, however, only under special circumstances. Moreover, even where feasible, the parties would not actually choose such a settlement in equilibrium. These considerations, and others discussed in the reply, serve to confirm …

The Double-Edged Sword Of Health Care Integration: Consolidation And Cost Control, Erin C. Fuse Brown, Jaime S. King

Erin C. Fuse Brown

The average family of four in the United States spends $25,826 per year on health care. American health care costs so much because we both overuse and overpay for health care goods and services. The Affordable Care Act's cost control policies focus on curbing overutilization by encouraging health care providers to integrate to promote efficiency and eliminate waste, but the the cost control policies largely ignore prices. This article examines this overlooked half of health care cost control policy: rising prices and the policy levers held by the states to address them. We challenge the conventional wisdom that reducing overutilization …

The Macarthur Adjudicative Competence Study: The Development And Validation Of A Research Instrument, Steven Hoge, Richard Bonnie, Norman Poythress, John Monahan

Norman Poythress

Assessment of competence to stand trial is a common evaluation that can have substantial consequences for defendants and the criminal justice system. Despite a voluminous literature, much remains unknown. An obstacle to progress in understanding what is better termed ldquoadjudicative competencerdquo is the absence of structured, standardized research measures for assessment of defendants. This article presents the legal framework, assessment strategy, instrument description, psychometric properties, and construct validation of the MacArthur Structured Assessment of the Competencies of Criminal Defendants (MacSAC-CD). The measures meet or exceed accepted indices of internal consistency, and interscorer agreement. Observed patterns of correlations among measures support …

Correspondence Between Self-Report And Interview-Based Assessments Of Antisocial Personality Disorder, Laura Guy, Norman Poythress, Kevin Douglas, Jennifer Skeem

Norman Poythress

Antisocial personality disorder (ASPD) is associated with suicide, violence, and risk-taking behavior and can slow response to first-line treatment for Axis I disorders. ASPD may be assessed infrequently because few efficient diagnostic tools are available. This study evaluated 2 promising self-report measures for assessing ASPD—the ASPD scale of the Personality Diagnostic Questionnaire-4 (PDQ-4; S. E. Hyler, 1994) and the Personality Assessment Inventory (PAI; L. Morey, 1991, 2007)—as well as the ASPD module of the Structured Clinical Interview for DSM–IV Axis II (SCID-II; M. B. First, R. L. Spitzer, M. Gibbon, J. B. W. Williams, & L. S. Benjamin, 1997). The …

Mentally Ill And Non-Mentally Ill Defendants' Abilities To Understand Information Relevant To Adjudication: A Preliminary Study, Steven Hoge, Norman Poythress, Richard Bonnie, Marlene Eisenberg

Norman Poythress

The legal construct of competence to stand trial, or “adjudicative competence,” is based on the premise that some mentally disordered defendants have impaired abilities when compared with most defendants and that adjudication should be barred if these competence-related abilities are significantly impaired. Where the line is drawn between sufficient and insufficient abilities has important consequences: as a result of being adjudicated incompetent, defendants may be detained and treated involuntarily and their trials will be delayed. However, no studies have systematically compared the capacities of relevant groups of defendants. In this studv. 84 criminal defendants—42 of whom were hospitalized as incompetent …

Externalizing Disorders Of Childhood And Adolescence, P.J. Frick, Eva Kimonis

Eva Kimonis

No abstract provided.

The Broward Mental Health Court: Process, Outcomes, And Service Utilization, Roger Boothroyd, Norman Poythress, Annette Christy, John Petrila

Norman Poythress

Mental health courts are one of a variety of special jurisdiction courts that have been created in a number of countries, including the United States (Petrila, 2003). While there is no prototypical mental health court (Steadman, Davidson, & Brown, 2001; Watson, Luchins, & Hanrahan, 2001), most of those in existence today share several common characteristics. These include (a) the creation of a special docket (usually, but not always, nonviolent misdemeanants with mental illness) that is (b) handled by a particular judge, with (c) a primary goal of diverting defendants from the criminal justice system and into treatment (Goldkamp & Irons-Guynn, …

Psychopathic Features In A Juvenile Diversion Population: Reliability And Predictive Validity Of Two Self-Report Measures, Diana Falkenbach, Norman Poythress, Kathleen Heide

Norman Poythress

The reliability and predictive validity of two experimental self-report versions of two measures of psychopathic features in youth, the Antisocial Process Screening Device (APSD: Frick & Hare, 2001) and a modified version of the Child Psychopathy Scale (CPS: Lynam, 1997) were examined in a sample of 69 arrested youth (M age¼14.4 years) referred to a juvenile diversion program. Parents or legal guardians completed parent-rating versions of the same measures. Reliability indicators for the APSD total measure were satisfactory although internal consistency indices (coefficient alpha) for the Callous/Unemotional and Impulsive/Conduct Problems scales were slightly lower than desirable. Reliability indicators for the …

Evaluation Of The Hare-Pscan In A Non-Clinical Population, Cristal Elwood, Norman Poythress, Kevin Douglas

Norman Poythress

Using 100 university undergraduates as participants, this study examined the structural reliability and construct validity of Hare and Hervé's P-SCAN (Hare & Hervé, 1999) a 90-item measure that purports to serve as an “… early warning system” or “rough screening device” (p. 1) for identifying individuals with substantial psychopathic features. Internal consistency indices (e.g. Cronbach's α, mean inter-item correlations) for the three P-SCAN subscales (Interpersonal, Affective, Lifestyle) suggested excellent reliability. Statistically significant, though modest correlations (range 0.21–0.33) were obtained in 5 of 6 comparisons with the self-report Primary psychopathy and Secondary psychopathy scales developed by Levenson, Kiehl, and Fitzpatrick (1995) …

Psychometric Properties Of Carver And White’S (1994) Bis/Bas Scales In A Large Sample Of Offenders, Norman Poythress, Jennifer Skeem, John Weir, Scott Lilienfeld

Norman Poythress

Contemporary motivational theories of psychopathy (Lykken, 1995) employ constructs from Gray’s Reinforcement Sensitivity Theory (RST; Gray, 1982), behavioral inhibition system (BIS) and behavioral activation system (BAS) functioning, to explain etiologic differences in psychopathy subtypes. Carver and White’s (1994) BIS/BAS scales are the most widely used measures of these constructs, yet there is a dearth of research on how these measures perform with offenders. Using a sample of 1515 offenders, we found evidence that five, rather than the usual four factors, underpin the BIS/BAS scales. Importantly, BIS items that tap into anxiety and fear sensitivity, respectively, split to form separate factors, …

The Relationship Between Psychopathic Personality Features And Malingering Symptoms Of Major Mental Illness, Norman Poythress, John Edens, M. Watkins

Norman Poythress

This study examined the relationship between psychopathy and malingering in a subsample of male prison inmates (n D 55) participating in a larger study of the clinical utility of various assessment measures in correctional settings. Participants’ capacity to feign major mental illness successfully was evaluated using standard cutoff scores for the detection of malingering on a variety of instruments, including the Structured Inventory of Malingered Symptomatology (SIMS; G. P. Smith & G. O. Burger, 1997), the Structured Interview of Reported Symptoms (SIRS; R. Rogers, R. M. Bagby, & S. E. Dickens, 1992), and the Personality Assessment Inventory (PAI; L. Morey, …

The Self-Report Psychopathy Scale And Passive Avoidance Learning: A Validation Study Of Race And Gender Effects , M. Epstein, Norman Poythress, K. Brandon

Norman Poythress

SRPS; psychopathy; gender; race; validity; passive avoidance errors; trait anxiety; intelligence

Stability Of Psychiatric Patients' Perceptions Of Their Admission Experience, Michele Cascardi, Norman Poythress, Lee Ritterband

Norman Poythress

The primary aim of this study was to evaluate the stability (i.e., consistency of patients’ responses over time) of newly developed scales to measure the admission experience of psychiatric hospitalization. Eighty-four psychiatric patients involuntarily committed to a crisis stabilization unit participated. All participants were admitted under an emergency petition or ex parte order for a psychiatric evaluation. Patients were interviewed soon after admission (M 5 3.33 days, SD 5 1.86 days). The test–retest interval was 24–48 hours with most (83.3%) re-evaluated at 24 hours. Overall, the measures showed acceptable levels of stability (r ’s range from .62 to .72). Factors …

Correlates Of Perceived Coercion During Psychiatric Hospital Admission, Michelle Cascardi, Norman Poythress

Norman Poythress

The objectives of this study were to replicate the study of C. W. Lidz et al (see record 1996-15479-001); examine the differences in perceptions about hospital admission for voluntary and involuntary patients (16 yr olds and older), all of whom had been involuntarily detained initially for psychiatric evaluation; and examine the impact of community members vs hospital staff, locus of control, and psychiatric symptom severity on patients' perceptions of coercion. Results substantiate earlier findings of Lidz et al in that legal status (involuntary), procedural justice, and negative pressures are significantly related to perceived coercion. Although all patients in this study …

Controversies In Evaluating Competency To Stand Trial, Norman Poythress, P. Zapf

Norman Poythress

No abstract provided.

Further Validation Of The Psychopathic Personality Inventory Among Offenders: Personality And Behavioral Correlates, John Edens, Norman Poythress, M. Watkins

Norman Poythress

The Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) is a relatively new self-report measure that has shown considerable promise as an index of psychopathic traits in both nonoffender and offender samples. The present study examined the construct validity and predictive utility of the PPI by examining its association with theoretically relevant scales of the Personality Assessment Inventory (PAI; Morey, 1991) among 60 male prison inmates, and its ability to predict institutional misbehavior in an expanded sample (n = 89). As expected, correlations with the PAI scales were highest for the Antisocial Features (ANT) and Aggression (AGG) scales (rs = …

Reliability Of Risk Assessment Measures Used In Sexually Violent Predator Proceedings, Cailey Miller, Randy Otto, Eva Kimonis, Adam Wasserman

Eva Kimonis

The field interrater reliability of three assessment tools frequently used by mental health professionals when evaluating sex offenders’ risk for reoffending—the Psychopathy Checklist–Revised (PCL-R), the Minnesota Sex Offender Screening Tool–Revised (MnSOST-R) and the Static-99—was examined within the context of sexually violent predator program proceedings. Rater agreement was highest for the Static-99 (intraclass correlation coefficient [ICC1] .78) and lowest for the PCL-R (ICC1 .60; MnSOST-R ICC1 .74), although all instruments demonstrated lower field reliability than that reported in their test manuals. Findings raise concerns about the reliability of risk assessment tools that are used to inform judgments of risk in high-stake …

Construct Validity Of The Youth Psychopathic Features Inventory (Ypi) And The Antisocial Process Screening Device (Apsd) With Justice Involved Adolescents, Norman Poythress, Richard Dembo, Jennifer Wareham, Paul Greenbaum

Norman Poythress

Two measures of psychopathic features in youths, the self-report version of the Antisocial Process Screening Device (APSD) and the Youth Psychopathic traits Inventory (YPI) were administered to 165 youths in a juvenile diversion program. For both measures, internal consistency was poor for the scales that assess the affective domain of psychopathic features; otherwise, internal consistency was excellent for the YPI and generally superior to that of the APSD. However, the published three-factor models for both measures did not replicate when examined using confirmatory factor analysis. Both measures obtained the expected correlations with measures of a variety of criminal justice (e.g., …

The Macarthur Adjudicative Competence Study: A Comparison Of Criteria For Assessing The Competence Of Criminal Defendants, Richard Bonnie, Steven Hoge, John Monahan, Norman Poythress

Norman Poythress

A set of measures assessing competence-related abilities was administered to three groups of criminal defendants: a group committed for restoration of competence, a group identified by jail personnel as mentally ill but not incompetent, and a group without identified mental disorder. Data from this study were used to test key assumptions bearing on the legal criteria for adjudicative competence. The. data show that among defendants able to understand the nature and purpose of the criminal proceedings, a significant proportion have an impaired ability to appreciate their situations as criminal defendants or to communicate relevant information to counsel; among defendants able …

Evaluating The Efficiency And Community Safety Goals Of The Broward County Mental Health Court, Annette Christy, Norman Poythress, Roger Boothroyd, John Petrila

Norman Poythress

Mental health courts have developed as one response to persons with mental illness who are involved with the criminal justice system. This study investigated the efficiency and safety goals of one such court in Broward County, FL. Mental health court (MHC) clients spent significantly fewer days in jail for the index arrest associated with study enrollment than a comparison group. MHC clients had similar survival time to re-arrest up to one year after study enrollment. MHC clients did not significantly differ from the comparison group in selfreported aggressive acts over an 8 month follow-up period, while they did self-report significantly …

Types Of Aggression, Responsiveness To Provocation, And Callous-Unemotional Traits In Detained Adolescents, Luna Muñoz, Paul Frick, Eva Kimonis, Katherine Aucoin

Eva Kimonis

The present study investigated differences in the behavioral and psychophysiological responses to provocation and in the level of callous-unemotional traits in boys exhibiting different patterns of aggression. Eighty-five boys (ages 13–18) in a juvenile detention center played a competitive computer task against a hypothetical peer who provided low and high levels of provocation. Youth high on both self-reported reactive and proactive aggression showed different behavioral responses to provocation than youth high on only reactive aggression. Specifically, the combined group showed high levels of aggressive responses without any provocation, whereas the group high on reactive aggression showed an increase in aggressive …