Medicine and Health Sciences Commons^™

Quintavalle: The Quandary In Bioethics, Lisa Cherkassky

Journal of Law and Health

The case of R. (Quintavalle) v. Human Fertilisation Embryology Authority (and Secretary of State for Health) presents a handful of legal problems. The biggest legal query to arise from the case is the inevitable harvest of babies, toddlers and very young children for their bone marrow. This article unpacks the judicial story behind Quintavalle to reveal how the strict provisions of the Human Fertilisation and Embryology Act 1990 - namely ‘suitable condition’ under schedule 2 paragraph 1(1)(a) and ‘treatment services’ and ‘assisting’ under section 2(1) - were widely misinterpreted to introduce the social selection of embryos into law. The legal …

Healer, Witness, Or Double Agent? Reexamining The Ethics Of Forensic Psychiatry, Matthew U. Scherer

Journal of Law and Health

In recent years, psychiatrists have become ever more prevalent in American courtrooms. Consequently, the issue of when the usual rules of medical ethics should apply to forensic psychiatric encounters has taken on increased importance and is a continuing topic of discussion among both legal and medical scholars. A number of approaches to the problem of forensic psychiatric ethics have been proposed, but none adequately addresses the issues that arise when a forensic encounter develops therapeutic characteristics. This article looks to the rules governing the lawyer-client relationship as a model for a new approach to forensic psychiatric ethics. This new model …

Mending Invisible Wounds: The Efficacy And Legality Of Mdma-Assisted Psychotherapy In United States' Veterans Suffering With Post-Traumatic Stress Disorder, Jonathan Perry

Journal of Law and Health

Though Veteran Affairs has provided crucial life sustaining—and often lifesaving—treatments to returning soldiers, the substantial and ever-increasing rates of veteran suicides, drug addictions, and criminal behavior indicate a need for broader options in treatment. One of the most profound discoveries uncovered through MDMA-assisted psychotherapy research is MDMA’s facilitation of the alleviation of addictive behavior in subjects, and, as a result, an alleviation of addictions in general. Addiction is one of the key symptoms of post-traumatic stress disorder (PTSD) and drug abuse plays a large role in the other afflictions suffered by veterans, namely criminal activity and a high rate of …

Quality Of Death People With Terminal Illnesses Are Turning To An Age-Old Method To End It All: Self-Starvation, Kazi E. Awal, Alyssa Pagano

Capstones

Voluntarily stopping eating and drinking (VSED) is getting more attention in the medical community. Though physician assisted dying legislation passed in two more states in 2016--there are now 7 states where it is legal--the practice, where doctors prescribe a lethal dose of sedatives so that terminally ill patients can end their own lives, is inaccessible to many. But fasting to death is a way for patients suffering from terminal illnesses or other debilitating diseases to end their lives on their own terms that is legal everywhere. As extreme as it sounds, research shows the process can be made comfortable with …

Improving Community Health Through Hospital Community Benefit Spending: Charting A Path To Reform, Sara J. Rosenbaum, Maureen Byrnes, Sara Rothenberg, Rachel Gunsalus

Health Policy and Management Faculty Publications

No abstract provided.

A Comprehensive Review Of The 2016 Asha Code Of Ethics, Robin L. Edge Ph.D., Ccc-Slp, Bess Sirmon-Taylor Ph.D., Ccc-Slp, Raul F. Prezas Ph.D., Ccc-Slp

Journal of Human Services: Training, Research, and Practice

The American Speech-Language-Hearing Association (ASHA) initially implemented a Code of Ethics in 1952, and has periodically revisited the content of the document with revisions to reflect the expanding scope of practice within speech-language pathology and audiology and to clarify certain concepts. Code revision is a cyclical mandated task of the ASHA Board of Ethics conducted to assure accuracy, currency, and completeness of this most important document (Solomon-Rice & O’Rourke, 2016). The current version of the Code of Ethics (2016) was modified from the previous version (2010r), with an updated preamble, definitions of related vocabulary, and re-organized language in the principles. …

Community Health Centers And Medicaid Payment Reform: Emerging Lessons From Medicaid Expansion States, Peter Shin, Jessica Sharac, Zoe Barber, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers represent a major source of primary health care for the nation’s Medicaid beneficiaries. Because the Federally Qualified Health Center (FQHC) payment system is encounter-based, health centers and Medicaid agencies in ACA expansion states are actively pursuing payment reforms that will enable health centers to adopt strategies that can more effectively respond to the considerable and complex health and social needs of people served by health centers, and more efficiently address the surging volume of patient care. In five expansion states whose alternative payment experiments are underway, health centers and Medicaid agencies are testing payment alternatives, such as …

Health It Security: An Examination Of Modern Challenges In Maintaining Hipaa And Hitech Compliance, Andrew S. Miller, Bryson R. Payne

KSU Proceedings on Cybersecurity Education, Research and Practice

This work describes an undergraduate honors research project into some of the challenges modern healthcare providers face in maintaining compliance with the Health Insurance Portability and Accountability Act (HIPAA) and HITECH (Health Information Technology for Economic and Clinical Health) Act. An overview of the pertinent sections of both the HIPAA and HITECH Acts regarding health information security is provided, along with a discussion of traditionally weak points in information security, including: people susceptible to social engineering, software that is not or cannot be regularly updated, and targeted attacks (including advanced persistent threats, or APTs). Further, the paper examines potential violations …

Mid-Atlantic Ethics Committee Newsletter, Fall 2016

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Emergency Medical Services And Public Policy In Durban, Kwazulu-Natal, John Buyske

Independent Study Project (ISP) Collection

This project seeks to explore the realities of the emergency medical system in the Durban area, particularly relative to government policy. It contextualizes its findings within the literature on public policy. Data for the project was collected via nine in-depth interviews with various professionals working in the field of emergency medical services, as well as a survey of fourteen citizens conducted in the peri-urban township of Cato Manor. This data was analyzed using qualitative methods. While every participant had different views and a different perspective on emergency services, some recurring themes and trends became evident, allowing for conclusions to be …

Zika Virus And Global Health Security, Lawrence O. Gostin, James G. Hodge Jr.

Georgetown Law Faculty Publications and Other Works

Americans are largely apathetic about the risks of Zika virus and Congress cannot agree on preparedness funding. Strategies to counter the spread of Zika by the World Health Organisation (WHO) grossly underestimate the disease’s impact. WHO and member countries lack sufficient resources to respond. Consequences of fiscal apathy can be measured in lives lost and long-term disabilities. Zika prevention is a matter of global health security.

The epidemiologic brunt of Zika in South America falls largely on vulnerable women at heightened risk of exposure through mosquitoes and sexual transmission. Resulting transmission to fetuses and infants will have generational impacts in …

Financial Hardship From Purchasing Medications For Senior Citizens Before And After The Medicare Modernization Act Of 2003 And The Patient Protection And Affordable Care Act Of 2010: Findings From 1998, 2001, And 2015, Anthony W. Olson, Jon C. Schommer, David A. Mott, Lawrence M. Brown

Pharmacy Faculty Articles and Research

BACKGROUND: The Medicare Modernization Act of 2003 (Medicare Part D) added prescription drug coverage for senior citizens aged 65 years and older and applied managed care approaches to contain costs. The Patient Protection and Affordable Care Act of 2010 (ACA) had the goals of expanding health care insurance coverage and slowing growth in health care expenditures.

OBJECTIVES: To (a) describe the proportion of senior citizens who had prescription drug insurance coverage and the proportion who experienced financial hardship from purchasing medications in 2015, and (b) compare the findings with those collected in 1998 and 2001.

METHODS: Data were obtained in …

Resource Guide For Addiction And Mental Health Care Consumers: Answering Questions About Insurance Coverage And Parity For Addiction And Mental Health Care Services, Lucy C. Hodder, Michele D. Merritt, Margaret H. Schmidt, Jacqueline Botchman, Caitlyn Ebert, Marguerite Corvini, Kate Crary, Bridget Drake

Law Faculty Scholarship

Navigating the maze of health insurance coverage can be difficult. For individuals with addiction or mental illness, the process of getting treatment approved and paid for by health insurance can be overwhelming. As a result, many people give up when their health insurance company denies coverage for needed services. This Guide can help people learn how to access health insurance and use their coverage to pay for treatment. This Guide also provides a basic explanation of consumers’ rights under the federal Mental Health Parity and Addiction Equity Act.

Smoking On The Margins: A Comprehensive Analysis Of A Municipal Outdoor Smoke-Free Policy, Ann Pederson, Chizimuzo T. C. Okoli, Natalie Hemsing, Renée O'Leary, Amanda T. Wiggins, Wendy Rice, Joan L. Bottorff, Lorraine Greaves

Nursing Faculty Publications

Background: This study examined the formulation, adoption, and implementation of a ban on smoking in the parks and beaches in Vancouver, Canada.

Methods: Informed by Critical Multiplism, we explored the policy adoption process, support for and compliance with a local bylaw prohibiting smoking in parks and on beaches, experiences with enforcement, and potential health equity issues through a series of qualitative and quantitative studies.

Results: Findings suggest that there was unanimous support for the introduction of the bylaw among policy makers, as well as a high degree of positive public support. We observed that smoking initially declined following the ban’s …

Implementation Of The Affordable Care Act In Physical Therapy, Greg Austin

Mahurin Honors College Capstone Experience/Thesis Projects

Introduction: With the implementation of the Affordable Care Act (ACA) in 2010, many medical specialties prepared to see reimbursement rates altered. Not impervious to this trend was the field of physical therapy (PT). This change in reimbursement structure could impact the effectiveness of PT treatment. Under this model, a patient may not be able to receive the appropriate number of visits to a physical therapist, resulting in a loss of utilization in the injured area and, possibly, a loss of independence. Methods: A literature review was performed to determine reimbursement rate impact on PT. A seven-item open-ended survey regarding various …

The Right For Autonomy, The Duty Of Disclosure And Public Health Considerations – The 2013 Polio Crisis In Israel As A Case Study, Dr. Nili Karako Eyal

Pace Law Review

Despite sharing the same theoretical framework of discussion with other papers, this paper addresses an ethical and legal issue that has received little attention in academic and public discourse: the duty of disclosure in the context of vaccinations. In particular, the paper addresses the question whether public health considerations provide a justification for restricting the duty of disclosure in the case of vaccination.

Delimitating the research question to the issue of disclosure has several implications. First, the decision to vaccinate the population with bOPV as describe above and the decision to adopt a voluntary vaccination policy are not the focus …

Toward An International Constitution Of Patient Rights, Alison Poklaski

Indiana Journal of Global Legal Studies

In the past decade, medical tourism-the travel of patients across borders to receive medical treatment-has undergone unprecedented growth, fueled by the globalization of health care and related industries. While medical tourism can benefit patients through increased access to treatment and cost-savings, medical travel also raises concerns about ensuring quality of care and legal redress in medical malpractice. Moreover, existing regulations fail to address these unprecedented issues. The multilateral adoption of an International Constitution of Patient Rights (ICPR) is necessary in order to more effectively preserve medical tourism's benefits and guard against its risks.

Will The Ebola Epidemic Serve To Make Reform Of The Broken Health Research And Development Framework Go Viral?, Jeremy Mcdonald

Indiana Journal of Global Legal Studies

The recent Ebola outbreak in West Africa has captured the public imagination as few other epidemics have, as its rapid spread and lethal effect demonstrated the devastating toll that infectious diseases can exact from a world unprepared to confront them. In light of the epidemic's tragic consequences, numerous experts have called for reform of the system of global health governance whose shortfalls allowed the epidemic to assume the horrifying dimensions it did. Among the many inadequacies that the outbreak uncovered is the insufficient amount of research into and development of treatments and vaccines for infectious diseases of poverty, among them …

Impeding Access To Quality Patient Care And Patient Rights: How Myriad Genetics' Gene Patents Are Unknowingly Killing Cancer Patients And How To Calm The Ripple Effect, Marisa Noelle Pins

Journal of Intellectual Property Law

No abstract provided.

Delinking Investment In Antibiotic Research And Development From Sales Revenues: The Challenges Of Transforming A Promising Idea Into Reality, Kevin Outterson, Unni Gopinathan, Charles Clift, Anthony So, Chantal Morel, John-Arne Røttingen

Faculty Scholarship

1. The current business model for antibiotics is plagued by market failures and perverse incentives that both work against conservation efforts and provide insufficient rewards to drive the development of much-needed new treatments for resistant infection.

2. Many new incentive mechanisms have been proposed to realign incentives and support innovation and conservation over the long term. The most promising of these are based on the idea of delinking rewards from sales volume of the antibiotic — the notion of “delinkage.”

3. Some critical design issues for delinkage remain, such as how to secure access to badly needed new products when …

Toward A Common Secure Future: Four Global Commissions In The Wake Of Ebola, Lawrence O. Gostin, Oyewale Tomori, Suwit Wibulpolprasert, Ashish K. Jha, Julio Frenk, Suerie Moon, Joy Phumaphi, Peter Piot, Barbara Stocking, Victor J. Dzau, Gabriel M. Leung

Georgetown Law Faculty Publications and Other Works

The world is becoming increasingly vulnerable to pandemics resulting from globalization, urbanization, intense human/animal interchange, and climate change. A series of global health crises have emerged since 2000, ranging from Severe Acute Respiratory Syndrome (SARS) and its phylogenetic cousin Middle East Respiratory Syndrome (MERS), to pandemic Influenza A (H1N1), Ebola, and the ongoing Zika virus epidemic. The Ebola epidemic gave rise to four global commissions proposing a bold new agenda for global health preparedness and response for future infectious disease threats.

Four global commissions reviewing the recent Ebola virus disease epidemic response consistently recommended strengthening national health systems, consolidating and …

Increasing Access To Primary Care Using Np’S: The Framework For An Academic Based Nurse-Managed Center In California, Prabjot (Jodie) Sandhu

Doctor of Nursing Practice (DNP) Projects

The dynamics of health care delivery and the role of health care providers is a changing canvas in the United States. The implementation of the Affordable Care Act (ACA), sets a goal to increase access to health care. The systems that support the ACA are constantly under scrutiny as failing to provide key answers to provider shortage and health care access issues. Nurse Practitioners (NPs) who are recognized by the ACA as a comprehensive part of this revolution are in a unique place to find opportunities to promote increased access to health and primary care services. While NPs in California …

How Are Migrant Health Centers And Their Patients Faring Under The Affordable Care Act?, Jessica Sharac, Rachel Gunsalus, Chi Tran, Peter Shin, Sara Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Migratory and seasonal agricultural workers (MSAWs) provide essential labor for farming in all its branches in the United States. Between 2.4 and 3 million MSAWs live across the U.S. in every state but are clustered in areas dense with agricultural employment. As a population already susceptible to poor health outcomes because of poverty and work-related health risks, MSAWs depend on community health centers, especially those known as migrant health centers that receive additional migrant funding. Reporting data from a national survey of agricultural workers, as well as findings from analyses of data from the Uniform Data System (UDS) that covers …

A Yellow Fever Epidemic: A New Global Health Emergency?, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

The worst yellow fever epidemic in Angola since 1986 is rapidly spreading, including the capital, Luanda. In Angola, the epidemic began in December 2015 and the laboratory-confirmed outbreak was reported to the World Health Organization (WHO) on January 21, 2016. Angola has had 2023 suspected cases and 258 deaths as of April 26, 2016. China, the Democratic Republic of Congo, and Kenya also have reported cases arising from infected travelers from Angola. Namibia and Zambia also share a long border with Angola, with considerable population movement between the countries. Similar to other recent epidemics, quick and effective action to stop …

Is The United States Prepared For A Major Zika Virus Outbreak?, Lawrence O. Gostin, James G. Hodge Jr.

Georgetown Law Faculty Publications and Other Works

Zika virus has emerged as a global public health crisis with active transmission in the Americas and Caribbean. The World Health Organization (WHO) declared a Public Health Emergency of International Concern (PHEIC), and recently WHO reported there is a scientific consensus that Zika is a cause of microcephaly and Guillain-Barré syndrome (GBS). In the U.S. the Centers for Disease Control and Prevention (CDC) activated its emergency operations center at its highest capacity. President Obama requested $1.86 billion in emergency funding. Shamefully, Congress has yet to appropriate the funding needed for Zika preparedness, and the President has had to reallocate Ebola …

Heredity In The Epigenetic Era: Are We Facing A Politics Of Reproductive Obligations?, Michael J. Crawford

Biological Sciences Publications

Recent research in the emerging field of epigenetics has implications with the potential to re-ignite acrimony in the discourse of reproductive rights, medical ethics, and the role of the state in our homes and in our lives. For scientists, epigenetics has profoundly realigned our understanding of heredity: epigenetics provides a mechanism through which the environmental challenges met in one generation can be inscribed and transmitted to future offspring. Although both genetic parents have the potential to transmit heritable epigenetic changes to their offspring, mothers have a particularly potent effect because nutrition in the uterine environment can exert a supplemental effect …

Mid-Atlantic Ethics Committee Newsletter, Spring 2016

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Law & Healthcare Newsletter, Vol. 23, No. 2, Spring 2016

Law & Health Care Newsletter

No abstract provided.

Inquiry Into The Implementation Of Bush’S Executive Order 13211 And The Impact On Environmental And Public Health Regulation, Elizabeth Ann Glass Geltman, Gunwant Gill, Miriam Jovanovic

Publications and Research

Executive Order 13211, promulgated in 2001, requires the federal government to consider the impact of federal action on energy independence as part of the George W. Bush’s National Energy Policy. This law review examines whether EO 13211 was used to curtail environmental protection and natural resource conservation. The article begins with a review of the procedure required of federal agencies under EO 13211 and its associated documents. The paper then examines case law and published federal rulemaking proceedings and examines how federal agencies apply tests to evaluate the potential energy effect. The study concludes that EO 13211 strikes a reasonable …

The United Nations Sustainable Development Goals: Achieving The Vision Of Global Health With Justice, Eric A. Friedman, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

We are resolved to free the human race from the tyranny of poverty and want and to heal and secure our planet” (UN General Assembly, 2015, September 25, preamble). So pronounces the 2030 Agenda, the United Nations declaration on the Sustainable Development Goals (SDGs), adopted on September 25, 2015, succeeding the Millennium Development Goals (MDGs). If achieved, the SDGs will secure an improved level of health, development, and global justice. However, if the international community fails to live up to its commitments, an untold number of people will likely perish prematurely, people’s opportunities to thrive will be cut off, social …