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Articles 1 - 23 of 23
Full-Text Articles in Medicine and Health Sciences
Medical-Legal Partnerships Reinvigorate Systems Lawyering Using An Upstream Approach, Kate L. Mitchell, Debra Chopp
Medical-Legal Partnerships Reinvigorate Systems Lawyering Using An Upstream Approach, Kate L. Mitchell, Debra Chopp
Articles
The upstream framework presented in public health and medicine considers health problems from a preventive perspective, seeking to understand and address the root causes of poor health. Medical-legal partnerships (MLPs) have demonstrated the value of this upstream framework in the practice of law and engage in upstream lawyering by utilizing systemic advocacy to address root causes of injustices and health inequities. This article explores upstreaming and its use by MLPs in reframing legal practice.
Giving People The Words To Say No Leads Them To Feel Freer To Say Yes, Rachel Schlund, Roseanna Sommers, Vanessa K. Bohns
Giving People The Words To Say No Leads Them To Feel Freer To Say Yes, Rachel Schlund, Roseanna Sommers, Vanessa K. Bohns
Articles
We examine how to structure requests to help people feel they can say no (or yes) more voluntarily. Specifically, we examine the effect of having the requester provide the request-target with an explicit phrase they can use to decline requests. Part of the difficulty of saying no is finding the words to do so when put on the spot. Providing individuals with an explicit script they can use to decline a request may help override implicit scripts and norms of politeness that generally dictate compliance. This should make individuals feel more comfortable refusing requests and make agreement feel more voluntary. …
Locating Liability For Medical Ai, W. Nicholson Price Ii, I. Glenn Cohen
Locating Liability For Medical Ai, W. Nicholson Price Ii, I. Glenn Cohen
Articles
When medical AI systems fail, who should be responsible, and how? We argue that various features of medical AI complicate the application of existing tort doctrines and render them ineffective at creating incentives for the safe and effective use of medical AI. In addition to complexity and opacity, the problem of contextual bias, where medical AI systems vary substantially in performance from place to place, hampers traditional doctrines. We suggest instead the application of enterprise liability to hospitals—making them broadly liable for negligent injuries occurring within the hospital system—with an important caveat: hospitals must have access to the information needed …
Consent Searches And Underestimation Of Compliance: Robustness To Type Of Search, Consequences Of Search, And Demographic Sample, Roseanna Sommers, Vanessa K. Bohns
Consent Searches And Underestimation Of Compliance: Robustness To Type Of Search, Consequences Of Search, And Demographic Sample, Roseanna Sommers, Vanessa K. Bohns
Articles
Most police searches today are authorized by citizens' consent, rather than probable cause or reasonable suspicion. The main constitutional limitation on so-called “consent searches” is the voluntariness test: whether a reasonable person would have felt free to refuse the officer's request to conduct the search. We investigate whether this legal inquiry is subject to a systematic bias whereby uninvolved decision-makers overstate the voluntariness of consent and underestimate the psychological pressure individuals feel to comply. We find evidence for a robust bias extending to requests, tasks, and populations that have not been examined previously. Across three pre-registered experiments, we approached participants …
Designing A Fulfilling Life In The Law, Bridgette Carr, Vivek Sankaran, Taylor J. Wilson
Designing A Fulfilling Life In The Law, Bridgette Carr, Vivek Sankaran, Taylor J. Wilson
Articles
There is a mental health crisis in the legal profession. This isn’t news; in 2017, the National Task Force on Lawyering Well-Being acknowledged that the profession has failed to give adequate regard to the well-being of lawyers. High rates of chronic stress, depression, and substance use suggest that “the current state of lawyers’ health cannot support a profession dedicated to client service and dependent on the public trust.”
From Zero To Thrive: A Model Of Cross-System And Cross-Sector Relational Health To Promote Early Childhood Development Across The Child-Serving Ecosystem, Alison L. Miller, Sara F. Stein, Rebeccah Sokol, Rachel Varisco, Phoebe Trout, Megan M. Julian, Julie Ribaudo, Joshua B. Kay, Natasha V. Pilkauskas, Nicole Gardner-Neblett, Todd I. Herrenkohl, Kara Zivin, Maria Muzik, Katherine L. Rosenblum
From Zero To Thrive: A Model Of Cross-System And Cross-Sector Relational Health To Promote Early Childhood Development Across The Child-Serving Ecosystem, Alison L. Miller, Sara F. Stein, Rebeccah Sokol, Rachel Varisco, Phoebe Trout, Megan M. Julian, Julie Ribaudo, Joshua B. Kay, Natasha V. Pilkauskas, Nicole Gardner-Neblett, Todd I. Herrenkohl, Kara Zivin, Maria Muzik, Katherine L. Rosenblum
Articles
Early relational health between caregivers and children is foundational for child health and well-being. Children and caregivers are also embedded within multiple systems and sectors, or a “child-serving ecosystem”, that shapes child development. Although the COVID-19 pandemic has made this embeddedness abundantly clear, systems remain siloed and lack coordination. Fostering relational health amongst layers of this ecosystem may be a way to systematically support young children and families who are facing adversity. We integrate theory, examples, and empirical findings to develop a conceptual model informed by infant mental health and public health frameworks that illustrates how relational health across the …
The Impact Of The Covid-19 Pandemic On First-Generation Women Test-Takers: Magnifying Adversities, Stress, And Consequences For Bar Exam Performance., Freiburger Erin, Victor D. Quintanilla, Kurt Hugenberg, Sam Erman, Nedim Yel, Anita Kim, Mary C. Murphy
The Impact Of The Covid-19 Pandemic On First-Generation Women Test-Takers: Magnifying Adversities, Stress, And Consequences For Bar Exam Performance., Freiburger Erin, Victor D. Quintanilla, Kurt Hugenberg, Sam Erman, Nedim Yel, Anita Kim, Mary C. Murphy
Articles
By magnifying gender- and socioeconomic status-based inequalities, the COVID-19 pandemic caused stress and disrupted career progress for professional students. The present work investigated the impact of pandemic-related stress and prevailing barriers on structurally disadvantaged women preparing for a high-stakes professional exam. In Study 1, we found that among US law students preparing for the October 2020 California Bar Exam—the professional exam that enables one to become a practicing attorney in California—first-generation women reported the greatest stress from pandemic-related burdens and underperformed on the exam relative to others overall, and particularly compared to continuing-generation women. This underperformance was explained by pandemic-related …
Marijuana And Patents: The Complicated Relationship Between Patent Rights And The Federal Criminalization Of Marijuana, Reza Roghani Esfahani, Howard Bromberg
Marijuana And Patents: The Complicated Relationship Between Patent Rights And The Federal Criminalization Of Marijuana, Reza Roghani Esfahani, Howard Bromberg
Articles
Difficult questions arise in the context of marijuana-related inventions, patent procurement, and patent enforcement. These questions are a subset of the contradictions in the law of marijuana, where the federal government prohibits marijuana use and yet many of the states legalize, regulate, and tax it. This federal prohibition could discourage research into the health effects of marijuana and makes it difficult for marijuana-related innovations to satisfy statutory patentability requirements. It also renders enforcement of marijuana patents questionable, making marijuana businesses and patent owners vulnerable to nonpracticing patent entities, sometimes called "patent trolls."
Financial Toxicity During Breast Cancer Treatment: A Qualitative Analysis To Inform Strategies For Mitigation, Laila A. Gharzai, Kerry A. Ryan, Lauren Szczygiel, Susan Goold, Grace Li Smith, Sarah T. Hawley, John A.E. Pottow, Reshma Jagsi
Financial Toxicity During Breast Cancer Treatment: A Qualitative Analysis To Inform Strategies For Mitigation, Laila A. Gharzai, Kerry A. Ryan, Lauren Szczygiel, Susan Goold, Grace Li Smith, Sarah T. Hawley, John A.E. Pottow, Reshma Jagsi
Articles
Financial toxicity from cancer treatment is a growing concern. Its impact on patients requires refining our understanding of this phenomenon. We sought to characterize patients' experiences of financial toxicity in the context of an established framework to identify knowledge gaps and strategies for mitigation. Semistructured interviews with patients with breast cancer who received financial aid from a philanthropic organization during treatment were conducted from February to May 2020. Interviews were transcribed and coded until thematic saturation was reached, and findings were contextualized within an existing financial toxicity framework. Thirty-two patients were interviewed, of whom 58% were non-Hispanic White. The mean …
Voices From A Prison Pandemic: Lives Lost From Covid-19 At Lakeland Correctional, Kimberly Thomas
Voices From A Prison Pandemic: Lives Lost From Covid-19 At Lakeland Correctional, Kimberly Thomas
Articles
Coronavirus tore through jails and prisons like wildfire. In some states, more than half of the people incarcerated there tested positive for COVID-19; nearly 400,000 people in prison across the United States have tested positive. For people in prison, COVID-19 brought the loss of close friends, solitary confinement, loss of connection with family and programming, lack of information, and fear of contracting the virus. It has also reminded those who are incarcerated of the one-dimensional way in which people in prison are perceived. As stated by one collaborator, Cory Souders, "[s]o many men and women who come to prison are …
Suicide Prevention And Mood Disorders: Self-Exclusion Agreements For Firearms As A Suicide Prevention Strategy, Melvin G. Mcinnis, Stephen B. Thompson, Sofia D. Merajver, Carl E. Schneider
Suicide Prevention And Mood Disorders: Self-Exclusion Agreements For Firearms As A Suicide Prevention Strategy, Melvin G. Mcinnis, Stephen B. Thompson, Sofia D. Merajver, Carl E. Schneider
Articles
Suicide involves a complex set of behaviors and emotions that lead up to actions that may be based on planning and forethought or the result of impulse. While there are a host of antecedent circumstances the presence of a mood disorder, primarily depression, is the most common factor in suicide. While management of depression is recognized as important prevention strategy in depression, the means by which suicide occurs must be a critical element of prevention. Policies that lower access to the means for suicide will decrease the fatality. Guns are associated with half of suicides and the case fatality rate …
Respecting Autonomy And Enabling Diversity: The Effect Of Eligibility And Enrollment On Research Data Demographics, Kayte Spector-Bagdady, Shengpu Tang, Sarah Jabbour, Nicholson Price, Ana Bracic, Melissa S. Creary, Sachin Kheterpal, Chad M. Brummett, Jenna Wiens
Respecting Autonomy And Enabling Diversity: The Effect Of Eligibility And Enrollment On Research Data Demographics, Kayte Spector-Bagdady, Shengpu Tang, Sarah Jabbour, Nicholson Price, Ana Bracic, Melissa S. Creary, Sachin Kheterpal, Chad M. Brummett, Jenna Wiens
Articles
Many promising advances in precision health and other Big Data research rely on large data sets to analyze correlations among genetic variants, behavior, environment, and outcomes to improve population health. But these data sets are generally populated with demographically homogeneous cohorts. We conducted a retrospective cohort study of patients at a major academic medical center during 2012–19 to explore how recruitment and enrollment approaches affected the demographic diversity of participants in its research biospecimen and data bank. We found that compared with the overall clinical population, patients who consented to enroll in the research data bank were significantly less diverse …
Opioid Settlement Funds: Do Not Neglect Patients With Pain, Mark C. Bicket, Barbara Mcquade, Chad M. Brummett
Opioid Settlement Funds: Do Not Neglect Patients With Pain, Mark C. Bicket, Barbara Mcquade, Chad M. Brummett
Articles
The opioid crisis has escalated in the setting of the COVID-19 pandemic to new extremes and has claimed more than half a million lives in the US since 2000. Lawsuits to address the civil and criminal liability of drug companies and other groups have originated from federal, state, local, and tribal jurisdictions. When successful, there will likely be billions of dollars and significant discretion as to how these funds are spent. Several groups have produced reports with principles to address the toll of addiction using settlement funds. However, they lack actionable strategies to address the needs of patients with pain, …
The Coronavirus And The Risks To The Elderly In Long-Term Care, William Gardner, David States, Nicholas Bagley
The Coronavirus And The Risks To The Elderly In Long-Term Care, William Gardner, David States, Nicholas Bagley
Articles
The elderly in long-term care (LTC) and their caregiving staff are at elevated risk from COVID-19. Outbreaks in LTC facilities can threaten the health care system. COVID-19 suppression should focus on testing and infection control at LTC facilities. Policies should also be developed to ensure that LTC facilities remain adequately staffed and that infection control protocols are closely followed. Family will not be able to visit LTC facilities, increasing isolation and vulnerability to abuse and neglect. To protect residents and staff, supervision of LTC facilities should remain a priority during the pandemic.
Response To: How Should We Respond To Pregnancy And Substance Use?, Frank E. E. Vandervort, Vincent J. Palusci
Response To: How Should We Respond To Pregnancy And Substance Use?, Frank E. E. Vandervort, Vincent J. Palusci
Articles
We begin our reply by asking the reader to consider this typical case taken from Professor Vandervort’s current practice. It is one of several similar cases currently being handled by the clinic he works in and similar to many dozens—perhaps hundreds—of cases handled over the past 30 years.
To Protect And Provide For Children, Prenatal Substance Use Must Be Considered Abuse., Frank E. E. Vandervort, Vincent J. Palusci
To Protect And Provide For Children, Prenatal Substance Use Must Be Considered Abuse., Frank E. E. Vandervort, Vincent J. Palusci
Articles
The use of drugs and alcohol during pregnancy is harmful to the developing child. When children are born having been exposed to these substances, children’s protective services should uniformly substantiate child maltreatment in order to ensure that the child’s parent(s) and the child receive the treatment and services necessary to address the child’s immediate safety, protect the government’s compelling interest in the child’s welfare, and ensure the best long-term outcome for the child.
The Orphan Drug Act At 35: Observations And An Outlook For The Twenty-First Century, Nicholas Bagley, Benjamin Berger, Amitabh Chandra, Craig Garthwaite
The Orphan Drug Act At 35: Observations And An Outlook For The Twenty-First Century, Nicholas Bagley, Benjamin Berger, Amitabh Chandra, Craig Garthwaite
Articles
On the thirty-fifth anniversary of the adoption of the Orphan Drug Act (ODA), we describe the enormous changes in the markets for therapies for rare diseases that have emerged over recent decades. The most prominent example is the fact that the profit-maximizing price of new orphan drugs appears to be greater today than it was in 1983. All else equal, this should reduce the threshold for research and development (R&D) investment in an economically viable product. Further, the small size of patient populations for orphan drugs, together with the increasing prevalence of biologics among orphan drugs, have created a set …
Technical Standards And Lawsuits Involving Accommodations For Health Professions Students, Samuel R. Bagenstos
Technical Standards And Lawsuits Involving Accommodations For Health Professions Students, Samuel R. Bagenstos
Articles
This article will discuss the legal obligations of medical schools to accommodate applicants and students with disabilities. The article begins by describing the problem of denial of medical education to such students, a problem that results from both discrimination in admissions and denial of accommodations to incumbent students with disabilities. The article then discusses the disability rights legislation that prohibits discrimination against—and requires reasonable accommodation of—qualified medical students with disabilities. It concludes by reviewing a number of lawsuits involving requests for accommodation and how disability rights law was applied in those cases.
Protection Or Harm? Suppressing Substance-Use Data, Austin B. Frakt, Nicholas Bagley
Protection Or Harm? Suppressing Substance-Use Data, Austin B. Frakt, Nicholas Bagley
Articles
What if it were impossible to closely study a disease affecting 1 in 11 Americans over 11 years of age — a disease that’s associated with more than 60,000 deaths in the United States each year, that tears families apart, and that costs society hundreds of billions of dollars? What if the affected population included vulnerable and underserved patients and those more likely than most Americans to have costly and deadly communicable diseases, including HIV–AIDS? What if we could not thoroughly evaluate policies designed to reduce costs or improve care for such patients?
Using Screening And Assessment Evidence Of Trauma In Child Welfare Cases, Frank E. Vandervort
Using Screening And Assessment Evidence Of Trauma In Child Welfare Cases, Frank E. Vandervort
Articles
If you are a child welfare lawyer representing children, parents, or the child welfare agency, understanding how traumatic experiences may impact your clients will help you frame your advocacy. Understanding children and their parents’ histories of exposure to potentially traumatic life events and how those events have impacted the client’s functioning—in school, in interactions with other people, and as parents—can be critical to framing your approach in the case. Evidence of the client’s trauma history and any compromised functioning that may have resulted from that trauma is critical to integrate into your advocacy.
Long-Term Financial Burden Of Breast Cancer: Experiences Of A Diverse Cohort Of Survivors Identified Through Population-Based Registries, Reshma Jagsi, John A.E. Pottow, Kent A. Griffith, Cathy Bradley, Ann S. Hamilton, John Graff Rutgers University, Steven J. Katz, Sarah T. Hawley
Long-Term Financial Burden Of Breast Cancer: Experiences Of A Diverse Cohort Of Survivors Identified Through Population-Based Registries, Reshma Jagsi, John A.E. Pottow, Kent A. Griffith, Cathy Bradley, Ann S. Hamilton, John Graff Rutgers University, Steven J. Katz, Sarah T. Hawley
Articles
Purpose: To evaluate the financial experiences of a racially and ethnically diverse cohort of long-term breast cancer survivors (17% African American, 40% Latina) identified through population-based registries. Methods: Longitudinal study of women diagnosed with nonmetastatic breast cancer in 2005 to 2007 and reported to the SEER registries of metropolitan Los Angeles and Detroit. We surveyed 3,133 women approximately 9 months after diagnosis and 4 years later. Multivariable models evaluated correlates of self-reported decline in financial status attributed to breast cancer and of experiencing at least one type of privation (economically motivated treatment nonadherence and broader hardships related to medical expenses). …
Malpractice Suits And Physician Apologies In Cancer Care, Eugene Chung, Jill R. Horwitz, John A.E. Pottow, Reshma Jagsi
Malpractice Suits And Physician Apologies In Cancer Care, Eugene Chung, Jill R. Horwitz, John A.E. Pottow, Reshma Jagsi
Articles
Conside the following case: The patient is a 44-year-old woman who presents for radiation treatment of an isolated locoregional recurrence of breat cancer in her chest wall, 3 years after undergoing masectomy. At the time of diagnosis, she had T2N2M0 disease, with four of 15 lymph nodes involved with tumor. She received a masectomy with negative margins and appropriate chemotherapy, but none of her physicians talked to her about postmasectomy radiation therapy, which would clearly have been indicated to reduce her risk of locoregional failure and would have been expected to improve her likelihood of survival. She asks the radiation …
The Impact Of Traumatic Stress And Alcohol Exposure On Youth: Implications For Lawyers, Judges, And Courts, Frank E. Vandervort
The Impact Of Traumatic Stress And Alcohol Exposure On Youth: Implications For Lawyers, Judges, And Courts, Frank E. Vandervort
Articles
Since its inception in the late nineteenth century, the juvenile court has been concerned with the legal problems of children and their families. From the court’s earliest days, it has sought to address child abuse and neglect and juvenile delinquency as social problems that result from familial and community breakdown. Over the decades, researchers from various disciplines have provided varying explanations of how and why family systems break down, why some parents fail to nurture their children, why some physically or sexually abuse their children, and why some children become delinquent.