Law Commons^™

Addressing Medicaid/Marketplace Churn Through Multimarket Plans: Assessing The Current State Of Play, Sara Rosenbaum

Health Policy and Management Faculty Publications

No abstract provided.

Discovering A Gold Mine Of U.S. Government Information: Exploring The Hathitrust Catalog And Its Rich Veins, Bert Chapman

Libraries Faculty and Staff Presentations

The Hathitrust Catalog provides researchers at member institutions with exponentially expanded access to historical U.S. Government information resources. This presentation describes how researchers can use this resource to conduct substantive research using government information resources on public policy issues such as Internal Revenue Service program problems, infectious diseases such as Ebola, and U.S. foreign relations with the former Soviet Union/Russian Federation.

The President’S National Security Agenda Curtailing Ebola, Safeguarding The Future, Lawrence O. Gostin, Henry A. Waxman, William Foege

Georgetown Law Faculty Publications and Other Works

A clear lesson of the Ebola epidemic in West Africa is the need for strong public health systems globally, including in the United States. Ebola has highlighted the dangers of weak public health systems, from the immense shortage of health workers in West Africa to the budget cuts at the U.S. Centers for Disease Control and Prevention. In response to Ebola and the broader threat of infectious disease, President Obama has proposed a $6.2 billion supplemental funding request to Congress. The supplemental would surge resources for containing and treating Ebola in West Africa -- including a reserve of funds to …

Filling In The Blanks On Reducing Tobacco Product Addictiveness In The Fctc Partial Guidelines For Articles 9 & 10, Eric N. Lindblom

Georgetown Law Faculty Publications and Other Works

The existing Partial Guidelines for Implementation of Articles 9 & 10 of the WHO Framework Convention for Tobacco Control includes a strategy for regulating tobacco products to reduce their attractiveness, but does not yet provide any guidance for reducing either the toxicity or the addictiveness of tobacco products. Section 1.2.1.2, “Addictiveness (dependence liability),” states only that: “This section has been left blank intentionally to indicate that guidance will be proposed at a later stage.” A related footnote says that the blanks will be filled “as new country experience, and scientific, medical and other evidence become available. . . [and] will …

Addressing The Ethical, Legal, And Social Issues Raised By Voting By Persons With Dementia, Jason H. Karlawish, Richard J. Bonnie, Paul S. Appelbaum, Constantine Lyketsos, Bryan James, David Knopman, Christopher Patusky, Rosalie A. Kane, Pamela S. Karlan

Jason Karlawish

This article addresses an emerging policy problem in the United States participation in the electoral process by citizens with dementia. At present, health care professionals, family caregivers, and long-term care staff lack adequate guidance to decide whether individuals with dementia should be precluded from or assisted in casting a ballot. Voting by persons with dementia raises a series of important questions about the autonomy of individuals with dementia, the integrity of the electoral process, and the prevention of fraud. Three subsidiary issues warrant special attention: development of a method to assess capacity to vote; identification of appropriate kinds of assistance …

Is The United States Prepared For Ebola?, Lawrence O. Gostin, James G. Hodge Jr., Scott Burris

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic is a humanitarian crisis and a threat to international security. It is not surprising that isolated cases have emerged in Europe and North America, but a large outbreak in the United States, with its advanced health system, is unlikely. Yet the handling of the first domestically diagnosed Ebola case in Dallas, Texas, raised concerns about national public health preparedness. What were the critical health system vulnerabilities revealed in Dallas, and how can the country respond more effectively to novel diseases in a globalized world?

Ebola: A Crisis In Global Health Leadership, Lawrence O. Gostin, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

At the core of the present Ebola crisis in West Africa is a lack of global health leadership. WHO should be the global health leader, following its constitutional charge, yet it is significantly under-resourced, having a direct effect on its rapid response capacity. The Organization's response to this crisis has been constantly behind, from low funding appeals to its delay in declaring this outbreak to be a Public Health Emergency of International Concern under the binding International Health Regulations (2005) (IHR). The IHR themselves have proven insufficient, as countries have failed to cooperate in building the public health capacities that …

Public Health In The Age Of Ebola In West Africa, Michael T. Osterholm, Kristine A. Moore, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The Ebola epidemic, with its fast-growing toll and real potential for spreading into much of Africa, including major cities, has the makings of a “Black Swan” event. Such events, using the term coined by Nassim Nicholas Taleb, are: 1) unpredictable, outside the realm of regular expectations; 2) have a major impact, and; 3) are rationalized after the fact as being explainable and predictable.

We have learned from this outbreak the potential for an infectious disease to be politically, economically, and socially destabilizing, and that what kills us may be very different from what frightens us or substantially affects our social …

Human Trafficking To Northern America: The Balkan Connection, Natalya Timoshkina, Naser Miftari, Antonela Arhin

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

This paper draws on the results of a large multi-method study, which examined human trafficking from the former Eastern Bloc to Northern America (Canada and the United States). The study was conducted in 2011-2013, and funded by the Social Sciences and Humanities Research Council of Canada (SSHRC). The analysis is grounded in the findings from 9 countries of the Balkan region included in the study: Albania, Bulgaria, Bosnia and Herzegovina, Croatia, Kosovo, Macedonia, Montenegro, Serbia, and Slovenia. The following data sources were used: (a) national and international reports, media and academic articles, and various documents (in English and official languages …

Hidden In Plain Sight: Exploring The Vulnerabilities Of Street-Working Boys In Se Asia, Jarrett Davis, Glenn Miles

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

The sexual exploitation of men and boys is often little understood and commonly goes ignored. Internationally, it is said that 1 in 6 boys are sexually abused before reaching adulthood and in some nations the exploitation and abuse of boys far outweighs that of girls. Social and cultural norms often assume men and boys to be inherently strong and/or invulnerable to sexual exploitation; however, research in this area continues to show these assumptions to be false. Because of this lack of awareness, the efforts of the organizations and individuals who work to provide for the needs of male victims are …

Bra’S For A Cause: A Service Learning Project In A Freshman Level Human Trafficking Course, Beth A. Wiersma

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

Women and Children for Sale: The Global Problem of Human Trafficking is a General Studies Portal course for college freshman at a Midwestern university. The students in the course were surveyed the first day of class about why they chose the course, what they hoped to get out of the course, what they believed to be true about human trafficking, and how they learned about human trafficking. During the semester the students planned and carried out a service learning project “Bras for a Cause”. This project involved educating others about human trafficking and collecting bras. The bras are sent overseas …

Human Trafficking, Education And Migration At Ngos In Cambodia And Thailand, Robert Spires, Xinyi Duan

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

This presentation is based on in-progress collaborative research between researcher Dr. Bob Spires and Hong Kong-based NGO Liberty Asia. The research involves interviews and observations conducted at multiple NGOs in Cambodia and Thailand working to address human trafficking and incorporating educational components into their programs. The study uses comparative lenses to examine issues of education and migration in both the Cambodian and Thai context for human trafficking survivors and at-risk populations. The study is interdisciplinary, drawing on the work on human trafficking in several social science fields. The framework for the research is based on Frank Laczko and Elzbieta Gozdziak’s …

Analysis Of Human Trafficking Cases In Rhode Island, 2009-2013, Donna M. Hughes, Rachel Dunham, Faith Skodmin, Lucy Tillman, Jessica Wainfor

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

This presentation is an analysis of seven state and federal cases of human trafficking, including forced labor and sex trafficking, in Rhode Island from 2009 until 2013. In 2009, Rhode Island passed a comprehensive human trafficking law. Since then there have been six cases of sex trafficking and one case of forced labor. Sources for information on the human trafficking cases were police reports, witness statements, court documents and media reports. This presentation will briefly summarize the cases and discuss the similarities and difference among the cases and discuss of some key findings from these cases, which include:
1) Victims …

The Problem Of State Intervention In Post-Abolition Slavery: A Critique Of Consensus, Anthony Talbott, David Watkins

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

Slavery is now illegal by all states and under international law. Contrary to the hopes of abolitionists, this state of affairs has transformed rather than eradicated slavery as an institution. Furthermore, responses by states to post-abolition forms of slavery have often been less than ideal. This paper begins by comparing two state responses to slavery in the early 20th century: the federal peonage trials in Montgomery, Alabama from 1903-1905, and the federal response to an alleged epidemic of “white slavery” from 1909-1910, culminating in the passage of the White Slave-Traffic Act. Taken together, these responses engender pessimism about the state …

Physicians' Perspectives On The Current Handling Of Medical Malpractice In Jordan, Jason Yohan Hwang

Independent Study Project (ISP) Collection

Research on medical malpractice has increased over the past few decades. However, such studies have primarily focused on malpractice in Western countries like America. In areas like the Middle East, studies on malpractice has been lacking. Thus, this study tries to fill this gap. The purpose of this study is to understand physicians’ perspectives on the current handling of medical malpractice in Jordan. To answer this research question, the study uses both surveys and interviews to focus on three main themes: one, physicians’ understanding of the term, malpractice; two, evaluation of the current malpractice system; and three, attitudes toward a …

Human Rights Infringements In Brazil’S Penitentiary System Understood Through Access To Healthcare, Sara Morris

Independent Study Project (ISP) Collection

Brazil has a reputation of being home to some of the worst penitentiary conditions worldwide, eventually leading the United Nations to make an appeal to the Brazilian government in 2003 to analyze their systems and make necessary improvements. The poor conditions and lack of access to legal counsel, living space, and specifically healthcare, cause riots and uprisings within prisons that in the past have lead to death of prisoners and guards. Prisons serve a very specific purpose in society, and according to most social theorists that is to reform, not to torture. In Brazil there is no capital punishment, so …

Many Paths To Primary Care: Flexible Staffing And Productivity In Community Health Centers, Leighton C. Ku, Bianca K. Frogner, Erika Steinmetz, Patricia Pittman

Health Policy and Management Issue Briefs

No abstract provided.

The Ebola Epidemic: A Public Health Emergency Of International Concern, Lawrence O. Gostin, Daniel Lucey, Alexandra Phelan

Georgetown Law Faculty Publications and Other Works

On August 8, 2014, the World Health Organization (WHO) Director-General Margaret Chan declared the West Africa Ebola crises a “public health emergency of international concern,” triggering powers under the 2005 International Health Regulations (IHR).

The most affected West African states have attempted classic public health measures with varied success, including quarantine and isolation, social distancing, risk communication, and travel restrictions. These have involved a trade off between population health and human rights; sometimes to the disadvantage of both. At the same time, the countries’ health systems and human resources are fragile, impeding an effective response.

Beyond the public health and …

The Historic Role Of Boards Of Health In Local Innovation: New York City’S Soda Portion Case, Lawrence O. Gostin, Belinda H. Reeve, Marice Ashe

Georgetown Law Faculty Publications and Other Works

Childhood and adult obesity pose major risks for cancer, diabetes, and cardiovascular disease, with the poor and racial minorities suffering from disproportionately high burdens of obesity and chronic disease. With current policies failing, cities and states have moved forward with creative prevention measures–-with boards of health driving policy innovation in many local jurisdictions. The New York City Board of Board of Health’s (NYCBH) soda portion limit pushed the boundaries of innovation, but was struck down on June 26, 2014 by New York State’s highest court, which held that the Board trespassed on the City Council’s authority.

The Court’s decision ignored …

Virus Sharing, Genetic Sequencing, And Global Health Security, Lawrence O. Gostin, Alexandra Phelan, Michael A. Stoto, John D. Kraemer, K. Srinath Reddy

Georgetown Law Faculty Publications and Other Works

The WHO’s Pandemic Influenza Preparedness (PIP) Framework was a milestone global agreement designed to promote the international sharing of biological samples to develop vaccines, while that ensuring poorer countries would have access to those vaccines. Since the PIP Framework was negotiated, scientists have developed the capacity to use genetic sequencing data (GSD) to develop synthetic viruses rapidly for product development of life-saving technologies in a time-sensitive global emergency—threatening to unravel the Framework. Access to GSD may also have major implications for biosecurity, biosafety, and intellectual property (IP).

By rendering the physical transfer of viruses antiquated, GSD may also undermine the …

Ebola: Towards An International Health Systems Fund, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The current outbreak of Ebola virus disease (EVD) in West Africa is spiraling out of control, but it never had to happen. What can the international community do now to bring the epidemic under control, and how can we prevent the next one?

The counties most affected by Ebola (Guinea, Liberia, and Sierra Leone), rank among the lowest in global development, lacking essential public health infrastructure. If the affected countries had adequate public health systems, they probably would have contained Ebola within rural settings, avoiding the first outbreak in major urban areas.

More than 130 health workers have died from …

Health Insurance Benefits Advisors: Understanding Responsibilities, Regulations, Restrictions And The Relevance To Implementing The Affordable Care Act, Alexandra M. Stewart, Marisa A. Cox, Leighton Ku

Health Policy and Management Issue Briefs

This brief describes the operational differences among six different types of benefits advisors including: 1) Commercial agents and brokers, 2) Medicaid enrollment brokers, 3) navigators, 4) non-navigator assistance personnel (or in-person assisters), 5) certified applications assisters, and 6) health center outreach and enrollment assistance workers. We will address: 1) the role of each benefits advisor 2) the health plans with which benefits advisors are authorized to work 3) training requirements, 4) compensation 5) conflict of interest requirements, and 6) the impact benefits advisors have on consumer enrollment decisions.

The Social And Economic Implications Of Human Trafficking In Nigeria: Naptip In Focus, Eunice I. Anuforom

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

Human trafficking is globally recognized as a modern day slavery with multifarious negative socio-economic, legal and health implications. Besides drugs trafficking and gun running, human trafficking has become a lucrative business globally and yields an estimated US$32 million annually. Traffickers trade on human lives, subject them to gory and traumatic experiences in order to make profits. Human trafficking is therefore the worst form of human rights violations and a gender based violence against female who constitute the majority of the victims in the country. Regrettably, Nigeria occupies the ignoble position of a source, transit and destination country for trafficking. In …

A Content Analysis Of Backpage.Com Advertisements In Louisville, Kentucky, Theresa C. Hayden

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

Backpage.com and Craigslist are replacing the street corner as a crime source for buying and selling of sex. “To reduce commercial sexual exploitation and enforce existing trafficking laws, communities must first recognize the extent of the problem within their local area (Janson, Mann, Marro, & Matvey, 2013, 99). In a population density study conducted in 15 major U. S. cities, it was found that males over 18 years of age who buy sex online ranged from 0.6% in San Francisco to 21.4% in Houston (Roe-Sepoqitz, Hickle, Gallagher, Smith, & Hedberg, 2013). Researchers in the Greater Cincinnati area found a high …

Reconstructing A College Model For Countering Human Trafficking, Ron D. Petitte

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

Assessment is a hallmark of 21st Century academia. Accordingly, the 2013 college model for countering human trafficking² was reviewed and assessed by the author, leading to a restructuring of the model, in order to present developments that have occurred since the October 2013 Interdisciplinary Conference on Human Trafficking, at the University of Nebraska-Lincoln, as well as attempting to engineer a more practical and effective model: There are two areas of research that link directly to the spectre of human trafficking. The first is economics; and, the question that is raised: “Is human trafficking, today, the result of unjust economic …

The Aca’S Contraceptive Mandate: Religious Freedom, Women’S Health, And Corporate Personhood, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

On June 30 2014 the Supreme Court decided Burwell v Hobby Lobby Stores, Inc, in a deeply divided judgment that engaged religious freedom, women’s health, and corporate personhood. Three closely held for-profit organizations challenged the Affordable Care Act’s contraceptive mandate, objecting to four contraceptive methods that they believe acted as abortifacients, in violation of their Christian beliefs.

The Court held that the contraceptive mandate violated the Religious Freedom Restoration Act of 1993, ruling that the Act’s protections extended to closely held corporations, with the mandate substantially burdening their religious freedoms. The Court acknowledged the federal government’s compelling interest in …

Healthy Living Needs Global Governance, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

It may seem counter-intuitive, but the same factors that drive the spread of infectious diseases also contribute to the dominance of non-communicable diseases (NCDs) in the global burden of disease—urbanization, global markets and harmonized cultures. NCDs have overtaken infectious diseases as the leading cause of morbidity and premature mortality worldwide, with deaths concentrated among the poor due to the growing availability and affordability of highly-processed, unhealthy foods, alcohol and tobacco.

The global response to NCDs has been slow and fractured, with the World Health Organization dedicating scant funding and the United Nations waiting until September 2011 to hold a high-level …

E-Cigarettes, Vaping, And Youth, Lawrence O. Gostin, Aliza Y. Glasner

Georgetown Law Faculty Publications and Other Works

E-cigarettes, a relatively new product, storming the tobacco industry are causing a massive stir among public health advocates. While e-cigarettes have the potential to serve as an effective harm reduction tool for existing smokers, they also may present an equally tempting pathway to first time smoking, particularly among youth. Many fear that e-cigarettes will revive the popular smoking culture that has taken decades to dismantle.

In April 2014, the FDA issued proposed rules to “deem” or extend its authority over tobacco products to regulate electronic cigarettes, cigars, pipe tobacco, nicotine gels, waterpipe (hookah) tobacco, and orally ingested dissolvable tobacco products. …

Not All Women Are Mothers: Addressing The Invisibility Of Women Under The Control Of The Criminal Justice System Who Do Not Have Children, Venezia Michalsen, Jeanne Flavin

Department of Justice Studies Faculty Scholarship and Creative Works

Research has consistently shown that most women under the control of the criminal justice system are mothers. The robustness of this finding has been accompanied by a failure to consider the characteristics and needs of women without children. In this study, we examine data on 1,334 formerly incarcerated women. Findings indicate that while mothers and non-mothers share some characteristics, they differ on several others, most notably demographic profile, mental health, and timing of contacts with the criminal justice system. These results suggest a need to recognize the diversity among women offender groups, particularly when developing policies and programs need.

Global Rules For Global Health: Why We Need An Independent, Impartial Who, Devi Sridhar, Julio Frenk, Lawrence O. Gostin, Suerie Moon

Georgetown Law Faculty Publications and Other Works

Over the past few years the World Health Organization (WHO) has been undergoing a significant reform process. The immediate trigger was a budget crisis in 2010 that spurred massive lay-offs at the global agency. But at a more fundamental level, deeper systematic changes in global health governance have made reform imperative. While WHO reform draws relatively little attention outside diplomatic circles in Geneva, at stake are critical issues that will impact public health everywhere. This article’s key messages are:

• Recent outbreaks of MERS highlight the need for a global response to infectious disease
• The WHO has had a crucial role …