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Ending The War On People With Substance Use Disorders In Health Care, Kelly K. Dineen, Elizabeth Pendo Jan 2021

Ending The War On People With Substance Use Disorders In Health Care, Kelly K. Dineen, Elizabeth Pendo

All Faculty Scholarship

Earp et al. (2021) provide a robust justification for the decriminalization of drugs based on the systemic racism that fuels the “war on drugs” and the ongoing harms of drug policies to individuals. The authors’ call for decriminalization is a necessary but insufficient step in addressing the entrenched structural, institutional, and individual discrimination that leads to the inequitable and unjust treatment of people with substance use disorder (PWSUD). Nothing short of robust enforcement of existing legal protections and sweeping legal reforms in the regulation of addiction treatment, controlled substances, health care finance, and civil rights law will be adequate to ...


Disparities In Health Care: The Pandemic’S Lessons For Health Lawyers, Danielle Pelfrey Duryea, Nicole Huberfeld, Ruqaiijah Yearby Jan 2021

Disparities In Health Care: The Pandemic’S Lessons For Health Lawyers, Danielle Pelfrey Duryea, Nicole Huberfeld, Ruqaiijah Yearby

All Faculty Scholarship

Population-level disparities in health and health care came to the forefront of U.S. public consciousness in 2020. As the racial, ethnic, and socioeconomic stratification of COVID-19 infection and death rates emerged with chilling clarity, the Black Lives Matter protests of the summer focused millions of Americans on the complex, structural nature of inequity and its long-lasting effects.

Access to quality health care is a “social determinant of health,” meaning that it is one of the “non-medical factors that influence health outcomes . . . the conditions in which people are born, grow, work, live, and age, and the wider set of forces ...


Lessons Learned: Strengthening Medicaid To Address Health And Economic Emergencies, Nicole Huberfeld, Sidney Watson Jan 2021

Lessons Learned: Strengthening Medicaid To Address Health And Economic Emergencies, Nicole Huberfeld, Sidney Watson

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COVID-19 has disproportionately harmed low-income people, especially Black and Latino populations, seniors, and people with disabilities. Medicaid plays an essential role in providing coverage and access to care for these populations. As COVID-19 disrupted employment, earnings, and insurance coverage, Medicaid enrollment increased, in part because Congress offered states increased Medicaid funding in return for maintaining eligibility and enrollment for the duration of the public health emergency (PHE). At the same time, many states expanded eligibility and streamlined enrollment to assure that people could secure and keep coverage. Such policies resulted in more than 5.3 million more Americans having Medicaid ...


Covid-19, Courts, And The 'Realities Of Prison Administration.' Part Ii: The Realities Of Litigation, Chad Flanders Jan 2021

Covid-19, Courts, And The 'Realities Of Prison Administration.' Part Ii: The Realities Of Litigation, Chad Flanders

All Faculty Scholarship

Lawsuits challenging prisons and jails for not doing enough to stop the spread of COVID-19 among inmates have faced mixed results in the courts: wins at the district court level are almost always followed by losses (in the form of stays of any orders to improve conditions) at the appeals court level or at the Supreme Court. This short article tries to explain why this is happening, and makes three comparisons between how district courts and appeals courts have analyzed these lawsuits. First, district courts and appeals courts tend to emphasize different facts in their decisions. District courts focus more ...


Covid-19 Employee Health Checks, Remote Work, And Disability Law, Elizabeth Pendo Jan 2021

Covid-19 Employee Health Checks, Remote Work, And Disability Law, Elizabeth Pendo

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The Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities, about 61 million individuals in the U.S. The law’s protections in the workplace are especially important during COVID-19, which has worsened pre-existing disparities experienced by people with disabilities. The ADA also applies to new strategies to reduce the risk of COVID-19 infection in the workplace. This Chapter will focus on two strategies that impact individuals with and without disabilities – employee health screening, testing and vaccination policies, and new or expanded remote work programs.


Editor, Ethical Challenges In Discharge Planning: Stories From Patients, Elizabeth Pendo Jan 2021

Editor, Ethical Challenges In Discharge Planning: Stories From Patients, Elizabeth Pendo

All Faculty Scholarship

This symposium includes twelve personal narratives from patients and their caregivers who have navigated challenges in planning for discharge from the hospital and transition to care at home, a rehabilitation facility, long-term care facility, or hospice. Three commentaries on these narratives are also included, authored by experts and scholars in the fields of medicine, bioethics, and health policy with particular interest in vulnerable populations. The goal of this symposium is to call attention to the experiences of patients during transitions in care and to enrich discussions of ethical issues in discharge planning.


The Intellectual Property Of Covid-19, Ana Santos Rutschman Jan 2021

The Intellectual Property Of Covid-19, Ana Santos Rutschman

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The response to COVID-19 is indissolubly tied to intellectual property. In an increasingly globalized world in which infectious disease pathogens travel faster and wider than before, the development of vaccines, treatments and other forms of medical technology has become an integral part of public health preparedness and response frameworks. The development of these technologies, and to a certain extent the allocation and distribution of resulting outputs, is informed by intellectual property regimes. These regimes influence the commitment of R&D resources, shape scientific collaborations and, in some cases, may condition the widespread availability of emerging technologies. As seen throughout this ...


Intellectual Property As A Determinant Of Health, Ana Santos Rutschman Jan 2021

Intellectual Property As A Determinant Of Health, Ana Santos Rutschman

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Public health literature has long recognized the existence of determinants of health, a set of socio-economic conditions that affect health risks and health outcomes across the world. The World Health Organization defines these determinants as “forces and systems” consisting of “factors combin[ing] together to affect the health of individuals and communities.” Frameworks relying on determinants of health have been widely adopted by countries in the global South and North alike, as well as international institutional players, several of which are direct or indirect players in transnational intellectual property (IP) policymaking. Issues raised by the implementation of IP policies, however ...


Is There A Cure For Vaccine Nationalism?, Ana Santos Rutschman Jan 2021

Is There A Cure For Vaccine Nationalism?, Ana Santos Rutschman

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“[V]accine nationalism . . . should serve as a reality check for the status of global health cooperation in the twenty-first century.”


Vaccine Clinical Trials And Data Infrastructure, Ana Santos Rutschman Jan 2021

Vaccine Clinical Trials And Data Infrastructure, Ana Santos Rutschman

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We find ourselves at a momentous turn in the history of vaccines. The COVID-19 pandemic triggered a quasi-global vaccine race that not only compressed vaccine research and development (R&D) timelines, but also paved the way for the administration of a new type of vaccine technology – mRNA vaccines, which work in substantially different ways from the vaccines in use before the pandemic.

While the process of bringing emerging COVID-19 vaccines to market has taken place in an unusually short timeframe, it was largely predicated on the same scientific and regulatory processes that govern the development, approval and deployment of new ...


Systemic Racism, The Government’S Pandemic Response, And Racial Inequities In Covid-19, Ruqaiijah Yearby, Seema Mohapatra Jan 2021

Systemic Racism, The Government’S Pandemic Response, And Racial Inequities In Covid-19, Ruqaiijah Yearby, Seema Mohapatra

All Faculty Scholarship

During the COVID-19 pandemic, the federal and state governments have ignored racial and ethnic minorities’ unequal access to employment and health care that results in racial inequities in COVID-19 infections and deaths. In addition, they have enacted laws that further exacerbate these inequities. Consequently, many racial and ethnic minorities are employed in low-wage essential jobs that lack paid sick leave and health insurance. This lack of benefits causes them to go to work even when they are sick and prevents them from receiving appropriate medical treatment. As a result, racial and ethnic minorities have disproportionately been infected and died from ...


Protecting The Rights And Wellbeing Of People With Disabilities During The Covid-19 Pandemic, Elizabeth Pendo Jan 2021

Protecting The Rights And Wellbeing Of People With Disabilities During The Covid-19 Pandemic, Elizabeth Pendo

All Faculty Scholarship

The COVID-19 pandemic has exposed and exacerbated significant inequities experienced by people with disabilities. It has also emphasized the value of legal protections against discrimination based on disability. The Americans with Disabilities Act was enacted 30 years ago to eliminate discrimination against people with disabilities and ensure equal opportunity across major areas of American life (ADA, 2008). Together with an earlier law, the Rehabilitation Act of 1973 Rehabilitation Act, 2012), this landmark civil rights law impacts a broad range of issues raised by the COVID-19 pandemic and protects a large and growing number of Americans. This Chapter focuses on application ...


Gaps In Worker Protections That Increase Essential Workers’ Exposure To Covid-19, Ruqaiijah Yearby Jan 2021

Gaps In Worker Protections That Increase Essential Workers’ Exposure To Covid-19, Ruqaiijah Yearby

All Faculty Scholarship

States and localities designated more than 55 million Americans as essential workers. Essential workers not only comprise those employed by the health care and food and agriculture industry, but also include teachers, grocery store workers, transit and airline workers, mail and delivery workers, energy sector and utility workers, and domestic workers (Petition for Emergency, 2020). Racial and ethnic minorities are disproportionately employed as essential workers, with Black Americans the most likely to be essential workers (Petition for Emergency, 2020). Essential workers have been left vulnerable to workplace COVID-19 infections and deaths in large part due to the federal and state ...


FacebookʼS Latest Attempt To Address Vaccine Misinformation — And Why ItʼS Not Enough, Ana Santos Rutschman Nov 2020

FacebookʼS Latest Attempt To Address Vaccine Misinformation — And Why ItʼS Not Enough, Ana Santos Rutschman

All Faculty Scholarship

On October 13, 2020 Facebook announced the adoption of a series of measures to promote vaccine trust “while prohibiting ads with misinformation that could harm public health efforts.” In the post written by Kang-Xing Jin (head of health) and Rob Leathern (director of product management), the company explained that the new measures were designed with an emphasis on encouraging widespread use of this yearʼs flu vaccine, as well as in anticipation of potential COVID-19 vaccines becoming available in the near future.

The changes focus mainly on the establishment of a multiprong informational campaign about the seasonal flu vaccine, which includes ...


Resolving Tensions Between Disability Rights Law And Covid-19 Mask Policies, Elizabeth Pendo, Robert Gatter, Seema Mohapatra Jul 2020

Resolving Tensions Between Disability Rights Law And Covid-19 Mask Policies, Elizabeth Pendo, Robert Gatter, Seema Mohapatra

All Faculty Scholarship

As states reopen, an increasing number of state and local officials are requiring people to wear face masks while out of the home. Grocery stores, retail outlets, restaurants and other businesses are also announcing their own mask policies, which may differ from public policies. Public health measures to stop the spread of the coronavirus such as wearing masks have the potential to greatly benefit millions of Americans with disabilities, who are particularly vulnerable to the impact of COVID-19. But certain disabilities may make it difficult or inadvisable to wear a mask.

Mask-wearing has become a political flashpoint, putting people with ...


The Importance Of Standardized Data Collection And Reporting In Improving Medical Care For Immigration Detainees, Allison Michelle Bowen Jun 2020

The Importance Of Standardized Data Collection And Reporting In Improving Medical Care For Immigration Detainees, Allison Michelle Bowen

Saint Louis University Journal of Health Law & Policy

The provision of substandard medical care for immigration detainees has become somewhat of a norm for some time now. From October 1, 2003 to June 5, 2017, alone, there were a total of 172 deaths in ICE custody. This number is only rising as the number of detainee beds increases and ICE continues to not be held accountable. Presently, there lacks a mechanism for oversight and accountability of ICE. This Comment suggests that requiring standardized data collection and reporting efforts is a crucial first step towards improving the medical care for immigration detainees and creating a mechanism for oversight and ...


Table Of Contents Jun 2020

Table Of Contents

Saint Louis University Journal of Health Law & Policy

No abstract provided.


Damage Control Interdisciplinarity: An Antidote To Death Despair In Military Medicine, Erika "Ann" Jeschke Jun 2020

Damage Control Interdisciplinarity: An Antidote To Death Despair In Military Medicine, Erika "Ann" Jeschke

Saint Louis University Journal of Health Law & Policy

“Diseases of despair” is a conceptually broad category used to describe the phenomenon of premature mortality caused by suicide, drug poisoning, and alcoholic liver disease. Central to this conceptualization of mortality is that death occurs too early in an entire population of individuals infected with social despair. Implicit in the diseases of despair construct is a powerful normative claim about the manner and time of death—that death is bad if it is contextualized in unwanted conditions and happens before reaching midlife. As such, diseases of despair ought to be reduced, if not eliminated. Interestingly, military medical research on combat ...


Masthead Jun 2020

Masthead

Saint Louis University Journal of Health Law & Policy

No abstract provided.


An Argument For Explicit Public Health Rationale In Lgbtq Antidiscrimination Law As A Tool For Stigma Reduction, Heather A. Walter-Mccabe, M. Killian Kinney Jun 2020

An Argument For Explicit Public Health Rationale In Lgbtq Antidiscrimination Law As A Tool For Stigma Reduction, Heather A. Walter-Mccabe, M. Killian Kinney

Saint Louis University Journal of Health Law & Policy

The lesbian, gay, bisexual, transgender (inclusive of nonbinary), and queer (collectively, LGBTQ) community is experiencing health inequities at alarming rates. From behavioral health issues, to violence issues, to increased rates of homelessness, structural stigma impacts LGBTQ communities at a disproportionate rate. Suicide numbers are particularly concerning. The LGB community rate of suicide is two to three times that of the general population. For the transgender and nonbinary community, that number soars to nearly nine times that of the general population. In this article, we examine the social determinates of health impacting the LGBTQ community and the ways structural stigma supports ...


#Metoo Meets The Emergency Room: Providing And Paying For Care After A Sexual Assault, Stacey L. Worthy, Shruti R. Kulkarni, Taylor J. Kelly, Jessica Johnson Jun 2020

#Metoo Meets The Emergency Room: Providing And Paying For Care After A Sexual Assault, Stacey L. Worthy, Shruti R. Kulkarni, Taylor J. Kelly, Jessica Johnson

Saint Louis University Journal of Health Law & Policy

Sexual assault continues to be a major public health problem in the United States. Compounding the problem, survivors of sexual assault all too often face challenges of obtaining and paying for sexual assault forensic exams (SAFEs), commonly referred to as a “rape kit,” and related medical services. Sexual assault survivors who do seek medical care in the emergency department (ED) are often turned away for several reasons, such as EDs determining that sexual assault is not an emergency medical condition, failing to carry SAFEs, or refusing to treat survivors who lack proof of insurance. Denial of care can further traumatize ...


A Practical Policy Proposal To Solve The Rural Hospital Puzzle, Brandon M. Hall Jun 2020

A Practical Policy Proposal To Solve The Rural Hospital Puzzle, Brandon M. Hall

Saint Louis University Journal of Health Law & Policy

Since the 1980s, waves of rural hospital closures have intermittently plagued the U.S. health care landscape. Although the Affordable Care Act and its expansion of Medicaid have provided a vital lifeline to rural hospitals over the last decade, policy makers have yet to implement a permanent solution powerful enough to stabilize and offset the institutional and populational constraints that have promulgated the widespread hospital closure crisis plaguing rural communities.

This article argues that rural hospitals need to repurpose themselves to better serve the demands of their patient populations in order to survive the unique demographic and economic challenges they ...


Taking The Politics Out Of Vaccines: Increasing Vaccination Rates Without Repealing Exemptions, Kylie A. Thompson Jun 2020

Taking The Politics Out Of Vaccines: Increasing Vaccination Rates Without Repealing Exemptions, Kylie A. Thompson

Saint Louis University Journal of Health Law & Policy

Vaccinations have become a vital part of disease prevention and public health; however, they remain a controversial topic in our society today. Non-medical exemptions to mandatory vaccination laws are the core of most of the controversy surrounding vaccinations. This Comment examines the controversy surrounding vaccinations and proposes interventions communities can adopt to increase vaccination rates without repealing non-medical exemptions to mandatory vaccination laws.


Table Of Contents Jan 2020

Table Of Contents

Saint Louis University Journal of Health Law & Policy

No abstract provided.


Masthead Jan 2020

Masthead

Saint Louis University Journal of Health Law & Policy

No abstract provided.


Supporting Employee Lactation: Do U.S. Workplace Lactation Benefit Mandates Align With Evidence-Based Practice?, Candice L. Thomas, Lauren D. Murphy, Drake Van Egdom, Haley R. Cobb Jan 2020

Supporting Employee Lactation: Do U.S. Workplace Lactation Benefit Mandates Align With Evidence-Based Practice?, Candice L. Thomas, Lauren D. Murphy, Drake Van Egdom, Haley R. Cobb

Saint Louis University Journal of Health Law & Policy

Within the United States, there are governmental benefits and policies in place to support breastfeeding mothers as they return to work. However, the effectiveness and inclusiveness of these policies is not always clear. Because of this, breastfeeding at work, in general, and governmental workplace mandates, specifically, often receive negative press and social media attention as women struggle to reconcile their workplace and lactation demands. To provide evidence-based recommendations for how to best support breastfeeding employees, we use an organizational science perspective to review the existing research for evidence on the (1) effectiveness of the existing legal benefits and supports within ...


Costs Vs. Compensation: Legal And Policy Recommendations For Addressing Workplace Sexual Harassment, Heather Mclaughlin, Christine Thomas Jan 2020

Costs Vs. Compensation: Legal And Policy Recommendations For Addressing Workplace Sexual Harassment, Heather Mclaughlin, Christine Thomas

Saint Louis University Journal of Health Law & Policy

The recent #MeToo Movement has unequivocally shown that workplace sexual harassment is a widespread issue. Since December 2017, workers around the globe have shared personal stories of sexual harassment, as well as the tolls it caused on their health and careers. In this Article, we review extant interdisciplinary research on the negative consequences of sexual harassment for workers’ physical, psychological, and behavioral health; their career and earnings trajectories; and for broader organizational culture. Understanding these costs sheds light on how best to reduce and respond to workplace sexual harassment. We offer three suggestions for law and policy: (1) expand legal ...


Expanding Patient Access To Breast Cancer Genetic Testing Through Incentive Regimes, Megan K. Hart Jan 2020

Expanding Patient Access To Breast Cancer Genetic Testing Through Incentive Regimes, Megan K. Hart

Saint Louis University Journal of Health Law & Policy

It is estimated that 268,600 women were diagnosed with breast cancer in 2019 alone, and as many as 26,860 of these women could have developed breast cancer due to a genetic disposition.[1] While over one million women have undergone genetic testing to identify variations in the BRCA1 and BRCA2 genes, the test results are often ambiguous due to identified variations for which the breast cancer development risk is unknown.[2] A new technology known as CRISPR has the potential to change this state of uncertainty due to its capability to identify thousands of BRCA1 and 2 gene ...


The Legal And Ethical Considerations Of The Posthumous Retrieval Of Gametes, Patrick Monahan Jan 2020

The Legal And Ethical Considerations Of The Posthumous Retrieval Of Gametes, Patrick Monahan

Saint Louis University Journal of Health Law & Policy

In the United States, federal and state laws on the issue of posthumous retrieval of gametes are almost non-existent. As the field of medicine continues to grow and more posthumous gamete retrieval procedures become viable, state courts and hospitals are left on their own when patients and family members ask their doctors to perform such procedures. As such, there exists wide variability from hospital to hospital and state to state for a deeply personal and time-sensitive procedure. By reviewing state court cases and hospital policies, this article demonstrates the variability between practices and illustrates key questions that arise when requests ...


Introduction, Ruqaiijah Yearby Jan 2020

Introduction, Ruqaiijah Yearby

Saint Louis University Journal of Health Law & Policy

No abstract provided.