Law Commons^™

Tribal Water Rights And Tribal Health: The Klamath Tribes And The Navajo Nation During The Covid-19 Pandemic, Robin Kundis Craig

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Centering Racial Equity: Disparities Task Forces As A Strategy To Ensure An Equitable Pandemic Response, Dawn M. Hunter, Betsy Lawton

Saint Louis University Journal of Health Law & Policy

COVID-19 has had a stark and severe impact on health, economic stability, housing, and education in communities of color in the United States. As the pandemic has unfolded, the disproportionate number of cases, hospitalizations, and deaths due to COVID-19 among Black, Hispanic and Latinx, and Indigenous people has served as a stark reminder that the systems and structures that lead to these disparities need to be changed in order to achieve equitable outcomes.

This Article assesses efforts by cities, counties, states, and organizations to address the impact of COVID-19 on communities of color through formal task forces or working groups …

Racism, Health Equity, And Crisis Standards Of Care In The Covid-19 Pandemic, Charlene Galarneau, Ruqaiijah Yearby

Saint Louis University Journal of Health Law & Policy

Long-standing and deeply embedded institutional racism, notably anti-Black racism in U.S. health care, has provided a solid footing for the health inequities by race evident in the COVID-19 pandemic. Inequities in susceptibility, exposure, infection, hospitalization, and treatment reflect and reinforce this racism and cause incalculable and preventable suffering in and loss of Black lives. This Article identifies multiple expressions of racism evident in the crisis standards of care (CSC) created by states and health care institutions to guide the ethical allocation of scarce critical care resources including ventilators. Contextualized within the broad landscape of health inequities pre-COVID-19 as well as …

Seeking Safety While Giving Birth During The Pandemic, Elizabeth Kukura

Saint Louis University Journal of Health Law & Policy

As COVID-19 spread throughout the United States in early 2020, many pregnant people sought alternatives to delivering in a hospital. Midwifery practices offering services at home or in a freestanding birth center reported record numbers of inquiries, including from people looking to transfer care near the end of pregnancy. Whether due to fear of COVID-19 exposure in health care settings or out of a desire to avoid restrictive hospital policies regarding support people and newborn separation, people who had not previously considered home birth were newly drawn to midwifery care and others who had considered a midwife-attended birth redoubled their …

Disability, Access, And Other Considerations: A Title Ii Framework For A Pandemic Crisis Response (Covid-19), George M. Powers, Lex Frieden, Vinh Nguyen

Saint Louis University Journal of Health Law & Policy

This Article examines how plans for emergency medical rationing during the COVID-19 pandemic may discriminate against those with disabilities. More specifically, this Article lays out the obligation of state and local governments under Title II of the ADA in creating and enforcing equitable and fair rationing plans during this COVID-19 crisis. For example, ventilator shortages are a common occurrence. The ADA, similar to other civil rights laws, operates so that a person with a disability is not denied a ventilator or other resources because of his/her disability. One reason that a person with a disability may be denied limited medical …

Skirting The Law: Medicaid Block Grants And Per-Capita Caps In A Pandemic, Laura D. Hermer

Saint Louis University Journal of Health Law & Policy

To what extent can an administration abridge Medicaid’s entitlement status by administrative fiat? In the final year of the Trump administration, just before the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) sought to push the outer bounds of this question by announcing the Healthy Adult Opportunity (HAO) initiative. It invited states to submit § 1115 demonstration applications to cover individuals not eligible for Medicaid benefits under the state’s Medicaid plan—meaning, in many cases, the Affordable Care Act’s (ACA’s) Medicaid expansion population. Spending on those populations would be capped, not by purporting to waive federal law regarding matching …

Finding The Cluster: Balancing Privacy And Public Health Amid The Covid-19 Pandemic, Jessie L. Bekker

Saint Louis University Journal of Health Law & Policy

More than 800,000 Americans have died and more than fifty-seven million sickened since March 2020 from the COVID-19 virus and its highly contagious variants. Public health officials urged the public to mask up, socially distance, and stay home in order to curb the virus’ spread in the early months of the pandemic before a vaccine was approved. Meanwhile, those same officials blocked access to valuable information pinpointing areas of disease concentration—“hotspots”—which could have alerted members of the public of locations to avoid. Those officials generally—and usually incorrectly—cited the Health Insurance Portability and Accountability Act (HIPAA) as grounds for …

The Urban Trauma Drama: The Intersecting Path Of Criminal Justice And Public Health Revealed During The Covid-19 Pandemic, José Felipé Anderson

Saint Louis University Journal of Health Law & Policy

Our society often operates under the delusion that more incarceration in urban areas will make us safer. Crowded cities and the problems for its inhabitants are not new. Those problems often fall more heavily on minority groups. Failed education, healthcare unavailability, and a lack of decent housing have made it difficult for cities to cope with addiction and crime. The COVID-19 pandemic has made the issues in the criminal system harder to ignore. Decline of major manufacturing jobs in cities like the steel and auto industries removed key opportunities for those seeking to overcome poverty and raise families. Debilitating riots …

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 …

Social Media Self-Regulation And The Rise Of Vaccine Misinformation, Ana Santos Rutschman

All Faculty Scholarship

This essay examines the main characteristics and shortcomings of mainstream social media responses to vaccine misinformation and disinformation. Parts I and II contextualize the recent expansion of vaccine information and disinformation in the online environment. Part III provides a survey and taxonomy of ongoing responses to vaccine misinformation adopted by mainstream social media. It further notes the limitations of current self-regulatory modes and illustrates these limitations by presenting a short case study on Facebook—the largest social media vehicle for vaccine-specific misinformation, currently estimated to harbor approximately half of the social media accounts linked to vaccine misinformation. Part IV examines potential …

Meat Processing Workers And The Covid-19 Pandemic: The Subrogation Of People, Public Health, And Ethics To Profits And A Path Forward, Kelly K. Dineen

Saint Louis University Journal of Health Law & Policy

The COVID-19 pandemic has highlighted and exacerbated existing health injustices. People who are Latino/Latinx, Black, Indigenous or members of other minority groups have disproportionately paid with their very lives. The pandemic has also exposed the complex interdependence of worker health and well-being, community health, and economic security. Industries like meat processing facilities—with congregate and high-density workplaces staffed by workers who are already disadvantaged by structural discrimination—must reckon with decades of subrogation and exploitation of workers. During this pandemic, the industry has pushed that exploitation to a point of no return. Policies to protect workers need a reset to an orientation …

The Problem With Relying On Profit-Driven Models To Produce Pandemic Drugs, Ana Santos Rutschman

All Faculty Scholarship

The longstanding problems of relying on a market response to a pandemic are becoming readily apparent in the United States, which has quickly become the epicenter of the COVID-19 outbreak. The problems are particularly pronounced in pharmaceutical markets, where we are pinning our hopes for both cures and vaccines. In previous work we have shown how characteristics of healthcare markets in the United States create a divergence between the private incentives of for-profit companies and public health needs, leading to sub-optimal health outcomes in what is a uniquely market-driven healthcare system. In this Essay, written as the COVID-19 pandemic unfolds, …

Mapping Misinformation In The Coronavirus Outbreak, Ana Santos Rutschman

All Faculty Scholarship

The coronavirus outbreak has sent ripples of fear and confusion across the world. These sentiments—and our collective responses to the outbreak—are made worse by rampant misinformation surrounding the new strain of the virus, COVID-2019. In this post, I survey some of the most pervasive areas of tentacular coronavirus-related misinformation that has proliferated online -- as well as the responses of social media companies like YouTube, Facebook, Pinterest and TikTok that may ultimately prove inadequate given the magnitude of the problem.

Comments On The Preliminary Framework For Equitable Allocation Of Covid-19 Vaccine, Ana Santos Rutschman, Julia Barnes-Weise, Robert Gatter, Timothy L. Wiemken

All Faculty Scholarship

On September 1, 2020 the National Academies released a draft framework for Equitable Allocation of a COVID-19 Vaccine. In this response, we analyze the proposed framework and highlight several areas.

Among the proposed changes, we highlight the need for the following interventions. The final framework for distribution of COVID-19 vaccines should give a higher priority to populations made most vulnerable by the social determinants of health. It should incorporate more geography-based approaches in at least some of the four proposed phases of vaccine distribution. It should address the possibility of a vaccine being made available through an emergency use authorization …

Reviving Focused Scrutiny In The Constitutional Review Of Public Health Measures, Robert Gatter

All Faculty Scholarship

This article re-examines the "focused scrutiny" standard proposed by Prof. Scott Burris in 1989 and argues for its application particularly during an infectious disease emergency such as the COVID-19 pandemic. Focused scrutiny seeks to tie judicial review of the constitutionality of public health measures closely to the facts of the particular disease and to evidence of the efficacy of each governmental action to prevent the spread of that disease, even when courts adopt rational basis testing.

Protecting The Rights Of People With Disabilities, Elizabeth Pendo

All Faculty Scholarship

One in four Americans — a diverse group of 61 million people — experience some form of disability (Okoro, 2018). On average, people with disabilities experience significant disparities in education, employment, poverty, access to health care, food security, housing, transportation, and exposure to crime and domestic violence (Pendo & Iezzoni, 2019). Intersections with demographic characteristics such as race, ethnicity, gender, and LGBT status, may intensify certain inequities. For example, women with disability experience greater disparities in income, education, and employment (Nosek, 2016), and members of under-served racial and ethnic groups with disabilities experience greater disparities in health status and access …

Medicaid's Vital Role In Addressing Health And Economic Emergencies, Nicole Huberfeld, Sidney Watson

All Faculty Scholarship

Medicaid plays an essential role in helping states respond to crises. Medicaid guarantees federal matching funds to states, which helps with unanticipated costs associated with public health emergencies, like COVID-19, and increases in enrollment that inevitably occur during times of economic downturn. Medicaid’s joint federal/state structure, called cooperative federalism, gives states significant flexibility within federal rules that allows states to streamline eligibility and expand benefits, which is especially important during emergencies. Federal emergency declarations give the secretary of Health and Human Services temporary authority to exercise regulatory flexibility to ensure that sufficient health care is available to meet the needs …

Center For Progressive Reform Report: Protecting Workers In A Pandemic--What The Federal Government Should Be Doing, Thomas Mcgarity, Michael C. Duff, Sidney A. Shapiro

All Faculty Scholarship

The "re-opening" of the American economy while the coronavirus that causes COVID-19 is still circulating puts workers at heightened risk of contracting the deadly virus. In some blue-collar industries, the risk is particularly acute because of the inherent nature of the work itself and of the workplaces in which it is conducted. And the risk, for a variety of reasons, falls disproportionately on people of color and low-income workers. With governors stay-at-home orders and other pandemic safety restrictions, Center for Progressive Reform Member Scholars Thomas McGarity, Michael Duff, and Sidney Shapiro examine the federal government's many missed opportunities to stem …

Substance Use Disorder, Discrimination, And The Cares Act: Using Disability Law To Strengthen New Protections, Kelly K. Dineen, Elizabeth Pendo

All Faculty Scholarship

The COVID-19 pandemic is having devastating consequences for people with substance use disorders (SUD). SUD is a chronic health condition—like people with other chronic health conditions, people with SUD experience periods of remission and periods of exacerbation and relapse. Unlike people with most other chronic conditions, people with SUD who experience a relapse may face criminal charges and incarceration. They are chronically disadvantaged by pervasive social stigma, discrimination, and structural inequities. People with SUD are also at higher risk for both contracting the SARS-CoV-19 virus and experiencing poorer outcomes. Meanwhile, there are early indications that pandemic conditions have led to …

The Reemergence Of Vaccine Nationalism, Ana Santos Rutschman

All Faculty Scholarship

This short essay explores the reemergence of vaccine nationalism during the COVID-19 pandemic. The essay traces the pre-COVID origins of vaccine nationalism and explains how it can have detrimental effects on equitable access to newly developed vaccines.

Ip Preparedness For Outbreak Diseases, Ana Santos Rutschman

All Faculty Scholarship

Outbreaks of infectious diseases will worsen, as illustrated by the recent back-to-back Ebola and Zika epidemics. The development of innovative drugs, especially in the form of vaccines, is key to minimizing future outbreaks, yet current intellectual property (IP) regimes are ineffective in supporting this goal.

IP scholarship has not adequately addressed the role of IP in the development of vaccines for outbreak diseases. This Article fills that void. Through case studies on the recent Ebola and Zika outbreaks, it provides the first descriptive analysis of the role of IP from the pre- to the post-outbreak stages, specifically identifying IP inefficiencies. …

Ebola, Quarantine, And Flawed Cdc Policy, Robert Gatter

All Faculty Scholarship

The CDC’s Interim Guidance for Monitoring and Movements of Persons with Potential Ebola Virus Exposure is deeply flawed because it disregards the science of Ebola transmission. It recommends that officials quarantine individuals exposed to the virus but who do not have any symptoms of illness, ignoring the fact that only those with Ebola symptoms can communicate the virus to others. Consequently, any quarantine order based on the Guidelines is surely unconstitutional and illegal under most states’ public health statutes — as exemplified by the State of Maine’s failed petition to quarantine Nurse Kaci Hickox in October 2014. This article examines …

Mobile Medical App Regulation: Preventing A Pandemic Of “Mobilechondriacs”, Nathaniel R. Carroll

Saint Louis University Journal of Health Law & Policy

No abstract provided.

The Ongoing And Iterative Task Of Pandemic Preparedness, Robert Gatter

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Reflections On Preparedness: Pandemic Planning In The Bush Administration, Stewart Simonson

Saint Louis University Journal of Health Law & Policy

No abstract provided.