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Full-Text Articles in Law
When Desperate Patients Go To Court For Unproven Treatments - The Battle For Hospital Independence, Christopher Robertson, Margaret Houtz
When Desperate Patients Go To Court For Unproven Treatments - The Battle For Hospital Independence, Christopher Robertson, Margaret Houtz
Faculty Scholarship
As the Covid-19 pandemic wears on, patients have asked courts to compel hospitals to administer unproven therapies, with mixed legal results. Although talk radio hosts, politicians, and social media users have promoted various treatment approaches, they have given particular attention to ivermectin. The Food and Drug Administration (FDA) has approved ivermectin for use in humans for treating onchocerciasis (river blindness), intestinal strongyloidiasis, certain other parasitic worms, head lice, and skin conditions such as rosacea. Although this approval facilitates legal offlabel use for prophylaxis against or treatment of other conditions, both the FDA and the Centers for Disease Control and Prevention …
Progress In The Fight Against Multidrug Resistant Bacteria?: A Review Of Fda-Approved Antibiotics 2010-2015, Kevin Outterson
Progress In The Fight Against Multidrug Resistant Bacteria?: A Review Of Fda-Approved Antibiotics 2010-2015, Kevin Outterson
Faculty Scholarship
A weak antibiotic pipeline and the increase in drug-resistant pathogens have led to calls for more new antibiotics. Eight new antibiotics were approved by the U.S. Food and Drug Administration (FDA) between January 2010 and December 2015: ceftaroline, fidaxomicin, bedaquiline, dalbavancin, tedizolid, oritavancin, ceftolozane-tazobactam, and ceftazidime-avibactam. This study evaluates the development course and pivotal trials of these antibiotics for their innovativeness, development process, documented patient outcomes, and cost. Data sources were FDA approval packages and databases (January 2010 to December 2015); the Red Book (Truven Health Analytics); Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations (FDA); and supplementary information …
Cancer And The Constitution: Choice At Life's End, George J. Annas
Cancer And The Constitution: Choice At Life's End, George J. Annas
Faculty Scholarship
J. M. Coetzee's violent, anti-apartheid Age of Iron, a novel the Wall Street Journal termed “a fierce pageant of modern South Africa,” is written as a letter by a retired classics professor, Mrs. Curren, to her daughter, who lives in the United States. Mrs. Curren is dying of cancer, and her daughter advises her to come to the United States for treatment. She replies, “I can't afford to die in America. . . . No one can, except Americans.” Dying of cancer has been considered a “hard death” for at least a century, unproven and even quack remedies have been …
Thalidomide And The Titanic: Reconstructing The Technology Tragedies Of The Twentieth Century, George J. Annas
Thalidomide And The Titanic: Reconstructing The Technology Tragedies Of The Twentieth Century, George J. Annas
Faculty Scholarship
The Titanic has become a metaphor for the disastrous consequences of an unqualified belief in the safety and invincibility of new technology. Similarly, the thalidomide tragedy stands for all of the "monsters" that can be inadvertently or negligently created by modern medicine. Thalidomide, once banned, has returned to the center of controversy with the Food and Drug Administration's (FDA's) announcement that thalidomide will be placed on the market for the treatment of erythema nodosum leprosum, a severe dermatological complication of Hansen's disease. Although this indication is very restricted, thalidomide will be available for off-label uses once it is on the …
A National Bill Of Patients' Rights, George J. Annas
A National Bill Of Patients' Rights, George J. Annas
Faculty Scholarship
In one of the most enthusiastically received proposals in his January State of the Union address, President Bill Clinton called on Congress to enact a national bill of rights in health care. The President said, “You have the right to know all your medical options, not just the cheapest. You have the right to choose the doctor you want for the care you need. You have the right to emergency room care, wherever and whenever you need it. You have the right to keep your medical records confidential.”
The Bell Tolls For A Constitutional Right To Physician-Assisted Suicide, George J. Annas
The Bell Tolls For A Constitutional Right To Physician-Assisted Suicide, George J. Annas
Faculty Scholarship
For Whom the Bell Tolls, Ernest Hemingway's novel about the Spanish Civil War, ends with its American hero, Robert Jordan, mortally wounded and trying to decide whether to commit suicide with a machine gun or risk capture by trying to retain consciousness long enough to cover the retreat of his comrades. Confronting his impending death, Jordan thinks, “Dying is only bad when it takes a long time and hurts so much that it humiliates you.” Hemingway, one of the most American of American writers, committed suicide with a shotgun. Most suicides in the United States are committed with guns, but …
Patients' Rights In Managed Care - Exit, Voice, And Choice, George J. Annas
Patients' Rights In Managed Care - Exit, Voice, And Choice, George J. Annas
Faculty Scholarship
The ability of consumers to complain effectively about services and products is a key ingredient of the market. In Exit, Voice, and Loyalty, economist Albert O. Hirschman argues that the ability to take one's business elsewhere may not be enough to empower consumers in markets where all providers act similarly. Instead of simply going elsewhere, consumers need to have an effective way to voice their complaints, in order to give providers an incentive to be more responsive to consumers' interests. Marc Rodwin has suggested that the Hirschman analysis may be particularly relevant to members of managed-care organizations and ``individuals with …
Reefer Madness: The Federal Response To California's Medical-Marijuana Law, George J. Annas
Reefer Madness: The Federal Response To California's Medical-Marijuana Law, George J. Annas
Faculty Scholarship
Marijuana is unique among illegal drugs in its political symbolism, its safety, and its wide use. More than 65 million Americans have tried marijuana, the use of which is not associated with increased mortality. Since the federal government first tried to tax it out of existence in 1937, at least partly in response to the 1936 film Reefer Madness, marijuana has remained at the center of controversy. Now physicians are becoming more actively involved. Most recently, the federal drug policy against any use of marijuana has been challenged by California's attempt to legalize its use by certain patients on the …
The Promised End: Constitutional Aspects Of Physician-Assisted Suicide, George J. Annas
The Promised End: Constitutional Aspects Of Physician-Assisted Suicide, George J. Annas
Faculty Scholarship
The debate over physician-assisted suicide has dramatically shifted to a discussion of constitutional issues. This spring, within a month of each other, U.S. Circuit Courts of Appeals on both coasts ruled that state prohibitions of assisted suicide are unconstitutional when applied to physicians who prescribe lethal medication for terminally ill, competent adults who wish to end their lives. The Ninth Circuit includes Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, Oregon, and Washington, and the Second Circuit includes New York, Connecticut, and Vermont. Both courts reached the same conclusion but for different legal reasons.
Adding Injustice To Injury - Compulsory Payment For Unwanted Treatment, George J. Annas
Adding Injustice To Injury - Compulsory Payment For Unwanted Treatment, George J. Annas
Faculty Scholarship
A New York court this year issued one of the most disturbing and aberrant appellate opinions of the past two decades concerning the right to refuse treatment.1 In my view, the judges ruling in Grace Plaza v. Elbaum made a series of errors: they assumed that institutions can have ethics apart from those of their physicians; they believed that both institutions and physicians are primarily motivated by money; and they approved the use of legal threats by institutions and physicians against patients and their families. In this court's idiosyncratic view, dying and medical care seem to be not about …
Risky Business: Setting Public Health Policy For Hiv-Infected Health Care Professionals, George J. Annas
Risky Business: Setting Public Health Policy For Hiv-Infected Health Care Professionals, George J. Annas
Faculty Scholarship
In JULY 1991, THE UNITED STATES SENATE VOTED 81 to 18 to impose a $10,000 fine and a ten-year jail sentence on any HTV-infected physicians who treated patients without disclosing their HIV status. Senator Jesse Helms, the sponsor of the measure, explained his rationale: “Let the punishment fit the crime. . . . I believe in horsewhipping. I feel that strongly about it” (Tolchin 1991). Later, Senator Helms wrote that HIV-infected physicians who practice medicine “should be treated no better than the criminal who guns down a helpless victim on the street” (Helms 1991). In his article he explained that …
Nancy Cruzan And The Right To Die, George J. Annas
Nancy Cruzan And The Right To Die, George J. Annas
Faculty Scholarship
[...]the majority improperly implied that continued existence and treatment in a persistent vegetative state is either beneficial or neutral, whereas in fact "an erroneous decision not to terminate life-support robs a patient of the very qualities protected by the right to avoid unwanted medical treatment... [a] degraded existence is perpetuated; his family's suffering is protracted; the memory he leaves behind becomes more and more distorted.5 " Finally, Justice Brennan argued that the Missouri rules are simply out of touch with reality; people do not write elaborate documents about all the possible ways they might die and the various interventions doctors …
The Right To Refuse Treatment: A Model Act, George J. Annas
The Right To Refuse Treatment: A Model Act, George J. Annas
Faculty Scholarship
Although the right to refuse medical treatment is universally recognized as a fundamental principle of liberty, this right is not always honored. A refusal can be thwarted either because a patient is unable to competently communicate or because providers insist on continuing treatment. To help enhance the patient's right to refuse treatment, many states have enacted so-called "living will" or "natural death" statutes. We believe the time has come to move beyond these current legislative models, and we therefore propose a Model Act that clearly enunciates an individual's right to refuse treatment, does not limit its exercise to the terminally …
The Emerging Stowaway: Patients' Rights In The 1980s, George J. Annas
The Emerging Stowaway: Patients' Rights In The 1980s, George J. Annas
Faculty Scholarship
At one point in Edgar Allan Poe's Narrative of Arthur Gordon Pyr of Nantucket, Pym, who has stowed away in the hold of a whaling vessel, believes he has been abandoned and that the hold will be his tomb. He expressed sensations of "extreme horror and dismay," and "the most gloomy imaginings, in which the dreadful deaths of thirst, famine, suffocation, and premature interment, crowded in as the prominent disasters to be encountered."
The Care Of Private Patients In Teaching Hospitals: Legal Implications, George J. Annas
The Care Of Private Patients In Teaching Hospitals: Legal Implications, George J. Annas
Faculty Scholarship
In Herman Melville's novel Moby Dick Ishmael searches for knowledge in diverse ways; he views the world not only through his senses but symbolically and metaphorically. At one point, he is tied to the pagan harpooner Queequeg by a "monkey-rope," and it is his duty to use this rope to pull Queequeg free from the sharks surrounding the dead whale that Queequeg is butchering when Queequeg slips from his perch atop the whale. Should he fail, Queequeg's weight will pull them both into the shark-filled waters. Ishmael ponders: "I seemed distinctly to perceive that my own individuality was now merged …