Health Law and Policy Commons^™

Mandatory Hiv Testing Of Accused Rapists: Whose Rights Are We Protecting? An Ethical And Legal Analysis, Melissa S. Iotti

Richmond Public Interest Law Review

At times, the law appears confusing and unfair. Criminal defendants receive the strictest of all standards of review: "guilt beyond a reasonable doubt." But why are the accused afforded greater constitutional protections than the victim? One reason may be found by examining the intent of the authors of the United States Constitution. Our founding fathers wanted Americans to escape the kind of persecution suffered under English rule. From its inception, the Constitution and the laws that followed were based on public policy and ethics. This legal precedence is used to interpret new laws. However, because of precedence, laws often do …

Keeping Pace: A New Paradigm For The Ethical Use Of Medical Technology, Kay Ely-Pierce

Richmond Public Interest Law Review

Advances in health care technology have forged a mighty sword in the ongoing battle against illness and death. That sword, however, is doubleedged and unfortunately has not been presented with guidance for its judicious use. Our health care system provides the technological power to prolong life, or perhaps more accurately to "sustain bodily functions" indefinitely, yet it has not compelled us, as a society, to seriously ask, "should we?" And, if we should, "when and for whom, and under what circumstances?" This is the ethical legacy of health care in the 20th century. There is but a short time to …

Complexities In Biomedical Decision Making, George P. Smith Ii

Richmond Public Interest Law Review

A central focus of medical ethics is directed toward an effort to not only decide, but to make explicit what those duties are or should be for all physicians. The particulars will, of course, fluctuate according to different social structures, differing views of medicine, health, and cure, as well as different capabilities. In a word, medical ethics is situational. One view postulates that medical ethics is essentially ordinary ethics--but applied to medicine. Another view recognizes two elements: dilemma ethics and virtue ethics. Dilemma ethics concerns itself with the moral rightness or wrongness of human actions. Virtue ethics refers to the …

Ethical Justifications For Voluntary Active Euthanasia, Bernadette Spina

Richmond Public Interest Law Review

The topic of euthanasia gives rise to a host of ethical questions including those regarding the quality of life, beneficence, and the responsibilities of physicians toward their patients. While there are many kinds of cases in which euthanasia may be considered, such as those involving severely handicapped newborns and patients with debilitating but not fatal conditions, this paper focuses on the situation of late-state terminally ill patients who are suffering and want active euthanasia as an option for ending their pain. This paper explains why, under such circumstances, voluntary active euthanasia may be ethically justified. Active and passive euthanasia are …

Medical Records On-Line: What Happened To Privacy? A Legal Analysis, Marcia Weiss

Richmond Public Interest Law Review

The computerization of health information and medical records, including sensitive personal information that potentially reveals intimate details of one's life, habits, or genetic predisposition, is a mixed blessing. While offering a means of streamlining and improving the health care delivery system through speed and immense storage capacity, computerized medical information also presents new challenges as it impacts our right of privacy and expectation of confidentiality, creating serious ethical and legal issues. Non-uniform, patchwork statutory guidelines among the states have led to uncertainty and confusion surrounding disclosure, accessibility, and storage of medical data. This paper examines the legal ramifications surrounding issues …

Liver Transplant Dilemma: The Alcoholic, Medicaid Patient, Vanessa Williamson

Richmond Public Interest Law Review

A case scenario on Ivan Bradford. Ivan is a fifty-five year old, white male in need of a liver transplant. Ivan has been an alcoholic since he was thirty-two years old, and has developed an irreversible advanced liver disease, cirrhosis. In essence, the disease is the end result in scarring of the liver due to prolonged alcohol abuse. This scarring prevents the liver from performing many of its vital functions. Without a liver transplant Ivan will die.

The Gift Of Life:Ethical And Social Consequences Of Organ Donation, Michelle Wong

Richmond Public Interest Law Review

Organ transplantation is a comprehensive subject covering many different issues: medical, social, political and economic. This paper focuses on the ethical and social implications of organ donation. Also presented are the different policy and program options attempting to meet the immense demand for donors. Part I addresses an initial obstacle to organ transplantation-- consent. Part II describes the ethical conflicts related to donor sources. Part III examines possible transplant policy solutions and the potential ramifications of their implementation. Part IV concludes with suggestions for future solutions and a recommendation for an effective policy which can increase the organ donor supply, …

Blood As A Biological "Drug": Scientific, Legal, And Policy Issues In The Regulation Of Placental And Umbilical Cord Stem Cell Transplantation, Jennifer Kulynych

University of Richmond Law Review

Not all blood cells are created equal. Some are born, carry out their appointed tasks-red blood cells oxygenating the blood, white blood cells fighting infection-and die. But an elusive subset have special properties: they are the progenitors of all the many types of peripheral (circulatory) blood cells, and as such, they have the potential to reconstitute an entire blood supply. Known as hematopoietic stem cells, these blood cells reproduce indefinitely. For patients with leukemia or other blood diseases, the transplantation of hematopoietic stem cells from another person's bone marrow can provide the gift of life.

Leaving The Door Ajar: The Supreme Court And Assisted Suicide, Melvin I. Urofsky

University of Richmond Law Review

In June, 1997, the Supreme Court ruled that a constitutional right to assisted suicide exists in neither the Due Process nor the Equal Protection Clauses of the Fourteenth Amendment. But while a federal right does not exist, the Court made it quite clear that the states had ample leeway in which to fashion law on this issue; moreover, the concurring opinions of five Justices strongly implied that, should the states enact legislation that would severely limit end-of-life choices, the Supreme Court would revisit the issue. Far from slamming the door shut on assisted suicide, the Court left it more than …

When Species Collide: An Analysis Of The Use Of Anencephalic Infants And Non-Human Animals As Organ Donors, Mary Ann Palese Chandler

Richmond Journal of Law and the Public Interest

This article examines the organ transplant problem with a focus on these two potential sources. Part II exposes the problem which, simply stated, is that a serious shortage of transplantable organs makes identification of new sources of donor organs a necessity. Part III deals with the anencephalic infant as a source of organs. It discusses the nature of this fatal birth defect, the manner in which these infants have been dealt with in the past, and how they are treated today. The article goes on to discuss why these infants may be a valuable potential source of organs for pediatric …

Keeping Pace: A New Paradigm For The Ethical Use Of Medical Technology, Kay Ely-Pierce

Richmond Journal of Law and the Public Interest

Advances in health care technology have forged a mighty sword in the ongoing battle against illness and death. That sword, however, is doubleedged and unfortunately has not been presented with guidance for its judicious use. Our health care system provides the technological power to prolong life, or perhaps more accurately to "sustain bodily functions" indefinitely, yet it has not compelled us, as a society, to seriously ask, "should we?" And, if we should, "when and for whom, and under what circumstances?" This is the ethical legacy of health care in the 20th century. There is but a short time to …

Complexities In Biomedical Decision Making, George P. Smith Ii

Richmond Journal of Law and the Public Interest

A central focus of medical ethics is directed toward an effort to not only decide, but to make explicit what those duties are or should be for all physicians. The particulars will, of course, fluctuate according to different social structures, differing views of medicine, health, and cure, as well as different capabilities. In a word, medical ethics is situational. One view postulates that medical ethics is essentially ordinary ethics--but applied to medicine. Another view recognizes two elements: dilemma ethics and virtue ethics. Dilemma ethics concerns itself with the moral rightness or wrongness of human actions. Virtue ethics refers to the …

Medical Records On-Line: What Happened To Privacy? A Legal Analysis, Marcia Weiss

Richmond Journal of Law and the Public Interest

The computerization of health information and medical records, including sensitive personal information that potentially reveals intimate details of one's life, habits, or genetic predisposition, is a mixed blessing. While offering a means of streamlining and improving the health care delivery system through speed and immense storage capacity, computerized medical information also presents new challenges as it impacts our right of privacy and expectation of confidentiality, creating serious ethical and legal issues. Non-uniform, patchwork statutory guidelines among the states have led to uncertainty and confusion surrounding disclosure, accessibility, and storage of medical data. This paper examines the legal ramifications surrounding issues …

Liver Transplant Dilemma: The Alcoholic, Medicaid Patient, Vanessa Williamson

Richmond Journal of Law and the Public Interest

A case scenario on Ivan Bradford. Ivan is a fifty-five year old, white male in need of a liver transplant. Ivan has been an alcoholic since he was thirty-two years old, and has developed an irreversible advanced liver disease, cirrhosis. In essence, the disease is the end result in scarring of the liver due to prolonged alcohol abuse. This scarring prevents the liver from performing many of its vital functions. Without a liver transplant Ivan will die.

The Gift Of Life:Ethical And Social Consequences Of Organ Donation, Michelle Wong

Richmond Journal of Law and the Public Interest

Organ transplantation is a comprehensive subject covering many different issues: medical, social, political and economic. This paper focuses on the ethical and social implications of organ donation. Also presented are the different policy and program options attempting to meet the immense demand for donors. Part I addresses an initial obstacle to organ transplantation-- consent. Part II describes the ethical conflicts related to donor sources. Part III examines possible transplant policy solutions and the potential ramifications of their implementation. Part IV concludes with suggestions for future solutions and a recommendation for an effective policy which can increase the organ donor supply, …

Medicaid Eligibility Planning For Aged Clients In Virginia, Jonathan D. Frieden

University of Richmond Law Review

The Medicaid program is a jointly financed federal and state assistance program established under Title XIX of the Social Security Act of 1965. The purpose of the program is to provide "federal financial assistance to States that choose to reimburse certain costs of medical treatment for needy persons." The Medicaid program's federal statutory and regulatory framework was described by Justice Powell of the United States Supreme Court as "among the most intricate ever drafted by Congress." Justice Powell added that the Act's "Byzantine construction... makes [it] 'almost unintelligible to the uninitiated." To add to these already significant difficulties, each state …

Patient-Psychotherapist Privilege: Acces To Clinical Records In The Tangled Web Of Repressed Memory Litigation, Elizabeth F. Loftus, John R. Paddock, Thomas F. Guernsey

University of Richmond Law Review

The 1990s promise to be an era of mental health litigation whose outcomes that some predict will dwarf the settlements awarded recently in lawsuits over sexual improprieties between psychotherapists and their patients. One expert estimates that over 17,000 claims will be filed in the next decade, with litigation costs in excess of $250 million. These new cases emerged as therapy patients began to accuse fathers and mothers, uncles and grandfathers, former neighbors and teachers, psychotherapists and countless others of sexually abusing them years ago.

Paying Physicians More To Do Less: Financial Incentives To Limit Care, David Orentlicher

University of Richmond Law Review

As the explosion in health care costs has led to serious ef- forts at cost containment, concerns have been raised that some of the methods used to contain costs may cause more harm than good. In particular, many commentators have criticized the practice of giving physicians personal financial incentives to limit the provision of care to their patients. These critics have argued that, if physicians are paid more to do less, patients will suffer harm from undertreated illness, and patient trust in the patient-physician relationship will be seriously compromised. Accordingly, it is argued, financial incentives for physicians to limit care …

Looking For A Nonlegal Process: Physician-Assisted Suicide And The Care Perspective, Paul J. Zwier

University of Richmond Law Review

One of the many benefits of an interdisciplinary seminar like the Allen Chair-sponsored Bioethics seminar held at the University of Richmond Law School in 1995 was that members of the seminar had the opportunity to study the effects of the legal system's attempt to regulate bioethical issues. No question proved more troubling for the seminar than the question of physician-assisted suicide. Seminar participants, both members of the class and speakers, divided deeply on the legality of physician-assisted suicide, and for good reason. The discussions started with court decisions that were found to be both divisive and unsatisfactory. A number of …

Choices For A Child: An Ethical And Legal Analysis Of A Failed Surrogate Birth Contract, Adam Marshall

University of Richmond Law Review

In today's world of increasingly sophisticated reproductive technologies which offer once infertile couples the chance to have their own child, one wonders what wisdom King Solomon would provide in a conflict involving a woman hired to bear another couple's child. This paper explores such a situation.

The Legalization Of Physician-Assisted Suicide: Creating A Regulatory Potemkin Village, Daniel Callahan, Margot White

University of Richmond Law Review

Over the past two decades, both professional and lay opinion have shown a markedly favorable shift toward the legalization of euthanasia and physician-assisted suicide (PAS). Yet the translation of that support into legislation has come more slowly. Only in 1994, after the failure in some states to enact legislation and the defeat of ballot initiatives in California in 1991 and Washington in 1992, did an initiative finally succeed in Oregon. Although a court injunction has prevented it from taking effect, the fact of its passage marks an historical milestone. Among Western countries, euthanasia and PAS are legally available only in …

Medical Use Of Marijuana: Legal And Ethical Conflicts In The Patient/Physician Relationship, Matthew W. Grey

University of Richmond Law Review

Kenneth Jenks was born a hemophiliac, inheriting the condi- tion from his mother. He contracted the HIV virus from a blood transfusion in 1980 and unknowingly passed the virus to his wife, Barbara Jenks. Mrs. Jenks was the first to suffer the effects of the illness. Her weight dropped by nearly forty pounds in three weeks due to constant debilitating nausea, and she was repeatedly hospitalized for two- to three-week stretches. Mrs. Jenks tried a half-dozen different oral medications for nausea to no avail, and could not function after shots for nausea left her in a stupor. Mr. Jenks experienced …

Special Issues In Bioethics And The Law, Alexander Morgan Capron, Elizabeth Loftus, David Orentlicher, Daniel Callahan

University of Richmond Law Review Symposium

"Genetics and Insurance Discrimination" lecture given by Alexander Morgan Capron, Henry W. Bruce University Professor of Law and Medicine, Co-Director of the Pacific Center for Health Policy and Ethics at University of Southern California.

"The Repression of Memory Controversy" lecture given by Elizabeth Loftus, Professor of Psychology and Adjunct Professor Law at the University of Washington, Seattle.

"Healthcare Reform: Threats to the Patient/Physician Relationship" lecture given by David Orentlicher, Director of the Division of Medical Ethics at the American Medical Association.

"Healthcare and Medical Progress: Can We Afford It?" lecture given by Daniel Callahan, Co-Founder and President of the Hastings …

Give Use Your Tired, Your Poor, Your Huddled Masses . . . Except When They Have Hiv: An Analysis Of Current United States Immigration Policy Regarding Hiv-Positive Aliens In Light Of Guantanamo Bay, Jason W. Konvicka

University of Richmond Law Review

On September 30, 1991, a party of military leaders overthrew the first democratically elected government in Haitian history. Although Haiti's former president, Jean Bertrand Aristide escaped to safety, many of his supporters were not so fortunate. Numerous Haitians were tortured and killed due to their political affiliation. Fearing similar persecution, thousands of Haitian nationals abandoned their belongings and fled to the high seas in an attempt to reach the United States. Soon thereafter, the United States Coast Guard began interdicting an increasing number of Haitian boats as they made their way into international waters.

Blood Bank And Blood Products Manufacturer Liability In Transfusion-Related Aids Cases, Dana J. Finberg

University of Richmond Law Review

Can a blood bank or a blood products manufacturer be held liable if a patient contracts AIDS through a transfusion of blood or a blood product? And, if so, should the bank or manufacturer be held liable? As of February 1989, approximately 200 cases touching on this issue were pending in the United States.

University Of Richmond Law Review

University of Richmond Law Review

No abstract provided.

Annual Survey Of Virginia Law: Health Care Law, Steven D. Gravely

University of Richmond Law Review

The health care industry continued its dynamic course in late 1991 and early 1992. Feeding the frenzy of activity were the Virginia General Assembly and the judiciary. This article focuses on key legislative, regulatory, and judicial events of the past year, and examines their effect on health care in Virginia.

Annual Survey Of Virginia Law: Recent Developments In Medical Malpractice And Health Care Law, Peter M. Mellette

University of Richmond Law Review

Over the past year, medical malpractice and health care law in the Commonwealth have undergone significant changes. Major case decisions and significant legislative activity, both at the state and federal levels, have altered the playing field for many health care providers, insurers, and consumers.

University Of Richmond Law Review

University of Richmond Law Review

No abstract provided.

Annual Survey Of Virginia Law: Health Care Law, Heman A. Marshall Iii

University of Richmond Law Review

Health care law has proven to be a fertile ground for both legislative and judicial activity. The field covers a wide range of legal concerns including regulatory issues such as the Virginia Certificate of Public Need laws, hospital licensure statutes, antitrust issues as they relate to the activities of physicians, hospitals and other health care related institutions, as well as basic issues of contract and tort law. The recent year witnessed substantial legislative and judicial changes. This article discusses these changes as they affect hospitals, physicians and other participants in the health care industry in the Commonwealth of Virginia.