Health Law and Policy Commons^™

Litigating The Youth Mental Health Crisis: Mechanisms To Regulate Addictive Social Media Design, Talia Elliott

Washington and Lee Law Review

While social media offers real benefits to users, such as providing access to information and facilitating the free exchange of ideas, excessive social media use is associated with increases in anxiety, depression, and other serious mental-health harms. Social media platforms are designed to maximize profit by capturing user attention, resulting in interfaces that are dangerously addictive and prone to exposing users to harmful content. Currently, social media users alone bear the burden of navigating the dangers of social media. This is untenable. Young users, whose less developed brains leave them more vulnerable to addictive design features, find self-regulation especially challenging. …

Pragmatic Conceptualism, Public Nuisance, And The American Opioid Litigation, Benjamin C. Zipursky

Washington and Lee Law Review

Public nuisance as a part of American tort law has been as high profile in the first decades of this century as products liability law was in the last several decades of the twentieth century. The American opioid litigation over the past decades is a spectacular example, filling headlines and generating billions of dollars of settlements. There is a plausible argument, however, that the doctrinal core of the opioid litigation is meritless because there simply is no “interference with public right” as required by public nuisance law. The first aim of this Article is to articulate and assess that argument. …

Drug War Repair Guarantees, Amber Baylor

Washington and Lee Law Review

Drug legalization, especially cannabis legalization, is a critical step forward in states’ willingness to address systemic disparities, privacy intrusions, violence, and other harms of the drug war. Yet, reforms center on legalization and repair through a narrow lens, focused on changes to the penal code. The public has found that narrow forms of legalization cannot serve their purported reparative purpose. Narrowly drawn legalization is illusory. Drug war harms and punishment for legalized substance use continue. Legalization reforms are vulnerable to political trends, resulting in rollback and retrenchment of drug war operations.

Legalization cannot deliver on its reparative terms without guarantees. …

Medicaid’S Broken Promise To Children, Jerron R. Wheeler

Washington and Lee Law Review

In the United States, poor children’s access to necessary healthcare is determined more by geography than medical need. This variation is not the result of thoughtful local tailoring but of excessive state autonomy and passive federal oversight. The result is a fragmented and unequal system that obscures accountability and fails the Nation’s most vulnerable children.

Building on scholarship showing how decentralized implementation of federal social programs can erode America’s social safety net, this Article examines how one of Congress’s most ambitious entitlements for children—Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit has been quietly undermined. In light of …

Long Covid, Silent Suffering, And Work, Joseph A. Seiner

Washington and Lee Law Review

Though most recover from COVID quickly, countless others remain chronically ill. Five years after the start of the pandemic, Long COVID continues to harm the economy, forcing thousands from employment at a time when businesses are struggling to find workers. With over thirty million individuals in the United States having contracted Long COVID, the illness cannot be dismissed as merely malingering or psychosomatic in nature.

With no diagnostic test for identifying Long COVID, skepticism about the illness persists. Many are scared to acknowledge their affliction with the disease and fear being stigmatized. Those who suffer silently struggle to perform their …

Against A Medical Exception To Equal Protection, Govind Persad

Washington and Lee Law Review

Government regulations of medicine sometimes treat patients differently based on their race or sex. Does heightened scrutiny apply to such regulations—as is usual when law treats someone differently based on a protected characteristic? Or is there a medical exception to equal protection?

Recently, in United States v. Skrmetti, the Supreme Court upheld a law that restricted access to medical treatments for transgender minors. Though its holding did not rely on medical exceptionalism, its discussion reinvigorated interest in a “medical exception” to equal protection: that medical decisions are exempt from the searching review applied when governmental decisions consider protected characteristics.

For …

Stealth Consolidation: Healthcare’S Process Of Quietly Dodging Antitrust Enforcement, Nathan Rush

Washington and Lee Law Review Online

The healthcare industry has become highly concentrated due to increased rates of consolidation. Mergers and acquisitions among healthcare providers have become extremely common, making dominant hospital systems the norm. When healthcare provider markets are highly concentrated, competition deteriorates, leaving patients to suffer the consequences: higher prices for lower quality care.

The federal antitrust agencies tasked with preserving competition have failed to combat the consolidation trends that are plaguing the healthcare industry. Vertical consolidation between hospitals and physician groups has especially gone unchecked. The Hart-Scott-Rodino Act, a federal antitrust law, requires merging parties to give the agencies pre-merger notice. This law, …

Immortal Justice: Why The Henrietta Lacks Family Merits Restitution Today, Suzette Malveaux

Scholarly Articles

Almost three quarters of a century have passed since Henrietta Lacks had her cells biopsied from her cervix without her knowledge or consent. Upon discovering that Henrietta’s cells were immortal, scientists have been able to solve the most vexing medical problems of modern times and save countless lives worldwide. Aware of the cells’ scandalous origins, big pharma has nonetheless commercialized and wildly profited from the HeLa cell line without sharing the benefit with Henrietta’s family, who has been left traumatized and destitute by the initial theft.

Despite the passage of time, Henrietta’s family is seeking restitution today from pharmaceutical companies …

Double Dosing: How Brand-Name Pharmaceutical Manufacturers Manipulate Patent Rules To Extend Market Exclusivity, Elizabeth Hertzberg

Washington and Lee Law Review

A robust patent system is important for spurring innovation, but it is not without risk. Because a patent owner has exclusivity over the patented subject matter for a specific term, there is incentive to extend that monopoly however possible. Identical subject matter is unpatentable, but obvious variants of an existing patent may be allowed if the applicant agrees to the same expiration date for both patents. This agreement is called a terminal disclaimer. While patents tied together with terminal disclaimers may not necessarily lead to unjust patent term extensions, an army of terminal disclaimers directed at one invention presents a …

Heat Camps: Juvenile Curfews, Extreme Heat & The Eighth Amendment, Norrinda Brown

Washington and Lee Law Review

For decades, in the summertime, America has confined certain of its youth in what are essentially open-air heat camps. In city after city, camp-form is established through the enactment of warm-weather juvenile curfews which keep the youth at home or in state-sponsored centers during summer nights and, increasingly, during days as well. Local governments justify these curfews with general notions of “public safety,” including to protect the youth they confine. But the laws are not benevolent. Reducing youth mobility by curfew results in exclusion, oversurveillance, and potentially lethal heat punishment of the youth, possibly in violation of the Eighth Amendment. …

Alabama’S Ivf Immunity Law: A Constitutional License To Kill?, Dani Wasshausen

Washington and Lee Law Review

In today’s post-Dobbs world, states may freely define fetal “persons” and those fundamental rights afforded to them, but not without consequence. The Supreme Court of Alabama’s groundbreaking decision in LePage v. Center for Reproductive Medicine, P.C., holding that frozen embryos are “children” under the Wrongful Death of a Minor Act, led fertility clinics and services across the state to close. These in vitro fertilization (IVF) providers feared liability exposure because their standard practices—including embryonic fertilization, testing, cryopreservation, and transfer—inevitably result in damage or death to embryos. The Alabama Legislature swiftly responded by enacting a law granting broad civil and criminal …

Patients V. Profits: Addressing Private Equity’S Incursion On Healthcare, Michael Mccarthy

Washington and Lee Law Review

Between 2013 and 2023, private-equity-sponsored investment funds spent one trillion dollars on healthcare acquisitions, targeting hospitals, physician practices, and specialty providers. This Note examines the growing role of private equity in the US healthcare system and its implications for cost, quality, and competition.

ring struggling hospitals and medical practices much-needed capital and managerial expertise. In practice, however, prevalent private equity practices often create moral hazards by prioritizing short-term financial gains over long-term community health. Their reliance on debt, short investment horizons, and consolidation strategies can translate into higher prices, compromised care, and anticompetitive behavior. Mounting empirical studies reinforce these concerns, …

Is There A Librarian In The House? Researching Federal And Virginia State Health Law, Andrew J. Christensen

Library Scholarship

Health law is a complex and diverse practice area, encompassing issues ranging from insurance law and patient privacy to medical malpractice and vaccine law. Researching health law thus entails a combination of primary and secondary resources, statutory and regulatory updates, and often a nuanced or multijurisdictional understanding of healthcare policy. For both career specialists and lawyers who are new to the field, finding accurate, current information on both federal and state-specific health laws is critical.

Luckily, the librarian is in. This guide highlights key resources and practical strategies for effectively researching federal and Virginia health law, tailored to legal practitioners …

A Constitutional Mandate To Adopt Avs, Kevin Frazier

Washington and Lee Law Review Online

The rapid advancement of autonomous vehicle (“AV”) technology presents a unique opportunity to enhance public safety by drastically reducing road fatalities. Despite significant private sector investment and demonstrated improvements in AV performance, public adoption and integration remain hindered by regulatory gaps and societal skepticism. This Article argues that the federal government has an affirmative obligation, rooted in the doctrine of a right to effective government, to champion the adoption of technologies like AVs that meaningfully promote the general welfare.

Drawing on the Preamble’s mandate to advance the general welfare and lessons from the transition from the Articles of Confederation to …

Transformative Experiences, Anticipatory Regret, And Informed Consent, Elizabeth Lanphier, Shannon Fyfe

Scholarly Articles

Regret risk is not consistently part of information sharing within informed consent. Yet two kinds of decisions that often invoke concerns about future regret, abortion and sterilization, raise considerations for the role of regret in clinical decision-making and informed consent, particularly regarding decisions about potentially transformative experiences. We distinguish between first-personal and second-personal anticipatory regret and argue that first-personal anticipatory regret can play a productive role, but second-personal anticipatory regret can function in ways that are pernicious. Introducing second-personal anticipatory regret into medical informed consent processes is, we argue, not only not required for informed medical decision-making, but impermissible within …

The Supreme Court During Covid-19: Keeping Its Head When Those About It Were Losing Theirs, Timothy C. Macdonnell

Scholarly Articles

Alexander Hamilton's Federalist No. 78 suggests that one of the reasons for a life-tenured judiciary whose pay cannot be altered is because "judges may be an essential safeguard against the effects of occasional ill humours in the society." Our Nation's history is replete with instances of ill humor leading to violations of constitutional rights. Wars, epidemics, natural disasters, civil unrest, and economic crises all demand governments to act and act swiftly. But courts, and particularly the United States Supreme Court, are necessary to check governments when they go too far in contending with an emergency.

Historically the country's courts have …

Addressing Mental Disability Head On: The Challenges Of Reasonable Accommodation Requests For Virginia Housing Providers, Haley Fortner

Washington and Lee Law Review Online

A person’s home should be a sanctuary of safety, security, and comfortability away from the demands of the outside world. Yet for many people living with mental illness, a home can all too easily become a sort of temporary prison. Nowhere is this more apparent than when a housing provider stands in the way of allowing someone with a mental disability the equal opportunity to use and enjoy their home. Fair housing law’s reasonable accommodation requirement works to ensure those living with mental illness receive the accommodations they need in order to live safely and comfortably in their own home. …

Standing Up To Bounty Laws: Examining State Standing Jurisprudence And Its Effect On Laws Enforced Through Private Rights Of Action, Olivia A. Luzzio

Washington and Lee Journal of Civil Rights and Social Justice

The Texas Heartbeat Act (SB 8) adopted a unique enforcement scheme that succeeded in circumventing Roe v. Wade’s protection of a woman’s right to abortion before viability. By prohibiting enforcement of the Act by public officials and instead authorizing enforcement solely through civil actions by “any person,” SB 8 effectively ended a women’s right to abortion after a fetal heartbeat is detected. The passage of this law placed the protection of other constitutionally endowed rights in jeopardy and facilitated the passage of similarly constructed legislation, such as California’s Senate Bill 1327, which authorizes “any person” to sue anyone who manufactures …

Supporting Healthy Futures: Capitalizing On Medicaid’S Epsdt Medical Necessity Standard, Teressa Colhoun

Washington and Lee Law Review

Youth mental health is in crisis. Children report increased rates of suicidal ideology, depression, and anxiety. Diagnosis rates soar. Pediatric mental health care remains difficult to access. When services are accessible, they are costly—often sending families into medical debt.

This Note discusses Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (“EPSDT”) benefit. Specifically, it studies the EPSDT benefit’s creation, structure, and administration. This Note focuses on the context in which the EPSDT benefit operates, particularly how health care financing models impact benefit administration. It suggests that the EPSDT benefit has the capacity to address crucial gaps in pediatric mental health …

Exploring The African Regional Human Rights Standards As The Basis For An Enabling Environment For Self-Managed Abortion, Lucia Berro Pizzarossa, Michelle Maziwisa, Ebenezer Durojaye

Washington and Lee Journal of Civil Rights and Social Justice

Self-managed abortion holds great promise to save lives and promote reproductive autonomy, particularly in Africa. Indeed, the African region records very high numbers of unsafe abortions, and the burden of abortion-related mortality is the highest globally. Abortion remains generally criminalized in violation of numerous internationally and regionally recognized human rights standards. The advent of abortion medicines and the increased grassroots energy geared towards curbing the harms of unsafe abortion evince medical abortion holds great promise for revolutionizing people’s access to high-quality reproductive care. This study discusses regional human rights frameworks, policy, case law, and a few representative domestic legislative frameworks …

The Low-Hanging Fruit: Health, Rights, And The Commission, Bright Nkrumah

Washington and Lee Journal of Civil Rights and Social Justice

The year 2022 marked the 35th anniversary of the African Commission on Human and Peoples’ Rights. As it is a custom in many communities, when one reaches this milestone, it is an opportune time to introspect and reflect on the successes and challenges encountered in one’s journey. It is this template that the paper adopts to measure the prospects and setbacks of the African Commission in the advancement of the right to health. The Article argues that while the body remains the poster child of the continent’s human rights architecture, its inability to clearly articulate how states ought to advance …

A Miscarriage Of Justice: How Femtech Apps And Fog Data Evade Fourth Amendment Privacy Protections, Rachel Silver

Washington and Lee Journal of Civil Rights and Social Justice

After the fall of Roe v. Wade, states across the country have enacted extreme abortion bans. Anti-abortion states, emboldened by their new, unrestricted power to regulate women’s bodies, are only broadening the scope of abortion prosecutions. And modern technology provides law enforcement with unprecedented access to women’s most intimate information, including, for example, their menstrual cycle, weight, body temperature, sexual activity, mood, medications, and pregnancy details. Fourth Amendment law fails to protect this sensitive information stored on femtech apps from government searches. In a largely unregulated private market, femtech apps sell health and location data to third parties like Fog …

Deserving Life: How Judicial Application Of Medical Amnesty Laws Perpetuates Substance Use Stigma, Scott Koven

Washington and Lee Law Review

To combat the continued devastation wrought by the opioid crisis in the United States, forty-eight states have passed medical amnesty (or “Good Samaritan”) laws. These laws provide varying forms of protection from criminal punishment for certain individuals if medical assistance is sought at the scene of an overdose. Thus far, the nascent scholarly conversation on medical amnesty has focused on the types of statutory protections available and the effectiveness of these statutes. To summarize, although medical amnesty laws have helped combat drug overdose, the statutes are replete with arbitrary limitations that cabin their life-saving potential.

This Note extends the dialogue …

Constitutional Confidentiality, Natalie Ram, Jorge L. Contreras, Laura M. Beskow, Leslie E. Wolf

Washington and Lee Law Review

Federal Certificates of Confidentiality (“Certificates”) protect sensitive information about human research subjects from disclosure and use in judicial, administrative, and legislative proceedings at both the state and federal levels. When they were first authorized by Congress in the 1970s, Certificates covered sensitive information collected in research about drug addiction use. Today, however, they extend to virtually all personal information gathered by biomedical research studies. The broad reach of Certificates, coupled with their power to override state subpoenas and warrants issued in the context of law enforcement, abortion regulation, and other police powers typically under state control, beg the question whether …

The Impact Of Government Sponsored Segregation On Health Inequities: Addressing Death Gaps Through Reparations, Mariya Denisenko

Washington and Lee Law Review

Government sponsored segregation of urban neighborhoods has detrimentally impacted the health of Black Americans. Over the last century, federal, state, and local governments have promulgated racist laws and policies that shaped the racial divide of communities in major metropolitan cities. This divide has contributed to poor health outcomes and large discrepancies in life expectancy for Black Americans when compared to their White counterparts. While health is impacted by various factors, segregation has been shown to impose various challenges that make it difficult for Black Americans to attain good health.

Segregated Black communities struggle with economic inequality, environmental racism, and face …

Severe Mental Illness And The Death Penalty: A Menu Of Legislative Options, Richard J. Bonnie

Washington and Lee Journal of Civil Rights and Social Justice

In 2003, the American Bar Association established a Task Force on Mental Disability and the Death Penalty to further specify and implement the Supreme Court’s ruling banning execution of persons with intellectual disability and to consider an analogous ban against imposing the death penalty on defendants with severe mental disorders. The Task Force established formal links with the American Psychological Association, the American Psychiatric Association, and the National Alliance on Mental Illness and the final report was approved by the ABA and the participating organizations in 2005 and 2006. This brief article focuses primarily on diminished responsibility at the time …

Abortion, The Underground Railroad, And Evidentiary Privilege, Tom Lininger

Washington and Lee Law Review

Building on my recent article in the Minnesota Law Review proposing reforms of evidentiary privilege law, this Article focuses on the unique context of communication about abortion. There is an urgent need to protect such communication in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which allowed states to recriminalize abortion. Now abortion seekers, providers, and third parties who aid and abet abortion could face significant exposure to both criminal penalties and civil suits in many states. Those states are attempting to extend the reach of their bans by sanctioning out-of-state travel and …

Zooming In: Analyzing Annual Meeting Format Changes Amidst A Global Pandemic, Mark T. Wilhelm, Danielle Clifford

Washington and Lee Law Review Online

Beginning in March of 2020, public companies in the United States were forced to take unprecedented measures to observe corporate formalities while following the government-mandated health and safety measures resulting from the COVID-19 pandemic. Those measures made in-person activities and meetings either incredibly challenging or, in certain jurisdictions, illegal. Because “proxy season,” the time when public companies typically hold their annual meetings of stockholders, followed shortly after the mass implementation of COVID-19 lockdowns and quarantines, public companies that had historically held these meetings in-person were left scrambling to find an alternative means to meet. Nearly overnight, the pandemic caused an …

Pandemic As Transboundary Harm: Lessons From The Trail Smelter Arbitration, Russell A. Miller

Scholarly Articles

The COVID-19 pandemic has caused incalculable harm around the world. The fact that this immense harm can be traced back to a localized outbreak in or near Wuhan, China, raises questions about the responsibility China might bear for the pandemic under public international law. Famously applied in the seminal Trail Smelter Arbitration (1938/1941), the Transboundary Harm Principle provides that no state can use or allow the use of its territory in a manner that causes significant harm in the territory of other states. This article does not intend to tap into the unseemly, xenophobic spirit that animates much of the …

Disciplining Doctors: A Call For Caution When Responding To Physicians' Counter-Consensus Speech In The Time Of Covid-19, Timothy Macdonnell

Scholarly Articles

The COVID-19 pandemic affected nearly every aspect of life in the United States, including most notably, work-life, home-life, and community-life. During the pandemic, the government took extraordinary steps to try and reduce the spread of the disease by closing businesses, mandating the wearing of masks, and requiring vaccines. Government officials repeatedly justified their actions by stating that they were "following the science." However not all members of the scientific/medical community agreed with these actions. Some of these counter-consensus opinions were labeled mis/dis/mal/information.

As the COVID-19 pandemic dragged on, calls to punish doctors for COVID-19 misinformation increased. Some doctors who claimed …