Health Law and Policy Commons^™

The Law's Response To Reproductive Genetic Testing: Questioning Assumptions About Choice, Causation And Control, Karen H. Rothenberg

Faculty Scholarship

No abstract provided.

Problems With Employer-Provided Health Insurance — The Employee Retirement Income Security Act And Health Care Reform, Wendy K. Mariner

Faculty Scholarship

Health care reform is in the wind. As the nation prepares for a new presidential term, a more equitable and cost-effective health care system is beginning to sound inevitable.1 But the shape of that system remains a matter of debate. Employer-provided health insurance is the cornerstone of several national proposals for reform.2 3 4 5 6 The Bush administration's preference for tax credits rested on the assumption that most employers would continue to provide health insurance to their employees. President-elect Bill Clinton's proposal relies on insurance reform to enable small businesses to buy affordable private health insurance. Lawmakers …

Myth And Reality: The Threat Of Medical Malpractice Claims By Low Income Women, Karen H. Rothenberg

Faculty Scholarship

No abstract provided.

The Supreme Court, Abortion, And The Jurisprudence Of Class, Wendy K. Mariner

Faculty Scholarship

The US Supreme Court's decision in Planned Parenthood of Southeastern Pennsylvania v Casey both protects a woman's liberty to choose to terminate her pregnancy and permits the state to make it more difficult for her to exercise her choice. In their opinion on the case, Justices O'Connor, Kennedy, and Souter eloquently defend constitutional protection of the right to make intimate decisions like continuing or ending a pregnancy. At the same time, they permit the state to try to persuade pregnant women not to have abortions and to make abortion harder to obtain and more costly, as long as the state's …

Staffing National Health Care Reform: A Role For Advanced Practice Nurses, Linda H. Aiken, William M. Sage

Faculty Scholarship

Expanding access and coverage while containing costs can only be accomplished by getting more health care value for our money. Two facts about our current system make this seem possible. First, the currently uninsured are not costless. Providing stop-gap health care to those who lack health insurance is extremely expensive -- people without formal coverage cannot afford preventive services, delay treatment of illness and face substantial barriers to reaching appropriate providers. When they receive care, it is often degrading, usually complicated and costly, and more than occasionally too late. The cost of this "uncompensated" care is borne by all of …

Competition Law And Anticompetitive Professional Behavior Affecting Health Care, Frances H. Miller

Faculty Scholarship

No abstract provided.

Mum's The Word: The Supreme Court And Family Planning, Wendy K. Mariner

Faculty Scholarship

On May 23, 1991, the US Supreme Court upheld federal regulations that prohibit federally funded family planning programs from counseling about or referring for abortion. As a result, government benefits may now entail substantial costs. The regulations changed the nature of government-assisted family planning from comprehensive care and counseling to limited services and government-prescribed information. The reasoning in Rust v Sullivan allows government to limit freedom of speech in federally funded programs. The decision may have been influenced by antiabortion sentiment, but it does not affect the legality of abortion. Instead, it sets a precedent for government control of whether …

Setting Standards For The Use Of Dna-Typing Results In The Courtroom — The State Of The Art, George J. Annas

Faculty Scholarship

DNA typing, sometimes called DNA fingerprinting or profiling, has been the focus of heated exchanges in courtrooms, the popular press, and scientific journals. It is a powerful law-enforcement weapon, especially in cases of rape, because it has the potential to exonerate a suspect or to place him at the scene of a crime. On the other hand, it is of no use in rape cases like those in which William Kennedy Smith and Mike Tyson were accused, in which coitus is conceded to have occurred and the only real issue is consent. When should judges permit evidence from DNA typing …

Cleaning House: Environmental Hazards Can Undermine A Property's Use And Value, Michael B. Gerrard

Faculty Scholarship

Numerous horror movies and books depict the woes that befall fictional homeowners who don't know or care that they are living too close to cemeteries or brooding woods or scenes of hauntings.

However, even the vivid imaginations of filmmakers and novelists can't conjure up some of the real-life horrors that environmental hazards can create for property owners. These hazards can destroy the value and salability of property, render it unusable for its intended purpose, and burden owners with clean-up costs, fines and lawsuits.

Fortunately, an alert eye and inexpensive tests can identify most common environmental dangers.

Health Warnings, Smoking, And Cancer - The Cipollone Case, George J. Annas

Faculty Scholarship

The figures have become familiar. Tobacco use has been declared "the single most important preventable cause of [premature] death in the United States, accounting for one of every six deaths, or some 390,000 deaths annually. "The health goals of the nation for the year 2000 call for reducing the prevalence of cigarette smoking to 15 percent among adults (a 48 percent decrease from the current 29 percent) and reducing the rate of beginning smoking among teenagers to 15 percent (a 50 percent decrease from the current rate of 30 percent). The goal of reducing smoking in the United States is …

The Economics And Politics Of Emergency Health Care For The Poor: The Patient Dumping Dilemma, Maria O'Brien

Faculty Scholarship

As the numbers of uninsured mount⁴ because of job dislocations, exhaustion of benefits, and unaffordably high premiums, the incidence of "dumping" by private hospitals is, predictably, on the rise. Dumping occurs when a hospital, in violation of federal or state law, transfers an emergency patient to another (usually public) hospital or simply refuses any treatment based on the patient's inability to pay.5 In addition to the completely uninsured, favorite dumping targets include Medicare and Medicaid patients, AIDS patients, and cancer patients whose therapy may cost more than the maximum reimbursement under private insurance.

Dumping is merely a part of …

The Changing Landscape Of Human Experimentation: Nuremberg, Helsinki, And Beyond, George J. Annas

Faculty Scholarship

Since World War II there have been persistent efforts at both the national and international level to develop rules to protect the rights and welfare of subjects of human experimentation.' These efforts have focused primarily on codifying the rights of subjects, and protecting their welfare by prior peer review of research protocols. In recent years research regulations have been under attack by politicians, drug companies, researchers, and advocacy groups. In less than half a century, human experimentation has been transformed from a suspect activity into a presumptively beneficial activity. With this transformation, traditional distinctions between experimentation and therapy, subject and …

Using Genes To Define Motherhood - The California Solution, George J. Annas

Faculty Scholarship

Sometimes (although not often) new forms of medical technology raise unique legal and social-policy issues that require new laws. In vitro fertilization, followed by the transfer of the embryo to a woman who did not contribute the ovum, is such a technique, because when the child's gestational mother is not the child's genetic mother, society must decide which is the child's legal mother. A California Court of Appeal, the first appellate court anywhere in the world to rule on this issue, decided in late 1991 that genes determine motherhood.

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 …

National Institutes Of Health Workshop Statement. Reproductive Genetic Testing: Impact On Women, Karen H. Rothenberg, Elizabeth Thomson

Faculty Scholarship

No abstract provided.

Introduction: The Right To Die After Cruzan, Diane E. Hoffmann

Faculty Scholarship

No abstract provided.

Of Mice But Not Men: Problems Of The Randomized Clinical Trial, Samuel Hellman, Deborah Hellman

Faculty Scholarship

No abstract provided.

The Influence Of Law And Lawyers On Patient Care, Diane E. Hoffmann

Faculty Scholarship

No abstract provided.

Medical Treatment Decisions And Competency In The Eyes Of The Law: A Brief Survey, Patricia D. White, Susan J. Hankin

Faculty Scholarship

No abstract provided.

Mengele's Birthmark: The Nuremberg Code In United States Courts, George J. Annas

Faculty Scholarship

Experimentation on human beings is so difficult to justify that the attempt is seldom even made. Usually its justification is simply assumed, and vague notions of progress or national emergency are suggested as sufficient rationales. The United States, a society dedicated to both progress and human rights, has been profoundly ambivalent about human experimentation. On the one hand, we have consistently argued in our ethical codes that the rights and welfare of research subjects must be protected; on the other hand, we have consistently used perceived emergencies, both national and medical, as an excuse to jettison individual rights and welfare …

Medicaid Reform Through Setting Health Care Priorities, Robert L. Schwartz

Faculty Scholarship

The face of American health care has changed since the creation of the two largest government funded health programs, Medicare and Medicaid. Whatever positive cultural benefits those programs have provided, they have carried with them one overwhelming defect: a language with obscure and untreatable words and phrases which has added to the mystery and impenetrability of the underlying substantive law. This article discusses Oregon’s proposal for prioritization, reviews legal arguments, a policy argument against the proposal, and finally concludes that any priority list that generalizes from condition-treatment pairs necessarily overgeneralizes, that the range of cost-utility ratios for any condition-treatment pair …

The Long Dying Of Nancy Cruzan, George J. Annas

Faculty Scholarship

With the Nancy Cruzan decision, ¹ the post-Reagan Supreme Court continued recreating America's legal landscape by transferring traditional rights from its citizens to state legislatures and state officials. Attorneys Bopp and Marzen see Cruzan as a cause for celebration. ² The more common view is that it is a hollow acceptance of the technological imperative that requires all Americans to engage in extensive damage control. Given the composition of the Court, constituted by President Ronald Reagan to overrule Roe v. Wade, Bopp and Marzen correctly note that the result in Cruzan was "practically inevitable." But its inevitability does not …

Restricting Doctor–Patient Conversations In Federally Funded Clinics, George J. Annas

Faculty Scholarship

We have come to accept, as a matter of both law and medical ethics, that open and honest discussion is crucial to the doctor–patient relationship. We accordingly deplore the practice in Plato's Greece whereby, for slaves, "verbal communication between healer and patient was reduced to a minimum." But restricting conversation between doctor and patient has now become a matter of government policy, again distinguishing patients according to economic class.

The Health Care Proxy And The Living Will, George J. Annas

Faculty Scholarship

A legally enforceable declaration can be executed only 14 days or more after a person is diagnosed as having a terminal illness, defined as one that will cause the patient's death "imminently," whether or not life-sustaining procedures are continued. [...]even though this statute was inspired by her story, it would not have helped Quinlan, because she was not terminally ill.

Regulating Ethics Committees In Health Care Institutions - Is It Time?, Diane E. Hoffmann

Faculty Scholarship

No abstract provided.

Gestational Surrogacy And The Health Care Provider: Put Part Of The "Ivf Genie" Back Into The Bottle, Karen H. Rothenberg

Faculty Scholarship

No abstract provided.

Professional Decisions And Ethical Values In Medical And Law Students, Robert L. Schwartz, Agnes G. Rezler, Pamela Lambert, S. Scott Obenshain, Joan Mciver Gibson, David A. Bennahum

Faculty Scholarship

The purpose of this project is to evaluate and compare the values used by medical and law students when dealing with ethical dilemmas in the professional practice of law and medicine. It is assumed that conflict between doctors and lawyers often arises out of the different values that members of each profession apply to similar dilemmas.

The Law And Economics Of Organ Procurement, Keith N. Hylton

Faculty Scholarship

This paper presents an economic analysis of the organ procurement system in the U.S. and examines proposals to alleviate the shortage of transplantable organs. The paper's principal conclusions are: (1) Although non-market solutions deserve the highest priority, demand increases fueled by improvements in transplant technology will probably make some market-based solution necessary in the future. (2) Quality deterioration and coercion will not necessarily be worrisome problems under a market-based procurement system.

New Fda Drug Approval Policies And Hiv Vaccine Development, Wendy K. Mariner

Faculty Scholarship

Conducted a study of Food and Drug Administration (FDA) law and policy including interviews with FDA officials in the Center of Biologics Evaluation and Research and the Office of the General Counsel. Suggests that the new FDA drug review policies do not fit vaccines. Instead, the nature of vaccines, and HIV vaccines in particular, argues for adherence to a more rigorous form of review. (JLN)

Women And Aids - Racism, Sexism, And Classism, Taunya L. Banks

Faculty Scholarship

No abstract provided.