Health Law and Policy Commons^™

Cooperative Federalism And Healthcare Reform: The Medicare Part D 'Clawback' Example, Elizabeth Weeks Leonard

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This symposium article recounts recent litigation by several states over a provision of the Medicare Modernization Act Part D prescription drug benefit: The clawback, which requires states to pay the a potentially substantial portion of new federal program. I then examine the unique federalism implications of the clawback for ongoing state and federal health reform initiatives.

In spring 2006, several states petitioned the United States Supreme Court for original jurisdiction to hear a challenge to one provision of the new Medicare Part D prescription drug law. The federal government, while taking over prescription drug coverage for dually eligible beneficiaries, required …

Bibliography Of Law Review Articles On Disability Law, Ann Puckett

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Bibliography of law review articles discussing legal issues pertaining to disabilities, originally presented as a continuously updated online database.

Beyond Compensation: Using Torts To Promote Public Health, Elizabeth Weeks Leonard

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Personal injury litigation, or tort law, traditionally, has been viewed as antithetical to the goals of public health. The focus on individual compensation for injuries resulting from accidents, products, and international wrongdoing arguably does not serve the "greater good" or communitarian objectives of public health. This Article, originally presented on a January 2006 AALS Panel on Teaching Public Health In Law School, takes issue with the traditional view and will demonstrate ways that personal injury litigation and public health objectives may be complimentary and mutually reinforcing. Some areas of tort law, such as mass torts against tobacco companies, toxic polluters, …

After The Catastrophe: Disaster Relief For Hospitals, Elizabeth Weeks Leonard

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Disaster planning for health care providers following the September 11, 2001, terrorist attacks and, more recently, Hurricane Katrina, focuses on preparing hospitals and other emergency services to respond to victims' medical needs. But little attention has been paid to the challenges that providers would face resuming normal operations after responding to the catastrophe. A large-scale catastrophe could create unprecedented demand for health care and emergency services. Hospitals already struggle to fulfill the high demand for and high costs of emergency care. Following a major disaster, hospitals would face additional financial challenges. Strained capacity and financial reserves, may force hospitals to …

Book Review: "Hardwired Behavior: What Neuroscience Reveals About Morality", Stacey A. Tovino

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The field of neuroethics has been described as an amalgamation of two branches of inquiry: the ethics of neuroscience and the neuroscience of ethics. The ethics of neuroscience, which has received considerable attention over the past three to four years, is concerned with the ethical principles that should guide brain research and the treatment of neurological disease, as well as the effects that advances in neuroscience have on our social, moral, and philosophical views. The neuroscience of ethics, which has received considerably less attention, may be described as a scientific approach to understanding ethical behavior. Psychiatrist and lawyer Laurence Tancredi …

The Visible Brain: Confidentiality And Privacy Implications Of Functional Magnetic Resonance Imaging, Stacey A. Tovino

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Functional magnetic resonance imaging (fMRI) has built on a number of technologies, including electroencephalography, magnetoencephalography, positron emission tomography, and single-photon emission computed tomography, to become one of the decade’s most powerful tools for mapping sensory, motor, and cognitive function. Scientists also are using fMRI to study the neural correlates of a range of conditions, characteristics, and social behaviors, including severe brain injury, major depression, schizophrenia, dyslexia, cocaine addiction, compulsive gambling, pedophilia, racial evaluation, deception, cooperation, altruism, and even sexual preference. Poised to move outside the research context, fMRI and its ability to detect correlations between brain activations and sensitive and …

Watch Out For Whistleblowers, Leslie C. Griffin

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No abstract provided.

Making Research A Requirement Of Treatment: Why We Should Sometimes Let Doctors Pressure Patients To Participate In Research, David Orentlicher

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In this article, Professor David Orentlicher argues that when a patient could be offered one of multiple established treatments, doctors should be able to offer treatment only if the patient agrees to participate in research aimed at determining which of the treatments is most effective. Making treatment conditional on research participation will help researchers complete badly needed studies.

Incorporating Literature Into A Health Law Curriculum, Stacey A. Tovino

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Literature has had a long relationship with medicine through literary images of disease, literary images of physicians and other healers, works of literature by physician-writers, and the use of literature as a method of active or passive healing. Literature also has had a long relationship with the law through literary images of various legal processes, lawyers, and judges, works for literature by lawyer-writers, and the use of literature as therapy. At last count, eighty-four law schools in the United States and Canada reported offering some variations of a “law and literature” course and recent scholarship demonstrates that literature increasingly is …

A Primer On The Law And Ethics Of Treatment, Research, And Public Policy In The Context Of Severe Traumatic Brain Injury, Stacey A. Tovino

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From the 1976 case of Karen Ann Quinlan to the March, 20, 2004, statement of Pope John Paul II, physicians, lawyers, and theologians have struggled with the legal and ethical implications of treatment and public policy decisions in the context of devastating brain injury. Recent medical literature proposing an ethical framework for interventional cognitive neuroscience involving patients in states of minimal consciousness raises additional legal and ethical issues in the context of clinical research.

Using the Mathew Kosbob case as a point of departure, this article discusses the legal and ethical issues raised by treatment and research, as well as …

Confidentiality And Privacy Implications Of Functional Magnetic Resonance Imaging, Stacey A. Tovino

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Advances in science and technology frequently raise new ethical, legal, and social issues, and developments in neuroscience and neuroimaging technology are no exception. Within the field of neuroethics, leading scientists, ethicists, and humanists are exploring the implications of efforts to image, study, treat, and enhance the human brain.

This article focuses on one aspect of neuroethics: the confidentiality and privacy implications of advances in functional magnetic resonance imaging (“fMRI”). Following a brief orientation to fMRI and an overview of some of its current and proposed uses, this article highlights key confidentiality and privacy issues raised by fMRI in the contexts …

Hospital Chaplaincy Under The Hipaa Privacy Rule: Health Care Or "Just Visiting The Sick?", Stacey A. Tovino

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Approximately seventy-nine percent of Americans believe that praying can help people recover from illness, injury or disease, and nearly seventy-seven percent of American patients would like spiritual issues discussed as part of their care. Despite Americans' strong beliefs in the health-related benefits of religious and spiritual practices and traditions, the preamble to the federal Department of Health and Human Services' ("HHS") health information privacy rule (the "Privacy Rule") explains that health care "does not include methods of healing that are solely spiritual" (the "preamble"). The preamble concludes that, "clergy or other religious practitioners that provide solely religious healing services are …

Book Review: "The Birth Of Surrogacy In Israel", Stacey A. Tovino

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Instead of analyzing Israel’s Surrogate Motherhood Agreements Act from a purely legal or theoretical perspective, D. Kelly Weisberg weaves individuals, events, and other factors into a fascinating story about the Israeli legislative process. A case in point: Weisberg begins by exploring the private lives of Rachel and Benjamin, the biological parents of twin babies carried by Sarah, the first surrogate moth to carry a baby under Israel’s surrogacy law. Weisberg also explores the story of Naomi and Dan, the biological parents of a baby boy carried by Hanna, the second surrogate mother to carry a baby under the legislation. Readers …

Book Review: "Jewish Biomedical Law: Legal And Extra-Legal Dimensions", Stacey A. Tovino

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Three extra-legal themes—the influence of morality upon Jewish law (halakhah), the growing awareness and implementation of the value of patient autonomy, and the role of scientific progress in the shaping of halakhic decisions—distinguish Daniel Sinclair’s work from other sin the field of Jewish biomedical law. Students and lawyers new to Jewish biomedical law may struggle with Sinclair’s decision to reserve until the final chapter his theories regarding how biomedical halakhah works. However, advanced students and scholars in the field will appreciate the opportunity to understand Sinclair’s three extra-legal themes in context and his decision to root his final …

Book Review: "Introduction To Jewish And Catholic Bioethics: A Comparative Analysis", Stacey A. Tovino

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Aaron Mackler’s agenda is to provide an orientation to ethical reasoning in the Roman Catholic and Jewish traditions, explore Roman Catholic and Jewish deliberations in five areas of bioethics, and identify and examine the traditions’ divergent and convergent methodologies. Mackler’s spirit is to learn more about his own religious traditions by studying the traditions of others. Accomplishing his agenda while remaining true to his spirit, Mackler shows just how much Jewish and Catholic thinkers can learn from one another.

The Impact Of Hsas On Health Care Reform: Preliminary Results After One Year, Edward J. Larson, Marc Dettmann

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With over one year having passed since the Medicare Modernization Act ("MMA") authorized the creation of the first individual Health Savings Accounts ("HSA"), this Article reviews the context, structure, promise, and impact of this new type of tax-advantaged account. The Article begins by briefly reviewing the context of this reform, documenting what both Presidents Clinton and Bush noted about rising costs and decreasing access. The Article then reviews the HSA legislation itself, H.R. 2596, and summarizes how HSAs operate. Part IV of this Article reviews the claims made for HSAs when H.R. 2596 passed as part of the MMA. Part …

Gauging The Cost Of Loopholes: Health Care Pricing And Medicare Regulation In The Post-Enron Era, Elizabeth Weeks Leonard

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This article explores the problem of risk perception and regulatory loopholes in the unique era of corporate governance that followed Enron and other high-profile corporate scandals. The article draws on behavioral law and economics theory to examine pressing issues in U.S. welfare policy reform. The current Administration's domestic agenda features proposals to privatize traditional government welfare programs, including Social Security and Medicare. Those proposals rely on market competition and other profit incentives to improve quality and reduce program costs. The article traces a detailed case study of a prominent for-profit hospital corporation, the impact of public perceptions of corporate wrongdoing, …

Feeding Tubes, Slippery Slopes, And Physician-Assisted Suicide, David Orentlicher, Christopher M. Callahan Md

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No abstract provided.

Use And Disclosure Of Protected Health Information For Research Under The Hippa Privacy Rule, The: Unrealized Patient Autonomy And Burdensome Government Regulation, Stacey A. Tovino

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This article offers a legal and ethical analysis of the requirements of federal privacy regulations (herein after the “Privacy Rules”) relating to the use and disclosure of individually identifiable health information for research activities. Section II of this article provides a legal summary of the Privacy Rules’ complex research provisions. Sections III and IV of this article analyze the Privacy Rules’ research provisions from a legal and ethical perspective. Specifically, Section III addresses whether the Privacy Rules promote autonomy by analyzing certain of the legal rights attributed to individuals who are the subjects of health information including: (1) the general …

Not So Peaceful Coexistence: Inherent Tensions In Addressing Tort Law Reform, Jeffrey W. Stempel

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As Professor Michael Green's comments trenchantly remind us, all of this has a familiar ring: insurers and tort defendants claim unfairly escalating liability, plaintiffs' lawyers and consumer groups counterattack, and (for the most part), insurers and defendants obtain some of the relief they seek. The tort reform victories are not so overwhelming as to completely unravel the historical rights of victims or the power of courts generally, but some constriction of rights inevitably occurs. During periods of quiescence, plaintiffs and consumers take back some lost territory through common law victories expanding claimant rights, or through specific legislation. Statutes that permitted …

American Midwifery Litigation And State Legislative Preferences For Physician-Controlled Childbirth, Stacey A. Tovino

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From the colonial period to the Great Depression, lay midwives attended a large proportion of deliveries that occurred in the United States. As late as 1900, midwife-attended home births accounted for approximately one-half of all births in the United States. By 1950, however, physicians attended more than eighty percent of all deliveries in the hospital setting. Historians have analyzed and interpreted birth statistics, medical textbooks, medical school curricula, minutes of medical society meetings, public health reports, articles in medical journals and popular magazines, letters from laboring mothers, diaries of midwives, legislative committee reports, and state legislation to identify issues of …

The Rise And Fall Of Managed Care: A Predictable Tragic Choices Phenomenon, David Orentlicher

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No abstract provided.

Symposium, Justice And Democracy Forum: The Law And Politics Of Tort Reform, Ann C. Mcginley

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On April 25, 2003, the University of Nevada, Las Vegas (“UNLV”) Center for Democratic Culture (“CDC”) and the William S. Boyd School of Law sponsored a one-day symposium addressing issues of tort reform. In particular, the Forum addressed concerns regarding construction defect litigation and medical malpractice, two areas of current and substantial concern in Nevada. As reflected in the discussion at the Forum, both topics received considerable attention from the Nevada State Legislature during its 2003 Session. Ultimately, the legislature enacted amendments to state statutes governing claims for defective construction. Despite significant lobbying by physicians and insurers, the legislature did …

The New Economic Credentialing: Protecting Hospitals From Competition By Medical Staff Members, Elizabeth Weeks

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This Article addresses hospitals' use of economic criteria to determine a physician's qualifications for staff privileges. Hospitals are resorting to economic conflict-of-interest credentialing policies in an attempt to ensure physicians' loyalty and mantain their own economic viability. Physicians, however, argue that entrepenurial activities are necessary for them to meet the economic challenges posed by declining reimbursement and rising insurance costs. This Article surveys the numerous legal theories that litigants and enforcement authorities could employ in attacking these new types of credentialing policies. The Article concludes that, in most jurisdictions, hospitals should be able to implement their policies in ways that …

Universality And Its Limits: When Research Ethics Can Reflect Local Conditions, David Orentlicher

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No abstract provided.

Placebo-Controlled Trials Of New Drugs: Ethical Considerations, David Orentlicher

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No abstract provided.

Doctors, Hmos, Erisa, And The Public Interest After Pegram V. Herdrich, Jeffrey W. Stempel, Nadia Von Magdenko

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The Employee Retirement Income Security Act of 1974 was enacted in the wake of highly publicized pension disasters in order to protect employee pension rights. Born as a piece of pro-worker legislation, it initially was criticized by business groups as a cause of bureaucratic arteriosclerosis that was worse than the disease of pension failures. Even worse, it prompted many employers to consider dispensing with pension plans altogether rather than struggle with the administrative and financial obligations of ERISA. Business, labor, and the public all complained about the law's complexity. It even became something of a national joke as regulators took …

The Implementation Of Oregon’S Death With Dignity Act: Reassuring, But More Data Are Needed, David Orentlicher

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Undoubtedly, empirical data from Oregon will play a key role for academics, legislators, judges, and the public as debate over the legalization of physician-assisted suicide continues. A central issue in the debate is whether a right to assisted suicide can be limited to only the truly compelling cases, or whether it will in practice be provided to patients who choose it out of depression, coercion, or misunderstanding. Empirical research can provide critical insights into this question.

Beyond Cloning: Expanding Reproductive Options For Same-Sex Couples, David Orentlicher

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No abstract provided.

Medical Malpractice: Treating The Causes Instead Of The Symptoms, David Orentlicher

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No abstract provided.