Health Law and Policy Commons^™

Patient Safety, Risk Reduction, And The Law, Larry I. Palmer

Cornell Law Faculty Publications

"Patient safety" has come of age. With the publication of several empirical studies of medical injuries and the recent Institute of Medicine Report, To Err is Human: Building a Safe Health System, scholars from a variety of disciplines are advocating "systems thinking" as a way of preventing medical accidents. These scholars have been influenced by efforts to reduce accidents in other high risk industries such as aviation and scholarship in law proposing "no fault systems" for compensating medical accident victims. This article proposes that in order to incorporate "systems thinking" about medical error reduction, legal scholarship on the health care …

Telemedicine And Integrated Health Care Delivery: Compounding Malpractice Liability, Patricia C. Kuszler

Articles

This Article considers how theories of medical negligence might be applied in the context of telemedicine and integrated delivery health plans. Part Two summarizes the history of telemedicine, its increasing breadth of application and opportunity and promise for the future. Part Three reviews traditional negligence principles and precedents and demonstrates how they might be applied when a telemedicine interaction results in negligence and harm to the patient. Part Four discusses evolving theories of shared liability applicable to health plans and managed care entities. Finally, Part Five demonstrates how shared liability theories will be applied to situations involving telemedicine technologies.

Corralling Kevorkian: Regulating Physician-Assisted Suicide In America, Steve Calandrillo

Articles

This article examines the evolution and history of the development of the right-to-die in America, the ethical considerations surrounding physician-assisted suicide (P.A.S.), and the dangers posed by the rise of managed care. I then explore and analyze efforts to legalize and regulate assisted suicide (Netherlands, Oregon, The Model State Act), and suggest the criteria I believe are essential to include in any P.A.S. regulatory scheme.

So You're Having Another Woman's Baby: Economics And Exploitation In Gestational Surrogacy, Angie G. Mcewen

Vanderbilt Journal of Transnational Law

While placing a monetary value on a product or service seems natural in many areas of society, it presents new challenges when introduced into the reproductive arena.' Society has confronted a similar debate before. Life insurance was once viewed as a form of trafficking in human lives. The acceptance of valuation in this and other areas represents a shift in cultural values that must now confront birthing arrangements.

The emergence of new reproductive technologies has ushered in new possibilities not only for women unable to bear children, but also for women willing to bear children for another, and for individuals …

Reviving The Public/Private Distinction In Feminist Theorizing Symposium On Unfinished Feminist Business, Tracy E. Higgins

Faculty Scholarship

The public/private distinction has been a target of thoroughgoing feminist critique for quite some time now. Indeed, attacking the public/private line has been one of the primary concerns (if not the primary concern) of feminist legal theorizing for over two decades. If Carole Pateman is correct, one would think that this particular problem might be assigned to the category of "finished business" by this time. In this Essay, I do argue that the critique is, in certain ways, finished business in that it is no longer particularly useful in its most common forms. More importantly, however, I suggest several ways …

The Duty To Treat Asymptomatic Hiv-Positive Patients Or Face Disability Discrimination Under Abbott V. Bragdon: The Scylla And Charybdis Facing Today's Dental And Health Care Providers, Lisa Taylor Hudson

University of Richmond Law Review

Imagine yourself in the following scenario. You are an experienced dentist with a small private practice, and you routinely accept new patients and referrals. One of your long-time patients is scheduled for a routine tooth cleaning and dental examination. You make every effort to keep updated documentation on your patients, and in that pursuit, you request that the. patient complete a basic written health questionnaire. In the section relating to medications and relevant medical history, the patient reveals that she is taking medications for Acquired Immunodeficiency Syndrome ("AIDS"),' and that she has tested positive for Human Immunodeficiency Virus ("HIV-positive").

University Of Richmond Law Review

University of Richmond Law Review

No abstract provided.

Gene Therapy: Legal And Ethical Issues For Pregnant Women , Angela Liang

Cleveland State Law Review

The decision to undergo gene therapy in utero for the sake of a fetus should legally rest with the pregnant woman rather than the judiciary or the legislature. Part I of this article provides an overview of the current scope of gene therapy. Part II discusses previous court decisions that either granted or denied petitions for involuntary prenatal intervention. Part III analyzes three reasons why the courts should not impose gene therapy on pregnant women as the technology becomes available. First, a policy that mandates gene therapy would place an undue burden on pregnant women and violate the Equal Protection …

Determining The Immunity Measuring Stick: The Impact Of The Health Care Quality Improvement Act And Antitrust Laws On Immunity Aspects Of Granting Privileges To Physician Assistants, Joseph Mark Saponaro

Cleveland State Law Review

This note examines the antitrust developments that affect the health care industry; the Health Care Quality Improvement Act of 1986; the treatment of peer review process immunity for physicians as it now exists; how non-physician providers are dealt with in the peer review process; and where physician assistants fit into the whole scheme. Part I of this note lays a foundation of antitrust principles, briefly explaining the applicable portions of the Sherman Act. Part I continues by setting forth the approaches, rule of reason versus per se rule, that courts utilize when dealing with antitrust situations. After explaining these governing …

Justification By Faith, Carl E. Schneider

Articles

In June 1997 a sixteen-year-old girl named Shannon Nixon began to feel ill. Her parents belonged to the Faith Tabernacle Church, one of a number of American sects which believe that illness should be treated spiritually rather than medically. Accordingly, the Nixons prayed for Shannon and took her to be anointed at their church. Shannon reported that she felt better and that the spiritual treatment had gained her her victory-her recovery. Before long, however, Shannon again felt ill. She became weaker and weaker and then fell into a coma. A few hours later she died. An autopsy revealed that she …

Illuminating The Possible In The Developing World: Guaranteeing The Human Right To Health In India, Sheetal B. Shah

Vanderbilt Journal of Transnational Law

This Note argues that the recognition of the social right to health offers a step forward in empowering individuals to gain control over their social environments in the developing world. Part II discusses the potential of social human rights to alleviate suffering in the developing world. Social human rights recognize that the state must provide individuals with the basic social conditions necessary to live with human dignity. Part III explores the legal obligations of social rights and their current status in human rights jurisprudence. It also discusses the most pressing challenges facing implementation of social rights at the national level. …

Managed Care And Mental Health: Clinical Perspectives And Legal Realities, Jesse Goldner

All Faculty Scholarship

Managed care is beginning to dominate the delivery of mental health services. The Article reviews limitations on managed care's ability to deal adequately with mental illness. It discusses empirical and other research examining the use of primary care providers as gatekeepers and it explores utilization review mechanisms, focusing particularly on providers' responses to UR. The impact on quality, access and continuity of care on discrete populations is analyzed. The article then surveys a variety of legal issues in the regulation of managed care, particularly as they apply to the provision of mental health services. These include ERISA, parity and liability …

Antitrust And The Health Care Industry: The View From The Three Branches, Thomas L. Greaney

All Faculty Scholarship

This article provides a critical appraisal of the summer's three major health care antitrust events. The California Dental Association case, the Justice Department's challenge to the Aetna-Prudential merger, and the proposed Quality Health Care Coalition Act of 1999 are likely to have a significant influence on the trajectory of antitrust enforcement in the coming years. The author argues that the reasoning of these precedents suffers from an over reaction to the managed care bogeyman and a lack of attention to sound antitrust jurisprudence. In a postscript, it finds similar shortcomings with the Eighth Circuit's recent decision in FTC & State …

Shaping Regional Economies To Sustain Quality Work: The Cooperative Health Care Network, Peter R. Pitegoff

Faculty Publications

This chapter chronicles a creative response to social retrenchment, a saga of strategic deployment of accessible resources and a reshaping of regional economic forces for the benefit of targeted labor markets. While charting its own course, CHCB is part of a mutually supportive network of health care employers and trainers, including successful home care companies in Philadelphia and the South Bronx. Together, these three corporations form the core of the Cooperative Health Care Network and employ over 500 home health aides. About 80 percent of the employees were formerly dependent on public assistance. The network [network] experience and their applicability …

Information/Consent/Authorization For Minors' Participation In Research, Jocelyn Downie

Articles, Book Chapters, & Popular Press

Following the workshop described in the previous article "Children and Decision-Making in Health Research," I decided to "operationalize" the approach taken to the issue of minors and consent/authorization. What follows is a proposed set of instructions for investigators that could be provided by REBs to investigators to facilitate the process of applying for ethical approval for research involving minors and to ensure respect for minors who are participating in research.

Drug Treatment Courts: Evolution, Evaluation, And Future Directions, Gloria Danziger, Jeffrey Kuhn

All Faculty Scholarship

No abstract provided.

Herd Behavior In Designer Genes, Peter H. Huang

Publications

The ability of individuals to choose their children's genes has increased over time and may ultimately culminate in a world involving free market reprogenetic technologies. Reprogenetic technologies combine advances in reproductive biology and genetics to provide humans increased control over their children's genes. This Article offers economic perspectives that are helpful in understanding the possibly unexpected ethical, legal, and social issues at stake in using reprogenetic technologies for trait enhancement selection. The Appendix analyzes two competitive games that might arise in such a biotechnological society. Specifically, the Article focuses on herd behavior, caused by either a popularity contest or positional …

Medical Ethics And Human Rights: Legacies Of Nuremberg, George J. Annas, Michael A. Grodin

Faculty Scholarship

Many of our most important human rights documents are the product of the world's horror during the carnage of World War II. The broadest and most powerful declaration of human rights, the Universal Declaration of Human Rights, was adopted by the membership of the new United Nations in 1948. But there are also much more specific statements of the world's aspirations for all of its inhabitants. August 1997 marked the 50th anniversary of the conclusion of the trial of Nazi physicians at Nuremberg, a trial which has been variously designated as the "Doctors' Trial" and the "Medical Case."² In …

Is It Worth The Trouble? The New Policy On Dissemination Of Information On Off-Label Use Under The Food And Drug Administration Modernization Act Of 1997, Elizabeth Weeks Leonard

Scholarly Works

On January 14, 1998 the Food and Drug Administration (FDA) approved the use of a product previously marketed as Excedrin Extra Strength^® for use in treating migraine headaches. As part of the approval for the new use of the product, FDA required the pharmaceutical manufacturer of Excedrin^®, Bristol-Myers Squibb, to relabel and repackage the product. The new product is called “Excedrin Migraine^®” and is sold side-by-side with Excedrin Extra Strength^®. Both over-the-counter (OTC) products contain the same active ingredients: 250 milligrams of acetaminophen, 250 milligrams of aspirin, and sixty-five milligrams of caffeine. Many …

Genetic Test Results And The Duty To Disclose: Can Medical Researchers Control Liability?, Richard L. Furman, Jr.

Seattle University Law Review

This Comment examines research on the human genome and explores the existence of a duty to disclose genetic test results in clinical and research settings. Part II begins with a hypothetical describing how such a duty to disclose can arise. Part III (A-C) describes advances in the sequencing of the human genome, the development of reliable tests for genetic disorders, and issues regarding access and control of genetic test samples and results. Part III (D) looks at the tort law basis for a general duty of physicians to disclose medical information, the specific duty of clinical physicians to disclose the …

The Last Resort: The Use Of Physical Restraints In Medical Emergencies, George J. Annas

Faculty Scholarship

Public awareness of the use of restraints in medicine has been greatly heightened by a five-part investigative series on physical restraints in psychiatric hospitals by the Hartford Courant and reaction to it by Connecticut's U.S. senators, Joseph Lieberman and Christopher Dodd. In October 1998 the Courant 's 50-state survey identified 142 patients who had died while in restraints or seclusion in the past decade, and the total number is probably much higher. The newspaper advocated the need for national standards for the use of restraints, impartial oversight, and accountability “for behavior that is cruel and even criminal.” The use of …

Waste And Longing: The Legal Status Of Placental Blood Banking, George J. Annas

Faculty Scholarship

Waste is not always what it seems. In his Cold War novel Underworld, for example, Don DeLillo explores the multifaceted qualities of waste. “Waste,” he notes, “is the secret history, the underhistory, the way archaeologists dig out the history of early cultures, every sort of bone and broken tool, literally from under the ground.”1 And waste can also be transformed into money:

They are trading garbage in the commodity pits in Chicago. They are making synthetic feces in Dallas. You can sell your testicles to a firm in Russia that will give you four thousand dollars and then remove …

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Stem Cell Politics, Ethics And Medical Progress, George J. Annas, Arthur Caplan, Sherman Elias

Faculty Scholarship

Controversy over how to fund and regulate stem cell research continues in the US and is unlikely to be resolved anytime soon. The National Institutes of Health (NIH) has announced that it is prepared to fund stem cell research under yet-to-be-specified guidelines. The National Bioethics Advisory Commission (NBAC) issued a report on stem cells in mid-September, recommending that Congress change the law to permit the derivation and use of stem cells from embryos no longer needed for reproduction purposes that are stored at in vitro fertilization (IVF) clinics. The NBAC also recommended that the Department of Health and Human Services …

Preface: Electronic Medical Information: Privacy, Liability And Quality Issues, Frances H. Miller

Faculty Scholarship

This symposium issue explores the timely topic of health care information and information technology, and their impact on health care delivery. The potential for mischief in this area has been the subject of many a dire prediction, but documented instances of negligence or abuse are thus far relatively rare. As information technology becomes more and more sophisticated and pervasive, however, legal problems are increasingly possible-if not probable-and these articles examine a wide range of issues related to the phenomenon.