Health Law and Policy Commons^™

Do Not Resuscitate Decision-Making: Ohio's Do Not Resuscitate Law Should Be Amended To Include A Mature Minor's Right To Initiate A Dnr Order, Allison Mantz

Journal of Law and Health

Part One discusses Ohio's current DNR (Do Not Resuscitate) law, which does not include an exception for mature minors. It explains the medical difference between initiating a valid DNR order and refusing life-sustaining medical treatment. However, the note solely focuses on DNR and how it relates to a minor's right to initiate his or her own DNR order in light of parental disagreement. Part two explains the evolution of the minor and healthcare. Specifically, the progression from the early common law assumption that minors lack the capacity to consent, to the present, in which minors are permitted to make some …

To Preempt Or Not To Preempt: Hmo Liability Pre And Post Pegram V. Herdrich , Adam D. Glassman

Journal of Law and Health

Should consumers have the right to sue their HMOs (health maintenance organizations) for the way they deliver medical care? In recent years, the federal courts have focused their attention upon, inter alia, the issue of whether HMOs have a duty to reveal financial incentive provisions contained in contracts between the HMO plan physicians to plan members and beneficiaries under a health plan. In fact, on June 12, 2000, the United States Supreme Court, in Pegram v. Herdrich, pondered whether HMO physicians and administrators are fiduciaries under the Employee Retirement Income Security Act (ERISA), and if so, must they exercise their …

Iolta In The Balance: The Battle Of Legality And Morality Between Robin Hood And The Miser Recent Development., Katherine L. Smith

St. Mary's Law Journal

Interest on Lawyers Trust Account (IOLTA) programs recently survived a constitutional challenge. IOLTA programs require interest earned from trust accounts deposited with client money to fund legal services for the poor. Many states, including Texas, maintain a mandatory IOLTA program, requiring all lawyers who handle client funds to participate. Proponents of IOLTA argue it benefits civil justice. Opponents argue it is an unconstitutional taking in violation of the Fifth Amendment. The Fifth Circuit held IOLTA accounts to be an unconstitutional taking of client property. The Ninth Circuit, however, found IOLTA accounts constitutional, holding that IOLTA accounts are not a taking …

Accountants' Accountability To Nonclients In Texas., Jessica P. Gomez

St. Mary's Law Journal

This Comment proposes that accountants be held liable to any foreseeable user of their work product to ensure the deterrence of negligence on their part. Currently, the three main common law theories concerning whether nonclients can sue accountants for negligence are: (1) the privity rule; (2) the Restatement (Second) of Torts § 552; and (3) the foreseeability standard. Many states follow the Restatement approach entitled “Information Negligently Supplied for the Guidance of Others.” Texas imposes liability on accountants but fails to extend protections to third parties who rely upon the accuracy of financial statements. Further, Texas liability does not expose …

Getting What We Should From Doctors: Rethinking Patient Autonomy And The Doctor-Patient Relationship, Roger B. Dworkin

Articles by Maurer Faculty

No abstract provided.

A Tripartite Threat To Medical Records Privacy: Technology, Hipaa's Privacy Rule And The Usa Patriot , Nathan J. Wills

Journal of Law and Health

Proceeding from the proposition that privacy is a fundamental right, this essay notes the importance of maintaining medical records privacy in light of the increased use of technology. It describes the Privacy Rule promulgated under HIPAA, which was intended to strengthen medical records privacy, but notes the restriction of privacy rights following September 11, 2001 ("9/11"). In light of circumscribed privacy rights, the Privacy Rules becomes much more important in protecting medical records privacy. Unfortunately, the Rule falls short of this goal by potentially running afoul of the First and Fourth Amendments. It also fails to provide adequate medical records …

What Successful Companies Know That Law Firms Need To Know: The Importance Of Employee Motivation And Job Satisfaction To Increased Productivity And Stronger Client Relationships, Theresa M. Neff

Journal of Law and Health

This note examines the importance of employee motivation and job satisfaction to increased productivity and stronger client relationships with law firms. In Part I, I discuss how the pressure of the legal profession can affect lawyers' relationships with their staff members. My analysis will center on recent studies on lawyer job satisfaction, the impact of stress on lawyers, and the public's perception of lawyers. In Part II, I discuss the law firm as a "service" organization and the implications of that orientation. In this section, I also emphasize the importance of building and maintaining relationships with clients and how law …

How Mfn Clauses Used In The Health Care Industry Unreasonably Restrain Trade Under The Sherman Act, Beth Ann Wright

Journal of Law and Health

When used in the health care industry, an MFN clause is a contractual agreement that guarantees a health insurer the same best price as their market competitors. MFN clauses have the effect of unnecessarily raising consumer costs, reducing choice among providers, constraining access to care and preventing the development of alternative health care delivery models. The purpose of this paper is four-fold. First, to design a four-quadrant matrix to evaluate the pro-competitive and anticompetitive purpose and effects of MFN clauses under Section 1 of the Sherman Act. Second, to defeat the jurisprudential presumption that MFN clauses are pro-competitive in the …

True Risk Management: Physicians' Liability Risk And The Practice Of Patient-Centered Medicine, Anand Das, Jack Schwartz, Evan G. Derenzo

Journal of Law and Health

While most physicians understand that a serious deficiency in technical care increases their risk of liability, too often their risk management behavior indicates that they do not fully appreciate the impact that poor interpersonal skills have on patients' motivations to sue. Ironically, many of these physicians have taken risk management steps that have increased, rather than reduced, their exposure to lawsuits. In this paper, we argue that a strong legal and factual claim does not invariably explain patients' decisions to sue. Dissatisfaction with the physician's interpersonal care as well as with the clinical outcome is often a factor. Conversely, patients …

Best Methods For Increasing Medical Translators For Limited English Proficient Patients: The Carrot Or The Stick?, Paula Hein

Journal of Law and Health

Private physicians struggle to provide translators for patients, especially in rural areas like the one in which Dr. Kerr practices. Translators cost anywhere from thirty dollars to four hundred dollars depending on such factors as the time needed to translate, whether or not the translator is trained as a medical translator, and the language that is being translated. Telephone language lines, which provide translation over the phone through a dial up service, costs providers an average of two dollars and fifty cents ($2.50) per minute. There is also the price of the extra personnel time that is required to develop, …

The Latex Allergy Crisis: Proposing A Healthy Solution To The Dilemma Facing The Medical Community, Lynn Cherne-Breckner

Journal of Law and Health

The explosion in the number and severity of latex allergies began with the emergence of the AIDS epidemic as the Centers for Disease Control issued universal precautions advising health care workers to use protective barriers to prevent the spread of the infection. This resulted in constant use of the gloves by medical workers and a great increase in demand for cost effective gloves. Essentially, the quality of the glove making process decreased, increasing the amount of allergy inducing proteins excreted to wearers. Afflicted workers include physicians, nurses, dentists, dental hygienists, operating room personnel, laboratory technicians and ambulance attendants among others. …

The Muhammad Ali Boxing Reform Act: Its Problems And Remedies, Including The Possibility Of A United States Boxing Administration, Devin J. Burstein

Cardozo Arts & Entertainment Law Journal

No abstract provided.

Rethinking Legally Relevant Mental Disorder, Christopher Slobogin

Vanderbilt Law School Faculty Publications

The law insists on maintaining mental disorder as a predicate for a wide array of legal provisions, in both the criminal justice system and the civil law. Among adults, only a person with a "mental disease or defect" can escape conviction for an intentional, unjustified crime on grounds of cognitive or volitional impairment.' Only people with "mental illness" or "mental disorder" may be subjected to indeterminate preventive commitment based on dangerousness. Under the laws of many states, only people with a mental disorder are prevented from making decisions about treatment, criminal charges, wills, contracts, and a host of other important …

Genetic Health And Eugenics Precedents: A Voice Of Caution, Larry I. Palmer

Faculty Publications

No abstract provided.

Sex, Marriage, Medicine, And Law: 'What Hope Of Harmony?', Thomas Wm. Mayo

Faculty Journal Articles and Book Chapters

This essay offers a critique of the Kansas Supreme Court's decision in In re Estate of Gardiner, 42 P.3d 120 (Kan. 2002), and similar cases that hold that for purposes of the opposite-sex marriage rule, an individual's sex is determined at birth, is genetically fixed, and cannot be changed through surgery or hormone therapy. The result for transgendered individuals is a legal regime that is hostile to medical care that brings external sex characteristics into line with sexual identity. The result for society is a legal rule that is at odds with scientific opinion. Finally, the result for the opposite-sex …

Puppy Love: Bioterrorism, Civil Rights, And Public Health, George J. Annas

Faculty Scholarship

Florida has been the state humorists most like to make fun of since the 2000 presidential election, especially when it comes to politics. And humorists are almost the only commentators who can be counted on to tell us the truth about the state of American politics today. When Californians decided to recall their Governor, for example, Conan O'Brien observed: "Yesterday Arnold Schwarzenegger announced he would run for governor of California. The announcement was good news for Florida residents, who now live in the second-flakiest state in the country."' And when more than 200 people filed to run for Governor, Jay …

Hipaa Regulations: A New Era Of Medical-Record Privacy?, George J. Annas

Faculty Scholarship

The new privacy regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) become effective April 14, 2003. This article outlines the implications of the new policy for practicing physicians. The regulations will affect virtually every physician, because they apply to any health care provider who conducts any business electronically, including billing. The regulations require health care providers to provide patients with a privacy notice that informs them who will have access to their records without their explicit consent and about patients' rights to inspect and amend their own records.

The Right To Health And The Nevirapine Case In South Africa, George J. Annas

Faculty Scholarship

Thanks to activists in South Africa, the right to health as a human right has returned to the international stage, just as it was being displaced by economists who see health through the prism of a globalized economy and by politicians who see it as an issue of national security or charity. The current post-apartheid debate in South Africa is not about race but about health, and in this context, the court victory by AIDS activists in the nevirapine case has been termed not only, as stated in one British newspaper, “the greatest defeat for [President Thabo] Mbeki's government” but …

Arbitrage, Bioethics, And Cloning: The Abcs Ofgestating A United National Cloning Convention, Rosario M. Isasi, George J. Annas

Faculty Scholarship

America's inability to craft a regulatory ethics of abortion has led to a
/="/">wild west of unregulated research with human embryos and pregnant
/="/">women by our private infertility industry. Because of an "all or nothing"
/="/">research mentality, it is becoming increasingly impossible to suggest
/="/">outlandish and reckless reproductive research possibilities without seeing
/="/">them actually pursued. And if even the wild west seems a bit inhospitable
/="/">to particular research goals, such as cloning to produce the genetic duplicate
/="/">of an existing person, media darlings like Severino Antinori and Zavos
/="/">Panos, and even members …

Policy Choices And Model Acts: Preparing For The Next Public Health Emergency, Ken Wing

Faculty Articles

This article explores policy choices and model acts related to public health administration in the U.S. This article provides information of the general public or state policymakers concerning important policy choices, variation of the pre-existing legal structure in each state, and the principles of separation of powers in limiting legislature's ability to delegate legislative-type decisions.

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

Scholarly Works

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 …

A Healer Or An Executioner: The Proper Role Of A Psychiatrist In A Criminal Justice System, Gregory Dolin

All Faculty Scholarship

This article argues that despite the benefits of ridding the criminal justice system of some uncertainty and ignorance with respect to mental health issues, the very close involvement of psychiatrists in the criminal justice system as practiced in the United States is not only illogical and bad policy, but also unethical from the viewpoint of medical ethics. Part II of this article will lay the groundwork for the argument by discussing the history of the insanity defense, and of science's involvement with criminal justice; while Part III, will look into the association of science and the administration of justice in …

The Invention Of Health Law, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

By default, the courts are inventing health law. The law governing the American health system arises from an unruly mix of statutes, regulations, and judge-crafted doctrines conceived, in the main, without medical care in mind. Courts are ill-equipped to put order to this chaos, and until recently they have been disinclined to try. But political gridlock and popular ire over managed care have pushed them into the breach, and the Supreme Court has become a proactive health policy player. How might judges make sense of health law's disparate doctrinal strands? Scholars from diverse ideological starting points have converged toward a …

Clinical Uncertainty And Healthcare Disparities, Maxwell Gregg Bloche, Ana I. Balsa, Thomas G. Mcguire, Naomi Seiler

Georgetown Law Faculty Publications and Other Works

The Institute of Medicine Report, Unequal Treatment: Confronting Racial and Ethnic Disparities, affirms in its first finding: "Racial and ethnic disparities in health care exist and, because they are associated with worse outcomes in many cases, are unacceptable." The mechanisms that generate racial and ethnic disparities in medical care operate at the levels of the health care system and the clinical encounter. Research demonstrates the role of health care system factors, including differences in insurance coverage and other determinants of healthcare access, in producing disparities. Research also shows, however, that even when insurance status and other measures of access are …

Disasters First: Rethinking Environmental Law After September 11, Michael B. Gerrard

Faculty Scholarship

Many environmental statutes were enacted, or at least spurred along, in direct response to disasters. The Federal Water Pollution Control Act of 1972 followed from the Santa Barbara Oil Spill; the Emergency Planning and Community Right-to-Know Act (EPCRA) resulted from the chemical gas disaster in Bhopal, India; the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) was sparked by the Love Canal incident; and the Oil Pollution Acte was a reaction to the Exxon Valdez oil spill.

The terrorist attacks of September 11, 2001 have led to the Homeland Security Act and to several other enactments. The collapse of the …

Developing A Full And Fair Evidentiary Record In A Nonadversary Setting: Two Proposals For Improving Social Security Disability Adjudications, Jeffrey Lubbers, Frank S. Bloch, Paul R. Verkuil

Scholarly Articles in Law Reviews & Journals

No abstract provided.

The Louisa Van Wezel Schwartz Symposium On Mental Health Issues In Correctional Institutions - Proceedings, Brenda V. Smith

Scholarly Articles in Law Reviews & Journals

Now, you would think that I was as old as dirt after listening to that introduction. Well, the truth is, I am as old as dirt. And I told Paul Quander that we are both as old as dirt.

First, I want to thank Arlene for inviting me. Many, many months ago Arlene called and asked me if I would speak at this symposium on mental health in correctional institutions.

Racism Or Realpolitik? U.S. Foreign Policy And The Hiv/Aids Catastrophe In Sub-Saharan Africa, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Internet Pharmacies And The Need For A New Federalism: Protecting Consumers While Increasing Access To Prescription Drugs, Linda C. Fentiman

Elisabeth Haub School of Law Faculty Publications

In this article I will argue that Internet pharmacies pose a significant public health problem, as they raise the classic eternal triangle of health care issues--access, quality, and financing--in a new technological context. Part II describes the phenomena of Internet pharmacies, and Part III reviews the present regulatory scheme. Part IV explains why the current legal framework is inadequate to address the public health and safety problems posed by Internet pharmacies, focusing particularly on the jurisdictional, constitutional, and practical obstacles to effective state oversight of Internet pharmacies. Part V argues that comprehensive federal oversight of Internet prescribing and dispensing is …

Pushing Drugs: Genomics And Genetics, The Pharmaceutical Industry, And The Law Of Negligence, Heidi Li Feldman

Georgetown Law Faculty Publications and Other Works

This article presents a piece of a larger, ongoing project on the phenomenon of market-driven manufacturing (MDM) and how tort law should address it. In contrast to the larger project, this article provides a relatively brief overview of the general phenomenon of MDM, but zeros in on how pharmaceutical manufacturers specifically practice MDM. MDM is a well-documented, much practiced activity, although American courts do not recognize MDM as a discrete category of conduct. The basic idea of MDM is that marketing considerations should continuously control every aspect and stage of a product's lifecycle. When a company engages in MDM, it …