Health Law and Policy Commons^™

Who Decides Whether A Patient Lives Or Dies?, Diane E. Hoffmann, Jack Schwartz

Faculty Scholarship

No abstract provided.

Medical Torture: End Of Life Decision-Making In The United Kingdom And United States, Jon D. Feldhammer

Cardozo Journal of International and Comparative Law

The note examines the legal and ethical challenges surrounding end-of-life medical decisions in the United States and the United Kingdom, highlighting the failure of both countries to effectively implement patients' end-of-life plans. It argues that the current legal frameworks in both nations often lead to prolonged, painful, and futile medical treatments, violating patient dignity and human rights. The analysis critiques the lack of consensus on medical futility and proposes a legislative model to balance patient autonomy, physician discretion, and ethical medical practice.

Institutional Oversight Of Clinical Trials And The Drug Approval Process, Paul B. Miller

Osgoode Hall Law Journal

The institutional and federal bodies responsible for regulatory review and oversight of clinical trials in Canada serve distinct yet complementary functions in ensuring that clinical trials provide scientifically rigorous and ethically sound evaluation of new therapeutic products. To date, academics and reformers alike have discussed reform priorities for federal and institutional review in isolation, as if their guiding purposes are distinct. This article identifies the overlapping objectives of federal and institutional review, argues for the importance of coordination of institutional and federal oversight structures, and identifies potential points of coordination.

Patients And Biobanks, Ellen Wright Clayton

Vanderbilt Law School Faculty Publications

The question about the privacy of medical information can be stated simply: To what extent can and should patients control what the medical record contains and who has access to it and for what purposes? Patients often have apparently conflicting views on this subject. On the one hand, we, as patients, say that we prize privacy and that we fear that information will be used to harm us. On the other hand, we value the benefits that come from improved communication among providers, such as having our visits covered by third party payers and advances in medical science, which often …

Plan B Contraceptive And The Role Of Politics In Medicine: A Comparative Analysis Of The "Switch" Of Emergency Contraception From Prescription To Non-Prescription In The United States, France, The United Kingdom, And Canada, Mary E. Armstrong

ExpressO

Of the approximately 6 million pregnancies in the United States each year, almost half are unintended. Of these unintended pregnancies, approximately four in ten will end in abortion. Plan B emergency contraception is a drug that has the potential to reduce the number of abortions performed each year in half. Despite contentions from various religious and political sects, Plan B is not an abortifacient. It acts by preventing a pregnancy from starting rather than terminating a pregnancy that is already established. On December 16, 2003, a panel of medical and scientific experts gathered by the Food and Drug Administration (FDA), …

Brain Imaging And Privacy: How Recent Advances In Neuroimaging Implicate Privacy Concerns , David P. Finn

ExpressO

This paper deals with recent advances in neuroimaging technologies which could begin to implicate privacy concerns in the near future.

Biopolitics At The Bedside: Proxy Wars And Feeding Tubes, Joshua E. Perry

ExpressO

In the aftermath of Terri Schiavo’s dramatic final weeks of life, George Annas speculated that proponents of “culture of life” politics might “now view [themselves] as strong enough to generate new laws . . . to require that incompetent patients be kept alive with artificially delivered fluids and nutrition.” Indeed, Professor Annas’ prescience has been demonstrated by the post-Schiavo introduction in two dozen state legislatures of over fifty different bills making it more onerous to remove a patient’s artificial nutrition and hydration (ANH). With minor exception, however, most of the proposed legislation has either stalled or been watered down, prompting …

Hedonic Damages, Hedonic Adaptation, And Disability, Samuel R. Bagenstos, Margo Schlanger

ExpressO

This article contributes to the broad debate over “adaptive preferences” in law, economics, and political philosophy by addressing an important ongoing controversy in tort law. Hedonic damages compensate for the lost enjoyment of life that results from a tortious injury. Lawyers seeking hedonic damages in personal injury cases emphasize their clients’ new status as compromised and damaged persons, and courts frequently uphold jury verdicts awarding hedonic damages to individuals who experienced disabling injuries based on a view that disability necessarily limits one’s enjoyment of life. This view is consonant with a general societal understanding of disability as a tragedy and …

Law & Health Care Newsletter, V. 14, No. 1, Fall 2006

Law & Health Care Newsletter

No abstract provided.

A Tough Pill To Swallow: Does The First Amendment Prohibit Wv From Regulating Pharmaceutical Companies' Advertising Expenses To Lower The Cost Of Prescription Drugs?, Brienne Taylor Greiner

West Virginia Law Review

No abstract provided.

Why Health Courts Are Unconstitutional, Amy Widman

Pace Law Review

No abstract provided.

Disability Discrimination In Long-Term Care: Using The Fair Housing Act To Prevent Illegal Screening In Admissions To Nursing Homes And Assisted Living Facilities, Eric M. Carlson

ExpressO

Nursing homes and assisted living facilities routinely require applicants to disclose an extensive amount of medical information. Not infrequently, these long-term care facilities use the information to deny admission to those applicants with relatively greater care needs. These denials constitute illegal discrimination under the Americans with Disabilities Act and the Rehabilitation Act, but generally consumers are unaware of these protections or find litigation too expensive and time-consuming under their generally difficult circumstances.

These illegal denials of service could be limited by active enforcement of the Fair Housing Act’s no-inquiry regulation, which prohibits a housing provider from inquiring into an applicant’s …

The Convicted Felon As A Guardian: Considering The Alternatives Of Potential Guardians With Less-Than-Perfect Records, Mike Jorgensen

ExpressO

Courts require discretion in appointing guardians. Oftentimes, the legislature prevents the courts from exercising discretion when statutes are enacted that prohibit felons from serving as guardians under any circumstances. Yet, the need for guardians is increasing and will continue to do so due to the exponential growth in the aging elder population.

At the same time, however, the pool of potential guardians is shrinking in size. Additionally, the same reducing pool of eligible guardians is being attenuated further by having a disproportionate amount of felonies.

The groups most impacted by these trends are the indigent and the minorities. The indigent …

A Friendly Approach To Reducing Medical Malpractice Litigation, Aaron A. Bucco

ExpressO

A Friendly Approach to Reducing Medical Malpractice Litigation focuses on practical and feasible solutions to the rising threat of medical malpractice litigation by establishing that psychological principles are fundamental to point-of-care physician-patient interaction. Several universities discussed in the article have recognized the benefits of incorporating bedside manner techniques into the curriculum. The article attempts to extend the logic understood by those universities to medical malpractice insurance providers as a means to effectively preempt litigation as opposed to maintaining a reactive posture, or worse, limiting the rights of patients, thereby raising their guard and weakening their tolerance for error.

Protecting Rights Or Waiving Them? Why 'Negotiated Risk' Should Be Removed From Assisted Living Law, Eric M. Carlson

ExpressO

Assisted living facilities claim that negotiated risk agreements give residents the freedom to act against facility advice. On the contrary, negotiated risk was proposed originally to waive a facility’s liability for inadequate care, and liability waiver remains a significant component of negotiated risk.

This Article offers the first detailed legal analysis of state negotiated risk laws. Due to negotiated risk’s dueling definitions – based either on the against-facility-advice scenario or the inadequate care scenario – state law is marked by ambiguity and inconsistency. Currently, fifteen states address negotiated risk in law, and an additional state has developed a standardized negotiated …

Effects Of Food Marketing To Kids: I'M Lovin' It?, Eileen Salinsky

National Health Policy Forum

This issue brief reviews key findings and recommendations from the Institute of Medicine study on food marketing and its effects on childhood obesity. The brief describes the childhood obesity epidemic, discusses key trends associated with rising childhood obesity rates, and considers the relative role of marketing practices on diet and obesity within the broader context of complex contributory factors. The brief also summarizes the current legal framework for regulating marketing directed at children; discusses voluntary, self-regulatory mechanisms; and highlights proposals to re-orient marketing practices to combat childhood obesity.

In Sickness, Health, And Cyberspace: Protecting The Security Of Electronic Private Health Information, Sharona Hoffman, Andy Podgurski

ExpressO

The electronic processing of health information provides considerable benefits to patients and health care providers at the same time that it creates serious risks to the confidentiality, integrity, and availability of the data. The Internet provides a conduit for rapid and uncontrolled dispersion and trafficking of illicitly-obtained private health information, with far-reaching consequences to the unsuspecting victims. In order to address such threats to electronic private health information, the U.S. Department of Health and Human Services enacted the HIPAA Security Rule, which thus far has received little attention in the legal literature. This article presents a critique of the Security …

A Closer Look At The Medicare Part D Low–Income Benchmark Premium: How Low Can It Go?, Mary Ellen Stahlman

National Health Policy Forum

This issue brief explains how the Medicare Part D low–income benchmark premium is calculated, what factors influence the level of the low-income benchmark premium in any given year, and the implications of the benchmark amount for Medicare drug plans and beneficiaries as it changes from year to year. The paper provides a simplified, two-year example of how the low-income benchmark premium is calculated in order to illustrate the key factors that influence it.

Oy Canada! Trade's Non-Solution To "The Problem" Of U.S. Drug Prices, Daniel Gilman

Faculty Scholarship

Price disparities—price “differentiation” or “discrimination”—in pharmaceuticals markets have, in recent years, been the subject of much discussion. Price sensitivity should come as no surprise: Medicines play an increasingly important role in healthcare, while pharmaceuticals prices continue to rise. When prices vary greatly within markets or between neighboring markets, the pressure towards arbitrage is clear. This paper considers the question whether the re-importation of medicines from Canada or the EU is well advised and argues that it is not. First, we might reasonably question the extent to which we wish, as a matter of policy, to manage pharmaceuticals pricing; among other …

Why It Is Time To Eliminate Genomic Patents, Together With Natural Extracts Doctrine That Have Supported Such Patents, Allen K. Yu

ExpressO

The constitutional purpose of intellectual property is to “promote the progress of science and useful arts.” Given the utilitarian basis of patents, it is critical that policies and laws must be continually adjusted to reflect the needs of new technologies. When the law tries to shield itself from rather than confront the realities of underlying technologies, patents end up actually subverting rather than promote technological progress. This paper explores why the natural extracts doctrine belongs to the class of doctrines that subvert progress. The doctrine, established over a century ago to enable the patenting of purified compounds for use as …

Premium Assistance In Medicaid And Schip: Ace In The Hole Or House Of Cards?, Cynthia Shirk, Jennifer Ryan

National Health Policy Forum

This issue brief explores the use of premium assistance in publicly financed health insurance coverage programs. In the context of Medicaid and the State Children’s Health Insurance Program (SCHIP), premium assistance entails using federal and state funds to subsidize the premiums for the purchase of private insurance coverage for eligible individuals. This paper considers the evolution of premium assistance and some of the statutory and administrative limitations, as well as private market factors, that have prevented widespread enrollment in Medicaid or SCHIP premium assistance programs. Finally, this issue brief offers some ideas for potential legislative and/or programmatic changes that could …

“Just Scanning Around” With Diagnostic Medical Ultrasound: Should States Regulate The Non-Diagnostic Uses Of This Technology?, Archie A. Alexander

ExpressO

Recent advances in medical imaging have provided physicians with more accurate diagnostic information, which has allowed them to tailor their therapies to reduce health care costs. These recent advances have caused the New England Journal of Medicine to hail diagnostic medical imaging as one of the greatest contributions to medicine in last thousand years. Yes, modern diagnostic imaging plays a major role in medicine, especially in the case of diagnostic imaging technology. One reason this technology has assumed such a prominent position worldwide is the usage of higher sound intensities by its manufacturers for better image quality. A recent survey …

Don't Bring Me Your Tired, Your Poor: The Crowded State Of America's Emergency Departments, Jessamyn Taylor

National Health Policy Forum

If the time comes, people expect that the emergency department (ED) will have the resources necessary to treat them in a timely, high-quality manner. Increasingly, however, EDs may not be able to meet that expectation. Hospitals in urban areas with large populations, high population growth, and higher-than-average numbers of uninsured are particularly crowded: ambulances are often diverted to other hospitals and patients are frequently forced to “board” in the hallways (while they wait to be transferred to another facility or part of the hospital). This issue brief places EDs in the context of the U.S. health care system and its …

Abortion: Ensuring Access, Sanda Rodgers, Jocelyn Downie

Articles, Book Chapters, & Popular Press

Access to reproductive health care is essential to women’s health, and for some women, abortion is a key component of that care. But not all women in Canada have adequate, or in some cases any, access to abortion. It is important for Canadian physicians to know the facts about access to abortion so that they can better protect and promote the health of their female patients.

Mid-Atlantic Ethics Committee Newsletter, Summer 2006

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Drugged, Carl E. Schneider

Articles

The Supreme Court's recent decision in Gonzales v. Oregon, like its decision last year in Gonzales v. Raich (the "medical marijuana" case), again raises questions about the bioethical consequences of the Controlled Substances Act. When, in 1970, Congress passed that act, it placed problematic drugs in one of five "schedules," and it authorized the U.S. attorney general to add or subtract drugs from the schedules. Drugs in schedule II have both a medical use and a high potential for abuse. Doctors may prescribe such drugs if they "obtain from the Attorney General a registration issued in accordance with the …

The Electronic Health Record In Practice: Why, How, And What Next?, Lisa Sprague, Sally Coberly

National Health Policy Forum

This local site visit was intended to allow participants to observe the electronic health record (EHR) as used in practice by two U.S. leaders in technology and quality, the Veterans Health Administration (VHA) and Kaiser Permanente (KP). The VHA has employed an EHR system since 1997; KP is in the process of implementing a standard system for all clinicians nationwide. The site visit was designed to provide an opportunity for participants to explore both the expected benefits from EHR adoption and the specific lessons these two large, integrated delivery systems have learned in their transition from paper to electronic records. …

Bond Repudiation, Tax Codes, The Appropriations Process And Restitution Post-Eminent Domain Reform, John H. Ryskamp

ExpressO

This brief comment suggests where the anti-eminent domain movement might be heading next.

Till Death Do Us Part: Marriage, Hiv/Aids And The Law In Zimbabwe, Slyvia Chirawu

ExpressO

Lying in Sub Saharan Africa, the epicenter of the HIV/AIDS epidemic, Zimbabwe has grappled since 1985 to prevent and mitigate the impact of HIV/AIDS. Statistics point out to one glaring factor- the disproportionate impact of HIV/AIDS on women and in the case of Zimbabwe married women. Laws, policies and practices in relation to marriage predispose married women to HIV/AIDS infection. The answer to protecting women does not lie entirely in the law but in transformative gender equality.

Zimbabwe has two types of recognized marriages and the third type , the unregistered customary law union is given limited recognition. The thread …

National Institutes Of Health State-Of-The-Science Conference Statement: Cesarean Delivery On Maternal Request, Karen H. Rothenberg

Faculty Scholarship

No abstract provided.