Health Law and Policy Commons^™

Livestock Animal Cloning: This Steak Is Giving Me Déjà Vu, Blake M. Mensing

Sustainable Development Law & Policy

No abstract provided.

Using The Clean Water Act To Protect Our Ocean's Biodiversity, Kate Halloran

Sustainable Development Law & Policy

No abstract provided.

Putting The Community Back Into The "Community Benefit" Standard, Jessica Berg

Georgia Law Review

Disputes about tax exemption for hospitals are occurring all over the country. Local tax authorities have revoked tax- exempt status for some hospitals. State governments are considering whether to require minimum amounts of charity care in exchange for tax exemption. Congress is debating whether hospitals should remain a part of the nonprofit sector at all. At the same time, uninsured individuals are suing hospitals for unfair billing and collection practices. Creative accounting and expansive definitions of "free" care have led to a variety of non ideal practices by hospitals in order to balance their bottom line, while maintaining tax-exempt status. …

The Parity Cure: Solving Unequal Treatment Of Mental Illness Health Insurance Through Federal Legislation, Christopher J. Churchill

Georgia Law Review

American health care reform has drawn both impassioned critics and vociferous supporters. Although underinsured and uninsured Americans face a dire plight, the mentally ill-even those with private health insurance-confront even greater hurdles. While drawing substantially less outcry, many insurance plans place limits on mental illness coverage that do not apply to physical illnesses. Though Congress recently passed the Mental Health Parity and Addiction Equity Act of 2008 (the MHPAEA), it did not solve the problem. The MHPAEA eliminates some disparity-such as higher deductibles for mental health treatment-but still allows insurers to impose unequal annual coverage limits. Furthermore,the MHPAEA shares the …

Phase Six Pandemic: A Call To Re-Evaluate Federal Quarantine Authority Before The Next Catastrophic Outbreak, John T. Clarkson

Georgia Law Review

At some point in the future, the United States will confront a deadly pandemic. One potential response to blunt the impact of an outbreak may be the use of a large-scale quarantine. The current statutory framework governing federal quarantine authority, however, is outdated and in need of revision. Any reform must acknowledge that the federal government may be best positioned to respond to national health threats and must simultaneously create limits on federal power to ensure a proper balance of power remains between the states and the federal government. This Note proposes that Congress focus its reform efforts on adding …

Taking From Trailblazers: Learning From Those Who Have Gone Before When Approving Biosimilars, John A. Little, Jr.

Georgia Law Review

The creation of an approval pathway for biosimilar biologicalproducts holds tremendous promise for increased competition in the biopharmaceutical market and financial savings to the health care system. Yet, safely achieving these promised benefits depends heavily on the Food and Drug Administration's ability to evaluate and compare these complicated molecules to previously approved products. Because biosimilars are different than generic drugs, the FDA's current practice of considering only its prior finding of safety and efficacy of a reference product is ill-suited for approval of biosimilars. Unfortunately, the new pathway included in recently enacted health care reform legislation ignores this distinction and …

State Of Emergency: Why Georgia's Standard Of Care In Emergency Rooms Is Harmful To Your Health, Jason R. Graves

Georgia Law Review

Patients injured by medical negligence have historically
been able to recover for the injuries they sustained. In
2005, however, the Georgia General Assembly passed
Georgia Senate Bill 3, which gave virtual immunity to
emergency room doctors and those practicing in obstetrics
wards. The Bill requires a showing of gross negligence by
clear and convincing evidence to prevail on a medical
malpractice claim against those protected by the statute.
The law prevents injured patients who cannot meet this
standard from recovering any damages, even
compensation for medical bills arising from the negligent
act. The legislature enacted the Bill in an effort …

Mapping The Issues: Public Health, Law And Ethics, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The field of public health is typically regarded as a positivistic pursuit and, undoubtedly, our understanding of the etiology and response to disease is heavily influenced by scientific inquiry. Public health policies, however, are shaped not only by science but also by ethical values, legal norms, and political oversight. Public Health Law and Ethics: A Reader (expanded and updated 2nd ed., 2010) probes and seeks to illuminate this complex interplay, through a careful selection of government reports, scholarly articles, and court cases together with discussion and analysis of critical problems at the interface of law, ethics, and public health. The …

The Unconscionable Health Gap: A Global Plan For Justice, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

International norms recognize the special value of health. The WHO Constitution states that “the enjoyment of the highest attainable standard of health” is a fundamental human right. The right to health, moreover, is a treaty obligation with clear obligations. Despite robust international norms, unconscionable health disparities exist between the world’s rich and poor, causing enormous suffering. The WHO urges “closing the health gap in a generation” through action on the social determinants of health. As the Marmot Commission observed: “the social conditions in which people are born, live, and work are the single most important determinant of good or ill …

Reducing Distracted Driving: Regulation And Education To Avert Traffic Injuries And Fatalities, Lawrence O. Gostin, Peter D. Jacobson

Georgetown Law Faculty Publications and Other Works

In this article, we consider the legal and policy implications of distracted driving (the tendency of people to use electronic devices while operating a motor vehicle). After reviewing the empirical evidence showing that distracted driving has serious adverse consequences, we discuss the legal basis for governmental interventions to reduce distracted driving. These interventions include laws restricting the use of electronic devices while driving, especially sending text messages. Since drivers have at best a reduced expectation of privacy, these restrictions should easily survive legal challenges. At the same time, it is important to consider the responsibility of automobile manufacturers to improve …

Adaptation To The Health Consequences Of Climate Change As A Potential Influence On Public Health Law And Policy: From Preparedness To Resilience, Lindsay F. Wiley

Georgetown Law Faculty Publications and Other Works

Because the health effects of climate change are likely to be significant and far-reaching, a key component of climate change adaptation will be our public health infrastructure. Perhaps counter-intuitively, recent emphasis in public health law on preparedness for extraordinary events may be to the detriment of our ability to cope with the health impacts of climate change. While existing emergency preparedness law will necessarily be an important backdrop for health-focused climate change adaptation efforts (especially with regard to natural disasters and infectious disease outbreaks), the focus on emergency preparedness in recent years does not necessarily situate us well for handling …

The Right To Bear Arms: A Uniquely American Entitlement, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

In District of Columbia v. Heller the Supreme Court held that individuals have a constitutional right to own firearms, notably to keep a loaded handgun at home for self-protection. The historic shift announced by Heller was the recognition of a personal right, rather than a collective right tied to state militias. In McDonald v. Chicago, the Supreme Court – in a familiar 5-4 ideological split – held that the 2nd Amendment applies not only to the federal government, but also to state and local gun control laws. In his dissent, Justice Stevens predicted that “the consequences could prove far more …

The Joint Action And Learning Initiative On National And Global Responsibilities For Health, Lawrence O. Gostin, Gorik Ooms, Mark Heywood, Just Haffeld, Sigrun Møgedal, John-Arne Røttingen, Eric A. Friedman, Harald Siem

Georgetown Law Faculty Publications and Other Works

A population’s health and wellbeing is primarily a national responsibility. Every state owes all of its inhabitants a comprehensive package of essential health goods and services under its obligations to respect, protect, and fulfill the human right to health. Yet health is also a global responsibility. Every state has a duty to ensure a safe and healthy world, with particular attention to the needs of the world’s poorest people. Improving health and reducing unconscionable health inequalities is both an international obligation under the human right to health and a matter of global social justice.

The mutual obligations of states to …

Much Ado About Possibly Pretty Little: Mccarran-Ferguson Repeal In The Health Care Reform Effort, Christopher L. Sagers

Law Faculty Articles and Essays

Since 1945, the McCarran-Ferguson Act (MFA) has shielded the “business of insurance” from antitrust liability, so long as the challenged conduct is “regulated by State Law” and does not constitute “boycott, coercion, or intimidation.” This law, like the dozens of other statutory antitrust exemptions that still exist for other industries, has more or less always been controversial, and efforts to repeal it date back more than thirty years. This Essay asks two questions: (1) what consequences the pending repeal measures might have if one of them becomes law; and (2) what a close examination of this effort might teach us …

Healthcare Reform & The Missing Voice Of Complementary And Alternative Medicine, Gwendolyn R. Majette

Law Faculty Articles and Essays

Given the high prevalence of complementary and alternative medicine (CAM) use by Americans, coupled with the emphasis placed on prevention in many of the healthcare reform proposals, this article argues that CAM should play a role in the healthcare reform conversation. Part I provides the background information on CAM including its definition, CAM use, and its cost. This section also broadly outlines the contours of the early healthcare reform proposals, those in existence as of January 2009. Part II describes how CAM would ideally be integrated into the United States healthcare system. Part III outlines the reasons CAM has been …

The Invisible Woman: Availability And Culpability In Reproductive Health Jurisprudence, Beth A. Burkstrand-Reid

University of Colorado Law Review

Women's health is widely assumed to be a significant consideration in reproductive rights cases. Court decisions relating to contraception, abortion, and childbirth demonstrate that while this assumption may have historical validity, consideration of women's health is often truncated in recent reproductive rights jurisprudence. This occurs, in part, through the application of one or both of two recurring tools. First, judges regularly-and often inaccurately-cite the theoretical availability of alternative reproductive health services as proof that women's health will not suffer even if a law curtailing reproductive rights is upheld. I label this the "availability tool." Second, when alternatives are not available, …

Courts' Struggle With Infertility: The Impact Of Hall V. Nalco On Infertility-Related Employment Discrimination, Kerry Van Der Burch

University of Colorado Law Review

This Note focuses on a recent Seventh Circuit case of first impression, Hall v. Nalco, which held that Title VII prohibits an employer from firing an employee for absenteeism related to infertility treatments. Because Hall is the first circuit court decision to rule that fertility-treatment discrimination can be a form of sex discrimination under Title VII, it represents a victory for infertile employees suffering from workplace discrimination. Yet Hall tells a tale of missed opportunities. This Note highlights how both the Seventh Circuit and the plaintiff, Cheryl Hall, missed opportunities to expand legal protection for employees undergoing infertility treatments. First, …

Cutting The Fat Out Of Health-Care Costs: Why Medicare And Medicaid Write-Offs Should Not Be Recoverable Under Oklahoma’S Collateral Source Rule, Michael W. Cromwell

Oklahoma Law Review

No abstract provided.

Access To Medicine In An Era Of Fractal Inequality, Frank Pasquale

Faculty Scholarship

No abstract provided.

Last Stand? The Criminal Responsibility Of War Veterans Returning From Iraq And Afghanistan With Posttraumatic Stress Disorder, Thomas L. Hafemeister, Nicole A. Stockey

Indiana Law Journal

As more psychologically scarred troops return from combat in Iraq and Afghanistan, society's focus on and concern for these troops and their psychological disorders has increased With this increase and with associated studies confirming the validity of the Posttraumatic Stress Disorder (PTSD) diagnosis and the genuine impact of PTSD on the behavior of war veterans, greater weight may be given to the premise that PTSD is a mental disorder that provides grounds for a "mental status defense, " such as insanity, a lack of mens rea, or self-defense. Although considerable impediments remain, given the current political climate, Iraq and Afghanistan …

Discrimination Out Of Dismissiveness: The Example Of Infertility, David Orentlicher

Indiana Law Journal

In recent years, antidiscrimination theory and doctrine have rested heavily on the "anticaste" principle first invoked in Strauder v. West Virginia According to this principle, equal protection law and antidiscrimination statutes should eradicate public-and private-policies that subject some persons to ongoing stigma and subordination and therefore to second-class status in society. This Article argues that while a focus on stigma and subordination is important, it misses a key source of discrimination-the discriminationt hat arises from dismissiveness. Antidiscrimination law has recognized the need to overcome the discrimination that results from invidious bias, unfair stereotyping, irrational fear accumulated myths, or simple neglect.A …

Contraception, Abortion, And Health Care Reform: Finding Appropriate Moral Ground, Dena S. Davis

Law Faculty Articles and Essays

In this essay, I make the argument that abortion and contraception are fundamentally different actions that occupy fundamentally different moral space, and that justify fundamentally different political action. I conclude that, while it is morally licit, even morally obligatory, for people who believe that embryos are people like us, to attempt to impede access to abortion, it is morally illicit to attempt to block access to contraception (including sterilization).

Can There Be A Progressive Bioethics?, Richard O. Lempert

Book Chapters

Progressive bioethics-the words are not an oxymoron. Far from it; they are more redundant than oppositional. Yet they leave me almost as uneasy, as if they were contradictory. My unease exists because bioethics should be neither progressive nor regressive, neither right wing nor left wing, neither liberal nor conservative. It should be just good, sound ethics applied to the often difficult moral problems posed by present-day medicine and the genomic revolution.

I do not mean to suggest by this that all bioethicists need agree. Respectable ethicists using established modes of ethical analysis have long disagreed on and argued for different …

What Are The Policy Implications Of Use Of Epidemiological Evidence In Mass Torts And Public Health Litigation, Christopher Ogolla

St. Thomas Law Review

The distinctions between the standards of proof employed in epidemiology and in law inform the central thesis of this paper. This analysis began by describing the role of epidemiology in mass torts and public health litigation. It later argues that because mass torts cover such a wide area, there are several problems related to epidemiology in litigation, particularly scientific uncertainty and inconsistent factual claims. Part II discusses recent cases where epidemiological evidence was raised and debated, distinguishing between vaccine-related and non-vaccine-related cases. Courts have differentiated vaccine-related cases from non-vaccine-related cases, principally because Congress enacted a vaccine act designed to compensate …

Pursuing Health As Foreign Policy: The Case Of China, Yanzhong Huang

Indiana Journal of Global Legal Studies

Eastphalia Emerging?: Asia, International Law, and Global Governance, Symposium. Indiana University Maurer School of Law, Bloomington, Indiana, 2009

Diagnosing American Health Care: Economic Stakeholders And Bioethical Considerations, Jonathan Will

Journal Articles

Cost. Access. Quality. These are three objectives that must drive a responsible discussion regarding reform of the delivery of health care in this country, and specifically, decreasing (or at least controlling) cost while increasing access and quality.

From A Constitutional Right To A Policy Of Exceptions: Abigail Alliance And The Future Of Access To Experimental Therapy, Patricia J. Zettler, Seema K. Shah

Faculty Publications By Year

Although there has been considerable attention to the plight of terminally ill patients with highly sympathetic constitutional and contractual claims that they should be permitted access to unapproved drugs, courts have been appropriately reluctant to grant such claims. Congress and administrative agencies have the requisite institutional competence to decide complex policy issues related to science and health care such as those involved in establishing an expanded access program. Congress and FDA should allow only limited access to unapproved therapies because there are significant concerns about the safety and efficacy of unapproved drugs. Moreover, many of the proposals to widen access …

African Americans Can't Win, Break Even, Or Get Out Of The System: The Persistence Of “Unequal Treatment ” In Nursing Home Care, Ruqaiijah A. Yearby

All Faculty Scholarship

Empirical data show that racial disparities in the quality of care provided by nursing homes are a common occurrence, not isolated to Illinois. Nine years after the publication of the groundbreaking Institute of Medicine Study (“IOM study”) Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, which acknowledged continued racial disparities in health care and provided suggestions for the elimination of these disparities, racial disparities still remain. One chief example of the continuation of racial disparities in health care is in the provision of nursing home care.

Decades of empirical research studies have shown that racial disparities in accessing quality …

Does Twenty-Five Years Make A Difference In “Unequal Treatment”?: The Persistence Of Racial Disparities In Health Care Then And Now, Ruqaiijah A. Yearby

All Faculty Scholarship

In 1985, the Secretary of the U.S. Department of Health and Services (HHS) issued a landmark report that exposed the persistence of racial disparities in the U.S. healthcare system. Unfortunately, twenty-five years later, racial disparities in healthcare continue to persist. For example, since 1985, more African-Americans have died from coronary disease, breast cancer, and diabetes than Caucasians, even though more Caucasians suffer from these diseases than African-Americans. Notwithstanding their increased mortality rates, African Americans “have a statistically significantly lower mean number of annual ambulatory [walk-in] visits and are less likely to have seen a physician in [any given] year.” Studies …

Litigation, Integration, And Transformation: Using Medcaid To Address Racial Inequities In Health Care, Ruqaiijah A. Yearby

All Faculty Scholarship

Instances of racial discrimination in health care continue despite the enactment of civil rights laws, such as Title VI of the Civil Rights Act of 1964 *329 (Title VI). Title VI prohibited racial discrimination by health care entities receiving government funding such as Medicaid payments. The federal government focused its initial efforts on hospitals. Because hospitals relied on federal funding, the federal government was able to force hospitals to integrate without much resistance from the hospital industry. However, since this accomplishment the government has relied too heavily on assurances of compliance from other health care entities, such as nursing homes, …