Health Law and Policy Commons^™

Access To Court Cases From The Supreme Court’S 2020–2021 Term: The New Majority’S Debut, Sarah Somers, Jane Perkins, Abigail Coursolle, Sarah Grusin

Saint Louis University Journal of Health Law & Policy

Throughout the Supreme Court’s first term without Justice Ruth Bader Ginsburg, the Court issued only a few major opinions with respect to access to the Court for civil litigants, and it issued none that discarded major precedents. Yet, in several areas, the Court demonstrated an increasingly conservative bent and began to lay the groundwork for major changes. In this Article, we discuss selected opinions from the Court’s 2020–2021 term that may have an impact on access to the courts for individuals seeking to vindicate civil and constitutional rights. In particular, it focuses on cases that may affect access for low-income …

The Impact Of Bostock V. Clayton County On Access To Health Care For Lgbtq Persons, Hiba B. Al-Ramahi

Saint Louis University Journal of Health Law & Policy

LGBTQ individuals face countless acts of discrimination in health care insurance and delivery. In spite of this inequality, there are zero LGBTQ-inclusive health insurance protections in over half of the United States. Title VII of the Civil Rights Act (Title VII) and Section 1557 of the Patient Protection and Affordable Care Act (ACA) are two federal statutes that prohibit discrimination, in relevant part, on the basis of sex. Both federal statutes have been greatly impacted by the Supreme Court decision in Bostock v. Clayton County, which interpreted “sex” in Title VII to include gender identity and sexual orientation. This …

“Woman Enough” To Win? An Analysis Of Sex Testing In College Athletics, Brenna M. Moreno

Saint Louis University Journal of Health Law & Policy

In recent years, dozens of bills restricting the rights of transgender, or trans, individuals have been introduced in state legislatures throughout the country. To date, ten states have successfully passed laws prohibiting trans athletes from competing on teams in accordance with their gender identities. For its athletes, the National Collegiate Athletic Association (NCAA), the United States’ largest intercollegiate athletic organization, has pursued a compromise to balance trans inclusion and fair competition. Established in 2011, the NCAA’s conditionally inclusive policy permits trans women—meaning those who were assigned the sex of male but identify as women—to compete on a women’s team only …

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Saint Louis University Journal of Health Law & Policy

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Saint Louis University Journal of Health Law & Policy

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Foreword: Probing The Intersection Of Climate Change And Public Health, Ana Santos Rutschman

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Pursuing Climate Justice: Learning The Lessons Of The Covid-19 Response, Lance Gable

Saint Louis University Journal of Health Law & Policy

The COVID-19 pandemic and the climate crisis have many parallels. Both are large disruptive events that pose foundational threats to humanity through the capacity to cause substantial harm and death to humans. Both pose complex and multifaceted challenges perpetuated by multiple factors that are difficult to interrupt or mitigate. Both are subject to evolving scientific understandings of their underlying causes and potential interventions. Both are novel challenges not previously faced by most humans alive today that comprise potential threats to human society over an extended time period. These similarities allow scholars and policymakers to extrapolate and understand how the responses …

Tribal Water Rights And Tribal Health: The Klamath Tribes And The Navajo Nation During The Covid-19 Pandemic, Robin Kundis Craig

Saint Louis University Journal of Health Law & Policy

Public health measures to combat COVID-19, especially in the first year before vaccines became widely available, required individuals to be able to access fresh water while remaining isolated from most of their fellow human beings. For the approximately 500,000 households in the United States and over two million Americans who lacked access to reliable indoor running water, these COVID-19 measures presented a considerable added challenge on top of the existing risks to their health from an insecure water supply.

Many of these people were Native Americans, whose Tribes often lack fully adjudicated, quantified, and deliverable rights to fresh water. To …

Meeting Water Affordability Challenges In The Era Of The Unexpected, Amy Hardberger

Saint Louis University Journal of Health Law & Policy

The vast majority of Americans depend on a public water supply for the procurement and delivery of their water. Water providers are tasked with securing water supplies for the future, building and maintaining the infrastructure needed for delivery, and ensuring service is available for new customers. This system has worked for many decades in part because the costs of water and construction were relatively low; however, in the past twenty years, water rates have increased at twice the rate of inflation. At the same time, income has remained stagnant. Water services now require a larger percentage of household budgets than …

Preventing Maternal Deaths: A Critical Feminist Approach To Maternal Mortality In The United States, Jemalyn Harvey

Saint Louis University Journal of Health Law & Policy

With roughly 700 women dying each year as a result of pregnancy and/or delivery complications, the United States has the highest rate of maternal deaths in the developed world. As each year passes, the maternal death rate continues to increase, despite the fact that sixty percent of these deaths are preventable. Factors such as quality care, receiving accurate and timely medical diagnoses, and recognizing urgent maternal warning signs all contribute to the preventability of deaths and why women, particularly women of color, so often fall victim to this tragic phenomenon. As an effort to address maternal death in the United …

Making Rights Meaningful: Advocating For Simple Changes In Federal Agency Practice To Promote Health Equity, Mary Quandt

Saint Louis University Journal of Health Law & Policy

Despite federal protections afforded by Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act, Americans still experience prohibited discrimination in health care on the basis of race, color, and national origin. The Department of Health and Human Services’ Office for Civil Rights (“HHS OCR”) investigates complaints and enforces protections when alleged discrimination occurs in health care covered entities receiving federal funding. The legal analyses produced in these investigations can be valuable tools for covered entities to utilize in their efforts to remain in compliance with civil rights laws, yet few are ever made public …

Hiv No Longer A Death Sentence But Still A Life Sentence: The Constitutionality Of Hiv Criminalization Under The Eighth Amendment, Lauren Taylor

Georgia Law Review

When the HIV/AIDS epidemic began in the 1980s in the United States, there was mass confusion and hysteria regarding HIV transmission and prevention, leading many states to enact HIV criminalization statutes to prosecute persons living with HIV who either exposed another person to HIV or put someone in danger of being exposed to HIV. Yet, almost forty years later, these statutes are still used to criminalize and control the behaviors of people living with HIV, and in some cases, impose lengthy prison sentences hinging on the possibility of exposure. These HIV criminalization statutes and subsequent criminal cases often do not …

Crisis Pregnancy Centers: An Inherently Unjust Limitation To Reproductive Rights, Rebecca Feinberg, Danielle Pacia

Scholarly Works

This paper’s purpose is two-fold. First, it presents an ethical analysis that details why the current practices of Crisis Pregnancy Centers (CPCs) are unethical and violate women’s reproductive freedom. Second, it proposes policy solutions to mitigate inequities and disinformation caused by the practices of CPCs, in an attempt to protect the women who, fall prey to their services

The Impact Of Uncertainty Regarding Patent Eligible Subject Matter For Investment In U.S. Medical Diagnostic Technologies, A. Sasha Hoyt

Washington and Lee Law Review

Historically, 35 U.S.C. § 101, the statute governing patent eligible subject matter, has been construed broadly—with its legislative history indicating that it should cover “anything under the sun that is made by man.” The Supreme Court crafted three exceptions to § 101: (1) abstract ideas, (2) laws of nature, and (3) natural phenomena. In recent years, the Supreme Court’s eligibility jurisprudence has further narrowed § 101 to effectively exclude meritorious medical diagnostic methods. Indeed, since the Court’s decision in Mayo Collaborative Services v. Prometheus Laboratories, Inc., the Federal Circuit has held every single diagnostic method claim brought before it …

Managing And Monitoring The Menopausal Body, Naomi R. Cahn, Bridget J. Crawford, Emily Gold Waldman

Elisabeth Haub School of Law Faculty Publications

This Essay explores how menopausal bodies are managed and monitored through both menopausal hormone therapy (MHT) and the burgeoning market for technology-driven menopause products and services. While each of these allegedly improves the menopause experience, a closer investigation reveals a more complex interaction of profit motives and traditional notions of gender identity. The Essay identifies problems with—and suggests some solutions for reforming—current practices of monitoring and managing the menopausal body.

Careful consideration of menopause brings this Essay into ongoing conversations about theorizing beyond the gender binary and stereotypical notions of femininity. Purveyors of both MHT and menopause-related digital products and …

Reconnecting The Patient: Why Telehealth Policy Solutions Must Consider The Deepening Digital Divide, Laura C. Hoffman

Law Faculty Articles and Essays

This Article will attempt to untangle the complicated web of providing telehealth to those populations it is potentially capable of further alienating from access to healthcare including: 1) race/minority populations, 2) aging adults, 3) individuals with disabilities, 4) non-English speakers, 5) individuals living in rural areas, 6) socioeconomic class, and 7) children, in order to advance the argument that telehealth can be successful in providing healthcare access to these populations. Rather than suggesting that telehealth simply "cannot work" for these populations, instead consideration can and must meet these individuals through technology, access, and policy developments.

First, this Article will explain …

Lifesaving Discrimination, Dallan F. Flake

American University Law Review

Racial minorities in the United States, and Black people in particular, experience worse health outcomes and lower-quality medical care than White people do. Mounting empirical evidence indicates that for Black Americans, and perhaps other racial minorities, this gap can be narrowed if they are given the choice to receive care from physicians of their same race. Given the significant benefits of patient-physician racial concordance for people of color, this Article argues that medical providers who do not have enough physicians of color on staff to meet their patients’ needs should be permitted in some cases to make race conscious physician-hiring …

How To Survive The Culture Wars: Conflict Of Laws Post-Dobbs, Roger Michalski

American University Law Review

Abortion is the latest flashpoint in the culture wars. Post-Dobbs, red and blue states are hard at work codifying different approaches within their boundaries. However, pills, women, transactions, medical services, and information will cross those boundaries. Both sides already fight about who gets to regulate such boundary-crossing activity with each accusing the other of trespassing on the regulatory space of their disagreeing neighbors.

This is dangerous terrain. A house divided against itself needs tools to mediate and constructively tackle conflict. Without such tools, divisions will deepen and provide an endless stream of incidents to further divide the country. The choice …

Asking Too Much: The Ninth Circuit’S Erroneous Review Of Social Security Disability Determinations, Stephen E. Smith

Lewis & Clark Law Review

Disability determinations made by the Social Security Administration’s administrative law judges are subject to judicial review by Article III courts. By statute, these courts apply the “substantial evidence” standard of review on appeal from the agency. The substantial evidence standard is a forgiving one that defers to the findings of the agency. But the Ninth Circuit Court of Appeals has modified this standard. It now reviews certain categories of SSA findings not only for substantial evidence, but for support by “clear and convincing reasons.” This heightened standard of review is facially at odds with the statutorily mandated substantial evidence standard. …

On What Basis Did Health Canada Approve Oxycontin In 1996? A Retrospective Analysis Of Regulatory Data, Jessie Pappin, Itai Bavli, Matthew Herder

Articles, Book Chapters, & Popular Press

The marketing and sale of oxycodone (OxyContin) by Purdue Pharma has commanded a great deal of legal and policy attention due to the drug’s central role in the ongoing overdose crisis. However, little is known about the basis for OxyContin’s approval by regulators, such as Health Canada in 1996. Taking advantage of a recently created online database containing information pertaining to the safety and effectiveness of drugs, we conducted a retrospective analysis of Purdue Pharma’s submission to Health Canada, including both published and unpublished clinical trials. None of the trials sponsored by Purdue Pharma sought to meaningfully assess the risks …

The Pandemic And The Public Nuisance: Judicial Intervention In The Era Of Covid-19 And The Collective Right To Public Health, Kyra Ziesk-Socolov

Washington and Lee Journal of Civil Rights and Social Justice

Amidst the unprecedented disruption caused by COVID-19, workplace lawsuits around the country began to apply a longstanding common law theory in a novel way: employee plaintiffs argued that their employers’ noncompliance with state and federal public health guidance designed to curb the spread of the virus should be enjoined as a public nuisance. Although some of these initial public nuisance suits were dismissed, others successfully forced defendant businesses to either alter their COVID safety practices or temporarily close. This Article explores the first pandemic-era public nuisance suit, Rural Community Workers Alliance v. Smithfield Foods, brought by meatpacking plant workers …

Reproductive Privacy In The World: Critical Examination Of June Medical Services, L.L.C. V. Russo And Buck V. Bell, Kumiko Kitaoka

Washington and Lee Journal of Civil Rights and Social Justice

Using insights from Professor Stephen A. Simon’s Universal Rights and the Constitution, this Article argues that national courts should continue to assume an active role in the protection of privacy rights by giving due consideration to the nature of the privacy right in combination with the merits of the universal right theory. This Article then demonstrates that both foreign national courts and domestic state courts have recognized the right to procreate and key aspects of the right to abortion as fundamental rights.

Part II introduces the universal right theory, explaining why the theory is particularly relevant to the protection …

Fostering Production Of Pharmaceutical Products In Developing Countries, William Fisher, Ruth L. Okediji, Padmashree Gehl Sampath

Michigan Journal of International Law

The ways in which pharmaceutical products are currently developed, manufactured, and distributed fail to meet the needs of developing countries. The recent emergence of new infectious diseases, the associated surge of healthcare nationalism, and the prevalence of substandard and falsified drugs have strengthened substantially the net benefits of augmenting the capacity of developing countries to produce such products locally. Most previous efforts to do so have foundered. The chance of success in the future would be maximized by the adoption of five strategies : (a) clarifying the zones of discretion created by the relevant treaties to ensure that local firms …

Healthcare Education Leaves The Hills: Frontier Nursing University’S Move From Appalachia, Hannah Haksgaard

Faculty Publications

Rural communities lack maternity and childbirth services, and access is getting worse. Despite the serious need for more rural-focused childbirth services, Frontier Nursing—the most famous rural-focused childbirth healthcare provider and educator—recently left the historic rural location it had called home since its inception nearly a century ago. Frontier Nursing, established in the Appalachian Mountains in 1925, initially provided nursing and midwifery care focused on the residents of Leslie County, Kentucky, and in 1939 established a school in Leslie County to train future rural nurse-midwives. Despite success over nearly 100 years deep in the remote and rural Appalachian foothills, Frontier Nursing …

Hb 1013: Georgia Mental Health Parity Act, Justin Crozier, Betsy Hicks, Jordan Kalteux

Georgia State University Law Review

The Act overhauls Georgia’s mental health system by enforcing compliance with federal mental health parity law. Most notably, the Act requires health insurers to provide coverage for mental health and substance use disorders equitably with physical health and defines generally accepted standards of care. The Act requires insurers to submit annual parity compliance reports and requires the Commissioner to make annual data calls and submit annual reports. The Act requires compliance with a minimum 85% medical loss ratio. The Act provides for cancelable loans to Georgia residents enrolled in related educational programs and creates grant programs for accountability courts. The …

Hb 752: Psychiatric Advance Directive Act, Andrew Krawtz, Adam Xie, Matthew Sweat

Georgia State University Law Review

The Act amends Georgia laws relating to mental health and provides a statutory psychiatric advance directive form. The Act allows citizens with diagnosed mental health disorders to appoint a mental health agent to make treatment decisions on their behalf. The Act delineates the responsibilities, duties, and immunities of physicians and other providers using a psychiatric advance directive and clarifies the psychiatric advance directive’s interaction and relationship with other types of advance directives for health care.

Not So Private, Stacey A. Tovino

Faculty Articles

Federal and state laws have long attempted to strike a balance between protecting patient privacy and health information confidentiality on the one hand and supporting important uses and disclosures of health information on the other. To this end, many health laws restrict the use and disclosure of identifiable health data but support the use and disclosure of de-identified data. The goal of health data de-identification is to prevent or minimize informational injuries to identifiable data subjects while allowing the production of aggregate statistics that can be used for biomedical and behavioral research, public health initiatives, informed health care decision making, …

Worth A Shot: Encouraging Vaccine Uptake Through "Empathy", Jody L. Madeira

Articles by Maurer Faculty

Pro- and anti-vaccine organizations and individuals have frequently invoked empathy as a strategy for increasing uptake of COVID-19 precautions, including vaccinations. On one hand, vaccine supporters deployed empathy to defuse conflict, prioritize safeguarding the collective welfare, and avoid government mandates. On the other hand, vaccine opponents used empathy to emphasize the alleged individual effects of pandemic precautions, mobilize public voices, and stress the importance of medical freedom in policy-making contexts.

This Article first defines empathy and reviews empathy scholarship, paying particular attention to its relationship with narrative and the contexts where empathy can be difficult or dangerous. It then applies …

The Limits Of Regulation By Insurance, Kenneth S. Abraham, Daniel Benjamin Schwarcz

Indiana Law Journal

Insurance is an enormously powerful and beneficial method of spreading risk and compensating for loss. But even insurance has its limits. A new and misleading aspiration for insurance—that it also can and often does substitute for or significantly complement health and safety regulation—is increasingly in vogue. This vision starts from the uncontroversial recognition that insurers typically adopt measures designed to counteract “moral hazard,” the tendency of insurance to blunt policyholders’ incentives to take care. But proponents of this vision go on to contend that the risk-reducing potential of insurance is significantly more extensive than is traditionally imagined, because insurers are …

The Next Pandemic Might Be A Petdemic, Hillary Greene

Indiana Law Journal

A new scientific study shows that COVID-19 can be transmitted from cats to humans. Luckily, this channel of transmission seems extremely rare, at least thus far. But next time—and there will be a next time—we may not be so fortunate. This Article addresses this underappreciated risk of what I term a “petdemic”—a pandemic or epidemic that involves significant disease transmission between pets and humans. With nearly 70% of U.S. households owning pets, a petdemic could be catastrophic. One of our go-to responses for even perceived petdemics, honed over the last century, is to slaughter our pets. This pioneering Article proposes …