Medical Jurisprudence Commons^™

When Death Is Not Binary, Teneille R. Brown

Indiana Law Journal

There are few dichotomies more recognized than the one between life and death. Given the many legal rights that pivot on this distinction, one would think that the law has exceptionally clear standards for diagnosing death. It may surprise you then to learn that the line between legal life and death is no longer so obvious. That is, in a growing number of cases, there is now disagreement about whether someone is legally dead or alive. This is due to two things: the development of medical devices that can breathe for patients with severe brain injuries, and neuroimaging technology that …

The Chemical Straightjacket: Institutional Over-Use Of Psychotropic Drugs On Children In Lieu Of Therapeutic Community Mental Health Services, Marisa Leib-Neri

Indiana Journal of Law and Social Equality

This Article argues that the abysmal state of children’s mental health in America is in part due to an overreliance on and over prescription of psychotropic drugs inside psychiatric residential institutions in lieu of community based mental health services. This overreliance on residential institutions and psychotropic drugs has allowed a new form of chemical restraint to flourish—the chemical straitjacket. This Article uses the medication lists of twelve children in seven different North Carolina psychiatric residential treatment facilities to demonstrate how the chemical straitjacket operates: the prescription of drugs not approved for pediatric populations, counter to evidence-based practices for particular diagnoses, …

A Bloody Mess: Why Blood Plasma Donation Centers Are Not Public Accommodations Subject To Title Iii Of The Americans With Disabilities Act, Kevin D. Marshall

Indiana Journal of Law and Social Equality

No abstract provided.

Medical Research Without Consent? It's Like Deja Vu All Over Again, Lois Shepherd, Donna Chen

Indiana Law Journal

When patients seek medical care, they trust their physician to offer treatments that are in their best medical interests and to engage them in a shared decision-making process to determine the best way forward. But today, in hospitals and doctors’ offices around the country, physicians also place patients in research studies that randomly assign them to a standard of care treatment, sometimes without the patients’ knowledge or consent. In such studies, patients may receive a treatment that results in worse outcomes for them, some of which can be serious and permanent. What’s more, there are reasons to be concerned that …

Meet Our New Faculty: Jenn Oliva, James Owsley Boyd

Keep Up With the Latest News from the Law School (blog)

Professor Jenn Oliva joined Indiana Law earlier this summer as a professor of law and as Val Nolan Faculty Fellow. Prior to joining the IU Maurer Law faculty, Professor Oliva served as Professor of Law and Co-Director of the UCSF/UC Law Consortium on Law, Science & Health Policy at the University of California College of Law, San Francisco. She has also served as Associate Dean for Faculty Research & Development and Director of the Center for Health & Pharmaceutical Law at Seton Hall University School of Law where she was selected as the law school’s 2021 Professor of the Year …

Pain Management, Disorders Of Consciousness, And Tort Law: An Emergency Tort To Fix A Longstanding Injustice, Joseph J. Fins, Zachary E. Shapiro

Indiana Law Journal

We address the systemic undertreatment of pain for individuals diagnosed with disorders of consciousness (DoC). Patients with DoC are often unable to communicate due to damage to their brains, and because DoC patients appear to be insensate, practitioners often believe that these patients are unable to feel pain and may not offer them analgesia, even before painful medical procedures. However, science shows that many DoC patients are able to feel pain, even if they are unable to communicate their distress. This Article moves from recognition of this problem to proposing solutions, in particular exploring what the legal system can do …

Madeira Serves As Legal Commentator In Netflix’S “Our Father”, James Owsley Boyd

Keep Up With the Latest News from the Law School (blog)

No abstract provided.

I Just Took A Dna Test—Turns Out, I'M 100% Breaching My Donor Anonymity Contract: Direct-To-Consumer Dna Testing And Parental Medical-Decision-Making, Morgan C. York

Indiana Journal of Global Legal Studies

Part I of this note provides a brief history of assisted reproductive technology and its increased use throughout the world, illustrating the growing number of donor-conceived children and the related importance of knowing genetic information. Part I also surveys regulations concerning donor anonymity in the United States and the United Kingdom to illustrate different jurisdictions' approaches to the regulation of donor anonymity. This note uses the United Kingdom as a model of countries that have prohibited sperm donor anonymity. Part II of this note discusses direct-to-consumer DNA testing, specifically 23andMe's products. This note selects 23andMe as the direct-to-consumer company for …

Passport To Plastics: Cosmetic Surgery Tourism, Medical Malpractice, And The Automatic Establishment Of Personal Jurisdiction By Way Of The Joint Commission International, Elizabeth Astrup

Indiana Journal of Global Legal Studies

For centuries, tourists have visited lands near and far in search of experiences unavailable in their home countries. From golfing the best courses in the world, to yoga retreats in remote locations, many tourist activities provide experiential opportunities along with health and wellness benefits. Currently, an increasing number of individuals are opting to cross international borders to receive medical treatments, often at reduced costs. While many scholars use the term health tourism to encompass all health and wellness travel purposes, this note uses the term medical tourism to distinguish tourism for the specific purpose of medical treatments or procedures. Medical …

Healthcare Licensing And Liability, Benjamin Mcmichael

Indiana Law Journal

The United States’ affordable care crisis and chronic physician shortage have

required advanced practice registered nurses (APRNs) and physician assistants

(PAs) to assume increasingly important roles in the healthcare system. The increased

use of these nonphysician providers has improved access to healthcare and lowered

the price of care. However, restrictive occupational licensing laws—specifically,

scope-of-practice laws—have limited their ability to care for patients. While these

laws, by themselves, have important implications for the healthcare system, they also

interact with other legal regimes to impact the provision of care. Restrictive scopeof-

practice laws can increase the malpractice liability risk of physicians and …

Ivf Errors - Is This Only The Tip Of The Iceberg?, Jody L. Madeira, Steven R. Lindheim Md, Mark P. Trolice

Articles by Maurer Faculty

ART errors are fortunately a rare occurrence. but humans are fallible and mistakes are inevitable. As social media sensationalizes these events, we, as infertility specialists, must be vigilant in reviewing existing risk management systems and consider other options to minimize/eliminate these events. ART programs should work to emphasize honesty and transparency to improve quality of care.

Societal Pressures And Procreative Preferences For Gay Fathers Successfully Pursuing Parenthood Through Ivf And Gestational Carriers, Steven R. Lindheim Md, Jody L. Madeira, Artur Ludwin, Emily Kemmer, J. Preston Parry, Georges Sylvestre, Guido Pennings

Articles by Maurer Faculty

This retrospective study surveyed decision-making and challenges among 78 gay cisgender male couples utilizing in-vitro fertilization (IVF) and a gestational carrier. While most couples (67.1%) found the decision to actively pursue fertility treatment ‘not difficult’, 32.9% felt that it was ‘somewhat difficult’ or ‘very or extremely difficult’. Almost 30% of couples had not undertaken financial planning for treatment, which introduced delays of N2 years for 25.3% of participants. Conceiving twins was ‘important to very important’ in 52.3% of couples, and 84.2% of couples chose to transfer two embryos to ‘increase the odds’ or reach an ideal family size in a …

Uncommon Misconceptions: Holding Physicians Accountable For Insemination Fraud, Jody L. Madeira

Articles by Maurer Faculty

No abstract provided.

Court Personnel Attitudes Towards Medication-Assisted Treatment: A Statewide Survey, Barbara Andraka-Christou, Meghan Gabriel, Jody L. Madeira, Rod D. Silverman

Articles by Maurer Faculty

Background: Despite its efficacy, medication-assisted treatment (MAT) is rarely available in the criminal justice system in the United States, including in problem-solving courts or diversionary settings. Previous studies have demonstrated criminal justice administrators' hostility towards MAT, especially in prisons and jails. Yet, few studies have examined attitudes among court personnel or compared beliefs among different types of personnel. Also, few studies have explored the relationship between MAT education/training and attitudes. Finally, few studies have directly compared attitudes towards methadone, oral buprenorphine, and extended-release naltrexone in the criminal justice system.

Methods: We modified a survey by Matusow et al. (2013) to …

Legal Principles And Seminal Legal Cases In Oocyte Donation, Jody L. Madeira, Susan L. Crockin

Articles by Maurer Faculty

Oocyte donation has played an increasingly important role in assisted reproductive technologies since the early 1980s. Over the past 30 years, unique legal standards have evolved to address issues in the oocyte donation procedure itself as well as the disputes over issues, such as parentage, that inevitably arise with new technologies, particularly for individuals seeking to build nontraditional families. This essay will explore oocyte donation's legal aspects as well as seminal law concerning the procedure, including statutory law (uniform and model provisions and enacted state laws) and selected judicial opinions concerning surrogacy and parentage, testing of oocyte donors, mix-ups of …

Circumvention Medical Tourism And Cutting Edge Medicine: The Case Of Mitochondrial Replacement Therapy, I. Glenn Cohen

Indiana Journal of Global Legal Studies

'Medical Tourism" is the travel of patients from a home country to a destination country for the primary purpose of receiving health care. "Circumvention Tourism" is a sub-type of such travel where the motivation is circumventing a domestic prohibition on accessing a medical service. This Article focuses on such circumvention tourism for cutting-edge medicine. I use the recently reported case of travel to Mexico for Mitochondrial Replacement Therapy as a springboard for examining the legal and ethical issues raised by the practice and to discuss restrictive regulation in place in the United States.

This Article derives in part from the …

Against Seminal Principles: Ethics, Hubris, And Lessons To Learn From Illicit Inseminations, Jody L. Madeira, Steven R. Lindheim Md, Mark V. Sauer Md

Articles by Maurer Faculty

This short essay addresses the ethical implications of Illicit inseminations, instances of fertility fraud in which a physician uses his own gametes to impregnate a patient.

Inform And Consent: More Than Just "Sign Here", Jody L. Madeira, Kathryn Coyne, Ami S. Jaeger Md, J. Preston Parry Md, Steven R. Lindheim Md

Articles by Maurer Faculty

No abstract provided.

Toward An International Constitution Of Patient Rights, Alison Poklaski

Indiana Journal of Global Legal Studies

In the past decade, medical tourism-the travel of patients across borders to receive medical treatment-has undergone unprecedented growth, fueled by the globalization of health care and related industries. While medical tourism can benefit patients through increased access to treatment and cost-savings, medical travel also raises concerns about ensuring quality of care and legal redress in medical malpractice. Moreover, existing regulations fail to address these unprecedented issues. The multilateral adoption of an International Constitution of Patient Rights (ICPR) is necessary in order to more effectively preserve medical tourism's benefits and guard against its risks.

Social & Legal Perspectives On Underuse Of Medication-Assisted Treatment For Opioid Dependence, Barbara Andraka-Christou

Maurer Theses and Dissertations

Medication-assisted treatment (MAT) in combination with counseling is considered the most effective treatment for opioid dependence by the World Health Organization, U.S. Department of Health and Human Services, and American Society of Addiction Medicine. Two MAT medications, buprenorphine and methadone, are considered essential medicines by the World Health Organization. Despite MAT’s effectiveness, it is severely underused in U.S. treatment settings, including physicians’ offices, hospitals, the Veterans Administration, residential treatment centers, prisons, and drug courts. The dissertation examines social and legal reasons for under-use of MAT in the U.S., including dominance of abstinence-only treatment methods, separation of addiction treatment from mainstream …

Abortion, Informed Consent, And Regulatory Spillover, Katherine A. Shaw, Alex Stein

Indiana Law Journal

The constitutional law of abortion stands on the untenable assumption that any state’s abortion regulations impact citizens of that state alone. On this understand-ing, the state’s boundaries demarcate the terrain on which women’s right to abortion clashes with state power to regulate that right.

This Article uncovers a previously unnoticed horizontal dimension of abortion regulation: the medical-malpractice penalties imposed upon doctors for failing to inform patients about abortion risks; the states’ power to define those risks, along with doctors’ informed-consent obligations and penalties; and, critically, the possi-bility that such standards might cross state lines. Planned Parenthood v. Casey and other …

Paper Trails, Trailing Behind: Improving Informed Consent To Ivf Through Multimedia Applications, Jody L. Madeira, Barbara Andraka-Christou

Articles by Maurer Faculty

Though intended to educate patients on the risks, benefits, side effects and alternatives within medical treatment, informed consent documents may have unanticipated consequences for patients. Patients may regard these forms as little more than a ritual to access treatment. Or patients may perceive that these forms exist to protect doctors rather than to contribute to a meaningful, patient-protective educational interaction. To rehabilitate the informed consent project, this essay considers the baggage that informed consent documents have acquired through practical use, explores patients' and providers' lived experience of informed consent, and considers whether a multimedia consent application would be a viable …

The Role Of Agency: Compensated Surrogacy And The Institutionalization Of Assisted Reproduction Practices, Jody L. Madeira, June Cabone

Articles by Maurer Faculty

The surrogacy debate often conflates what should be seen as three distinct issues: the permissibility of the practice under any circumstances, the role of for-profit intermediaries in arranging surrogacy, and the role of compensation in influencing decision-making.

For those who see surrogacy as intrinsically objectionable, nothing short of a total ban will suffice. For those who object to the commodification of reproduction or to the role of for-profit agencies in recruiting surrogates, however, the solutions lie in regulation rather than prohibition. Commercial agencies, unlike infertile couples who enter into arrangements with their friends and relatives, are repeat players. They are …

Respecting Intent And Dispelling Stereotypes By Reducing Unintended Pregnancy, Dawn E. Johnsen

Articles by Maurer Faculty

No abstract provided.

The Increasing Weight Of Regulation: Countries Combat The Global Obesity Epidemic, Allyn L. Taylor, Emily Whelan Parento, Laura A. Schmidt

Indiana Law Journal

Obesity is a global epidemic, exacting an enormous human and economic toll. In the absence of a comprehensive global governance strategy, states have increasingly employed a wide array of legal strategies targeting the drivers of obesity. This Article identifies recent global trends in obesity-related legislation and makes the normative case for an updated global governance strategy.

National governments have responded to the epidemic both by strengthening traditional interventions and by developing novel legislative strategies. This response consists of nine important trends: (1) strengthened and tailored tax measures; (2) broadened use of counter-advertising and health campaigns; (3) expanded food labeling; (4) …

Surrogate Testimony After Williams: A New Answer To The Question Of Who May Testify Regarding The Contents Of A Laboratory Report, Jennifer Alberts

Indiana Law Journal

No abstract provided.

The Art Of Informed Consent: Assessing Patient Perceptions, Behaviors, And Lived Experience Of Ivf And Embryo Disposition Informed Consent Processes, Jody L. Madeira

Articles by Maurer Faculty

No abstract provided.

Conceiving Of Products And The Products Of Conception: Reflections On Commodification, Consumption, Art, And Abortion, Jody L. Madeira

Articles by Maurer Faculty

This paper rejects the dichotomy between patient and consumer roles and focuses instead on how attributes of each are meaningful to those seeking health care. Arguing that health care is already commodified, it suggests that both medicine and the market offer strategies for handling commodification. The important questions are how we understand these attributes and their role in care relationships, and which attributes we should encourage. The medical profession and patient role have long accommodated commodification, using fiduciary roles, flat fees and opaque pricing to distance payment and pricing from care provision. In contrast, the market and consumer role emphasize …

Generic Entry Jujitsu: Innovation And Quality In Drug Manufacturing, W. Nicholson Price Ii

IP Theory

The manufacturing side of the pharmaceutical industry has been neglected in innovation theory and policy, with the unfortunate result of stagnant manufacturing techniques driving major problems for the healthcare system. This innovation failure has roots in ineffective intellectual property incentives and high regulatory hurdles to innovative change. Changes in pure regulation or intellectual property incentives have significant potential to help the innovation deficit, but are not the only possibility for change. A relatively minor regulatory change could harness the powerful dynamics of pioneer/generic competition surrounding generic drug market entry. If pioneer firms were permitted to make label claims committing to …

Selling Art: An Empirical Assessment Of Advertising On Fertility Clinics' Websites, Jim Hawkins

Indiana Law Journal

Scholarship on assisted reproductive technologies (ART) has emphasized the commercial nature of the interaction between fertility patients and their physicians, but little attention has been paid to precisely how clinics persuade patients to choose their clinics over their competitors’. This Article offers evidence about how clinics sell ART based on clinics’ advertising on their websites. To assess clinics’ marketing efforts, I coded advertising information on 372 fertility clinics’ websites. The results from the study confirm some suspicions of prior ART scholarship while contradicting others. For instance, in line with scholars who are concerned that racial minorities face barriers to accessing …