Medicine and Health Sciences Commons^™

Broken Promises: The Granite State’S Return To The Institutionalization Of Children With Disabilities, Elizabeth Trautz

The University of New Hampshire Law Review

In 1975, the New Hampshire legislature enacted a progressive statute which mandated the Department of Health and Human Services “to establish, maintain, implement and coordinate a comprehensive service delivery system for developmentally disabled persons.” This law was innovative for its time; it decreed that individual service plans (ISPs) be developed for every client in the state’s service delivery system, guaranteed “a right to adequate and humane habilitation and treatment[,]” and contemplated the state’s area agency system as we know it today. The statute was a steppingstone for the 1981 class action lawsuit of Garrity v. Gallen. This was one of …

Workplace Violence Prevention For Nurses And Healthcare Workers In The State Of Maine A Health Policy Initiative, Gretchen Forsley

DNP Scholarly Projects

Abstract

Background: Health care workplace violence is a pervasive and persistent problem, underreported, and when reported it is tolerated, excused, or ignored. Prior to the pandemic, the “normal” demands of a stressful workplace for a resilient nurse might include short staffing, a lack of resources, violence, bullying, and disruptive behaviors from patients or families. Since the pandemic, the rates of increasing healthcare violence can be attributed to several factors such as delays in care and services, reducing admissions and procedures, consistent understaffing, a lack of adequate mental health services, increased violence against women, limited or no visitor policies, low-security coverage, …

Post-Pandemic Privacy Law, Tiffany C. Li

Law Faculty Scholarship

COVD-19, the global pandemic that began in 2019, altered how we live our lives in just about every way imaginable. Some of those changes were obvious-for example, those who were fortunate enough to be able to work from home began working online-while other changes were more subtle. The latter category included unprecedented levels of data collection by governments and organizations purporting to collect information that would help stop the pandemic's spread. Given the deadly nature of COVID-19, few would question any public health efforts, no matter their impact on privacy. However, the lack of attention to privacy issues during the …

Youth Homelessness - State Policy Review, Adam Mercer

Student Research Projects

This project was sponsored by Waypoint within their runaway and homeless youth continuum. Waypoint is a private non-profit operating in New Hampshire and supporting homeless youth statewide. The objective of the project was to review state policies affecting youth for the purpose of increasing Waypoint’s ability to advocate for legislative changes that can prevent and bring an end to youth homelessness.

The rights and freedoms of minors in unsafe situations are often limited and tied to another person’s guardianship, which may not be the best option for them. Expanding their rights through new policy could improve their safety, quality of …

Bill To Restrict Indoor Tanning For Minors In The State Of Maine, Jamie M. Lowery

DNP Scholarly Projects

Background: Melanoma is the deadliest and the most common type of cancer in individuals age 15 to 29. Evidence has shown that ultraviolet radiation overexposure at younger ages significantly increases the risk of developing non-melanoma and melanoma skin cancer in later years. Despite these concerns, approximately 1.6 million minors under the age of 18 participate in the use of indoor tanning devices annually. The high prevalence of skin cancer in the United States continues to be a public health issue that warrants continued preventative and regulatory action. In spite of the health risks associated with indoor tanning, the state of …

Substance Use Disorder Treatment Confidentiality Boot Camp, Lucy C. Hodder, Stephanie Cameron, Marcy Doyle, Christina Muñiz, Jeanne Ryer Edd

Law Faculty Scholarship

[Excerpt]: "INTRODUCTION: The Health Law and Policy Programs at UNH School of Law, Institute for Health Policy and Practice, and the NH Citizens Health Initiative have contracted with several of the New Hampshire Building Capacity for Transformation Delivery System Reform Incentive Payment (DSRIP) Integrated Delivery Networks (IDN) to provide technical assistance to the IDNs as they develop confidentiality tools related to substance use disorder services projects.

A UNH Team assisted the IDNs by providing an educational summary of federal and state confidentiality requirements, focusing on 42 CFR Part 2, and hosting IDN interdisciplinary teams in three Substance Use Disorder (SUD) …

Marijuana Regulation And Federalism, John M. Greabe

Law Faculty Scholarship

[Excerpt] "Federal law makes the cultivation and use of marijuana illegal for all purposes. Yet, over the past two decades, 28 states plus the District of Columbia have legalized marijuana for medicinal purposes, and eight states plus the District of Columbia have legalized it for recreational purposes. Marijuana regulation thus provides a useful and timely example for exploring the ways in which the distribution of power between the federal government and the states can facilitate policy change."

Opinion: The Mental Health Parity And Addiction Equity Act: What Parity Means For New Hampshire, Lucy C. Hodder

Law Faculty Scholarship

[Excerpt] "New Hampshire lawyers can help clients and colleagues with mental health or substance use disorders by advising individuals how to overcome barriers to insurance coverage for treatment, and encouraging them to pursue state and federally mandated internal, external and expedited appeal opportunities when denied coverage."

Antimicrobial Resistance (Amr) And Multidrug Resistance (Mdr): Overview Of Current Approaches, Consortia And Intellectual Property Issues, Andrew Jenner, Niresh Bhagwandin, Stanley P. Kowalski

Law Faculty Scholarship

The supply of new diagnostics and treatments is insufficient to keep up with the increase in antimicrobial resistance (AMR) and multidrug resistance (MDR) as older medicines are used more widely and microbes develop resistance to them. At the same time, significant quantities of antibiotics are used on patients and animals that do not need them, while others who do need them lack access.

Effective responses to AMR/MDR require effort by both the public and private sectors to develop and disseminate new diagnostics, vaccines and treatments on a global scale, as well as to adapt them to local needs. This calls …

Resource Guide For Addiction And Mental Health Care Consumers: Answering Questions About Insurance Coverage And Parity For Addiction And Mental Health Care Services, Lucy C. Hodder, Michele D. Merritt, Margaret H. Schmidt, Jacqueline Botchman, Caitlyn Ebert, Marguerite Corvini, Kate Crary, Bridget Drake

Law Faculty Scholarship

Navigating the maze of health insurance coverage can be difficult. For individuals with addiction or mental illness, the process of getting treatment approved and paid for by health insurance can be overwhelming. As a result, many people give up when their health insurance company denies coverage for needed services. This Guide can help people learn how to access health insurance and use their coverage to pay for treatment. This Guide also provides a basic explanation of consumers’ rights under the federal Mental Health Parity and Addiction Equity Act.

Privacy And Accountability In Black-Box Medicine, Roger Allan Ford, W. Nicholson Price Ii

Law Faculty Scholarship

Black-box medicine—the use of big data and sophisticated machine learning techniques for health-care applications—could be the future of personalized medicine. Black-box medicine promises to make it easier to diagnose rare diseases and conditions, identify the most promising treatments, and allocate scarce resources among different patients. But to succeed, it must overcome two separate, but related, problems: patient privacy and algorithmic accountability. Privacy is a problem because researchers need access to huge amounts of patient health information to generate useful medical predictions. And accountability is a problem because black-box algorithms must be verified by outsiders to ensure they are accurate and …

A Gateway To Future Problems: Concerns About The State By-State Legalization Of Medical Marijuana, Paul Lewis

The University of New Hampshire Law Review

[Excerpt] “Before 2009, every American presidential administration had been uniform in its policy of consistently enforcing the nation’s drug laws. Pursuant to federal law, possession, use, or cultivation of any drug deemed illegal by Congress was, universally, a prosecutable offense. Notwithstanding this unwavering policy, throughout the 1990s and early 2000s, the marijuana industry continued to grow, and several states legalized medicinal marijuana despite the standing federal prohibition. Moreover, President Barrack Obama, shortly after taking office, broke precedent with his predecessors when he put forth a policy of non-enforcement through a publicly released memorandum authored by the then Deputy Attorney General, …

Reopening The Discussion Of The Loss Of Opportunity Doctrine In New Hampshire: A Look At Decisions Made In Light Of Current Times, Benjamin Lajoie

The University of New Hampshire Law Review

[Excerpt] “A close family member is diagnosed with late-stage breast cancer and now only has a fifteen percent chance of survival. She soon dies. Prior to her diagnosis, she had routine screenings every two years, but her previous doctor failed to detect the then existing cancer when she would have had a fifty percent chance of survival. In New Hampshire, from a legal standpoint, there has been no wrong.

This legal concept of negligent medical care that causes a patient to have a lower percentage of survival, or a less favorable outcome, is referred to as the “loss of opportunity” …

Do You Believe He Can Fly? Royce White And Reasonable Accommodations Under The Americans With Disabilities Act For Nba Players With Anxiety Disorder And Fear Of Flying, Michael Mccann

Law Faculty Scholarship

This Article examines the legal ramifications of Royce White, a basketball player with general anxiety disorder and obsessive compulsive disorder, playing in the NBA. White's conditions cause him to have a fear of flying, thus making it difficult to play in the NBA. This subject is without precedent in sports law and, because of the unique aspects of an NBA playing career, lacks clear analogy to other employment circumstances. This dispute also illuminates broader legal and policy issues in the relationship between employment and mental illness.

This Article argues that White would likely fail in a lawsuit against an NBA …

Dietary Supplement Labeling: Cognitive Biases, Market Manipulation & Consumer Choice, Michael Mccann

Law Faculty Scholarship

There exists increasing concern that the Dietary Supplements Health and Education Act (DSHEA) has proven ineffective. Much of the concern regards the disparity in legislative treatment between dietary supplements, foods, and pharmaceutical drugs. Namely, while pharmaceutical drugs must undergo years of costly pre-market testing, most supplements, like foods, can immediately enter the market, and only after repeated instances of adverse reactions can the Food and Drug Administration (FDA) remove them. Such a framework appears to belie both consumer expectations and marketing strategies, as supplements tend to be most perceived for their apparent medicinal qualities. This philosophy of waiting for a …

Contraceptive Sabotage, Leah A. Plunkett

Law Faculty Scholarship

This Article responds to the alarm recently sounded by the American College of Obstetricians and Gynecologists over “birth control sabotage”—the “active interference [by one partner] with [the other] partner’s contraceptive methods in an attempt to promote pregnancy.” Currently, sabotage is not a crime, and existing categories of criminal offenses fail to capture the essence of the injury it does to victims. This Article argues that sabotage should be a separate crime—but only when perpetrated against those partners who can and do get pregnant as a result of having sabotaged sex. Using the principle of self-possession—understood as a person’s basic right …

Nudging The Fda, W. Nicholson Price Ii, I. Glenn Cohen

Law Faculty Scholarship

[Excerpt] "The FDA’s regulation of drugs is frequently the subject of policy debate, with arguments falling into two camps. On the one hand, a libertarian view of patients and the health care system holds high the value of consumer choice. Patients should get all the information and the drugs they want; the FDA should do what it can to enforce some basic standards but should otherwise get out of the way. On the other hand, a paternalist view values the FDA’s role as an expert agency standing between patients and a set of potentially dangerous drugs and potentially unscrupulous or …

Making Do In Making Drugs: Innovation Policy And Pharmaceutical Manufacturing, W. Nicholson Price Ii

Law Faculty Scholarship

Despite increasing recalls, contamination events, and shortages, drug companies continue to rely on outdated manufacturing plants and processes. Drug manufacturing’s inefficiency and lack of innovation stand in stark contrast to drug discovery, which is the focus of a calibrated innovation policy that combines patents and FDA regulation. Pharmaceutical manufacturing lags far behind the innovative techniques found in other industries due to high regulatory barriers and ineffective intellectual property incentives. Among other challenges, although manufacturers tend to rely on trade secrecy because of the difficulty in enforcing patents on manufacturing processes, trade secrecy provides limited incentives for innovation. To increase those …

Patent Landscape Of Helminth Vaccines And Related Technologies, Jon R. Cavicchi, Stanley P. Kowalski, John Schroeder, Rayna Burke, Jillian Michaud-King

Law Faculty Scholarship

Executive Summary This report focuses on patent landscape analysis of technologies related to vaccines targeting parasitic worms, also known as helminths. These technologies include methods of formulating vaccines, methods of producing of subunits, the composition of complete vaccines, and other technologies that have the potential to aid in a global response to this pathogen. The purpose of this patent landscape study was to search, identify, and categorize patent documents that are relevant to the development of vaccines that can efficiently promote the development of protective immunity against helminths. The search strategy used keywords which the team felt would be general …

Patent Landscape Of Influenza A Virus Prophylactic Vaccines And Related Technologies, Jon R. Cavicchi, Stanley P. Kowalski, David L. Pflugh, Jeremy Barton, Jeffrey Janovetz, John Schroeder

Law Faculty Scholarship

Executive Summary: This report focuses on patent landscape analysis of technologies related to prophylactic vaccines targeting pandemic strains of influenza. These technologies include methods of formulating vaccine, methods of producing of viruses or viral subunits, the composition of complete vaccines, and other technologies that have the potential to aid in a global response to this pathogen. The purpose of this patent landscape study was to search, identify, and categorize patent documents that are relevant to the development of vaccines that can efficiently promote the development of protective immunity against pandemic influenza virus strains.

The search strategy used keywords which the …

From Trusted Confidant To Witness For The Prosecution: The Case Against The Recognition Of A Dangerous-Patient Exception To The Psychotherapist-Patient Privilege, Deborah Paruch

The University of New Hampshire Law Review

[Excerpt] “In 1996, in Jaffee v. Redmond, the U.S. Supreme Court, pursuant to the authority set forth in Federal Rule of Evidence 501, recognized a psychotherapist-patient privilege in the federal courts. In doing so, the Court acknowledged the essential role that confidentiality plays in a therapist-patient relationship and also recognized the important role that psychotherapy plays in the mental health of the American citizenry. However, in dicta set out in a footnote near the conclusion of the opinion (footnote 19 of the opinion), the Court suggested that the privilege might not be absolute, that it might need to “give way …

Pledge Your Body For Your Bread: Welfare, Drug Testing, And The Inferior Fourth Amendment, Jordan C. Budd

Law Faculty Scholarship

Proposals to subject welfare recipients to periodic drug testing have emerged over the last three years as a significant legislative trend across the United States. Since 2007, over half of the states have considered bills requiring aid recipients to submit to invasive extraction procedures as an ongoing condition of public assistance. The vast majority of the legislation imposes testing without regard to suspected drug use, reflecting the implicit assumption that the poor are inherently predisposed to culpable conduct and thus may be subject to class-based intrusions that would be inarguably impermissible if inflicted on the less destitute. These proposals are …

Preliminary Report On Patent Literature, Search Methodology And Patent Status Of Medicines On The Who Eml 2009, Jon R. Cavicchi, Stanley P. Kowalski

Law Faculty Scholarship

Over the past several decades the World Health Organization (WHO) has produced the Essential Medicines List (EML) to assist countries in deciding what medicines should be essential and available in National Essential Medicine Lists.1 WHO, through the work of regional offices, supports nations using the EML to ensure the quality, availability, and affordability of pharmaceuticals required to promote and advance public health in nations across the globe. However in some cases, access to EML pharmaceuticals might be complicated by existing patents, i.e., where issued, patent rights might pose obstacles to access and inclusion in national EMLs. Indeed, in developed and …

Exhausted Or Unlicensed: Can Field-Of-Use Restrictions In Biotech License Agreements Still Prevent Off-Label Use Promotion After Quanta Computer?, Kristal M. Wicks

The University of New Hampshire Law Review

[Excerpt] “In the biotechnology (biotech) industry, companies must be increasingly aware of their intellectual property and how their licensing strategies can impact their rights. When licensing patented technology, it is common practice for biotech companies to include restricted field-of-use provisions in their license agreements. Such provisions permit a licensee to only use licensed technology in a defined field and restrict use or development in another field. This licensing strategy plays an important role within the biotech industry because it allows companies to more effectively control their intellectual property and to more efficiently research and develop pharmaceutical products.

A problem that …

One Toke Over The Line: The Proliferation Of State Medical Marijuana Laws, Troy E. Grandel

The University of New Hampshire Law Review

[Excerpt] “Marijuana has been used for medicinal purposes for at least five thousand years. In fact, it was used medicinally in the United States up until the twentieth century when antidrug zealots managed to prohibit it. Prohibition was the status quo until 1996 when California became the first state to adopt a law allowing medicinal marijuana use. Since then, thirteen additional states, along with the District of Columbia, have enacted similar laws. More states are now lining up with their own laws, which are in various stages of adoption. In addition, the Supreme Court has impacted the issue, both with …

Intellectual Property, Medicine And Health: Current Debates, Stanley P. Kowalski

Law Faculty Scholarship

Johanna Gibson’ s “Intellectual Property, Medicine and Health: Current Debates” is an ambitious attempt to bridge the gap between IPR (largely patents) and the ethical, moral and philosophical issues which should influence global access to innovations in health. This intent is noteworthy and timely, as the complexities are important to address and there is an urgent need for clear-headed strategy. However, disappointingly, the book largely fails, as it is a rambling polemic that lacks focus, clarity and originality. Wading through the thicket of verbiage becomes so daunting that whatever message might be present is lost. The book also is flawed …

Stepping Beyond The Smith Plaintiffs‘ Reliance On Corso: An Alternative Approach To Recovering Emotional-Distress Damages In Wrongful-Birth Cases In New Hampshire, Parker B. Potter Jr.

The University of New Hampshire Law Review

[Excerpt] “More than twenty years ago, in Smith v. Cote, the New Hampshire Supreme Court held “that New Hampshire recognizes a cause of action for wrongful birth.” After so holding, the court then discussed the damages available to a prevailing wrongful-birth plaintiff. Among other things, the court held that when parental emotional distress associated with raising a disabled child, born after the mother had received negligent pre-natal assurance of the baby‘s normal health, “results in tangible pecuniary losses, such as medical expenses or counseling fees, such losses are recoverable.” The court further held that a wrongful-birth plaintiff may not recover …

Entitlements: Not Just A Health Care Problem, Andrew G. Biggs

The University of New Hampshire Law Review

[Excerpt] “A new consensus on entitlement reform has developed in Washington: rising per-capita health care spending is the only real crisis besetting the government‘s entitlement programs, while America‘s aging population and Social Security play minor roles at best. Some cite this view to shift the policy emphasis from entitlement cost control to the restructuring of the U.S. health sector, including private health care. But this new consensus is flawed. Using standard accounting practices and including all major government entitlement programs, population aging will play an equal role with health care cost growth over the next seventy-five years and a significantly …

Revisiting The Regulation Debate: The Effect Of Food Marketing On Childhood Obesity, Nicole E. Hunter

The University of New Hampshire Law Review

[Excerpt] “Despite the widespread concern regarding childhood obesity, there is broad divergence of opinion regarding responsibility for the crisis. Whether the government, food industry, or parents are accountable has become the focus of much debate. Public health groups have attempted various strategies to confront childhood obesity, such as litigation, legislation, and government regulation. While many researchers and advocates agree that government should play an affirmative role with respect to childhood obesity, they are very much divided over what that role should be. For example, although none of these acts has become law, eighty-six bills have been proposed regarding obesity since …

Got Controversy - Milk Does, Margaret Sova Mccabe

Law Faculty Scholarship

This article analyzes ongoing controversy over how to best label rBST-free milk. Recombinant bovine somatotropin is a genetically engineered drug administered by some farmers to their dairy herds to increase milk production. FDA first approved its use in 1994, despite great controversy. The FDA also issued labeling guidelines that allowed voluntary disclosure of rBST-free milk, so long as it carried the disclaimer that no difference could be detected between milk produced with rBST and rBST-free. The controversy continues today as consumers express a preference for rBST-free milk and many rBST-free producers label their milk this way. "Conventional" milk (with rBST) …