Medicine and Health Sciences Commons^™

The Rise And Fall Of A Reproductive Right: Dobbs V. Jackson Women’S Health Organization, Carol Sanger

Faculty Scholarship

Although the phrase “Post-Roe Era” is still used by those who want to underscore the loss wrought last June by Dobbs v. Jackson Women’s Health Organization, it is only a matter of time before the present state of reproductive constitutionalism solidifies into the more authoritarian “Dobbs Era.” In these early days of transition, states are still figuring out what they want the legal status of abortion to be, ever since Dobbs overruled both Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania v. Casey, thus tossing the issue of abortion’s legality back to the states for …

The Nih-Moderna Vaccine: Public Science, Private Profit, And Lessons For The Future, Christopher J. Morten

Faculty Scholarship

This commentary highlights the scientific history of the NIH-Moderna COVID-19 vaccine and corroborates Sarpatwari’s theme of private capture of value created by the public. The commentary also identifies missteps by the Trump and Biden Administrations and offers policy recommendations: better contracts with and incentives for pharmaceutical manufacturers and a not-for-profit “public option” for pharmaceutical development.

Extending Postpartum Medicaid: State And Federal Policy Options During And After Covid-19, Jamie R. Daw, Emily Eckert, Heidi Allen, Kristen Underhill

Faculty Scholarship

The United States is facing a maternal health crisis with rising rates of maternal mortality and morbidity and stark disparities in maternal outcomes by race and socioeconomic status. Among the efforts to address this issue, one policy proposal is gaining particular traction: extending the period of Medicaid eligibility for pregnant women beyond 60 days after childbirth. The authors examine the legislative and regulatory pathways most readily available for extending postpartum Medicaid, including their relative political, economic, and public health trade-offs. They also review the state and federal policy activity to date and discuss the impact of the COVID-19 pandemic on …

The Southern Hospitals Report, Elizabeth Reiner Platt, Katherine M. Franke, Candace Bond-Theriault, Amy Littlefield

Faculty Scholarship

When research for this report was first initiated, it was intended to answer a narrow question: is abortion care restricted at historically Protestant hospitals in the U.S. South? Strict limits on access to abortion at Catholic hospitals — and the ways in which this can obstruct and delay even emergency medical care — are already well documented in legal and medical literature and news media. In contrast, restrictions at Protestant hospitals have not been extensively studied and are not well understood. Our research sought to fill this gap in knowledge. We focused on the U.S. South because Catholic hospitals are …

The Big Data Regulator, Rebooted: Why And How The Fda Can And Should Disclose Confidential Data On Prescription Drugs And Vaccines, Christopher J. Morten, Amy Kapczynski

Faculty Scholarship

Medicines and vaccines are complex products, and it is often extraordinarily difficult to know whether they help or hurt. The Food and Drug Administration (FDA) holds an enormous reservoir of data that sheds light on that precise question, yet currently releases only a trickle to researchers, doctors, and patients. Recent examples show that data secrecy can be deadly, and existing laws such as the Freedom of Information Act (FOIA) cannot solve the problem. We present here a wealth of new evidence about the urgency of the problem and argue that the FDA must “reboot” its rules to proactively disclose all …

Abortion Talk, Clare Huntington

Faculty Scholarship

Public service announcements routinely note that one in eight women will be diagnosed with breast cancer. Advocates frequently invoke the twenty percent wage gap between men and women. And educational groups often cite the (more contested) statistic that one in five women will be sexually assaulted during college. But there is another data point not regularly part of public conversation: nearly one in four women will have an abortion by the age of forty-five. The widespread — but largely secret — practice of terminating pregnancies is what Carol Sanger wants us to talk about. As much as possible.

Trauma, Depression, And Burnout In The Human Rights Field: Identifying Barriers And Pathways To Resilient Advocacy, Sarah Knuckey, Margaret Satterthwaite, Adam Brown

Faculty Scholarship

Human rights advocates often confront trauma and stress in their work. They are exposed to testimony about heinous abuses; work in insecure locations; visit physical sites of abuse; review forensic, photographic, and video evidence; directly witness abuses; experience threats; and can also suffer detention, be attacked, or be tortured themselves. Such exposure risks adversely impacting the wellbeing and mental health of advocates. While the human rights field is diverse and work varies widely, most – if not all – advocates are likely directly or indirectly exposed to potentially traumatic events or material in the course of their work. The degree …

Putting Prep Into Practice: Lessons Learned From Early-Adopting U.S. Providers’ Firsthand Experiences Providing Hiv Pre-Exposure Prophylaxis And Associated Care, Sarah K. Calabrese, Manya Magnus, Kenneth H. Mayer, Douglas S. Krakower, Adam I. Eldahan, Lauren A. Gaston Hawkins, Nathan B. Hansen, Trace S. Kershaw, Kristen Underhill, Joseph R. Betancourt, John F. Dovidio

Faculty Scholarship

Optimizing access to HIV pre-exposure prophylaxis (PrEP), an evidence-based HIV prevention resource, requires expanding healthcare providers’ adoption of PrEP into clinical practice. This qualitative study explored PrEP providers’ firsthand experiences relative to six commonly-cited barriers to prescription – financial coverage, implementation logistics, eligibility determination, adherence concerns, side effects, and anticipated behavior change (risk compensation) – as well as their recommendations for training PrEP-inexperienced providers. U.S.-based PrEP providers were recruited via direct outreach and referral from colleagues and other participants (2014-2015). One-on-one interviews were conducted in person or by phone, transcribed, and analyzed. The sample (n = 18) primarily practiced …

Het Gebruik Van Risicotaxatie Instrumenten Onder Spv-En (The Use Of Risk Assessment Instruments Among Community Psychiatric Nurses), Sophie De Valk, Corine De Ruiter, Jorge Folino, Matthew Large, Thierry Pham, Kim Reeves, Carolina Condemarin, Louise Nielsen, Martin Rettenberger, Robyn Mei Yee Ho, Verónica Godoy-Cervera, Kimberlie Dean, Maria Francisca Rebocho, Karin Arbach-Lucioni, Martin Grann, Katharina Seewald, Michael W. Doyle, Sarah Desmarais, Richard Van Dorn, Randy Otto, Jay Singh

Faculty Scholarship

Dutch Abstract: Auteur en een groot aantal alumni-collega's van de Universiteit van Maastricht, hebben gekeken welke risicotaxatie-instrumenten SPV-en gebruiken om het risico van recidive in te schatten bij clienten uit de forensische psychiatrie. Met behulp van START kan volgens hen het risico voor anderen, het risico op victimisatie, risico op zelfbeschadigend gedrag, suïcidegevaar, ongeoorloofde afwezigheid, middelenmisbruik en zelfverwaarlozing bij deze forensische groep vastgesteld worden.

English Abstract: The author and colleagues from the University of Maastricht investigated the use of structured risk assessment instruments in forensic psychiatry. Using instruments such as the START may aid in the assessment of violence, victimization, …

Neuroscience And The Child Welfare System, Clare Huntington

Faculty Scholarship

Increasingly, scholars and policymakers are calling for programs that take a preventive approach to child abuse and neglect, rather than our current tendency to respond only after a crisis. There are significant social and economic arguments supporting this shift. The Nurse-Family Partnership, developed by David Olds and discussed in this symposium, illustrates how specific investments in family functioning can lower rates of child abuse and neglect, leading to a host of positive outcomes for children and society, from greater educational attainment to less involvement in the criminal justice system. Thinking about child well-being more broadly, the Nobel laureate James Heckman …

The Effect Of Female Education On Fertility And Infant Health: Evidence From School Entry Policies Using Exact Date Of Birth, Justin Mccrary, Heather Royer

Faculty Scholarship

This paper uses age-at-school-entry policies to identify the effect of female education on fertility and infant health. We focus on sharp contrasts in schooling, fertility, and infant health between women born just before and after the school entry date. School entry policies affect female education and the quality of a woman’s mate and have generally small, but possibly heterogeneous, effects on fertility and infant health. We argue that school entry policies manipulate primarily the education of young women at risk of dropping out of school.

Introduction To The Symposium Issue On Alternative Dispute Resolution Strategies In End-Of-Life Decisions, Carol B. Liebman

Faculty Scholarship

At about 8:30 p.m. on a spring evening approximately twenty-five years ago when I was living in Newton, Massachusetts, our telephone rang. It was the emergency judge on duty that week asking me to go to a nearby suburban hospital to represent a sixty-eight-year-old woman whom I'll call Mrs. P. She had been hospitalized for heart failure and was refusing treatment, saying that she wanted to die with dignity.

Mrs. P and her husband had traveled to Boston from her home, a small town in New York about five hours away, to meet their newest grandchild. When I arrived at …

The Sympathetic Discriminator: Mental Illness, Hedonic Costs, And The Ada, Elizabeth F. Emens

Faculty Scholarship

Social discrimination against people with mental illness is widespread. Treating people differently on the basis of mental illness does not provoke the same moral outrage as that inspired by differential treatment on the basis of race, sex, or even physical disability. Indeed, many people would freely admit preferring someone who does not have a mental illness as a neighbor, dinner party guest, parent, partner, or person in the next seat on the subway. Moreover, more than ten years after the Americans with Disabilities Act (the "ADA" or "Act") expressly prohibited private employers from discriminating on the basis of mental, as …

Federalism And The Future Of Health Care Reform, Richard Briffault, Sherry Glied

Faculty Scholarship

An important theme in the ongoing health care reform debate is federalism. During the battle over the Clinton Health Plan in 1993–94, the question of which level of government — federal or state — should take the leading role in health policy was almost as contentious as the particular proposals for extending access to quality health care and controlling health care costs. With the failure in 1994 to achieve comprehensive legislation at the national level, many policymakers and commentators gave fresh attention to the states as potential agents for health care reform.

Intoxication And Aggression, Jeffrey Fagan

Faculty Scholarship

Evidence of an association between use of illicit substances and aggressive behavior is pervasive. But the precise causal mechanisms by which aggression is influenced by intoxicants are still not well understood. Research on intoxication and aggression often has overlooked the nonviolent behavior of most substance users, controlled use of substances, and the evidence from other cultures of a weak or nonexistent relation between substance use and aggression. There is only limited evidence that ingestion of substances is a direct, pharmacological cause of aggression. The temporal order of substance use and aggression does not indicate a causal role for intoxicants. Research …