Prescription opioids are an important tool for physicians in treating pain but also carry significant risks of harm when prescribed inappropriately or misused by patients or others. Recent increases in opioid-related morbidity and mortality has reignited scrutiny of prescribing practices by law enforcement, regulatory agencies, and state medical boards. At the same time, the predominant 4D model of misprescribers is outdated and insufficient; it groups physician misprescribers as dated, duped, disabled, or dishonest. The weaknesses and inaccuracies of the 4D model are explored, along with the serious consequences of its application. This Article calls for development of an evidence base in this area and suggests an alternate model of misprescribers, the 3C model, which more accurately characterizes misprescribers as careless, corrupt, or compromised by impairment.

This Article offers a thorough analysis of an important public health issue, namely how to confront the growing problem of deceptive claims regarding foods and dietary supplements, including increasingly prevalent but unverifiable claims. The authors call for the creation of a limited private right of action under the Federal Trade Commission (FTC) Act for deceptive health-related claims for these products. The proposal responds to the growing market for these products and the inadequacy of current laws and enforcement actions to prevent such claims. In crafting the limited private right of action, the authors attempt to enhance consumer protection without undermining federal agency primacy in enforcement. The Article ends with an appendix setting forth proposed language for a statutory amendment to the FTC Act incorporating the authors' proposal.

Stakeholders in law, medicine, and religion are unable to reach consensus about how best to address conflicts between healthcare providers' conscientious objections to treatment and patients' rights to access medical care. Conscience laws that protect objecting providers and institutions from liability are criticized as too broad by patient advocates and as too narrow by defenders of religious freedom. This Article posits that some of the tension between these stakeholders could be mitigated by statutory recognition of a duty on the part of healthcare institutions or providers to disclose conscientiously motivated limitations on practice. While this solution would not guarantee a patient's access to treatment, referral, or information from any given provider, it would prevent some of the more egregious cases of denial of treatment—those where patients are not made aware that a legal and clinically defensible treatment option is excluded from a provider's or institution's scope of practice and so have no opportunity to seek care elsewhere.

Kidney chains are a recent and novel method of increasing the number of available kidneys for transplantation and have the potential to save thousands of lives. However, because they are novel, kidney chains do not fit neatly within existing legal and ethical frameworks, raising potential barriers to their full implementation.

Kidney chains are an extension of paired kidney donation, which began in the United States in 2000. Paired kidney donations allow kidney patients with willing, but incompatible, donors to swap donors to increase the number of donor/recipient pairs and consequently, the number of transplants. More recently, transplant centers have been using non-simultaneous, extended, altruistic donor (“NEAD”) kidney chains—which consist of a sequence of donations by incompatible donors—to further expand the number of donations. This Article fully explains paired kidney donation and kidney chains and focuses on whether NEAD chains are more coercive than traditional kidney donation to a family member or close friend and whether NEAD chains violate the National Organ Transplant Act's prohibition on the transfer of organs for valuable consideration.

In September of 2014, Elisabeth Rosenthal of The New York Times detailed a burgeoning problem she termed “drive-by-doctoring,” a practice in which patients go to the hospital for surgery with an in-network physician who, without the patient's knowledge or consent, is assisted by, or consults with, an out-of-network physician during the procedure. While the in-network physician's costs are covered by the patient's insurance, the out-of-network physician charges large fees for her participation, which typically are not fully covered by the patient's insurance plan and are instead passed directly through to the patient. Patients wake from surgery with surprise medical bills that can total over one hundred thousand dollars. Providers typically attempt to collect the full amount of these surprise charges, which “can be especially significant because … they may involve out-of-network providers who bill 20 to 40 times the usual local rates ….”

The First Amendment and reproductive freedom have recently been pitted against each other on more than one occasion. In June 2014, the Supreme Court held that a Massachusetts law creating a buffer zone in front of abortion-providing centers was a violation of the First Amendment. In Maryland, the city of Baltimore and Montgomery County have passed ordinances to regulate crisis pregnancy centers (“CPCs”), which would effectively require the facilities to advertise that they are not medically licensed and do not provide abortion care. The president of a group of CPCs describes CPCs as “organizations out to offer ‘pro-life counseling;’” pro-choice proponents, however, “argue that the centers are deceptive, presenting themselves as medical facilities and even abortion clinics in order to lure pregnant women in, and then bombard them with guilt trips, emotional abuse, and even lies in an effort to keep them from having abortions.” In two cases, CPCs in Maryland have sued to enjoin these ordinances.