The tremendous toll that COVID-19 has taken on this country’s minority population is the most recent reminder of the health disparities between people of color and people who classify themselves as white. There are many reasons for these disparities, but one that gets less attention than it deserves is the lack of physicians of color available to treat patients of color.

Progesterone is essential both for ovulation and for the formation of the secretory endometrium which is required for nidation: it plays a central role in the establishment and maintenance of pregnancy. Given the multifaceted role of progesterone in the reproductive process, an anti-progestational compound such as RU 486 (Mifepristone, Roussel-Uclaf, Paris, France) could be expected to have a number of potential clinical applications in human fertility regulation including termination of pregnancy, induction of missed menses, postcoital contraception and inhibition of ovulation and implantation.

Our research and clinical evaluation have mainly been directed to termination of pregnancy and to inhibition of implantation. The aim of this presentation is to summarize briefly our experience with the use of RU 486 in these areas.

One thing is certain about the Supreme Court's decision in Webster v. Reproductive Health Services: It will stimulate state legislatures to enact more legislation regulating abortion. Justice Blackmun candidly described the main opinion, written by Chief Justice Rehnquist (part majority, part plurality), as an “implicit invitation to every State to enact more and more restrictive abortion laws, and to assert their interest in potential life as of the moment of conception.” For many pro-choice advocates, this is an ominous development; for some, it is extremely frightening. For most pro-life advocates, however, this is a hopeful result; some enthusiastically perceive the prospect to reenact the 19th century abortion prohibition. But the most passionate activists on both sides are mistaken; both those who are frightened about “dark ages” abortion prohibitions and those who are gloating about turning back the clock misunderstand the significance and holding of Webster. Webster is a victory for moderation; it signifies the revival of a long-term process of political give-and-take, public education and debate, and legislative compromise.

The standard of medical care provided in prisons has emerged recently as an important issue in the areas of public health and prisoners' rights. Prison conditions have long been of concern to both the medical and legal professions. However, little progress was made in prison health care until the early 1970s when the federal courts began to recognize civil rights actions by prisoners pressing for adequate medical care. This article discusses the problems involved with providing medical care in prisons, the development of constitutional standards for prison medical services, and, collaterally, the difficulties encountered when pursuing prison reform by means of federal litigation.

In June 2021, Missouri passed the “Second Amendment Preservation Act” (SAPA). Though SAPA passed easily and had gubernatorial support, many Missouri law enforcement agencies, including the Missouri Sheriff’s Association, oppose it. Missing from this policy conversation, and deserving of analysis, is the voice of Missouri citizens. Using qualitative interview data and survey data, we explored what if anything Missouri gun owners knew about SAPA and what they perceived its effects would be on gun-related murders, suicides, gun thefts, and mass shootings. Most Missouri gun owners had not heard about SAPA and were ambivalent about its potential effect on gun safety outcomes. Our findings also indicate that respondents’ attitudes toward SAPA and the impact of such policy on safety is driven by gun ownership (i.e., primary versus living in a household with firearms), partisan identification, and attitudes toward government firearm regulation.

From 2018 through 2020, HHS approved state Medicaid demonstration waivers to impose new eligibility conditions such as work requirements, connecting current “personal responsibility” rhetoric and historical suspicion of malingering. The Biden administration reversed course but advocated to the Supreme Court for expansive administrative discretion. This approach supports health equity now but could enable reemergence of restrictive health policies down the road.

The traditional living donor was very healthy. However, as the supply-demand gap continues to expand, transplant programs have become more accepting of less healthy donors. This paper focuses on the other extreme, asking whether and when individuals who have life-limiting conditions (LLC) should be considered for living organ donation. We discuss ethical issues raised by 1) donation by individuals with progressive severe debilitating disease for whom there is no ameliorative therapy; and 2) donation by individuals who are imminently dying or would die by the donation process itself.

On July 2, 2001, a medical milestone was reached when Robert Tools received a total artificial heart implant at Jewish Hospital in Louisville, Kentucky. Tools was implanted with an AbioCor artificial heart, one of several brands of new-generation artificial hearts that has been approved by the U.S. Food and Drug Administration (FDA) for clinical trial. The AbioCor heart was developed by Abiomed of Danvers, Massachusetts.

Following the surgery, physicians were guardedly enthusiastic about the device and optimistic about the patient’s future. Tools, 59, has had a history of numerous heart attacks and by-pass surgery, as well as diabetes and kidney problems. He met the requirements of the AbioCor protocol because he was not a candidate for transplant, death was otherwise probable within thirty days, and other interventions were deemed ineffective. Researchers hope that strengthening his heart function will result in increased function of his other vital organs, thus prolonging the patient's life and increasing his energy. But because the device is experimental, nothing can be promised.

Both law and medicine rely on self-regulation and codes of professionalism to ensure duties are performed in a competent, ethical manner. Unlike physicians, however, judges are lawyers themselves, so judicial oversight is also self-regulation. As previous literature has highlighted, the hesitation to report a cognitively-compromised judge has resulted in an “opensecret” amongst lawyers who face numerous conflicts of interest.

Through a case study involving a senior judge with severe cognitive impairment, this article considers the unique ethical dilemmas that cognitive specialists may encounter when navigating duties to patient, society, and the medical profession, without clear legal guidance.

Systemic self-regulatory inadequacies in the legal profession are addressed, as well as challenges that arise when trying to preserve the trust and dignity of an incapacitated patient who must fulfill special duties to society.

Ultimately, because of their unique neurological expertise and impartial assessments, we submit that allowing cognitive specialists to submit their assessments to an internal judiciary board may act as an additional check and balance to ensure the fair and competent administration of justice.

Increasing reports of financial entanglements involving scientist and industry have led some to question the neutrality of research results. In December 2003, a story in the Los Angeles Times shocked readers by exposing several cases of NIH scientists embroiled in serious financial conflicts of interest.1 It was revealed, for example, that senior NIH official Stephen Katz was a paid consultant to Schering AG, a German pharmaceutical company with which he was involved in conducting clinical trials. In a similar case, John Gallin, director of the NIH's Clinical Center, was discovered to have co-authored an article on a company's gene-transfer technology, while being paid as a consultant to a subsidiary of the same company. Jeffrey Schlom, director of the National Cancer Institute's Laboratory of Tumor Immunology and Biology, helped direct NIH-funded studies examining wider use for a particular cancer drug while serving as a consultant whose highest-paying client was looking to genetically engineer that drug.

The intensity of the opposition to health reform in the United States continues to shock and perplex proponents of the Patient Protection and Affordable Care Act (PPACA). The emotion (“Abort Obama”) and the apocalyptic rhetoric (“Save our Country, Protect our Liberty, Repeal Obamacare”), render civil and evidence-based debate over the implications and alternatives to specific provisions in the law difficult if not problematic. The public debate has largely barreled down two non-parallel yet non-intersecting paths: opponents focus on their fear of government expansion in the future if PPACA is implemented now, while proponents focus on the urgency and specifics of our health care market problems and the limited number of tools we have to address them. Frustration on both sides has led opponents to deny the seriousness of our health system’s problems and proponents to ignore the risk of governmental overreach. These non-intersecting lines of argument are not moving us closer to a desired and necessary resolution.

Georgia State University College of Law, through the Center for Law, Health & Society, developed a pair of online libraries for faculty teaching public health law in schools of law or public health. Development of these libraries was funded by a grant from the Robert Wood Johnson Foundation as part of The Future of Public Health Law Education: Faculty Fellowship Program. This article describes the goals of the program addressed by the libraries, the development process, the resources included, and how faculty may benefit from the materials and provide materials benefitting other faculty across the country.

The rising cost of the opioid antagonist and overdose reversal agent naloxone is an urgent public health problem. The recent and dramatic price increase of Evzio, a naloxone auto-injector produced by Kaléo, shows how pharmaceutical manufacturers entering the naloxone marketplace rely on market exclusivity guaranteed by the patent system to charge prices at what the market can bear, which can restrict access to life-saving medication. We argue that 28 U.S.C. § 1498, a section of the federal code that allows the government to use patent-protected products for its own purposes in exchange for reasonable compensation, could be used to procure generic naloxone auto-injectors, or at least bring Kaléo to the negotiating table. Precedent exists for the use of § 1498 to procure pharmaceuticals, and it could give meaning to the federal government's recent declaration of a public health emergency around the opioid epidemic, discourage new market entrants from charging exorbitant prices, and yield important public health benefits.

In the wake of several highly publicized lawsuits over drugs recalled for safety – most notably, Vioxx and Paxil – the Food and Drug Administration (FDA) and the pharmaceutical industry have faced increasingly intense public scrutiny over the drug testing and approval process. Critics blame the FDA's shorter pre-market approval process that has resulted from the enactment of the Prescription Drug User Fee Act (PDUFA), which effected, among other changes, an increased number of reviewers, a higher review load for each reviewer, and the implementation of “user fees” from companies submitting drugs for review. While many have posited that the lack of safety in some FDA-approved drugs was caused by the enactment of PDUFA, the results of a recent study from the Tufts Center for the Study of Drug Development have indicated that there is no statistically significant correlation between the number of drugs recalled for safety and the enactment of PDUFA.

The Netherlands does not have any specific legislation pertaining to human biological materials and data collection by biobanks. Instead, these issues are governed by a patchwork of laws, codes of practices, and other ethical instruments, where special emphasis is given to the right to privacy and self-determination. While draft legislation for biobanking was scheduled to enter into force in 2007, as of mid-2015 such legislation was still under consideration, with the intent that it would focus particularly on individual self-determination, the interests of research, the use of bodily materials collected by biobanks for criminal law purposes, and dilemmas around results that are clinically relevant for biobank participants. Under the current framework, the amount of privacy protection afforded to data is linked to its level of identifiability. International sharing of personal data to non-EU/European Economic Area countries is allowed if these countries provide adequate protection.

In the last several years, Brazil has gained international attention as an emerging BRIC economy, was awarded the 2014 World Cup and 2016 Olympics, and elected its first female president. This has led many to declare that Brazil is emerging as a potential world power for the 21st century. In addition to improving its international stature, in the last several decades Brazil has also significantly improved the availability and quality of health care within the country. Despite these gains, however, Brazil still suffers from poor maternal health. In fact, Brazil's Maternal Mortality Ratio is five to ten times higher than the rates in high-income countries. Last year, these conditions lead the United Nations Committee on the Elimination of Discrimination against Women to issue a decision declaring that Brazil was violating its international obligations to provide pregnant women with adequate health care, and to call for a reduction in preventable maternal deaths. It is against this backdrop that Brazil enacted a new law last December, Provisional Measure 557 (MP 557), to require pregnant women to register with the state.

In 1889, The British Medical Journal published a piece titled, “Detective Medicine,” which describes feats of medical detection performed by physicians attending malingering prisoners. Though simulating illness had a long history, the medicalization of malingering at the fin de siècle led to a proliferation of such case histories and cheerful records of pathological feigners thwarted.

Vaccine apartheid is creating conditions that make for premature death, poverty, and disease in racialized ways. Invoking vaccine apartheid as opposed to euphemisms like vaccine nationalism, is necessary to highlight the racialized distributional consequences of vaccine inequities witnessed with COVID-19. This commentary clarifies the concept of vaccine apartheid against the historical and legal usage of apartheid. It reflects on the connections and important disjunctions between the two. It places the intellectual property regime under heightened scrutiny for reform and transformation. This commentary finds that drawing on the intersections between a human rights and health justice approach can provide creative and novel approaches for anti-subordination. It concludes that acknowledging and naming the structural injustice of vaccine apartheid is only the first step towards providing redress.

Medical aid in dying (MAiD), despite being legal in many jurisdictions, remains controversial ethically. Existing surveys of physicians’ perceptions of MAiD tend to focus on the legal or moral permissibility of MAiD in general. Using a novel sampling strategy, we surveyed physicians likely to have engaged in MAiD-related activities in Colorado to assess their attitudes toward contemporary ethical issues in MAiD.