In the Brief for the United States as Amicus Curiae supporting the Attorney General of Missouri in the Webster case, the Department of Justice invoked a favorable image of European legislative responses to the practice of abortion in order to argue the appropriateness of locating legislative control at the state level, as opposed to the level of federal law. It was further claimed that it was necessary for the Court to set aside its 1973 decision in Roe v. Wade in order for legislation in the U.S. to be consistent with the laws of other countries with which the U.S. “shares a common cultural tradition.”

The foundation on which these arguments were based is fundamentally flawed. The Department's brief omitted reference to the setting of Western European national legislation within the framework of international law , and in particular of the European Convention on Human Rights and Fundamental Freedoms.

The “right to repair” movement highlights opportunities to reduce health care costs and promote public health resilience through increased competition in the way in which medical devices are serviced and updated over their lifespan. We review legislative and legal facets of third-party repair of medical devices, and conclude with specific recommendations to help this market function more efficiently to the benefit of patients and health care systems.

It should come as no surprise to any observer of health policy debates that the preemption provisions of the Employee Retirement Income Security Act (ERISA) will play a major role in determining the contours of any health reform initiative. For the past few years, many states have been aggressively pursuing health reform experiments, while congressional action has essentially been deadlocked along partisan political lines. Yet after the 2008 election results, there is reason to expect considerable congressional attention to health reform. President Obama has made health reform a priority of his administration, and several members of Congress have long been waiting for an opportunity to pursue health reform legislation.

Despite successful transplantation outcomes in Europe, uncontrolled organ donation after circulatory determination of death (uDCDD) has essentially been a non-starter in North America. In this paper, I identify and explore a set of interesting, ethics-related considerations that are of relevance to this organ donation-transplantation practice. The analysis provides a theoretical platform for my development of a proposal for the creation of a particular ethical practice and policy space for kidney uDCDD in the U.S. and Canada that recognizes and aims to effectively address the various, identified challenges and constraints.

Dr. James Graves was convicted of manslaughter, racketeering, and drug charges in association with overdose deaths of four of his patients from the painkiller OxyContin. A Florida court then sentenced the physician to 62.9 years in prison. This is the first criminal conviction of a doctor in the United States related to OxyContin deaths.

Dr. Graves, who ran a pain management office, was charged with recklessly writing prescriptions to those that could afford an office visit and failed to ask appropriate questions beforehand. Prosecutors in the case said that the physician prescribed drugs like OxyContin to as many as ninety patients a day, after only a short office visit. The prosecution claimed that Graves was “‘selling prescriptions for cash without any real examination, diagnostic testing, or follow-up, no consultation, no real assessment of their medical needs.’”

This narrative provides insight into medical education for Black physicians in South Carolina in the 1960s, during the civil rights movement. It also discusses the many rewards and challenges of being a physician of color, describes what has been done to develop programs that benefit minority communities, and argues that more such programs are needed.

Kara Swanson has painted a textured portrait of Alan Guttmacher, showing the tension between his embrace of medical paternalism and simultaneous rejection of the legal paternalism that regulated women’s access to abortion before Roe v. Wade. Swanson explains Guttmacher’s route, navigating the troubled waters between “what was medically indicated and what was legally permissible” in the realm of reproductive medicine, the path that Guttmacher identified as the “doctor’s dilemma.” She takes us from his 1930s practice, creatively assisting in his patient’s use of reproductive technologies such as artificial insemination, to the era post Roe v. Wade, after which he seems to have come to terms with a fuller commitment to autonomous reproductive choices. We learn that Guttmacher’s early career provided opportunities to exercise some of his prerogatives as a doctor in the absence of clear legal constraints. By the end of his life, the Supreme Court came close to having endorsed his preference, as Swanson notes, “privileging the doctor/patient relationship and medical expertise.”

It comes as no surprise that, for the first time in nearly 15 years, a serious debate has emerged about the need to ensure quality, affordable coverage for all Americans. The statistics and stories about cost, coverage, and quality shortcomings abound and are indisputable. Setting the human consequences aside, the economic, budgetary competitiveness and demographic challenges facing the nation demand pragmatic and comprehensive reform. As health care costs (and cost-shifting from the uninsured) weigh down businesses and workers alike as well as federal, state, and local governments, stakeholders and forward-looking policymakers have started the drum-beat of reform — to the relief of most Americans.

Payment reforms that link health care providers’ reimbursements to their performance on various metrics incentivize providers to improve the quality and efficiency of care they provide to patients. Unfortunately, these reforms also create strong incentives for providers to reject patients who do not adhere to medical advice. This commentary argues that providers’ avoidance of non-adherent patients flouts the medical profession's commitment to patients’ best interests, undermines patients' trust in health professionals, and aggravates disparities in health. Moreover, the economic incentives under payment reforms that encourage quality and efficiency gains are weakened when providers can escape the financial penalties for poor outcomes by simply firing their non-adherent patients.

During the past decade, a new term has entered the medical/legal lexicon : maternal-fetal conflict. Implicit in the terminology is the assumption that a pregnant woman and her fetus have separate and competing rights. This concept has stimulated extensive legal and ethical debate, primarily in the context of medical interventions (cesarean sections and blood transfusions) forced on unwilling pregnant women, and in corporate efforts to bar fertile women from hazardous jobs. On one side of the debate are the proponents of the future child's right to be born of sound mind and body, and society's interest in the delivery of healthy newborns. On the other side, are advocates of a woman's right to reproductive autonomy, bodily integrity, due process, confidential medical treatment, and freedom from gender discrimination. Neither side has challenged the formulation of the problem, or has examined its permeation into public health policy.

This is one of four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and nineteen multi-disciplinary partner organizations. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by policymakers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.

This paper focuses on the fourth core element: information that can be used in shaping and applying law as a public health tool, specifically in the context of public health emergencies.