The “public charge” rule is a long-standing immigration policy that seeks to determine the likelihood that a prospective immigrant will become dependent on the government for subsistence. When the Trump administration sought to expand the criteria that would count against an applicant for permanent residency to include public benefits historically excluded from the calculation, thousands of commenters wrote to oppose or support the proposed changes. This paper explores the moral and practical reasons commenters provided for their position on the public charge rule and considers the value of the public comment process for immigration, health, and social policy.

Rare is the pharmacist today who does not participate as a service provider in one or several third party prescription insurance programs. Latest figures indicate that 372.7 million prescriptions or 25.4 percent of all prescriptions dispensed in this country were paid for at least in part by some form of prescription drug insurance.’ The economic impact which these third party programs are having on the retail pharmacist has caused their prominence as one of the most serious and important issues in pharmacy today.

Most third party prescription programs (TPPPs) are similar in structure and include a program administrator or insurance company, a sponsor (often an employer or labor union), subscribers or beneficiaries. and the participating pharmacies. Typically, the insurer or program administrator (hereinafter. the administrator) offers a contract or a “pharmacy agreement” to each pharmacy in a particular area. Each pharmacy must then decide whether or not to accept the agreement and become a participating pharmacy.

Antitrust challenges to agreements between hospitals and physicians who provide patient services have become one of the most common types of antitrust litigation in the past few years. Two recent decisions by different circuit courts of appeal highlight the legal and medical principles on which such disputes will be decided.

In August 1982, the United States Court of Appeals for the Seventh Circuit vacated a preliminary injunction entered in favor of an individual anes-thesiologist who had complained that after an anesthesia group terminated her employment, the hospital wrongfully refused to allow her to continue to serve patients. The Seventh Circuit, in Dos Santos v. Columbus-Cuneo- Cabrini Medical Center, expressed serious doubt whether under antitrust analysis, a single hospital could ever be treated as a distinct market for the purchase and sale of health care services. The court remanded the case to the federal district court, where it is still pending.

Every lawyer and law teacher is familiar with the basic developments in computer-assisted legal research that have changed at least the method of legal research. Computer-assisted research has gone far beyond LEXIS and Westlaw (computerized collections of state and federal legislation and decisions, as well as other legal material) in areas that are of critical importance to effective research for the teacher of health law. The nature of health law research has special, although perhaps not unique, characteristics that are particularly benefited by computer assistance.

Research in health law, especially policy-oriented research, rarely relies entirely on case law. Rather, its reach extends to interdisciplinary or cross-disciplinary research, comparative research, and the popular, as well as the scholarly, view. While health law teachers develop the ability to keep abreast of the rapid changes in case law and federal statutes and regulations, it is more difficult to keep pace with legislative developments on a state-bystate basis.

The articulation by a court of a new constitutional norm serves a valuable function: the right, as elaborated by judicial opinion, provides a standard for critically evaluating current social practices. The “right to refuse treatment,” that “newly created constitutional right of personal autonomy,” draws attention to the problems of institutionalized mental patients and their desires to make their own decisions to accept or reject drug therapies, particularly where severe side effects are involved. The enunciation of the right to refuse treatment, with its hard-edged overtones, forces us to look at the tension created by the conflict between institutional attempts to treat these patients, the sometimes antithetical desire of those within the institution to control them without regard for treatment impact, and the patient's desire to retain whatever control is left to him in such settings.

The right to refuse treatment-like its common law analogue in tort, informed consent doctrine-draws its roots from concepts of personal autonomy that pervade both tort doctrine and constitutional law.

The Report of the Massachusetts Task Force on Organ Transplantation can be described as an incunabulum. This strange word, properly referring to a book produced in the first decades of printing with movable type, literally means “in the cradle.” The Task Force document appears in the infancy of a discussion that is certain to grow: the public policy debate over the allocation of scarce resources. The debate was born several years ago, but until now has either been argued in general terms or by way of administrative devices. The Task Force addresses a quite particular issue: how to or whether to make available to the citizens of the Commonwealth and their neighbors the medical technology of organ transplantation. It approaches the problem with a vivid awareness of the expense of this technology as well as the constraints on health care resources and financing.

On July I, 1992, I received a phone call from a reporter asking for my response to Leona Benten's choice to defy the U.S. Food and Drug Administration's ban on RU 486 by bringing a single personal dose of the abortifacient drug into the U.S. on a flight from Europe. By the end of the day, my colleagues and I at the New York-based Center for Reproductive Law and Policy had been asked and had agreed to represent Leona and her companions, Dr. Louise Tyrer and Lawrence Lader, in their legal challenge to the import ban and, more urgently, in their effort to retrieve the RU 486 pills that were confiscated from Leona by U.S. Customs officials at the airport. Leona, who was 6 weeks pregnant and who desperately wanted to terminate her pregnancy by a non-surgical abortion method, had only two more weeks in which to use the drug according to prevailing medical protocol.

The 2006 term of the United States Supreme Court is now well underway, and the results of the congressional mid-term elections are in. No doubt, decisions will be handed down and national legislation proposed – perhaps even enacted – that will directly or indirectly affect the physician-patient relationship as well as the profession of medicine itself. Of major concern to physicians, patients, and the lay public is the ongoing, rather contentious debate surrounding both patient access to adequate pain control and what constitutes proper physician conduct in treating patients who are experiencing either chronic or end stage disease pain. Those knowledgeable in palliative medicine maintain that an “epidemic of undertreated pain” now exists, and probably has existed for more than a decade. A significant number of patients experience unnecessary pain and suffering, and this disturbing phenomenon is both an individual patient care problem and a public health concern.

There is a fine balance between civil liberties and protection of the public’s health.

Legislators, especially those in the western United States, are concerned about selling the Model State Act (“Act”) because of the loss of civil liberties. State constitutions give governors broad powers, such as declaring martial law and giving public health leaders the authority to act. State laws should consider issues such as property rights; taking of businesses and supplies; quarantine and isolation; due process; coordination among states, counties and cities; communication systems; conscription of doctors and nurses; and compensation. When two mock emergency response drills were held in New Mexico, concerns arose regarding opening records associated with dams, national laboratories, waste repositories, and three air force bases.

Government encouragement of free markets is a highly effective means of fostering pharmaceutical innovation; the NIH, by including “free-market provisions” in its licensing agreements that discourage anti-competitive and research-impeding behavior, can do a great deal to support this goal even without legislative overhaul.

The legal treatment of physician-assisted suicide (PAS) is in flux. Reform has been impelled by several forces, including the recent success of novel constitutional arguments in the Ninth and Second Circuit Courts of Appeals. I will review and discuss Compassion in Dying v. State of Washington and Quill v. Vacco, addressing the constitutional arguments, and then briefly considering the attractions and difficulties of these new constitutional theories.

Before 1990, state criminal laws dealing with assisted suicide had reached a remarkably stable consensus: suicide was not illegal, but assisting suicide was a criminal action with no distinction typically made between physicians and others who assisted. The details of the relevant criminal law varied from state to state. Some states had criminal statutes specifically addressing assisted suicide, while others treated the practice under more general homicide statutes. But in no state was it clearly legal for a physician to prescribe a lethal medication at the request of a dying patient. While remarkable legal developments took place during the 1970s and 1980s regarding other aspects of the rights of dying patients (including the right to refuse resuscitation and other life-sustaining treatments and the right to withdraw from life-sustaining treatment including nutrition and hydration), there was relative quiescence regarding the law of PAS.

Mary was angry. Youre going to take my pain medications away, aren't you? These were the first words she spoke as I walked into the examining room. Mary had a complex medical history, beginning with a back injury in 1988 that led to several surgical procedures, multiple injections of local anesthetic and corticosteroids, and placement of a dorsal column stimulator, none of which provided significant relief of her pain. Crippled by severe and sharp pain in her lower back and left leg, she had sought help from several physicians, and had most recently been referred to me specifically, as she put it, to take away the pain medications.

Not that the pain medications had afforded Mary a normal life by any stretch of imagination. She was taking eight to ten moderate strength opioid tablets per day in an effort to decrease her pain. She was not active, choosing to spend most of her time at home. She had quit her job shortly after the work-related accident. In fact, the workman's compensation board is still disputing her claim, and this dispute took a toll on Mary.