When the South Carolina Supreme Court upheld the conviction and twelve-year sentence of Regina McKnight, it affirmed that state 's commitment to bring the full force of the law to the punishment of pregnant women who use drugs. Prosecutors linked the delivery of Ms.McKnight 's stillborn baby to her use of cocaine, and argued successfully for a finding of homicide by child abuse. The McKnight judgment follows the South Carolina Supreme Court decision in the case of Cornelia Whitner. Whitner was sentenced to prison for illegal drug use during pregnancy on the grounds that the viable fetus is a child under the state s criminal child endangerment statute.

On the basis of constitutional concerns such as due process and privacy, worries that criminal prosecutions may thwart public policy goals such as keeping families together and promoting the health of women and children, and findings that legislatures did not intend to include the fetus in the scope of drug laws or child abuse and neglect laws, criminal prosecution has been resisted in most jurisdictions.

We must resist thoroughly reframing climate change as a health issue. For human health–centric ethical frameworks omit dimensions of value that we must duly consider. We need a new, an environmental, research ethic, one that we can use to more completely and impartially evaluate proposed research on mitigation and adaptation strategies.

While empirical evidence has exposed the harms and health disparities flowing from being denied a wanted abortion, we know less about how anti-abortion laws and policies impact health care more broadly. This article surveys the public health impacts of Dobbs on health care beyond wanted abortion care. The article argues that focusing the public’s attention on the harmful consequences of abortion bans for healthcare beyond wanted abortion care could help to fend off further restrictions on abortion

Climate change poses real and immediate impacts to the public health of populations around the globe. Adverse impacts are expected to continue throughout the century. Emphasizing co-benefits of climate action for health, combining adaptation and mitigation efforts, and increasing interagency coordination can effectively address both public health and climate change challenges.

In the context of medical tourism, circumvention tourism consists of traveling abroad with the intention of participating in a health-related activity that is prohibited in one’s own country but not in the destination country. This practice raises a host of legal and ethical questions that focus on how the traveler should be treated once they have returned home. Joshua Shaw1 deftly shows that the question of whether circumvention tourists should be punished in their home countries is not something that can be answered in principle and without reference to the prima facie morality of the prohibition. This implicates formalist accounts of circumvention tourism developed by Pennings2 and Huxtable3 that argue against punishing travelers who access fertility treatments and medical assistance in dying abroad on the grounds that civic peace and stability require opportunities for individuals to travel internationally to access domestically prohibited medical services.

The First Amendment to the US Constitution protects commercial speech from government interference. Commercial speech has been defined by the US Supreme Court as speech that proposes a commercial transaction, such as marketing and labeling. Companies that produce products associated with public health harms, such as alcohol, tobacco, and food, thus have a constitutional right to market these products to consumers. This article will examine the evolution of US law related to the protection of commercial speech, often at the expense of public health. It will then identify outstanding questions related to the commercial speech doctrine and the few remaining avenues available in the United States to regulate commercial speech including the use of government speech and addressing deceptive and misleading commercial speech.

In Britain the movement towards “Community Care” gathers apace. Segregation techniques in their traditional forms are steadily losing ground to newer community based alternatives. Both America and Britain have seen a massive reduction in the register of patients resident in mental hospitals; specifically in America from a peak of 560,000, and in Britain 165,000 in 1955, to some 273,000 and 70,000 respectively. And how has this been achieved? Through the rhetoric of “community care,” whose influence over policy in hospital admissions and discharges has been particularly remarkable, according to Peter Sedgwick, in that it does not in reality exist. America has been swift to adopt this new panacea “community care” where the emptying of asylums has turned out to have unforeseen problems. Creedmoor asylum for the borough of Queens in New York released 3,000 patients within a few months. Britain has been rather slow to follow—perhaps a little less ruthless—but the reduction of beds continues.

In a paper that has recently attracted discussion, David Shaw has attempted to criticize the distinction the law has drawn between withdrawing and withholding life-sustaining measures on the one hand, and euthanasia on the other, by claiming that the body of a terminally ill patient should be seen as akin to life support. Shaw compares two cases that we might, at least at first, regard as distinct, and argues that they are not. In the first case, Adam, who is dying of lung cancer, is connected to a ventilator and requests to be disconnected. In the second case, Brian, also dying of cancer, is not connected to anything, and so he requests his doctor to provide him with a lethal injection. In the first case, Shaw contends, Adam is being kept alive by a ventilator. In the second case, Brian is being kept alive by his body.

The use of a mechanical device is an ancient and crude form of contraception. Desert dwellers in ancient Africa placed stones in the uteruses of their camels to prevent conception during long treks across the Sahara. The metal intrauterine devices (IUDs) used in the late 1800s caused severe pelvic infections that, in the absence of antibiotics, often proved fatal. The first stainless steel and polyethelene IUDs were developed around 1960, and these attained a relatively reliable degree of safety. New compositions and materials decreased the risk of infection, and innovative devices could be inserted without dilating the cervix.

As mechanical means of contraception grew in popularity, pharmaceutical companies began to fight for a competitive edge, each touting the design or materials of its product as safer and niore efficient. By the mid-l970s, it is estimated, more than 15 million IUDs had been distributed throughout the world, many in developing nations.

In the face of limited resources during the COVID-19 pandemic response, public health experts and ethicists have sought to apply guiding principles in determining how those resources, including vaccines, should be allocated.

Racism, which has pervaded and debased life in many countries, was given little attention by the international community before the Second World War when international law only governed relationships between states; the way in which individuals were treated within their own states was considered to be a purely domestic affair. The revulsion engendered by the Nazi atrocities however had a profound effect on world opinion, and in 1945 the “United Nations” grew out of the League of Nations with the hope that this body could contribute to the maintenance of international peace and encourage worldwide respect for human rights and fundamental freedoms. Three years later, in 1948, the Nationalist Party came into power in South Africa and the racial attitudes of the time were committed to the statute books in this country.

Calls for the inclusion of women in clinical trials raise the obvious question: why have sponsors excluded them? The answer most often given is one tragically evocative word: Thalidomide. The tragedies of the children born with seal limbs because their mothers took this over-the-counter sleeping pill and cure for morning sickness showed that, contrary to previous perceptions, the placenta could not be depended upon to filter out toxins before they reached the fetus. The specter of birth defects spawned sponsors’ fears of a variety of catastrophes which contributed to closing the doors of clinical trials for women.

This paper will not argue that the possibility of birth defects arising from the ingestion of an experimental drug does not exist. Sadly, scientists do not yet have the ability to predict which drugs will cause birth defects. Rather, it will argue that case law does not provide a basis for sponsor liability when a woman gives informed consent and the regulations governing clinical trials are followed.

Medical liability remains a major concern among U.S. physicians, and according to the American Medical Association (AMA) the United States is currently experiencing its third fullblown medical liability crisis with many physicians limiting their practices as a result of rising malpractice costs. The AMA, many in the medical community, and several prominent politicians including former president George W. Bush have called for medical liability reform including caps on non-economic damages. Some researchers argue that the medical liability crisis has been overdrawn. Several studies have shown that the vast majority of patients injured through medical malpractice do not sue, that the insurance cycle is likely major contributor to rising malpractice insurance premiums, and that defensive medicine likely plays a minor role in rising health care costs. Further, evidence shows that malpractice damage caps may lead to a crossover effect where juries increase the amount of economic damages they award to offset limitations in non-economic damages available.

The growing popularity of noncoital solutions to infertility has raised questions about the need for public policies to regulate these techniques. While surrogacy has dominated public attention, controversy has also surrounded in vitro fertilization (IVF), embryo freezing, and gamete donation.

The policy concerns arise from the potential impact that the means of noncoital reproduction—embryo manipulation or use of gamete donors and surrogates—could have on offspring, collaborators, the family, and gender-based reproductive roles. For example, IVF techniques involving the creation and manipulation of human embryos may harm embryos and the offspring to which they lead. Noncoital techniques involving gamete donors and surrogates raise issues of offspring welfare, the interests of collaborators, exploitation of women, and effects on the family and society generally.

A basic question for public policy is the scope of private discretion over noncoital means of forming families. Should the state prohibit or regulate use of these techniques, or should their use be left to the free choice of infertile couples, collaborators, and physicians? Since state limits on reproductive choice are necessarily problematic, the issue is whether noncoital reproduction poses risks so significantly different from coital reproduction that regulation is justified.

The “medical malpractice crisis” in the 1970s involved not only a greater number of suits, but also the emergence of new sorts of claims against medical practitioners. One such claim was the wrongful birth suit, where parents sued their physician on their own behalf for negligence that resulted in the birth of an unwanted child. A related claim, wrongful life, involved a suit brought on behalf of a defective infant against a physician or laboratory that failed to give correct information about a potential defect to the parents. These claims have been the subject of much controversy for judges and commentators.

The debate over wrongful life suits involving “impaired” children continues. Courts in Michigan have recently rejected the wrongful life cause of action, while, in Washing ton, the action has been allowed. Some academic critics have also continued to oppose the wrongful life action. In a recent commentary in the pages of this journal, one critic wrote: “Wrongful life actions, by whatever name they may be called, accord with neither logic nor experience, and should not be allowed.”

Recently, the California Supreme Court found an established medical standard of care to be inadequate and replaced it with a judicially constructed medical standard of practice premised on the rule of reasonable prudence. California thus joined the State of Washington and became the second state to sanction the invocation of reasonable prudence in the fashioning of judicially formulated medical standards of care.

As this article will illustrate, the Supreme Courts of California and Washington are, in a narrow class of cases, imposing a greater duty of care on physicians than previously mandated by the medical profession. These courts are impliedly stating that although the physicians complied with the particular standard of care within their profession, they could have better protected their patients had they pursued a more prudent course of conduct. Moreover, in choosing between the innocent and damaged plaintiff and the equally innocent and compliant physician, the courts have reasoned that the plaintiff should not have to bear the risk of loss and, consequently, have imposed liability on the physician.