It is intended that this exploration of different interfaces of law and medicine will present a general overview. These reflections on some comparisons of and, particularly, contrasts between the health professions and the legal profession do not aspire to the profundity, moderation, or elegance of, for instance, Prof. William Curran's recent learned discourse. They are self-consciously more polemical than a truly scholarly study should be, and include some crude or simplistic characterizations. Their purpose is to provoke reaction, however, and thereby to contribute to health professionals' and lawyers' consideration of their experience of each other.

It is trite to observe that the two inevitabilities of modern existence are death and taxes. It is more interesting to observe the consequence, however: that the professional mediators of death and taxes—namely, health professionals and lawyers—are equally inescapable. Members of these professions are not necessarily propelled into each other's arms, but in their professional and personal lives they cannot extricate themselves from each other's disciplines.

This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where (1) quality of life suffers because of disability-focused exclusion or injustice differently from cases where (2) lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life.

Communicable diseases, especially those that are readily contagious, are on the rise as evidenced by the emergence of viruses like severe acute respiratory syndrome (SARS), the global resurgence of resistant forms of ancient mycobacteria such as extensively drug resistant tuberculosis (XDR TB), and the 2009 swine flu outbreak in Mexico. Moreover, each of us, no matter who we are or where we live, is just as likely to transmit contagious diseases to others as we are to contract such diseases from others. As cogently described in the title of a recent book by Margaret Battin et al., we are all potential “victims and vectors.”

Just as contagious diseases are readily passed person to person, so too can they readily be passed across local and national boundaries. We therefore all have a stake in the development of effective infectious disease control policies on a national scale, with “effective” being the operative term: regulations and statutes that are neither enforceable nor likely to be complied with may do more harm than good.

Early announcements of this special journal issue solicited authors interested in contributing articles on the subject of “costs at the end of life.” Those who replied were then informed the title was being changed, on the basis of early subscriber interest (or, perhaps disinterest), in “rational end-of-life treatment.” Because that seemed a still inadequate reflection of the authorial concerns of responding potential contributors, the editors again changed the title, two months later, to “Making Treatments More Rational and Compassionate for the Chronically Critically Ill.” At that point the editors gave up and decided this issue’s final title would be determined only after the papers were submitted and reviewed.

Planning of effective responses to the recent resurgence of tuberculosis in the United States, and particularly in New York City, requires review of our knowledge of (1) the factors that led to the decline of tuberculosis in the U.S. and other countries during the nineteenth and the first three-quarters of the twentieth century, and (2) the recent changes in these same factors and the rise of new factors that have contributed to its resurgence. Because the analysis of the impact of all of these factors in both the remote and the recent past is controversial, it is important to use a well-defined framework to organize the analysis. The framework we will use is shown in Table 1. To the classic epidemiologic triad of Agent, Host and Environment it adds the category of Health Services. In this paper we redefine both the classic and new categories using current disciplines and concepts applicable to tuberculosis.

Disparities exist in the health, livelihood, and opportunities for the 46-60 million people living in America’s rural communities. Rural communities across the United States need a new energy and focus concentrated around health and health care that allows for the designing capturing, and spreading of existing and new innovations. This paper aims to provide a framework for policy solutions to build a healthier rural America describing both the current state of rural health policy and the policies and practices in states that could be used as a national model for positive change.

Advances in medical technology have a habit of raising new, and usually unexpected, ethical and legal questions. Such questions arise when patients or physicians, for a variety of reasons, defer cardiopulmonary resuscitation (CPR) or other treatment with so-called no-code or do-not-resuscitate (DNR) orders. When all parties to the DNR order, including physicians, patient, and family, agree that it is appropriate in a given case, there is rarely controversy. However, when one party dissents from a no-code status, most commentators agree, grave moral, social, and legal questions are raised.

The most troublesome issues concerning DNR orders arise when physicians and family disagree about the appropriateness of such an order in the case of a mentally incompetent patient. These episodes not only raise complex legal issues but also go to the heart of, and challenge, modern medical ethics and the relationship of doctor to patient.

The payment of human subjects is an area where Institutional Review Boards (IRBs) have wide discretion. Although the “Common Rule” requires the provision of full information to human research participants to secure valid consent, the Rule is silent on the issue of payment. Still, some federal agencies offer guidance on the matter. For example, the National Science Foundation (NSF) cautions that high payments for risky research “may induce a needy participant to take a risk that they normally would prefer not to take.” For research under its purview, the Food and Drug Administration (FDA) guidance provides that “[a]dvertisements may state that subjects will be paid, but should not emphasize the payment or the amount to be paid, by such means as larger or bold type.” One might read the FDA guidance to permit the advertisement for human subjects to state the specific amount of payment, as long as it is not emphasized.

This study examined the extent to which concussion management plans at National Collegiate Athletic Association (NCAA) member schools were in line with NCAA Concussion Policy and best practice recommendations in absence of any process to ensure compliance. Most schools' concussion management plans were in compliance with 3 (60%) or 4 (25.6%) of the NCAA's 4 required components. Annual athlete education and acknowledgement was the requirement least often included, representing an area for improvement. Further, schools tended to more often include best practices that were more medically-oriented (e.g., including baseline examination), compared to best practices that were less medical in nature (e.g., avoiding flagrant head hits).

Despite exponential growth in the past decades, most aspects of the assisted reproductive technology (ART) industry remain largely unregulated; recently, pressure has been mounting for coordinated study and regulation of this developing industry. On March 28, 2008, lawyers, health care professionals, representatives from sperm banks, consumers of ART services, and other stakeholders in ART industry gathered at DePaul University College of Law for its Health Law Institute’s symposium titled “Tracking Change: The Feasibility of a Voluntary Gamete Donor Registry in the United States.” The implementation of a registry would mark the first effort in the United States to centralize, maintain, and disseminate information about gamete donors by collecting and storing genetic and identifying information about egg and sperm donors. Establishing a registry requires balancing the interests of donor-conceived individuals, their parents, gamete donors, health care professionals, and society as a whole, as well as ensuring the privacy and safety of all involved.

In a recent article published in the Journal of Law, Medicine & Ethics, David DeGrazia criticized the two pivotal assumptions that underlie President Bush’s policy on funding stem cell research. Those assumptions are (1) that we originate as single-cell zygotes at the time of conception and (2) that we have full moral status as soon as we originate.

In this paper, I would like to concentrate on the first of those assumptions and show in light of recent findings in embryological development that DeGrazia’s criticisms have to be rejected. I shall save my discussion of DeGrazia’s critique of the second assumption for a later article that can take into account DeGrazia’s further elaboration of his position.

Predictive medical information is used by underwriters to assess the future risk of a claim in medically based insurance products such as health, life, and disability insurance. Medical underwriting involves the science of evaluating medical information to determine the risk for groups of individuals with various medical conditions. In disability insurance, this involves an evaluation of medical information to predict the risk of becoming disabled.

Before discussing medical underwriting, an understanding of certain terms used by disability insurance companies and the products that are available is required. The first is the definition of disability. The Americans with Disabilities Act (ADA) defines disability as the following:

A physical or mental impairment that substantially limits one or more of the major life activities; or has a record of such an impairment; or is regarded as having such an impairment even when no impairment exists, no substantial limitation results from the impairment, or the impairment is only substantially limiting because of the attitudes of others.

Ethical, evidence-informed decision making is undermined by the grave concerns that have emerged over the trustworthiness of clinical trials published in biomedical journals. The inescapable conclusion from this growing body of research is that what we see, even in the most highly regarded peer-reviewed journals, cannot be trusted at face value. Concerns of inaccurate, biased, and insufficient reporting of trials are impossible to resolve without access to underlying trial data. Access to such data, including things like clinical study reports—huge, unabridged, detailed reports of clinical trials—would minimise the risk of distortions and selective publication. But the FDA, the world’s greatest custodian of those data, just sits on them. We see no reason why FDA should not publicly release clinical study reports with minimal redactions. The European regulator is already doing this, but FDA’s holdings are far greater. Data transparency is not simply an “opportunity” FDA might consider, but rather an ethical imperative. The Blueprint is good but does not go far enough. We do not need gates, barriers and committees between us and access to aggregate reports on drugs and other interventions which we are prescribing or using daily. Let’s leave the nannies at home.

The COVID-19 pandemic laid bare systemic inequities shaped by social determinants of health (SDoH). Public health agencies, legislators, health systems, and community organizations took notice, and there is currently unprecedented interest in identifying and implementing programs to address SDoH. This special issue focuses on the role of medical-legal partnerships (MLPs) in addressing SDoH and racial and social inequities, as well as the need to support these efforts with evidence-based research, data, and meaningful partnerships and funding.

Gene therapies to treat sickle cell disease are in development and are expected to have high costs. The large eligible population size — by far, the largest for a gene therapy — poses daunting budget challenges and threatens to exacerbate health disparities for Black patients, who make up the vast majority of American sickle cell patients.

This paper evaluates the existing research on Stand Your Ground (SYG) laws in terms of the extent to which it has accounted for gender. In particular, we address (a) what the available evidence suggests are the gender-based impacts of SYG laws and (b) where, how, and why considerations of gender may be missing in available studies.

Group Violence Interventions (GVIs) combine a focused deterrence law enforcement approach with community mobilization and social services. The current study qualitatively examines Project Longevity, Connecticut's largest GVI initiative, to contribute to the limited literature on implementation of gun violence reduction strategies. Relying on interviews with 24 of Project Longevity law enforcement and non-law enforcement partners, we explore the establishment of interagency collaboration, which was viewed by study participants as the most pressing implementation challenge of Project Longevity. Our case study results offer important lessons to practitioners responsible for implementing GVI strategies.

My purpose is to provide an update on recent Texas regulatory and statutory changes adopted , since the passage in Texas of the Intractable Pain Treatment Act in 1989 (Pain Act) (see Table l). First, I describe the rules adopted by the Texas State Board of Medical Examiners (TSBME) that authorize physicians to prescribe opioids for the treatment of pain (Pain Rules) (see Table 2). Second, I detail recent statutory changes that pertain to education of physicians and medical students about pain treatment. All of these changes attempt to create a better legal environment for the treatment of chronic pain in Texas.

Before describing the Pain Rules adopted in Texas, the question Why adopt rules, rather than simply ask TSBME to issue a policy statement? must be answered. Many states, most notably California, have issued policy statements that clarify for physicians the parameters within which they may treat pain? Policy statements, unlike administrative regulations, do not have the force of law.