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Upholding Tribal Sovereignty in Federal, State, and Local Emergency Vaccine Distribution Plans J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Heather Erb, Kristin Peterson, Brittany Sunshine, Gregory Sunshine, the CDC COVID-19 Vaccine Task Force Federal Entities Team
Cross jurisdictional collaboration efforts and emergency vaccine plans that are consistent with Tribal sovereignty are essential to public health emergency preparedness. The widespread adoption of clearly written federal, state, and local vaccine plans that address fundamental assumptions in vaccine distribution to Tribal nations is imperative for future pandemic response.
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INTRODUCTION J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Vineeta Gupta
The National Public Health Law Conference: People. Policy. Progress., held October 2023, brought together more than 400 stakeholders in public health to explore how law and policy can be leveraged to advance health equity, improve data sharing for community health, protect access to reproductive health and facilitate system change.
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Reclaiming Public Health Authority: Toward a Legal Framework that Centers the Public’s Health, in the Courts and Beyond J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Sabrina Adler, Wendy E. Parmet, Linda Tvrdy, Sara Bartel
This paper summarizes key shifts in judicial decisions relating to public health powers during the pandemic and the implications of those decisions for public health practice. Then, it gives a preview and call for partnership in developing a legal framework for authority that guides public health to better activities, processes, and accountability in service of the public’s health.
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The Pregnant Workers Fairness Act Leaves Agricultural Workers Behind J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Prashasti Bhatnagar
The new federal Pregnant Workers Fairness Act advances important protections for pregnant workers, but leaves behind agricultural workers, who are overrepresented in hazardous occupational environments. This article highlights the connection between workplace pregnancy discrimination and health inequities. It concludes with a discussion of immigrant-led advocacy efforts to eliminate health inequities
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Understanding Local Alcohol Control in Wisconsin: Building a Database of Local Municipal Alcohol Policies J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Felice F. Borisy-Rudin, Robert MacKenzie, Maureen Busalacchi, Constance Kostelac
In Wisconsin, many alcohol policies are regulated at the local level. To examine the relationship between local policies, alcohol use and health outcomes, our team developed a database to collect local alcohol policies. Initial results highlight differences in how policies are defined, enforced, and made available to the public.
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Breaking Free From the “War on Drugs”: Examples From Three Leader States J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Corey Davis, Amy Judd Lieberman
While the federal government continues to pursue a punitive “War on Drugs,” some states have adopted evidence-based, human-focused approaches to reducing drug-related harm. This article discusses recent legal changes in three states that can serve as models for others interested in reducing, rather than increasing, individual and community harm.
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Prevalence and Use of Driver Monitoring Systems: A National Survey in the United States J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Johnathon P. Ehsani, Jeffrey Michael, Michelle Duren, Emmanuel Drabo, Ahmed Sabit
The purpose of this study was to measure the prevalence of use of driver monitoring systems among U.S. adults, and factors influencing their adoption. One in five U.S. adults has used driver monitoring, primarily to obtain a discount on insurance. Safety benefits and financial incentives are likely to influence adoption.
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Opportunities in Public Health Law: Supporting Current and Future Practitioners J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Alexis Etow, Rebecca Johnson
Law is a critical determinant of health that public health practitioners encounter in everyday practice. Yet most do not receive any formal public health law training. This article discusses tangible opportunities for strengthening the capacity of current and future practitioners to leverage law to advance health equity priorities.
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Barriers and Opportunities for Tribal Access to Public Health Data to Advance Health Equity J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Carrie Field, Sarah Price, A.C. Locklear
Public health authorities (PHAs), including Tribal nations, have the right and responsibility to protect and promote the health of their citizens. Although Tribal nations have the same need and legal authority to access public health data as any other PHA, significant legal challenges continue to impede Tribal data access.
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Recent State Legislative Attempts to Restructure Public Health Authority: The Good, The Bad, and The Way Forward J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Darlene Huang Briggs, Elizabeth Platt, Leslie Zellers
The COVID-19 pandemic spurred legal and policy attacks against foundational public health authorities. Act for Public Health — a partnership of public health law organizations — has tracked legislative activity since January 2021. This article describes that activity, highlighting 2023 bills primarily related to vaccine requirements and policy innovations undertaken in the wake of the pandemic. Finally
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Challenging Pennsylvania’s Firearm Preemption Law as a Public Health Danger: The Case of Philadelphia J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Sami Jarrah, Benjamin Geffen, Giselle Babiarz, Benjamin Hartung, Amy Cook, Megan Todd
Firearm violence has soared in American cities, but most states statutorily preempt municipal firearm regulation. This article describes a unique collaboration in Philadelphia among elected officials, public health researchers, and attorneys that has led to litigation based on original quantitative analyses and grounded in innovative constitutional theories and statutory interpretation.
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Climate Change and Health: Public Health and Legal Strategies to Reduce Reliance on Fossil Fuels, Increase Air Quality, and Improve Human Health J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Jill Krueger, Jamie Long, Jean C. Bikomeye
Reliance upon fossil fuels and limited greenspace contribute to poor indoor and outdoor air quality and adverse health outcomes, particularly in communities of color. This article describes justice-informed public health and legal interventions to increase access to greenspace and accelerate the transitions to renewable energy and away from gas appliances.
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Local Public Health Departments at the Intersection of Climate Change, Health Equity, and Public Health Laws and Policies J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Massoud Agahi, Erika Bartlett, Betsy Lawton, Jennie McAdams, Rachel Roy, Cameron Salehi
Public health laws and policies are uniquely able to mitigate the adverse and inequitable health impacts of climate change. This article summarizes some key considerations in developing such laws and policies and a variety of approaches local public health departments are using to increase climate resilience and health equity.
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Scalable, Coordinated Strategies Leveraging Community Health Workers in Addressing the Adverse and Inequitable Health Effects of Climate Change J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Massoud Agahi, Erika Bartlett, Betsy Lawton, Cameron Salehi
Effective climate change resilience in local communities must center each community’s unique challenges and essential role in developing climate resilience strategies. This article will discuss recent developments by the federal government that align with a community-centered approach, and how Community Health Workers can influence the outcomes.
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Building Successful Partnerships Between State Health Departments and Attorney General Offices: The Minnesota Example J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Dana Farley, Carman Leone, Caroline Palmer
In recent years, the Minnesota Attorney General’s Office and the Minnesota Department of Health have cultivated a productive partnership to strengthen the state’s multidisciplinary response to overlapping health equity and social justice issues. This article describes shared efforts in three areas: post-conviction justice, drug overdose, and human trafficking/exploitation.
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Unlocking Public Health Data: Navigating New Legal Guardrails and Emerging AI Challenges J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Fallon J. Cochlin, Charles D. Curran, Cason D. Schmit
Here, we analyze the public health implications of recent legal developments — including privacy legislation, intergovernmental data exchange, and artificial intelligence governance — with a view toward the future of public health informatics and the potential of diverse data to inform public health actions and drive population health outcomes.
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The Association Between State-Level Prenatal Substance Use Policies and Rates of Maternal Mortality in the United States: A Legal Epidemiology Study J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Kathryn A. Thomas, Cara A. Struble, Madeline R. Stenersen, Kelly Moore
Little research has explored relationships between prenatal substance use policies and rates of maternal mortality across all 50 states, despite evidence that prenatal substance use elevates risk of maternal death. This study, utilizing publicly available data, revealed that state-level mandated testing laws predicted maternal mortality after controlling for population characteristics.
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The Phenomenon of Teen Delay in Driving Licensure: Considerations at the Intersection of Mobility and Social Welfare for Emerging Adults J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Federico E. Vaca, Emmanuel Fulgence Drabo, Kaigang Li
In 2021, there were 11.7 million licensed young drivers in the U.S. This is 1.5 million fewer young drivers compared to 2007. The phenomenon of delay in driving licensure among teens has notable implications for opportunities positioning them for life success when transitioning into emerging adulthood and in later life.
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State Driving Under the Influence of Drugs Laws J. Law Med. Ethics (IF 1.6) Pub Date : 2024-07-12 Alexandra N. Origenes, Sarah A. White, Emma E. McGinty, Jon S. Vernick
Drug-impaired driving is a growing problem in the U.S. States regulate drug-impaired driving in different ways. Some do not name specific drugs or amounts. Others do identify specific drugs and may regulate cannabis separately. We provide up-to-date information about these state laws.
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Making Sense of Semenya before the European Court of Human Rights. J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Matteo Winkler,Giovanna Gilleri
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Pre-Mortem Interventions for the Purpose of Organ Donation: Legal Approaches to Consent J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Renée Taillieu, Matthew J. Weiss, Dan Harvey, Nicholas Murphy, Charles Weijer, Jennifer A Chandler
PrécisThe administration of Pre-Mortem Interventions (PMIs) to preserve the opportunity to donate, to assess the eligibility to donate, or to optimize the outcomes of donation and transplantation are controversial as they offer no direct medical benefit and include at least the possibility of harm to the still-living patient. In this article, we describe the legal analysis surrounding consent to PMIs
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A Rule-Based Solution to Opaque Medical Billing in the U.S. J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Christopher A. Bobier
Patients and physicians do not know the cost of medical procedures. Opaque medical billing thus contributes to exorbitant, rising medical costs, burdening the healthcare system and individuals. After criticizing two proposed solutions to the problem of opaque medical billing, I argue that the Centers for Medicare and Medicaid Services should pursue a rule requiring that patients be informed by the
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Physician-Based Approaches to Price Transparency: A Solution in Search of a Problem? J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Sherry Glied
Physician-based transparency approaches have been advanced as a strategy for informing patients of the likely financial consequences of using services. The structure of health care pricing and insurance coverage, and the low uptake of existing tools, suggest these approaches are likely to be unwieldy and unsuccessful. They may also generate new ethical challenges.
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Enacting Relational Public Health: Federally Qualified Health Centers During the COVID-19 Pandemic J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Danielle Pacia, Johanna Crane, Carolyn Neuhaus, Nancy Berlinger, Rachel Fabi
PrécisFederally Qualified Health Centers (FQHCs) proved to be critical points of access for people of color and other underserved populations during the COVID-19 pandemic, administering 61% of their COVID-19 vaccinations to people of color, compared to the 40% rate for the overall United States’ vaccination effort. To better understand the approaches and outcomes of FQHCs in pandemic response, we conducted
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A Federally Qualified Health Center-led Ethics & Equity Framework & Workflow Checklist: An Invited Commentary in Response to a Relational Public Health Framing of FQHCs During COVID-19 J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Cristina Huebner Torres, Sylvia Baedorf Kassis, Sadath Sayeed, Barbara E. Bierer, Karen M. Emmons
With disparate rates of morbidity and mortality among minoritized communities, COVID-19 illuminated the need for equity-informed practices in public health. Pacia et al posit FQHCs as entities that addressed inequity when others failed. This commentary further situates how FQHCs address the public health crisis of institutional racism and related health inequities every day and presents a FQHC-led
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A Whole-Person Approach to Harm Reduction for Women J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Somer Brown
Women are the fastest-growing population of people who use drugs in the US. As a group, they are more likely than men to experience stigma, poverty, and negative mental health outcomes. This article discusses the unique needs of women drug users in the US and provides suggestions on how to leverage national attention — and federal funding — to make harm reduction services in the US more gender sensitive
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Lowering the Age of Consent for Vaccination to Promote Pediatric Vaccination: It’s Worth a Shot J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Margaret Irwin, Derek R. Soled, Christy L. Cummings
This paper challenges historically preconceived notions surrounding a minor’s ability to make medical decisions, arguing that federal health law should be reformed to allow minors with capacity as young as age 12 to consent to their own Centers for Diseases Control and Prevention (CDC)-approved COVID-19 vaccinations. This proposal aligns with and expands upon current exceptions to limitations on adolescent
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Minor Consent for Vaccination: Ethically Justified, Politically Fraught J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 James Colgrove
Policies allowing some minors to consent to receive recommended vaccines are ethically defensible. However, a policy change at the federal level expanding minor consent for vaccinations nationwide risks triggering a political backlash. Such a move may be perceived as infringing on the rights of parents to make decisions about their children’s health care. In the current post-COVID environment of heightened
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Diversion to Treatment when Treatment is Scarce: Bioethical Implications of the U.S. Resource Gap for Criminal Diversion Programs J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Deniz Aritürk, Michele M. Easter, Jeffrey W. Swanson, Marvin S. Swartz
PrécisDespite significant scholarship, research, and funding dedicated to implementing criminal diversion programs over the past two decades, persons with serious mental illness and substance use disorders remain substantially overrepresented in United States jails and prisons. Why are so many U.S. adults with behavioral health problems incarcerated instead of receiving treatment and other support
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Addressing Bioethical Implications of Implementing Diversion Programs in Resource-Constrained Service Environments J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Josephine D. Korchmaros, Kevin Hall
The opioid epidemic demands the development, implementation, and evaluation of innovative, research-informed practices such as diversion programs. Aritürk et al. have articulated important bioethical considerations for implementing diversion programs in resource-constrained service environments. In this commentary, we expand and advance Aritürk et al.’s discussion by discussing existing resources that
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“A Most Equitable Drug”: How the Clinical Studies of Convalescent Plasma as a Treatment for SARS-CoV-2 Might Usefully Inform Post-Pandemic Public Sector Approaches to Drug Development J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Quinn Grundy, Chantal Campbell, Ridwaanah Ali, Matthew Herder, Kelly Holloway
Interventional clinical studies of convalescent plasma to treat COVID-19 were predominantly funded and led by public sector actors, including blood services operators. We aimed to analyze the processes of clinical studies of convalescent plasma to understand alternatives to pharmaceutical industry biopharmaceutical research and development, particularly where public sector actors play a dominant role
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A Public Option for Clinical Trials? Lessons from Convalescent Plasma J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Victor Roy, Joseph S. Ross, Reshma Ramachandran
The case of clinical trials for convalescent plasma during COVID-19 illustrates important lessons for realizing public sector approaches to biomedical research and development. These lessons, centering on mission, transparency, and spillover effects, can be translated to wider efforts to develop a “public option” for clinical trials.
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Do Physicians Have a Duty to Support Secondary Use of Clinical Data in Biomedical Research? An Inquiry into the Professional Ethics of Physicians J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Martin Jungkunz, Anja Köngeter, Eva C. Winkler, Christoph Schickhardt
Secondary use of clinical data in research or learning activities (SeConts) has the potential to improve patient care and biomedical knowledge. Given this potential, the ethical question arises whether physicians have a professional duty to support SeConts. To investigate this question, we analyze prominent international declarations on physicians’ professional ethics to determine whether they include
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Diverting Data and Drugs: A Narrative Review of the Mallinckrodt Documents J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Antoine Lentacker, Kelly Pham, Jason M. Chernesky
U.S. law imposes strict recording and reporting requirements on all entities that manufacture and distribute controlled substances. As a result, the prescription opioid crisis has unfolded in a data-saturated environment. This article asks why the systematic documentation of opioid transactions failed to prevent or mitigate the crisis. Drawing on a recently disclosed trove of 1.4 million internal records
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The Opioid Industry Documents Archive: Advancing Public Health Through Industry Document Disclosure J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 G. Caleb Alexander, Kate Tasker
More than twenty-five years after the first signs of potential harm, the US remains locked in the grip of an opioid epidemic, with more Americans dying from overdoses than ever before.1 Diversion of prescription opioids plays an important role in opioid-related harms. Much of the scientific and public health focus on diversion has been on end-users, given how commonly non-medical prescription opioid
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Addressing Unmet Social Needs and Social Risks — A Qualitative Interview-Based Assessment of Parent Reported Outcomes and Impact from a Medical Legal Partnership J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Erin Talati Paquette, Jennifer Kusma Saper, Hassan Khan, Sasha Becker, Zecilly Guzman, Valerie Alvarez Renteria, Sarah Hess, Karen Sheehan
Medical legal partnerships address individual legal needs that can create impediments to health. Little is known about outcomes from medical legal partnerships and their relationship to access to justice. This paper reports outcomes from one medical legal partnership from the perspective of the client, with specific emphasis on impact on health and concepts related to access to justice. We suggest
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Justice, Labor, Research, and Power: The Significance and Implications of Parent-Reported Outcomes in Medical-Legal Partnership J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 James Bhandary-Alexander
As a legal aid union president in New Haven, laboring within shouting distance of a different large research university, I recall how our membership rolled our eyes when Professors Greiner, Pattanayak, and Hennesy of Harvard published their study providing evidence, through a randomized control trial, that law clinic housing work made no difference for clients.1 Representing, as I was, “lawyers, secretaries
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Church Against State: How Industry Groups Lead the Religious Liberty Assault on Civil Rights, Healthcare Policy, and the Administrative State J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Joanna Wuest, Briana S. Last
Industry-funded religious liberty legal groups have sought to undermine healthcare policy and law while simultaneously attacking the rights of sexual and gender minorities. Whereas past scholarship has tracked religiously-affiliated healthcare providers’ growing political power and attendant transformations to legal doctrine, our account emphasizes the political donors and visionaries who have leveraged
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No Strings Attached: How Catholic Institutions Prospered at the Expense of the Administrative State and Patient Autonomy J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Lori Freedman, Kimani Paul-Emile
Catholic hospitals and health systems have proliferated and succeeded in American healthcare; they now operate four of the largest health systems and serve nearly one in six hospital patients. Like other religious entities that Wuest and Last write about in this issue, in their article Church Against State, they have benefited by and supported the long reach of conservative efforts to undermine the
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Assessing Impacts of “Anti-Equity” Legislation on Health Care and Public Health Services J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 James G. Hodge, Erica N. White, Jennifer L. Piatt, Camille Laude
A deluge of state “anti-equity” legislative bills seek to reverse prevailing trends in diversity, equity, and inclusion; withdraw protections of LGBTQ+ communities; and deny access to gender-based care for trans minors and adults. While the political and constitutional fate of these acts is undetermined, profound impacts on patients and their providers are already affecting the delivery of health care
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Toward Transparency and Trust: Assessing and Addressing Key Ethical Concerns in Normothermic Regional Perfusion J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Amanda Buster, Ellen C. Meltzer, Lisa Trost, Amanda Courtright-Lim, Timothy Ingall, Jon Tilburt
Normothermic Regional Perfusion, or NRP, is a method of donated organ reperfusion using cardiopulmonary bypass or a modified extracorporeal membrane oxygenation (ECMO) circuit after circulatory death while leaving organs in the dead donor’s corpse. Despite its potential, several key ethical issues remain unaddressed by this technology.
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Integrating Public Health Ethics into Public Health Policymaking: Being in the Room Where It Happens J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Jalayne J. Arias, Daniel S. Goldberg
This commentary takes up a challenge posed by Franklin Miller in a 2022 essay in Bioethics Forum. Dr. Miller queried whether bioethicists could be useful in public health policy contexts and while he refrained from issuing an ultimate opinion, did identify several challenges to such utility. The current piece responds to the challenges Dr. Miller identifies and argues that with appropriate training
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Medicare Should Cover Weight Loss Drugs as Long as the Prices are Affordable J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Catherine S. Hwang, Aaron S. Kesselheim, Benjamin N. Rome
Glucagon-like peptide-1 receptor agonists are effective for treating obesity, but the high cost of these medications endangers the financial viability of our health care system. To ensure that these drugs are available to Medicare beneficiaries, pharmaceutical manufacturers must lower their prices.
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Teaching Global Health Law: Preparing the Next Generation for Future Challenges J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Lawrence O. Gostin, Sarah L. Bosha, Benjamin Mason Meier
Following from sweeping law reforms across the global health landscape, there is a need to prepare the next generation to advance global health law to ensure justice for a healthier world. Educational programs across disciplines have increasingly incorporated the field of global health law, with new courses examining the law and policy frameworks that apply to the new set of public health threats,
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Battling Environmental Racism in Cancer Alley: A Legislative Approach J. Law Med. Ethics (IF 1.6) Pub Date : 2024-05-31 Megan Resener Garofalo
This Paper argues that to protect at-risk communities — and all Americans — from the deadly effects of environmental racism, Congress must pass the Environmental Justice for All Act. The Act is intended to “restore, reaffirm, and reconcile environmental justice and civil rights.” It does so by restoring an individual’s right to sue in federal court for discrimination based on race, ethnicity, or national
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State Medical Board Reform: A Patient Safety Imperative. J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Christopher G Roy
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INTRODUCTION: Medical-Legal Partnerships: Equity, Evolution, and Evaluation J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Katherine K. Kraschel, James Bhandary-Alexander, Yael Z. Cannon, Vicki W. Girard, Abbe R. Gluck, Jennifer L. Huer, Medha D. Makhlouf
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
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A Clarion Call for Change: The MLP Imperative to Center Racial Discrimination and Structural Health Inequities J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Dayna Bowen Matthew, Emily A. Benfer
Across the country, legal and health care professionals who understand that health outcomes are most influenced by social and environmental conditions have improved patient health by adopting the interdisciplinary MLP health care delivery model. However, the MLP field cannot advance population health, let alone long-term health equity, until it addresses the structural determinants of health inequity
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Quantifying “Community Power” and “Racial Justice” in the Medical-Legal Partnership Literature J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Alicia Turlington, Jonathan Young, Dina Shek
Medical-Legal Partnerships (MLPs) have been widely acclaimed for promoting health equity and achieving meaningful outcomes. Yet, little to no research has analyzed if this critical work has been done with communities — through meaningful engagement and building power — or if it has been done for communities without their involvement.
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Using Racial Justice Principles in Medical-Legal Partnership Design and Implementation J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Alice Setrini
Medical-legal partnerships (MLPs) have the potential to address racial health disparities by improving the conditions that constitute the social determinants of health. In order to live up to this potential, these partnerships must intentionally incorporate seven core racial justice principles into their design and implementation. Otherwise, they are likely to replicate the systemic barriers that lead
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Hospital-Based Medical-Legal Partnerships for Complex Care Patients: Intersectionality and Ethics Considerations J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Megha Garg, Jennifer Oliva, Alice Lu, Marlene Martin, Sarah Hooper
Health systems are integrating medical-legal partnerships (MLPs) into clinical care and increasingly center “complex care” patients. These patients have intersecting medical and social needs and often face systemic inequities that exacerbate their chronic health conditions. This paper describes a role for MLPs in hospital quality initiatives; examines the ethics of MLPs assisting with guardianship
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A Financial Case for a Medical-Legal Partnership: Reducing Lengths of Stay for Inpatient Care J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Barak D. Richman, Breanna Barrett, Riya Mohan, Devdutta Sangvai
While Medical-Legal Partnerships (MLPs) have improved the health and well-being of the people they serve, most healthcare institutions will only invest in an MLP if they are convinced that doing so will improve its balance sheet. This article offers a detailed estimation of the cost savings that an MLP targeted toward the most acute legal needs would accrue to an academic medical center (AMC) in North
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Targeting Health-Related Social Risks in the Clinical Setting: New Policy Momentum and Practice Considerations J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Blake N. Shultz, Carol R. Oladele, Ira L. Leeds, Abbe R. Gluck, Cary P. Gross
The federal government is funding a sea change in health care by investing in interventions targeting social determinants of health, which are significant contributors to illness and health inequity. This funding power has encouraged states, professional and accreditation organizations, health care entities, and providers to focus heavily on social determinants. We examine how this shift in focus affects
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Swimming Together Upstream: How to Align MLP Services with U.S. Healthcare Delivery J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 William M. Sage, Keegan D. Warren
Medical-legal partnership (MLP) embeds attorneys and paralegals into care delivery to help clinicians address root causes of health inequities. Notwithstanding decades of favorable outcomes, MLP is not as well-known as might be expected. In this essay, the authors explore ways in which strategic alignment of legal services with healthcare services in terms of professionalism, information collection
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Leveraging Academic-Medical Legal Partnerships to Advance Health Justice J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Vicki W. Girard, Yael Z. Cannon, Deborah F. Perry, Eileen S. Moore
Unmet legal needs contribute to housing, income, and food insecurity, along with other conditions that harm health and drive health inequity. Addressing health injustice requires new tools for the next generations of lawyers, doctors, and other healthcare professionals. An interprofessional group of co-authors argue that law and medical schools and other university partners should develop and cultivate
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Medical-Legal Partnerships Reinvigorate Systems Lawyering Using an Upstream Approach J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 L. Kate Mitchell, Debra Chopp
The upstream framework presented in public health and medicine considers health problems from a preventive perspective, seeking to understand and address the root causes of poor health. Medical-legal partnerships (MLPs) have demonstrated the value of this upstream framework in the practice of law and engage in upstream lawyering by utilizing systemic advocacy to address root causes of injustices and
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Applying a Social Ecological Model to Medical Legal Partnerships Practice and Research J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Susan McLaren, Lisa Radtke Bliss, Christina Scott, Pam Kraidler, Robert Pettignano
The social ecological model (SEM) is a conceptual framework that recognizes individuals function within multiple interactive systems and contextual environments that influence their health. Medical Legal Partnerships (MLPs) address the social determinants of health through partnerships between health providers and civil legal services. This paper explores how the conceptual framework of SEM can be
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The Synergy of Legal and Medical Palliative Care: Challenges and Opportunities in Palliative MLP and the Yale Experience J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Rebecca Iannantuoni, Emily B. Rock, Abbe R. Gluck
Palliative care and medical-legal partnership are complementary disciplines dedicated to integrating care to treat the whole patient and intervening before a legal or medical issue is at a crisis point. In this paper, we discuss the founding and operations of the Yale Palliative Medical Legal Partnership, give examples of typical cases, explain special considerations in this area of law, and propose
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The Family Regulation System and Medical-Legal Partnerships J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Kara R. Finck, Susanna Greenberg
This article confronts the challenges and opportunities presented by medical-legal partnerships (MLPs) representing families impacted by the family regulation system. Based on the authors’ experience developing a collaboration between a medical-legal partnership, interdisciplinary law school clinic and nurse home visiting program focused on clients impacted by the family regulation system, the article
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Camden Coalition Medical-Legal Partnership: Year One Analysis of Civil + Criminal MLP Model in Addiction Medicine Setting J. Law Med. Ethics (IF 1.6) Pub Date : 2024-03-13 Jeremy S. Spiegel, Matthew S. Salzman, Iris Jones, Landon Hacker
In 2022, the Camden Coalition Medical-Legal Partnership began providing civil and criminal legal services to substance use disorder patients at Cooper University Health Care’s Center for Healing. This paper discusses early findings from the program’s first year on the efficacy of the provision of criminal-legal representation, which is uncommon among MLPs and critical for this patient population. The