HealthLawProf Blog

Editor: Katharine Van Tassel
Akron Univ. School of Law

A Member of the Law Professor Blogs Network

Saturday, April 23, 2005

DHHS Promises Renewed Emphasis on Failed Abortions

Robert Pear in today's N.Y. Times reports that DHHS Secretary Michael Leavitt yesterday

told doctors and hospitals on Friday that they must make every effort to save the lives of premature babies born after failed abortions.

The administration's directive said such efforts were required by a 2002 law known as the Born-Alive Infants Protection Act [P.L. 107-207]. Michael O. Leavitt, the secretary of health and human services, said the federal government would "aggressively enforce" the law.

The legislative director of the National Right to Life Committee hailed the announcement, while there was no comment from the American College of Obstetricians and Gynecologists, the AMA, NARAL Pro-Choice America, or the Center for Reproductive Rights[tm]

April 23, 2005 | Permalink

Friday, April 22, 2005

Playgroups and Childhood Leukemia

Reuters reports on a recent set of studies showing that very young children who are exposed to other children (i.e., carriers of common illnesses and infections) in social settings are less likely to develop childhood Leukemia.  The report states,

Sending very young children to daycare centers and playgroups could help protect them from childhood leukemia, researchers said on Friday.

Some degree of exposure to common illnesses early on is important for the immune system, they agreed.

Unknown infections, along with a genetic default that occurs before birth, are the most likely cause of childhood leukemia, they added in a study.

“Early exposure to infections through social contact seems to be protective against the disease,” Professor Mel Greaves, of the Institute of Cancer Research in London, told a news conference. . . .

Scientists have been puzzled by the causes of childhood leukemia since it was first diagnosed. But the 15-year United Kingdom Childhood Cancer Study, which involved more than 13,000 children including nearly 2,000 with leukemia, suggests that a double whammy -- the genetic default and the timing or pattern of infection early in life are critical. “The crucial second event is some kind of infection,” said Greaves.

In a separate study to be published online by the British Medical Journal on Friday, scientists found that children who attend day care center or playgroups during the first few months of their life are less likely to develop leukemia.

This is good news.  I am especially excited since my son has been sick (nothing horrible, just run of the mill ear infections and colds) practically this entire year and now I know that there was potentially a silver lining to this series of childhood illnesses.  Selfishly, however, I wonder if there is any benefit to the parent of said child who also tends to be exposed to the infection. [bm]

April 22, 2005 | Permalink

International Health Law Continued

Erza Klein continues his discussion about health care with an overview of the German and Japanese health care systems. [bm]

April 22, 2005 | Permalink

New Article by Philip Peters

Peters_1  Professor Philip G. Peters, Ruth L. Hulston Professor of Law at the University of Missouri-Columbia School of Law has a new and timely article entitled, "The Meaning of Human Conception."  The abstract follows:

ABSTRACT:

On February 4th, 2005, an Illinois court ruled that frozen embryos are human beings, thereby exposing a fertility clinic to wrongful death liability for accidentally discarding several of them. Although the case was widely depicted as novel, it was actually only the latest in a series of legislative enactments, judicial opinions, and administrative rulings that extend a variety of legal protections to embryos from the moment of conception.

Contrary to common assumption, however, there is no "moment" of human conception. Instead, conception is a process extending over several days and several cell divisions. In this Article, I argue that the conception is not complete until the embryonic genome begins to function. Although the freshly inseminated egg possesses all of the raw materials from which the embryo's future genome will be assembled, that potential is not realized until, at the eight-cell stage, the nuclear DNA of mother and father are fused and commence functioning as an integrated unit.

Prior to that, a new human life is being conceived, but has not yet been conceived Much will turn on whether the courts choose this definition of conception or one that occurs much earlier, such as insemination of the ovum by a sperm. That is because many important activities take place between insemination of the egg and activation of the embryonic genome. They include the culling of poor quality in vitro embryos prior to implantation, the destruction of pre-activation embryos in scientific research, the extraction and destruction of totipotent cells for purposes of prenatal genetic diagnosis, and even the use of certain emergency contraceptives. In addition, the definition of conception will directly affect disputes over the status and disposition of the 400,000 frozen embryos lying in cold storage across the country, many of which were frozen before genome activation. The definition that I propose will place these activities outside the scope of the life-begins-at-conception laws. Although many people will find this a surprising conclusion, it is, I contend, dictated by the gradual nature of the transformation taking place inside the inseminated egg.

[bm]

April 22, 2005 | Permalink

New Futility Case: Baby Charlotte (UK)

The news wires report that a High Court Family Division judge in London has affirmed an October 2004 order that an 18-month-old baby, Charlotte Wyatt, should be allowed to die over the objections of parents who want life-sustaining treatment continued (BBC, Daily Telegraph, ABC/AP).  The baby was born three months premature, weighing one pound, and with brain, lung, and kidney damage.  Her physicians testified that "terminally ill with a chronic respiratory disease, said the judge. He was convinced by the majority medical opinion that Charlotte was unlikely to survive even with ventilation. If she did, her life would again become intolerable. It would not be in her best interests 'to die in the course of futile aggressive treatment'."  Although the comparison is inapt, the AP story finds echoes of Terri Schiavo in the British case, in which the baby's parents vow to take their case to the Court of Appeal.  [tm]

April 22, 2005 | Permalink

Krugman on Health Care: Part III

The New York Times' op-editorialist and Princeton economist, Paul Krugman, scores a bulls-eye in today's third column on what's wrong with the way we finance and deliver health care.  A massive bureaucracy that is dedicated to figuring out how to shift costs to another payer has proved to be phenomenally expensive and, in the end, to produce worse health outcomes because of gaps in coverage, risk selection, and delaying or refusing to pay for care.  His previous columns are available here[tm]

April 22, 2005 | Permalink

Thursday, April 21, 2005

Funny Living Will

If the Schiavo case has you considering how to draft a living will, you may want to check out The New Yorker's "Shouts and Murmurs" column by Paul Rudnick.  The column is entitled, "My Living Will."  Here are a few of my favorite provisions:

           1.   If I should remain in a persistent vegetative state for more than fifteen years, I would like someone to turn off the TV.

12.  If my doctor pronounces me brain-dead, I would like to see the new Ashton Kutcher movie.

15.  I would like to die at home, surrounded by my attorneys.       

17.   In lieu of flowers or donations, I would prefer rioting.

18.  I would like my entire estate to become the property of my cat, Fluffy, who said, “He wouldn’t want to live like this, with that zit.”      

22.  At my memorial service, I would like my clergyman to begin his eulogy with the words “I suppose, in a way, we all killed him.”

[bm]

April 21, 2005 | Permalink

Sex Selection in the UK

According to an article in Slate, it appears that the British government is not adverse to tackling some of the tricky questions raised by artificial reproductive technologies.  The article entitled, "Lads or Lasses:  The British Go For Sex Selection" by Emily Bazelon, discusses the decision of the Science and Technology committee of the British Parliament to recommend allowing couples who conceive through in vitro fertilization to screen their embryos for sex. The article states,

The March report by Britain's House of Commons Science and Technology Committee took up the question of sex selection for couples who use IVF. The committee gave some weight to sex selection's troubling ramifications, chiefly demographic. Because of the preference for sons in China and India, the ratio of boys to girls has already been thrown off in those countries, in some places by as much as 140 to 100. Estimates suggest that nearly one in 10 female fetuses is aborted in India for reasons that have nothing to do with the health of the baby or the mother, even though sonograms performed to determine sex have been banned since 1994. "It could be argued that by permitting people to choose the sex of their child in this country we are legitimising the choices among cultures where boys are preferred," the committee report admits. But its authors point out that sex-related abortion and infanticide is already happening abroad, and then punt the whole thing to Parliament for further consideration.

It is an interesting article with links to the final British report. [bm]

April 21, 2005 | Permalink

Wednesday, April 20, 2005

Chimeras: The Next New Thing?

Tuesday's Boston Globe had a valuable article on the subject of "chimeras -- animals whose bodies are a mosaic, with their own cells intermixed with those of another animal -- to model diseases, test drugs on live human cells, and harvest organs for transplant" -- yet another context in which we can debate what exactly we mean by the term "human."  One of the March 4 sessions of the President's Commission on Bioethics was devoted to this subject.  As the Globe article notes, the U.S. Patent Office turned down an application for a patent on a "humanzee," at the same time calling on Congress for guidance.  The Nov./Dec. 2002 issue of Legal Affairs ran a debate on the chimera-patent question.  [tm]

April 20, 2005 | Permalink

International Health Care

Ezra Klein's blog is running a series of articles on health care in other countries.  It provides some basic  background and the comments contain some helpful links.  So far, his blog has covered France and England  and it appears that there will be some further examination of this topic during the rest of the week.

He also has a brief post about today's GM earnings annoucement and its connection to health care costs.  You may be interested in some of the solutions that people have suggested to this problem of increasing costs of health care. [bm]

Update:  Here is his post on Canada's health care system.

April 20, 2005 | Permalink

Congratulations to Mary Crossley

Mcrossley Professor Mary A. Crossley, Florida Bar Health Law Section Professor of Law at Florida State University College of Law and a courtesy member of the faculty of the Florida State University College of Medicine, has been named the next dean of the University of Pittsburgh School of Law, effective July 2005.  Congratulations to Professor Crossley and to the University of Pittsburgh School of Law!  [bm]

April 20, 2005 | Permalink

New Pope and New Positions on Bioethics

The bioethics blog, Blog.Bioethics.net, links to an overview of Pope Benedict XVI and his views on bioethics issues, particularly the use of stem cells.  It should be interesting to see what policies will be promoted by the Catholic church on this issue, and apparently we won't have long to wait because a new bioethics statement is already in the works.  [bm]

April 20, 2005 | Permalink

Tuesday, April 19, 2005

Pharmacists, Birth Control, and Conscience Clauses

Tuesday's New York Times had a good article on this subject, with a set of helpful maps showing where state bills have been introduced and voted down or are still pending.  In brief, the article states:

Around the country, in at least 12 states, including Indiana, Texas and Tennessee, so-called conscience clause bills have been introduced, which would allow pharmacists to refuse to dispense contraceptives if they have moral or religious objections. Four states already have such laws applying specifically to pharmacists: Arkansas, South Dakota, Mississippi and Georgia.

Proposals in three states - California, Missouri and New Jersey - would have the opposite effect, compelling pharmacies to fill any legal prescription.

In California, West Virginia and a few other states, there is a legislative tug of war, with both types of bills pending in the legislature. In Arizona last week, Gov. Janet Napolitano, a Democrat, vetoed a bill that would have allowed pharmacists to refuse to dispense such drugs.

[tm]

April 19, 2005 | Permalink

Florida's Tort Reform

An article in the Daily Business Review reports on the progress of Tort reform legislation in Florida.    [bm]

April 19, 2005 | Permalink

Health Care Markets

Majikthise has a lengthy post on Health Care Markets and links to many recent discussions that are critical of our current system of health care delivery.  [bm]

April 19, 2005 | Permalink

Monday, April 18, 2005

Satisfaction with Health Care in America

The Washington Monthly has an interesting report on a survey discussing satisfaction with the American Health Care system.  Kevin Drum, the blog editor, states,

. . . here are the percentages of Americans who say they are "fairly or very satisfied" with their own health system:

    • Poor: 45%

Elderly: 61%

    • Everyone else: 34%

This is pretty remarkable. First, the elderly in America, who are covered by a state-run national healthcare system (Medicare and Medicaid) are way more satisfied with their healthcare than everyone else. As it happens, the elderly in other countries also tend to report higher satisfaction levels than other people, but usually by just a few percentage points. In America, where the elderly are covered by a national system and others aren't, the elderly are more satisfied by a whopping 27 percentage points.

Second, even the poor are more satisfied with their healthcare than the rest of us. The poor generally rely on a combination of Medicaid, emergency rooms, and free clinics for their healthcare, a system that's hard to beat for sheer inefficiency and appalling service. But even at that, the rest of us, who are mostly covered by employer-provided health insurance, are less satisfied than the poor. The system of health coverage provided to the vast majority of American citizens is so bad that we like it even less than the jury-rigged system the poor are forced to use.

[bm]

April 18, 2005 | Permalink

Wrongful Birth Cases in Ohio

Last week, the Ohio Supreme Court heard arguments in two cases concerning the tort of wrongful birth, Schirmir v. Mt. Aburn Obstetrics & Gynecologic Assocs., and Lois Marie Coleman et al. v. Vikram Dogra, M.D., et al. . Both cases involved apparent negligent genetic counseling.  A brief overview of the cases appears in the Cincinnati Post.   In addition, the Ohio Supreme Court now has streaming video of its oral arguments and you may access them here

My students watched the webcasts as part of my health law class.  It was a great experience to not only have discussed these cases but to see them argued and learn what issues appeared to be most important to the Justices.  I don't know whether your state supreme court also has streaming video of their arguments but you may want to check because they provide a great teaching tool.  [bm]

April 18, 2005 | Permalink

Sunday, April 17, 2005

Law School Rankings

The National Law Journal has an article about some of the fall-out from this year's U.S. News and World Report rankings.  The article states,

The rankings, have become "the 800-pound gorilla of legal education," according to Jeffrey Stake, a law professor at Indiana University School of Law-Bloomington.  .  .   .    Concern that the rankings are prompting law schools to change their operations in hopes of increasing their scores, all to the detriment of legal education, informed the program.   "There are incentives being created out there that are not good for law students," Stake said. His school came in 36th this year, up four spots.

U.S. News & World Report is aware that "some of the schools have a numbers game," said Robert Morse, director of data research for the publication. He said that it has modified its methodology in some ways to help alleviate the problem and may continue to do so.

This year, for example, the magazine changed the way it measures each school's Law School Admission Test (LSAT) numbers because of concerns that schools were not reporting the figures accurately, Morse said. Those changes have stirred controversy of their own, with some saying they now create a disadvantage for minorities.

The publication receives enormous attention and scrutiny because it has virtually no competition in law school rankings, Morse said.

"It's scary. It's taken on a life of its own," he said.

I can definitely agree with that last statement. [bm]

April 17, 2005 | Permalink