HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Saturday, May 7, 2005

Marcia Angell book - Reading for Exams

Paul Krugman references a book by Marcia Angell entitled, "The Truth about Drug Companies: How They Deceive Us and What to Do About It.”  I haven't read it yet but had already placed it on my summer reading list.  If you are interested, I am linking to a shorter piece that she wrote for the New York Times Book Review.  Also, here is a critical review of the book as well from the pharmaceutical industry.  [bm]

May 7, 2005 | Permalink

Friday, May 6, 2005

Paul Krugman Continues His Health Care Analysis

Paul Krugman has another great article today in the New York Times concerning the 2003 Medicare plan.  Enjoy!  [bm]

May 6, 2005 | Permalink

Ron Chernow's Column on the Judiciary

This is more of a general legal topic --- Today's New York Times contains a wonderful background piece on the judiciary and helps put the current battle over its power (or lack thereof) into some historical perspective.  It is just a brief overview but written by Ron Chernow, who writes well and with great knowledge about the subject.  If you haven't read his biography of Alexander Hamilton, I recommend it highly.  [bm]

May 6, 2005 | Permalink

Thursday, May 5, 2005

New Reproductive Rights Article

Susan Frelich Appleton, Lemma Barkeloo and Phoebe Couzins Professor of Law, Washington University School of Law (St. Louis) has written an informative and thought provoking new essay entitled, "Unraveling the 'Seamless Garment': Loose Threads in Pro-Life Progressivism," which will appear in the second volume of the University of St. Thomas Law Journal.  The abstract follows: 

   "Pro-life progressivism" purports to approach many contested
  issues of the day in a unified and consistent manner - often
  expressed through the metaphor of the "seamless garment." This
  approach opposes abortion, the death penalty, and unjustified
  war; it supports the provision of health care for all citizens
  and financial assistance for the poor; and it professes
  allegiance to progressive and egalitarian ideals. This brief
  essay offers a pro-choice reply, developed for a conference and
  symposium called "Can the Seamless Garment Be Sewn? The Future
  of Pro-Life Progressivism."

  The current practice of in vitro fertilization (IVF) not only
  shows repronormativity at work but also exposes biases and blind
  spots in the contemporary pro-life position. IVF, which
  routinely creates extra embryos destined for destruction,
  remains almost completely unregulated - and virtually ignored by
  those who oppose abortion freedom in the name of embryonic and
  fetal life. This examination of IVF confirms what historians and
  political scientists have observed before: The abortion debate
  emerges as primarily a conflict about feminism, motherhood, and
  women's roles.

  This essay concludes by noting some initiatives that
  progressives might pursue to promote gender equality and respect
  for women's decisions while reducing the number of abortions
  actually chosen.

For the full article, please click here. [bm]   

May 5, 2005 | Permalink

Evidence-Based Medicine

Slate's online magazine contains a new article entitled, "Bedside Wisdom:  It still beats medicine-by-the-numbers.  In the article, Sherwin B. Nuland discusses evidence-based medicine in response to a newly published book on that subject.  He clearly is not a fan of such medicine.  He does a nice job briefly tracing the development of clinical epidemiology and then he states,

Needless to say, the entire notion that there can be such a thing as an epidemiological or mass approach to individual patient care has been difficult for some observers to accept. And as to evidence-based medicine! In Evidence-Based Medicine and the Search for a Science of Clinical Care, Jeanne Daly, a medical sociologist who is co-editor of the Australian and New Zealand Journal of Public Health, presents with admirable balance both the good reasons to be wary of such a coolly distanced and data-drenched approach to patient care and the good reasons to be welcoming of it. But though I admire her fairness, I remain skeptical of the concept's ultimate implications. To be sure, evidence-based medicine offers a method to put diagnosis and therapy on as scientific a basis as possible, removing physician fallibility as well as guesswork. But it fails to account for the extent to which doctors' choices are affected by the multiple complicating factors inherent in any illness, or, for that matter, simultaneous illnesses, patients' biological differences, or the differing ways in which disease can interact with proposed therapies.

It is an interesting read.[bm]

May 5, 2005 | Permalink

Wednesday, May 4, 2005

AIDS Research on Foster Children

It will be in all the papers tomorrow, but there's a major story breaking right now about NIH-funded AIDS research during the 1990s at some of the best known medical centers in the country.  It involved foster children and appeared to be conducted, in many cases, without proper consents and without the appointment of a monitor or advocate.  The AP story is here.  There will undoubtedly be more on this over the next few days.  [tm]

May 4, 2005 | Permalink

Less Love for "Ugly" Children

The New YorkTimes science page has an article on a recent study by several researchers at the University of Alberta in Edmonton who studied how parents interacted with their children while shopping in supermarkets.   They found that the allegedly ugly children were more neglected and allowed to engage in potentially dangerous behavior.  One researcher states an evolutionary rationale for such behavior.

Dr. W. Andrew Harrell, executive director of the Population Research Laboratory at the University of Alberta and the leader of the research team, sees an evolutionary reason for the findings: pretty children, he says, represent the best genetic legacy, and therefore they get more care.

Fortunately some other experts disagreed with this rationale:

Not all experts agree. Dr. Frans de Waal, a professor of psychology at Emory University, said he was skeptical.

"The question," he said, "is whether ugly people have fewer offspring than handsome people. I doubt it very much. If the number of offspring are the same for these two categories, there's absolutely no evolutionary reason for parents to invest less in ugly kids."

Dr. Robert Sternberg, professor of psychology and education at Yale, said he saw problems in Dr. Harrell's method and conclusions, for example, not considering socioeconomic status.

"Wealthier parents can feed, clothe and take care of their children better due to greater resources," Dr. Sternberg said, possibly making them more attractive. "The link to evolutionary theory is speculative."

Maureen Dowd, the New York Times columnist, has some further comment on this study in her column today.   I find studies that proclaim that physically attractive people receive more benefits from love to money rather repugnant, even if they do turn out to be true someday.  If we are hardwired evolutionarily to prefer physically attractive individuals, then perhaps I could be persuaded to favor some sort of genetic engineering to remove that from our wiring - it seems to be a very ugly trait that leads to undesirable behavior. 

On a separate note, I must admit that I don't think the study proves very much other than parents may sometimes be more lax than they should be when taking care of their children.  Luke, age 2, now likes to play with the seatbelt in the cart - taking it on and off.  So, I am one of those parents whose child is not always strapped into the cart securely.  That said, I happen to think that he is quite the cutie (and I say that as a parent who looks nothing like her child) and love him very much.  I even love him and find him adorable looking when, as a result of crying fits during a haircut, he ends up with a crooked bowl cut which is decidedly unfashionable. [bm]

May 4, 2005 | Permalink

Congratulations to Alan Meisel

Alan Meisel, University of Pittsburgh professor of law and psychiatry and the Dickie, McCamey & Chilcote Professor of Bioethics, received the Pellegrino Medal “for contributions to American healthcare ethics and law in the selfless spirit of Edmund D. Pellegrino,” from Samford University in Birmingham, Ala.
The Pellegino Medal recognizes individuals known nationally as leaders for their contributions to healthcare ethics. 

Please click here for the formal award announcement from the University of Pittsburgh School of Law.  Congratulations on a well-deserved honor!  [bm]

May 4, 2005 | Permalink

Tuesday, May 3, 2005

DHHS' Leavitt Promotes Advance Directives

There's no mention of this yet on the DHHS newsies' web page, but the AP reported today that Secretary Leavitt issued a statement Monday encouraging Medicare enrollees to have living wills.  A response to the Terri Schiavo case?  Maybe.  A renewed emphasis on the value of promoting patient autonomy?  Possibly.  But Mr. Leavitt offered another justification in a Q&A session with hospital administrators: Encouraging new Medicare participants to write living wills could end up saving the government large amounts of money.

In related news, the American Hospital Association's web site now links to advance directive forms from every state.  The page is entitled "Put It In Writing" and is maintained by the National Hospice and Palliative Care Organization.   [tm]

May 3, 2005 | Permalink

New Public Health Blog

From Maternal and Child Health, I learned of this wonderful new public health blog.  It is called EffectMeasure.   These individuals who are devoted to public health cover a vareity of topics.  Most recently they have examined such topics as bird flu, obesity, pain medication, reproductive issues, and even Pete Seeger's Birthday.  I recommend that you bookmark it!  [bm]

May 3, 2005 | Permalink

Annual Health Law Teachers Conference

If you haven't registered for the 29th Annual Health Law Teachers Conference, you should do so quickly so that you receive the early-bird registration rate which expires on May 6th (this Friday!).  The conference will be held at the Baylor College of Medicine in Houston, Texas on June 3 and 4, 2005.  This is a terrific conference and I always look forward to it.   Here is the conference description:

Intended for professionals who teach law or bioethics in schools of law, medicine, public health, health care administration, pharmacy, nursing, and dentistry. ASLME’s Annual Health Law Teachers Conference combines presentations by experienced health law teachers with the opportunity for discussion among conference participants. The program is designed to provide participants with updates on issues at the forefront of law and medicine and to provide them with the opportunity to share strategies, ideas, and materials.

For registration information, please click here. [bm]

May 3, 2005 | Permalink

Monday, May 2, 2005

Supreme Court and Solomon Amendment

According to a variety of news sources, the Supreme Court has granted review to the case of Rumsfeld v. Forum for Academic and Institutional Rights, No. 04-1152.  The issue is:  Does a federal statute that denies federal funding for law schools that deny military recruiters the same access to campus given other employers violate the schools' First Amendment right to oppose discrimination against gays and lesbians?

SCOTUSblog has a more detailed discussion concerning the case and the important issues it raises.  [bm]

May 2, 2005 | Permalink

Increase in Professional Discipline Actions

The AmNews reports that state medical boards reported disciplinary actions against physicians increased by 20% between 2003 and 2004.

Numbers the Federation of State Medical Boards released last month showed that state boards in 2004 took 5,502 prejudicial actions such as revocations, suspensions and reprimands against physicians. That's up from 4,590 actions in 2003. Substance abuse, unprofessional conduct and prescribing violations were the main reasons for discipline in 2004.

Non-prejudicial actions, which include license reinstatement after probation, climbed to 763 in 2004 from 640 in 2003. These board measures don't adversely impact physician licenses, but the federation said they consume time and resources, leaving small staffs less time to focus on in-depth investigations.

The 2004 numbers continue a rise in doctor discipline. Total board actions rose 36% over the past five years, with 6,265 actions in 2004.

The article also discusses the reasons behind the increased action.   It states the growing physician population is one reason and the other relates to improvements in the medical boards.  It also appears that some state medical boards have a broad range of responsibilities, some of which do not appear to relate that closely to whether they are good doctors.  For example, Missouri disciplines doctors for failing to pay state income tax.  [bm]

May 2, 2005 | Permalink

Discrimination and Health

Sunday's Washington Post has a very interesting article entitled, "Study Links Discrimination, Blacks' Health," which examines a recently completed study on the impact that discrimination may have on racial minorities and their health.   As Rob Stein reports,

[Tene T. Lewis, a health psychologist at Rush University Medical Center in Chicago] and her colleagues studied 181 black women ages 45 to 58 in Chicago and Pittsburgh who are participating in a large, ongoing project, called the Study of Women's Health Across the Nation (SWAN), that is examining a host of health issues among middle-age women.

As part of the SWAN project, every year between 1996 and 2001 the women answered a questionnaire designed to measure encounters with subtle racial discrimination. The questionnaire asked each woman if, in her "day-to-day life," she had had one of 10 experiences, including: "You are treated with less courtesy than other people"; "You receive poorer service than other people at restaurants or stores"; and "People ignore you or act as if you are not there."

"We're not talking overt incidents. It's not racism in the form of being chased down the street because you have brown skin or being called a name," Lewis said. "We're talking about subtleties -- everyday insults that build up over time."

The women's scores over the years were averaged on a four-point scale, and in 2001 the participants underwent an examination known as a CT scan to measure coronary artery calcification -- buildup of calcium inside arteries that supply blood to the heart. It is considered an early stage of heart disease -- the nation's leading cause of death.

The more discrimination the women reported, the more likely they were to have calcification, the researchers found. After accounting for age, geographic location and education, the researchers found that for every unit of increase in perceived discrimination, the odds of having calcification nearly tripled. The chances of having calcification remained 2 1/2 times higher even after the researchers took into consideration such factors as high blood pressure, cholesterol, smoking, age and body weight.


May 2, 2005 | Permalink

Sunday, May 1, 2005

Cover the Uninsured Week

The Cincinnati Enquirer has an article today examining the hardships of individuals who have lost their health insurance.  It also contains information about local events that will take place to raise awareness about the uninsured.  You may want to check your local paper for information in your area concerning this important topic.  [bm]

May 1, 2005 | Permalink