TortsProf Blog

Editor: Christopher J. Robinette
Southwestern Law School

Monday, September 26, 2022

Spectrum Stabbing Damages Reduced to $1.15 Billion

In late June, a Texas jury found Spectrum liable in the death of one of its customers.  The company employed an internet installer who robbed and stabbed an 83-year-old woman to death.  The jury found the murderer was 10% responsible and Spectrum was 90% responsible.  The jury awarded $375 million in compensatory damages; Spectrum's share was $337.5 million.  In late July, in a second phase of trial, the jury awarded the family $7 billion in punitive damages.  Earlier coverage is here.  

As anticipated, the $7 billion punitive damages award has been reduced by the trial judge.  The plaintiffs' attorneys actually requested the reduction to protect the verdict on appeal.  They requested a ratio of 2:1 and received it.  The total award is now $1.15 billion.  Spectrum states it will appeal.  Dave Simpson at Law360 has the story (behind a paywall; it is also available on Lexis).  

September 26, 2022 in Current Affairs, Damages | Permalink | Comments (0)

Thursday, September 22, 2022

Wells on Absolute Official Immunity in Constitutional Litigation

Mike Wells has posted to SSRN Absolute Official Immunity in Constitutional Litigation.  The abstract provides:

Absolute official immunity blocks recovery for constitutional violations that occur in the course of legislative, judicial, prosecutorial, and testimonial functions, no matter how egregiously the officer has acted. The basic policy underlying the doctrine is that constitutional litigation will produce unacceptable social costs, mainly by discouraging officials from acting boldly and effectively in the public interest. It may be necessary to sacrifice the vindication of constitutional rights and deterrence of violations in some circumstances, but the Court’s broad function-based limits give too much weight to the costs of constitutional remedies and pays too little attention to the vindication and deterrence benefits. Shifting from the crude function-based approach to a more nuanced cost-benefit methodology would make good sense—and all the more so because the shift would align the Court’s doctrine with the values it has identified as underlying official-immunity law. Of particular importance, such a reform would support the recognition of multiple exceptions to present-day absolute-immunity rules, thus better serving the overarching remedial goals of constitutional tort law.

September 22, 2022 in Scholarship | Permalink | Comments (0)

Monday, September 19, 2022

SLU: Workers' Comp: 50 Years Later

On October 11, from 9-1 CST, Saint Louis University is hosting a conference entitled "Fifty Years After 'Inadequate and Inequitable':  Reflections on State Workmen's Compensation Laws."  Panelists are Jason Bent, Mike Duff, James Gallen, Price Fishback, and Ye Yuan.  The blurb:

In 1970, Congress noted in its prelude to the enactment of the Occupational Safety and Health Act that “serious questions have been raised concerning the fairness and adequacy of present workmen’s compensation laws in the light of the growth of the economy, the changing nature of the labor force, increases in medical knowledge, changes in the hazards associated with various types of employment, new technology creating new risks to health and safety, and increases in the general level of wages and the cost of living.”In reaction to these developments Congress established a National Commission on State Workmen’s Compensation Laws to “undertake a comprehensive study and evaluation of State workmen’s compensation laws in order to determine if such laws provide an adequate, prompt, and equitable system of compensation.” The Commission formed by President Nixon was tasked with providing a “detailed statement of the findings and conclusions of the Commission, together with such recommendations as it deems advisable” no later than July 31, 1972. That report was made, about fifty years ago. The Commission’s ultimate conclusion was “that State workmen’s compensation laws are in general neither adequate nor equitable.”The purpose of this conference is to reflect upon the significance of the report as a moment in the legal history of the treatment of workplace injury. To aid in the reflection, we discuss what workers’ compensation is, the justice it attempts to effectuate, what happened leading up to the 1970s, and the system’s uncertain future.

CONTACT:

Falethia HawthorneProgram CoordinatorWilliam C. Wefel Center for Employment LawSaint Louis University School of Lawfalethia.hawthorne@slu.edu 

September 19, 2022 in Conferences, Legislation, Reforms, & Political News | Permalink | Comments (0)

Thursday, September 15, 2022

Savige & Witt on Foreseeability

Morgan Savige & John Fabian Witt have posted to SSRN Foreseeability Conventions.  The abstract provides:

How has the foreseeability standard survived its critics? Law relies on foreseeability to solve hard legal problems in a vast array of doctrinal fields. But for a century and more, critics have pilloried the standard as hopelessly indeterminate. Decisionmakers, observe the critics, can characterize virtually any consequence as either foreseeable or unforeseeable. It all depends on how one tells the story. This Article explains the conundrum of foreseeability’s puzzling persistence by offering a novel account of how foreseeability has flourished in fields like tort, contract, and crime. Foreseeability has survived and flourished, the Article proposes, not because it carries determinate meaning (it does not), but because lawyers, judges, and juries have established fixes or hacks -- what in this Article we call foreseeability conventions -- to settle what would otherwise be intractable foreseeability problems. Foreseeability conventions work because they give the concept meaning in particular fields and in discrete situations, furthering the law’s basic goals in especially thorny categories of recurring cases. We describe two types of conventions: storytelling or narrative conventions, on the one hand, and per se conventions, on the other. We offer salient illustrations, relying especially on the law of torts, showing how the law substitutes rough-hewn proxies for impenetrable foreseeability questions. In closing, we propose that the conventions strategy for resolving indeterminacy is widespread and even pervasive in the law. We observe, too, that the conventions strategy is being put to use today in solving controversial, high-profile legal problems in our age of political and cultural division – even as social fracture risks undermining the tacit agreements on which doctrinal conventions rest.

September 15, 2022 in Scholarship | Permalink | Comments (0)

Wednesday, September 14, 2022

Billauer on Genetic Testing and Negligence

Barbara Pfeffer Billauer has posted to SSRN An Introduction to Using Genetics in Defending Legal Cases:  a Legal Defense Grounded in Genetics--Is DNA-Testing the Magic Wand to Winning (Or Losing) a Negligence Case?.  The abstract provides:

An introduction to the use of genetic markers and mutations to defend causal claims in toxic tort cases, exemplified by recent use in asbestos cases.

September 14, 2022 in Scholarship | Permalink | Comments (0)

Monday, September 12, 2022

Mullenix on the Principles of the Law of Aggregate Litigation

Linda Mullenix has posted to SSRN Aggregationists at the Barricades:  Assessing the Impact of the Principles of the Law of Aggregate Litigation.  The abstract provides:

In 2004 the American Law Institute began work on THE PRINCIPLES OF THE LAW OF AGGREGATE LITIGATION, finally published in 2010. The Principles was addressed to legislatures, administrative agencies, attorneys, private actors, and courts concerning multiparty, multiforum litigation. A purpose of the Principles was to suggest best practices for these institutions and actors.

This essay describes the Principles in the historical context when complex litigation began to dominate federal dockets in the 1980s. It discusses the emergence of a cohort of aggregationists dedicated to liberalizing federal procedure to support, enhance, and encourage the speedy and efficient resolution of complex litigation. The Principles built upon a longstanding ALI concern with the burgeoning and rapidly changing judicial crisis relating to the resolution of complex litigation. The Principles suggested substantial changes in existing class action jurisprudence and judicial case management, recommending more robust embrace of liberalized aggregative procedures. Initially, the Reporters advocated for a root-and-branch revision but, as the essay documents, the final Principles reflected more modest compromises. The essay thoroughly canvasses the proposed recommendations and the subsequent embrace of the proposals.

This essay concludes that while the Principles project has left its mark, courts and legislative bodies still have not addressed or resolved many issues the Principles identified. Since publication most judges seem comfortable with prevailing jurisprudence and not especially interested in rewriting procedural doctrine governing complex litigation. The Principles has not resulted in a root-and-branch revision of aggregate procedure. Rather, reception of the Principles suggests that a more incremental approach to legal reform has prevailed, and the efforts of the avid aggregationists must await another day.

Apart from questions whether the Principles fulfilled its stated purpose, this essay explores fundamental questions about the Institute’s role in moving the law in certain directions based on the goals of committed actors. On one interpretation, the Principles represented a well-intended effort to provide judges with guidance “where there was little established law.” On another, perhaps more problematic view, the Principles represented the desires of actors who, frustrated by judicial resistance to aggregate litigation, used ALI auspices to change the law in a desired direction. These questions go to the heart of the ALI’s role in guiding attorneys, judges, and rulemaking bodies in furtherance of civil justice. Whether the liberalization of aggregate procedure is a desirable goal is a normative question that the ALI Principles project assumed but did not address.

September 12, 2022 in MDLs and Class Actions, Scholarship | Permalink | Comments (0)

Friday, September 9, 2022

The Steamship Reynolds

Many of us teach Vincent v. Lake Erie Transp. Co. around this time of year, the private necessity case of the steamship Reynolds tied to a dock during a terrible storm in Duluth.  A website named "Great Lakes Vessel History" has additional information about the ship.  Apparently the Reynolds was sunk by a German submarine in WW I:

Transferred 1915 to off-Lakes service during World War I.  Cut in two, towed to tidewater and rejoined Torpedoed and sunk May 19, 1918 by German submarine UB-74 off Ile d’Yeu, Bay of Biscay, Atlantic Ocean off the coast of France.

Thanks to Don Gifford for the tip.

September 9, 2022 in Teaching Torts | Permalink | Comments (0)

Monday, September 5, 2022

Avraham & Porat on the Dark Side of Insurance

Ronen Avraham & Ariel Porat have posted to SSRN The Dark Side of Insurance.  The abstract provides:

When insurance works properly it provides insureds with optimal incentives to prevent losses, alongside coverage for losses that could not be prevented efficiently. But insurance has an overlooked dark side to it as well. Insurers employ various tactics to shift losses to their insureds or to their victims in order to minimize their own costs instead of reducing their insureds’ losses. Worse, insurers might also act to increase or maintain long term risks, ensuring the future of the insurance business that can’t exist without risks. To this end, we suspect, insurers engage in anti-competitive practices and trigger harmful behaviors of their insureds or third parties, in order to increase demand for insurance coverage. Policymakers should be aware and critical of insurers’ perverse incentives that counteract the interests of the insureds and society.

September 5, 2022 in Scholarship | Permalink | Comments (0)

Wednesday, August 31, 2022

Goldberg on Torts at the ALI

John Goldberg has posted to SSRN Torts in the American Law Institute.  The abstract provides:

The American Law Institute (“ALI”) has devoted much attention to tort law. This attention has come in different forms. This chapter labels these, respectively: “ALI in the Mode of Appellate Court,” “ALI in the Mode of Law Reform Commission,” and “ALI in the Mode of Think Tank.” Each of these can be placed along a spectrum of ambitiousness with respect to law reform. None is unambitious. But Appellate Court Mode is tethered to doctrine, Think Tank Mode is untethered, and Law Reform Commission Mode lies somewhere in between. One might suppose that the ALI’s promise – which enables leading academics, in consultation with members of the bench and bar and others, to undertake long-term, large-scale research projects – resides in work at the more ambitious end of the spectrum. However, based on an admittedly impressionistic survey, I will suggest that, in the domain of tort law, the Institute has had important successes when proceeding in the manner of an appellate court, and has courted trouble when operating in the other modes.

August 31, 2022 in Scholarship | Permalink | Comments (0)

Saturday, August 27, 2022

Ford Hit With $1.7 Billion Punitive Damages Verdict in Pickup Truck Rollover Case

A Georgia jury awarded $24 million in compensatory and $1.7 billion in punitive damages to the sons of a couple killed when their Ford pickup truck rolled over.  The roof of the truck collapsed after a tire blowout, killing the couple.  The jury heard evidence of a number of prior similar incidents, but many of those cases have been resolved with confidential settlements.  The jury also heard evidence of Ford's wealth.  Even the plaintiffs' lawyer admits the punitive damages award is likely to be reduced, as it is approximately 70 times the compensatory damages award.  Georgia has a split-recovery system, one of approximately eight, in which the state receives a portion of a punitive damages awards (in this case, 3/4).

Hannah Albarazi at Law 360 has the story, quoting Cathy Sharkey, Ben Zipursky, and me.

August 27, 2022 in Current Affairs, Damages | Permalink | Comments (0)

Thursday, August 25, 2022

Hylton on Risk Preferences and Settlement

Keith Hylton has posted to SSRN Mutual Optimism and Risk Preferences in Litigation.  The abstract provides:

Why do some legal disputes fail to settle?  From a bird’s eye view, the literature offers two categories of reasons.  One consists of arguments based on informational disparities.  The other consists of psychological arguments.  This paper explores the psychological theory.  It presents a model of litigation driven by risk preferences and examines the model’s implications for trials and settlements.  The model suggests a foundation in Prospect Theory for the Mutual Optimism model of litigation.  The model’s implications for plaintiff win rates, settlement patterns, and informational asymmetry with respect to the degree of risk aversion are examined.

August 25, 2022 in Scholarship | Permalink | Comments (0)

Wednesday, August 24, 2022

Two by Keating

Greg Keating has posted two pieces to SSRN.  First, Form and Function in Tort Theory.  The abstract provides:

Contemporary tort theory is a contest between instrumentalism and formalism. The prominence of instrumentalism is no surprise. American tort theory was born in the work of Oliver Wendell Holmes and his views were resolutely, if elusively, instrumentalist. Until very recently, economic views have dominated contemporary discussions of tort law in the American Legal Academy, and the economic analysis of torts is uncompromisingly instrumentalist. The rise of formalism, by contrast, is surprising. Legal realism swept over American legal thought long ago. Ever since, formalism has been treated more as epithet than as credible position by American legal scholars. In contemporary tort theory, though, formalism has roared back to life and struck some powerful blows against instrumentalism. Tort, these neo-formalists argue, is not an instrument for the pursuit of independently valuable ends. It is an institution whose norms are constitutive of just relations among persons. The bipolar, backward-looking form of the ordinary tort lawsuit has been the fulcrum that critics of economic analysis have used to pivot tort theory away from economic instrumentalism. That form, prominent tort theorists have persuasively argued, instantiates a backward-looking morality of responsibility, not a forward-looking morality of regulation. But the formalist enterprise has its own weaknesses. For one thing, formalist tort theory has tended to reshape tort law in ways that beg the questions that the theory purports to answer. For another, just relations among persons are a matter of substance as well as form. In the case of tort law, just relations require that tort law identify and safeguard those interests urgent enough to justify imposing reciprocal responsibilities of care and repair. We cannot, therefore, pull the rabbit of a convincing conception of tort law out of the hat of the field’s formal structure. What tort theory needs is two-pronged theory—theory that can both make sense of form and—by attending to tort law’s role in safeguarding our urgent interests from impairment and interference at each other’s hands—also illuminate tort law’s independently significant substance.

Second, Enterprise Liability.  The abstract provides:

In American tort law “enterprise liability” is a response to the profound transformation of the social world brought about by modern industrial, technological society. In this world, most accidental harm is not the random byproduct of isolated individuals going about their idiosyncratic existences in civil society. Instead, the harms and wrongs characteristic of modern social life are the inevitable, and predictable, byproduct of the basic productive activities of modern life. Enterprise liability expresses the idea that responsibility for these harms and wrongs should be absorbed by the activities that engender them, and then be distributed across all those who benefit from those activities —not left on the individuals who happen either to inflict or to suffer them. This chapters seeks to explains the institutional logic of, and normative justification for, enterprise liability, and to show how and why it constitutes a distinctive regime of responsibility.

August 24, 2022 in Scholarship | Permalink | Comments (0)

Monday, August 22, 2022

The History of Wilkinson v. Downton

The 1897 English case of Wilkinson v. Downton is famous for establishing the equivalent of intentional infliction of emotional distress long before that was a viable cause of action in the United States.  The case involved a pub patron playing an attempted practical joke by telling the pub owner's wife that her husband, who was away at the races, was "smashed up" in an accident involving a horse-drawn vehicle.  The wife experienced traumatic emotional damages.

On the Incorporated Council of Law Reporting for England and Wales (ICLR) Blog, Professor Rachael Mulheron QC (Hon) of Queen Mary University of London Department of Law provides the background history of the case, including what became of the pub.

Thanks to David McFadden for the tip.

August 22, 2022 in Damages, Weblogs | Permalink | Comments (0)

Thursday, August 18, 2022

Abraham & White on the Nature of the Judicial Process

Ken Abraham & Ted White have posted to SSRN Doctrinal Forks in the Road:  The Hidden Message of The Nature of the Judicial Process.  The abstract provides:

This Essay was prepared for a Symposium at the Yale Law School, celebrating the one-hundredth anniversary of The Nature of the Judicial Process, the published version of four lectures Judge Benjamin Cardozo delivered at Yale Law School between February 14 and 18, 1921. Revisiting these lectures presents a challenge to the contemporary reader. That challenge is to imagine how the lectures could have generated the strongly affirmative reaction that they apparently did. In this Essay, we seek first to recover that reaction and to juxtapose it against our initially far less enthusiastic response. We then identify a feature of the lectures that was not remarked upon when they were first published and has not been emphasized since: Cardozo’s examination of how appellate judging is frequently about whether to extend what he called a doctrinal 'path', or not to extend that path. If the path is extended, existing doctrinal propositions are treated as governing not only the case at hand, but also as applying to an expanded set of potential future cases. But if the path is not extended, the doctrinal principles embodied in a set of previous cases are deemed inapposite to the current case, and a developing doctrinal path is truncated, thus limiting its application to future cases.

We then show how Cardozo employed the concepts of doctrinal paths and 'forks in the road' in several of his most famous torts cases. We conclude that when Cardozo’s discussion of those concepts is understood as one of the principal contributions of The Nature of the Judicial Process, the lectures can be understood to be of lasting as well as historical significance.

August 18, 2022 in Conferences, Scholarship | Permalink | Comments (0)

Tuesday, August 16, 2022

Wriggins on Race and Insurance

Jenny Wriggins has posted to SSRN The Color of Property and Auto Insurance:  Time for Change.  The abstract provides:

Insurance company executives issued statements condemning racism and urging change throughout society and in the insurance industry after the huge Black Lives Matter demonstrations in summer 2020. This time period presents a crucial opportunity both for examining insurance as it relates to race and racism, including history and current regulation, and for actual, overdue changes in insurance in the U.S. Two of the most important types of personal insurance are property and automobile.

Part I begins with history, focusing on property insurance, auto insurance, race, and racism in urban areas around the mid-twentieth century. Private insurers deemed large areas of cities where African Americans lived to be “blighted” and refused to insure all homes in these areas, despite lacking clear evidence of increased risk. This created a property insurance crisis in the cities. Affordable automobile insurance in areas such as Harlem was hard to come by; complaints of race discrimination went back to the 1930s.The federal government got involved in the late 1960s after state and local remedies were insufficient. The federal Urban Property Protection and Reinsurance Act of 1968 (UPPRA) was aimed to incentivize private insurance companies to enter the urban market and to support states in establishing plans (known as Fair Access to Insurance Requirements or FAIR Plans) that would require companies to cover a certain amount of risk in urban areas.

The UPPRA and FAIR plans led to a robust urban property insurance market at minimal cost to the government and industry, Part II finds. The federal program later was discontinued and largely forgotten, probably due to its success. This forgotten history tells us that insurance markets have not functioned in a neutral way and that for long periods companies did not sell property insurance based on objective neutral data but based on at least in part on racial prejudice. It further shows that the federal government can play a socially positive rule in insurance markets without miring the government in taking on the entire risk or costing taxpayers huge sums. Yet the reform measures did not end redlining or challenge many of the equity issues involved in insurance. Property and auto insurance companies have shifted in recent decades from explicit race-based exclusions to the use of facially neutral practices for pricing and underwriting such as algorithms, machine learning, and credit scores. However, insurance antidiscrimination law (which is largely state law) has not kept pace. No federal law directly bans race discrimination in auto insurance, and federal housing antidiscrimination law has not been consistently applied to housing insurance practices which have a disproportionate impact on racial minorities.

Three reforms would improve current practices, Part III asserts. First, insurance regulation should require more disclosure with requirements parallel to those of the Home Mortgage Disclosure Act. Insurers should be required to collect and disclose specific data on insurance applications and declinations, membership in protected groups, and other information. Second, a private cause of action should potentially be made available for insurance discrimination when insurance practices lead to a disparate impact on African Americans and other racial minorities. Third, insurance regulation should be shifted away from rate regulation which currently serves no useful purpose; this would make more room and time for the other proposed reforms which might lead to long overdue changes in property and auto insurance regulation and practices.

August 16, 2022 in Scholarship | Permalink | Comments (0)

Friday, August 12, 2022

JOTWELL Torts: Bublick on Kendrick on Public Nuisance

At JOTWELL, Ellie Bublick reviews Leslie Kendrick's The Perils and Promise of Public Nuisance.

August 12, 2022 in Scholarship, Weblogs | Permalink | Comments (0)

Thursday, August 11, 2022

TX: Jury Awards $7 Billion in Punitive Damages Against Cable Company

In late June, a Texas jury found Spectrum liable for the death of one of its customers.  The cable company employed an internet installer who robbed and stabbed an 83-year-old woman to death.  The jury found the murderer 10% responsible and Spectrum 90% responsible.  Years earlier, Spectrum had ceased industry-standard, pre-employment verification checks.  Such a check would have revealed that the murderer had fabricated his work history and was fired from several jobs for theft and misconduct.  The company also had notice that the murderer was suffering emotional and financial problems prior to the robbery and murder.  The jury awarded $375 million in compensatory damages, of which part Spectrum was to pay $337.5 million.  The jury also determined that Spectrum forged an arbitration agreement.

In late July, the jury awarded the plaintiffs $7 billion in punies.  The forgery finding allowed the plaintiffs to avoid Texas's cap on punitive damages.  That verdict, however, is going to be severely tested on post-trial motions and appeal.  The Court's Due Process jurisprudence does not impose a hard cap, but it does set limits.  In State Farm v. Campbell, the Court stated that few awards exceeding a single-digit ratio between punitive and compensatory damages will satisfy Due Process.  It further stated that an award of more than four times might be close to the line of constitutional impropriety, and that when compensatory damages are substantial, a one-to-one ratio is likely the outermost limit.  The current ratio is approximately 20:1.  

Awards of this magnitude are often reduced.  The largest punitive damages award to an individual of which I am aware is a 2002 California jury verdict of $28 billion against Phillip Morris.  Ultimately, after 9 years of appeals, the award was reduced to $28 million.  The plaintiff had died years earlier.   

Cara Salvatore at Law 360 has the story (behind a pay wall).

August 11, 2022 in Current Affairs | Permalink | Comments (1)

Wednesday, August 10, 2022

Torts Position at UIC

The University of Illinois-Chicago School of Law invites applications for several tenure-track candidates to begin teaching in the fall of 2023.  Our needs are varied but one of our primary areas of interest is Torts.  Other needs include Property, Legal Research and Writing, Criminal Law, Professional Responsibility, and Business Associations.
 
Candidates must have a Juris Doctor from an ABA-approved law school or its equivalent from a foreign country; a record of teaching excellence or demonstrated potential to become an excellent teacher and a record of high-quality scholarship or demonstrated potential to produce high-quality scholarship; and a demonstrated interested in serving the academy, the community, and legal profession at an urban, public as part of the university community. 
 
If you or anyone you know is interested in applying, please visit https://uic.csod.com/ux/ats/careersite/1/home/requisition/30?c=uic
 where you will find a link to the application process.  Applicants should submit a letter of intent, current curriculum vitae, and the name of three professional references no later than October 7, 2022.  

August 10, 2022 in TortsProfs | Permalink | Comments (0)

Monday, August 8, 2022

Magliocca on Dobbs and Wrongful Birth Actions

At Prawfsblawg, Gerard Magliocca discusses the effects of Dobbs on wrongful birth actions.

August 8, 2022 in Current Affairs | Permalink | Comments (0)

Monday, July 25, 2022

Fox on Medical Disobedience

Dov Fox has posted to SSRN Medical Disobedience.  The abstract provides:

The conscience regime that governs American healthcare is broken. When physicians or pharmacists deny treatment by appeal to their heartfelt convictions, conscience laws in most states shield them from being fired or disciplined. In many, they can’t be held liable for malpractice or prosecuted for endangering patients, however badly they needed care, or serious the resulting harm. Refusers don’t even have to tell patients which procedures are medically indicated, let alone help them to access those options elsewhere. So long as refusers invoke conscience, they almost always go scot-free. There’s virtually no such protection for clinicians who have equally conscientious reasons to perform interventions that their employer or state rules out.

Emboldened by the Supreme Court’s recent decisions in Little Sisters of the Poor and Dobbs, hospitals and legislatures increasingly prohibit services from abortion, emergency contraception, and long-term birth control to puberty blockers, advance directives, and aid-in-dying. Now clinicians are laying their careers and freedom on the line to supply these forbidden forms of care. The treatments that they seek to provide bear crucial differences, to be sure. Some the law prohibits, others it permits. Some are safer, or more effective, than others. Some require facilities and staff. Others, a prescription pad. Some fall squarely within the medical norm. Others push its boundaries, or cross them. These particulars matter. But they also miss a simple fact: Providers honor patients’ wishes, while refusers override them. Yet only refusers’ conscience counts. This asymmetry selectively burdens conscientious providers and drives desperate patients underground.

Fixing this regime demands principled reforms, tailored to distinct levels of authority: the employer and the state. To offset the costs of workplace exemptions, this Article proposes disclosure mandates and objector fees for conscience-claiming clinicians, and distancing measures for the institutions that employ them to mitigate the expressive harms that come from accommodating practices they oppose. The stakes differ when doctors and nurses defy government restrictions. This Article introduces a partial excuse that would take the edge off of the penalties that otherwise attach to certain practices that clinicians undertake in the name of conscience. This limited defense of “medical disobedience” would afford modest space for dissent and debate that a pluralistic democracy needs, in negotiating the controversies of our time, to adapt to moral change from within. That compromise also equips us to resolve the long-simmering tension between the practice of medicine and the rule of law that has reached a boiling point today.

July 25, 2022 in Scholarship | Permalink | Comments (0)