This book contains a collection of treaty documents and soft law on health care rights and health ethics which are used in health law training programs. Regional documents and explanatory reports on health care rights, which are derived from international human rights law, provide a way of "unwrapping" government obligations in health care, making rights more specific, accessible, and (judicially) accountable. In addition, soft law declarations and medical ethics contribute to understanding the moral meaning of (...) human rights in health care. As such, the principles and standards provide practical guidance for States when dealing with equal access to health care services, the rights of patients, biomedical research, organ donations and transplants, genetics, and public health. The book covers the basic documents, while general comments and explanatory reports amplify the principles embodied in the human rights treaties. The authoritative interpretations clarify a 'European approach' on a State's obligations concerning health care rights and ethics. (shrink)

This column will be the first in a series exploring innovative ways to teach concepts and ideas in health law across a wide variety of classrooms, schools, and curriculums.

Global health law has now emerged as an area of specialisation for students interested in global problems concerning health due largely, if not principally, to the inspiring lifelong scholarly work of Professor Lawrence Gostin. A growing number of universities in the world have established programs on global health law in which they address questions of equity and solidarity in addressing public health issues and emergencies, global and national preparedness for pandemics and other health related emergencies, (...) international health regulations, and the intersection between health and human rights, to mention a few. We can expect that as global health threats and inequalities in access to health continue to rise, interest in global health law as a field of legal research and education will continue to grow. (shrink)

I come from a medical family. My father and uncle were physicians, and my father also chaired a department at a West Coast medical school for over 30 years. I am sure I got my interest in teaching from him. My brother is a physician and is currently the safety and quality officer of a Canadian province. My mother operated the last non-automated medical laboratory in my state. I have always understood what sacrifices are made by health care professionals, (...) and I think I have managed to learn a bit about their motivations as well.I was in private practice for ten years with litigation firms, and the last five years of that time I worked for a firm that specialized in professional liability defense and health law. (shrink)

Bigotry distractions are strategic invocations of racism, transphobia, or negative stigma toward other marginalized groups to shape political discourse. Although the vast majority of Americans agree on large policy issues ranging from reducing air pollution to prosecuting corporate crime, bigotry distractions divert attention from areas of agreement toward divisive identity issues. This article explores how the nefarious targeting of identity groups through bigotry distractions may be the tallest barrier to health reform, and social change more broadly. The discussion extends (...) the literature on dog whistles, strategic racism, and scapegoating. (shrink)

Neither the individualistic regulatory health paradigm nor the vulnerable populations approach of public health can provide the legal structure necessary to address the most pressing problems in health care today. These approaches fail to address conflicts between individuals and populations as well as challenges to qualifying for care and are in inherent conflict with each other, sometimes within the same statute. As health concerns become more global, it is necessary to move past a vulnerable populations approach (...) to a broader population approach that respects individual choice but does not sacrifice community health for liberty interests. (shrink)

The legion of nettlesome, even litigious, issues at the interface of the entwined fields of law, public health, and ethics sorely warrant rapt, informed discussion. Indeed, unabashed confronting of the thicket of thorny issues overfilling the enmeshed, vexing fields of public health, law, and ethics is, in sooth, a Sisyphean task. Distinguished lawyer, experienced public health researcher, and very able writer Lawrence Gostin merits hearty felicitations for his workaday efforts in editing this prolix tome, entitled Public (...) class='Hi'>Health Law and Ethics: a Reader, which illumines a quite broad swathe of the complex fabric of issues interconnecting law, public health, and ethics.The excellently edited tome crafted by Gostin is structured as a congeries of reprinted materials, principally academic articles and law cases, presented in excerpted fashion, with expert, insightful commentary provided by Gostin germane to the reprinted materials and generally appertaining to the practice and theory of public health law and ethics. Gostin assigned himself the daunting …. (shrink)

Suicide is a public health problem which will require an integrated cross-sector approach to help reduce prevalence rates. One strategy is to include the legal system in a more integrated way with suicide prevention efforts. Caine explored a public health approach to suicide prevention, depicting risk factors across the socio-ecological model. The purpose of this paper is to examine laws that impact suicide prevention at the individual, relational, community, and societal levels. These levels are fluid, and some interventions (...) will fall between two, such as a community-level approach to training that enhances provider-patient relationships. At the individual level, we will review laws to improve screening requirements across systems. At the relational level, we note interventions with couples having conflict, such as protection orders and access to attorney consultations, which have been known to be injury prevention mechanisms. At the community level, we discuss legislation that recommends suicide prevention efforts for key individuals working as frontline providers in the medical and educational systems. At the societal level, we explore public awareness campaigns that target stigma reduction for those suffering from mental health burden and enhance linkage to care. The article closes with the discussion that laws are good, but their implementation is essential. (shrink)

Global health law for pandemics currently lacks legal obligations to ensure distributional and reparative justice. In contrast, international environmental law contains several novel international legal mechanisms aimed at addressing the effects of colonialism and global injustices that arise from the disproportionate contributions to — and impacts of — climate change and biodiversity loss.

Law and racism are intertwined, with legal tools bearing the potential to serve as instruments of oppression or equity. This Special Issue explores this dual nature of health law, with attention to policing in the context of mental health, schools, and substance use disorders; industry and the environment in the context of food advertising, tobacco regulation, worker safety, and environmental racism; health care and research in the context of infant mortality, bias in medical applications of AI, and (...) diverse inclusion in research; and anti-racist teaching and practice in the context of building an interprofessional curriculum and medical-legal partnerships. (shrink)

Lawyers are most often portrayed and understood to be zealous advocates for individual clients in adversarial litigation or zero-sum transactions. Law schools provide excellent preparation for this type of lawyer role, but lawyers' unique understanding of the law is also needed for systemic advocacy, policymaking, and legal education to solve the most difficult societal problems. An interdisciplinary public health law class is one way for law schools to provide students an opportunity to explore and develop these other professional identities.

Following the confirmation of U.S. Supreme Court Justice Brett Kavanaugh in one of the most sensational jurisprudence events of the modern era, we examine potential repercussions across multiple themes in public health, law, and policy stemming from his ideology and the confirmation process.

I would like to extend my appreciation to the planning committee of this outstanding conference, the Centers for Disease Control and Prevention and the American Society of Law, Medicine & Ethics for allowing me to have this great opportunity to share my experience in teaching and studying medical and public health law and ethics with my U.S. colleagues. This morning, USA Today is reporting that Brundtland, the Director General of the World Health Organization, finally declared that the aggressive (...) control measures have stopped SARS. I think it is a special achievement on her part as she departs the WHO in less than two weeks. The new Director General of the WHO, JW Lee, is a close friend of mine. (shrink)

Interdisciplinary teaching can be a hard sell to the legal academic community. Over almost three decades, I have spoken at conferences on a variety of subjects. When I have presented on this particular topic, however, I have drawn my most meager crowds. Is it because we think interdisciplinary pedagogy is a bad idea, that we are ill-equipped, or that it is generally too difficult to do successfully? After a dozen years of creating and teaching an interdisciplinary course in law and (...) medicine, I confess that it is now my other, law-only courses that I feel I have to justify. Why is an interdisciplinary approach to teaching law the exception rather than the rule?My path to creating an interdisciplinary course in law and medicine began indirectly and with impatience at my own teaching of family law. I had been a professor of family law for decades, and I had developed a sophisticated set of simulations that asked students to negotiate a settlement in a marital dissolution case. (shrink)

Our course on social justice and health began as an experiment between Roger Williams University School of Law and the Warren Alpert Medical School of Brown University. As a course for both law and medical students, it broke relatively new ground by focusing on the intersection between law and the social determinants of health and the ways in which lawyers and doctors might partner to address social and health disparities. The course blends professionalism, ethics, and problem-solving by (...) using case studies that raise practical challenges at the intersection of poverty, law, and health. This kind of collaborative, interdisciplinary teaching presents many challenges and rewards, which I discuss in this essay. (shrink)

The prison-industrial complex has historically operated as a mechanism for social control generally and as a tool to restrict women’s reproductive capacities specifically. Reproductive justice is a domain within the practice of health law. However, health law as currently practiced is ill-equipped to understand how the carceral state functions as a structural determinant of health or how legacies of oppression have facilitated the abridgment of incarcerated women’s reproductive capacities.

The Public Health Law Association’s grant proposal described the problem of accessing public health law information, and the charge for this paper, as follows:The last decade has witnessed a renaissance in public health law. An array of forces have given rise to new model acts, important litigation developments and a growing body of academic research in the field. While there have been some initial attempts to collate important materials, practitioners in the field lack access to “real world” (...) documents and practice guides. If public health law is to remain an organic and growing field and, more importantly, if the fruits of this renaissance are to have lasting practical effect, practitioners in multiple fields must have access to this body of knowledge. (shrink)

Health and health care are vitally important to all of us, and academic interest in the law regulating health has, over the last 50 years, become an important field of academic study. An analysis of the development of, changes in, and scope of Health Law and Ethics to date, is both timely and of interest to students and scholars alike, along with an exploration of its likely future development. This work brings together contributions from leading and (...) emerging scholars in the field. Each contributor has been invited to select and analyse a 'leading work', which has for them shed light on the way that Health Law and Ethics has developed. The chapters are both autobiographical, reflecting upon the works that have proved significant to contributors, and also critical analyses of the current state of the field. This collection also includes a specially written Introduction and Conclusion, which critically reflect upon the development of Health Law and Ethics and its likely future developments in the light of the reflections by contributors on their chosen leading works. The book will be of interest to students, teachers and researchers in Health Law and Ethics, as it provides critical discussions and assessments of some of the leading scholarship in the field. (shrink)

Public health ethics is emerging as a new field of inquiry, distinct not only from public health law, but also from traditional medical ethics and research ethics. Public health professional and scholarly attention is focusing on ways that ethical analysis and a new public health code of ethics can be a resource for health professionals working in the field. This article provides a preliminary exploration of the ethical issues faced by public health professionals in (...) day-to-day practice and of the type of ethics education and support they believe may be helpful. (shrink)

This report provides an overview of training individuals in public health law. This report is designed to broadly outline the issues in order to facilitate discussion at the November 2007 PHLA meeting in Washington, D.C. I found that attorneys and public health practitioners have different approaches to training and practice. Materials and programs that seek to train individuals must be designed to fit within the professional culture of the targeted group. The differences between the two professional cultures can (...) be a barrier to training if not acknowledged in the design of training programs and materials.In a selected overview of materials and programs available, I found that there is an unmet need for responsive materials and programs. I also found that networking and conference opportunities can play an important role in training that should be explored. I also discuss joint degree programs. The report concludes with a series of future recommendations to facilitate discussion. (shrink)

Public health law research reveals significant complexities underlying the use of law as an effective tool to improve health outcomes across populations. The challenges of applying public health law in practice are no easier. Attorneys, public health officials, and diverse partners in the public and private sectors collaborate on the front lines to forge pathways to advance population health through law. Meeting this objective amidst competing interests requires strong practice skills to shift through sensitive and (...) sometimes urgent calls for action to address known threats to the health of individuals and the community. It also necessitates objective, timely information and national and regional legal support. (shrink)

Law is an essential tool for improving public health infrastructure and outcomes; however, existing state statutory public health laws may be insufficient. Built over decades in response to various diseases/conditions, public health laws are antiquated, divergent, and confusing. The Turning Point Public Health Statute Modernization National Collaborative addressed the need for public health law reform by producing a comprehensive model state act. The Act provides scientifically, ethically, and legally sound provisions on public health infrastructure, (...) powers, duties, and practice. This article examines how statutory law can be a tool for improving the public's health, existing needs for public health law reform, themes and provisions of the Turning Point Act, and how it is being used by public health practitioners. (shrink)

This essay argues that feminist legal theory offers an important, and underutilized, perspective to examine health law and policy. We use several theoretical frameworks developed by feminist legal theorists including relational autonomy, intersectionality, vulnerability theory, and the feminist critique of the public-private divide to demonstrate the utility of these theories to health law analysis. These frameworks provide insights relevant not only to issues that obviously relate to gender, but also to matters of choice, quality, and access that are (...) less obviously gender-related. We map three key areas of existing scholarship and future inquiry at the intersection of health law and feminist legal theory: patient choice and relational autonomy, patriarchy, power and patient safety, and access to health care and healthy living conditions at the public-private divide. Uniting these areas of inquiry is a nagging question central to the relationship between critical legal scholarship and pragmatic action to combat injustice: Can we use legal rights to achieve our aims even as we recognize them as tainted tools that have propped up oppressive social structures? A feminist agenda for health law and policy must grapple with this dilemma. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction (Abbott) and the assignment of responsibilities (...) (Gusfield). This theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as 'intentionally taking the life of another person by a physician, upon that person's request' can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities . (...) This theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities. This (...) theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

The Centers for Disease Control and Prevention’s goal is to develop a surveillance system of public health laws that would both support research and analysis among policymakers and legislators, and support the scientific basis for public health law. This session was convened, in part, to discuss the value of creating an electronic system to track public health legal information. Public health surveillance is the “ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related (...) event for use in public health action to reduce morbidity and mortality and to improve health. Data disseminated by a public health surveillance system can be used for immediate public health action, program planning and evaluation, and formulating research hypotheses.” There is currently no system available that meets the goals of this definition of “surveillance” for public health laws. (shrink)

McDonough Hall, Room 508, 600 New Jersey Ave, NW, Washington, DC 20001, USA; Email: gostin{at}law.georgetown.edu ' + u + '@' + d + ' '//--> Abstract As a consequence of rapid globalization, the need for a coherent system of global health law and governance has never been greater. This article explores the health hazards posed by contemporary globalization on human health and the consequent urgent need for global health law to facilitate effective multilateral cooperation in advancing (...) the health of populations equitably. It sets forth the first definition of the emerging field of "global health law." After explicating the central features identified in the definition, the article examines the "grand challenges" to reaching the full potential of global health law to advance human health in just and effective ways. CiteULike Connotea Del.icio.us What's this? (shrink)

As Steve Kaminshine said in his comments at the symposium honoring Charity Scott, I was recruited to come to Georgia State University as a “Law and Bioethics” scholar who had spent more than sixteen years shuttling between an office in a hospital and another in a law school. But when I first visited Georgia State Law, I did not know that more than ten years earlier Charity Scott had spent the better part of an academic year living and breathing clinical (...) ethics at Grady Memorial Hospital.1 Because of her usual habit of immersion in all learning experiences, in that year Charity gained more insight into how hospitals work and how physicians behave when they are knee deep in their professional milieu of life and death decision-making than many full-time bioethics academics do in a career. For the rest of her career Charity kept one foot well planted in the medical context, as an advisor in problems of research ethics, as a teacher in her own medical-legal partnership structured around real-life clinical problems, and as an ethical analyst who could never be accused of mouthing a mantra of phrases, the “vacuous incantation of abstract principles”2 that might pass for bioethics discourse in some circles. (shrink)

Originally edited by Timothy Stoltzfus Jost, this text examines how different countries around the world approach the same challenges in health care law and ethics: how to finance care for as many people as possible; how to ensure quality care; how to best secure patients' rights; how to regulate abortion, end of life decision making, and assisted reproduction; and how to manage infectious diseases, tobacco use, and human subject research. The new edition considers a broader array of countries, particularly (...) from Asia, Latin America, Africa, and the Middle East. (shrink)

This is a pivotal moment in the global governance response to pandemic threats, with crucial global health law reforms being undertaken simultaneously in the coming years: the revision of the International Health Regulations, the implementation of the GHSA Legal Preparedness Action Package, and the negotiation of a new Pandemic Treaty. Rather than looking at these reforms in isolation, it will be necessary to examine how they fit together, considering: how these reforms can complement each other to support pandemic (...) prevention, preparedness, and response; what financing mechanisms are necessary to ensure sustainable health governance; and why vital norms of equity, social justice, and human rights must underpin this new global health system. (shrink)

This symposium issue of the Journal of Law, Medicine & Ethics is about public health law, not health-care law. There is a difference. Most scholarly writing has examined the rich and textured field of health-care law or law and medicine. This field revolves around several broad themes related to the health-care system: delivery, financing, and research and innovation.In studying health-care delivery, scholars have examined everything from the physician/patient relationship to systems of care. In studying financing, (...) scholars have examined theories of competition and justice to ensure cost-efficient access to care. And in studying research and innovation, scholars have studied everything from human subject protection to intellectual property. (shrink)

This article describes implementation of a longitudinal curriculum in public health law, building on doctrinal coursework with skills-based coursework and opportunities for interdisciplinary, community-based engagement and service learning. It specifically describes development of a Policy Practicum, giving an example of how law students can learn policy skills and skills of effective community coalition work through a healthy homes partnership, highlighting areas where the curriculum can incorporate interdisciplinary education. It offers lessons learned during the curriculum-building process, and concludes with a (...) more intensive service-learning strategy through the development of a Policy Lab. (shrink)

This essay describes an interdisciplinary educational experiment in health law. The experiment was funded by the National Science Foundation, received Institutional Review Board approvals, incorporated inter-disciplinary faculty and graduate students from several universities in Atlanta, and employed problem-based learning. After discussing my motivation to undertake this experimental approach to teaching health law, I explain how the course was developed and structured and how we are assessing its results. I also offer some reflections on why other health law (...) teachers might be motivated to incorporate some features of our experimental approach into their own classes, and some thoughts on how they might do so based on lessons learned.I undertook this experiment to test in an educational setting an approach to problem solving that I have developed for addressing certain kinds of seemingly intractable policy problems. I call this a “navigational approach” to “fractious problems.”. (shrink)

This paper will begin with a brief account of the mandate and description of the Law Reform Commission of Canada and its Protection of Life Project, secondly, point to a limitation imposed upon it by the nature of health law in Canada and, thirdly propose some basic questions which such commissions have both the luxury and the duty to wrestle with and resolve. In my view it is these fundamental challenges which ought to be the major components of the (...) standards by which national commissions such as ours are judged. (shrink)

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, non-state actors, and regulatory instruments that structure global health. Such interdisciplinary training must (...) be expanded throughout the world to prepare future practitioners to strengthen global health law — ensuring a foundation for global health in legal studies and law and global health studies. Meeting this imperative for global health law teaching — establishing academic courses and textbooks on global legal responses to shared health threats — will be necessary to support students to address the global health challenges of the future. (shrink)

Human rights offer to ground global health law in equity and justice. Human rights norms, advocacy, and strategies have proven successes in challenging private and public inequities and in realizing more equitable domestic and global health governance. However, mobilizing human rights within global health law faces enormous political, economic, technological, and epidemiological challenges, including from the corrosive health impacts of power, politics, and commerce. This article focuses on what human rights could bring to three major global (...) health law challenges — health systems strengthening and universal health coverage, the commercial and economic determinants of health, and pandemic disease threats. We argue that human rights offer potentially powerful norms and strategies for achieving equity and justice in these and other key global health domains. The challenge for those working in human rights and global health law is to work nimbly, creatively, and courageously to strengthen the contribution of these instruments to health justice. (shrink)

The emerging global climate crisis threatens human health in unprecedented ways, yet global health concerns have not been sufficiently considered within international climate change efforts. A more collaborative pathway could advance efforts to mitigate and adapt to climate change while protecting public health and social justice.

Global health law in theory and practice can either work to ameliorate the devastating consequences of colonialism, class hierarchies, and structural racism in health, or it can ratify and exacerbate them. It can protect, under protect, overprotect, or fail to protect – it is not and cannot be neutral. Global health law reflects the choices and practices of States and other actors, which includes both action and inaction. Inaction or silence on the part of global health (...) law is a choice that ratifies the status quo of coloniality, class exploitation, and structural racism in health. (shrink)