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Large-sized soda ban as an alternative to soda tax. 大规模禁止苏打水作为苏打税的替代方案。
Q2 Social Sciences Pub Date : 2013-01-01
Hery Michelle Min

This Note examines New York City's Sugary Drinks Portion Cap Rule (Soda Ban), which was originally set to become effective March 12, 2013. The New York County Supreme Court's decision in New York Statewide Coalition of Hispanic Chambers of Commerce v. New York City Department of Health and Mental Hygiene suspended the Soda Ban on March 11, 2013. The First Department of the Appellate Division of New York State Supreme Court affirmed the suspension on July 30, 2013. However, the complex economic policy and constitutional issues arising from the proposed Soda Ban deserve as much attention as the ultimate result of the legal challenge to the ban. Both courts struck down the Soda Ban on the grounds that it violated the separation of powers doctrine. The lower court further held that the Soda Ban was arbitrary and capricious. This Note does not focus solely on the holdings of the two courts, but takes a broader approach in analyzing the issues involved in the Soda Ban. By comparing and contrasting tobacco products with sugary beverages, this Note explains why the public seems to find the Soda Ban less appealing than tobacco regulations. Specifically, this Note addresses how the failed attempts of numerous states and cities to implement soda taxes demonstrate the complexity of policies geared toward curbing obesity; how fundamental values, such as health, fairness, efficiency, and autonomy factor into obesity policies; and the fact that legislatures and courts are struggling to determine the scope of public health law intervention. The Note explores how the Soda Ban, despite its judicial suspension, could represent a stepping-stone in combating the obesity epidemic.

本文考察了纽约市的含糖饮料限量规定(苏打禁令),该规定原定于2013年3月12日生效。2013年3月11日,纽约县最高法院在纽约州西班牙裔商会联盟诉纽约市卫生和精神卫生部门一案中暂停了苏打禁令。2013年7月30日,纽约州最高法院上诉部第一部门确认了暂停执行的决定。然而,拟议的苏打禁令所引起的复杂经济政策和宪法问题,与对禁令提出法律挑战的最终结果一样值得关注。两个法院都以违反三权分立原则为由,驳回了汽水禁令。下级法院进一步认为,苏打禁令是武断和反复无常的。本说明并不仅仅侧重于两个法院的判决,而是采用更广泛的方法来分析苏打禁令所涉及的问题。通过比较和对比烟草产品和含糖饮料,本报告解释了为什么公众似乎认为苏打禁令不如烟草法规吸引人。具体来说,本文论述了许多州和城市实施汽水税的失败尝试如何表明了旨在遏制肥胖的政策的复杂性;健康、公平、效率和自主性等基本价值观如何影响肥胖政策;事实上,立法机构和法院正在努力确定公共卫生法干预的范围。该报告探讨了苏打禁令,尽管它是司法暂停,但如何成为对抗肥胖流行病的踏脚石。
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引用次数: 0
Snake oil salesmen or purveyors of knowledge: off-label promotions and the commercial speech doctrine. 蛇油推销员或知识提供者:标签外促销和商业言论学说。
Q2 Social Sciences Pub Date : 2013-01-01
Constance E Bagley, Joshua Mitts, Richard J Tinsley

The Second Circuit's December 2012 decision in United States v. Caronia striking down the prohibition on off-label marketing of pharmaceutical drugs has profound implications for economic regulation in general, calling into question the constitutionality of restrictions on the offer and sale of securities under the Securities Act of 1933, the solicitation of shareholder proxies and periodic reporting under the Securities Exchange Act of 1934, mandatory labels on food, tobacco, and pesticides, and a wide range of privacy protections. In this Article we suggest that Caronia misconstrues the Supreme Court's holding in Sorrell v. IMS Health, which was motivated by concerns of favoring one industry participant over another rather than a desire to return to the anti-regulator fervor of the Lochner era. Reexamining the theoretical justification for limiting truthful commercial speech shows that a more nuanced approach to regulating off-label marketing with the purpose of promoting public health and safety would pass constitutional muster. We argue that as long as the government both has a rational basis for subjecting a particular industry to limits on commercial speech intended to further a legitimate public interest, rather than unfounded paternalism, and does not discriminate against disfavored industry participants, those limits should be subject to intermediate scrutiny under the Central Hudson standard. We believe that our articulation of the commercial speech doctrine post-Sorrell will help resolve the current split in the Circuits on the appropriate standard of review in cases involving both restrictions on commercial speech and mandated speech. Finally, we critique the FDA's 2011 Guidance for Responding to Unsolicited Requests for Off- Label Information (draft) and present a proposal for new rules for regulating the off-label marketing of pharmaceutical drugs based on transparency, the sophistication of the listener and the type of information offered, and the requirement that the pharmaceutical company comply with ongoing duties of training, monitoring, reporting, and auditing.

2012年12月,第二巡回法院在美国诉卡罗尼亚案(United States v. Caronia)中推翻药品说明书外营销禁令的裁决对总体经济监管产生了深远影响,质疑1933年《证券法》对证券发行和销售的限制、1934年《证券交易法》对股东代理的征求和定期报告的限制、食品、烟草和农药的强制性标签的合宪性。以及广泛的隐私保护。在这篇文章中,我们认为Caronia曲解了最高法院在Sorrell诉IMS Health案中的判决,该判决的动机是出于对一个行业参与者的偏袒,而不是为了回到Lochner时代的反监管热情。重新审视限制真实商业言论的理论依据表明,以促进公共健康和安全为目的,对标签外营销进行更细致入微的监管将通过宪法审查。我们认为,只要政府有合理的依据来限制特定行业的商业言论,以促进合法的公共利益,而不是毫无根据的家长作风,并且不歧视不受欢迎的行业参与者,这些限制应该受到中央哈德逊标准的中间审查。我们相信,我们对索雷尔案后商业言论原则的阐述将有助于解决目前巡回法院在涉及商业言论限制和强制言论案件的适当审查标准上的分歧。最后,我们对FDA 2011年《回应未经请求的标签外信息请求指南(草案)》进行了批评,并提出了一项关于药品标签外营销监管新规则的建议,该规则基于透明度、听者的成熟度和提供的信息类型,以及制药公司遵守持续培训、监测、报告和审计职责的要求。
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引用次数: 0
Cooperative federalism and hydraulic fracturing: a human right to a clean environment. 合作联邦制与水力压裂法:享有清洁环境的人权。
Q2 Social Sciences Pub Date : 2012-02-17 DOI: 10.2139/SSRN.2007234
E. Burleson
This Article argues that filling the energy governance gaps regarding unconventional natural gas can best be accomplished through collaborative governance that is genuinely adaptive and cooperative. Through cooperative federalism, combined with procedural rights for inclusive, innovative decision-making, state and non-state actors should design and implement the requisite safeguards before further natural gas development advances. Hydraulic fracturing provisions are strikingly fragmented and have sparked a fierce debate about chemical disclosure, radioactive wastewater disposal, and greenhouse gas emissions. United States natural gas production may stunt the direction and intensity of renewable energy by up to two decades and will not provide a bridge to a sound energy policy if it "erode[s] efforts to prepare a landing at the other end of the bridge." Unconventional natural gas extraction need not become a transition to a new addiction. This Article analyzes how cooperative federalism and inclusive decision-making can provide legitimacy and transparency when balancing property rights against police powers to regulate natural gas production.
本文认为,填补非常规天然气能源治理空白的最佳方式是真正具有适应性和合作性的协同治理。通过合作联邦制,结合包容性、创新性决策的程序性权利,国家和非国家行为体应该在进一步推进天然气开发之前设计和实施必要的保障措施。水力压裂法的规定非常分散,并引发了关于化学物质披露、放射性废水处理和温室气体排放的激烈辩论。美国的天然气生产可能会阻碍可再生能源的方向和强度长达20年,如果它“侵蚀了准备在桥的另一端着陆的努力”,就不会为健全的能源政策提供桥梁。非常规天然气开采不一定会成为一种新瘾的过渡。本文分析了合作联邦制和包容性决策如何在平衡财产权与监管天然气生产的警察权力时提供合法性和透明度。
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引用次数: 5
Cooperation and Division: An Empirical Analysis of Voting Similarities and Differences During the Stable Rehnquist Court Era — 1994 to 2005 合作与分裂:稳定的伦奎斯特法院时代投票的异同实证分析(1994 - 2005)
Q2 Social Sciences Pub Date : 2012-01-16 DOI: 10.2139/SSRN.1986402
Mark S. Klock
The Stable Rehnquist Court Era (SRCE) covers the period from the appointment of Justice Breyer to the passing of Chief Justice Rehnquist. There has been only one longer period of stability in the Court’s history, and that was in the early nineteenth century when far fewer cases were decided. Because the composition of the Court held constant for so long, the SRCE presents a unique opportunity to conduct a statistical analysis of the Justices’ votes. I present a statistical empirical analysis of voting for this period, both for the potentially interesting results and as an example of how to conduct and present an empirical study which is objective and replicable. Some of the findings include the following: only a few pairs of Justices have statistically significant differences in voting records; the magnitude of the departure from independent voting is enormous in statistical terms; Justice Thomas is the most predictable Justice; and Justice Scalia is the least-changed Justice. Of particular interest is a finding that is contrary to conventional wisdom. Conventional wisdom suggests that the median Justice closest to the center, presumably Justice Kennedy, is the most influential Justice. However, I have developed a measure of influence which employs the statistically significant effects the Justices have on each other, and this suggests that the most influential Justices on the Court during the SRCE were Rehnquist, Souter, and Breyer.
稳定的伦奎斯特法院时代(SRCE)涵盖了从任命布雷耶大法官到伦奎斯特首席大法官去世的这段时期。在最高法院的历史上,只有一个较长的稳定时期,那就是在19世纪初,当时判决的案件要少得多。由于最高法院的组成长期保持不变,因此SRCE为对大法官的投票进行统计分析提供了一个独特的机会。我对这一时期的投票进行了统计实证分析,既是为了潜在的有趣结果,也是为了作为如何进行和提出客观和可复制的实证研究的一个例子。其中一些发现包括:只有几对大法官在投票记录上有统计上的显著差异;从统计角度来看,脱离独立投票的程度是巨大的;托马斯法官是最可预测的法官;而斯卡利亚大法官是变化最小的大法官。特别令人感兴趣的是一项与传统观点相反的发现。传统观点认为,最接近中间的大法官,大概是肯尼迪大法官,是最有影响力的大法官。然而,我开发了一种衡量影响力的方法,该方法利用了大法官之间在统计上的显著影响,这表明在SRCE期间最有影响力的大法官是伦奎斯特、苏特和布雷耶。
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引用次数: 0
Cooperative federalism and hydraulic fracturing: a human right to a clean environment. 合作联邦制与水力压裂法:享有清洁环境的人权。
Q2 Social Sciences Pub Date : 2012-01-01
Elizabeth Burleson

This Article argues that filling the energy governance gaps regarding unconventional natural gas can best be accomplished through collaborative governance that is genuinely adaptive and cooperative. Through cooperative federalism, combined with procedural rights for inclusive, innovative decision-making, state and non-state actors should design and implement the requisite safeguards before further natural gas development advances. Hydraulic fracturing provisions are strikingly fragmented and have sparked a fierce debate about chemical disclosure, radioactive wastewater disposal, and greenhouse gas emissions. United States natural gas production may stunt the direction and intensity of renewable energy by up to two decades and will not provide a bridge to a sound energy policy if it "erode[s] efforts to prepare a landing at the other end of the bridge." Unconventional natural gas extraction need not become a transition to a new addiction. This Article analyzes how cooperative federalism and inclusive decision-making can provide legitimacy and transparency when balancing property rights against police powers to regulate natural gas production.

本文认为,填补非常规天然气能源治理空白的最佳方式是真正具有适应性和合作性的协同治理。通过合作联邦制,结合包容性、创新性决策的程序性权利,国家和非国家行为体应该在进一步推进天然气开发之前设计和实施必要的保障措施。水力压裂法的规定非常分散,并引发了关于化学物质披露、放射性废水处理和温室气体排放的激烈辩论。美国的天然气生产可能会阻碍可再生能源的方向和强度长达20年,如果它“侵蚀了准备在桥的另一端着陆的努力”,就不会为健全的能源政策提供桥梁。非常规天然气开采不一定会成为一种新瘾的过渡。本文分析了合作联邦制和包容性决策如何在平衡财产权与监管天然气生产的警察权力时提供合法性和透明度。
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引用次数: 0
Documenting death: public access to government death records and attendant privacy concerns. 记录死亡:公众获得政府死亡记录和随之而来的隐私问题。
Q2 Social Sciences Pub Date : 2012-01-01
Jeffrey R Boles

This Article examines the contentious relationship between public rights to access government-held death records and privacy rights concerning the deceased, whose personal information is contained in those same records. This right of access dispute implicates core democratic principles and public policy interests. Open access to death records, such as death certificates and autopsy reports, serves the public interest by shedding light on government agency performance, uncovering potential government wrongdoing, providing data on public health trends, and aiding those investigating family history, for instance. Families of the deceased have challenged the release of these records on privacy grounds, as the records may contain sensitive and embarrassing information about the deceased. Legislatures and the courts addressing this dispute have collectively struggled to reconcile the competing open access and privacy principles. The Article demonstrates how a substantial portion of the resulting law in this area is haphazardly formed, significantly overbroad, and loaded with unintended consequences. The Article offers legal reforms to bring consistency and coherence to this currently disordered area of jurisprudence.

本文探讨了获取政府持有的死亡记录的公共权利与死者隐私权之间有争议的关系,死者的个人信息包含在这些记录中。这一准入权之争涉及核心民主原则和公共政策利益。开放获取死亡记录,如死亡证明和尸检报告,通过揭示政府机构的绩效、揭露政府潜在的不法行为、提供公共卫生趋势数据以及帮助调查家族史等方式,服务于公众利益。死者家属以隐私为由反对公开这些记录,因为这些记录可能包含有关死者的敏感和尴尬信息。解决这一争议的立法机构和法院一直在努力调和相互竞争的开放获取和隐私原则。这篇文章展示了在这一领域产生的法律的很大一部分是如何随意形成的,明显过于宽泛,并充满了意想不到的后果。文章提出了法律改革,以使这一目前混乱的法理学领域具有一致性和连贯性。
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引用次数: 0
Welcome to the wild west: protecting access to cross border fertility care in the United States. 欢迎来到狂野的西部:保护在美国获得跨境生育护理的机会。
Q2 Social Sciences Pub Date : 2012-01-01
Kimberley M Mutcherson

As has been the case with other types of medical tourism, the phenomenon of cross border fertility care ("CBFC") has sparked concern about the lack of global or even national harmonization in the regulation of the fertility industry. The diversity of laws around the globe leads would-be parents to forum shop for a welcoming place to make babies. Focusing specifically on the phenomenon of travel to the United States, this Article takes up the question of whether there should be any legal barriers to those who come to the United States seeking CBFC. In part, CBFC suffers from the same general concerns raised about the use of fertility treatment in general, but it is possible to imagine a subset of arguments that would lead to forbidding or at least discouraging people from coming to the United States for CBFC, either as a matter of law or policy. This paper stands in opposition to any such effort and contemplates the moral and ethical concerns about CBFC and how, and if, those concerns warrant expression in law. Part I describes the conditions that lead some couples and individuals to leave their home countries to access fertility treatments abroad and details why the United States, with its comparatively liberal regulation of ART, has become a popular CBFC destination for travelers from around the world. Part II offers and refutes arguments supporting greater domestic control over those who seek to satisfy their desires for CBFC in the United States by reasserting the importance of the right of procreation while also noting appropriate concerns about justice and equality in the market for babies. Part III continues the exploration of justice by investigating the question of international cooperation in legislating against perceived wrongs. This Part concludes that consistent legislation across borders is appropriate where there is consensus about the wrong of an act, but it is unnecessary and inappropriate where there remain cultural conflicts about certain practices—in this case assisted reproduction.

与其他类型的医疗旅游一样,跨境生育护理(CBFC)现象引发了人们对生育行业监管缺乏全球甚至国家协调的担忧。世界各地法律的多样性导致准父母们去论坛购物,寻找一个受欢迎的地方生孩子。本文特别关注到美国旅行的现象,讨论了是否应该对那些来美国寻求CBFC的人设置任何法律障碍的问题。在某种程度上,CBFC受到了人们对使用生育治疗的普遍担忧,但可以想象,有一些争论会导致禁止或至少是劝阻人们来美国进行CBFC,无论是作为法律问题还是作为政策问题。本文反对任何此类努力,并考虑了CBFC的道德和伦理问题,以及这些问题如何以及是否需要在法律上表达。第一部分描述了导致一些夫妇和个人离开自己的国家到国外接受生育治疗的条件,并详细说明了为什么对抗逆转录病毒治疗的监管相对宽松的美国成为世界各地旅行者的热门CBFC目的地。第二部分通过重申生育权利的重要性,同时指出对婴儿市场的正义和平等的适当关注,提出并驳斥了支持对那些在美国寻求满足CBFC欲望的人进行更大的国内控制的论点。第三部分继续探讨正义,调查国际合作的问题,以立法反对所察觉的错误。这一部分的结论是,在人们对某种行为的错误达成共识的情况下,跨国界的一致立法是合适的,但在某些做法——在这种情况下是辅助生殖——仍然存在文化冲突的情况下,跨国界的一致立法是不必要和不合适的。
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引用次数: 0
Torture, Impunity, and the Need for Independent Prosecutorial Oversight of the Executive Branch 酷刑、有罪不罚以及对行政部门进行独立检察监督的必要性
Q2 Social Sciences Pub Date : 2011-01-24 DOI: 10.31228/osf.io/v3rb5
F. Quigley
Allegations of Executive Branch misconduct present an inherent conflict of interest because prosecutorial discretion is invested in a U.S. Attorney General appointed by – and serving at the pleasure of – the President. Various commentators, including Justice Antonin Scalia, Professor Stephen Carter, and the many critics of the former independent counsel statute have posited that checks on executive power provided by the Legislative Branch, the Judiciary, and political pressure will overcome any potential conflicts of interest. This sanguine view of adequate Executive Branch oversight was put to the test when high-level members of the George W. Bush Administration authorized acts of torture. After widespread public disapproval, Congress and the courts responded with efforts to rein in the Administration’s actions. However, the Department of Justice under the Bush Administration not only refused to investigate and prosecute allegations of sanctioning torture, but its attorneys also led the efforts to overcome congressional, judicial, and popular resistance to the Executive Branch conduct – and did so while explicitly acknowledging that the Executive Branch could expect little or no judicial oversight for its actions. Ultimately, the President who sanctioned torture left office, and the voters elected a President who expressed sharply different views on torture. However, the subsequent Administration of President Barack Obama, although affiliated with a different party and on record as opposed to acts of torture sponsored by the previous Administration, has also declined to pursue prosecution of high-level members of the Bush Administration. This most recent development shows that the conflict of interest presented by presidential control over Executive Branch prosecution transcends predictable concerns of self-preservation. The conflict of interest also highlights the natural desire of a sitting President to avoid prosecutions of previous executive officials when such prosecutions would consume political capital needed for the President’s broader legislative and foreign policy agendas. When it comes to controlling Executive Branch criminal conduct, the current structure designed to provide checks and balances comes up empty and thus must be reformed. The most direct and effective reform would be the direct election of the U.S. Attorney General. Even less precise remedies, such as a revived and improved independent counsel or Congress enacting provisions to break up the current monopoly over Executive Branch prosecution, would be significant improvements over the current system, which mocks the principle of equal justice for all.
对行政部门不当行为的指控存在固有的利益冲突,因为检察官的自由裁量权投资于由总统任命并为总统服务的美国司法部长。包括大法官安东宁·斯卡利亚(Antonin Scalia)、斯蒂芬·卡特(Stephen Carter)教授和前独立检察官法规的许多批评者在内的各种评论员都认为,立法部门、司法部门和政治压力对行政权力的制约将克服任何潜在的利益冲突。当乔治·w·布什(George W. Bush)政府的高层成员授权实施酷刑时,这种对行政部门充分监督的乐观看法受到了考验。在公众普遍反对之后,国会和法院做出回应,努力控制政府的行动。然而,布什政府时期的司法部不仅拒绝调查和起诉批准酷刑的指控,而且其律师还带头努力克服国会、司法部门和民众对行政部门行为的抵制——而且在这样做的同时,明确承认行政部门的行为很少或根本不会受到司法监督。最终,批准酷刑的总统离职了,选民选出了一位对酷刑表达截然不同观点的总统。然而,后来的奥巴马政府虽然隶属于另一个政党,并且公开反对前任政府支持的酷刑行为,但也拒绝起诉布什政府的高级官员。最近的事态发展表明,总统对行政部门起诉的控制所带来的利益冲突超出了可预见的自我保护问题。利益冲突也凸显了现任总统避免起诉前任行政官员的自然愿望,因为这种起诉会消耗总统更广泛的立法和外交政策议程所需的政治资本。在控制行政部门的犯罪行为方面,目前旨在提供制衡的结构是空洞的,因此必须进行改革。最直接和有效的改革将是美国司法部长的直接选举。即使是不那么精确的补救措施,如恢复和改进独立检察官或国会颁布条款打破目前对行政部门起诉的垄断,也将是对现行制度的重大改进,因为现行制度嘲弄了人人享有平等司法的原则。
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引用次数: 0
Hormone therapy for inmates: a metonym for transgender rights. 囚犯激素治疗:变性人权利的代名词。
Q2 Social Sciences Pub Date : 2011-01-01
Silpa Maruri

The issue of hormone therapy for transgender inmates, while seemingly limited in importance, is one that involves issues of greater importance for the transgender community. The greatest issue at the heart of the matter is the legal argument that is traditionally used to gain access to hormone therapy: the Eighth Amendment. The Eighth Amendment prohibits deliberate indifference to the medical needs of inmates. Traditionally, transgender inmates have gained access to hormone therapy by appealing to the DSM-IV's classification of Gender Identity Disorder (GID) as a mental illness, and by establishing that prison officials' failure to provide hormone therapy constitutes deliberate indifference to a serious medical need. However, appeal to GID is a double-edged sword: while it allows access to hormone therapy, it does so by describing transgender individuals as somehow sick or infirm. This description is at odds with the transgender community's conceptualization of itself. This Note seeks to square the legal arguments for provision of hormone therapy to transgender inmates with the philosophical backdrop that shapes the transgender rights movement by using Plyler v. Doe as a model. This Note argues that access to hormone therapy by transgender inmates involves the intersection of a quasi-fundamental right with a quasi-suspect class. By utilizing such an argument, the transgender community is not bound by the negative expressive effect that the law may have in describing it as infirm or deficient.

对跨性别囚犯进行激素治疗的问题,虽然看起来重要性有限,但对跨性别群体来说,却是一个更重要的问题。这个问题的核心最大问题是传统上用于获得激素治疗的法律论据:第八修正案。第八修正案禁止故意漠视囚犯的医疗需求。传统上,变性囚犯通过诉诸DSM-IV将性别认同障碍(GID)分类为精神疾病,并确立监狱官员未能提供激素治疗构成对严重医疗需求的故意漠不关心,来获得激素治疗。然而,对性别认知障碍的诉求是一把双刃剑:虽然它允许人们接受激素治疗,但却把跨性别者描述成某种程度上有病或体弱多病的人。这种描述与跨性别群体对自身的概念不一致。本文试图以普莱勒诉多伊案为例,将为跨性别囚犯提供激素治疗的法律论据与塑造跨性别权利运动的哲学背景结合起来。本报告认为,变性囚犯获得激素治疗涉及准基本权利与准嫌疑人阶层的交集。通过利用这样的论据,跨性别群体不受法律描述其软弱或有缺陷时可能产生的负面表达效果的约束。
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引用次数: 0
Refractory pain, existential suffering, and palliative care: releasing an unbearable lightness of being. 难以忍受的疼痛,存在的痛苦,以及缓和的治疗:释放无法承受的生命之轻。
Q2 Social Sciences Pub Date : 2011-01-01
George P Smith

Since the beginning of the hospice movement in 1967, "total pain management" has been the declared goal of hospice care. Palliating the whole person's physical, psychosocial, and spiritual states or conditions is central to managing the pain that induces suffering. At the end-stage of life, an inextricable component of the ethics of adjusted care requires recognition of a fundamental right to avoid cruel and unusual suffering from terminal illness. This Article urges wider consideration and use of terminal sedation, or sedation until death, as an efficacious palliative treatment and as a reasonable medical procedure in order to safeguard the "right" to a dignified death. Once the state establishes a human right to avoid refractory pain of whatever nature in end-stage illness, a coordinate responsibility must be assumed by health care providers to make medical judgments consistent with preserving the best interests of a patient's quality of life by alleviating suffering. The principle of medical futility is the preferred construct for implementing this professional responsibility. Rather than continue to be mired in the vexatious quagmire of the doctrine of double effect--all in an effort to "test" whether end-stage decisions by health care providers are licit or illicit--a relatively simple test of proportionality, or cost-benefit analysis, is proffered. Imbedded, necessarily, in this equation is the humane virtue of compassion, charity, mercy or agape. Assertions of state interest in safeguarding public morality by restricting intimate associational freedoms to accelerate death in a terminal illness are suspicious, if, indeed, not invalid. No terminally ill individual suffering from either intractable somatic or non-somatic pain, or both, should be forced to continue living.

自1967年临终关怀运动开始以来,“全面疼痛管理”一直是临终关怀的目标。缓和整个人的身体、社会心理和精神状态或条件是控制引起痛苦的疼痛的核心。在生命的最后阶段,调整护理伦理的一个不可分割的组成部分要求承认避免因绝症而遭受残酷和不寻常痛苦的基本权利。本文敦促更广泛地考虑和使用临终镇静或镇静至死,作为一种有效的姑息治疗和合理的医疗程序,以保障有尊严死亡的"权利"。一旦国家确立了在终末期疾病中避免任何性质的难治性疼痛的人权,卫生保健提供者就必须承担协调责任,作出符合通过减轻痛苦来维护病人生活质量的最佳利益的医疗判断。医疗无效原则是实现这一职业责任的首选结构。与其继续陷入双重效应理论的恼人泥潭——所有这些都是为了“检验”医疗服务提供者在最后阶段做出的决定是合法还是非法——倒不如提供一种相对简单的比例性检验,或成本效益分析。在这个等式中必然包含着同情、慈善、仁慈或爱的人性美德。通过限制亲密的结社自由来加速绝症患者的死亡,从而维护公共道德的国家利益的主张,即使不是无效的,也是值得怀疑的。任何身患绝症的人,无论是顽固性躯体疼痛还是非躯体疼痛,或者两者兼而有之,都不应该被强迫继续生活下去。
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引用次数: 0
期刊
Cornell Journal of Law and Public Policy
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