Journal of Law Medicine & Ethics最新文献

Major shifts underway in US vaccine policies reflect widespread misinformation, notably including unproven claims of harms from vaccines. Vaccination misconceptions also include an array of falsities about the scope and extent of governmental powers and protections. Exposing these "legal myths" clarifies existing foundations of vaccine laws and policies, providing guidance on appropriate responses to quell vaccine hesitancy.

This article explores CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, as a model collaboration between attorneys, public health groups and city leaders that advances a package of 12 evidence-based policies addressing key social determinants of health and centering equity.

Psychedelic medicines hold the promise of therapeutic benefit for many suffering from serious unmet mental health needs, leading to substantial demand even before these drugs receive FDA approval based on demonstrated safety and effectiveness for particular conditions. Recognizing FDA approval as the ideal path for psychedelics intended for medical use and drawing on lessons from medical marijuana, we encourage policymakers to balance the need for evidence, the importance of patient safeguards, and the desire for speed. They should increase support for psychedelic research, reject approaches that could inhibit that research, explore improvements to FDA's existing pre-approval access pathway, and avoid politically motivated FDA approval of psychedelic medicines.

Dignity has been a notoriously elusive concept to philosophers. Nevertheless, in the realms of politics, law, and policymaking, appeals to dignity are frequent, and do not always align with the understandings most commonly endorsed by the philosophical literature. This paper considers how "dignity" is frequently appealed to in ethical arguments about the permissibility of abortion, and argues that the judicial decisions related to reproductive and LGBTQ+ rights over the past 30 years in the United States offer deep insights into the nature of "dignity" that philosophers and other theorists ought to pay attention to. These insights not only have profound implications for our understanding of the nature of "dignity," but also for ethical analysis more broadly.

Employers purchase health benefits for more than 60% of the nonelderly population, making employers both important custodians of employee well-being and important actors in the health care ecosystem. Because employers typically have unilateral control over health and retirement benefits, the federal Employee Retirement Income Security Act (ERISA), enacted in 1974, imposes fiduciary obligations on employers when they manage or administer benefits. We provide evidence, from a novel survey of respondents who administer or oversee health benefits for their companies, that many employers appear to neglect even the most basic of their fiduciary obligations to their employees. This neglect may help explain the poor performance of employer plans in controlling costs and providing access to health care, and it suggests that many employers may be vulnerable to liability from ERISA lawsuits.

Psychedelic treatment with psilocybin is receiving increased attention following clinical trials showing it may help treat end-of-life anxiety, depression, and several other conditions. Despite this, physicians may be reluctant to prescribe psilocybin and carry out psilocybin treatment because of the stigma surrounding psychedelics and the potential for medical malpractice liability. This paper explores whether psilocybin treatment gives rise to a risk of medical malpractice liability for physicians. Following an overview of psilocybin treatment and its regulatory regime in Canada, exploratory vignettes are used to highlight the relevance and limits of malpractice claims. This paper argues that the lack of established medical standards, standardized training, and credentialing contribute to liability risks surrounding psilocybin treatment. More clinical trials, meta-studies of research analyses, and knowledge sharing will help to develop training programs and medical standards of practice to better realize psilocybin's potential.

In his widely anthologized article on the therapy-enhancement distinction, Resnik argues that, from a moral point of view, the claim that something is not health related cannot be a dispositive argument against the permissibility of enhancements. He further states how the permissibility of an intervention will depend on considerations like the intention for its use and the likely consequences that will ensue, and whether these violate any moral standards. Within this framework, in this paper I first argue that enhancements may be morally permissible on autonomy grounds (its political conception); and secondly, that this permissibility does not dissolve a moral distinction between therapies and enhancements, with the reason being that there is still a difference between something being generally permissible (i.e., therapies) and something being conditionally permissible (i.e., enhancements). But that is not all that is important for a moral therapy-enhancement distinction. I also argue that the distinction - apart from being about "permissibility" (at the level of regulation of individual use) - is also about regarding justice more broadly (at the level of what is owed to individuals). What captures the moral distinction more fully is that therapies are, generally speaking, not only morally permissible but also owed to persons (due to being enablers of social cooperation and competition), whereas, at this stage, enhancements can only be morally permissible. I demonstrate the appeal of this view by considering its stability and usefulness across specialized bioethical contexts and across various kinds of enhancements and show that its practical value for policy lies in its legitimizing / anticipatory and prioritizing functions.

Recognizing the increased demand for public health law skills within the public health workforce, ChangeLab Solutions, in collaboration with the Centers for Disease Control and Prevention, conducted a pilot program to increase knowledge of law among public health students. In partnership with a team of curriculum consultants, ChangeLab Solutions developed and piloted a curriculum across eight public health programs that consisted of six modules which focused on defining public health law and explaining its role in shaping health outcomes and inequities. Faculty members that piloted the modules found students had an increased knowledge of public health law concepts after completing the modules. Faculty members also experienced several barriers that might hinder effective delivery of the curriculum. Integration of public health law concepts into public health coursework within SPPH is one method of increasing students' preparedness and capacity to use legal tools in addressing health outcomes and inequities.

Hot tap water is the most common source of scald injuries, representing a quarter of all scald injuries requiring hospitalization in the United States. Children and older adults are at increased risk of scald burns. Evidence suggests that poor knowledge of burn risks and treatment among parents and the public may contribute to the burden of scald injuries in children. Medical and injury surveillance categorizes most scald burns as unintentional injuries. However, scald burns can also lead to investigation by the justice system if the injury is suspected to result from abuse or neglect. The Department of Justice recommends assessing criminal intent in childhood scald burns based on traditional indicators derived from medical research: burn uniformity, areas of sparing, burn locations, family history, and speed of medical care. In this study, we present an overview of the existing literature on intentional scald burns in children caused by hot tap water in order to improve their identification and prevention. This systematic review aims to answer two questions: (1) What are the indicators of intentional scald burns in children according to the literature and (2) Is the body of evidence for common indicators of intentional scald burns subject to bias?

We report on an experience with impostor research participants, people who misrepresent themselves, and identify characteristics that can be used by investigators to screen out such participants. We compare the responses of impostor and valid participants, showing that impostors meaningfully change qualitative study findings with implications for policy interventions or follow-on research informed by the study. It is important for investigators to be alert to the potential for impostor participants and plan their research accordingly.