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COVID-19, Doctors, and the “Realities of Prison Administration” Part I: The Realities of a Subject Matter Expert
Get PDFCOVID-19 is still novel. As scientists continue racing to characterize the virus and its mutations, promote behavioral change, and optimize treatment and vaccination strategies, public policy makers shift their attention from one high priority population to the next. These spotlights have converged on one truism of the pandemic: COVID-19 infection, and all its sequelae, have magnified long-established social and structural inequities in U.S. institutions—including practices in jails, prisons, and detention facilities. While these facilities were recognized as early incubators of the virus, the response of the facility administrators and local leaders were at best uneven and at worst nonexistent. When lawsuits began rolling out and judges wanted to learn what was going on inside these population black boxes, they called on subject matter experts. This Article is an account of one subject matter expert’s travels, inspections, declarations, and virtual hearings during the first chaotic months of the pandemic. The author recounts his wildly diverse reception as an expert in jails and courtrooms from Detroit to East Baton Rouge. At times, expertise was recognized and honored; at other times, expertise was toyed with and dismissed. The Article concludes with suggesting that not only are U.S. court proceedings typically not a good fit for expert testimony, but courts are also not designed to recognize or promote health policy or even prohibit cruel and unusual punishment. Our elected officials in the legislative and executive branches need to honor their responsibilities for the health and well-being of all of their constituents—even those behind bars
Examining Sociodemographic Data Reporting Requirements in State Disease Surveillance Systems
Get PDFLaw plays an important role in the collection of data related to disease and injury in a population. A robust system of laws sets out requirements for the collection, analysis, and dissemination of disease reporting data from local, state, territorial, and federal public health institutions. Occurrence of disease, including outbreaks of novel infectious agents like coronaviruses, influenza viruses, and others that have arisen in recent years, often require epidemiologists and others to understand not only the etiology and specific context of diseases and conditions, but also the trajectory of their spread among and across communities. Capturing sociodemographic data is critical to identifying the disproportionate impacts of diseases and conditions on diverse populations and determining an appropriate public health response. This Article discusses a legal epidemiological scan of state disease reporting laws that require the capture and reporting of sociodemographic information. Analyzing these state laws can serve as a potential starting point to assist in understanding why gaps in data exist and can help address these challenges in anticipation of future disease outbreaks or spread
Balancing Public Health and Privacy: Lessons from Digital Contact Tracing for COVID-19 Vaccination Tracking Efforts
Get PDFThe COVID-19 pandemic has brough the tension between individual privacy and public health initiative to the fore, in part because many of the solutions to the challenges of the pandemic proposed are digital. The first year of the pandemic has revealed that the Health Insurance Portability and Accountability Act is both too restrictive of traditional public health activities but also underprotective of important categories of health data. The failure of digital contact tracing applications to make a difference in combatting the pandemic during its early stages also illustrates the tension between individual privacy and public health surveillance. In order to harness the power of digital health to combat COVID-19 and other public health crises, we must resolve this tension through building trust in digital public health and modernizing our health data privacy regulation
“Under the Guise of Public Health:” The Biden Administration and Title 42
Get PDFIn March 2020, the Trump Administration set forth a policy, now known as Title 42, which closed U.S. borders and allows government officials to immediately expel migrants—including asylum seekers—citing public health concerns in light of the COVID-19 pandemic. Still in effect today, Title 42 has faced criticism from legal experts and health experts alike, who claim the policy directly conflicts with asylum laws and has little basis in public health. In this article, Casey Plach explores this criticism and critiques the Biden Administration’s continued use of Title 42.https://scholarship.law.slu.edu/lawjournalonline/1081/thumbnail.jp
Systemic Racism, the Government’s Pandemic Response, and Racial Inequities in COVID-19
Get PDFDuring the COVID-19 pandemic, the federal and state governments have ignored racial and ethnic minorities’ unequal access to employment and health care that results in racial inequities in COVID-19 infections and deaths. In addition, they have enacted laws that further exacerbate these inequities. Consequently, many racial and ethnic minorities are employed in low-wage essential jobs that lack paid sick leave and health insurance. This lack of benefits causes them to go to work even when they are sick and prevents them from receiving appropriate medical treatment. As a result, racial and ethnic minorities have disproportionately been infected and died from COVID-19. Although these actions seem race “neutral,” they exemplify systemic racism. Racial and ethnic minorities are deemed inferior to white people, and thus they do not receive the same access to resources, such as employment and health care. This essay illustrates how systemic racism has resulted in racial inequities in COVID-19 infections and deaths through case studies in employment and health care. Using the health justice framework, it concludes with suggestions to eradicate systemic racism, redress harm, and engage community in implementing an equitable pandemic response
Missouri’s Chance at Low-Cost Renewable Energy ‘Gone with the Wind’?
Get PDFThe Grain Belt Express, a large-scale wind energy transmission line that will span across much of the Midwest, may now be blocked from proceeding in Missouri if House Bill 527 passes in the state Senate. In this article, Jeff Becker advocates against the passage of the bill, arguing that it is contrary to the state\u27s public interest because it would deprive Missourians of the substantial benefits the project, both economic and environmental.https://scholarship.law.slu.edu/lawjournalonline/1060/thumbnail.jp
Diversity from the Perspective of Corporate Boards and Lawyer Disciplinary Boards
Get PDFThis Article addresses the organizing question of this symposium—whether diversifying state medical boards (SMBs) would improve their effectiveness in disciplining doctors—by drawing on the comparable experiences of corporate boards of directors and lawyer disciplinary boards. Reexamining our own qualitative study of corporate board diversity conducted several years ago, we find that almost of all of the arguments for board diversity raised in the business literature or our own interviews also tend to support diversity on SMBs. Reviewing the legal profession’s experience with the diversity question on lawyer disciplinary boards, we find that many of these arguments have also been recognized, at least implicitly, by state bars and are embodied in the legal profession’s initiatives to improve diversity in its disciplinary processes. Based on these two sources of evidence, our recommendation is that SMBs should continue and strengthen their efforts to pursue diversity. Specifically, we recommend that each board publish its demographic diversity targets along with an annual report on a standard form reporting the board’s diversity compared to those targets and an explanation whenever a diversity target is not achieved. Energizing external actors like medical professional associations to support and advocate for SMB diversity efforts may also be helpful along with considering how to make SMB service more attractive to potential diverse members
Contextualizing and Strengthening State Medical Board Responses to Physician Sexual Misconduct
Get PDFAs the instrument through which states regulate the professional conduct of medical practitioners, state medical boards play a critical role in addressing physician sexual misconduct. Sexual misconduct in the medical profession is particularly troubling given that physicians are often privy to the most intimate aspects of their patients’ lives. Patients place a profound trust in their physician, and the resulting relational dynamic may impact how a patient perceives or reacts to a physician’s conduct. State medical boards are often criticized for failing to respond appropriately to instances of sexual misconduct. However, some of these criticisms fail to consider historical attempts by these boards to address this issue; they particularly fail to recognize that medical boards are just as proactive as other professional organizations in addressing and sanctioning sexual misconduct. Criticisms also fail to fully appreciate the impact of the complaint-based structure of state medical regulatory law, the lack of information sharing between other stakeholders in health care and state medical boards, and structural and legal constraints that impact the ability of state boards to investigate accusations of misconduct and discipline licensees accordingly. In sum, most critiques of state board actions in legal literature fail to properly contextualize state board responses and thus present solutions that miss the mark. The purpose of this paper is to contextualize the responses of state medical boards and highlight the efforts that have already been made by individual medical boards and the Federation of State Medical Boards (FSMB) to address sexual misconduct. Particular focus will be given to the FSMB’s Workgroup on Physician Sexual Misconduct and the 2020 FSMB Report on Physician Sexual Misconduct (FSMB Report). The FSMB Report illustrates the barriers that prevent medical boards from responding more robustly to reports of sexual misconduct. It also provides recommendations in furtherance of the FSMB’s effort to improve identification of improper physician behaviors. The proactive efforts of the FSMB to address sexual misconduct serve as a critical foundation for more expansive collaborative efforts across health care to eradicate sexual harassment, abuse, and other forms of misconduct
Human Rights and Disinformation Under the Trump Administration: The Commission on Unalienable Rights
Get PDFThe former administration of Donald J. Trump shattered norms governing the responsibility to relay accurate, truthful information to the public. Whether regarding trivialities or vital issues of the day, the “Trump Doctrine” unleashed a global torrent of damaging misinformation and disinformation. This penchant for falsehood and distortion did not spare U.S. human rights policy. The administration’s decision to establish a Commission on Unalienable Rights (COUR) represented a high-water mark in its campaign to subvert international human rights norms.
After introducing key concepts relating to misinformation and disinformation, this article reviews the establishment of the COUR and the substance of its final report. Among other things, the COUR report prioritizes “unalienable rights” while dismissing other “lesser” or “newer” rights intended to protect vulnerable groups. Coupled with this hierarchical framing, the report aspires to freeze the substance of human rights as it was in 1948 and to invoke state sovereignty as a legitimate shield against international scrutiny of domestic human rights conditions.
With this background established, the Article explores how the COUR’s disinformation assault on the common political knowledge shared by democratic states operated to disrupt shared values while empowering authoritarian and illiberal actors. More damaging, this section also demonstrates how the administration compounded this disinformation fissure through its subsequent advocacy of selective elements of the COUR report for the purpose of prioritizing “religious liberty” at the expense of other rights, as well as the United States’ longstanding democratic alliances.
The final section of this Article reasons that restoration of the United States’ vital leadership role in the international community is contingent on repairing its commitment to the promotion and protection of human rights both at home and abroad. Despite the Biden administration’s swift, if perfunctory, repudiation of the COUR project, the Article concludes that an effective and durable rebuttal of its pernicious and lingering disinformation will demand more significant policy and educational change
Manipulating Disclosure: Creative Compliance in the Israeli Food Industry
Get PDFFront-of-package food labels meant to inform consumers of the food’s nutritional values through simple and easy-to-comprehend graphic rating and warning systems are gaining increasing popularity in regulatory spheres. Around the world, health regulators have adopted front-of-package disclosure systems based on infographics, symbols, logos, colors, numbers, and letters, via both mandatory and voluntary schemes, while others, such as the U.S. Food and Drug Administration (“FDA”), are considering adopting them. The recent Israeli food-labeling reform reveals consumer misinformation tactics deployed by food companies through various graphic manipulations that can be regarded as “creative compliance.” Adding to the policy and theory of disclosure regulation, this Article discusses the misinformation effect of graphic disclosure and suggests soft law tools for combating this regulatory failure, such as regulatory shaming and voluntary regulatory agreements