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Damage Control Interdisciplinarity: An Antidote to Death Despair in Military Medicine
Get PDF“Diseases of despair” is a conceptually broad category used to describe the phenomenon of premature mortality caused by suicide, drug poisoning, and alcoholic liver disease. Central to this conceptualization of mortality is that death occurs too early in an entire population of individuals infected with social despair. Implicit in the diseases of despair construct is a powerful normative claim about the manner and time of death—that death is bad if it is contextualized in unwanted conditions and happens before reaching midlife. As such, diseases of despair ought to be reduced, if not eliminated. Interestingly, military medical research on combat casualties abides by a comparable normative understanding of mortality—that combat provides a less than optimal context in which to die and that those who die on the battlefield do so too young. In response to this implicit normative ideal, military medical research and practice have made major strides in developing effective life-saving interventions in the past twenty years. Service members’ lives are saved after catastrophic injury due to advances in the combat damage control medical paradigm. The achievements of this paradigm are enshrined in an overall ninety-two percent survival rate for service members injured in Iraq and Afghanistan and have initiated interest in achieving zero preventable deaths after catastrophic injury in both military and civilian medicine. While medical achievements in Iraq and Afghanistan are laudable, primarily focusing on achieving zero preventable combat deaths constructs a military-medical culture wherein the despair of death is implicitly woven into military health policy, training, and organizational culture. This article will explore the complex challenge of addressing death despair in combat casualty management. I develop a modest argument suggesting that to effectively shift expectations relative to death and dying in casualty management, the Defense Health Agency needs to support interdisciplinary research that focuses on strategic second-order organizational change before developing health policy and medical training in preparation for future large-scale combat operations. In specific, I suggest that this interdisciplinary team needs to be led by academic experts in anthropology, history, and political science in collaboration with military medical and strategic experts
Smoke Screens: An Initial Analysis of the Coronavirus Lawsuits in the United States Against China and the World Health Organization
Get PDFIn this short essay we provide a preliminary analysis of the lawsuits filed by Missouri against China, and New York against the World Health Organization over the COVID-19 pandemic. We also situate the lawsuits against the expanding coronavirus-related misinformation “epidemic.
Medicaid\u27s Vital Role in Addressing Health and Economic Emergencies
Get PDFMedicaid plays an essential role in helping states respond to crises. Medicaid guarantees federal matching funds to states, which helps with unanticipated costs associated with public health emergencies, like COVID-19, and increases in enrollment that inevitably occur during times of economic downturn. Medicaid’s joint federal/state structure, called cooperative federalism, gives states significant flexibility within federal rules that allows states to streamline eligibility and expand benefits, which is especially important during emergencies. Federal emergency declarations give the secretary of Health and Human Services temporary authority to exercise regulatory flexibility to ensure that sufficient health care is available to meet the needs of those impacted. Under federal guidance, states have implemented a variety of options to respond to the COVID-19 pandemic. In addition, Congress enacted short-term legislative responses that increase federal funding for Medicaid and open new pathways for eligibility and payment for some COVID-19 testing. These responses have softened the double blow of the pandemic and its attendant recession, but more federal and state action is necessary. Congress should enact an increase in federal funding that lasts beyond the public health emergency to help states ride out the economic impact of the pandemic; provide extra funding to encourage states to adopt Medicaid expansion; offer states more funding for enrollment efforts to reach newly uninsured populations; and require state and local demographic data collection as a condition of federal funding to inform evidence-based public health efforts. State governments should use all available emergency flexibility options to streamline application and enrollment processes and take advantage of increased federal funding possibilities.This paper was prepared as part of Assessing Legal Responses to COVID-19, a comprehensive report published by Public Health Law Watch in partnership with the de Beaumont Foundation and the American Public Health Association
Co-Worker Evidence in Court
Get PDFThis symposium explores ways to empower workers. Many employment laws rely on workers filing private rights of action to enforce the underlying substantive law. Unfortunately, when workers file these claims in court, courts often do not allow them to rely on evidence from their co-workers. While courts regularly allow employers to submit co-worker evidence of a plaintiff’s poor performance or lack of qualifications, they often diminish or exclude a plaintiff’s co-worker evidence that the plaintiff performed well or possessed desired qualifications. This Article identifies and explores this evidentiary inequality. It argues that efforts to empower workers must include the power to support one another in litigation and that courts should be careful about rejecting plaintiffs’ co-worker evidence, while relying on similar evidence offered by employers
Exploring Sectoral Solutions for Digital Workers: The Status of the Artist Act Approach
Get PDFDigital workers have not had significant success in securing conventional forms of collective workplace representation, particularly statutory collective bargaining. This article examines an established sectoral bargaining statute, the Status of the Artist Act (SOA), as a possible model for collective bargaining legislation that is better suited to regulate digital work than the Wagner Act model (WAM) of labor legislation. Key features of the WAM labor legislation pose significant barriers for digital worker organizing. These include requirements to: demonstrate employee status, accurately estimate the number of employees in the proposed used, the requirement to demonstrate sufficient support. The WAM is oriented towards single-employer, single location, enterprise-level bargaining units. This is ill-suited to the organization of digital work. Recent certification cases involving Uber, Lyft, and Foodora illustrate the difficulties of these WAM features for digital worker organizing. The SOA, applicable to self-employed professional artists, shares much of the WAM framerk, but it departs from the WAM in crucial ways designed to overcome collective bargaining barriers for the arts sector. Key differences include: no requirement for workers to establish employee status; a broader approach to appropriateness relieves against fragmented, small, units characteristic of the WAM; a “most representative” standard instead of majority support means certification does not turn on the applicant’s ability to accurately determine the number of workers in the proposed unit; limited challenges to representativeness; and, collective agreements provide a minimum floor, facilitating representation of heterogeneous workers in a unit. Organization of work and workers in the digital work and arts sectors share important similarities including the “gig” nature of the work and the geographic dispersion of workers. This article suggests that the structural similarities between digital and arts work, reflected in the SOA framework, offer guidance for a more effective statutory collective bargaining system for digital workers
The Bar Exam and the COVID-19 Pandemic: The Need for Immediate Action
Get PDFThe novel coronavirus COVID-19 has profoundly disrupted life in the United States. Among other challenges, jurisdictions are unlikely to be able to administer the July 2020 bar exam in the usual manner. It is essential, however, to continue licensing new lawyers. Those lawyers are necessary to meet current needs in the legal system. Equally important, the demand for legal services will skyrocket during and after this pandemic. We cannot close doors to the profession at a time when client demand will reach an all-time high.
In this brief policy paper, we outline six licensing options for jurisdictions to consider for the Class of 2020. Circumstances will vary from jurisdiction to jurisdiction, but we hope that these options will help courts and regulators make this complex decision. These are unprecedented times: We must work together to ensure we do not leave the talented members of Class of 2020 on the sidelines when we need every qualified professional on the field to keep our justice system moving
Ensuring the Reproductive Rights of Women with Intellectual Disability
Get PDFBackground: Women with intellectual disability experience disparities in sexual and reproductive health care services.Methods: To explore perceptions of caring for persons with disability, including individuals with intellectual disability, we conducted open-ended individual interviews with 20 practising physicians and three video-based focus group interviews with an additional 22 practising physicians, which reached data saturation. Interviews were transcribed verbatim. We used conventional content analysis methods to analyse transcripts.Result: Physicians indicated that intellectual disability can pose challenges to providing sexual and reproductive health care. Observations coalesced around four themes: (1) communication; (2) routine preventive care; (3) contraception and sterilisation; and (4) conception and parenthood. Observations raised concerns about equity of access to reproductive care for women with intellectual disability.Conclusions: In our sample of physicians, we found attitudes that might compromise reproductive care for women with intellectual disability, suggesting that gaps remain in ensuring reproductive rights of women with intellectual disability
Why the Government Shouldn\u27t Pay People to Get Vaccinated Against COVID-19
Get PDFAs several pharmaceutical companies approach the Food and Drug Administration (FDA) seeking authorization to bring COVID-19 vaccines to market, concerns about vaccine mistrust cloud the prospects of imminent vaccination efforts across the globe. These concerns have prompted some commentators to suggest that governments may nudge vaccine uptake by paying people to get vaccinated against COVID-19. This post argues that, even if potentially viable, this idea is undesirable against the backdrop of a pandemic marked by the intertwined phenomena of health misinformation and mistrust in public health authorities. Even beyond the context of COVID-19, paying for vaccination is likely to remain dubious public health policy likely to backfire in terms of (re)building public trust in vaccines