Shavelson and colleagues (2023) describe how medical aid-in-dying laws in the United States prohibit assistance in administering aid-in-dying medication. This prohibition distinguishes aid in dying...

Persons with dementia often prefer to participate in decisions about their health care, but may be prevented from doing so because healthcare decision-making law facilitates use of advance directives or surrogate decision makers for persons with decisional impairments such as dementia. Federal and state disability law provide alternative decision-making models that do not prevent persons with mild to moderate dementia from making their own healthcare decisions at the time the decision needs to be made. In order to better promote autonomy (...) and wellbeing, persons with dementia should be accommodated and supported so they can make their own healthcare decisions. (shrink)

During the final months of Sri Lanka's 2006–2009 civil war, Sri Lankan armed forces engaged in a disproportionate and indiscriminate shelling campaign against the Liberation Tigers of Tamil Eelam, which culminated in the deaths of tens of thousands of civilians. Conventional wisdom suggests that Sri Lanka undermined international humanitarian law. Significantly, however, the Sri Lankan government did not directly challenge such law or attempt to justify its departure from it. Rather, it invented a new set of facts about its conduct (...) to sidestep its legal obligations. Though indirect, this challenge was no less significant than had Sri Lanka explicitly rejected those obligations. Drawing on Clark et al.'s concept of denialism, this article details the nature of Sri Lanka's challenge to the standing of IHL. At the core of its denialist move, Sri Lanka maintained that while the LTTE was using civilians as human shields, government forces were adhering to a zero civilian casualty approach. With this claim, Sri Lanka absolved itself of any responsibility for the toll inflicted on civilians and sealed its conduct off from the ambit of IHL. This case illustrates how actors can considerably undermine the law using strategies of contestation far more subtle than direct confrontation. (shrink)

Pullman (2023) compares medically-assisted dying (MAiD) laws and rates of medically-assisted deaths in Canada and California, noting some differences in the legal regime and a higher rate of MAiD i...

In early 2013, the Indian government introduced new rules governing the conduct of clinical trials involving human participants. Among other provisions, the law requires that sponsors of research compensate participants who are injured during the course of their research participation. This article examines the effects of India's compensation law and the efforts that policymakers in India have made to tailor the law since its passage. I use the legal concept of acoustic separation as a framework to explain and justify the (...) approach that India has taken in refining its regulation of research related injuries. I conclude that India's example may provide useful lessons for research sponsors and lawmakers in other regulatory states seeking to promote a well-regulated biomedical research industry. (shrink)

Dynamic Consent is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health (...) information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people.In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation. (shrink)

This Paper argues that to protect at-risk communities — and all Americans — from the deadly effects of environmental racism, Congress must pass the Environmental Justice for All Act. The Act is intended to “restore, reaffirm, and reconcile environmental justice and civil rights.” It does so by restoring an individual’s right to sue in federal court for discrimination based on race, ethnicity, or national origin regardless of intent under the Civil Rights Act of 1964, strengthening the National Environmental Policy Act, (...) and providing economic incentives focused on environmental justice. (shrink)

It would be difficult to find a major figure in the history of European political thought who would not have attempted to say something about how authority emerges, or is justified and critiqued, in the world beyond the single polity. Quite frequently, that effort would have involved some idea about a legal order, or at least a set of rules or regularities applicable in that world. Thomas Hobbes was neither the first nor the last major thinker who believed that the (...) 'international' realm was characterised by the independence of states existing 'in the state and posture of gladiators', thus apparently denying that legal rules or practices or legal thinking could have much relevance therein. Yet others believed, as Immanuel Kant did, that without a constitutional vocabulary not much that was meaningful could be said about the human pursuit of freedom, and that silence about the latter would not only constitute a moral failure but an intellectual and perhaps political mistake. For a long time, the idiom of natural law claimed to offer a universally valid frame for thinking about the nature of the political, as well as providing authority for lawyers' speculations about the rules and principles governing the conduct of individuals and corporate bodies wherever they might move. The name of the relevant discipline at German universities from the late seventeenth century onwards-ius naturae et gentium, the law of nature and of nations-revealed the full scope of its ambition. That discipline may have died away (although that is a debatable proposition) but any political thinking worth its salt will today (perhaps especially in the twenty-first century) aim to say something about how authority emerges, is maintained or critiqued not only within but also outside the single state. The world of 'nations' or even 'humanity' is established as an important theme of political and legal speculation. (shrink)

This book explores Rousseau's contribution to the Republican tradition in political thought. Through comparisons with various Republican lineages, it addresses problems that have defined and redefined Republicanism: attaining virtue, preserving liberty, sustaining the social order, orienting persons toward the common good, and having the law rule over men.

Worldwide, growing numbers of refugees are pushed from their homes. At the same time, fewer and fewer are able to access so-called “durable solutions” to their displacement. This has prompted a flurry of efforts to repair the foundering refugee regime. Many such efforts attempt, implicitly or explicitly, to resolve tensions between legal principles, moral duties, and national interests surrounding refugees. As part of a roundtable on “Balancing Legal Norms, Moral Values, and National Interests,” this essay questions the drive toward oversimplification (...) that has characterized these debates, recognizing that some such tensions are “baked into” the problem of refugeehood. While debates have typically focused on the obligation to admit refugees, and on “responsibility sharing,” I advance the conversation by exploring how law, morality, and national interests are entangled in efforts to support durable solutions for refugees, focusing on voluntary repatriation. What does recognition of the intrinsic and in some senses irreconcilable tensions in the refugee regime mean for efforts to support solutions? I argue that advancing durable solutions, however imperfect, for refugees does not mean definitively overcoming these tensions, but rather navigating them to identify context-specific opportunities to reposition refugees as full and equal citizens as a critical step toward reducing their precarity. (shrink)

This book brings together an international collection of experts in reproductive ethics, law, disability studies, and medicine to explore the challenging future of reproduction and children. From the medical to the social and from the financial to the legal, the authors explore the expanding impact of reproductive genetics on our society. New advances in genetic technologies are revolutionizing the practice of reproductive medicine. We have expanded our ability to detect genetic changes in embryos and fetuses in ways that potentially allow (...) to identify, treat, or prevent a growing range of diseases. The development of gene-editing technologies raises questions about the possibility of removing disease-causing variants from embryos before pregnancy implantation. The growing sophistication of prenatal genomic sequencing offers us glimpses into the whole genome of the developing fetus. And, the increasingly sophisticated science of 'gene matching' allows us greater and greater foreknowledge of how the genomes of two individuals will combine in a future child. This is an indispensable book on the newest developments in bioethics caused by the sciences. Chapter 5 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com. (shrink)

Although the Federal Common Rule requires that informed consent documents include all material information, it does not specify the content of materials used to recruit human subjects. In particular, there is no federal regulation relating to how payment for research participation is to be advertised. Rather, the FDA has issued guidance, advising researchers not to emphasize payment information. In order to determine how IRBs have interpreted this guidance, we coded the policies of the top 100 institutions by receipt of NIH (...) funding, in order to determine whether they require, permit, or forbid researchers to disclose the amount of compensation in their recruitment materials. We found that the vast majority of institutions implicitly or explicitly permit such disclosures; however, there are a significant number of IRBs at each extreme, some discouraging or forbidding with others encouraging or mandating such disclosures. Such heterogeneity in local regulations suggests that IRB discretion may be imposing costs on human subjects and the scientific enterprise that outweigh the benefits. We suggest that this heterogeneity should be resolved towards a national consensus on permissibility. (shrink)

The payment of human subjects is an area where Institutional Review Boards have wide discretion. Although the “Common Rule” requires the provision of full information to human research participants to secure valid consent, the Rule is silent on the issue of payment. Still, some federal agencies offer guidance on the matter. For example, the National Science Foundation cautions that high payments for risky research “may induce a needy participant to take a risk that they normally would prefer not to take.” (...) For research under its purview, the Food and Drug Administration guidance provides that “[a]dvertisements may state that subjects will be paid, but should not emphasize the payment or the amount to be paid, by such means as larger or bold type.” One might read the FDA guidance to permit the advertisement for human subjects to state the specific amount of payment, as long as it is not emphasized. (shrink)

This volume deploys recent feminist epistemological frameworks to analyze how concepts like knowledge, authority, rationality, objectivity and testimony were constructed in Greece and Rome. The introduction serves as a field guide to feminist epistemological interpretations of classical sources, and the following sixteen chapters treat a variety of genres and time periods, from Greek poetry, tragedy, philosophy, oratory, historiography and material culture to Roman comedy, epic, oratory, letters, law and their reception. By using an intersectional approach to demonstrate how epistemic systems (...) exclude and pathologize the experiences of ancient women and other oppressed groups, these contributions aid in the recovery of non-dominant narratives and reveal issues of sex, gender, race, ethnicity, sexual identity, religion, age, class, familial status and citizenship in the ancient and modern world. The volume contributes to a more inclusive and equitable study of classical antiquity and builds transhistorical connections capable of exposing similar injustices in our own time. (shrink)

I read Montesquieu’s 'Persian Letters' as an attempt to theorize a liberated alternative to despotic rule. As Montesquieu argues in 'The Spirit of the Laws,' fear—specifically fear of the ruler’s emotional and material excesses—dominates the life of the despotic subject. Although in the 'Letters' the seraglio is the despotic state’s parallel, the seraglio is the site of over owing and barely governed passions. Montesquieu’s solution to the excesses of the seraglio is not the eradication of emotion; rather, he o (...) ers a template for transforming negative passion—fear—into courage, a prelude to a potentially liberating experience. is transformation is portrayed most clearly in the character of Roxane, the rebellious wife whose courageous actions precipitate the collapse of the seraglio. I argue that Roxane’s insurrection and suicide evoke a model established by the Roman matriarch Lucretia. Though not traditional political actors themselves, both Lucretia and Roxane anticipate the possibility of a personal and political liberation through their refusal of fear-based, despotic politics in favour of alternative emotional regimes based in courage. (shrink)

This paper introduces the concept of gothic violence in order to better theorize how domination operates in Mary Wollstonecraft’s unfinished novel, The Wrongs of Woman, or Maria. The fictive companion to A Vindication of the Rights of Woman, Maria is an account of the titular character’s struggle for self-determination in all aspects of her life, including her desire for a companionate partnership. I argue that Maria’s ultimate lack of freedom is directly attributable to coverture, the patriarchal legal fiction whereby wives (...) are subsumed under the legal persona of their fathers or husbands. Building on scholarship that positions Wollstonecraft as a republican feminist, I show how Maria articulates what I call gothic violence, a form of psychic domination that places the other in a condition of unfreedom by denying their status as an autonomous being and holding them in subordination through a variety of techniques, such as denial of legal and social status and testimonial quieting. I show how gothic violence results in the unfreedom of women through its reliance on domestic settings and intimate relationships, and with the support of law and custom, of which coverture is a central example. I conclude by suggesting that attending to gothic violence in Wollstonecraft’s thought allows us to further see the continuity between her political and fictional writings. (shrink)

In recent years, the law in the area of recovered memories in child sexual abuse cases has developed rapidly. See J.K. Murray, “Repression, Memory & Suggestibility: A Call for Limitations on the Admissibility of Repressed Memory Testimony in Abuse Trials,” University of Colorado Law Review, 66 : 477-522, at 479. Three cases have defined the scope of liability to third parties. The cases, decided within six months of each other, all involved lawsuits by third parties against therapists, based on treatment (...) in which the patients recovered memories of sexual abuse. The New Hampshire Supreme Court, in Hungerford v. Jones, 722 A.2d 478, allowed such a claim to survive, while the supreme courts in Iowa, in J.A.H. v. Wadle & Associates, 589 N.W.2d 256, and California, in Eear v. Sills, 82 Cal. Rptr. 281, rejected lawsuits brought by nonpatients for professional liability. (shrink)

A key feature of unregulated mHealth research is the diversity of participants in this space. Applying an approach drawn from user experience design, we describe a set of archetypal unregulated mHealth researcher “personas,” which range from individuals who seek empowerment or have philanthropic objectives to those who are primarily motivated by financial gain or have misanthropic objectives. These descriptions are useful for evaluating policies applicable to mHealth to understand how they will impact various stakeholders.

Rousseau’s embrace of ceremony and festivals in his Considerations on the Government of Poland demonstrates one way for republican political thought to develop a substantive treatment of civic virtue. Differentiating the narcissism of spectacle and theater that Rousseau critiques in the Letter to d’Alembert from the Considerations’ call for a generous affect, I demonstrate that the latter is compatible with a republican ethos premised on civic virtue and patriotic attachment to the nation-state. Rousseau argues for the instantiation of political practices (...) that constantly cultivate political virtue and their associated affective orientations. His treatment of civic ceremonies in the Considerations should be read as an attempt to inculcate patriotic affect in republican citizens via constitutional measures. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Play, Laugh, LoveCynthia Willett’s Challenge to PhilosophyMegan CraigIt is an honor to respond to Cynthia Willett’s work, which has been an inspiration for me personally as well as a crucial corrective to the biases and blind spots of Western philosophy. Reading her entails reviewing some of the most basic features of one’s life: the place you call home, the people you live with, your mother or primary caregiver, the (...) words you utter, the other animals you love or ignore, and local conditions for justice, for play, for laughter, and for art. Her four major texts, all of them ethical, confront irony, motherhood, social justice, and animals. Because it would be impossible to deal comprehensively with the ways in which Willett has challenged and strategically sabotaged philosophy, my remarks here will focus on her most recent book, Interspecies Ethics, which expands several aspects of her early work on irony and laughter and her groundbreaking research on affect in Maternal Ethics and Other Slave Moralities.Interspecies Ethics is a brave and joyful investigation into the possibilities for camaraderie and justice among and between animal species. The book is moving in its descriptions of animal behaviors and sharp in its critique of philosophy’s implication in the chasm between human beings and other animals. Willett’s text is also ingenious in its performative aspects. She devotes much of her attention to the comic and to laughter, in spite of the grave subject matter she tackles and a final chapter devoted to J. M. Coetzee’s Disgrace. She not only enjoins us to consider other animals’ capacities for laughter and humor, she tells jokes. Her first chapter, “Can the Animal Subaltern Laugh?” [End Page 59] (co-written with her sister) revolves around a Colbert Report episode relating to monkeys and ends with the phrase “ jello and porn” (probably the first-ever invocation of these terms, together, in a philosophical text). Willett’s humor recalibrates the expectations we have for philosophical prose and expands the resources we might use when philosophizing. Additionally, in laughing along with Willett, we are already exhibiting our animal natures. As she writes, “Waves of laughter lower defenses and mock the borders of subjects and groups, exposing these borders as more porous than they might have been thought” (Willett 2014, 79). In the spirit of forging a community of the laughing, Willett begins her thinking about animals not from the perspective of pity, shame, or horror at what we do to them, but from a celebratory glee in animal life.In this essay, I will stress a few of the themes running through Willett’s work and pose three questions for further discussion. These relate, in order, to interspecies contact, playgrounds, and to her reading of Disgrace.Contact EthicsWillett is concerned with the world we share with other animals, with our common lots and the blurred edges of our differing bodies and habitats. Her book invites an awareness of the tragic fates of so many animals, but also the ridiculous, comical, and joyous aspects of our overlapping animal natures. Her emphases fall on playfulness, laughter, and musicality—traits she observes across animal species and that challenge human exceptionalism. Interspecies Ethics continues Willett’s ongoing project of reimagining the conditions for ethical life. Rather than an ethics based in infinite responsibility, one premised on sympathy and the recognition of mutual suffering, or an ethics rooted in the internalization of a universal law, Willett envisions an ethics grounded in “call and response,” which she describes as “discourse ethics across species” (Willett 2014, 27). For her, “discourse” means an initial, preverbal, rhythmic participation in the life of another creature. This is a far cry from the rational discourse ethics associated with Habermas. Instead, she sees call and response ethics as a tentative, playful exchange that challenges accounts of language, reason, and rationality. It also corrects Levinasian response or alterity ethics by reminding us that “responding to alterity is not [equivalent to] living with those other creatures” (Willett 2014, 9). In a way, Willett’s vision of ethics entails normalizing and extending the Levinasian face to face encounter to see what happens when we face... (shrink)

The covert administration of medication occurs with incapacitated patients without their knowledge, involving some form of deliberate deception in disguising or hiding the medication. Covert medication in food is a relatively common practice globally, including in institutional and homecare contexts. Until recently, it has received little attention in the bioethics literature, and there are few laws or rules governing the practice. In this paper, we discuss significant, but often overlooked, ethical issues related to covert medication in food. We emphasise (...) the variety of ways in which eating has ethical importance, highlighting what is at risk if covert administration of medication in food is discovered. For example, losing trust in feeders and food due to covert medication may risk important opportunities for identity maintenance in contexts where identity is already unstable. Since therapeutic relationships may be jeopardised by a patient’s discovery that caregivers had secretly put medications in their food, this practice can result in an ongoing deception loop. While there may be circumstances in which covert medication is ethically justified, given a lack of suitable alternatives, we argue that in any particular case this practice should be continually re-evaluated in light of the building moral costs to the relational agent over time. (shrink)

Delivering high quality genomics-informed care to patients requires accurate test results whose clinical implications are understood. While other actors, including state agencies, professional organizations, and clinicians, are involved, this article focuses on the extent to which the federal agencies that play the most prominent roles — the Centers for Medicare and Medicaid Services enforcing CLIA and the FDA — effectively ensure that these elements are met and concludes by suggesting possible ways to improve their oversight of genomic testing.

Firearm injury in the United States is a public health crisis in which physicians are uniquely situated to intervene. However, their ability to mitigate harm is limited by a complex array of laws and regulations that shape their role in firearm injury prevention. This piece uses four clinical scenarios to illustrate how these laws and regulations impact physician practice, including patient counseling, injury reporting, and the use of court orders and involuntary holds. Unintended consequences on clinical practice of (...) laws intended to reduce firearm injury are also discussed. Lessons drawn from these cases suggest that physicians require more nuanced education on this topic, and that policymakers should consult front-line healthcare providers when designing firearm policies. (shrink)

In the preface of the 2006 edition ofJust and Unjust Wars, Michael Walzer makes an important distinction between, on the one hand, “measures short of war,” such as imposing no-fly zones, pinpoint air/missile strikes, and CIA operations, and on the other, “actual warfare,” typified by a ground invasion or a large-scale bombing campaign. Even if the former are, technically speaking, acts of war according to international law, he proffers that “it is common sense to recognize that they are very different (...) from war.” While they all involve “the use of force,” Walzer distinguishes between the level of force used: the former, being more limited in scope, lack the “unpredictable and often catastrophic consequences” of a “full-scale attack.” Walzer calls the ethical framework governing these measuresjus ad vim, and he applies it to state-sponsored uses of force against both state and nonstate actors outside a state's territory that fall short of the quantum and duration associated with traditional warfare. Compared to acts of war,jus ad vimactions present diminished risk to one's own troops, have a destructive outcome that is more predictable and smaller in scale, severely curtail the risk of civilian casualties, and entail a lower economic and military burden. These factors makejus ad vimactions nominally easier for statesmen to justify compared to conventional warfare, though this does not necessarily mean these actions are morally legitimate or that they do not have potentially nefarious consequences. (shrink)

As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use (...) of this standard can have deleterious effects on those with many chronic conditions, it is especially burdensome for those in the minimally conscious state, where improvements are unpredictable and often not manifested through repeatable overt behaviors. Though the focus of this paper is on the challenges of brain injury and the minimally conscious state, which an estimated 100,000 to 200,000 individuals suffer from in the United States, the post-Jimmo arguments presented can and should have a broad impact as envisioned by the plaintiffs who brought the case on behalf of multiple advocacy groups representing patients with a range of chronic care conditions. (shrink)

In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents a unique pedagogical model for legal academia, and is closely influenced by the biomedical laboratory.

Since its inception in September 2010, the Network for Public Health Law has responded to hundreds of public health legal technical assistance claims from around the country. Based on a review of these data, a series of major trends in public health practice and the law are analyzed, including issues concerning: the Affordable Care Act, tobacco control, emergency legal preparedness, health information privacy, food policy, vaccination, drug overdose prevention, sports injury law, public health accreditation, and maternal breastfeeding. These and other (...) emerging themes in public health law demonstrate the essential role of law and practice in advancing the public's health. (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)

Since its inception in 2010, the Network for Public Health Law has aligned with federal, state, tribal, and local public health practitioners to assess how law can promote and protect the public’s health. In 2013, Network authors illustrated major trends in public health laws and policies emanating from an internal assessment of thousands of requests for technical assistance nationally. More recently, the Robert Wood Johnson Foundation has invited the Network and other partners to consider new ideas and strategies toward (...) building a “culture of health.” Per Figure 1, RWJF’s conception of a culture of health emphasizes key action areas essential to the promotion of health across all sectors and diverse populations. (shrink)

Patient narratives from two investigational deep brain stimulation trials for traumatic brain injury and obsessive‐compulsive disorder reveal that injury and illness rob individuals of personal identity and that neuromodulation can restore it. The early success of these interventions makes a compelling case for continued post‐trial access to these technologies. Given the centrality of personal identity to respect for persons, a failure to provide continued access can be understood to represent a metaphorical identity theft. Such a loss recapitulates the pain of (...) an individual's initial injury or illness and becomes especially tragic because it could be prevented by robust policy. A failure to fulfill this normative obligation constitutes a breach of disability law, which would view post‐trial access as a means to achieve social reintegration through this neurotechnological accommodation. (shrink)

Mobile devices with health apps, direct-to-consumer genetic testing, crowd-sourced information, and other data sources have enabled research by new classes of researchers. Independent researchers, citizen scientists, patient-directed researchers, self-experimenters, and others are not covered by federal research regulations because they are not recipients of federal financial assistance or conducting research in anticipation of a submission to the FDA for approval of a new drug or medical device. This article addresses the difficult policy challenge of promoting the welfare and interests of (...) research participants, as well as the public, in the absence of regulatory requirements and without discouraging independent, innovative scientific inquiry. The article recommends a series of measures, including education, consultation, transparency, self-governance, and regulation to strike the appropriate balance. (shrink)

This qualitative study describes the lived experience of physicians who work in communities that have experienced a public mass shooting. Semi-structured interviews were conducted with seventeen physicians involved in eight separate mass casualty shooting incidents in the United States. Four major themes emerged from constant comparative analysis: The psychological toll on physicians: “I wonder if I'm broken”; the importance of and need for mass casualty shooting preparedness: “[We need to] recognize this as a public health concern and train physicians to (...) manage it”; massive media attention: “The media onslaught was unbelievable”; and commitment to advocacy for a public health approach to firearm violence: “I want to do whatever I can to prevent some of these terrible events.”. (shrink)

A main objective of this study is to assess the opinions of 50 behavioral health patients on selective control over their behavioral and physical health information. We explored patients' preferences regarding current consent models, what health information should be shared for care and research and whether these preferences vary based on the sensitivity of health information and/or the type of provider involved. The other objective of this study was to solicit opinions of 8 behavioral health providers on patient-driven granular control (...) of health information and potential impact on care.Electronic surveys were implemented at an outpatient Behavioral Health facility that provides care for behavioral health patients with non-serious mental illnesses. The Patient Survey included questions regarding patients' demographics and about their concerns and preferences for data sharing for care and research. The Provider Survey included questions about their view on the current consent process and perceptions on barriers and facilitators to implement patient-controlled granular consent models.This novel study provides valuable preliminary data that can help guide future studies to better understand privacy choices of this underrepresented patient group. (shrink)

Phenomenological interviews with queer women in rural Nova Scotia reveal significant forms of trauma experienced during labour and birth. Situating the accounts of participants within both phenomenological and intersectional analyses reveals harms enabled by structurally embedded heteronormative and homophobic healthcare practices and policies. Our account illustrates the breadth and depth of harm experienced and outlines how these violate core ethical principles and values in healthcare.

Due to the prevalence, severity, and costs associated with autism spectrum disorders, it has become a public health issue. In response, state governments have adopted ASD-specific private insurance mandates requiring coverage of ASD screening, diagnosis, and treatment. Despite rapid uptake of these laws, differences exist in the type and levels of coverage, especially for allied health services including occupational therapy. We piloted a structured legal research methodology to code ASD insurance mandates that impact allied health service provisions. State private (...) insurance mandates were obtained from WestlawNext. A coding methodology was piloted on 14 states and included variables for age and service limits, treatments covered, and medical necessity. Coding methods were feasible and highly reliable among raters. Ten of 12 states had a coverage mandate, many with specific provisions for allied health providers. A full analysis of all 50 states is warranted to identify provisions affecting allied health providers serving individuals with ASD. (shrink)

With most states now making sex offender registration information available to the public, journalists must balance their obligation to inform the public about potential dangers with respect for individuals' rights. This article examines the problems journalists face in truth telling and minimizing harm and offers suggestions for covering community notification. At minimum, we suggest journalists verify the accuracy of information received from police, make independent judgments about whether or not publication of sex offender registration information is warranted, and provide background (...) information on the scope and effectiveness of community notification in their areas. (shrink)

The anti-patriarchy movement is going to undo ten thousand years of recorded history…. You watch. The time has come. Women are gonna take charge of society.I think [#MeToo] will have staying power because people, and not only women, men as well as women, realize how wrong the behavior was and how it subordinated women. So we shall see, but my prediction is that it is here to stay.As the story is told, #MeToo arrived in a kairotic moment. Jodi Kantor and (...) Megan Twohey's 5 October 2017 New York Times exposé of the methods Harvey Weinstein used to systematically harass and subsequently silence women in the entertainment industry opened the proverbial floodgates. Ten days later, actor Alyssa... (shrink)

On October 5th, 2017, the New York Times published an article that would establish the #MeToo movement and help millions of women across the globe to raise their voice and share their stories of sexual harassment, aggression and/or violence. If Harvey Weinstein was the main accused, he was, actually, the epitome of a systemic, as well as an endemic, issue that didn’t stop at the studios’ doors and was made possible thanks to a rather surprising and quite unexpected accomplice. In (...) fact, “Hollywood’s open secret” has been well-guarded by, among other things, the contract and its law. In the eyes of a contract law specialist, whether it be a man or a woman, the major highlight of Jodi Kantor and Megan Twohey’s article rests in their ability to have brought to light contracts—the, now, infamous and highly criticised “NDAs” (non-disclosure agreements)—that ensured Weinstein the freedom to buy his victims’ silence. The first goal of this essay is trying to understand, on the one hand, how could that be possible and, on the other hand, explain to a larger audience how a tool usually used for economic and commercial purposes could have been diverted from its traditional use. It also aims to present measures that have been adopted in the United States to fight these agreements, and imagine what could they be in a country such as France. Although these types of “NDAs” don’t seem to find their equivalent in the French public sphere, it is still helpful to ponder over remedies offered by the new French law of contract shall these contracts ever come to exist… or arise. (shrink)

This paper is an analysis of the reasoning behind Megan’s Laws, which pertain to the notification of communities when convicted sex offenders move into the area, especially those offenders who have carried out crimes against children. Liberals tend to criticize these laws and often point to the value of privacy, which they claim would be unacceptably compromised by allowing them. Communitarians tend to endorse these laws and often point to the value of safety, which they claim (...) would be unacceptably compromised were it not for such laws. Both sides also rely on the notion of human dignity in support of their arguments. In this paper, I offer a common foundation for these values and suggest implications regarding the moral acceptability of Megan’s Laws. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics for a Layered SelfLaughter, Reciprocity, Generosity, HomeCynthia WillettI can imagine no better way to respond to these insightful readings than to turn the spotlight on the important books that Ann Murphy and Megan Craig have written on affect and ethics! Craig’s book, Levinas and James: Toward a Pragmatic Phenomenology, weaves radical empiricism into phenomenology as only a philosopher who is also an artist could. Her evocative queries (...) on prereflective affects, perception, and ethical attunement shed light on the role of moods for unsettling rigid ego boundaries, ethical subjectivity, the feeling of being alive, the audible dimension of ethical encounters, life beyond a struggle to survive, temporality, and ethical ambiguity. These themes are compelling for any postmoral ethics that operates beyond or below the register of modern moral theory’s abstract laws and transparent cogitos. Her work balances an ethical concern for vulnerability with a vital regard for the vibrancy of living creatures and landscapes.Ann Murphy’s Violence and the Philosophical Imaginary illuminates philosophical questions with an abiding lucidity that does not weaken but amplifies the complexity and difficulty of ethics. Murphy’s work exposes how tropes of violence saturate philosophical discourses of both identity formation and of political and historical transformation, and how this violence, embedded in norms, denies sympathetic concern to those outside the limits of cultural intelligibility. Building upon recent work by Judith Butler, Adriana Caverero, and others, Murphy addresses the ambiguities arising from the multiple responses that exposure to vulnerability provokes. These responses can signal care but [End Page 70] they can also manifest violence. Even as she acknowledges the complex underside of cultural intelligibility, Murphy affirms sympathy and generous concern as paradigmatic virtues to be cultivated in response to various forms of violence. She probes the significance of shame and guilt for collective responsibility, ever alert to alterity and difference. With attentive care to the singular contributions of a broad range of philosophers and critical traditions, she argues compellingly for a corporeal ethics grounded on the ontological fact of vulnerability.Through their work, Murphy and Craig pose astute questions for my project, and, in fact, for any endeavor to conceptualize an ethics attentive to an embodied sociality. I describe the multifaceted approach I contribute toward this task as a call and response ethics for a layered self. Craig wonders if the more basic feature before any “call” is contact, touch, or immersion. She notes my concern that “any purported gap or abyss between humans and animals has less to do with unique human capacities than with the rise of urban centers and the loss of contact with other species.” Harm arises from a loss of contact. This is so true. Ethics as contact calls attention to the poetry of proximity, to erotic waves that transmit through the sound or feel of the other’s breath, the heat of the body, and the smell of the skin. This intense proximity serves as a compelling source for ethical sociality, resonating in some respects with what Merleau-Ponty explores as the sense of flesh and touch and, as Murphy suggests, a transcendental eros. This contact is as primal and ordinary as the skin-to-skin contact of caregiver and infant or, perhaps, the skin-to-hair contact of a terrier and her human companion, lost for a moment in inexplicable laughter. From these observations, Craig asks if “call and response” as a locution or central designation adequately captures the intimacy and intensity of these engagements.Craig’s remarks raise the further question of what is at stake in designations or phrasings. An ethics of call and response, designated as such, emerges from phenomenological but also crucially Africana and critical theory traditions. As a relational ethics, this ethics of call and response highlights social relations and expectations, opening a path outside of what Murphy characterizes as the trifecta of virtue ethics, deontology, and utilitarianism. It attends to desire (eros) beneath, in between, and above the prescriptive rules of moral reason or the interests of individuals. At its center are social bonds (friendship and companionship, community and domination, love, hate, and other social emotions, belonging and alienation, and the conflicts of groups and reconciliation) rather... (shrink)