Chapter 1. Introduction to Ethics 71 results (showing 5 best matches)
- The culture and norms of the legal system contribute particular values in bioethics debates. Law tends to emphasize consistency and equal treatment, for example, as primary principles. Law generally champions individual rights and personal autonomy over relationships. In addition, law contributes a very strong respect for procedure over a particular outcome. Standards adopted in legislation and case law have addressed some thorny issues in bioethics by specifying the procedure that should be used to resolve a conflict or factors that should be considered rather than by deciding the substantive outcome.
- Feminist bioethics offers an alternative to principlism in several respects. The many variations on feminism that fall within the umbrella of feminist bioethics share a commitment to the importance of understanding the social and economic context for the health care decision at issue. For example, some morally significant choices for patients may be severely constrained by inadequate financial and social support for the elderly, ill, or disabled and their caregivers. Feminist bioethics also widens the relevant circle of concern beyond the patient to include the well-being of family members. Feminist bioethics theories tend to share a primary concern for health care issues affecting women, whether as patients or as caregivers who most often will bear a direct burden in realizing the patient’s choices.
- Religious perspectives on issues in bioethics vary considerably, as would be expected with the diversity of religious viewpoints in the United States. Scholarship from a religious perspective contributes to the body of work in bioethics, and religious leaders participate in public policy debates on bioethics, some more vigorously than others. In addition, legal standards sometimes, although not always, accommodate religious perspectives of individuals in health care decision making. See, e.g., Chapters 4 and 5.
- A substantial portion of the law of bioethics governs the scope of individual liberties in regard to health care decision making. Many of the legal boundaries on individual decision making, such as legal limitations on abortion; the prohibition in most states against aid in dying; and participation in medical experimentation, are discussed elsewhere in this text. See Chapters 2, 5, and 8.
- Disability bioethics brings attention to the ways in which disability impacts health care decisions and experiences. It challenges the historical exclusion of disability perspectives in bioethics and argues that disability perspectives must be included in analysis of bioethics issues. Those perspectives are informed by the cultural history of medicalized treatment of people with disabilities, including denial of care, forced sterilization, institutionalization, abuse, and neglect. Disability theory argues that disability is part of the diversity of human experience, and rejects the view that life with disability is pitiable or unworthy of living. For example, it calls for examination of assumptions and biases about quality of life that may impact decisions made by physicians on behalf of or when advising people with disabilities. See Chapter 5.
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Preface 4 results
- For almost thirty years, Sandra Johnson and Robert Schwartz have been co-authors, with Barry Furrow, Tim Greaney, and Tim Jost, of Health Law: Cases, Materials and Problems, which is now in its Seventh Edition. The Health Law casebook has always included substantial coverage of bioethics issues, and the bioethics chapters have also been published, with additional material, as Bioethics: Health Care Law and Ethics. As those familiar with the casebooks will recognize, a few parts of this Nutshell are taken directly from one or the other of those casebooks. This Nutshell grows out of our experiences in writing these casebooks and in teaching our students over the years, and the new edition is substantially enriched by the addition of two future Health Law casebook authors, Robert Gatter and Elizabeth Pendo.
- We have enjoyed writing this book, and we have all enjoyed our new collaboration. One of the things we enjoy is that we do not agree with each other on several quite significant issues, and you may even notice this tension in the text. We have tried to be evenhanded, and we hope that we have explained how reasonable people can hold very different views on the propriety of applying law to almost every issue in bioethics.
- Our concern is to provide a foundation for legal analysis of the most durable bioethics issues that have consistently found themselves at the center of the public debate over the last quarter of a century, not to address all of the issues that have made an appearance in that debate. Our focus is on the legal issues, and these materials primarily address issues that have found their way into the courts, legislatures, and administrative agencies in the United States. We have included only a brief chapter to provide a precis of the more influential ethical theories at play in bioethics discussions. This Nutshell provides the overview—the forest, if you will; you will have to go elsewhere to study the individual trees in more detail.
- Our aim in this Nutshell is to provide students with a brief and accessible introductory overview of the central legal issues in bioethics. This volume is not meant to be, and is not, comprehensive. Our readers certainly will be able to list issues that we have not included.
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Chapter 10. Distributive Justice and Healthcare Reform 41 results (showing 5 best matches)
- Distributive justice is a core principle of the influential principlism approach to bioethics issues. See Chapter I, Section II.A. Concerns for the just allocation of limited or shared resources figure prominently in decision making regarding the retrieval and allocation of scarce human organs for transplantation. See Chapter 7. Conflict between distributive justice and other principles also plays a role in the ethical and legal analysis of topics discussed in other chapters. However, some argue that distributive justice has received insufficient attention in the field of bioethics. They critique what they see as the narrow focus on individual treatment decisions, and call for attention to the larger social and economic context and consequences of health care decisions. They similarly critique the legal system’s emphasis on autonomy and individual rights to the exclusion of relationships and equity among and between groups. See Chapter I, Section II.B–D.
- The traditional approach of federal anti-discrimination law is to prohibit discrimination based on specific characteristics of an individual. Those characteristics signify membership in a “protected class” or group that has experienced a history of discrimination and disadvantage. The traditional approach reflects the view that different treatment based on the identified characteristics likely is irrational, unfair or both. Some have argued for a universal approach that provides uniform protections to all without reference to specific characteristics. Supporters of the universal approach argue that it avoids counterproductive reliance on group identity and captures forms of unfairness not addressed under traditional anti-discrimination law. Viewed together, health care reform and anti-discrimination laws reflect a combination of these approaches. For example, a law that prohibits insurers from charging higher premiums based on race reflects the traditional approach, whereas a...
- First, it applies the same protections against nondiscrimination to each of the identified groups. For example, it is the first time that federal law has broadly prohibited discrimination in health care on the basis of sex (Title VII described above applies to employer sponsored health insurance). Second, it applies the non-discrimination requirement broadly across existing and new health programs and activities. Section 1557 applies to health insurers, hospitals, clinics, and any other entities that receive federal funds; federal programs such as Medicare, Medicaid, and CHIP; and the new health insurance marketplaces.
- Discriminatory barriers to access implicate the principle of distributive justice because they impede rather than promote the just allocation of health care. There is also a growing literature on the health effects of discrimination on individuals and communities. The importance of equal and non-discriminatory access is reflected in the number of federal laws prohibiting discrimination in health insurance or health care. Although states have been less active than the federal government in this area, many states also have laws prohibiting discrimination in health care, health insurance, or both, on various other bases, including health status.
- Title II of the Americans with Disabilities Act, 42 U.S.C. §§ 12101–12213 (1990), extends the non-discrimination requirement to all public entities regardless of receipt of federal funding. Together with the Rehabilitation Act, the ADA applies to all public entities, including state and local public health care programs, such as Medicare and Medicaid, and to private health care offices. These laws prohibit discrimination and require the removal of physical and other barriers to equal access. For example, the ADA requires that health care offices and facilities remove physical barriers and implement policies or procedures designed to accommodate special needs and promote access. The ADA was amended in 2008 to clarify that the statutory definition of disability should be construed in favor of broad coverage of individuals. See 42 U.S.C. § 12101 (2008).
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Title Page 5 results
- BIOETHICS AND LAW
- Professor Emerita of Law andCenter for Health Law Studies Saint Louis University School of Law
- Professor of Law and Co-Director, Center for Health Law Studies Saint Louis University School of Law
- Henry Weihofen Professor of Law Emeritus University of New Mexico School of LawHastings College of the Law
- Joseph J. Simeone Professor of LawCenter for Health Law Studies Saint Louis University School of Law
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Chapter 9. Public Health and Bioethics 62 results (showing 5 best matches)
- The code reflects a variety of ethical principles drawn from a variety of ethical frameworks. For example, pursuing civic engagement in public health policy and assuring that disenfranchised individuals can access resources necessary for health reflect a health justice framework. Meanwhile, respecting confidentiality except when necessary to prevent harm to others emphasizes traditional bioethics and respect for individual autonomy.
- The population health focus of public health challenges bioethics and its traditional emphasis on the principle of respecting individual autonomy. Public health demands that community health have moral value against which claims of individual autonomy must be justified. This does not require a separate “ethics of public health.” Instead, it
- Much of bioethics focuses on individual health. Yet, there is an ethic to public health as well. Population health is fundamental to a society’s functioning. Without it economies stall, governance systems are strained, and social connections splinter. Moreover, in the absence of population health, individual liberty is diminished.
- The bioethical principles of respecting individual autonomy, acting with beneficence and without maleficence, and pursuing justice are not incompatible with public health. Yet, discerning how they apply to public health is challenging especially because the principle of respecting individual autonomy dominates among these principles. Certainly, the principle of pursuing justice vindicates public health action that interferes with individual liberty when respecting autonomy would harm population health. So, for example, it justifies mandatory vaccination against infectious diseases. More challenging is public health action taken to protect individuals from their own autonomous and risky choices—such as smoking or eating an unhealthy diet—especially when those choices do not necessarily harm others. Traditionally, bioethics views such collective action as an unjustifiable violation of individual autonomy despite its beneficent purpose. Some theorists, however, have reconsidered the...and
- Given the prominence of administrative agencies in public health practice, administrative law is central to public health law. Indeed, many legal battles over public health interventions have turned on administrative law principles with opponents arguing that an agency’s action exceeded its legal powers. For example, in FDA v. Brown and Williamson, 529 U.S. 120 (2000), a cigarette manufacturer claimed that cigarette regulations were void because, in promulgating them, FDA acted outside the scope of its statutorily delegated power to regulate drugs and medical devices. The Supreme Court set aside the regulations, applying the doctrine—a core administrative law doctrine—to hold that authorizing language in the statute was not ambiguous and thus that the Court need not defer to the agency’s interpretation of its own statutory powers.
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Chapter 6. Aid in Dying 37 results (showing 5 best matches)
- Like many other issues in bioethics, aid in dying is particularly controversial in some religious circles. Many religious groups believe it is wrong for any person to intentionally cause his own death under almost any circumstance, while others believe that the choice ought to be made by the patient, and that there are circumstances where a decision to take one’s own life is morally permissible. In the secular discussion of this issue, advocates for permitting aid in dying usually take a utilitarian course, while natural law theorists oppose it and deontological thinkers are ambivalent about how to protect the patient’s autonomy while showing full respect for every person’s life.
- Over the first eighteen years during which the Oregon law was in effect—from 1998 to 2016—1545 legal, lethal prescriptions were written under the Oregon statute and 991 patients died as a result of taking a prescription written in accord with the law. The number of prescriptions written and the number of deaths that have ensued have both increased annually over that period. There were 24 prescriptions written (and 16 deaths) the first year, and 218 prescriptions written, and 132 deaths from ingestion of the medication, in 2015. Over the first couple of decades, just under 60% of those who received prescriptions have actually taken them.
- Along the way, the physician is instructed by the Oregon law to obtain a consult with another physician to confirm the diagnosis and the fact that the disease is terminal, and verify that the patient is making an informed, voluntary, and competent decision. In addition, the physician must refer the requesting patient to appropriate counseling if the physician believes the patient may be suffering from any mental disorder or depression “causing impaired judgment.” The law encourages, but does not require, patients to tell their family members of their choice. Finally, the statute requires the Oregon Department of Health to keep meticulous records, which the State has made available to the public, providing a wealth of information on many aspects of the effect of the law. The Washington Death with Dignity Act, the Vermont Patient Choice and Control at End of Life Act and the California End of Life Option Act are very similar, although California requires an additional written...
- The debate on aid in dying, euthanasia and related medical procedures is taking place outside of the United States, too, and it is marked by the same arguments and concerns elsewhere that have been raised here. Most national laws make any such intervention illegal, either directly or indirectly, through general homicide statutes and other criminal laws. The first formal legislative action to legalize the process was taken by the Northern Territory’s Parliament in Australia in 1995, and four patients availed themselves of the protections in that statute before it was effectively overturned by the National Parliament two years later. The Supreme Court of Colombia found a constitutional right to medical assistance in ending life under limited circumstances in 1997. That ruling stands as law in Colombia today, although the cultural and political environment has limited the actual availability of this process.
- The issue has also arisen in common law litigation over state statutes and common law that appears to outlaw aid in dying. Most famously, throughout the 1990s Jack Kevorkian, a Michigan pathologist, challenged Michigan’s limitations (both statutory and common law) on physicians who wished to help patients end their lives. Kevorkian used a suicide machine that allowed patients—one of whom was photographed playing tennis shortly before operating the machine—to end their lives by pressing a button. After several Kevorkian victories in the courts and the Michigan State legislature, in 1999 he was convicted of murder in a trial in which he represented himself. Whatever one may think of his skill as a physician, he was not a very good lawyer. His conviction arose out of his act injecting a lethal dose directly into a man in his early 50s who was suffering from ALS. Showing more courage or (depending on your position) disregard for the law than was discrete, Kevorkian broadcast the whole...
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Outline 67 results (showing 5 best matches)
Chapter 2. Human Reproduction 138 results (showing 5 best matches)
- In 1997 the world was stunned by the revelation that a Scottish laboratory had cloned a mammal—to be precise, a Finn Dorset sheep. Scientists achieved this by removing the nucleus from a sheep ovum, replacing it with the genetic material from the sheep to be cloned, and then reimplanting the genetically changed ovum back into the surrogate mother sheep. In fact, that one cloned sheep was the only success in almost 300 attempts, and scientists warned that the likelihood that this technology would be available for human beings remained, for the present, several years away. Despite this, the bioethics community began a world-wide discussion on the consequences of cloning as a form of human reproduction.
- Several national and state bioethics commissions, task forces, and advisory boards have considered the ethics of both reproductive and therapeutic cloning to evaluate the need for legal regulation. While there is a consensus that we should be concerned about potential safety problems in reproductive cloning, there is disagreement over everything else. Some believe that reproductive cloning should be an option available, at least to some people under some circumstances. Others argue that this unnatural and potentially dangerous and socially disruptive process is never morally tolerable. Some believe that therapeutic cloning to produce stem cells for medical research is not only permitted, but is morally required to help those suffering from diseases we may be able to conquer, while others conclude that creating a fertilized ovum for the purpose of destroying it and using it for another person’s benefit is inherently morally wrong.
- Several states have attempted to apply criminal law, abuse and neglect law, dependent child law, civil commitment law, and ordinary tort law to cases where a pregnant woman may put her fetus at risk. For the most part, the state has attempted to intervene in these ways when the pregnant woman is engaging in some unhealthy (and, perhaps, illegal) activity like using illicit drugs or drinking too heavily during pregnancy.
- In addition to criminal prosecutions, civil commitment proceedings, and the mandatory injunctions (or their equivalents) that have been sought in the c-section cases, some states allow for separate child protective services actions under state abuse, neglect, “children in need of services,” or dependency laws. These laws allow the state to take legal and physical custody of a child in need and to provide the necessary services. Of course, a child protective services agency cannot take physical custody of a fetus under civil abuse and neglect law without also taking custody of the mother, and many states have been reluctant to permit this.
- Our society has had difficulty defining who is a “person.” In part, this arises out of the different and inconsistent purposes for which we seek a definition. The “person” from whom we wish to harvest a kidney for transplantation may be defined differently from the “person” who is protected by the Fourteenth Amendment, federal civil rights laws, and various other federal and state laws. Even when the purpose of the definition is settled—as when we seek to know who is a person able to bring an action under state tort law—there is no consensus on when the status of “personhood” first attaches.
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Index 65 results (showing 5 best matches)
Chapter 5. Decisions Regarding Life-Sustaining Treatment 106 results (showing 5 best matches)
- Whether applying ordinary civil law, abuse and neglect law, or some other species of state law, when a court is called upon to order medical treatment for a child against the wishes of a parent—usually the result of a complaint made by a health care provider, family member, or friend—the court will generally balance the constitutionally recognized parents’ interest in making health care decisions for their children with the child’s interest in receiving proper health care and the state’s constitutionally recognized interest in protecting the life and health of the child. The court will generally consider such factors as the relative maturity of the child, the chance the treatment will actually provide relief for the child, the side effects of the treatment (both physically and psychologically), and the length and quality of life both with and without the proposed treatment.
- If some decision making rights are available only to competent adults, the law must determine what constitutes competency for purposes of health care decisions. The requirement that decisions be made by competent adults grows out of the law of informed consent, which requires that consent be voluntary, informed, and competent. There are few detailed statutory definitions of competency, and the statutory treatment of this issue has been to focus on the process by which competency is determined rather than the substantive standards for finding competency. In fact, this is one of the rare areas of principle in which law declares the question to be a medical question, but medicine declares the question to be one of law. In the end, generally the law requires health care workers, often doctors, to testify as to incompetence (or even to declare incompetence) based on unarticulated legal and medical standards.
- When cases are prosecuted as child abuse and neglect cases, they must follow the state procedure and substantive law that applies to those cases. Medical neglect includes the failure to seek appropriate health care for a child, and a parent found by clear and convincing evidence to have medically neglected a child may lose legal custody to the state. The loss of legal custody does not require the loss of physical custody, and in the course of a child neglect action a court may order the child to undergo the questioned treatment but still leave the child in the physical custody of the parents, as long as they do not obstruct the treatment. A determination that a child is medically neglected does not necessarily mean that parents are culpable, although a few states have imposed their separate criminal abuse and neglect laws, or even involuntary manslaughter laws, on Christian Scientist and other parents whose decisions not to seek treatment for their children have resulted in the...
- While the distinction between providing nutrition and hydration and providing other forms of care has been rejected by most bioethicists, physicians, and professional organizations, there is a minority that views it to have continuing value and it persists in the law of many states. Some living will statutes specifically exclude the performance of any procedure to provide nutrition or hydration from the definition of death-prolonging procedures, for example, and thus do not extend any statutory immunity to those who remove nutrition or hydration from a patient. This may be because we associate nutrition and hydration with the most basic care society owes all of its members, and because we are worried about the effect allowing their discontinuation would have on the society-wide respect for life. Alternatively, this may be the result of the religious divide that is so obvious throughout our national debate over end-of-life care. Even with such a statute, the common law reliance on...and
- Over the past decade most states have enacted “family consent laws,” either as a part of the adoption of UHCDA or independently of it. These family consent laws authorize statutorily designated family members to make health care decisions for their relatives in circumscribed situations. These statutes often apply to a wide range of health care decisions (including, in most cases, decisions to forgo life-sustaining treatment), although sometimes they apply only when there has been a physician’s certification of the patient’s inability to make the health care decision, and sometimes they are limited to particular kinds of treatment (e.g., cardiopulmonary resuscitation). In addition, family consent laws often provide immunity from liability for family members and physicians acting in good faith, and judicial authority to resolve disputes about the authority of the family members under the statutes.
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Chapter 7. Organ Transplantation 47 results (showing 5 best matches)
- Surviving family members have challenged the nonconsensual removal of tissue and organs as a violation of their Constitutional right to property. These claims rest on the family’s common law or state statutory authority to possess the decedent’s body for purposes of disposal. The scope of this common law right is quite ambiguous, however, and had been interpreted primarily as a duty to dispose of the body, related to public health concerns, rather than as a property right to the body for all purposes. Cases considering whether the Constitutional right extended to conflicts over organ retrieval have produced mixed results. A series of investigative reports in the Los Angeles Times, however, demonstrated that the California practice of tissue retrieval by coroners based on presumed consent had a disproportionate impact on minorities as 80% of coroner autopsies were performed on African-American or Latino individuals and only 16% on white decedents. The articles also revealed that the...
- The UAGA is a model statute developed by the National Conference of Commissioners on Uniform State Laws. The first version of the UAGA was published in 1968, and substantially revised versions appeared in 1987 and 2006, with some amendments in between. The UAGA is not operational as law unless it is adopted by a particular state; however, every state has adopted some version of the UAGA since its inception. Variations among the state anatomical gift statutes are common and significant, but the UAGA provides a useful general framework for the discussion of common legal issues.
- Federal law, which unlike the UAGA applies to retrieval before death as well as after death, provides that it is illegal for “any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce.” 42 U.S.C. § 274(e). The statute defines human organ as “human (including fetal) kidney, liver, heart, lung, pancreas, bone marrow, cornea, eye, bone, and skin or any subpart thereof.” This definition leaves some gaps. It does not cover tissue that is taken for research or commercial development rather than for human transplantation. It also does not cover materials such as semen, ova, and blood, which are bought and sold in rather robust markets. Although there is a market for the sale of ova for assisted reproduction, some states prohibit payment for ova to be used in stem cell research.
- The 2006 version of the UAGA, however, removed the provision for presumed consent as a response to litigation challenging the practice as unconstitutional. Almost all of the states have since repealed their previously adopted presumed consent laws.
- UNOS operates a national registry of patients in need of an organ transplant. The first step in the process of identifying a specific recipient for a specific organ is the listing of the patient on the national transplant registry. UNOS sets standards and guidelines for the listing of patients, but individual doctors and hospitals decide whether and when to list a particular patient. The time of listing and the patient’s medical condition (degree of urgency) as reported by the doctor determine the patient’s priority on the wait list.
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Chapter 4. Legal Standards for the Determination of Death 28 results (showing 5 best matches)
- Even though the authors of the report, including the lawyer member of the group, stated that no change in the law was necessary, their work eventually led to legislation nearly immediately in a few states and to the development of several model statutes proposed by scholars and professional organizations including the ABA and the AMA.
- The UDDA and all current state laws require the irreversible cessation of all brain function, including the brain stem, if death is to be declared based on the brain function criterion. This requirement distinguishes brain death from other conditions in which the patient has some even minimal brain function and would not be considered dead, like persistent vegetative state. See Section III, below. Although the whole brain death standard is very well accepted in law, there is still some discomfort and skepticism about brain death in both directions, with some philosophers and physicians arguing that it is too narrow and should be expanded and others arguing that the brain death standard embeds particular values that are not universally shared. See Sections II.C and III, below.
- For centuries, the common law standard of death held that death occurred when the individual’s heart and lung functions ceased. The irreversible cessation of cardio-pulmonary function was observable to anyone, and no effective interventions existed to restart these functions once they had stopped.
- Mechanically maintaining heart and lung function preserves the appearance of life, sometimes over a very long time, even if the brain has no activity whatsoever: blood circulates, body temperature remains warm, other organs such as kidneys and liver continue to function, and mechanical ventilation inflates and deflates the lungs. For this reason, the determination of death by the irreversible cessation of total brain function is sometimes called “brain death”—as if the patient is not completely dead. Although according to law, the individual is dead, news articles and health professionals frequently and incorrectly refer to a “brain dead” individual being kept “alive,” for example to extend a pregnancy.
- Determining the exact point at which death occurs can be legally significant. The law of estates, for example, uses the time of death to determine the precedence of interrelated wills, and a charge of homicide typically requires that death have occurred within one year of assault.
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Chapter 8. Regulation of Research with Human Subjects 122 results (showing 5 best matches)
- Research subjects have also brought suit claiming an interest in the products of the research in which they participated. These cases have been resolved on a number of state law grounds, including informed consent and property law as well as the application of the federal regulations. See Section V.B.2.
- Some states have by statute, regulation, or case law limited the research uses of public banks of tissue samples and records. In other states, the state itself is a partner in the development and use of a statewide biobank.
- Federal regulations dominate standard-setting for the conduct of medical research in the United States; however, state legislation, common law, and standards set by private organizations also influences the legal framework for research. This section briefly introduces these other standards while the rest of the chapter focuses almost exclusively on the federal regulations.
- The appellate court reversed the trial court’s dismissal of plaintiffs’ claim under the Alien Tort Statute, which provides U.S. federal courts with jurisdiction over tort claims by foreign nationals for violations of the “law of nations” or U.S. treaties. The appellate court held that “nonconsensual medical experimentation on humans” violated a universally accepted norm of customary international law, relying on the Nuremberg Code, the Declaration of Helsinki, and the federal regulations on research. The dissent argued, in part, that it was inappropriate to consider the Nuremberg Code, as it had no independent legal force, and the Declaration of Helsinki, as it is merely a private standard.
- Grimes v. Kennedy-Krieger Institute, Inc., 782 A.2d 807 (Md. 2001), is the most prominent judicial opinion considering claims of this sort. In , the court held that Maryland common law would recognize the relationship of researcher and research subject as one that creates a duty of care and resultant legal accountability and liability on the part of the researcher. The Court relied on the federal regulations on research to analyze the scope of the duty owed to the research subjects, although some argue that the Court misinterpreted those standards as they apply to children. See Section IV.C.1. The Court also held that the consent form created an enforceable “bilateral contract” between the parties.
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Chapter 3. Genetics 47 results (showing 5 best matches)
- The issue of confidentiality of medical information involves both the duty to keep information confidential and the rare obligation to disclose information. Statutes and common law doctrines applying to medical information generally, such as the federal Health Insurance Portability and Accountability Act (HIPAA), apply to genetic information. In addition, many states have enacted genetics-specific confidentiality and privacy statutes.
- As with the regulation of research with human subjects discussed in Chapter 8, regulation of the use of genetic information is influenced by its history. In the case of genetics, the law partnered with often imperfect science to disadvantage particular groups. These concerns and experiences contributed to the adoption of current legal standards that treat genetic information specially.
- The physician-patient relationship ordinarily includes a common law duty of confidentiality on the part of the doctor toward the patient. In unusual circumstances, however, the doctor may have the obligation or the authority to reveal otherwise confidential medical information under a common law “duty to warn.” Statutes also may require disclosure, prohibit disclosure, or authorize disclosure at the doctor’s discretion under particular circumstances.
- In the nineteenth century, Gregor Mendel, an Austrian monk known as the “Father of Genetics,” mapped the pathway of genes in the phenotypes (or appearances) of plants. Even earlier, farmers bred animals and crops to achieve desired characteristics. Although the genes were invisible, their influence in heredity was observable. James Watson and Francis Crick lifted the veil through which Mendel worked and revolutionized the understanding of genetics when they determined the double helix structure of DNA in the first half of the twentieth century. Subsequent research, especially through the multinational Human Genome Project (HGP), accelerated the understanding of the human genome and produced technologies that greatly increased the capacity for identifying associations of particular genes with particular physical conditions.
- Some statutes, for example, apply only to laboratory tests of DNA, while others include family medical history within the definition of genetics. In the case of HD, discussed in Section I.A, above, only an individual who has been tested for the gene will come within the protection of a statute that defines genetic information as the results of a laboratory test of DNA, and an individual who has a family history of the disease but has not been tested would not. The federal GINA uses the broader definition and covers the results of the genetic tests of the individual, tests of his or her family members, and family medical history.
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Advisory Board 11 results (showing 5 best matches)
- Professor of Law, Chancellor and Dean Emeritus, University of California, Hastings College of the Law
- Distinguished University Professor, Frank R. Strong Chair in LawMichael E. Moritz College of Law, The Ohio State University
- Professor of Law and Dean Emeritus,
- Professor of Law Emeritus, University of San Diego Professor of Law Emeritus, University of Michigan
- Professor of Law, Yale Law School
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Copyright Page 4 results
- and the Nutshell Logo are trademarks registered in the U.S. Patent and Trademark Office.
- The publisher is not engaged in rendering legal or other professional advice, and this publication is not a substitute for the advice of an attorney. If you require legal or other expert advice, you should seek the services of a competent attorney or other professional.
- West, West Academic Publishing, and West Academic are trademarks of West Publishing Corporation, used under license.
- Printed in the United States of America
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Dedication 4 results
- Publication Date: September 23rd, 2016
- ISBN: 9781634604703
- Subject: Health Law
- Series: Nutshells
- Type: Overviews
- Description: This book provides a concise analysis of areas in which the law has addressed issues in bioethics. Topics include assisted reproductive techniques and family-making, limitations on reproduction (including abortion, contraception and sterilization), the role of ethical and religious beliefs of health care professionals, the definition of death, end-of-life decision-making (including physician assisted death), genetics, research involving human subjects (including issues related to conflicts of interest), stem cell research, organ transplantation, and other emerging topics. The book provides an excellent introduction to the process of ethics decision-making as well as useful support for students.