Climate Change and Health: Mobilizing Public International Law into Action

The Petrie-Flom Center Staff Leave a comment

This post launches a new Digital Symposium, Climate Change and Health: Mobilizing Public International Law into Action by Guest Editors Thalia Viveros Uehara and Alicia Ely Yamin. Check back for more posts twice a week!

The election of Donald J. Trump, who has called climate change a “hoax” and in his prior administration pulled the U.S. out of the Paris Agreement, has sent shock waves through government and civil society leaders gathered at COP29. Argentina has walked away from the negotiations. Meanwhile, top leaders from the world’s largest polluting nations have not attended. COP29 was supposed to mobilize commitments to finance climate action as well as solidify the growing “health turn” within the U.N. Framework Convention on Climate Change (UNFCCC), including WHO guidance on integrating health into Nationally Determined Contributions. But that progress seems now in jeopardy.

This digital symposium makes clear that stakes could not be higher for global health. Projections estimate that between 2030 and 2050, climate-related health impacts could lead to an additional 250,000 deaths per year, largely from undernutrition, malaria, diarrhea, and heat stress. Furthermore, mental health conditions are worsening as extreme weather, livelihood losses, and wildfire smoke increase trauma.

Read More

Assisted Death for Psychiatric Suffering: Approaching Uncertainty with Humility

The Petrie-Flom Center Staff Leave a comment

by Zain Khalid

On May 22 this year, Zoraya Ter Beek, a 29-year-old woman from Netherlands, died by euthanasia on grounds of mental suffering. Zoraya had been diagnosed with chronic depression, borderline personality disorder, and autism and had struggled with self-harm and suicidal thinking for several year. She had tried numerous treatments, including 30 sessions of electroconvulsive therapy, until, as she reported her psychiatrist told her, “There’s nothing more we can do for you. It’s never going to get any better.”

Read More

Ghost Networks and Mental Healthcare

The Petrie-Flom Center Staff Leave a comment

by Rebekah Ninan

A recent lawsuit in the Southern District of New York has alleged that the health insurance company Anthem Blue and Cross Blue Shield violated state laws and committed fraud by maintaining “ghost networks” of mental health providers. Ghost networks are directories for insurance companies that contain outdated or inaccurate information about providers covered by the insurance plan. The lawsuit alleges that only seven of the first 100 providers on the Anthem directory for the state of the New York were contactable, in network, or accepting patients. This aligns with findings by the New York Attorney General that 86% of mental health care providers listed on New York health plans’ networks were ghosts. Getting stuck in a ghost network, unable to find a covered provider, can stymie a patient’s efforts to find mental healthcare, producing dire consequences.

Read More

What Type of Salt Should You Buy? Rethinking 1924 Food Fortification Policy in 2024

The Petrie-Flom Center Staff Leave a comment

by Jessica Samuels

For 100 years, food fortification, the practice of deliberately increasing the content of vitamins and minerals in a food, has been essential to combating public health crises. However, these practices have continued into the modern era. Because overconsumption of nutrients has been linked to toxicity and diseases, public health officials should continue to reflect on the benefits and risks of food fortification today.

History of Food Fortification

In the United States, food fortification (also known as enrichment) began in 1924 to address endemic goiter, enlargement of the thyroid gland. A physician in Cleveland suggested the use of salt since it was so commonly consumed to increase iodine consumption. After some persuasion, the Michigan State Medical Society studied the safety of iodized salt and launched the world’s first food fortification campaign. This was the first time food was deliberately manufactured with an eye towards addressing disease. However, while some members of the salt industry were excited by the potential to improve public health through their product, others were not. The Morton Salt Company argued that furnishing iodine to the populus properly belonged to large pharmaceutical companies. But the results were overwhelming: The incidence of goiter among children in Michigan decreased from 35% to 2.6%.

Read More

Alabama’s Maternity Care Desert Crisis: An Evaluation of Potential Policy Reforms

The Petrie-Flom Center Staff Leave a comment

by Rupa Palanki

The United States increasingly faces a crisis in maternal and infant health care. Over 2.3 million American women of reproductive age live in maternity care deserts — counties with little to no access to birthing centers and obstetric care. These deserts often result from rural hospital closures, health care provider shortages, and long-standing structural inequalities. The absence of accessible maternity services contributes to higher rates of preterm births and inadequate prenatal care, placing both pregnant individuals and their children at risk. Low-income and minority communities are especially vulnerable.

In Alabama, recent hospital and birthing unit closures have intensified local concerns about the state’s maternal health landscape. Today, over one-third of Alabama counties are maternity care deserts, and over a quarter of Alabama women have no birthing hospital within a 30-minute drive. With one of the nation’s highest maternal mortality rates, Alabama’s need for action is urgent. Below, I evaluate the strengths and limitations of three potential reforms aimed at addressing the Alabama maternity desert crisis.

Read More

Abortion debt: revolutionary acts and reclamations of care

The Petrie-Flom Center Staff Leave a comment

Photo credit: Melisa Slep

by Rishita Nandagiri and Lucía Berro Pizzarossa

Discussions about abortion tend to be dominated by considerations pertaining to medicine (e.g., “safety”) and law (e.g., “legality”). Medication abortion — misoprostol alone or in combination with mifepristone — has dramatically shifted these discussions. Brazilian women used misoprostol to self-manage their abortions in the 1980s, galvanizing Latin American and transnational feminist efforts to share knowledge and organize access to pills. In 2005, these medicines were added to the WHO’s Essential Medicines List. Self-managed abortion (SMA), which includes self-sourcing of abortion pills, self-diagnosis, and management of abortion processes and post-abortion care outside formal health systems, unsettles traditional understandings of what an abortion is, where and how it can (or should) occur, who a provider is, and what a “safe” abortion is. 

In April 2024, Polish activists from Abortion Without Borders (AWB) invoiced the Sejm (Polish parliament) €11.5 million ($12.4 million) for the financial costs and reproductive labor associated with  providing abortion access, resources, and care for Polish residents. AWB, an initiative by nine feminist organizations working across multiple countries, was founded in 2019 to provide information, support, and funding for abortion in Poland, either via pills or travel for in-clinic care abroad. Poland has some of the most restrictive abortion laws in Europe, which many describe as constituting a de facto ban on abortions. Ministry of Health statistics report Polish hospitals conducted only 161 abortions in 2022. In contrast, Polish non-governmental organizations estimate that, every year, 120,000-150,000 abortions are obtained via pills or procedurally. 

Read More

Open Genomics and Privacy: New Case Law in South Africa Affirms a Key Principle

Donrich Thaldar Leave a comment

by Donrich Thaldar

As the era of genomic medicine dawns, large-scale genomics projects are becoming increasingly central to health care advancements. Projects like FinnGen in Finland, the UK Biobank, and the All of Us initiative in the United States are charting new frontiers in precision medicine, enabling researchers to unlock the genetic codes underlying a wide array of diseases. These initiatives collect genetic data from hundreds of thousands of individuals, providing an invaluable resource to identify disease markers and tailor medical treatments to individuals’ genetic makeup. Such projects are not only pushing the boundaries of medical knowledge but are also laying the foundation for a future where treatments are more effective and personalized.

However, in the Global South, large-scale genomics projects are far fewer. Qatar has taken strides with its own Qatar Genome Program, but examples are still limited across Africa and other regions, where genomics research is often constrained by funding, infrastructure, and representation issues. In Africa, where genetic diversity is high but research representation has historically been low, the need for such projects is critical. Without local genomics data, the benefits of precision medicine may largely bypass African populations, further exacerbating global health inequities.

Read More

Legal Responses to the Potential Dangers of Menstrual Products

The Petrie-Flom Center Staff Leave a comment

by Rebekah Ninan

This summer, a startling study from researchers at University of California, Berkeley revealed tampons from several brands contain toxic heavy metals like lead, arsenic, and cadmium. This finding follows the 2023 discovery that many menstrual products contain per- and polyfluoroalkyl substances (PFAS), even those marketed as PFAS-free. All of these contaminants are linked to major health problems. This article explores the emerging policy and legal responses to this issue.

Read More

Does History Matter?

The Petrie-Flom Center Staff Leave a comment

by Elena Caruso

While the exact definition of self-managed abortion remains blurred, it currently tends to refer to the end of a pregnancy through the autonomous administration of pills outside of a public health facility. The World Health Organization (WHO) recommends self-management for pregnancies under 12 weeks, using a combination of mifepristone and misoprostol (or misoprostol alone) and it includes both medications in its list of essential medicines. In its Abortion Care Guidelines, the WHO states that medication abortion has “revolutionized” access to abortion care, emphasizing the novelty of this method.  

While the origins of self-managed abortion with pills are not fully elucidated, it is generally accepted that this practice dates back to the second half of the 1980s in Brazil, when women discovered and disseminated the information that misoprostol (a medication legally available for the treatment of stomach and duodenal ulcers) could safely and effectively be used to prevent pregnancies. In the current debate on self-managed abortion, engagement with history is often limited to a few background sentences. This “ahistorical” approach can leave the impression that self-managed abortion lacks a significant and notable history. 

Read More

When AI Turns Miscarriage into Murder: The Alarming Criminalization of Pregnancy in the Digital Age

The Petrie-Flom Center Staff Leave a comment

by Abeer Malik

Imagine: Overjoyed at your pregnancy, you eagerly track every milestone, logging daily habits and symptoms into a pregnancy app. Then tragedy strikes—a miscarriage. Amidst your grief, authorities knock at your door. They’ve been monitoring your digital data and now question your behavior during pregnancy, possibly building a case against you using your own information as evidence.

This dystopian scenario edges closer to reality as artificial intelligence (AI) becomes more embedded in reproductive health care. In a post-Dobbs world where strict fetal personhood laws are gaining traction, AI’s predictive insight into miscarriage or stillbirth are at risk of becoming tools of surveillance, casting suspicion on women who suffer natural pregnancy losses.

The criminalization of pregnancy outcomes is not new, but AI introduces a high-tech dimension to an already chilling trend. At stake is the privacy and the fundamental right of women to make decisions about their own bodies without fearing criminal prosecution. Alarmingly, the law is woefully unprepared for this technological intrusion.

Read More