By Emily Rock and James Bhandary-Alexander
On August 9, legislators introduced a new bill in Congress that allocates funding to the development of Medical-Legal Partnerships (MLPs), in recognition of the important role MLPs can play in the lives of older Americans.
As attorneys with the Medical-Legal Partnership program at the Solomon Center for Health Law and Policy at Yale Law School, we strongly encourage Congress to act quickly to pass this legislation.
By Liz Tobin-Tyler and Joel Teitelbaum
To us, health justice means change.
Changes to norms and attitudes, to systems and environments, to law and policy, to resource and opportunity distribution. Not cosmetic or peripheral change, but wide-scale, systemic change. For health justice to be realized — for all people to reach their full health potential — laws and policies must be geared toward restructuring the systems, practices, and norms that have heretofore advantaged some groups over others, and thus given them greater opportunity for good health, economic and social prosperity, and greater longevity.
We recognize that this kind of change is profoundly challenging, both biologically and structurally. Biologically, because humans are programmed to do what’s comfortable, and what’s comfortable is what’s already known. Structurally, because of the nation’s unique political, social, and cultural attributes. Some of these attributes include a strong sense of individualism, and thus an entrenched unwillingness to prioritize community benefit over individual choice; limited governmental power; capitalism; unprecedented wealth with massive inequality; resistance to growing racial and ethnic diversity; over-spending on the downstream consequences of the failure to invest in upstream wellness; and a willingness to enact and maintain policies and practices that privilege some lives over others.
For these reasons, we are not naïve about the prospects for major change in a relatively short period of time, but neither are we cowed by the challenge. We embrace the opportunity to get uncomfortable, to challenge the racist, gender-based, and ableist norms and attitudes in all forms that harm health and well-being, to raise awareness of the inert systems that perpetuate health injustice, and to promote innovative and progressive law and policy change.
One of the ways that we apply our approach to health justice is our work to develop and advance medical-legal partnerships (MLPs), as both an expert consultant (Liz) to and Co-Director (Joel) of the National Center for Medical-Legal Partnership.
The Health Law, Policy, Bioethics, and Biotechnology Workshop provides a forum for discussion of new scholarship in these fields from the world’s leading experts. Though the Workshop is typically open to the public, it is not currently, due to the COVID-19 pandemic. However, many of our presenters will contribute blog posts summarizing their work, which we are happy to share here on Bill of Health.
By Matthew S. Smith & Michael Ashley Stein
Persons with disabilities face an ongoing struggle to reclaim power and control over their lives.
The United Nations Convention on the Rights of Persons with Disabilities (CRPD) is an important tool in this struggle.
In mental health care settings, the CRPD has challenged states and practitioners to reject coercive forms of care orchestrated by substitute decision-makers — be they clinicians, family members, or court appointees — in favor of modalities that preserve and privilege individuals’ direct control over their care.
By Jennifer Cohen
Profit-motivated economic activity conflicts with the realization of population health and health justice.
To work toward health justice, we must recognize health as a function of (1) capitalist economic development processes, including (2) gendered and racialized divisions of labor. Together, these heighten the contradiction between the profit motive and the domestic and global requirements of public health. This contradiction is also evident in the ways (3) markets can misallocate inputs to health (e.g., hand sanitizer, personal protective equipment for medical practitioners) and how most people obtain health (e.g., as “consumers”).
By Lawrence O. Gostin
The COVID-19 pandemic has exposed marked limitations in the International Health Regulations (IHR) and constrained authorities of the World Health Organization (WHO). With a rising imperative to advance pandemic preparedness and response, more than twenty heads of government proposed a new pandemic treaty. This prospective pandemic treaty offers a pathway to develop innovative international legal obligations, strengthening core capacities, good governance, and compliance mechanisms to prepare for novel outbreaks with pandemic potential.
By Rachel Rebouché
Over the past few weeks, the headlines have been dominated by the implementation of a Texas “heartbeat” law. The law, which prohibits abortions after detection of fetal cardiac activity, “shall be enforced exclusively through . . . private civil actions” and “no enforcement may be undertaken by an officer of the state or local government.” For that reason, the Fifth Circuit, and then the Supreme Court, declined to enjoin the law’s application because, in part, no one had yet to enforce it. The Court did not opine on the law’s constitutionality, even though the statute directly contradicts precedent protecting abortion rights before viability. Indeed, as the DOJ argued in its recent lawsuit against Texas, the state designed the law specifically to circumvent judicial review.
What does Texas’s abortion ban have to do with health justice? The answer may not seem obvious because of how the debate over Texas’s law has been framed. Commentary has focused on whether or not litigants have standing to challenge the law or whether the federal government could successfully intervene to stop enforcement of the law. And these are important questions, especially for the providers and those “aiding and abetting” them, who are subject to the lawsuits of private citizens suing for $10,000 per procedure in violation of the law.
The costs of this law, however, could far exceed these potential damages. A health justice perspective highlights those costs and how lack of access to abortion entrenches economic and racial inequality.
By Cathy Zhang
The United States Supreme Court’s refusal to block Texas’s SB 8 abortion restriction earlier this month foreshadowed an uncertain future for abortion jurisprudence and put reproductive rights at the center of national discourse.
But abortion is not the only right at stake: the novel enforcement mechanism behind SB 8 may soon appear in a wide range of legislation, making it more difficult to challenge unconstitutional laws.
By Aziza Ahmed
When Black Lives Matters (BLM) activists say “I can’t breathe,” they are acknowledging that breathing is not simply biological — it is enabled or disabled by law and politics. They are right.
In fact, the legal and political environment shapes and legitimates the very tools we use to monitor our capacity to breathe.
The racial justice uprisings and the COVID-19 pandemic have inspired advocates, scholars, and researchers to examine the assumptions about race that have embedded themselves into these tools — the medical technologies we use to measure if, and how, a person is breathing and absorbing oxygen.
By Tsung-Ling Lee
Despite the World Health Organization’s (WHO) recent efforts to broaden participation, the international infectious disease control regime remains state-centric.
As such, the state-centric infectious disease regime violates the fundamental principle of how contagious diseases spread within and across countries — the virus recognizes no national borders, nor does the virus discriminate. The longstanding global health mantra — no country is safe until all countries are safe; no one is safe until everyone is safe — should guide global pandemic preparedness.
By Ameet Sarpatwari, Beatrice Brown, Alexander Egilman, Aviva Wang, and Aaron S. Kesselheim
Each month, members of the Program On Regulation, Therapeutics, And Law (PORTAL) review the peer-reviewed medical literature to identify interesting empirical studies, policy analyses, and editorials on health law and policy issues.
Below are the citations for papers identified from the month of August. The selections feature topics ranging from an overview on the evolution of medical device regulation in the United States, to an analysis of the impact of the disclosure of expanded access policies mandated by the 21st Century Cures Act, to an evaluation of how litigation has impacted the success of the Biologics Price Competition and Innovation Act.
A full posting of abstracts/summaries of these articles may be found on our website.