Medicine doctor and stethoscope in hand touching icon medical network connection with modern virtual screen interface, medical technology network concept

AI in Digital Health: Autonomy, Governance, and Privacy

The following post is adapted from the edited volume AI in eHealth: Human Autonomy, Data Governance and Privacy in Healthcare.

By Marcelo Corrales Compagnucci and Mark Fenwick

The emergence of digital platforms and related technologies are transforming healthcare and creating new opportunities and challenges for all stakeholders in the medical space. Many of these developments are predicated on data and AI algorithms to prevent, diagnose, treat, and monitor sources of epidemic diseases, such as the ongoing pandemic and other pathogenic outbreaks. However, these opportunities and challenges often have a complex character involving multiple dimensions, and any mapping of this emerging ecosystem requires a greater degree of inter-disciplinary dialogue and more nuanced appreciation of the normative and cognitive complexity of these issues.

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Surgeon at work in the operating room.

Litigation and Patient Safety: The Importance of Good Communication Strategies

By John Tingle

Good record keeping and communication practices are essential prerequisites for safe and proper patient care. Serious patient injury, including death, can result from poor record keeping and other communication failures.

A fundamental issue in England’s National Health Service (NHS) patient safety culture development, however, is whether health care staff implement the necessary communication changes in light of  adverse health care events. In fact, failure to learn from errors is a persistent patient safety theme that has featured strongly in various health regulatory, patient safety, and crisis inquiry reports going back over 20 years.

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Train tracks interchange leading around a curve as a controlled fire burns on the track during repairs.

COVID-19 and the Problem of Multiple Sufficient Causes

By Nina A. Kohn

Although politicians and pundits warned that businesses would drown in a “tidal wave” of lawsuits seeking to hold them liable for COVID-19 infections, plaintiffs face significant barriers to recovery. Not the least of these is the requirement that a tort plaintiff establish that the defendant was the “actual cause” (or “cause in fact”) of the plaintiff’s injury. This seemingly simple requirement creates a profound barrier to holding even the most negligent, reckless, and bad intentioned actors liable for spreading COVID-19. As others have observed, in a world in which SARS-CoV-2 is increasingly ubiquitous, plaintiffs will often be unable to show that their infections resulted from any particular bad actor’s behavior.

It is in this environment that a seldom used theory of causation — the “multiple sufficient causes” approach — may find new relevance. But it is also in this environment that the American Law Institute (ALI) — an organization comprised of leading lawyers, judges, and academics that publishes influential “Restatements,” or summaries, of common law — is being urged to jettison that theory in the Restatement Third of Torts.

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Gavel lying in a courtroom.

The Impossibility of Legal Accountability for COVID-19 Torts

By Chloe Reichel and Valerie Gutmann Koch

Since the first days of the COVID-19 pandemic, employers, businesses, and other entities have anticipated litigation around tort claims associated with the novel coronavirus. Early in 2020, scholars here began to grapple with questions of tort liability relating to the pandemic response. However, nearly three years later, it appears that the warnings of a “tidal wave” of lawsuits were vastly overstated.

In this symposium, we asked torts scholars to reflect on questions surrounding whether and how individuals and entities might be held liable for the harms associated with SARS-CoV-2 infection, particularly as infection has grown increasingly widespread and COVID mitigations have become more limited or entirely eliminated.

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American Constitution - We the people with US Flag and gavel.

Abortion Bans Threatening Pregnant Patients’ Lives Are Unconstitutional

By James G. Hodge, Jr., Jennifer Piatt, Erica N. White, Summer Ghaith, Madisyn Puchebner, and C. McKenna Sauer

Following the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which overturned the constitutional right to abortion, laws went into effect in multiple states that restrict when abortions may be provided, including during potentially life-threatening emergencies.

To the extent highly restrictive, amorphous, and indeterminate abortion bans contravene physician implementation of life-saving interventions for pregnant patients — and thus infringe upon the Fourteenth Amendment’s protection of the right to life — they are unconstitutional.

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Barbed wire in front of blue sky.

The Struggle to Survive in the Pandemic Prison

By Jamal Spencer and Monik C. Jiménez

Prisons, jails, and other carceral facilities have been core sites of the COVID-19 pandemic, from initial outbreaks in Chinese prisons to some of the largest outbreaks in the U.S. The uniquely dangerous physical conditions within carceral facilities (i.e., overcrowding, poor ventilation, and lack of sanitation); a high prevalence of chronic diseases among incarcerated people; and high levels of physical movement through facilities, resulted in environmental conditions ripe for uncontrolled SARS-CoV-2 transmission.

As early as June 2020, the mortality rate from COVID-19 among incarcerated people was three times higher than the general population and the infection rate five times higher. Yet, despite these inequities, the human toll of COVID-19 among incarcerated people has remained behind the walls and in the shadows. Without intentionally centering the voices of those who have lived in the most extreme conditions of social and physical marginalization, we fail to understand the full toll of the pandemic and impair our ability to respond humanely to future crises. 

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Austin, Tx/USA - May 23, 2020: Family members of prisoners held in the state prison system demonstrate at the Governor's Mansion for their release on parole due to the danger of Covid-19 in prisons.

Federal Failures to Protect Incarcerated People During Public Health Crises

By Rachel Kincaid

As the COVID-19 pandemic persists, and as we face the reality that future pandemics are coming (or have already begun), it’s a fitting time for the United States to take stock of how the carceral system has exacerbated the harms of COVID-19, and for policymakers to seriously consider what can and should be done differently going forward.

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Hand holding smartphone with colorful app icons concept.

The Fourth Amendment and the Post-Roe Future of Privacy

By Katie Gu

An April 2021 data privacy bill sponsored by Senator Ron Wyden (D-OR) has taken on new urgency in the post-Roe Digital Age.

The bipartisan bill, The Fourth Amendment Is Not For Sale Act, would close the current legal loophole through which the FBI, Department of Homeland Security, Department of Defense, Customs and Border Protection, Immigration and Customs Enforcement, and the Internal Revenue Service, have repeatedly purchased Americans’ personal and consumer information from data brokers.

In the wake of the recent Dobbs v. Jackson Women’s Health Organization decision, this bill may play an important role in protecting reproductive health data against government overreach and new forms of surveillance technologies.

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Washington, D.C. skyline with highways and monuments.

COVID-19 as Disability Interest Convergence?

By Jasmine E. Harris

Some have suggested that the COVID-19 pandemic could be a moment of what critical race theorist Derrick Bell called “interest convergence,” where majority interests align with those of a minority group to create a critical moment for social change.

It would be easy to think that interests indeed have converged between disabled and nondisabled people in the United States. From education to employment, modifications deemed “unreasonable” became not only plausible but streamlined with broad support.

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Protesters holding signs that read My Body My Choice, Human right, Bans Off Our Bodies, Abortion Is Healthcare.

Dobbs v. Jackson Women’s Health and Its Devastating Implications for Immigrants’ Rights

By Asees Bhasin

While reproductive injustice against immigrants is not new, they are now even more vulnerable to reproductive oppression in light of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturning the constitutional right to abortion.

Immigrant reproduction has long been vilified and opposed, with immigrant parents facing accusations of being hyper-fertile and giving birth to “anchor babies.” Additionally, pregnant immigrants have faced additional structural barriers to accessing necessary abortion care. This article explains how these injustices are likely to be exacerbated by the Dobbs ruling.

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