Doctors and patients sit and talk. At the table near the window in the hospital.

When and How to Resume Non-Urgent Care During COVID-19

By Louise P. King, MD, JD and Sigal Klipstein, MD

In recent days, we have seen our efforts at physical distancing flatten curves to mesas and begun to discuss re-opening for “elective” –- more commonly referred to as non-urgent -– medical care.

At some fundamental level, almost all care is essential to the individual seeking it, just as all lives have intrinsic value. The question then is not what is “essential,” because in trying to create such a list we will invariably wish to include so many conditions that we will list much of the breadth of medicine.

Instead, the question must be: can we accommodate non-emergent/non-urgent care safely or not, and if yes, which care do we address first as we re-open? While we cannot address all the issues raised by these questions in this short piece, we will highlight some considerations below.

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NHS building

Obtaining a Hospital Bed in the COVID-19 Pandemic: A Legal Perspective

By John Tingle

The recently reported case of University College London Hospitals NHS Foundation Trust v MB [2020] EWHC 882 captures well the value of English common case law in resolving complex health care disputes within the context of the COVID-19 pandemic and more generally.

Mr Justice Chamberlain in the Queen’s Bench Division of the High Court of Justice ruled recently that a patient, known as MB, who had occupied an NHS bed for over a year, must vacate it and instead receive care in the community. Her room could be required urgently by COVID-19 patients and there would be an increased risk of MB contracting COVID-19 if she remained in hospital.

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corridor with hospital beds

COVID-19 is a Perfect Storm of Hardship for US Immigrant Communities

By Amanda M. Gutierrez, Jacob Hofstetter, and Mary Majumder

The burdens of the COVID-19 pandemic are not borne equally. Immigrant communities, along with communities of color and people experiencing existing health inequities, are expected to face disproportionate effects.

This piece provides an overview of the spectrum of COVID-19-related risks – including socioeconomic hardship, vulnerability to infection, and challenges in access to care – faced by many of the 45 million immigrants in the U.S., especially those who are low-income or undocumented.

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WASHINGTON MAY 21: Pro-choice activists rally to stop states’ abortion bans in front of the Supreme Court in Washington, DC on May 21, 2019.

The Harms of Abortion Restrictions During the COVID-19 Pandemic

By Beatrice Brown

Several states, including Texas, Ohio, and Alabama, have dangerously and incorrectly deemed abortions a non-essential or elective procedure during the COVID-19 pandemic. The stated reason for these orders is to conserve personal protective equipment (PPE), a scarce, important resource for protecting health care workers treating COVID-19 patients.

However, these policies restricting abortion are unlikely to conserve PPE, and more importantly, they mischaracterize the nature and importance of abortions.

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Health care workers in personal protective equipment attend to a patient.

Preparing to Go Back to the Bedside During COVID-19: A Nurse-Turned-Bioethicist Reflects

By Emily Largent

Alarms are going off. They are loud and insistent, demanding the attention of doctors and nurses. I hear them, too.

Roughly a decade ago, I was a cardiothoracic ICU nurse in Los Angeles, California. Working with patients was deeply satisfying, but I regularly encountered ethical challenges that I wanted to address. Therefore, I stepped away from the bedside to go to law school and pursue my PhD in health policy. Now, I live in Philadelphia and work on ethical issues in medical policy and practice.

Recently, though, I renewed my California nursing license and began the process of pursuing a Temporary Practice Permit in Pennsylvania. The COVID-19 pandemic requires us all to sacrifice, to serve in ways that advance the greater good. So, I located the clogs I had pushed to the back of the closet and (literally) dusted them off. My parents sorted through the boxes I’d left in their garage when I moved east for grad school; they found my stethoscope and a few pairs of scrubs and shipped them to me. The box arrived this weekend.

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a covid 19 swab test being inserted into a vile

Maintaining Healthy Skepticism About Reported COVID-19 Findings

By Andy Podgurski and Sharona Hoffman

The COVID-19 pandemic presents special challenges to even well-informed and well-intentioned promulgators and consumers of medical research findings, including the legal community.

The stakes in the debate about handling the pandemic are extremely high in terms of lives, jobs, wealth, and political power. In addition, there are tremendous opportunities for researchers to receive attention and notoriety for influencing the debate.

All this means that perverse incentives exist to publicize initial scientific findings that are dubious, poorly vetted, and possibly dangerous to public welfare. The risk of promulgating false or misleading scientific claims is substantial, even when they are made by well-respected scientists affiliated with prestigious institutions. Government authorities must be extremely cautious about basing public policy decisions on inadequately vetted findings, no matter how much hype they get.

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view of Chicago

What Two Neighborhoods in Chicago Show About Disparities During COVID-19

By Michael Atalla

Minorities, especially African-Americans in metropolitan areas, are being infected with and dying from COVID-19 at higher rates than their white counterparts.

This phenomenon is occurring in many large cities like New York, Detroit, and New Orleans. This piece focuses on Chicago — arguably the most segregated city in all of America. Comparing two zip codes within Chicago city limits with similar population sizes but divergent racial composition, the disparities are striking.

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Box of Hydroxychloroquine Tablets

Human Subjects Research in Emergencies: The Texas Nursing Home “Study” (Part II)

By Jennifer S. Bard

This post is the second in a series about conducting human subjects research in emergencies. These posts are being written in response to a rapidly evolving situation and will reflect the state of knowledge at the time of writing.

In April 2020, Dr. Robin Armstrong, medical director of the Resort, a nursing home in Texas City, Texas, reported “signs of improvement” after he gave hydroxychloroquine, a drug approved by the FDA to treat malaria, to 39 of his nursing home patients who were diagnosed with COVID-19.

At about the same time, information was emerging that now represents the current understanding that hydoxychloroquine isn’t only ineffective in treating COVID-19, but also may cause serious harm to patients. Tensions were raised even higher by the seemingly inexplicable enthusiasm for this treatment by the President and some media outlets.

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New Virtual Issue of Journal of Law and the Biosciences: Editors’ Choice 2020

In this virtual issue from Journal of Law and the Biosciences, we present 17 informative articles, published in 2017-2019, hand-picked by the journal’s three Editors-in-Chief: Nita Farahany from Duke University, Hank Greely from Stanford University, and Glenn Cohen from Harvard Law School.

This specially curated article collection examines a range of matters focusing on the intersection of law and the biosciences, including whether a complete ban on surrogacy is compatible with the American Convention on Human Rights, what role should law play when genetic privacy is concerned, or what opportunities and challenges there are for forensic psychiatry regarding brain-based mind reading.

In selecting articles for this virtual issue, the Editorial Board aims to emphasize the high-quality studies published in Journal of Law and the Biosciences and hopes these will stimulate further research in this new important field.

Check out the full collection!

Busy Nurse's Station In Modern Hospital

Medical Licensure Law Suspensions During COVID-19 Present Opportunity for Change

By Alexa Richardson

As the coronavirus pandemic threatens to overwhelm the health care system, states have responded by broadly suspending licensure laws for health care providers.

The collective rollback of licensure laws is an opportunity for states to reexamine their priorities around provider licensing, and to pursue values like access to care and evidence-based scope of practice over protection of provider interest groups.

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