KYIV, UKRAINE - Feb. 25, 2022: War of Russia against Ukraine. A residential building damaged by an enemy aircraft in the Ukrainian capital Kyiv.

Misplaced Skepticism on Accountability for War Crimes Against Health Care in Ukraine

By Leonard Rubenstein

Russian attacks on hospitals, ambulances, and health workers in Ukraine — including more than 180 attacks confirmed by the World Health Organization, and double that number reported by the Ministry of Health — have gained global attention. In one case, viral photos document the evacuation of pregnant women, including one on a stretcher who later died, from a maternity hospital in Mariupol destroyed by Russian shelling. It is likely that investigations will show that many of these acts are war crimes. Accountability for these crimes must be pursued.

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London, England, UK, January 22nd 2022, Long covid symptoms sign on pharmacy shop window UK.

Mobilizing Long COVID Awareness to Better Support People with Acquired Disabilities

By Marissa Wagner Mery

Long COVID exposes an often-unacknowledged facet of disability: that one is far more likely to develop a disability than be born with one.

Estimates suggest that, at present, approximately 10 – 20 million Americans are now afflicted with the array of debilitating symptoms we now call Long COVID, which include fatigue, shortness of breath, and cognitive dysfunction or “brain fog.”

The upswell of advocacy and awareness around Long COVID should be mobilized to call attention to and address the challenges faced by newly-disabled adults, particularly with respect to employment.

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Sign at train station in Berlin that describes free support for pet owners coming from Ukraine.

Ethical Challenges Associated with the Protection of Pets in War

(Photo: Sign at the central train station in Berlin (Berlin Hauptbahnhof) that offers free support for pet owners coming from Ukraine. Courtesy of Kristin Sandvik.)

By Kristin Bergtora Sandvik

Introduction

The care for animals rapidly became a part of the humanitarian narrative of the attack on Ukraine.

There are countless accounts of the efforts of activists, shelters and zoo staff to keep animals alive, as well as underground operations to get them to safety. And, as Ukrainians flee for their lives, they are frequently accompanied by their pets.

EU initiatives and advocacy efforts by animal rights groups pushed receiving countries to modify entrance requirements, waive fees, provide veterinary services, and shorten or eliminate quarantine times. The EU announced a special derogation in Regulation 2013/576, allowing the import of Ukrainian refugee pets without meeting standard requirements. Many governments have welcomed Ukrainian pets with or without their owners, and without documentation, rabies vaccine, and/or microchip.

Humanitarian action is typically human centric; this broad societal acceptance of pets as legitimate refugee companions, and the attendant rapid regulatory accommodations, are unique developments. In this blog, I draw on perspectives from disaster studies, international humanitarian law (IHL), refugee studies, and animal studies to articulate a set of ethical dilemmas around classification and policymaking that arise when pets are recognized as a humanitarian protection problem.

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Doctors performing surgery.

The Need to Go Back to Basics in Patient Safety

By John Tingle and Amanda Cattini

In the hustle and bustle of our daily professional lives, it is sometimes all too easy to forget about the basics. In terms of health care practice and patient safety, these underpinning basic, foundational concepts include the need for proper patient communication strategies.

The consequences of failures in patient communication can be devastating. There is a need to go back to this basic issue at regular intervals.

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Two women shaking hands.

An Empathetic Ear: Strategies for Employer Health and Wellness Negotiations

By Stacey Lee, Jacobo Guzman, and Gladys Johnson

Amid federal and state vaccine mandates, labor shortages, and increased requests for remote work flexibility, employers find themselves in an evolving landscape with less latitude over their organization’s workplace. As a result, employers and employees find themselves in conversations about crafting a “new normal” in which worker well-being is featured more prominently than before.

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Gavel and stethoscope.

Long COVID and Physical Reductionism

By Leslie Francis and Michael Ashley Stein

Like plaintiffs with other conditions lacking definitive physiological markers, long COVID plaintiffs seeking disability anti-discrimination law protections have confronted courts suspicious of their reports of symptoms and insistent on medical evidence in order for them to qualify as “disabled” and entitled to statutory protection.

We call this “physical reductionism” in disability determinations. Such physical reductionism is misguided for many reasons, including its failure to understand disability socially.

Ironically, these problems for plaintiffs may be traced to amendments to the Americans with Disabilities Act (ADA) that were intended to expand coverage for plaintiffs claiming disability discrimination. Three provisions of the Americans with Disabilities Act Amendments Act (ADAAA) are appearing especially problematic for long COVID patients in the courts.

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Waiting area in a doctor's office

Churntables: A Look at the Record on Medicaid Redetermination Plans

By Cathy Zhang

The COVID-19 Public Health Emergency (PHE) expires at the end of this week, with Department of Health and Human Services (HHS) Secretary Xavier Becerra expected to renew the PHE once more to extend through mid-July.

When the PHE ultimately expires, this will also trigger the end of the Medicaid continuous enrollment requirement, under which states must provide continuous Medicaid coverage for enrollees through the end of the last month of the PHE in order to receive enhanced federal funding. This policy improves coverage and helps reduce churn, which is associated with poor health outcomes.

After the PHE, states can facilitate smooth transitions for those no longer eligible for Medicaid by taking advantage of the full 12- to 14- month period that the Centers for Medicare & Medicaid Services (CMS) has established for redetermining eligibility.

In August 2021, CMS released guidance giving states up to 12 months following the end of the PHE to redetermine whether Medicaid enrollees were still eligible and renew coverage. Last month, CMS released new guidance specifying that states must initiate redeterminations and renewals within 12 months of the PHE ending, but have up to 14 months to complete them. The agency is encouraging states to spread its renewals over the course of the full 12-month unwinding period, processing no more than 1/9th of their caseloads in a month, in order to reduce the risk of inappropriate terminations.

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GHRP affiliated researchers.

Introducing the Global Health and Rights Project’s New Affiliated Researchers

(Clockwise from top left: Alma Beltrán y Puga, Luciano Bottini Filho, Ana Lorena Ruano, María Natalia Echegoyemberry)

By Alicia Ely Yamin and Chloe Reichel

Leer en español.

In the years before the pandemic, and especially since the pandemic began, there have been increasing calls to decolonize global health. Setting aside what Ṣẹ̀yẹ Abímbọ́lá rightly characterizes as the slipperiness of both the terms “decolonizing” and “global health,” these calls speak to the need to reimagine governance structures, knowledge discourses, and legal frameworks — from intellectual property to international financial regulation.

Global health law itself, anchored in the International Health Regulations (2005), purports to present a universal perspective, but arguably rigidifies colonialist assumptions about the sources of disease, national security imperatives, priorities in monitoring “emergencies,” and governance at a distance. The diverse tapestry of international human rights scholarship related to health is often not reflected in analyses of the field from the economic North. In turn, that narrow vision of human rights has also increasingly faced critiques from TWAIL, Law & Political Economy, and other scholars, for blinkered analyses that fail to challenge the structural violence in our global institutional order — which the pandemic both laid bare and exacerbated.

In an attempt to enlarge discussion of these important topics and amplify diverse voices, the Petrie-Flom Center is welcoming four new affiliated researchers to the Global Health and Rights Project (GHRP).

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HVAC tech wearing mask and gloves changing an air filter

Providing Clean Air in Indoor Spaces: Moving Beyond Accommodations Towards Barrier Removal

By Jennifer Bard

One of the most persistently frustrating aspects of the Americans with Disabilities Act (ADA), as currently applied to schools and workplaces, is its emphasis on the eligibility of qualifying individuals for accommodation, rather than on population-based removal of barriers to participation.

This individualized approach has always been an uncomfortable fit, given the reality of changes in physical function throughout the lifespan, and is a particularly unsatisfying model for the collective threat of COVID-19, a novel virus that has not only caused at least a million deaths in the United States, but is likely to trigger a variety of disabling sequelae in many (perhaps most) of those who recover.

So far, however, there is mounting evidence that individuals who seek to protect themselves from infection with COVID-19 in school or in the workplace (very much including those who work in schools) are going to have to do based on their individual susceptibility to contracting COVID-19 or to being disproportionately affected by an infection.

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Medicine law concept. Gavel and stethoscope on book close up

Transdisciplinary Integration: The Only Way Forward for Public Health

By Scott Burris

As we look toward National Public Health Week amid two long years of a pandemic, reflection for us at the Center for Public Health Law Research has focused on how we move forward in a mostly broken public health system. We see public health law as a central component of a strong future for public health, where transdisciplinary partnership leads the way.

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