Alaska public health law reform

The Turning Point Model State Public Health Act (Turning Point Act), published in September 2003, provides a comprehensive template for states seeking public health law modernization. This case study examines the political and policy efforts undertaken in Alaska following the development of the Turning Point Act. It is the first in a series of case studies to assess states' consideration of the Turning Point Act for the purpose of public health law reform. Through a comparative analysis of these case studies and ongoing legislative tracking in all fifty states, researchers can assess (1) how states codify the Turning Point Act into state law and (2) how these modernized state laws influence or change public health practice, leading to improved health outcomes.     

The invention of health law

By default, the courts are inventing health law. The law governing the American health system arises from an unruly mix of statutes, regulations, and judge-crafted doctrines conceived, in the main, without medical care in mind. Courts are ill-equipped to put order to this chaos, and until recently they have been disinclined to try. But political gridlock and popular ire over managed care have pushed them into the breach, and the Supreme Court has become a proactive health policy player. How might judges make sense of health law's disparate doctrinal standards? Scholars from diverse ideological starting points have converged toward a single answer: the law should look to deploy medical resources in a systematically rational manner, so as to maximize the benefits that every dollar buys. This answer bases the orderly development of health care law upon our ability to reach stable understandings, in myriad circumstances, of what welfare maximization requires. In this Article, I contend that this goal is not achievable. Scientific ignorance, cognitive limitations, and normative disagreements yield shifting, incomplete, and contradictory understandings of social welfare in the health sphere. The chaotic state of health care law today reflects this unruliness. In making systemic welfare maximization the lodestar for health law, we risk falling so far short of aspirations for reasoned decision making as to invite disillusion about the possibilities for any sort of rationality in this field. Accordingly, I urge that we define health law's aims more modestly, based on acknowledgement that its rationality is discontinuous across substantive contexts and changeable with time. This concession to human limits, I argue, opens the way to health policy that mediates wisely between our desire for public action to maximize the well being of the many and our intimate wishes to be treated noninstrumentally, as separate ends. I conclude with an effort to identify the goals of health law, so constructed, should pursue and to suggest how a strategy of accommodation among these goals might apply to a variety of legal controversies.     

The future of public health law

Developments in medicine and constitutional law dictate modification of public health legislation in the United States. Traditionally overlooked by legislators, present public health laws provide inadequate decision-making criteria and inappropriate procedures for dealing with issues. Revised legislation should provide health care officials and agencies with the tools to balance individual rights against public health necessities. This Article makes four recommendations for legislative reform: (1) remove artificial legislative distinction between venereal and other communicable diseases; (2) provide criteria defining "public health necessity" to limit discretionary exercise of police power by health officials; (3) provide strong confidentiality protections in the collection and storage of public health information; (4) empower public health officials to select from a graded series of less restrictive alternatives in dealing with public health problems.     

The ghost that slayed the mandate

Virginia v. Sebelius is a federal lawsuit in which Virginia has challenged President Obama's signature legislative initiative of health care reform. Virginia has sought declaratory and injunctive relief to vindicate a state statute declaring that no Virginia resident shall be required to buy health insurance. To defend this state law from the preemptive effect of federal law, Virginia has contended that the federal legislation's individual mandate to buy health insurance is unconstitutional. Virginia's lawsuit has been one of the most closely followed and politically salient federal cases in recent times. Yet the very features of the case that have contributed to its political salience also require its dismissal for lack of statutory subject matter jurisdiction. The Supreme Court has placed limits on statutory subject matter jurisdiction over declaratory judgment actions in which a state seeks a declaration that a state statute is not preempted by federal law--precisely the relief sought in Virginia v. Sebelius. These statutory limits are a sea wall; they keep out, on statutory grounds, some suits that should otherwise be kept out on Article III grounds. The statutory and constitutional limits on federal jurisdiction over suits like Virginia v. Sebelius insulate federal courts from the strong political forces surrounding lawsuits that follow from state statutes designed to create federal jurisdiction over constitutional challenges by states to federal law. This Article identifies previously neglected jurisdictional limits, shows why they demand dismissal of Virginia v. Sebelius, and explains why it is appropriate for federal courts to be closed to suits of this type.     

The collision of healthcare and corporate law in a hospital closure case

This Article analyzes potential conflicts that arise from both the judicial and administrative approval processes that govern the closure of charitable hospitals through a sale of all or substantially all of their assets. Examining the recent closure attempt by the Manhattan Eye, Ear & Throat Hospital as an example, the Article highlights the various public health and corporate law issues that are raised when a not-for-profit hospital seeks closure. The Article thoroughly discusses both the statutorily and judicially required approval schemes applicable to the closure of charitable hospitals. The Article also suggests ways in which these conflicts might be avoided or remedied, as well as gives advice regarding hospital board decisionmaking.     

Consumer managed care appeals: are the available procedural protections fundamentally fair?

Managed care incentives to reduce costs have also resulted in incentives to deny care. Anecdotes concerning managed care denials of care have led to a consumer outcry for protection either through the use of procedural due process or by the establishment of patient rights that would include appeal and grievance protections. This Article reviews the procedural protections of constitutional due process, the Consumer Due Process Protocol, and the Patient Bill of Rights. The Article then extensively discusses the availability of these procedural protections in various public and private forums. The discussion of public forums includes proposals contained in recent national legislative initiatives. The author then reviews relevant federal and state law, as well as Uniform Law proposals. Next, the Article analyzes the protections provided by accreditation agencies, dispute resolution organizations, professional organizations, and health insurers. Finally, the author recommends criteria to be used to determine whether a procedure is fundamentally fair.     

The Journalist in the Courtroom

"Proceedings in all courts shall be open to the public." Such is the content of Article 157 of the Constitution of the USSR. The principle that judicial proceedings are to be open to the public—a principle that is contained in the nation's highest legislative act—is of enormous practical significance. The fact that judicial proceedings are open to the public is a guarantee that procedural norms are scrupulously observed in the process of examining the materials of a case, thereby substantially reducing the probability of judicial error. It goes without saying that the further improvement of social oversight over the work of law enforcement agencies is a necessary condition to the democratization of public life. What is more, the openness of judicial proceedings to public scrutiny is a powerful means for the legal education of citizens and of forming a truly socialist legal conscience.     

Commons ignorance: the failure of environmental law to produce needed information on health and the environment

One of the most significant problems facing environmental law is the dearth of scientific information available to assess the impact of industrial activities on public health and the environment. After documenting the significant gaps in existing information, this Article argues that existing laws both exacerbate and perpetuate this problem. By failing to require actors to assess the potential harm from their activities, and by penalizing them with additional regulation when they do, existing laws fail to counteract actors' natural inclination to remain silent about the harms that they might be causing. Both theory and practice confirm that when the stakes are high, actors not only will resist producing potentially incriminating information but will invest in discrediting public research that suggests their activities are harmful. The Article concludes with specific recommendations about how these perverse incentives for ignorance can be reversed.     

Law and public health: beyond emergency preparedness

This Article examines three questions: What is public health? What is public health law? What roles can lawyers play in public health? It first describes the breadth of public health, highlighting six trends shaping its future: social determinants of health; synergy between medicine and public health; shifts in focus from external (e.g., environmental and social) to internal (behavioral) risks to health; federalization of public health law; globalization of health risks and responses; and bioterrorism. Because the domains of law that apply to public health are equally broad, the Article next offers a conceptual framework for identifying the types of laws most suitable to different public health problems. Finally, the role of lawyers in the applied field of public health law is examined, first to encourage attention to law's effect on health, even laws having little apparent relationship to health; and second, to recognize that laws intended to achieve specific health outcomes may affect broader legal principles. Lawyers have a unique role to play in ensuring that the legal principles used to promote health also preserve justice.     

Recent developments in German health law

Health law provides the regulatory constitution for the medical and healthcare system. It covers individual medical treatment as well as public healthcare provision and is insofar medical law as well as social security law (statutory health insurance law). The medical and health sciences (public health sciences) are the main complementary disciplines of health law. This article gives an account of some representative developments in both fields which have taken place in the last three years.     

Construction of a policy arena: the case of public health in France

In this article we examine the transformation over the past two decades of public health as a policy arena in France from a backwater of little interest to politicians, bureaucrats, the media, and the public into a central preoccupation of the state. Recent dramatic health crises (the scandal over HIV-contaminated blood, mad cow disease, etc.) have substantially raised the political profile of (and corresponding state investment in) public health in France, offering opportunities and incentives for political actors not traditionally associated with public health to enter the field and challenging more traditional actors to galvanize themselves and compete for this newly attractive policy terrain. We use the occasion of the passage of a public health law in 2004, labeled by its proponents as the "first" public health law in one hundred years, to show how, in a context of national struggle to contain both risks and costs, "public health" -- chameleonlike -- has taken on various meanings and forms to serve highly conflicting political interests.     

Informing the Population About the Activity of State Agencies

Under the conditions of developed socialism, the general problem of informing the population, and that of its knowledge about matters of state and law in particular, becomes increasingly more pertinent. "The development of socialist democracy," said L. I. Brezhnev at a meeting with voters of the Bauman Electoral District in Moscow on June 10, 1966, "demands the solution of many problems that the Party has placed on the order of business." One of these tasks is "providing fuller information to the people about everything happening within the country and on the world scene, and increasing publicity [glasnost'] about the work of the agencies of Soviet government." The Communist Party associates improvement of socialist democracy particularly with the level of society's information "about the policies of the Party and state." (1) Therefore, the Soviet government pays much attention to the solution of questions associated with informing the citizenry about the work of governmental agencies and also about their regulation by law. Thus, for example, in the RSFSR law "On the District Soviet of Working People's Deputies of the RSFSR" (June 29, 1971), we read about the responsibility of the executive committee to inform the population about questions placed on the order of business of the soviet (Article 33), to bring decisions of the district soviet to the knowledge of the citizens (Article 38), and to report on its work at meetings of the working population and at citizens' places of employment (Article 55). Article 93 reads: "The district soviet of working people's deputies is responsible for informing the population about its functioning. …" Presidiums of the supreme Soviets of union and autonomous republics monitor observation of provisions of the law, assuring that the population will be widely informed on the work of state agencies. (2) In this connection, examination of the question of the content and forms whereby the population of the USSR becomes informed about the activity of state agencies is of interest.     

Why fairness cannot be automated: Bridging the gap between EU non-discrimination law and AI

In recent years a substantial literature has emerged concerning bias, discrimination, and fairness in artificial intelligence (AI) and machine learning. Connecting this work to existing legal non-discrimination frameworks is essential to create tools and methods that are practically useful across divergent legal regimes. While much work has been undertaken from an American legal perspective, comparatively little has mapped the effects and requirements of EU law. This Article addresses this critical gap between legal, technical, and organisational notions of algorithmic fairness. Through analysis of EU non-discrimination law and jurisprudence of the European Court of Justice (ECJ) and national courts, we identify a critical incompatibility between European notions of discrimination and existing work on algorithmic and automated fairness. A clear gap exists between statistical measures of fairness as embedded in myriad fairness toolkits and governance mechanisms and the context-sensitive, often intuitive and ambiguous discrimination metrics and evidential requirements used by the ECJ; we refer to this approach as “contextual equality.”This Article makes three contributions. First, we review the evidential requirements to bring a claim under EU non-discrimination law. Due to the disparate nature of algorithmic and human discrimination, the EU's current requirements are too contextual, reliant on intuition, and open to judicial interpretation to be automated. Many of the concepts fundamental to bringing a claim, such as the composition of the disadvantaged and advantaged group, the severity and type of harm suffered, and requirements for the relevance and admissibility of evidence, require normative or political choices to be made by the judiciary on a case-by-case basis. We show that automating fairness or non-discrimination in Europe may be impossible because the law, by design, does not provide a static or homogenous framework suited to testing for discrimination in AI systems.Second, we show how the legal protection offered by non-discrimination law is challenged when AI, not humans, discriminate. Humans discriminate due to negative attitudes (e.g. stereotypes, prejudice) and unintentional biases (e.g. organisational practices or internalised stereotypes) which can act as a signal to victims that discrimination has occurred. Equivalent signalling mechanisms and agency do not exist in algorithmic systems. Compared to traditional forms of discrimination, automated discrimination is more abstract and unintuitive, subtle, intangible, and difficult to detect. The increasing use of algorithms disrupts traditional legal remedies and procedures for detection, investigation, prevention, and correction of discrimination which have predominantly relied upon intuition. Consistent assessment procedures that define a common standard for statistical evidence to detect and assess prima facie automated discrimination are urgently needed to support judges, regulators, system controllers and developers, and claimants.Finally, we examine how existing work on fairness in machine learning lines up with procedures for assessing cases under EU non-discrimination law. A ‘gold standard’ for assessment of prima facie discrimination has been advanced by the European Court of Justice but not yet translated into standard assessment procedures for automated discrimination. We propose ‘conditional demographic disparity’ (CDD) as a standard baseline statistical measurement that aligns with the Court's ‘gold standard’. Establishing a standard set of statistical evidence for automated discrimination cases can help ensure consistent procedures for assessment, but not judicial interpretation, of cases involving AI and automated systems. Through this proposal for procedural regularity in the identification and assessment of automated discrimination, we clarify how to build considerations of fairness into automated systems as far as possible while still respecting and enabling the contextual approach to judicial interpretation practiced under EU non-discrimination law.     

Local law enforcement terrorism prevention efforts: A state level case study

Although law enforcement agencies across the nation have assumed part of the responsibility in the fight against terrorism, significant confusion exists as to the role of local law enforcement. While some agencies have taken steps towards terrorism prevention, little data has been collected on which agencies have taken the greatest steps, how those agencies have changed, and how other agencies should direct their activity. This case study of law enforcement census data from a single state considered variations in terrorism preparedness and predictors of preparedness. Agency size, presence of funding, and other variables significantly predict levels of terrorism preparedness. Important policy implications such as the distribution of funding and which agencies should be working towards terrorism preparedness are discussed.     

The economic analysis of public law

Law and economics in the United States and Europe focuses on private law. With the exception of work on antitrust and corporate finance, public law has been largely ignored. Yet economics is central to the understanding of social problems, such as environmental protection and occupational health and safety. Lawyer-economists need to study the relationship between government structure and policy outcomes. Economists must consider goals, such as democratic accountability and participation, which do not fit an efficiency framework.Lawyers and public officials need to recognize the social benefits of efficiency. Such legal-economic analysis can reveal failures in the way public law accommodates the practical reality of today's pressing social problems. It can also suggest solutions. In particular, economics can help with the design of substantive policies and with the analysis of government structures and process.     

监狱工作宗旨论析——基于执法为民理念

文章基于执法为民理念,阐释对监狱工作宗旨的理解。文章认为,监狱工作宗旨根源于党的根本宗旨,其实质是为人民服务;“为罪犯服务”的提法因其政治上、法律上的谬误而有悖于监狱工作宗旨,而“为罪犯改造服务”的提法因其逻辑上的含混而无法正确诠释监狱工作宗旨;监狱警察履行监狱工作宗旨,应当做到牢固树立人民公仆意识,忠诚执法,自觉服务于构建社会主义和谐社会。     

经济法的利益观

受到以主客观分离与对立为出发点的二元思维模式的影响 ,在社会结构方面形成了市民社会与政治国家分立的二元理论 ,在法学领域中也形成了以规制政治国家权力为主的公法部门和以调整市民社会关系为主的私法部门的二元划分。随着社会的发展 ,传统的关于市民社会与政治国家截然分开的理论受到挑战 ,政治国家与市民社会日渐融合 ,经济法的出现是这种趋势在法律上的体现之一。经济法作为贯穿于政治国家与市民社会领域的一个新兴的法律部门 ,其利益观体现出一定的综合性 ,融合了运行于市民社会中的私法与运行于政治国家中的公法的双重特征。经济法虽然以社会利益作为其首要的保护目标 ,但其对社会利益保护的实质是以个人利益为核心的个人利益、国家利益、社会利益之间协调的结果。     

Pluralism and local law in extraterritorial spaces

Based on ethnographic research, this article shows how legal orders are being established in spaces where the state law is absent. The case of refugee camps—often discussed as sites of legal limbo and state of exception—seems to be a space of legal pluralism. However, when observing local legal practices, this pluralism is dissolved into a powerful local camp law. This characteristic type of legal order is produced by social camp-specific mechanisms, camp materiality as well as the remaking of pre-camp structures. Therefore, refugee camps should be viewed as extraterritorial spaces with a high degree of legal autonomy that enables and forces residents to create a local camp law. The findings of this study add to the literature of law and order in camps and to the debates on plural configurations in extraterritorial spaces.     

Law enforcement and political change in post-civil war Nigeria

The impact of law enforcement on political change may be observed in three sets of attitudes by groups and individuals: national consciousness, that is the acceptance of the nation as a meaningful identity symbol; class consciousness, that is identification with a class against other classes; and legitimacy, that is the acceptance of the state as a rightful source of commands. A discussion of general theories of law enforcement and their impact on these attitudes, and of politics and the police in post-civil war Nigeria leads to the conclusion that the police, by the manner in which they enforce the laws, do have an effect on legitimacy orientations, though a weak one. Law enforcement agencies do not contribute significantly to the creation of social and political changes but reflect changes that arise and are fought out in other spheres of societal life.     

Absolute and relative support among citizen-voters for local law enforcement agencies: Correlates with selected dimensions of political ideology

During the last twenty years numerous studies have been published regarding public support for local law enforcement agencies. These studies have typically focused on three determinants of support-the social status of the citizen, citizen fear or actual victimization of crime, and the nature or frequency of citizen-police contacts. This somewhat exploratory research evaluates the impact of political ideology upon citizen support for law enforcement agencies. The thrust of the investigation builds upon much more limited considerations of ideology in earlier studies. An assessment and comparison of support according to absolute/diffuse measures and relative/specific measures of citizen-voter support are presented. Political ideology is defined in the context of contemporary liberal-conservative perspectives and operationalized according to nominal (self-identification)and issue-oriented techniques.