Hear no evil, see no evil, speak no evil: the unsightly Milosevic case

To ignore evil is to cause it to cease to exist, thought the ancients, and so, perhaps, think those who accuse former leaders of now dismembered countries, no longer in existence, of war crimes, and who would prevent those they accuse of raising the aggression which was committed against their country. Can the evil of aggression be willed out of existence if it goes unmentioned, and if international ad hoc bodies do not consider it a crime within their jurisdiction? And if the defendant is gagged, if judgments permit him to be removed from the courtroom altogether, will we be free from having to see and hear the evil he persistently identifies, and for which he points out there will be no justice? The Milosevic trial has been underreported to the point where “speaking evil” – that is, expressing criticism of the persistent procedural irregularities that have plagued the proceedings, and indeed the outright erosion of fair trial rights (heralded as “progress” in some quarters) – has become a demanding exercise. It is one we attempt here.     

Administrative "health courts" for medical injury claims: the federal constitutional issues

Our article analyzes whether the federal government may constitutionally supplant a traditional system of common-law trials before state judges and juries with new federal institutions designed by statute for compensating victims of medical injuries. Specifically, this article examines the federal constitutional issues raised by various proposals to replace traditional medical malpractice litigation in state courts with a federal system of administrative "health courts." In doing so, we address the following constitutional issues: 1. Is there federal authority to preempt state law (the commerce clause and spending clause issues)? 2. May jurisdiction be created in non-article 3 tribunals, and may claims be decided without trial by jury (the separation of powers and Seventh Amendment issues)? 3. Would pilot programs that require some claims to be pursued in a federal administrative forum while other claimants are left to pursue traditional state tort law remedies be constitutional (the equal protection issue)? The article concludes that a federal compensation system through administrative health courts should be constitutional provided the statute is appropriately drafted and that appropriate factual findings are made concerning the benefits to patients and the public as well as to doctors and their insurers.     

Delay reduction in the federal courts: Rule 50(b) and the Federal Speedy Trial Act of 1974

During the 1970s, 94 federal district courts implemented two major policy initiatives, Rule 50(b) of theFederal Rules of Criminal Procedure and the Federal Speedy Trial Act, that were designed in Washington to combat delay in the processing of federal criminal cases. Both of these initiatives established a national priority of delay reduction in criminal cases, encouraged local district court planning for delay reduction; established reporting procedures for monitoring local compliance, and provided for the determination of quantitative goals for the time to disposition of criminal cases. Neither initiative mandated specific activities for delay reduction; this determination was left to the discretion of local federal district courts. This research examines the effectiveness of Rule 50(b) and the Speedy Trial Act by constructing a 150-month time series of three measures of case processing time. A multiple-intervention time-series model found that both of these initiatives contributed to the dramatic reduction in the time to disposition in federal criminal cases. These effects persisted after controls for changes in case characteristics and judicial resources were introduced.Points of view expressed in this research are those of the author and do not necessarily represent the official position of the U.S. Department of Justice.     

Antitrust, health care quality, and the courts

Antitrust law represents the principal legal tool that the United States employs to police private markets, yet it often relegates quality and nonprice considerations to a secondary position. While antitrust law espouses the belief that vigorous competition will enhance quality as well as price, little evidence exists of the practical ability of courts to deliver on that promise. In this Article, Professors Hammer and Sage examine American health care as a vehicle for advancing understanding of the nexus among competition, quality, and antitrust law. The Article reports results of a comprehensive empirical review of judicial opinions in health care antitrust litigation between 1985 and 1999, with specific attention to courts' handling of quality and other nonprice concerns. Professors Hammer and Sage conclude that, although antitrust law cannot be expected to serve as the sole oversight mechanism for industries as complex and quality dependent as health care, courts have been successful incorporating some nonprice factors into antitrust analysis.     

Patients as consumers: courts, contracts, and the new medical marketplace

The persistent riddle of health-care policy is how to control the costs while improving the quality of care. The riddle's once promising answer--managed care--has been politically ravaged, and consumerist solutions are now winning favor. This Article examines the legal condition of the patient-as-consumer in today's health-care market. It finds that insurers bargain with some success for rates for the people they insure. The uninsured, however, must contract to pay whatever a provider charges and then are regularly charged prices that are several times insurers' prices and providers' actual costs. Perhaps because they do not understand the healthcare market, courts generally enforce these contracts. This Article proposes legal solutions to the plight of the patient-as-consumer and asks what that plight tells us about market solutions to the health-care quandary.     

Occupational health ethics: OSHA and the courts

Recent court decisions have stressed the necessity for cost-benefit analysis in evaluating Occupational and Safety Health Administration (OSHA) standards, thus raising difficult ethical questions which this paper analyzes using classical approaches of deontology and teleology. Since both modes of analysis have deficiencies, the need for a synthesis using economic and noneconomic measures is suggested.