Public health law in the new century

Public health law is a broad and sometimes nebulous field which has undergone extensive reform and rethinking over the past decade. This article provides a survey of current issues in public health law, highlighting these reforms and the potential for public health legislation to deal with upcoming threats, notably bioterrorism. While recognising the anxieties bioterrorism brings, public health responses must be grounded in a coherent philosophy of risk management. Its administrators must also be aware that large-scale threats to public health are not unprecedented and that past experience can provide an important guide for future strategies.     

Oversight of HMRC soft law: lessons from the Ombudsman

An investigation of the role which the Ombudsman plays in tax law, on which comparatively little has been written, reveals that the body makes an important and distinct contribution. There is now almost universal acceptance that tax law is overly complex and indeterminate. If the primary law offers few answers to the taxpayer, then HMRC’s role as administrator of the system becomes apparent. Soft law elaborating upon how HMRC will apply the primary law to a given class of taxpayers is rendered indispensable. In practice however, HMRC soft law has often been found to be deficient. Analysis of the current oversight arrangements for HMRC soft law immediately reveals the genesis of these issues. Select committees exercise Parliamentary control, whilst an independent body performs external audits. These entities however only incommensurately examine the soft law. Into this void steps the Parliamentary and Health Service Ombudsman, a body which has ‘carved for itself a distinctive niche’ in the public law framework. The paper accordingly seeks to elaborate upon the important role that the Ombudsman plays in scrutinising HMRC soft law and the lessons which can be derived from this analysis.     

Teaching medical ethics and law

The teaching of medical ethics is not yet characterised by recognised, standard requirements for formal qualifications, training and experience; this is not surprising as the field is still relatively young and maturing. Under the broad issue of the requirements for teaching medical ethics are numerous more specific questions, one of which concerns whether medical ethics can be taught in isolation from considerations of the law, and vice versa. Ethics and law are cognate, though distinguishable, disciplines. In a practical, professional enterprise such as medicine, they cannot and should not be taught as separate subjects. One way of introducing students to the links and tensions between medical ethics and law is to consider the history of law via its natural and positive traditions. This encourages understanding of how medical practice is placed within the contexts of ethics and law in the pluralist societies in which most students will practise. Four examples of topics from medical ethics teaching are described to support this claim. Australasian medical ethics teachers have paid less attention to the role of law in their curricula than their United Kingdom counterparts. Questions like the one addressed here will help inform future deliberations concerning minimal requirements for teaching medical ethics.     

Energy transitions and trade law: lessons from the reform of fisheries subsidies

Fossil fuel subsidies, like subsidies to the fishing sector, lead to trade-distorting and ecologically harmful practices. The US$35 billion in subsidies provided by countries every year to the fishing sector leads to more and more boats being built, even as 90% of fish stocks are either fully exploited or overfished. An estimated US$444 billion in subsidies are provided annually for the production of fossil fuels by G20 countries, even as evidence emerges that oil, gas and coal reserves must remain unexploited to limit global warming increases to 2 °C. Of course, each country has its own development priorities, livelihood concerns and need for food and energy security. Agreeing upon subsidy reform is a complex undertaking that requires the assessment of social, political and historical considerations, as well as the involvement of international and transnational legal regimes that govern climate change, energy, fisheries and trade. This article reviews proposals for reform within the World Trade Organization and regional trade agreements, including the new disciplines on fisheries subsidies that were endorsed in the text of the Trans-Pacific Partnership. Although the latter agreement is unlikely to enter into force, consensus is emerging on the need to prohibit subsidies that contribute to overfishing or that are linked to illegal, unreported or unregulated fishing. The article shows how these legal developments might inform attempts to limit fossil fuel production and consumption subsidies. It highlights the need for learning and open deliberation about subsidy reform by affected stakeholders, including representatives from international organizations and civil society. It also points to new arrangements that link compliance with subsidy rules to standards and benchmarks from fisheries regimes, and demonstrates how such inter-regime connections are legitimate in the context of the fragmentation of international law. While reform to fisheries subsidies is still preliminary and fraught, there are useful lessons for the equally important project of energy transitions.     

Exploring the flexibilities in TRIPS: lessons from India's pharmaceutical patent law

This article examines the extent to which the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) permits countries to utilize two key flexibilities, i.e. the exclusion of new forms of known drugs from patent protection and local working requirements to facilitate access to affordable medicines and foster domestic pharmaceutical innovation. It examines how India has implemented and recently utilized these two key flexibilities and concludes with the view that other developing countries can equally follow the Indian model.     

Navigating the minefield: legal ethics and healthcare law

Practicing law in the healthcare field is a daunting task due to the highly-regulated nature of the field and the increasing scrutiny of the conduct of industry providers, payors, and vendors. Attorneys must provide difficult opinions regarding matters with civil, criminal, and reimbursement implications and often are asked to represent multiple parties in healthcare-related settings. This article discusses some legal ethics issues for the healthcare practitioner and touches on some of the recent changes to the Model Rules of Professional Conduct, which were adopted by the American Bar Association's House of Delegates at its mid-February 2002 meeting. The authors conduct their analysis by applying the model rules to a number of hypothetical fact situations typical of those encountered in the day-to-day practice of healthcare law.     

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.