Jurisprudential Dilemmas of European Law

Making a first sketch of philosophical issues arising fromEuropean Community law I want to present a series ofmore or less obvious, and more or less interrelated dilemmas,or even double binds.(i) Deepening the community becomes incompatible withwidening membership. (ii) National states seem bothnecessary for and obstructive in articulating transnationalproblems. (iii) The more democracy is needed as a warrantfor the public exercise of political power in Europe, themore the very concept of democracy on a European scaleevades understanding. (iv) European unity presupposes aunifying rule of law, while member states have radicallydifferent conceptions of this principle. (v) Even the verycore of European integration, the common market, is subjectto two conflicting and, indeed, incompatible doctrines ofcompetition. In explaining the nature of each dilemma I willtry to take my cue from the Maastricht Treaty wherever thisseems suitable. Then I will elaborate on the jurisprudentialproblems involved in it. Finally, each section will be closedby an attempt to state the nature of these problems inphilosophical terms.     

MEDGuide and patient package inserts--again?

This article will trace the history and effects of the PPI from the time of its original concept by the FDA in the early 1970's to its current status. It will also address the response to this FDA initiative by the industry, medical community and consumer groups. Initiatives in other countries and future issues will also be discussed.     

The government's best offense is deference: the decision of the Supreme Court in Shalala v. Guernsey Memorial Hospital

The United States Supreme Court agreed with the Secretary of Health and Human Services that Guernsey Memorial Hospital's advance refunding transaction costs would be subject to a medicare reimbursement policy that is not based upon generally accepted accounting principles. According to the sharp dissent in this case, this policy, set forth in a manual provision, contradicts federal regulations.     

Physician recruitment after Hermann Hospital

The state of physician recruitment changed after the Internal Revenue Service required Hermann Hospital to publish its closing agreement with the IRS. The closing agreement released the long-awaited IRS "Hospital Physician Recruitment Guidelines." The IRS' recently proposed revenue ruling provides additional insight on acceptable physician recruitment practices as well.