This paper explores the use of mediation in medical treatment disputes through the lens of therapeutic justice (TJ), a concept developed in the 1990s to consider the therapeutic and anti-therapeutic effects of justice systems. The paper argues that mediation may be a mechanism for achieving therapeutic effects for people involved in medical treatment disputes. In doing so, the paper highlights the conflict that can often arise between healthcare professionals, family members and patients in medical treatment disputes and the related difficulties with using litigation to resolve this type of conflict. It has been suggested by judges, academics and policy-makers that mediation might be a better way of resolving conflict in these cases. While mediation and TJ have much in common, the paper explores the many tensions between them, considering ways in which mediation might need to be done differently to achieve therapeutic aims. Finally, the paper identifies six TJ features against which mediation can be tested to consider whether it can live up to the claims that it can be used to resolve medical treatment disputes more therapeutically.

Over the past twenty-five years, the Center for Health Law, Ethics, and Human Rights (CLER) has been a leader in torture treatment, advocacy, and education. In 1998, the Boston Center for Refugee Health and Human Rights (BCRHHR) was founded to provide holistic treatment to asylum seekers who have been tortured by their governments and justifiably feared further persecution if they returned to their countries. Seeking justice is an important part of healing for survivors, and BCRHHR clinicians work closely with immigration attorneys to document clinical evidence of torture to support asylum applications. Following the September 11 attacks in 2001, it was revealed that the U.S. government tortured captives and committed other war crimes. CLER scholars examined how doctors and lawyers worked with the Central Intelligence Agency (CIA) to rationalize and sanitize torture, providing legal immunity for perpetrators. My colleagues and I at CLER assumed a national leadership role in opposing practices that constitute torture, as well as cruel, inhumane, and degrading treatment. These practices included the force-feeding of hunger strikers, the Rendition, Detention, and Interrogation (RDI) program (a covert operation involving disappearances, extrajudicial detentions, and torture of suspects in the so-called “War on Terror”), the use of lawyers and physicians to justify these actions, and U.S. policies that authorized torture. We met with military officials of the Department of Defense (DOD) and hosted a meeting with international experts to brainstorm solutions. We evaluated the devastating effects of the U.S. torture program on detainees and testified in the military commission’s pretrial hearings for a detainee accused of terrorism.

Doctors and lawyers at the CLER have focused on understanding contemporary torture and the relevance of the Nuremberg Doctors’ Trial which condemned Nazi doctors for torturing prisoners. The CLER continues to promote the importance of International Human Rights Law.

The celebration of the anniversary of the Center for Health Law, Ethics & Human Rights (the “Center”) provides an opportunity to reflect on what defines the field of health law, as well as its conjoined twins of bioethics and human rights. The related fields are vast, and the subjects they encompass are ever-expanding. It is probably impossible to lay out a summary that does justice to their expansive, interdisciplinary scope. Instead, my discussion of the Center examines a subject that barely existed when the Center was formed in 19581 and that continues to make headlines more than sixty–six years later — organ transplantation. Transplantation is useful as an illustration of the joint fields of health law, bioethics, and human rights. It is a field that grew with us from infancy to maturity during the time of the Center’s growth and that illustrates how several related disciplines — most notably law and medical sciences — are essential to the development of organ transplantation. Additionally, organ transplantation and experiments involving organ transplantation have produced some of the most spectacular cases of human experimentation. Because of both the novelty and human drama these experiments involve, I will use some of them as examples of the pivotal health law and bioethics work the Center engages in. These examples, and others that will be touched on, lead me to conclude that there is no field that matches the life and death drama of health law, especially in the human organ transplantation field. This selective history of health law at the Center, including the definition of death and the limits of surrogate consent, suggest that the legal and bioethical issues brought to us by innovative organ transplantation surgery are unlikely to be exhausted any time soon.

This essay celebrates the BU Health Law Program upon its 70th anniversary, offering reflections on the founders of the program, Fran Miller, George Annas, and Wendy Mariner (“FGW,” endearingly), and their contributions to the field.

Current faculty offer reflections, including: Several speak to scholarly research, including Elizabeth McCuskey on health care finance, Aziza Ahmed on human rights, Dionne Lomax on antitrust, Christopher Robertson on trust, and Kathy Zeiler on the marketplace. Other contributors speak to the student experience, with Dianne McCarthy on mentorship, Laura Stephens on demanding excellence, Michael Ulrich on teaching, and Larry Vernaglia on merging law and public health. On FGW’s broader impacts, Nicole Huberfeld speaks to the translation of research to reach new audiences, and Kevin Outterson writes about FGW’s pivotal roles in establishing the health law field and the institutions that now define it.

Together these pieces testify to the astounding contributions of these scholar-teacher-leaders across many domains and dimensions of health law. While their contributions are countless and immeasurable, these reflections offer a start.

Current political divisions are destabilizing existing laws affecting the health field. Major changes in the field of health law have one thing in common: changes in who holds political power ‒ Congress and state legislatures, governors, presidents, judges, and agency officials. The laws that structure financial, economic, educational, and health care systems, environmental conditions, and civil society are primarily the product of elections that populate our political institutions. These structural determinants of health in turn create laws that influence how ‒ and how well ‒ we live and whether our society functions fairly under the rule of law. Thus, who gets elected matters a great deal to the health and safety of Americans. At the same time, changes in health laws resulting from elections may reveal shifts in the structures underlying our legal and economic systems and whether those shifts support or weaken principles of justice and the rule of law.

Bigotry distractions are strategic invocations of racism, transphobia, or negative stigma toward other marginalized groups to shape political discourse. Although the vast majority of Americans agree on large policy issues ranging from reducing air pollution to prosecuting corporate crime, bigotry distractions divert attention from areas of agreement toward divisive identity issues. This article explores how the nefarious targeting of identity groups through bigotry distractions may be the tallest barrier to health reform, and social change more broadly. The discussion extends the literature on dog whistles, strategic racism, and scapegoating.

Georgia State University College of Law Professor Emerita Charity Scott quoted these words from Albert Einstein in June of 2022 as she concluded a tribute to Professor Joseph (Jay) M. Healey, one of the founding lights of health law and health law teaching. She chose the quote because she thought the words and sentiment would resonate with Jay. I repeat it because Dr. Einstein’s words capture the essence and heart of Charity’s approach to teaching, pedagogy, and life. Charity modeled, urged, nudged, and taught the community of health law professors to embrace imagination and creativity. Charity’s vision has helped us be more creative and reflective teachers.2

This symposium Article describes how prison abolitionist arguments also support the hypothesis that a defining goal of health law should be the abolition of hospitals. Like prison abolitionism, the hospital abolition hypothesis can provide a constructive way to shift the focus of legal analysis from substantive dimensions (in health law — cost, quality, access, and equity) to the dimension of power.

As Steve Kaminshine said in his comments at the symposium honoring Charity Scott, I was recruited to come to Georgia State University as a “Law and Bioethics” scholar who had spent more than sixteen years shuttling between an office in a hospital and another in a law school. But when I first visited Georgia State Law, I did not know that more than ten years earlier Charity Scott had spent the better part of an academic year living and breathing clinical ethics at Grady Memorial Hospital.1 Because of her usual habit of immersion in all learning experiences, in that year Charity gained more insight into how hospitals work and how physicians behave when they are knee deep in their professional milieu of life and death decision-making than many full-time bioethics academics do in a career. For the rest of her career Charity kept one foot well planted in the medical context, as an advisor in problems of research ethics, as a teacher in her own medical-legal partnership structured around real-life clinical problems, and as an ethical analyst who could never be accused of mouthing a mantra of phrases, the “vacuous incantation of abstract principles”2 that might pass for bioethics discourse in some circles.

In 2006, the University of Maryland Carey School of Law had the privilege of co-hosting the annual Health Law Professors Conference with the American Society of Law, Medicine & Ethics (ASLME). Coincidentally, as director of the Law & Health Care Program at Maryland, I had the opportunity to announce the winner of the Jay Healey Health Law Teachers’ Award at the conference. The award is given to “professors who have devoted a significant portion of their career to health law teaching and whose selection would honor Jay [Healey’s] legacy through their passion for teaching health law, their mentoring of students and/or other faculty and by their being an inspiration to colleagues and students.”1 Healey, a Professor in the Humanities Department at the University of Connecticut School of Medicine, was the youngest recipient of the Society’s Health Law Teachers’ Award, which he received in 1990. He was passionate about teaching and had the idea to devote a session each year at the annual conference to teaching health law. It was always a plenary session at which he challenged us to be better teachers. Jay died in 1993, at the age of 46, not long after the Health Law Teachers conference that year, which he attended and which also happened to be held in Baltimore at the University of Maryland School of Law. Thereafter, the award was given in his name.

Few people in my memory have a name that more appropriately defines the life they have lived. “Charitable purpose” as defined in O.C.G.A. § 43-17-2 includes any charitable or benevolent purpose including health, education, or social welfare. Anyone who knew Charity Scott knows that she lived a life devoted to providing and improving the health of her community, the education of law students about health law and its use to improve the health of her community, and social welfare by addressing the socio-economic determinants of health. If she had not been assigned that name at birth, those of us who knew her could have easily assigned Charity as a nickname.

This special edition of JLME celebrates the life of Charity Scott, Professor Emerita and Founding Director of the Center for Law, Health & Society at Georgia State University College of Law.

Neither the individualistic regulatory health paradigm nor the vulnerable populations approach of public health can provide the legal structure necessary to address the most pressing problems in health care today. These approaches fail to address conflicts between individuals and populations as well as challenges to qualifying for care and are in inherent conflict with each other, sometimes within the same statute. As health concerns become more global, it is necessary to move past a vulnerable populations approach to a broader population approach that respects individual choice but does not sacrifice community health for liberty interests.

This article explores how the political ideal of data interacts with the legal entitlement of autonomy in the care of pregnant people guided by feminist theory and critical approaches to data. Using Scandinavian legislation and administrative practice, it analyses how the presence or absence of data, namely scientific evidence, interacts with pregnant people’s legal autonomy in healthcare. Data –particularly scientific evidence - is shown as something that is not neutral but open to interpretation and misappropriation. First, administrative complaints illustrate that not only a lack of scientific studies on pregnant people but also patriarchal attitudes have implications for care. Second, Scandinavian legislation authorizes the involuntary detention of pregnant drug users despite an absence of evidence supporting such drastic actions. Third, complaints bodies are found to frame injury to pregnant bodies as a natural consequence of birth, despite clear evidence as to the duties of healthcare professionals in preventing harm. A relational approach that sees the pregnant body and fetus as integrated though quintessentially unequal is needed. Evidence is not the only answer; an approach that recognizes the dignity of pregnant people must be central. This requires eliminating coercion, recognizing the pregnant patient as the decision maker in healthcare choices and prizing the birthing patient’s voice as a valuable data source.

This paper challenges historically preconceived notions surrounding a minor’s ability to make medical decisions, arguing that federal health law should be reformed to allow minors with capacity as young as age 12 to consent to their own Centers for Diseases Control and Prevention (CDC)-approved COVID-19 vaccinations. This proposal aligns with and expands upon current exceptions to limitations on adolescent decision-making. This analysis reviews the historic and current anti-vaccination sentiment, examines legal precedence and rationale, outlines supporting ethical arguments regarding adolescent decision-making, and offers rebuttals to anticipated ethical counterarguments.

Disputes over frozen embryos represent a particularly problematic case, legally and ethically, due to the ambiguity of their moral and legal status and the potential rights-claims which can be made with regard to them. Recent work has contextualised frozen embryos as liminal and suggested a contextual approach to their legal classification. By appeal to personal property law, with a lens provided by Roman law doctrines, and reproductive bioethics, we argue that frozen embryos may be subjects of property rights, providing a more stable framework for dispute resolution. To illustrate how a property approach would work, we reconsider the facts of the influential Evans case and argue that if a proprietary rather than promissory estoppel claim had been pursued, the reverse outcome may have been reached, to the benefit of women who are disproportionately harmed in these scenarios.

In light of a history of categorical exclusion, it is critical that pregnant people are included in research to help improve the knowledge base and interventions needed to address public health. Yet the volatile legal landscape around reproductive rights in the United States threatens to undue recent progress made toward the greater inclusion of pregnant people in research. We offer ethical and practical guidance for researchers, sponsors, and institutional review boards to take specific steps to minimize legal risks and ensure the ethical conduct of research with pregnant people in an evolving legal environment.

This column will be the first in a series exploring innovative ways to teach concepts and ideas in health law across a wide variety of classrooms, schools, and curriculums.

Death by neurological criteria (DNC) has remained controversial since its introduction over 50 years ago. Objections to the diagnosis of DNC have been coming before the courts in various jurisdictions, including at least seven recent challenges before the UK courts. In responding to these challenges, the UK courts have expressed no doubts as to the status of DNC and have affirmed that following a diagnosis of DNC, the matter of best interests is no longer relevant. Yet, the courts have also, tacitly, acknowledged that DNC is not quite the same as cardio-pulmonary death.

This paper begins by setting out the origins of DNC as a medico-legal construction, and its ongoing controversies. It then analyses the treatment of DNC, including authorisation of DNC testing, by the UK courts. It shows that the courts have been operating a form of ad hoc reasonable accommodation of different views of DNC but have done so without normative engagement. The paper argues that the courts should recognise that DNC disputes are not simply concerned with whether, as a matter of fact, DNC has been correctly diagnosed, but also raise profound questions about rights and interests, both of families and of the DNC dead.

The prison-industrial complex has historically operated as a mechanism for social control generally and as a tool to restrict women’s reproductive capacities specifically. Reproductive justice is a domain within the practice of health law. However, health law as currently practiced is ill-equipped to understand how the carceral state functions as a structural determinant of health or how legacies of oppression have facilitated the abridgment of incarcerated women’s reproductive capacities.