February 1, 2000 TABLE OF CONTENTS TABLE OF AUTHORITIES......................................................................................... .......................ii STATEMENT OF INTEREST............................................................................................ ................. v..

James A. Diefenbeck, Wayward Reflections on the History ofPhilosophyThomas R. Flynn Sartre, Foucault and Historical Reason. Volume 1:Toward an Existential Theory of HistoryMark Golden and Peter Toohey Inventing Ancient Culture:Historicism, Periodization and the Ancient WorldZenonas Norkus Istorika: Istorinis IvadasEverett Zimmerman The Boundaries of Fiction: History and theEighteenth‐Century British Novel.

In the mid-1990s, several state legislatures enacted a "second generation" of small group health insurance reforms that required guaranteed issue of all products and prohibited the use of health as a rating factor. We use data from two large employer surveys to compare the behavior of small business in nine states that adopted these reforms between 1993 and 1997 to the behavior of small business in 11 states and the District of Columbia, where neither of these small group (...) health insurance market reforms existed prior to 1997 (N = 8,465 in 1993; N = 12,219 in 1997). Our analyses focus on several outcomes: health insurance offer and enrollment rates in any employer plan, and in an HMO plan; turnover in offer decisions; and premiums, variability in premiums, and the rate of change in premiums. Overall, we find no effect of small group reform on any of the outcomes; the sign of the effect is not consistent across reform states, the estimates rarely attain statistical significance, and they show no consistent pattern across the outcomes within each state. Therefore, predictions of the harm these regulations might cause to the market have not come to pass. On the other hand, proponents' hopes for a solution to low coverage rates among small businesses have not materialized either. (shrink)

State law requirements for health care advance directive documents were reviewed in every state and the District of Columbia to determine whether they are consistent and/or flexible enough to permit the utilization by the public of “universal” advance directive forms, specifically a health care power of attorney, that would be valid under every state's advance directive statutes. Such documents would have to overcome the wide variability of state legal formalities for validity. If this could be accomplished, the public (...) would benefit from having a variety of multi-state or truly universal forms available that could be used with confidence in their validity.The review found that a basic, multi-state health care power of attorney appears to be feasible in 41 States and the District of Columbia, compared to 36 states and the District in 2005. Only nine states prevent recognition of a truly universal form. Some barriers were surmountable, including differing agent and witness requirements, execution requirements, and effectiveness triggers. Other barriers were insurmountable, including mandatory forms, mandatory disclosures, and decision-specific language requirements. The strategies identified for overcoming some barriers can be used by lawyers in drafting true multi-state directives. More importantly, states should simplify state advance directive laws to facilitate a more meaningful communication model of advance care planning. (shrink)

“Towards a Theory of Taxation” is a proper theme for an Englishman to take when giving a paper in America. After all it was from the absence of such a theory that the United States derived its existence. The Colonists felt strongly that there should be no taxation without representation, and George III was unable to explain to them convincingly why they should contribute to the cost of their defense. Since that time, understanding has not advanced much. In Britain we (...) still maintain the fiction that taxes are a voluntary gift to the Crown, and taxing statutes are given the Royal Assent with the special formula, “La Reine remercie ses bons sujets, accepte leur benevolence, et ainsi le veult” instead of the simple “La Reine le veult,” and in the United States taxes have regularly been levied on residents of the District of Columbia who until recently had no representation in Congress, and by the State of New York on those who worked but did not reside in the State, and so did not have a vote. Taxes are regularly levied, in America as elsewhere, on those who have no say on whether they should be levied or how they should be spent. I am taxed by the Federal Government on my American earnings and by state governments on my American spending, but I should be hard put to it to make out that it was unjust. Florida is wondering whether to follow California in taxing multinational corporations on their world-wide earnings. (shrink)

The original text of the Constitution of the United States of America, written over 200 years ago, constitutes the supreme source of law in the American legal system. The seven articles and twenty seven amendments dictate understanding of fundamental principles of the federation’s functioning and its citizens’ rights. The paper aims to present the evolution of the U.S. Constitution’s language interpretation as provided by its final interpreter - the Supreme Court of the United States. Example of the Second Amendment will (...) be analyzed to present the change in understanding of the language grammar and, as a consequence, the sense of the right to keep and bear arms in the light of the Supreme Court’s decision in the case of District of Columbia v Heller ). It will argue for the accuracy of statement of Charles Evans Hughes, former Chief Justice of the U.S. Supreme Court: “We are under a Constitution, but the Constitution is what the judges say it is...”. (shrink)

We examine the issues concerning the legality and ethicality of the Second Amendment right to bear arms balanced by the employer's duty to provide a safe workplace for its employees. Two court rulings highlight this balancing act: McDonald et al. v. City of Chicago et al. and District of Columbia v. Heller. “Stand Your Ground” and “Castle Doctrine” laws in the recent Trayvon Martin shooting on February 26, 2012 are also applicable. Various ethical frameworks examine the firearms debate (...) by viewing the Second Amendment from three perspectives. These include a pro‐gun perspective drawing upon libertarianism and fundamental rights; a moderate gun perspective drawing upon consequentialism and stakeholder theory; and finally, an anti‐gun perspective drawing upon a Public Health Ethics and peace ethics approach. We explore the issue of gun control from a business perspective as employers face ethical decisions in responding to legislation that allows guns in the workplace and/or in employer parking lots while still being responsible to provide a safe workplace for their employees. We make recommendations regarding how companies should manage by proactively avoiding legal challenges to employees' rights to own and carry guns into the workplace. This includes emphasis on enhanced security, Human Resource policies and monitoring rapidly changing laws. (shrink)

This guide accompanies the following article(s): ‘Full Disclosure of the “Raw Data” of Research on Humans: Citizens’ Rights, Product Manufacturer’s Obligations and the Quality of the Scientific Database.’Philosophy Compass 6/2 (2011): 90–99. doi: 10.1111/j.1747‐9991.2010.00376.x Author’s Introduction Securing consent (and informed consent) from patients and research study participants is a key concern in patient care and research on humans. Yet, the legal doctrines of consent and informed consent differ in their applications. In patient care, the judicial doctrines of consent and informed (...) consent are disclosure doctrines based on the obligation of physicians to inform their patients of the following types of information: the nature of the procedure the physician is recommending in the patent’s care (P), the alternatives to the physician‐recommendation (A), and the risks of procedure and its alternatives (R). In addition, the physician must provide truthful answers to the patient’s questions (Q) to the best of the physician’s abilities. In research on humans, the onus of disclosure by study sponsors and principal investigators is much greater than in patient care precisely because the purpose of research is not patient care. The purpose of research is the identification and development of new generalizable knowledge. Thus, participation in a research study or trial may not benefit the study volunteer at all. In addition, the participant may carry a heavy risk burden in relationship to any testing of a newly designed drug or device as part of their experiences in the research study. Presently, despite the risks borne by the research study participant, the raw data collected from volunteers in research trials are treated by courts as if they were the private property of the study sponsor rather than generally owed to the public as would be expected by an effort like research participation aimed at contributing to the development of generalizable knowledge. This paper reviews the obligations that study sponsors owe to their study participants based on the very definition of research as a systematic activity whose purpose is to develop generalizable knowledge to help all humans. Author Recommends Court cases Canterbury v. Spence, United States Court of Appeals, District of Columbia Circuit 464 F.2d 772 (1972). (Federal appellate decision heard in the District of Columbia, USA) Reibl v. Hughes, 2 S.C.R. 880 (1980). (Supreme Court of Canada) Rogers v. Whitaker, 175 C.L. R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Canterbury v. Spence is the landmark Federal informed consent case in the United States heard in the District of Columbia. In this case, Judge Spottswood Robinson articulated the reasonable person standard of informed consent. This standard was subsequently adopted by the Supreme Court of Canada (Reibl v. Hughes, 2 S.C.R. 880 (1980)) and the High Court of Australia (Rogers v. Whitaker, 175 C.L. R. 479 (1992)). The House of Lords rejected the reasonable person standard in England in Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985). Book Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. This book is a detailed guide for the review of scientific and ethical aspects of research on humans contained in the research study protocols and research informed consent forms which need to be submitted by study sponsors and principal investigators to institutional review boards (IRBs) for IRB review before a research study can receive approval to be conducted within a human study population in those institutions over which the IRB has authority. It also presents basic definitions in the area of research on humans and basic approaches to help conduct a deep review of the underlying scientific and ethical issues that are present within a research study protocol and its accompanying research informed consent form. Report National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). This U.S. National Commission in the Belmont Report argued for the necessity of a reasonable volunteer standard in research on humans in the United States. Arguing that the professional standard and the reasonable person standard of consent and informed consent were insufficient to base a disclosure standard in research on humans, this National Commission developed the reasonable volunteer standard where a study participant is to be approached in research informed consent with that information that a reasonable volunteer would want to know. Online Materials Belmont Report: Syllabus Topics for Lecture and Discussion Week I: Introduction and Overview Readings: Rogers v. Whitaker, 175 C.L.R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week II: The Different Standards of Consent and Informed Consent Readings: Canterbury v. Spence, 464 F.2d 772 (1972). (Federal appellate opinion heard in the District of Columbia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week III: Definition of Research Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 2 and 3) Week IV: How to Review a Research Study Protocol and Research Informed Consent Form Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 4–6, 10, and 12–14) Week V: Obligations in Research of Humans Versus Patient Care Reading: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). Focus Questions • How do the judicial doctrines of consent in England and Australia compare to the judicial doctrines of informed consent in the United States and Canada? • How does a professional standard of disclosure differ from a reasonable person standard of disclosure? • What is the definition of research? • How is a research study (study proposal and research informed consent form) reviewed from scientific and ethical bases for considerations of approval by an IRB? • How do the obligations of a study sponsor, a principal investigator, and a research team conducting a research trial on human study participants differ from the obligations of a physician caring for a patient? • Should all raw data of research derived from humans be made available to the public for use in developing generalizable knowledge to help others, or should raw data be considered the private property of the study sponsors (for example, prescription drug manufacturers), who fund the research trials? Seminar/project Idea Draw a timeline of the development of the basic concepts of consent and informed consent in patient care and in patient research. On this timeline, first place the dates of the key court cases in England, the United States, Canada, and Australia on consent and informed consent. Then place the date of the development of the Belmont Report. Why do differences exist between these four countries in terms of the legal requirements of informedness of a patient (in medical care) and a study participant (in medical research)? What roles if any do the concepts of self‐determination and self‐decision have in consent and informed consent in patient care and in informed consent in research on humans among the four countries of interest? What are the realities of research on human participants that require a new standard of informed consent, the reasonable volunteer standard, to be developed beyond the two standards in patient care, the professional standard, and the reasonable person standard? Counterpoint Arguments The following are counterpoint arguments that need to be appreciated to more fully understand the concepts that impact the thesis that ‘raw data’ should be open to the public to allow the opportunity of checking of the results of its associated scientific paper and for further analysis. De‐Identified (Anonymized) Raw Data A current approach to identifying (anonymizinig) raw data is based on the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L.104‐191). HIPAA was enacted by the U.S. Congress in 1996 to keep a person’s medical information private. In a research study, a person’s private medical information can become research data. HIPAA’s Privacy Rule allows a covered entity to de‐identify data by removing all 18 elements that could be used to identify the individual or the individual’s relatives, employers, or household members; these elements are enumerated in the Privacy Rule. The covered entity must also have no actual knowledge that the remaining information could be used alone or in combination with other information to identify the individual who is the subject of the information. Under this method, the identifiers that must be removed are the following: 1 Names. 2 All geographic subdivisions smaller than a state, including street address, city, county, precinct, ZIP Code, and their equivalent geographical codes, except for the initial three digits of a ZIP Code if, according to the current publicly available data from the Bureau of the Census: 2a. The geographic unit formed by combining all ZIP Codes with the same three initial digits contains more than 20,000 people. 2b. The initial three digits of a ZIP Code for all such geographic units containing 20,000 or fewer people are changed to 000. 3 All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, and date of death, and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older. 4 Telephone numbers. 5 Facsimile numbers. 6 Electronic mail addresses. 7 Social security numbers. 8 Medical record numbers. 9 Health plan beneficiary numbers. 10 Account numbers. 11 Certificate/license numbers. 12 Vehicle identifiers and serial numbers, including license plate numbers. 13 Device identifiers and serial numbers. 14 Web universal resource locators (URLs). 15 Internet protocol (IP) address numbers. 16 Biometric identifiers, including fingerprints and voiceprints. 17 Full‐face photographic images and any comparable images. 18 Any other unique identifying number, characteristic, or code, unless otherwise permitted by the Privacy Rule for re‐identification. Even though ‘raw data’ can be de‐identified (anonymized) so that there is no way to trace back the data to the study participant from which it was drawn, there are still questions whether the ‘de‐identified raw data’ can be given to other researchers or made public without the original study participant’s approval. It may be the case that this approval could be done at the start of any research study where the individual considering study participation would be counseled on what the process of de‐identification consists of and would be asked whether the participant would allow use of the data by other researchers or made available to the public in a de‐identified state. However, there may be questions of the study participants as to whether the data are truly de‐identified and untraceable back to the study participant since the participant would not be able to see the process actually being carried out in detail in all relevant circumstances. Using Raw Data in Context Simply being in possession of raw data is never enough to build on that data from a research perspective. Researchers need to understand the context of the scientific research study in which the data were collected. This research context includes (but is not limited to): (i) the scientific hypothesis of the research study, (ii) the inclusion and exclusion criteria selected by the research designers of the study to determine which study participants were included and which were excluded from the study, (iii) the methods used to collect the data and possibilities of errors in the data collection processes, and (iv) answers to questions regarding whether any data were excluded from the study data and why these data were excluded. Ownership Rights Over Data There are ownership rights over data. Ownership rights include court decision making related to the question which parties are to be considered as the owners of the data. Possible owners here include (but are not limited to) (i) the study sponsor whose only role was to fund that study, (ii) the principal investigator(s) who developed the scientific hypothesis, and (iii) individual study participants through special contracts made by individual participants who negotiate such contracts with study sponsors and principal investigators to share in the ownership of data. Examples of such data are participant sources of unique gene lines or unique cell lines to be used in future research. Objections to Data Sharing Finally, individual researchers may simply object to sharing data. A researcher’s arguments here may be simply stating that he or she has a right to fully analyze the data since the collection of the data was the researchers’ idea in the first place. These researchers may argue that they have the right to mine the data as fully as they can before deciding to make the data open to the public for others to analyze. Works Cited 1 Kaiser, J. ‘Making Clinical Data Widely Available.’Science 322.5899 (10 Oct. 2008): 217–8. 2 de Lusignan, S., J.F. Metsemakers, P. Houwink, V. Gunnarsdottir, and J. van der Lei. ‘Routinely Collected General Practice Data: Goldmines for Research? A Report of the European Federation for Medical Informatics Primary Care Informatics Working Group (EFMI PCIWG) from MIE2006, Maastricht, The Netherlands.’Informatics in Primary Care 14.3 (2006): 203–9. 3 Sim, I. ‘Human Studies Database Project’, CTSA Data Repositories Symposium (17 Oct. 2008). 23 Nov. 2010. 4 Sim, I., C.G. Chute, H. Lehmann, R. Nagarajan, M. Nahm, and R.H. Scheuermann. ‘Keeping Raw Data in Context.’Science 323.5915 (6 Feb. 2009): 713. 5 U.S. Department of Health and Human Services, National Institutes of Health, HIPAA Privacy Rule, Information for Researchers. 13 Nov. 2010. 6 Wilczynski, N.L., R.B. Haynes, and Hedges Team. ‘EMBASE Search Strategies for Identifying Methodologically Sound Diagnostic Studies for Use by Clinicians and Researchers.’BMC Medicine 29.3 (March 2005): 7. (shrink)

Excerpt from An Inquiry Concerning the Nature, End, and Practicability of a Course of Philosophical Education: To Which Is Subjoined a Moral Catechism BE IT remembered, That on the twenty Second day of Nlay in the year of ourlord Ohe thou sand eight hundred and twenty-two, and of'the Inde pendence of the Umted States bf America, the forty-sixth Paul Brown, -of the said District, hath deposited in the office of the, clerk of the District Court for the (...) class='Hi'>District of Columbia, the title of a book, the right whereof he claims as proprietor in the words follow mg, to Wit An inquiry concerning the nature, end, and Pagacti cability of a course of philosophical education To which is sub joined a moral catechism. By Paul Brown. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

This first-of-its-kind national survey of 485 psychiatrists in nine states and the District of Columbia finds substantial evidence of clinicians being uninformed, misinformed, and misinforming patients of their gun rights regarding involuntary commitments and voluntary inpatient admissions. A significant percentage of psychiatrists did not understand that an involuntary civil commitment triggered the loss of gun rights, and the majority of psychiatrists in states with prohibitors on voluntary admissions and emergency holds were unaware that patients would lose gun rights (...) upon voluntary admission or temporary commitment. Moreover, the survey found evidence that psychiatrists may use gun rights to negotiate “voluntary” commitments with patients: 15.9% of respondents reported telling patients they could preserve their gun rights by permitting themselves to be voluntarily admitted for treatment, in lieu of being involuntarily committed. The results raise questions of whether psychiatrists obtained full informed consent for voluntary patient admissions, and suggest that some medical providers in states with voluntary admission prohibitor laws may unwittingly deprive their patients of a constitutional right. The study calls into question the fairness of state prohibitor laws as policy, and — at minimum — indicates an urgent need for psychiatrist training on their state gun laws. (shrink)

Currently, all 50 states and the District of Columbia have youth concussion laws based on the core principals of the 2009 Lystedt Law of Washington State. On April 23, 2013, the state of Georgia signed into law House Bill 284, “The Return to Play Act of 2013” and became one of the last states to pass youth concussion legislation. This Act became effective on January 1, 2014. The purpose of this report is to highlight the legislative process of (...) enacting Georgia House Bill 284 and compare it to the legislation of other states. (shrink)

Syphilis occupies a unique position in the history of U.S. medicine and medical ethics. Given its widespread prevalence and variable presentation, syphilis was a major professional concern among late nineteenth‐ and early twentieth‐century physicians. Syphilis was also at the center of perhaps the most famous example of medical racism in our history, the U.S. Public Health Service Syphilis Study at Tuskegee, in which officials followed the natural history of the disease in a cohort of black men for forty years without (...) offering treatment, even once penicillin became available. In this essay, I call attention to a less well‐known aspect of syphilis and its history. I examine one of the disease's most dreaded manifestations, neurosyphilis (also known as general paresis or general paralysis of the insane), and its treatment via malarial inoculation from the 1920s into the 1950s. The goal of this treatment, dramatic even to observers at the time, was to produce spiking fevers that would kill the syphilitic spirochete and arrest the disease process. My focus will be on developments at St. Elizabeths Hospital, a large‐scale federal psychiatric facility in the District of Columbia that served the city's residents and members of the U.S. military. Physicians at St. Elizabeths were the first in the United States to experiment with malarial fever therapy, treating their initial cohort of patients in December of 1922.Malarial fever therapy raised a host of ethical questions, rendered all the more complex from today's vantage point by efforts to understand them within the context of the time. What sorts of risks, both from malaria and via indirect exposure, might be deemed acceptable in the treatment of a devastating and almost invariably fatal disease? How ought researchers and clinicians to have approached the question of consent, itself an evolving concept in the early decades of the twentieth century, when the disease they were targeting impaired a patient's ability to reason effectively? Finally, at a time when segregated and inferior care for black Americans was the norm and when the black community bore a disproportionate burden of disease, who would have had access to malarial fever therapy, and at what cost? (shrink)

The U.S. Court of Appeals for the District of Columbia upheld, in Presbyterian Medical Center of the University of Pennsylvania Health System v. Shalala, 170 F.3d 1146, a federal district court ruling granting summary judgment to the Department of Health and Human Services in a case in which Presbyterian Medical Center challenged Medicare's requirement of contemporaneous documentation of $828,000 in graduate medical education expenses prior to increasing reimbursement amounts. DHHS Secretary Donna Shalala denied PMC's request for reimbursement (...) for increased GME costs. The appellants then brought suit in federal court challenging the legality of an interpretative rule that requires requested increases in reimbursement to be supported by contemporaneous documentation. PMC also alleged that an error was made in the administrative proceedings to prejudice its claims because Aetna, the hospital's fiscal intermediary, failed to provide the hospital with a written report explaining why it was denied the GME reimbursement. (shrink)

In District of Columbia v. Heller, the Supreme Court is anticipated to finally decide whether the Second Amendment is an individual or a collective right. This article is not about the textual and historical arguments on the basis of which the Court is likely to make its decision. My topic is more fundamental. Assuming that the Second Amendment protects an individual right, what purpose does it serve? What are the possible reasons that private arms possession is sufficiently valuable (...) to deserve constitutional protection? Because it was insufficiently sensitive to the variety of justifications available, the majority in Parker v. District of Columbia (the D.C. Circuit case appealed in Heller) failed to identify the purposes of the Second Amendment. The passing comments it made were compatible with a large number of very different justifications. Second Amendment advocates have also been surprisingly muddled on the issue. This confusion has gone unnoticed because no one has, until now, offered a philosophically rigorous account of the justifications available and the important distinctions between them. Clarity about the value of private arms possession is essential for determining the scope of the Second Amendment under an individual right interpretation - a project that lower courts will be forced to undertake if Parker is affirmed. Courts commonly interpret the scope of a constitutional right in light of the interests the right protects. For this reason, they need a clear conception of why individuals have an interest in private arms possession. I offer this article as a first, but crucial, step toward answering this question. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 11.4 (2001) 391-400 [Access article in PDF] Bioethics Inside the Beltway A Shooting on Capitol Hill: "The Ruby Satellite System," Mental Illness, and Failure of the American Legal System Peter J. Cohen On 24 July 1998, Russell Eugene Weston, Jr., stormed the United States Capitol, forced his way through a security checkpoint, bypassed a metal detector, and entered the office complex of Representative Tom (...) DeLay (R-TX), the House Majority Whip (Weil 1998). During this period of terror, he shot and killed two officers of the Capitol Police and seriously wounded another as they attempted to end his foray. 1 Weston was severely wounded by several Capital police officers and taken into custody. After being treated for his injuries, he was incarcerated in the District of Columbia. 2On 5 May 1999, Weston was transferred to the Federal Correctional Institute in Butner, North Carolina (United States v. Weston, 69 F. Supp. 2d 99 (D.D.C. 1999), 103), where he remains to this day. He has neither been brought to trial nor received appropriate psychiatric therapy, but continues to be warehoused "in solitary confinement under constant observation... in a psychotic state (United States v. Weston, 255 F.3d 873; LEXIS 16851 (U.S. App. 2001b), 3-4 [LEXIS]). I will briefly detail the legal events responsible for this mad situation and suggest alternative actions that should have been taken at the very onset of the case. Early Chronology Although overtly the crime appeared to be senseless and without any conceivable motivation, Weston believed that his acts were justified and necessary. The story he told to the court-appointed forensic psychiatrist, Sally C. Johnson, M.D., 3 was that while working for NASA in the early 1980s, he had developed a "Ruby Satellite System," a powerful machine that could reverse time. With access to this system, nothing was permanent--the user could simply reverse time and exit from the current scene. However, the "System" was now controlled by cannibals who were developing and spreading "Black Heva," the deadliest disease known to [End Page 391] humankind, similar to HIV or the plague. It resulted from human corpses rotting and turning black. Time was running out, and Weston believed he had to return to override the "Ruby Satellite System" in the Capitol so that he could stem the spread of "Black Heva" and prevent world calamity. He believed that if he were tried, convicted, and even executed, he could simply time reverse himself, place himself in a safe within the Capitol, and subsequently resume his life at whatever point he chose (United States v. Weston, 206 F.3d 9 (D.C. Cir. 2000), 19-20).On 22 April 1999, the district court accepted Dr. Johnson's diagnosis that Weston suffered from paranoid schizophrenia, the symptoms of which were so severe that he would be incapable of understanding the proceedings against him and of assisting in his own defense. On this basis, the court had no difficulty in finding him incompetent to stand trial (U.S. v. Weston 1999, 102).At Weston's initial hearing, Dr. Johnson had testified that medication would be efficacious in treating Weston's delusions: [T]he standard of care in someone suffering from this type of symptom picture would be to treat them with medication.... [T]here is a good likelihood that he'll have a positive response, positive in the sense that his symptoms will diminish in response to treatment.... The potential benefits to treating the defendant far outweigh the risks.... (U.S. v. Weston 1999, 108) The defense presented no expert testimony refuting Dr. Johnson's presentation. The district court then ordered that Weston begin receiving medication in order to render him nondangerous and competent for trial (U.S. v. Weston 1999, 108-9). The Problem Weston refused to be medicated! 4 He has continued to claim that the administration of antipsychotic drugs against his will would violate his Fifth Amendment due process liberty interest in avoiding unwanted bodily intrusion and implicated... (shrink)

This guide accompanies the following article(s): ‘Full Disclosure of the “Raw Data” of Research on Humans: Citizens’ Rights, Product Manufacturer’s Obligations and the Quality of the Scientific Database.’Philosophy Compass 6/2 (2011): 90–99. doi: 10.1111/j.1747‐9991.2010.00376.x Author’s Introduction Securing consent (and informed consent) from patients and research study participants is a key concern in patient care and research on humans. Yet, the legal doctrines of consent and informed consent differ in their applications. In patient care, the judicial doctrines of consent and informed (...) consent are disclosure doctrines based on the obligation of physicians to inform their patients of the following types of information: the nature of the procedure the physician is recommending in the patent’s care (P), the alternatives to the physician‐recommendation (A), and the risks of procedure and its alternatives (R). In addition, the physician must provide truthful answers to the patient’s questions (Q) to the best of the physician’s abilities. In research on humans, the onus of disclosure by study sponsors and principal investigators is much greater than in patient care precisely because the purpose of research is not patient care. The purpose of research is the identification and development of new generalizable knowledge. Thus, participation in a research study or trial may not benefit the study volunteer at all. In addition, the participant may carry a heavy risk burden in relationship to any testing of a newly designed drug or device as part of their experiences in the research study. Presently, despite the risks borne by the research study participant, the raw data collected from volunteers in research trials are treated by courts as if they were the private property of the study sponsor rather than generally owed to the public as would be expected by an effort like research participation aimed at contributing to the development of generalizable knowledge. This paper reviews the obligations that study sponsors owe to their study participants based on the very definition of research as a systematic activity whose purpose is to develop generalizable knowledge to help all humans. Author Recommends Court cases Canterbury v. Spence, United States Court of Appeals, District of Columbia Circuit 464 F.2d 772 (1972). (Federal appellate decision heard in the District of Columbia, USA) Reibl v. Hughes, 2 S.C.R. 880 (1980). (Supreme Court of Canada) Rogers v. Whitaker, 175 C.L. R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Canterbury v. Spence is the landmark Federal informed consent case in the United States heard in the District of Columbia. In this case, Judge Spottswood Robinson articulated the reasonable person standard of informed consent. This standard was subsequently adopted by the Supreme Court of Canada (Reibl v. Hughes, 2 S.C.R. 880 (1980)) and the High Court of Australia (Rogers v. Whitaker, 175 C.L. R. 479 (1992)). The House of Lords rejected the reasonable person standard in England in Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985). Book Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. This book is a detailed guide for the review of scientific and ethical aspects of research on humans contained in the research study protocols and research informed consent forms which need to be submitted by study sponsors and principal investigators to institutional review boards (IRBs) for IRB review before a research study can receive approval to be conducted within a human study population in those institutions over which the IRB has authority. It also presents basic definitions in the area of research on humans and basic approaches to help conduct a deep review of the underlying scientific and ethical issues that are present within a research study protocol and its accompanying research informed consent form. Report National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). This U.S. National Commission in the Belmont Report argued for the necessity of a reasonable volunteer standard in research on humans in the United States. Arguing that the professional standard and the reasonable person standard of consent and informed consent were insufficient to base a disclosure standard in research on humans, this National Commission developed the reasonable volunteer standard where a study participant is to be approached in research informed consent with that information that a reasonable volunteer would want to know. Online Materials Belmont Report: Syllabus Topics for Lecture and Discussion Week I: Introduction and Overview Readings: Rogers v. Whitaker, 175 C.L.R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week II: The Different Standards of Consent and Informed Consent Readings: Canterbury v. Spence, 464 F.2d 772 (1972). (Federal appellate opinion heard in the District of Columbia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week III: Definition of Research Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 2 and 3) Week IV: How to Review a Research Study Protocol and Research Informed Consent Form Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 4–6, 10, and 12–14) Week V: Obligations in Research of Humans Versus Patient Care Reading: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). Focus Questions • How do the judicial doctrines of consent in England and Australia compare to the judicial doctrines of informed consent in the United States and Canada? • How does a professional standard of disclosure differ from a reasonable person standard of disclosure? • What is the definition of research? • How is a research study (study proposal and research informed consent form) reviewed from scientific and ethical bases for considerations of approval by an IRB? • How do the obligations of a study sponsor, a principal investigator, and a research team conducting a research trial on human study participants differ from the obligations of a physician caring for a patient? • Should all raw data of research derived from humans be made available to the public for use in developing generalizable knowledge to help others, or should raw data be considered the private property of the study sponsors (for example, prescription drug manufacturers), who fund the research trials? Seminar/project Idea Draw a timeline of the development of the basic concepts of consent and informed consent in patient care and in patient research. On this timeline, first place the dates of the key court cases in England, the United States, Canada, and Australia on consent and informed consent. Then place the date of the development of the Belmont Report. Why do differences exist between these four countries in terms of the legal requirements of informedness of a patient (in medical care) and a study participant (in medical research)? What roles if any do the concepts of self‐determination and self‐decision have in consent and informed consent in patient care and in informed consent in research on humans among the four countries of interest? What are the realities of research on human participants that require a new standard of informed consent, the reasonable volunteer standard, to be developed beyond the two standards in patient care, the professional standard, and the reasonable person standard? Counterpoint Arguments The following are counterpoint arguments that need to be appreciated to more fully understand the concepts that impact the thesis that ‘raw data’ should be open to the public to allow the opportunity of checking of the results of its associated scientific paper and for further analysis. De‐Identified (Anonymized) Raw Data A current approach to identifying (anonymizinig) raw data is based on the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L.104‐191). HIPAA was enacted by the U.S. Congress in 1996 to keep a person’s medical information private. In a research study, a person’s private medical information can become research data. HIPAA’s Privacy Rule allows a covered entity to de‐identify data by removing all 18 elements that could be used to identify the individual or the individual’s relatives, employers, or household members; these elements are enumerated in the Privacy Rule. The covered entity must also have no actual knowledge that the remaining information could be used alone or in combination with other information to identify the individual who is the subject of the information. Under this method, the identifiers that must be removed are the following: 1 Names. 2 All geographic subdivisions smaller than a state, including street address, city, county, precinct, ZIP Code, and their equivalent geographical codes, except for the initial three digits of a ZIP Code if, according to the current publicly available data from the Bureau of the Census: 2a. The geographic unit formed by combining all ZIP Codes with the same three initial digits contains more than 20,000 people. 2b. The initial three digits of a ZIP Code for all such geographic units containing 20,000 or fewer people are changed to 000. 3 All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, and date of death, and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older. 4 Telephone numbers. 5 Facsimile numbers. 6 Electronic mail addresses. 7 Social security numbers. 8 Medical record numbers. 9 Health plan beneficiary numbers. 10 Account numbers. 11 Certificate/license numbers. 12 Vehicle identifiers and serial numbers, including license plate numbers. 13 Device identifiers and serial numbers. 14 Web universal resource locators (URLs). 15 Internet protocol (IP) address numbers. 16 Biometric identifiers, including fingerprints and voiceprints. 17 Full‐face photographic images and any comparable images. 18 Any other unique identifying number, characteristic, or code, unless otherwise permitted by the Privacy Rule for re‐identification. Even though ‘raw data’ can be de‐identified (anonymized) so that there is no way to trace back the data to the study participant from which it was drawn, there are still questions whether the ‘de‐identified raw data’ can be given to other researchers or made public without the original study participant’s approval. It may be the case that this approval could be done at the start of any research study where the individual considering study participation would be counseled on what the process of de‐identification consists of and would be asked whether the participant would allow use of the data by other researchers or made available to the public in a de‐identified state. However, there may be questions of the study participants as to whether the data are truly de‐identified and untraceable back to the study participant since the participant would not be able to see the process actually being carried out in detail in all relevant circumstances. Using Raw Data in Context Simply being in possession of raw data is never enough to build on that data from a research perspective. Researchers need to understand the context of the scientific research study in which the data were collected. This research context includes (but is not limited to): (i) the scientific hypothesis of the research study, (ii) the inclusion and exclusion criteria selected by the research designers of the study to determine which study participants were included and which were excluded from the study, (iii) the methods used to collect the data and possibilities of errors in the data collection processes, and (iv) answers to questions regarding whether any data were excluded from the study data and why these data were excluded. Ownership Rights Over Data There are ownership rights over data. Ownership rights include court decision making related to the question which parties are to be considered as the owners of the data. Possible owners here include (but are not limited to) (i) the study sponsor whose only role was to fund that study, (ii) the principal investigator(s) who developed the scientific hypothesis, and (iii) individual study participants through special contracts made by individual participants who negotiate such contracts with study sponsors and principal investigators to share in the ownership of data. Examples of such data are participant sources of unique gene lines or unique cell lines to be used in future research. Objections to Data Sharing Finally, individual researchers may simply object to sharing data. A researcher’s arguments here may be simply stating that he or she has a right to fully analyze the data since the collection of the data was the researchers’ idea in the first place. These researchers may argue that they have the right to mine the data as fully as they can before deciding to make the data open to the public for others to analyze. Works Cited 1 Kaiser, J. ‘Making Clinical Data Widely Available.’Science 322.5899 (10 Oct. 2008): 217–8. 2 de Lusignan, S., J.F. Metsemakers, P. Houwink, V. Gunnarsdottir, and J. van der Lei. ‘Routinely Collected General Practice Data: Goldmines for Research? A Report of the European Federation for Medical Informatics Primary Care Informatics Working Group (EFMI PCIWG) from MIE2006, Maastricht, The Netherlands.’Informatics in Primary Care 14.3 (2006): 203–9. 3 Sim, I. ‘Human Studies Database Project’, CTSA Data Repositories Symposium (17 Oct. 2008). 23 Nov. 2010. 4 Sim, I., C.G. Chute, H. Lehmann, R. Nagarajan, M. Nahm, and R.H. Scheuermann. ‘Keeping Raw Data in Context.’Science 323.5915 (6 Feb. 2009): 713. 5 U.S. Department of Health and Human Services, National Institutes of Health, HIPAA Privacy Rule, Information for Researchers. 13 Nov. 2010. 6 Wilczynski, N.L., R.B. Haynes, and Hedges Team. ‘EMBASE Search Strategies for Identifying Methodologically Sound Diagnostic Studies for Use by Clinicians and Researchers.’BMC Medicine 29.3 (March 2005): 7. (shrink)

Thirty-four states, the District of Columbia, and Puerto Rico have legalized medical cannabis. While no two state medical cannabis programs are alike, public health concerns related to advertising, packaging and labeling, pesticide use, scientific research, and the role of medical cannabis in the opioid crisis are emerging across the country. This article examines these issues, the policy approaches states are adopting to protect patients and the public, and an assessment of the underlying federal legal landscape.

In Culture, Genre, and Literary Vocation, Michael Davitt Bell charts the important and often overlooked connection between literary culture and authors' careers. Bell's influential essays on nineteenth-century American writers—originally written for such landmark projects as The Columbia Literary History of the United States and The Cambridge History of American Literature—are gathered here with a major new essay on Richard Wright. Throughout, Bell revisits issues of genre with an eye toward the unexpected details of authors' lives, and invites us to (...) reconsider the hidden functions that terms such as "romanticism" and "realism" served for authors and their critics. Whether tracing the demands of the market or the expectations of readers, Bell examines the intimate relationship between literary production and culture; each essay closely links the milieu in which American writers worked with the trajectory of their storied careers. (shrink)

Do terminally ill patients who have exhausted all other available, government-approved treatment options have a constitutional right to experimental treatment that may prolong their lives? On May 2, 2006, a divided panel of the U.S. Court of Appeals for the District of Columbia, in a startling opinion, Abigail Alliance for Better Access to Developmental Drugs v. Von Eschenbach, held “Yes.” The plaintiffs, Abigail Alliance for Better Access to Developmental Drugs and Washington Legal Foundation, sought to enjoin the Food (...) and Drug Administration from refusing to allow the sale of investigational new drugs that had not yet received FDA approval. The terminally ill plaintiffs contended that they quite literally could not wait that long for the drugs. With no other treatment options available, the plaintiffs urged the court to recognize a fundamental, constitutional right to take potentially life-saving or life-prolonging drugs, even though the treatment had not been fully tested through human trials for safety and effectiveness and could not be legally marketed to the public. (shrink)

On May 2, 2006, a divided panel of the U.S. Court of Appeals for the District of Columbia, in a startling opinion, Abigail Alliance for Better Access to Developmental Drugs v. Eschenbach, held that terminally ill patients who have exhausted all other available options have a constitutional right to experimental treatment that FDA has not yet approved. Although ultimately overturned by the full court, Abigail Alliance generated considerable interest from various constituencies. Meanwhile, FDA proposed similar regulatory amendments, as (...) have lawmakers on both sides of the aisle in Congress. But proponents of expanded access fail to consider public health and consumer safety concerns. In particular, allowing patients to try unproven treatments, outside of controlled clinical trials risks both the study's outcome and the health of patients who might benefit from the deliberate, careful process of new drug approval as it currently operates under FDA's auspices. (shrink)

Legal orientalism -- Making legal and unlegal subjects in history -- Telling stories about corporations and kinship -- Canton is not Boston -- The District of China is not the District of Columbia -- Colonialism without colonies.

As of 2019, ten jurisdictions in the United States—Oregon, Washington, Montana, Vermont, California, Colorado, the District of Columbia, Hawaii, New Jersey, and Maine—have authorized physicians to...

Washington, D.C.’s City Council has recently taken the first step towards legalizing the use of “medical marijuana” in accordance with the provisions of the Legalization of Marijuana for Medical Treatment Initiative of 1998. This action was not overruled by the United States Congress within the 30-day deadline imposed by the District of Columbia’s Home Rule Statute. The Council is now crafting regulations that will govern the therapeutic and palliative use of this drug with the goal of avoiding some (...) of the problems faced by the other states that have legalized medical marijuana; however, the proposed rules do not establish criteria for legitimate medical practice when medical marijuana is recommended. If the enabling regulations are passed by the D.C. Council and not rejected by the Congress, the District of Columbia will join over onequarter of the states in legalizing medical marijuana. On the other hand, if the D.C. Council fails to act favorably on the final regulations, then the effective legalization of medical marijuana will die and not be reconsidered until next year. (shrink)

In May 2011, the clinical ethics group of the Center for Ethics at Washington Hospital Center launched a 40-hour, three and one-half day Clinical Ethics Immersion Course. Created to address gaps in training in the practice of clinical ethics, the course is for those who now practice clinical ethics and for those who teach bioethics but who do not, or who rarely, have the opportunity to be in a clinical setting. “Immersion” refers to a high-intensity clinical ethics experience in a (...) busy, urban, acute care hospital. During the Immersion Course, participants join clinical ethicists on working rounds in intensive care units and trauma service. Participants engage in a videotaped role-play conversation with an actor. Each simulated session reflects a practical, realistic clinical ethics case consultation scenario. Participants also review patients’ charts, and have small group discussions on selected clinical ethics topics. As ethics consultation requests come into the center, Immersion Course participants accompany clinical ethicists on consultations. Specific to this pilot, because participants’ evaluations and course faculty impressions were positive, the Center for Ethics will conduct the course twice each year. We look forward to improving the pilot and establishing the Immersion Course as one step towards addressing the gap in training opportunities in clinical ethics. (shrink)

Beliefs once limited to the extremes of the North American gun culture have become mainstream, while the US Supreme Court’s ruling in District of Columbia v. Heller and a spate of right-to-carry laws have contributed to the proliferation of guns in public life. These changes in political discourses, legislative agendas, and social practices are indicative of an emergent and pernicious form of subjectivity, which is here defined as self-defensive. Such subjectivity is characterized by a pathological identification with the (...) right of self-defense, which undermines the social conditions of individual freedom and renders subjects unable to comprehend the function of abstract rights within an informal normative order. Practically speaking, this raced and gendered subjectivity relies on extra-legal relations of domination for its reproduction. The rapid expansion of gun rights and the recent loosening of restrictions on self-defensive violence are argued to be responses to a perceived threat to these identity-constituting relations, rather than to the threat of violent crime, which has long been on the decline. (shrink)

Sixty years after the famous ‘Conférence des écrivains et artistes noirs at the Sorbonne’, and sixty years after Black-Label, the third collection of poetry by French Guianese Leon-Gontran Damas, the word “nègre” and “nigger” remain offensive words all too much used in postcolonial Europe today. Even after the short lived Obamamania, Damas’s poetry remains actual as it expresses the censorship all too many times endured by the lyrical voice who cannot speak out loud against those violent verbal, physical, and thus (...) psychological assaults. Consequently, his “mors dans la bouche”, or “bit in the mouth” is incoporated in his less wellknown work which testifies to the “mort dans l’âme”, it is the constant feeling of depression and blues lurking on the Black or coloured citizen of France and the West Indies. Standing in the shadow of the cofounders, and quite neglected by the leading Martinicans of the post-Négritude era, Damas nevertheless understood the urgency of transcontinental and transcultural solidarities in this battle and wrote against the dichotomies of race, class, and gender. Damas and James knew each other for over forty years. Damas read James’s novel, Minty Alley before they met in Paris when James was doing the research for The Black Jacobins, his landmark history of Tousssaint L’Ouverture and the revolution in the French colony of Saint-Domingue. Damas helped James with translations and discovering documents at the Bibliothèque Nationale. On one occasion, Damas brought James to the home of Robert Desnos. Both lived in Washington, DC, in the 1970s when Damas was at Howard University and James taught at Federal City College/University of the District of Columbia. (shrink)

The Second Amendment to the U.S. Constitution states: “A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.” Until recently, no federal appellate court had ever struck down any gun law as a violation of the Second Amendment. In fact, even laws outlawing most handgun possession, or restricting other types of firearms, had been upheld, in part, because the laws did not interfere with (...) the functioning of state militias.Then, in 2008, the U.S. Supreme Court — for the first time in nearly 70 years — decided a case squarely addressing the meaning of the Second Amendment. In District of Columbia v. Heller, the Supreme Court concluded that the Second Amendment protected an individual right to own handguns in the home, invalidating a Washington, D.C. law.But Heller left many issues undecided, including the precise scope of the Second Amendment. (shrink)

Context Opioid treatment agreements (OTAs) are documents that clinicians present to patients when prescribing opioids that describe the risks of opioids and specify requirements that patients must meet to receive their medication. Notwithstanding a lack of evidence that OTAs effectively mitigate opioids’ risks, professional organizations recommend that they be implemented, and jurisdictions increasingly require them. We sought to identify the jurisdictions that require OTAs, how OTAs might affect the outcomes of lawsuits that arise when things go wrong, and instances in (...) which the law permits flexibility for clinicians and health care institutions to adopt best practices. -/- Methods We surveyed the laws and regulations of all 50 states and the District of Columbia to identify which jurisdictions require the use of OTAs, the circumstances in which OTA use is mandatory, and the terms OTAs must include (if any). We also surveyed criminal and civil judicial decisions in which OTAs were discussed as evidence on which a court relied to make its decision to determine how OTA use influences litigation outcomes. -/- Findings Results show that a slight majority (27) of jurisdictions now require OTAs. With one exception, the jurisdictions’ requirements for OTA use are triggered at least in part by long-term prescribing. There is otherwise substantial variation and flexibility within OTA requirements. Results also show that even in jurisdictions where OTA use is not required by statute or regulation, OTA use can inform courts’ reasoning in lawsuits involving patients or clinicians. Sometimes, but not always, OTA use legally protects clinicians from liability. -/- Conclusions -/- Our results show that OTA use is entwined with legal obligations in various ways. Clinicians and health care institutions should identify ways for OTAs to enhance clinician–patient relationships and patient care within the bounds of relevant legal requirements and risks. (shrink)

The status of marijuana as an illegal drug has greatly evolved in recent years. Many countries have decriminalized possession of marijuana for personal use. Others have not decriminalized it but simply “tolerate” it for private personal use. Four countries have passed laws legalizing medical marijuana and one other tolerates the use of marijuana for medical purposes without having legislated a specific right for such possession and use. To date, 17 of the United States and the District of Columbia (...) have also passed laws regarding medical marijuana. However, state medical marijuana laws are at odds with the federal Controlled Substances Act, which prohibits possession of marijuana. This fact, in tandem with employer requirements under the Drug-Free Workplace Act, has created a dilemma for employers who have employees with medical conditions for which medical marijuana has been recommended. Given that 18 additional states currently have medical marijuana legislation pending, medical marijuana in the workplace is an issue which is not going to go away. As a result, it is time to examine the interface between federal and state laws as well as the public policy issues surrounding the lack of rights which medical marijuana patients have in their workplaces. (shrink)

The great challenge of rhetorical argument is to make discourse ethical without making it less logical. This challenge is of central importance throughout the full range of practical argument, and understanding the relation of the ethical to the logical is one of the principal contributions the humanities, in this case the study of rhetoric, can make to legal scholarship. Aristotle’s Rhetoric shows how arguments can be ethical and can create ethical relations between speaker and hearer. I intend to apply Aristotle’s (...) analysis to a phenomenon that did not yet exist for him, that of authority, by asking how the acts of asserting and accepting authority can be ethical acts. I take as a test case a peculiarly unfortunate and inept appeal to authority, that offered by the counsel for the District of Columbia in arguing Bolling v Sharp who cited Taney’s opinion in Dred Scott to clinch his point. By seeing just what goes wrong in such a maladroit appeal, I explore the rational, voluntary and ethical dimensions of a decision to accept a given commitment to authority. I use Joseph Raz’s analysis of authority and the relation of reason to authority, yet think I go beyond Raz by exploring the deliberate and voluntary nature of submission to authority. Choosing to be bound by an authority is an ethical act. As such it is always rational and yet never purely rational. The Supreme Court’s choice of authorities is part of its making itself into an authority, and is a paradigm of the ethical act of choosing to be obligated. Choosing to be committed or obligated is a central paradox of political theory and considerations of authority and obligation, at least since early social contract theorists. However, its importance for judicial reasoning, which at the same time chooses to submit to authority and itself becomes an authority, has not been noted. Consideration of the relations between the ethical and the logical can help us better to articulate the constitution of ethical authority. (shrink)

The events of September 11, 2001 have prompted significant concern to protect against future terror attacks, especially attacks that would involve the use of biological weapons - the most dangerous weapons of massdestruction considered accessible to terrorist groups and organizations. This concern, in turn, has led to a re-evaluation of the public health system and its preparedness to meet the challenges of treating a large number of people in circumstances of public fear and significant demand for resources. One important result (...) of this re-evaluation has been the development of a Model State Emergency Health Powers Act that is designed to grant state officials the authority necessary to coordinate an effective response to biological tenor. The Model Act was first publicized in late October, 2001,and a revised version was publicized December21, 2001.As of October 1,2002,legislation based on the Act had been introduced in thirty-six states, and versions of the Act had been enacted in twenty states and the District of Columbia. (shrink)

The events of September 11, 2001 have prompted significant concern to protect against future terror attacks, especially attacks that would involve the use of biological weapons - the most dangerous weapons of massdestruction considered accessible to terrorist groups and organizations. This concern, in turn, has led to a re-evaluation of the public health system and its preparedness to meet the challenges of treating a large number of people in circumstances of public fear and significant demand for resources. One important result (...) of this re-evaluation has been the development of a Model State Emergency Health Powers Act that is designed to grant state officials the authority necessary to coordinate an effective response to biological tenor. The Model Act was first publicized in late October, 2001,and a revised version was publicized December21, 2001.As of October 1,2002,legislation based on the Act had been introduced in thirty-six states, and versions of the Act had been enacted in twenty states and the District of Columbia. (shrink)

A true announcement of the law of creation, if a man were found worthy to declare it, would carry art up into the kingdom of nature, and destroy its separate and contrasted existence. The Common Core State Standards for the teaching of literature are now in effect in forty-four states and the District of Columbia. As is the case with previous standards developed at the state level since the 1990s, the Common Core State Standards are framed within a (...) familiar formalist paradigm for literature instruction specifying that high school students will read and study recognized literary works of art, exhibit knowledge of literary history, and demonstrate proficiency using authorized methods for critical.. (shrink)

In May of 2006, the Abigail Alliance for Better Access to Development Drugs appeared to have won a victory when a divided panel of the Court of Appeals for the District of Columbia Circuit ruled that “terminally ill, mentally competent adult patients” had a constitutionally protected right to access investigational medications. This victory was short lived, however. On August 7, 2007, the D.C. Circuit sitting en banc reversed this earlier decision, marking a setback in Abigail's campaign for removal (...) of the regulatory barriers that currently prevent terminally ill patients from gaining early access to investigational drugs. This loss represents a big blow for Abigail's cause, because there is no guarantee that they will have another day in court, and attaining their goal through other branches of the government remains uncertain. (shrink)

In May of 2006, the Abigail Alliance for Better Access to Development Drugs appeared to have won a victory when a divided panel of the Court of Appeals for the District of Columbia Circuit ruled that “terminally ill, mentally competent adult patients” had a constitutionally protected right to access investigational medications. This victory was short lived, however. On August 7, 2007, the D.C. Circuit sitting en banc reversed this earlier decision, marking a setback in Abigail's campaign for removal (...) of the regulatory barriers that currently prevent terminally ill patients from gaining early access to investigational drugs. This loss represents a big blow for Abigail's cause, because there is no guarantee that they will have another day in court, and attaining their goal through other branches of the government remains uncertain. (shrink)

On August 29, 2006, the United States Court of Appeals for the District of Columbia Circuit held that an injured ERISA plan beneficiary need not be “made whole” by any injury-related recovery from a third party in order for her ERISA plan to assert subrogation or reimbursement rights if the plan's terms either 1) “unambiguously establish a plan priority” to any funds a beneficiary recovers from a third party, or 2) are reasonably interpreted to establish such a priority (...) by an ERISA plan fiduciary clearly authorized to do so.In 1991, appellants William and Judith Moore purchased an ERISA health insurance policy from Blue Cross Blue Shield of the National Capital Area and its wholly-owned subsidiary CapitalCare. On September 10, 1992, the Moores’ daughter Alistaire, a plan beneficiary, was seriously injured in an automobile accident. (shrink)

After a tortuous legal process that resembled nothing so much as a game of chutes and ladders, on August 24, 2012, the United States Court of Appeals for the District of Columbia Circuit decided in favor of the Department of Health and Human Services' position that human embryonic stem cell research is not research that harms embryos, and therefore is not a violation of the Dickey‐Wicker Amendment. Bioethicists have been following this case because of our interest in the (...) ethics and politics of embryonic stem cell research, but the final decision hinged largely on a series of rather arcane points of law and procedure. (shrink)

During the last 115 years, the National Conference of Commissioners of Uniform State Laws has promulgated more than 300 uniform or model acts. These acts have been drafted to produce uniformity among state laws, and to provide clarity and stability in critical areas of the law. Uniform Anatomical Gift Acts were promulgated in 1968 and again in 1987. The third and most recent revision of the Act was promulgated in 2006 and amended in 2007. This act was placed on NCCUSL’s (...) target list; that is, commissioners were asked to make its enactment a priority in their home states. In 2007, 20 states enacted UAGA 2006; by mid-2008, UAGA 2006 had been introduced or enacted in over a dozen more states and the District of Columbia. NCCUSL’s goal for UAGA 2006 is enactment in all states by 2009. (shrink)

More than half of the S&P 500 and the Fortune 500 companies publish corporate social responsibility reports. CSR is at the heart of a new form of corporation, the benefit corporation, which requires the pursuit of a social purpose as well as pursuit of profit. Thirty-four states, plus the District of Columbia, have enacted benefit corporation legislation. Most laws require that benefit corporations publish reports on their social purpose performance using a third-party assessment format. The purpose of this (...) paper is to analyze 1,530 benefit corporations identified by B Lab and the state of Minnesota for proof of social purpose performance, as demonstrated in reports on their websites. The study found some companies with excellent reports, but those had had a CSR focus prior to becoming benefit corporations or had been Certified B Corporations. However, most benefit corporations in the study had no published reports; many have no websites. (shrink)

More than half of the S&P 500 and the Fortune 500 companies publish corporate social responsibility (CSR) reports. CSR is at the heart of a new form of corporation, the benefit corporation, which requires the pursuit of a social purpose as well as pursuit of profit. Thirty-four states, plus the District of Columbia, have enacted benefit corporation legislation. Most laws require that benefit corporations publish reports on their social purpose performance using a third-party assessment format. The purpose of (...) this paper is to analyze 1,530 benefit corporations identified by B Lab and the state of Minnesota for proof of social purpose performance, as demonstrated in reports on their websites. The study found some companies with excellent reports, but those had had a CSR focus prior to becoming benefit corporations or had been Certified B Corporations. However, most benefit corporations in the study had no published reports; many have no websites. (shrink)

By 2014, each of the fifty states and the District of Columbia will have a new health insurance exchange, or marketplace, established under the Patient Protection and Affordable Care Act. These exchanges are the centerpiece of the reform law: they will be the main portals where people who do not have health insurance coverage through their jobs and small businesses will go, either in person or online, to find a health plan and to learn about and apply for (...) federal subsidies. The most immediate challenge facing all fifty‐one exchanges is fulfilling their most basic role: ensuring that all who are eligible to enroll in qualified health plans and to receive federal subsidies in fact enroll. (shrink)

‘‘What Is Algebra?-Why This Book?’’ This is the amazing prelude to Taming the Unknown by Victor J. Katz, emeritus professor of mathematics at the University of the District of Columbia and Karen Hunger Parshall, professor of history of mathematics at the University of Virginia. This is an excellent book; its accurate historical and pedagogical purpose offers an accessible read for historians and mathematicians. [continue...].