Justifications for Non-­Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation

A central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to the intervention. However, in some circumstances it is tempting to say that the moral reason to obtain informed consent prior to administering a medical intervention is outweighed. For example, if an individual’s refusal to undergo a medical intervention would lead to the transmission of a dangerous infectious disease to other members of the community, one might claim that it would be morally permissible to administer the intervention even in the absence of consent. Indeed, as we shall discuss below, there are a number of examples of public health authorities implementing compulsory or coercive measures for the purposes of infectious disease control (IDC). The plausibility of the thought that non-consensual medical interventions might be justified when performed for the purpose of IDC raises the question of whether such interventions might permissibly be used to realize other public goods. In this article we focus on one possibility: whether it could be permissible to non-consensually impose certain interventions that alter brain states or processes through chemical or physical means on serious criminal offenders. We shall suggest that some such interventions might be permissible if they safely and effectively serve to facilitate the offender’s rehabilitation and thereby prevent criminal recidivism

Theories of Asbestos Litigation Cost - Why Two Decades of Procedural Reform Have Failed to Reduce Claimants\u27 Expenses

In twenty years of asbestos litigation, procedural reforms at all levels of the civil litigation system have failed to reduce plaintiffs’ attorneys’ fees. The result has been dramatic undercompensation of asbestos tort victims. This paper attempts to explain this remarkable fact using economic methodology. The paper offers three theories: First, that the continuing difficulty of assessing causation in asbestos and other mass tort cases predictably impedes the efforts of procedural reform to reduce costs; second, that changes in defendant and insurer risk attitudes have generated costly litigation; third, that collusion of plaintiffs’ attorneys to maintain prices cannot be ruled out. Each of these theories has some empirical support. Further, regardless of which turns out to be correct, the continuing high costs of civil litigation mean that resolution through the bankruptcy system will predictably harm future claimants, an unfair outcome. In the final assessment, civil procedure reform, the favored mechanism for resolving the asbestos case backlog, cannot achieve its objectives. Rather, reform must take into account substantive law and the motives and incentives of actors in the legal system. Holistic analysis of this type lends support to a comprehensive administrative remedies scheme, which has the best chance of decreasing the costs of compensation

Why not boys? The human papillomavirus vaccine schedule in the UK

The aim of this paper is to explore the ethical issues on why boys are not currently included in the human papillomavirus vaccination schedule in the United Kingdom (UK). There is a paucity of literature on the benefits of vaccinating boys (Hull and Caplan, 2009). The current vaccination schedule in the UK for HPV consists of a two-dose quadrivalent vaccination (against HPV types 6, 11, 16 and 18) for adolescent girls aged 11–13 years old. This is delivered as a school-based programme and is only offered to girls (NHS Choices, 2014; 2015). Currently, boys are not offered the vaccine and there are no plans to do so

The \u3cem\u3eLancet\u3c/em\u3e Commission on Global Health Law: The Transformative Power of Law to Advance the Right to Health

A new report by The Lancet-O’Neill-Georgetown University Commission on Global Health and the Law shows how law can fulfill the global pledge of the human right to health, while “leaving no one behind.” I call this “global health with justice.” We need both health and justice. By global health, I mean ever increasing indicators of good health and increased longevity in all countries around the world. By justice I mean that the global “good” of health must be fairly distributed both within and among countries. The Lancet Commission report offers a comprehensive roadmap towards realizing the law’s power to make us healthier and safer, describing how principles – like fairness, participation, and wielding evidence – can shape policies throughout government. It also vividly illustrates how good governance and the rule of law can advance both health and justice. We tend to think of science and medicine as the major drivers of good health. And, of course, these disciplines are vital to develop, implement, and improve healthcare, including pharmaceuticals, vaccines, and medical supplies. Yet, professional medical and nursing services make only a relatively small contribution to population health. More important are population-based interventions that modify core risks to health, such as diet, smoking, alcohol, and physical activity. These interventions are not the product of medicine or healthcare systems. Rather they are driven by law. In other words, what is the wonder drug that could save millions of lives? It is the law, enacted on the floors of national legislatures

A Wake-Up Call: Lessons from Ebola for the World's Health Systems

The report ranks the world's poorest countries on the state of their public health systems, finding that 28 have weaker defenses in place than Sierra Leone where, alongside Liberia and Guinea, the current Ebola crisis has already claimed more than 9,500 lives. The report also advises that prevention is better than cure, finding that the international Ebola relief effort in West Africa has cost $4.3bn, whereas strengthening the health systems of those countries in the first place would have cost just$1.58bn. Ahead of an Ebola summit attended by world leaders in Brussels today, the charity warns that alongside immediate much needed support to Sierra Leone, Liberia and Guinea, lessons need to be learned and applied to other vulnerable countries around the world