telemedicine practice review of the current ethical and legal challenges

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Essays on Cigarette Regulation, Prenatal Smoking, and Cross-Border Shopping

In my dissertation, I study the impact of cigarette regulation on two main outcomes: prenatal smoking and cross-border shopping. The first chapter of my dissertation concerns how state-level cigarette tax increases affect cross-state border shopping for cigarettes. To estimate this relationship, I use high-resolution census block group-by-month cellphone tracking data from Safegraph. I estimate a Callaway and Sant’Anna (2021) difference-in-differences model that accommodates my unique setting in which the tax increases I consider become effective at different times throughout the full length of the study. The use of this data allows me to avoid measurement error that could be present in self-reported data. I find that the median census block group (CBG) sent 0.53 more cross-border shoppers per month in response to a cigarette tax increase (19% increase from the pre-tax cross-border shopping mean). Further, I show that CBGs with many low educated adults and rural CBGs send substantially more cross-border shoppers than their respective counterparts. Performing a back-of-the-envelope calculation, I estimate that cigarette tax increases before 2019 increased cigarette tax revenue leakage in 2019 by $531,581 in Oklahoma and$9,084,824 in Kentucky. In sum, these results suggest that cross-border shopping remains an ongoing challenge for tobacco control policy efforts and for reducing tobacco-related disparities. The second chapter of my dissertation, written with my committee chair, studies how cigarette taxes and indoor smoking restrictions impact the propensity and intensity of smoking by a pregnant woman (prenatal smoking). We use data from the Nation Vital Statistics System to get smoking data from almost every pregnant woman in the USA from 1995 to 2018. To reduce bias from dynamic and heterogeneous treatment effects, we estimate a modified stacked difference-in-differences model that accommodates our unique policy environment in which policies are often gradually strengthened over time and dose increases vary. We find some evidence that indoor smoking restrictions modestly decreases prenatal smoking and, contrary to previous literature, that cigarette taxes do not significantly impact prenatal smoking. Indoor smoking restrictions may be better from a health-equity perspective than cigarette taxes

Framing post-conflict societies: an analysis of the international pathologisation of Cambodia and the post-Yugoslav states

The article examines the pathologisation of post-conflict societies through a comparison of the framing of the Cambodian and post-Yugoslav states. The notion of failed states fixes culpability for war on societies in question, rendering the domestic populations dysfunational while casting international rescue interventions as functional. The article suggests that the discourse of pathologisation can be understood not as a means of explaining state crisis so much as legitimising an indefinite international presence and deferring self-government

Congenital anomalies from a physics perspective. The key role of "manufacturing" volatility

Genetic and environmental factors are traditionally seen as the sole causes of congenital anomalies. In this paper we introduce a third possible cause, namely random "manufacturing" discrepancies with respect to ``design'' values. A clear way to demonstrate the existence of this component is to ``shut'' the two others and to see whether or not there is remaining variability. Perfect clones raised under well controlled laboratory conditions fulfill the conditions for such a test. Carried out for four different species, the test reveals a variability remainder of the order of 10%-20% in terms of coefficient of variation. As an example, the CV of the volume of E.coli bacteria immediately after binary fission is of the order of 10%. In short, ``manufacturing'' discrepancies occur randomly, even when no harmful mutation or environmental factors are involved. Not surprisingly, there is a strong connection between congenital defects and infant mortality. In the wake of birth there is a gradual elimination of defective units and this screening accounts for the post-natal fall of infant mortality. Apart from this trend, post-natal death rates also have humps and peaks associated with various inabilities and defects.\qL In short, infant mortality rates convert the case-by-case and mostly qualitative problem of congenital malformations into a global quantitative effect which, so to say, summarizes and registers what goes wrong in the embryonic phase. Based on the natural assumption that for simple organisms (e.g. rotifers) the manufacturing processes are shorter than for more complex organisms (e.g. mammals), fewer congenital anomalies are expected. Somehow, this feature should be visible on the infant mortality rate. How this conjecture can be tested is outlined in our conclusion.Comment: 43 pages, 9 figure

Privacy Protection for Mobile Health (MHEALTH) in Nigeria: A Consideration of the EU Regime for Data Protection as a Conceptual Model for Reforming Nigeria\u27s Privacy Legislation

The use of mobile technologies to provide and deliver healthcare is known as Mobile Health. Nigeria is one of the countries witnessing a profound use of these technologies. While discussions have focused on the potentials of this technologies to address the challenges in the health system, nothing is said about the risks from unauthorized disclosure or misuse of health information provided by users. This becomes worse when Nigeria\u27s laws do not offer adequate protection. As Mobile Health is a novelty to Nigeria, this thesis looks to relevant international standards on privacy protection. It does this by examining the European regime for protection of personal information. To prescribe this regime for Nigeria however, the differences in the socio-economic and cultural realities between Nigeria and Europe are presented and examined. This thesis argues that notwithstanding, Nigeria can draw on the European regime to reform its privacy framework

International Taxation in an Era of Digital Disruption: Analyzing the Current Debate

The “taxation of the digital economy” is currently at the top of the global international tax policymaking agenda. A core claim some European governments are advancing is that user data or user participation in the digital economy justifies a gross tax on digital receipts, new profit attribution criteria, or a special formulary apportionment factor in a future formulary regime targeted specifically at the “digital economy.” Just a couple years ago the OECD undertook an evaluation of whether the digital economy can (or should) be “ring-fenced” as part of the BEPS project, and concluded that it neither can be nor should be. Importantly, concluding that there should be no special rules for the digital economy does not resolve the broader question of whether the international tax system requires reform. The practical reality appears to be that all the largest economies have come to agree either that a) there is something wrong with the taxation of the “digital economy,” or b) there is something more fundamentally wrong with the structure of the current international tax system given globalization and technological trends. This paper is intended as a limited exploration of the second (or third, or fourth) best. It analyzes three policy options that have been discussed in general terms in the current global debate. First, I consider whether “user participation” justifies changing profit allocation results in the digital economy alone. I conclude that applying the user participation concept in a manner that is limited to the digital economy is intellectually indefensible; at most it amounts to mercantilist ring-fencing. Moreover, at the technical level user participation faces all the same challenges as more comprehensive and principled proposals for reallocating excess returns among jurisdictions. Second, I consider one such comprehensive international tax reform idea, loosely referred to by the moniker “marketing intangibles.” This idea represents a compromise between the present transfer pricing system and sales or destination-based reforms to the transfer pricing regime. I conclude that splitting taxing rights over “excess” returns between the present transfer pricing system and a destination-based approach is complex, creates new sources of potential conflict, and requires relatively extensive tax harmonization. This conclusion applies equally to user participation and marketing intangibles. If such a mechanism were nevertheless pursued, I suggest that a formulary system for splitting the excess return is the most manageable approach. Third, I consider “minimum effective taxation” ideas. I conclude that, as compared to the other two policy options discussed herein, minimum effective taxation provides a preferable path for multilateral cooperation

The role of the European Commission during the COVID-19 pandemic in fostering coordination and solidarity among member states

In the first weeks of the COVID-19 outbreak in the European Union, Member States reacted in a unilateral and nationalist manner that was contradictory to a spirit of solidarity. Therefore, this dissertation aimed to assess the European Commission’s role regarding the challenges of the Member States’ responses to the COVID-19 pandemic, especially regarding solidarity and coordination among them. The definition of European Solidarity is however weak, as demonstrated in the Literature review chapter. For a concept to gain its meaning and be defined, constant practice is needed. Through a qualitative document analysis of documents issued by the European Commission addressing the sanitary crisis caused by the COVID-19 pandemic in 2020, this dissertation aimed to answer its research question and validate its hypothesis. It was concluded that the European Commission played an active role in responding to the COVID-19 pandemic and fostering coordination and solidarity among Member States. During the analysis, it was also concluded that in its actions to respond to the pandemic, the Commission put in place the constant practice of European Solidarity, demonstrating what it means to act in a solidarity manner and pushing for Member States to act in such a manner through the indication of concrete actions. It was also concluded that in its action in response to the COVID-19 pandemic in 2020, the von der Leyen Commission was also coherent with its six policy priorities that guided the undertaken efforts.Nas primeiras semanas do surto de COVID-19 na União Europeia, os Estados Membros reagiram de uma forma unilateral e nacionalista contraditória ao espírito de solidariedade. Assim, esta dissertação procurou avaliar o papel da Comissão Europeia no que se refere aos desafios colocados pelas respostas dos Estados Membros à pandemia de COVID-19, especialmente relativamente à solidariedade e coordenação entre estes. A definição de Solidariedade Europeia é, no entanto, fraca, como demonstrado no capítulo da Revisão de Literatura. Para um conceito ganhar o seu significado e ser definido, é necessária a prática constante. Através de uma análise documental qualitativa de documentos emitidos pela Comissão Europeia relativamente à pandemia de COVID-19 em 2020, esta dissertação procurou responder à sua pergunta de partida e validar as suas hipóteses. Foi, então, concluído que a Comissão Europeia assumiu um papel importante ao responder à pandemia de COVID-19 e fomentar a coordenação e solidariedade entre Estados Membros. Durante a analise, concluiu-se também que nas suas ações em resposta à Covid-19, a Comissão colocou em prática a Solidariedade Europeia de forma constante, demonstrando como se age de maneira solidária e incentivando os Estados Membros a assim agir através da indicação de ações concretas. Conclui-se ainda que na sua ação em resposta à pandemia de COVID-19 em 2020, a Comissão von der Leyen foi coerente com as suas seis prioridades políticas, que guiaram os seus esforços

ELECTRONIC HEALTH RECORDS AS A LEGAL BARRIER OF CROSS-BORDER PROVIDING OF HEALTH CARE - PARADOX?

The subject of this article is the analysis of the Institute of Electronic Health Documentation, which has been discussed within the European Union for some time, but its current form in the legal systems of member states of the European Union does not correspond to the outlined vision. Electronic health documentation represents one of the pillars of e-Health, whose goal is to provide correct information at the right time, in the right place, and in the right form in all stages and processes of health care. The author deals with Slovak and European legislation related to electronic health documentation, presents the so-called electronic health book existing in the conditions of the Slovak Republic, and draws attention to the proposal for a new European regulation on the European Health Data Space, which aims to harmonize the rules for the creation and use of electronic health data, and thus strengthen the role of electronic health documentation for (including cross-border) provision of health care. The article aims to emphasize the most important challenges of the current and future legal regime of the transfer and exchange of electronic health data and other related ideas. &nbsp