The Hunter Doctrine: An Equal Protection Theory That Threatens Democracy

Referenda effect basic constitutional objectives by allowing individuals to participate equally in the governing process. The Supreme Court recently relied on the equal protection clause of the fourteenth amendment\u27 to invalidate a referendum procedure in Washington v. Seattle School District No. 1. A state initiative,which received support from a majority of the voting electorate,effectively forbade local school boards from implementing mandatory student reassignment programs aimed at eliminating de facto racial imbalance in state schools unless the electorate approved the proposed program. In finding an equal protection violation, the Court for the first time relied on a doctrine that it developed thirteen years earlier in Hunter v. Erickson. The Hunter doctrine provides that if state action reallocates governing power concerning a racial issue to place unique procedural burdens on minority interests, then the action embodies an explicitly racial classification, receives heightened judicial scrutiny, and must meet a heavy burden of justification. Ironically, the state school board in Seattle School District,acting under its authority to formulate educational policy, could have adopted the referendum result as a board policy without running afoul of the fourteenth amendment. Thus, the electorate decision not to bus students for racial purposes alone did not contravene the United States Constitution. Rather, the requirement of approval by referendum produced the constitutional violation. The Court\u27s reaffirmation and extension of the Hunter doctrine in Seattle School District raises serious questions about the scope of the doctrine. This Note analyzes the. theoretical bases of the Hunter doctrine and concludes that the Court has constructed a theory by which it can usurp without constitutional authority the most fundamental of state democratic powers: the referendum.Part II of this Note briefly discusses relevant equal protection theory. Part III sets forth the Hunter doctrine and examines subsequent Supreme Court decisions that have applied the doctrine.Part IV analyzes the reasons that courts have refused to rely on Hunter in assessing equal protection claims. Finally, part V suggests that the Hunter doctrine is an unsound equal protection theory because it subjects a traditional democratic process-the referendum-to constitutional attack

The impact of meridian balance method electro-acupuncture treatment on chronic pelvic pain in women: a three-armed randomised controlled feasibility study using a mixed methods approach

Introduction:\ud Chronic pelvic pain (CPP) is estimated to affect 6%–27% of women worldwide. In the United Kingdom, over 1 million women suffer from CPP and it has been highlighted as a key area of unmet need. Standard treatments are associated with unacceptable side effects. The meridian balance method electro-acupuncture (BMEA), and traditional Chinese medicine health consultation (TCM HC) (BMEA + TCM HC = BMEA treatment) may be an effective adjunct to standard treatment.\ud \ud Aim:\ud The aim of our study was to evaluate the feasibility of a future trial, to determine the effectiveness of the BMEA treatment for CPP in women. The primary objectives were to determine recruitment and retention rates. The secondary objectives were to assess the effectiveness of the BMEA treatment and acceptability of the study’s methodology.\ud \ud Methods:\ud Women with CPP were randomised into BMEA treatment (group 1), TCM HC alone (group 2) (each intervention administered twice weekly for 4 weeks) or National Health Service standard care (NHS SC, group 3). Primary outcomes were assessed by the proportion of eligible participants randomised, and the proportion of randomised participants who returned follow-up questionnaires. Interventions were assessed by validated pain/physical/emotional functioning questionnaires at baseline (0), 4, 8 and 12 weeks. Focus groups and semi-structured telephone interviews were embedded in the study.\ud \ud Results:\ud A total of 30 women (51% of those referred) were randomised over 8 months. Retention rates were 80% (95% confidence interval (CI): 74–96), 53% (95% CI: 36–70) and 87% (95% CI: 63–90), in groups 1, 2, and 3, respectively. Qualitative data suggested a favourable trial experience in groups 1 and 3.\ud \ud Discussion:\ud Group 2 retention rate was problematic and has implications for our next trial.\ud \ud Conclusion:\ud Our study suggests that a future trial to determine the effectiveness of BMEA treatment for women with CPP is feasible but with modifications to the study design

Psychoneuroimmunology: application to ocular diseases

Psychoneuroimmunology (PNI) is a relatively new discipline within the field of neuroscience which researches the relationship between emotional states, the central and peripheral nervous systems, and the endocrine and immune systems. Negative psychological states, such as stress, anxiety, and depression, may alter immune system regulation and modulation of peripheral cytokines. A plethora of PNI studies have shown that increased psychological stress and depression are associated with an alteration of immune functioning and worsened health outcomes for many conditions. To date, application of PNI methodology has not been reported for ocular diseases. This article provides an historical perspective on the origins of the rift between the emotional and spiritual from physical aspects of disease. A review of how stress is mediated through sympathetic adrenomedullary and hypothalamic pituitary axis activation with shifts in immunity is provided. The literature which supports spirituality in healing is presented. Finally, ocular diseases which would be most amenable to a PNI approach are discussed