Medical Disputes and Conflicting Values: Is There a “Right to Die” Later?

The article compares the benefits and disadvantages that each institutional approach, that of statutory law, courts, and hospital ethics consultants, brings to medical-futility disputes. Topics discussed include social and legal responses to conflicts about dying, conflicting values central to contemporary medial ethics, and value of autonomous patient choice

The Morality of Choice: Estate Planning and the Client Who Chooses Not to Choose

The Symposium focuses around two hypotheticals. The question posed about each-whether it is ethical for an estate lawyer to represent spouses, one of whom chooses subservience to the interests of the other-provokes discussion of a broad set of concerns about the scope and meaning of the contemporary family, and about the appropriate parameters of legal representation of family members

Biological Evaluations: Blood, Genes, and Family

The next Part of the Article (Part II) provides a brief overview of the ideology in terms of which society understood the family during the nineteenth, and most of the twentieth, century. Part III then summarizes the increasing readiness of society and of lawmakers since the 1960s, openly to premise delimitations of family on values once associated with the marketplace, but not the home. Parts II and III provide background to Part IV. Part IV, the heart of the Article, focuses on contemporary understandings of family that preserve a central role for the biological correlates of domestic relationships. The Part describes four social responses to the widespread presumption that biology (now generally, though not always, read as “DNA”) is significant to understandings of family in light of society’s commitment to autonomous choice in family settings...Finally, Part IV considers a fourth distinct form of family that depends centrally on presumptive biological (genetic) facts. This form of family (referred to here as a “medicalized family”) is remarkable in that it largely precludes choice while safeguarding individualism. It suggests a novel and potentially troubling notion of family

Personhood, Discrimination, and the New Genetics

Decoding the human genome and identifying genetic sequences may provide, among other things, for the production of individually tailored drugs, for medicines without side effects, and perhaps eventually for gene therapy that will replace dysfunctional genes with genes that preclude or cure illness. But, the same developments threaten society with the potential for devastating biological accidents, with broad invasions of individual and communal privacy, and with genetic bigotry and the revival of eugenic policies. Behind the concrete promises and threats that attend the new genetics lies another sort of change-more subtle than those more usually, and more easily, described and assessed, but as important. In particular, developments in molecular biology will likely alter-and in certain contexts have already begun to alter-the ideological frame within which people define themselves and their actions. This Article identifies and explores the ramifications of one such change. This change involves a fundamental shift in the locus of social value from the autonomous individual-long the central agent of thought and action in most domains of life\u27 in the post-Enlightenment West-to a larger whole, defined through the presumption of a shared genome. Among the consequences of this change are two evolving conceptions of a genetic family and a genetic ethnic group. Each threatens to eviscerate a set of basic values related almost exclusively to the autonomous individual. Among those values are privacy, equality, and choice. This Article focuses on potential consequences of this shift in the locus of social value for familial and for ethnic and racial groups.\u27 The widespread availability of genetic information may create, and appear to validate, negative images of groups defined through reference to DNA and alter understandings of personhood that now prompt the law to protect privacy, and to prohibit ethnic and racial discrimination

When Others Get Too Close: Immigrants, Class, and the Health Care Debate

This Article describes one genre of contemporary anti-immigrant rhetoric, examines the social and economic forces that engender that rhetoric, and delineates its implications for the national debate about health care reform. The Article details the underlying significance of America\u27s opaque, yet highly competitive, class system to immigration reform and to health care reform. It locates the population most compelled by anti-immigrant rhetoric in the so-called intermediate strata (more generally referred to as the lower middle class). Careful examination of the relevant rhetoric suggests a broad explanation of the nation\u27s reluctance, over almost a century, to construct a system of universal or near-universal health care coverage. In supporting its claims, the Article examines the remarkable story of Luis Jimenez, an undocumented Guatemalan immigrant who was deported to Guatemala at the expense and initiative of a Florida hospital; further, it examines a number of recent federal and state laws that preclude or significantly limit health care benefits for undocumented (and for many documented) immigrants