Global Health and Human Rights Imperative

Open any magazine, click on a television news channel, or surf the net and you are likely to find global health highlighted as one of the foremost challenges of new millennium. First, this article will consider the meaning and measures of global health and detail the path to improved health and development prescribed by the United Nations Millennium Development Goals. Second, it will trace the development of international human rights law as it relates to health. Third, it demonstrate how human rights and health, long traversing parallel routes, are in fact converging in the 21st Century quest for global health–a quest that is simultaneously being driven by evolving international rights and norms related to trade, labor, the environment and human security. The article will conclude that global health and human rights are products of new international norms of governance borne of our interdependence and ongoing multilateral collaboration

Balancing the Barriers: Exploiting and Creating Incentives to Promote Development of New Tuberculosis Treatments

This Article considers the many barriers that health-care providers and public health authorities face in stemming the modem TB epidemic. Part II reviews historical public health measures, their results, and their adaptability to resurgent and MDR-TB. Part III considers the fundamental barriers to a successful global effort using these public health strategies, concluding that these barriers are insurmountable given the current arsenal of anti-tuberculosis therapies. Part IV examines the reasons why research and development of new anti-tuberculosis drugs and vaccines have stagnated over the last quarter century. Finally, part V explores incentives that might revive research and development of such therapies and thus tip the scales toward control of this dangerous new white plague

Balancing the Barriers: Exploiting and Creating Incentives to Promote Development of New Tuberculosis Treatments

This Article considers the many barriers that health-care providers and public health authorities face in stemming the modem TB epidemic. Part II reviews historical public health measures, their results, and their adaptability to resurgent and MDR-TB. Part III considers the fundamental barriers to a successful global effort using these public health strategies, concluding that these barriers are insurmountable given the current arsenal of anti-tuberculosis therapies. Part IV examines the reasons why research and development of new anti-tuberculosis drugs and vaccines have stagnated over the last quarter century. Finally, part V explores incentives that might revive research and development of such therapies and thus tip the scales toward control of this dangerous new white plague

Telemedicine and Integrated Health Care Delivery: Compounding Malpractice Liability

This Article considers how theories of medical negligence might be applied in the context of telemedicine and integrated delivery health plans. Part Two summarizes the history of telemedicine, its increasing breadth of application and opportunity and promise for the future. Part Three reviews traditional negligence principles and precedents and demonstrates how they might be applied when a telemedicine interaction results in negligence and harm to the patient. Part Four discusses evolving theories of shared liability applicable to health plans and managed care entities. Finally, Part Five demonstrates how shared liability theories will be applied to situations involving telemedicine technologies

Financing Clinical Research and Experimental Therapies: Payment Due, But from Whom?

This article will explore the realm of clinical research and the question of who should finance such research. The first part will define the various types and levels of clinical research in terms of the regulatory controls and oversight applied to such research. Then the article will summarize how the costs of clinical research and experimental therapies have been covered in the past. Finally, the article will evaluate the risks and benefits derived by the various stakeholders and propose a financing rationale for therapies that places the burden of cost squarely on the stakeholders most likely to benefit

Curing Conflicts of Interest in Clinical Research: Impossible Dreams and Harsh Realities

This article will explore conflicts of interest in the context of clinical research, focusing on the incentives and practices that foster such conflicts. Part I will briefly define and categorize the revenue streams at play in clinical research—both contemporaneous with the clinical trial, and the downstream, long-term gains available to the researcher and research university. Part II will discuss how these entangled revenue streams result in financial and non-financial conflicts of interest that affect the nature and balance of the research enterprise and potentially endanger patients and human subjects. Part III will summarize current conflicts of interest regulations and policies, including methods for addressing and preventing conflicts of interest. Finally, Part IV will suggest some reforms to the current conflict of interest management strategies, with the concession that, absent a major culture shift in research institutions and existing law, conflicts of interest will continue to undermine confidence in the integrity of the research enterprise

What DNA Can and Cannot Say: Perspectives of Immigrant Families about the Use of Genetic Testing in Immigration

Genetic technologies are being implemented in areas that extend beyond the field of medicine to address social and legal problems. An emerging example is the implementation of genetic testing in the family petitioning process in immigration policy. This use of genetic testing offers the potential benefits of reducing immigration fraud and making the process more efficient and accessible for immigrants, especially those without documentation. However, little is known about the positive or negative impacts of such testing on immigrant families and their communities. This study collected empirical data through family interviews to understand the experiences and attitudes of individuals who have taken a DNA test to prove a family relationship for immigration purposes. Based on study results, we present a set of recommendations to improve the processes with which DNA testing is applied to immigration cases. We argue that DNA testing might serve as a useful tool for families who lack documentary evidence of a family relationship. However, testing might also reveal sensitive information, such as misattributed parentage, that can damage relationships and cause serious harm to beneficiaries, especially children. Petitioners should be provided with adequate information to form an understanding of the DNA test and its implementation as well as the positive and negative consequences from using it, in order to carefully assess whether DNA testing will help their case. We recommend that additional protections be put in place to safeguard children from the potential impacts of misattributed parentage or disclosure of hidden social adoptions. This research provides empirical evidence to inform policy related to the use of genetic testing in immigration

\u3ci\u3eVolk v. DeMeerleer\u3c/i\u3e Study

The University of Washington School of Law Center for Law, Science and Global Health was asked to “convene a study on the Washington State Supreme Court decision Volk v. DeMeerleer, 386 P.3d 254 (Wash. 2016).” The Volk case elaborated on the duty of mental health providers to protect foreseeable victims of a dangerous patient. The goal of the study was to evaluate whether or not this case “substantially changed the law [in Washington] on the duty of care owed to third parties by mental health providers and whether it has had an impact on access to mental health services in the state.” See Appendix A, Volk Appropriation, §(25)(a). This portion of our report details the results of the nationwide comprehensive survey of law and how Washington’s current law compares to other jurisdictions. The legislative appropriation for a comprehensive review of “duty to warn” and “duty to protect” law required three major subsets of legal research. First, it required an in-depth 50- state survey of legislative and case law related to the duty to warn and duty to protect. In the interest of being complete, we also included the District of Columbia. See Appendix A, Volk Appropriation, §(25(a)(i). Second, it included a detailed historical review and analysis of “duty to protect” lawsuits brought in Washington against outpatient mental health care providers since the decision in Petersen v. State, 671 P.2d 230 (Wash. 1983), the preeminent case in Washington prior to Volk. See Appendix A, Volk Appropriation, §(25(a)(iii). Finally, it included an analysis of how the Volk decision changed the law in Washington and how “Washington state’s law compares to other states.” See Appendix A, Volk Appropriation, §(25(a)(i). NOTE: All cases and statutes referred to in this text are available in the Appendix I, the complete summary of the fifty states and District of Columbia, and in the Supplementary Materials (each state’s statute and cases) available on the submitted USB drives or archived with the House Judiciary Committee. Note: Commissioned by the Washington State Legislature, House Judiciary Committee, Dec. 1, 2017. Patricia C. Kuszler and Terry J. Price, faculty supervisors. Research team: Tanya E. Karwaki, Jaclyn Greenberg, Annemarie Weiss, Gavin Keene.https://digitalcommons.law.uw.edu/clsgh/1000/thumbnail.jp

Users and non-users of web-based health advice service among Finnish university students – chronic conditions and self-reported health status (a cross-sectional study)

<p>Abstract</p> <p>Background</p> <p>The Internet is increasingly used by citizens as source of health information. Young, highly educated adults use the Internet frequently to search for health-related information. Our study explores whether reported chronic conditions or self-reported health status differed among Finnish university students using the Finnish Student Health Services web-based health advice service compared with those not using the service.</p> <p>Methods</p> <p>Cross-sectional study performed by a national postal survey in 2004. Material: A random sample (n = 5 030) of a population of 101 805 undergraduate Finnish university students aged 19–35. The response rate: 63% (n = 3 153). Main outcome measures: Proportion of university students reporting use a of web-based health advice service, diagnosed chronic conditions, and self-reported health status of users and non-users of a web-based health advice service. Statistical methods: Data were presented with frequency distributions and cross-tabulations and the χ²test was used.</p> <p>Results</p> <p>12% (n = 370) of Finnish undergraduate students had used the web-based health advice service and were identified as 'users'. The proportion of male students reporting allergic rhinitis or conjunctivitis was greater among users than non-users (24%, n = 22 vs. 15%, n = 154, χ², P = .03). The proportion of female students reporting chronic mental health problems was greater among users than non-users (12%, n = 34 vs. 8%, n = 140, χ², P = .03). There was no statistical significance between the group differences of male or female users and non-users in self-reported health status (good or fairly good, average, rather poor or poor).</p> <p>Conclusion</p> <p>Among young, highly educated adults the use of a web-based health advice service is not associated with self-reported health status. However, a web-based health advice service could offer support for managing several specific chronic conditions. More research data is needed to evaluate the role of web-based health advice services that supplement traditional forms of health services.</p