1.. HARD CASES 5. Legal Rights A. Legislation . . . We might therefore do well to consider how a philosophical judge might develop, in appropriate cases, theories of what legislative purpose and legal principles require. We shall find that he would construct these theories in the same manner as a philosophical referee would construct the character of a game. I have invented, for this purpose, a lawyer of superhuman skill, learning, patience and acumen, whom I shall call Hercules. I suppose that Hercules is a judge in some representative American jurisdiction. I assume that he accepts the main uncontroversial constitutive and regulative rules of the law in his jurisdiction. He accepts, that is, that statutes have the general power to create and extinguish legal rights, and that judges have the general duty to follow earlier decisions of their court or higher courts whose rationale, as l

Taking Rights Seriously

This report updates the 2009 recommendations by CDC's Advisory Committee on Immunization Practices (ACIP) regarding the use of influenza vaccine for the prevention and control of influenza (CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2009;58[No. RR-8] and CDC. Use of influenza A (H1N1) 2009 monovalent vaccine---recommendations of the Advisory Committee on Immunization Practices [ACIP], 2009. MMWR 2009;58:[No. RR-10]). The 2010 influenza recommendations include new and updated information. Highlights of the 2010 recommendations include 1) a recommendation that annual vaccination be administered to all persons aged >or=6 months for the 2010-11 influenza season; 2) a recommendation that children aged 6 months--8 years whose vaccination status is unknown or who have never received seasonal influenza vaccine before (or who received seasonal vaccine for the first time in 2009-10 but received only 1 dose in their first year of vaccination) as well as children who did not receive at least 1 dose of an influenza A (H1N1) 2009 monovalent vaccine regardless of previous influenza vaccine history should receive 2 doses of a 2010-11 seasonal influenza vaccine (minimum interval: 4 weeks) during the 2010--11 season; 3) a recommendation that vaccines containing the 2010-11 trivalent vaccine virus strains A/California/7/2009 (H1N1)-like (the same strain as was used for 2009 H1N1 monovalent vaccines), A/Perth/16/2009 (H3N2)-like, and B/Brisbane/60/2008-like antigens be used; 4) information about Fluzone High-Dose, a newly approved vaccine for persons aged >or=65 years; and 5) information about other standard-dose newly approved influenza vaccines and previously approved vaccines with expanded age indications. Vaccination efforts should begin as soon as the 2010-11 seasonal influenza vaccine is available and continue through the influenza season. These recommendations also include a summary of safety data for U.S.-licensed influenza vaccines. These recommendations and other information are available at CDC's influenza website (http://www.cdc.gov/flu); any updates or supplements that might be required during the 2010-11 influenza season also will be available at this website. Recommendations for influenza diagnosis and antiviral use will be published before the start of the 2010-11 influenza season. Vaccination and health-care providers should be alert to announcements of recommendation updates and should check the CDC influenza website periodically for additional information.

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Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009.

4. UNHCR notes with concern that although the country acceded to the 1951 Convention and the 1967 Protocol in 1999, incorporation of the 1951 Convention obligations into national legislation and normative acts has been slow and to date Kazakhstan has failed to comply with its obligation to give full effect to the Covenant in the domestic legal order, inter alia providing for effective judicial and other remedies for violations of these rights

United Nations High Commission for Refugees

Michel Foucault takes the reader on a serendipitous journey in tracing the history of madness from the 16th to the 18th centuries. Utilizing original documents, the author recreates the mood, the place, and the proper perspective in the history of madness. Madness or folly is viewed as part of the human condition and to be examined and illuminated through one of its many facets. At the end of the Middle Ages madness was seen either as a tragic or comic phenomenon. The Renaissance, with Erasmus' Praise of Folly , demonstrated how imagination and its derivatives were to thinkers of that day. The French Revolution introduced the so-called medical approach. Madness is a ubiquitous phenomenon that has common roots not only in medicine but in poetry and tragedy. Shakespeare brilliantly describes psychological phenomena with even greater clarity than Tuke or Wills. The author weaves a fascinating history showing the changing pattern of

Madness and Civilization: A History of Insanity in the Age of Reason.

Objectives To update a 2004 systematic review of health care service use and health outcomes related to differences in health literacy level and interventions designed to improve these outcomes for individuals with low health literacy. Disparities in health outcomes and effectiveness of interventions among different sociodemographic groups were also examined. Data sources We searched MEDLINE®, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, PsychINFO, and the Educational Resources Information Center. For health literacy, we searched using a variety of terms, limited to English and studies published from 2003 to May 25, 2010. For numeracy, we searched from 1966 to May 25, 2010. Review methods We used standard Evidence-based Practice Center methods of dual review of abstracts, full-text articles, abstractions, quality ratings, and strength of evidence grading. We resolved disagreements by consensus. We evaluated whether newer literature was available for answering key questions, so we broadened our definition of health literacy to include numeracy and oral (spoken) health literacy. We excluded intervention studies that did not measure health literacy directly and updated our approach to evaluate individual study risk of bias and to grade strength of evidence. Results We included good- and fair-quality studies: 81 studies addressing health outcomes (reported in 95 articles including 86 measuring health literacy and 16 measuring numeracy, of which 7 measure both) and 42 studies (reported in 45 articles) addressing interventions. Differences in health literacy level were consistently associated with increased hospitalizations, greater emergency care use, lower use of mammography, lower receipt of influenza vaccine, poorer ability to demonstrate taking medications appropriately, poorer ability to interpret labels and health messages, and, among seniors, poorer overall health status and higher mortality. Health literacy level potentially mediates disparities between blacks and whites. The strength of evidence of numeracy studies was insufficient to low, limiting conclusions about the influence of numeracy on health care service use or health outcomes. Two studies suggested numeracy may mediate the effect of disparities on health outcomes. We found no evidence concerning oral health literacy and outcomes. Among intervention studies (27 randomized controlled trials [RCTs], 2 cluster RCTs, and 13 quasi-experimental designs), the strength of evidence for specific design features was low or insufficient. However, several specific features seemed to improve comprehension in one or a few studies. The strength of evidence was moderate for the effect of mixed interventions on health care service use; the effect of intensive self-management inventions on behavior; and the effect of disease-management interventions on disease prevalence/severity. The effects of other mixed interventions on other health outcomes, including knowledge, self-efficacy, adherence, and quality of life, and costs were mixed; thus, the strength of evidence was insufficient. Conclusions The field of health literacy has advanced since the 2004 report. Future research priorities include justifying appropriate cutoffs for health literacy levels prior to conducting studies; developing tools that measure additional related skills, particularly oral (spoken) health literacy; and examining mediators and moderators of the effect of health literacy. Priorities in advancing the design features of interventions include testing novel approaches to increase motivation, techniques for delivering information orally or numerically, "work around" interventions such as patient advocates; determining the effective components of already-tested interventions; determining the cost-effectiveness of programs; and determining the effect of policy and practice interventions.

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Health literacy interventions and outcomes: an updated systematic review.

Covid-19 — The Law and Limits of Quarantine Community transmission of the new coronavirus is occurring in several parts of the United States, and travel bans and mandatory quarantines alone cannot ...

https://www.nejm.org/doi/pdf/10.1056/NEJMp2004211

Covid-19 - The Law and Limits of Quarantine.

A new California law ending religious and philosophical exemptions to vaccination requirements faces both legal and enforcement challenges. But other states will be watching closely to see whether it results in fewer vaccine-preventable illnesses.

Shifting Vaccination Politics — The End of Personal-Belief Exemptions in California

In March, Governor Deval Patrick declared the Massachusetts opioid-addiction epidemic a public health emergency, a move that allows governors and health officials to take extraordinary legal action. This unusual invocation of emergency powers raises important questions.

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What is a public health "emergency"?

MORE THAN 100 YEARS AGO, INEFFECTIVE AND OFten dangerous medicines were widely sold. Then, in 1906, the US Congress enacted the Pure Food and Drug Act, prohibiting the sale of misbranded, mislabeled, or adulterated foods and drugs in interstate commerce. Over the next 60 years, Congress tightened drug industry regulation, requiring manufacturers to demonstrate to the Food and Drug Administration (FDA) that their products are both safe and effective. In recent years, the FDA drug approval process has been heavily criticized. An Institute of Medicine report cites safety problems with approved drugs, such as rofecoxib, as evidence that FDA regulation has become too lax. By contrast, libertarians and some patients’ rights groups have castigated the FDA for blocking access to new and, they claim, potentially lifesaving drugs. In May 2006, the battle took a new turn when a 3-judge panel on the US Court of Appeals for the District of Columbia decided in Abigail Alliance for Better Access to Developmental Drugs v Von Eschenbach (panel opinion) that terminally ill patients have a constitutional right to purchase unapproved drugs that have successfully completed phase 1 testing. Recognizing the serious ramifications at stake, the FDA requested a rehearing before the full DC Circuit Court of Appeals. Recently, the court granted the FDA’s petition to rehear the case and vacated the panel opinion. If the full court approves the panel’s decision, the case may reshape the regulation and sale of pharmaceuticals and, perhaps, encourage increased use of unregulated drugs. Such a ruling would open the door to “the romance of the latest new untested treatment,” threatening the ability of the FDA to protect public health.

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=jama&articleId=204964&pdfFileName=jco60045_205_208.pdf

A New Era of Unapproved Drugs The Case of Abigail Alliance v Von Eschenbach

On February 20, 1905, the U.S. Supreme Court upheld the right of the city of Cambridge to mandate vaccination against smallpox. Wendy Parmet, Dr. Richard Goodman, and Amy Farber assert that today, as physicians, policymakers, and public health officials contemplate the use of law to protect the public from emerging and reemerging infectious diseases, it is instructive to revisit Jacobson v. Massachusetts.

Wendy E. Parmet

Papers

Covid-19 - The Law and Limits of Quarantine.

Shifting Vaccination Politics — The End of Personal-Belief Exemptions in California

What is a public health "emergency"?

A New Era of Unapproved Drugs The Case of Abigail Alliance v Von Eschenbach

Individual Rights versus the Public's Health — 100 Years after Jacobson v. Massachusetts