Georgetown University Law Center

About: Georgetown University Law Center is a based out in . It is known for research contribution in the topics: Supreme court & Global health. The organization has 585 authors who have published 2488 publications receiving 36650 citations. The organization is also known as: Georgetown Law & GULC.

Individual Preferences in Policy Analysis: A Normative Framework

Abstract: Measures of individual preferences are a key input in cost-benefit analysis. However, behavioral science has raised questions about the rationality of these preferences. The Nudge thesis relies on that scientific research to prescribe interventions to influence individual choices. However, the more modest step of limiting reliance on these preferences in evaluating non-paternalistic government policies has not been taken up. We lack a consistent theory of when public policy should defer to these preferences, with legal and policy advocates adopting ad hoc result-oriented approaches. I argue that policymakers should be prepared to override individual preferences in cases where their only plausible rational justification(s) sever their connection to social welfare, undermining their normative motivation. For time discounting, this means eliminating the pure time preference component of the discount rate for most purposes. For valuing mortality risks, it implies shifting from the value of a statistical life method to a modified value of a statistical life-year method.

Suicide Screening and Surveillance of Students, Discrimination, and Privacy: The Garrett Lee Smith Memorial Act

Abstract: The Garrett Lee Smith Memorial Act (GLS) was first enacted in 2004 for the purposes of early screening, intervention, and prevention of suicide in students 10 to 24 years of age, and to hire more college counselors. More than 16 years later, GLS suicide prevention programs have not been found to be effective in reducing suicide rates, while their harms have not been considered. This Article reviews the state of the evidence on school suicide prevention and explores the suicide surveillance of the GLS, its systems of peer-to-peer monitoring and reporting of marginalized students “at risk”—students with disabilities, racial/ethnic, sexual, and religious minorities, victims of bullying, students with homelessness or foster care records, and other suicide risk factors. It explores the GLS public health approach to address the burdens of suicidal students, isolate suicide risks, and avoid suicide contagion. It also describes possible harms of the GLS suicide surveillance approach: stigmatization; violated privacy; estrangement from peers, parents, therapists and other social supports; police involvement and warrantless searches; potential exacerbation of suicidality; and restricted civil rights in non-school settings such as employment and involuntary commitment proceedings. It then compares the threats imposed by school surveillance for violence and suicide and suggests that paternalistic justifications might account for the relative lack of concerns raised so far regarding the latter. The Article then briefly considers the functions of participating in suicide surveillance for teachers and staff, and concludes with recommendations to repeal the GLS.

The Right to Health as the Unheralded Narrative of Health Care Reform

Abstract: IN PASSING THE AFFORDABLE CARE ACT, THE UNITED States took a giant, if partial, step toward joining other nations wherein the right to health constitutes an inalienable moral and legal right. Although not widely appreciated, the right of every person to enjoy the highest attainable standard of physical and mental health (the right to health for short) is not merely an abstract moral imperative. Rather, it is an established international legal precept still to be fully embraced in the United States. Even though the right to health was overshadowed during the health care debate by other narratives, such as insurance reform, cost control, and care delivery, this right remains a central if unheralded narrative of the Affordable Care Act and its legacy. What is this right that engenders these bold claims? It is an assertion of the responsibility of governments to strive for “the highest attainable standard of physical and mental health.” It is an asseveration that governments will respect, protect, and fulfill the right to health by ensuring the availability, accessibility, acceptability, and quality of the care required. It is an averment that governments will honor the tenets of accurate information, nondiscrimination and equality, and participation. It is an avouchment that governments will address the “underlying determinants of health” such as sound housing, clean water, and adequate nutrition, especially as these determinants apply to the needs of poor and other marginalized populations. As such, the right to health constitutes a concept broader than that represented by the right to health care, covering elements that the Affordable Care Act, with its focus on health care, addresses only in limited, although important, ways. The right to health—or more precisely, to health care—as a moral dictum is associated with Senator Edward Kennedy’s impassioned expression of hope “that every American— north, south, east, west, young, old—will have decent, quality health care as a fundamental right and not a privilege.” Others have echoed these sentiments, not least President Obama who framed last year’s health care debate as a core ethical and moral obligation. Americans appear to agree, evidenced by the very existence of and broad support for the Medicare, Medicaid, and CHIP public safety net programs. Moreover, 72% of Americans strongly believe that health care should be considered a human right. The right to health is also a matter of international law, one drawing on the collective force of national constitutions, international and regional treaties, and other instruments. As such, the right to health is as established as the more familiar rights to freedom of expression and religion. Leading the way were British laws as early as 1802 triggered by the health threats of the Industrial Revolution, and the Mexican Constitution of 1843, which recognized the state’s role in public health. In 1925, Chile became the first nation to incorporate the right to health into its constitution. Now more than 100 countries boast a commitment to the right to health or health care in their constitutions. Beyond these national efforts, several critical global pacts incorporate the right to health. First among them was the constitution of the World Health Organization (WHO), which in 1946 identified the “enjoyment of the highest attainable standard of health” as “one of the fundamental rights of every human being.” Two years later, the United Nation (UN) General Assembly adopted the Universal Declaration of Human Rights (UDHR), article 25 of which guarantees the right to “a standard of living adequate for the health and well-being . . . including food, clothing, housing and medical care.” Many international lawyers view the UDHR as creating a binding customary international law, including as an interpretation of the human rights commitments in the UN Charter, under which states have committed to the “universal observance of, and respect for, human rights.” In 1966, the UDHR was expanded upon by the International Covenant on Economic, Social, and Cultural Rights (ICESCR), which asserts that signatory states recognize “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.” It was against this backdrop that the UN Commission for Human Rights created the mandate for a Special Rapporteur on the right of every person to enjoy the highest attainable standard of physical and mental health. The combined force of the

COVID-19 and the Loneliness Pandemic: Implications for Intimate Partner Violence Survivors

Abstract: The COVID-19 pandemic has dramatically highlighted domestic violence survivors’ isolation, and has triggered innovative efforts to reach out to people who are trapped in their homes, more endangered by a partner than by the virus. But a related – and extremely damaging - consequence of this challenging time has received far less attention: survivors’ intensified experience with loneliness. Although loneliness can be catalyzed by isolation, it is a distinct psychological phenomenon that is interior and subjective in nature. Loneliness is not only acutely painful in its own right, but it also inflicts a range of long-lasting health-related harms, and heightens survivors’ vulnerability to IPV, creating a vicious cycle that may continue long after strict stay-at-home policies end. This may be particularly true for marginalized survivors, for whom larger structural inequalities and institutional failures heighten and compound the negative impact of loneliness. This brief report describes what we know about the nature and costs of survivor loneliness; and argues that that the COVID-19 pandemic provides a useful impetus to both review the ways in which current DV interventions may help alleviate loneliness (as distinct from isolation), and how we might intentionally adopt deeper and more expansive measures, now and particularly after a return to “normal.”