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.

Strengthening the Detection of and Early Response to Public Health Emergencies: Lessons from the West African Ebola Epidemic

Abstract: BackgroundIn the year since the World Health Organization (WHO) was notified of an Ebola outbreak in West Africa, more than 24,000 cases have been reported and over 10,000 individuals have died. Moreover, countless non-Ebola deaths have occurred as a result of health system closings and an international aid effort in the $USD billions has been invested in control efforts. While the international response to the West African Ebola virus disease epidemic eventually exemplified the great potential of the global public health community, the protracted early response also revealed critical gaps, which likely resulted in exacerbation of the epidemic. It is incumbent on international health partners to learn from missteps that occurred in the early stages of the epidemic and strengthen our public health capacity to better respond to future public health emergencies.Findings and RecommendationsStrategies to consider to improve capacity to respond global health emergencies include: 1) development of a more precise system to risk stratify geographic settings susceptible to disease outbreaks, 2) reconsideration of the 2005 International Health Regulations Criteria to allow for earlier responses to localized epidemics before they reach epidemic proportions, 3) increasing the flexibility of the World Health Organization director general to characterize epidemics with more granularity, 4) development of guidelines for best practices to promote partnership with local stakeholders and identify locally acceptable response strategies, and, most importantly, 5) making good on international commitments to establish a fund for public health emergency preparedness and response.ConclusionsThe recent success of the global action to stem the Ebola virus disease epidemic is laudable but should not encourage complacency in our efforts to improve the global public health infrastructure. The current epidemic has revealed both the danger posed by disease outbreaks in states with weak health systems and their widespread impact in an increasingly globalized world. The power of global health law and global health institutions will remain seriously unrealized and deeply compromised if the Ebola epidemic does not spur fundamental reform.

Inequality and the Deficit

Abstract: The enormous increase in economic inequality in the United States should play a central role in public discourse about the federal deficit. This essay reviews statistical evidence of trends in the distribution of income and wealth in the United States. The evidence demonstrates a dramatic increase in economic inequality. The gap between the rich and poor, and between the rich and the middle class, is today wider than at any other time in the past four decades.

Wellness and Work: Mixed Messages in Residency Training.

Abstract: I commend Dr. Meeks and colleagues 1 for acknowledging the lack of evidence supporting the efficacy of individually based approaches to addressing resident wellness and wellbeing (e.g., mindfulness, resilience training). I also commend the authors for recognizing that current strategies for targeting the Bburnout epidemic^ in residency remain stubbornly focused on the individual to the exclusion of systematic factors. 2 However, I think Dr. Meeks and her colleagues are still too invested in individual, medical approaches to resident wellness and well-being that inadvertently stigmatize vulnerable groups. Dr. Meeks claims that Bhigh levels of burnout negatively impact individual residents and their patients by contributing to medical errors, lapses in professionalism, and poor patient satisfaction.^ The authors also appear to endorse the position of B[a]ccrediting agencies, physician and medical education associations [that] underscore the importance of well-being in the development of the competent, caring, and resilient physician.^ Yet current evidence does not support claims that trainees or physicians with burnout, poor well-being, poor health, or disabilities are dangerous or less competent than other clinicians; these comments, which regularly appear in the biomedical literature, stigmatize clinicians who are overweight, older, pregnant, or have health conditions or disabilities. Dr. Meeks also does not problematize the Accreditation Council for Graduate Medical Education’s (ACGME) new Common Program Requirements on resident well-being. These requirements, by stating that well-being is a component of resident competence (VI.C.) and identifying burnout, depression, and substance abuse as indicative of poor well-being ((VI.C.1.e) and VI.C.1.e). (1)), discriminate against residents with these conditions. Wellness and well-being initiatives may also provide cover for discrimination in indirect ways. Decisions to fire residents with mental disorders or disabilities, for example, may be justified on the basis of assumptions regarding burnout or poor well-being rather than disability. The decision to fire an overweight resident unwilling to participate in a wellness initiative may be framed as inability to Bidentify strengths, deficiencies, and limits in one’s knowledge and expertise^ about Bappropriate^ self-care. Dr. Meeks also continues to push for Btrack[ing] physician well-being^ and referring trainees Bexperiencing symptoms of poor mental health or acute crises to qualified individuals for assessment.^ Such activities may be legal if directed at medical students. But at the occupational level, resident referrals not adhering to the Americans with Disabilities Act’s rules on prohibited medical inquiries are illegal and discriminatory. Although I have raised these concerns with leaders and general counsel at professional medical organizations for years, the ACGME’s requirements have not changed, and these organizations have not been willing to educate members of the academic medical community about the appropriate legal rules that relate to these referrals.

Toward a Jurisprudence of the Civil Rights Acts

Abstract: What is the nature of the “rights,” jurisprudentially, that the 1964 Civil Rights Act legally prescribed? And, more generally, what is a “civil right”? Today, lawyers tend to think of civil rights and particularly those that originated in the 1964 Act, as antidiscrimination rights: our “civil rights,” on this understanding, are our rights not to be discriminated against, by employers, schools, landlords, property vendors, hoteliers, restaurant owners, and providers of public transportation, no less than by states and state actors, on the basis of race, gender, ethnicity, age, sexuality or disability. Contemporary civil rights scholarship overwhelmingly reflects the same conception: our civil rights are quasi-constitutional rights to be free of discrimination in the private as well as public world. But this conventional lawyerly understanding -– basically, that “civil rights” are “antidiscrimination rights” -– is clearly inadequate, certainly with respect to civil rights generally but also, and more tellingly, even with respect to the rights created and then protected by the ‘64 Act itself.First, on the general point: some of the “civil rights” sought or held across our history have not been antidiscrimination rights of any sort at all: labor rights, welfare rights, free speech rights, and the constitutional rights of criminal defendants have all, at various times, been championed as “civil rights,” and these rights are neither logically nor jurisprudentially tied to any conception of antidiscrimination. But furthermore, even the “civil rights” which are defined and then protected against discrimination by the 1964 Civil Rights Act, as well as by various Civil Rights Acts both before and subsequent to it, are not, in circular fashion, simply our rights not to be discriminated against on the basis of impermissible characteristics. Rather, the “civil rights” of which we cannot be discriminatorily deprived, whether originating in the ‘64 Act or elsewhere, are, after all, rights to something: a right to vote, or to physical security, or to enter contracts, or to own, buy or sell property, or to legal recourse in the aftermath of a wrong committed against us, or to write a will, or to be considered for or to hold down a job and to be paid fairly for our labor, or to the use of a restaurant or a hotel or a city bus, or to a public education, or to marry whom we love. And, these are just some of the public goods that have been recognized at various times as “civil rights,” of which we cannot be deprived by discriminatory action.Even if just that much is right, then the “civil right” protected by all of our Civil Rights Acts, including the ‘64 one, is considerably more complex, jurisprudentially, than the conventionally legalistic and formulaic equation of “civil rights” with “antidiscrimination rights” suggests. Minimally, the “civil right” recognized or protected by the various Civil Rights Acts is almost invariably a multilayered right, or a “right to a right”: it is a right to not be discriminatorily deprived of some underlying right. Only the first right in that phrase “a right to a right” is the antidiscrimination right. The second “right,” though, is the underlying civil right of which we cannot be discriminatorily deprived, and it is both itself complex, and highly variable: it might be a common law right, such as a right to enter contracts or sell property, or a statutory right, such as a right to vote, or simply a right to a social or public good, such as employment or educational opportunities, or the protection of a trustworthy police force against private violence. And, while we have generated a library of writing, and jurisprudence, and judicial opinions, on the nature of the first right in that phrase -– the right not to be deprived of various rights, on the basis of race, sex, and so forth -– we have devoted much less to the second: the nature of the underlying right of which we cannot be deprived. So, what is the jurisprudential nature of that right? What is a “civil right,” jurisprudentially, both with respect to the rights protected against discrimination by the Civil Rights Act of 1964, and more broadly? Again, and more generally, what is a “civil right”?

All Balls and No Strikes: The Roberts Court’s Anti-Worker Activism

Abstract: For decades, legislatures and courts have created and preserved rights and remedies for vulnerable groups—consumers, employees, victims of mass torts, investors, and the like. Both branches have extolled the virtues of these substantive rights and the private enforcement mechanisms required to effectuate them. However, despite statements like that of Justice Roberts and others that the judiciary is not a lawmaking body—indeed, that the judicial institution should take care to exercise restraint—the Roberts Court has engaged in sweeping reform that tends to extinguish these substantive rights. In 2012, I traced how the Roberts Court paid scant attention to the integral role private enforcement plays in various regulatory frameworks in which given substantive laws operate. By reducing or eliminating mechanisms of private enforcement, I argued, entire swaths of substantive law would go woefully under-enforced. Since that time, the Roberts Court’s civil justice and procedural jurisprudence—jurisprudence that has brought about systematic retrenchment of substantive rights—reveals that the Roberts Court is not so much inattentive to the exigencies of various regulatory frameworks. Instead, the Roberts Court jurisprudence tends to reveal an affirmative deregulatory aim. Far from merely calling balls and strikes, and in opinions involving questions as varied as ones about class-action rule interpretation, the permissibility of collective action waivers in arbitration agreements, the ability to opt out of collective bargaining dues on First Amendment grounds, standing, and others, the Roberts Court has achieved sweeping deregulation in the past decade. As has been traced in the literature, these deregulatory effects have been particularly pronounced in the area of consumer law. Moreover, the deregulatory effects for the underlying substantive regimes have often been achieved through somewhat indirect, procedural decision-making, but those effects have been almost as significant as if the Court had simply re-written the particular rights-bearing statutes. During October Term 2017, the Court moved beyond consumer law and ramped up its efforts to effectuate deregulation of employment law. Whatever protections workers have enjoyed throughout our nation’s history have been secured in large part through private enforcement. And to be sure, on their faces, critical workplace protection laws like Title VII and the Fair Labor Standards Act (“FLSA”)—both of which rely almost exclusively on private litigation for their effectuation—remain completely intact. However, in three critical (but less-blockbuster-than-Masterpiece Cakeshop) cases—Janus v. American Federation of State, County, and Municipal Employees, Epic Systems v. Lewis, and Encino Motorcars—the Court in back-to-back 5-4 rulings stripped workers of mechanisms to pursue their rights against employers who commit wrongs in the workplace. Both history and present experience teach us that the Court’s recent opinions will help eliminate the regulatory apparatus for workplace injury, and private employers will enjoy increased ability to essentially rewrite their obligations under substantive law through procedural vehicles. This essay proceeds as follows: Part A traces the Court’s employment law jurisprudence from October Term 2017. Part B discusses the regulatory consequences of these opinions and argues that the Court’s opinions this past term reflect political commitments that favor and disfavor certain types of claims and claimants.