Public health law has focused primarily on combatting stigma through laws targeting discrimination based on attributes (de jure), when the reach of stigma extends far beyond mere appearances. By exploring the lived experience of stigmatized individuals, policy makers might more deeply understand public health problems, more appropriately create health policies, and more effectively promote positive health behaviors. Efforts to address stigma must focus on all aspects of stigma to be effective.

In West Virginia, healthy smokers can now sue tobacco companies to require them to fund medical monitoring for health risks associated with smoking. In Blankenship, formally known as In re Tobacco Litigation (Medical Monitoring Case), the Circuit Court for Ohio County permitted a jury to decide the medical monitoring claim, despite the clam’s novelty and controversy. The unanimous jury refused to enforce the plaintiffs’ demands, and the court denied a motion for retrial. This trial was the second attempt of the class action lawsuit; the court had previously declared a mistrial when an attorney used the word “addiction” in front of the jury.

The court certified a class of residents of the state of West Virginia with more than a five “pack-year history” (at least one pack per day for five years) of smoking the defendant tobacco companies’ cigarettes, who did not have any of a list of named smoking-related illnesses, including various cancers and coronary heart disease, and who did not receive health care paid for – or reimbursed by – the state of West Virginia.

This article examines the unique disadvantages experienced by Black people and other people of color with substance use disorder in health care, and argues that an intersectional approach to enforcing disability rights laws offer an opportunity to ameliorate some of the harms of oppression to this population.

This article discusses an interdisciplinary and community-engaged public health law course that was developed as part of The Future of Public Health Law Education faculty fellowship program. Law and public health students worked collaboratively to assist a local health department in preparing for the law-related aspects of Public Health Accreditation Board review.

Traditionally the great majority of health care related malpractice suits have involved physicians and hospitals. Increasingly, however, greater attention is being given to nurses as potential defendants and thus as sources for recovery in malpractice suits. As a result, more recognition is emerging for nursing as a profession accountable for its practice. This article will examine the concept of accountability by:

1. 1. reviewing selected legal principles of malpractice;

2. 2. discussing the trend toward increased inclusion of nurses in malpractice actions and the implications of this trend; and

3. 3. describing an Expert Nurse Witness and Consultation Service which was developed to provide nursing opinion on the professionally accepted standard of nursing practice.

In the lead article Cynthia Northrop and Ann Mech discuss the growing role of nurses as expert witnesses in malpractice litigation. As they note, the increasing professionalization of nursing has led to more and more courts accepting the testimony of nurses as authoritative on the question of proper nursing practice. As a supplement to that article it is worth noting that nurses are also being called upon more frequently to testify on a wide variety of health care issues, and accordingly it is important for all nurses to have some familiarity with what goes on in a courtroom so that their testimony will be effective and useful to the judge and jury.

For example, I recently had occasion to sit in on the first day of trial of a case in Minneapolis involving the question of the appropriateness and lawfulness of an order not to resuscitate. During that day testimony was heard from four nurses, two laypersons, and one physician. Of these witnesses, only the physician seemed at home in the courtroom.

On March 31,1981, the New York Gurt of Appeals handed down its decision in the consolidated cases of Brother Joseph Fox and John Storar. The Eichner case was generally well known, having excited considerable national publicity both before and after the Appellate Division of the Supreme Court of New York handed down its opinion on March 17,1980. The Storar case,) conversely, was not as well known and was consolidated with the Eichner case, in the words of the Court of Appeals, because future similar cases would arise. As will be discussed more fully in this article, the consolidation of these two markedly dissimilar cases not only has created confusion, but also has served to obscure the position taken by the court of Appeals relative to other similar cases both in New York and other jurisdictions.

Brother Joseph Fox was an 83 year old member of a Catholic religious order who enjoyed good health until he suffered cardiac arrest during the performance of a hernia operation. As a result of the cardiac arrest, he became anoxic, suffered permanent brain damage, and became respirator-dependent.

George Annas’ review finds most of what is in the Hastings Center’s Guidelines on the Termination of Life-Sustaining Treatment and the Care of the Dying “solid.” He takes no issue with the major substantive points. The fundamental premise of the book—that patients’ interests must be protected and their decision-making authority defended—is a view Professor Annas has long championed as well.

Despite this basic agreement, Annas’ criticisms would be significant ones if the Guidelines were what he presents them to be. But they clearly are not. As the Guidelines themselves state: These are ethics guidelines; they are not legal guidelines. They are an attempt to offer practical and reasonably concise suggestions for how to make decisions; they are no substitute for the literature on the pros and cons of different approaches to the termination of treatment. They are meant to provoke a necessary process of debate within a health care institution; they are not the final moral truth.

This paper discusses the obligation of acute care hospitals and emergency services to treat patients. Since care rendered in these settings is, of necessity, provided by health care professionals, not buildings or programs, the obligation may be twofold. First, are there obligations for hospitals and emergency services to offer treatment? Second, do health care professionals practicing in these settings have an independent obligation to treat? How has the Supreme Court decision in Cruzan affected these obligations?

The tradition in this country has been that private hospitals had no obligation to treat patients, as opposed to public hospitals which were frequently set up for the very purpose of treating patients who had no other access to care. Over the years, statutes and case law have limited the rights of private hospitals and physicians to refuse to treat patients.

Pain can be a body-wrenching curse. Yet it is often a life-defining and supporting blessing!

Pain is a distinct physiological event, yet it is also an emotional, social, spiritual, and economic force. Pain in its more destructive form alters lives, changes relationships, and disrupts families.

Quality pain management should not be just a pharmacological response to a medical situation; it must also be a theological, ethical, and societal response to human need. Appropriate pain management is a gift to both the receiver and the provider. As a parish priest, a supervisor of pastoral services, and an ethics resource specialist, I have seen many pain-filled situations that have involved multiples of these dimensions.

Born in 1969, Casey died in 1995, just a few months after his twenty-sixth birthday. Casey was an intelligent, charismatic college student, strong in religious faith, who had few problems … at least until one day in the summer of 1994. That day he began to suffer extreme pain in his lower stomach and bowels.