Aerial lidar (light detection and ranging) has been hailed as a revolutionary technology in archaeological survey because it can map vast areas with high-precision and seemingly peer beneath forest cover. This excitement has led to a proliferation of lidar scans, including calls to map the entire land surface of earth. Highlighting how the growth of aerial lidar is tied to fast capitalism, this article seeks to temporarily pause the global rush for data collection/extraction by focusing on the ethical dilemmas of remotely scanning Indigenous homelands and heritage. Although lidar specialists must obtain federal permissions for their work, few engage with people directly in the path of their scans or descendant stakeholders. This oversight perpetuates colonial oppression by objectifying Indigenous descendants. To address Indigenous objectification, I argue that aerial lidar mapping should be preceded by a concerted, culturally sensitive effort to obtain informed consent from local and descendant groups. With the Mensabak Archaeological Project as a case study, I demonstrate how aerial lidar can become part of a collaborative, humanizing praxis.

Under the rule of law, everyone has a constitutional right to a remedy—that is, access to a court that decides a dispute over private rights and obligations according to the law of the land. Dispute resolution agreements are an instance of reflexive contracting, in other words, agreements on which substantive and procedural rules shall govern a contractual relationship. Where the choice for one or both parties is for a law or forum other than that applicable by default, dispute resolution agreements contain a waiver of the constitutional right to a remedy according to the law of the land. Party autonomy—that is, the freedom to contract on the rights and remedies applicable to the main contract—is conferred by reflexive contract law, that is, the law applicable to dispute resolution agreements. In this article I argue that reflexive contract law, in specifying the conditions under which reflexive contracts are enforced by the state, shall reflect the extent to which agreements to arbitrate, on forum selection, or on choice of law interfere with the constitutional right to a remedy. Coherent requirements as to the form and validity of consent, ex-ante information, or ex-post judicial control shall be proportional to the entailed dangers and the proficiency of the involved parties. However, as dispute resolution agreements are regulated by diverse instruments on the national, supranational, and international levels, consistency is very difficult to achieve. Moreover, the US and EU regulatory approaches regarding the protection of consumers and employees seem to be incommensurable.

You can sell your soul to the devil, but it would be especially devilish if the sale were hidden on page twenty-nine of the terms of service of a ride sharing app. Our world is full of contract text for which there are no readers, allowing term setters the unilateral power to make law. There are two ways to approach this problem: providing more information, better information or more salient information on contract terms—information model—or controlling the content of the terms of form contracts—control model. This Article explores the interplay between the information model and the control model for protection of recipients of standard form contracts. It argues that the control model and the information model are mutually exclusive from a conceptual point of view. Therefore, using information to protect consumers should be eschewed in favor of term control – we should say farewell to the information model. This would mean that, given strong court control, contract terms could be set without notice, possibility to review or assent to them. Where court control is weak it should be strengthened. This Article develops these arguments with a view to the European and U.S. discourse on standard form contracts.

Anosognosia, commonly understood as a lack of insight, renders individuals with schizophrenia and schizoaffective disorder unable to understand that they are living with a disease, often resulting in a refusal to accept treatment. Typically, to impose involuntary commitment in an effort to obtain treatment, an individual must be a danger to others or themselves. Even if involuntary commitment is imposed, however, an individual may remain competent to refuse medication—despite symptoms of anosognosia and an inability to understand that they are ill. This article examines the existing legal theories of competency and informed consent and proposes a statutory definition of competency that encompasses the specific needs of people with anosognosia, while considering the significant interests at stake when taking away an individual’s right to choose or refuse treatment.

The celebration of the anniversary of the Center for Health Law, Ethics & Human Rights (the “Center”) provides an opportunity to reflect on what defines the field of health law, as well as its conjoined twins of bioethics and human rights. The related fields are vast, and the subjects they encompass are ever-expanding. It is probably impossible to lay out a summary that does justice to their expansive, interdisciplinary scope. Instead, my discussion of the Center examines a subject that barely existed when the Center was formed in 19581 and that continues to make headlines more than sixty–six years later — organ transplantation. Transplantation is useful as an illustration of the joint fields of health law, bioethics, and human rights. It is a field that grew with us from infancy to maturity during the time of the Center’s growth and that illustrates how several related disciplines — most notably law and medical sciences — are essential to the development of organ transplantation. Additionally, organ transplantation and experiments involving organ transplantation have produced some of the most spectacular cases of human experimentation. Because of both the novelty and human drama these experiments involve, I will use some of them as examples of the pivotal health law and bioethics work the Center engages in. These examples, and others that will be touched on, lead me to conclude that there is no field that matches the life and death drama of health law, especially in the human organ transplantation field. This selective history of health law at the Center, including the definition of death and the limits of surrogate consent, suggest that the legal and bioethical issues brought to us by innovative organ transplantation surgery are unlikely to be exhausted any time soon.

Fifty years ago, George J. Annas and Joseph Healey introduced the concept of a “patient rights advocate” in their seminal 1974 article published in the Vanderbilt Law Review. Annas expanded this vision in the ACLU Handbook, The Rights of Hospitalized Patients, later broadening its scope to all medical settings. This essay traces the evolution of patient advocacy, highlighting pivotal milestones: the advent of cancer navigators, the rise of the patient safety movement, the establishment of patient advocacy organizations, the development of Patient Advocate Offices in hospitals, and the emergence of independent advocates with board certification. It also examines the impact of advocacy on healthcare outcomes, costs, and patient-provider satisfaction, and explores future directions for this vital and growing profession.

There is a growing movement within contemporary medical ethics to blur the boundaries between clinical medicine and clinical research. Some writers now argue that the research-practice distinction is outdated and the importance of distinguishing between research and medicine is no longer as pressing as it once was or seemed to be. Instead, we are now urged to view the health-care system as a dynamic “learning health-care system” in which research components are embedded within standard clinical care. This essay defends the ethical significance of the research-practice distinction while acknowledging the reality and usefulness of integrated health care. A key claim that this essay advances is that the principle of clinical equipoise, which has largely been rejected by research ethicists, can be reinterpreted and repurposed to help distinguish medical practices that call for more demanding forms of informed consent from those that do not.

In 1974, the Center for Law and Health Sciences at the Boston University School of Law provided legal background papers on informed consent to research to the newly created National Commission for the Protection of Human Subjects of Biomedical and Behavioral Sciences. These papers were written by George J. Annas, the Center’s Director, as well as Barbara F. Katz and I, who were staff attorneys at the time. These papers can be found in the appendices to the Commission reports1 and in our book Informed Consent to Human Experimentation: The Subject’s Dilemma,2 in which we present a refined version of those papers. This project introduced me to the world of human research ethics and the complexities of protecting the rights and welfare of research subjects.3 Over the past fifty years, I have sat on Institutional Review Boards (IRBs), been a member of the FDA’s Pediatric Research Advisory Board, and engaged in varying activities related to human subject protection. During this time, I took for granted that consent forms were the best method for ensuring that subjects were thoroughly informed about all aspects of the proposed research. Like many IRB members, I spent considerable time reviewing, editing, and debating with other IRB members about the precise wording of these forms.

In 2023, Henrietta Lacks’ family won a settlement from Thermo Fisher Scientific on the grounds that the company had been “unjustly enriched” by the sale of products developed with Henrietta’s cells. Given that hundreds of thousands of people have tissue stored in the United States, this article explores how today’s patients might fare if they similarly sued professionals and companies that undertake unauthorized research on or commercialization of their tissue on the grounds of conversion, unjust enrichment, lack of informed consent, breach of fiduciary duty and, where government entities are involved, Fourteenth Amendment claims. The article notes that the practices that were subsequently seen as unethical in Henrietta Lacks’ care continue in some health care institutions today. It also analyzes how research and commercialization without consent can lead to a lack of trust in the research enterprise and the unwillingness of people to participate in research.