September 28, 2012

The Supreme Court has spoken. In its June 28, 2012 decision, the Court permitted the largest expansion of health insurance in recent history by upholding the constitutionality of the Patient Protection and Affordable Care Act (ACA). It carved out one important exception: Congress may not withdraw existing Medicaid funds from states that elect not to participate in Medicaid expansion. Yet the Court’s decision has done little to bridge the sharp ideological divide regarding U.S. health policy.

This symposium brought together a distinguished group of legal, medical, political science, economic, and public health experts to chart the steps that policymakers need to undertake to achieve a workable program of reform.

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April 13, 2012

In recent years, child maltreatment has been strongly linked to identifiable risk factors, such as poverty and stress. The U.S. Centers for Disease Control has defined child maltreatment as an important public health problem and has an ongoing program of epidemiological research underway. Thus far, the child protection system has failed to respond to this new, epidemiological understanding of maltreatment. It has not developed evidence-based treatments or standardized diagnostic procedures, and it has woefully neglected prevention, the key to most successful public health campaigns. This symposium brought together a distinguished interdisciplinary group of legal, medical, and social science experts on child protection to chart the steps that policy makers need to undertake.

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March 18, 2011

At an interdisciplinary symposium held on March 18, entitled “Adolescents in Society: Their Evolving Legal Status,” panelists addressed the many complex issues that lie ahead for lawyers, educators, and others working with adolescents in the field. At the heart of the discussions was the transformation of the rights and protections accorded adolescents over the past decade, whether through court decisions, legislation, or social change. Although modern teens have more freedom to make their own decisions, data shows their decision-making skills have not yet fully formed, nor are they as neurologically and socially developed as adults. This new evidence has led to debates about teens in the juvenile justice system, in the health care system, and as users of the Internet, cellphones, and other technologies. Are they to be considered and treated as children or as adults?

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October 15, 2010

More than two decades of research shows that poor and vulnerable children in America, including children in foster care, receive more psychotropic medications than other children their age. These medications may include complex drug combinations that are prescribed off-label and without adequate evidence of favorable benefit-risk rations. The purpose of this roundtable is to better understand the significance of these patterns and disparities in the use of psychotropic medications, particularly antipsychotic drugs, among American children. Ultimately, the goal of this program is to identify changes in policy and practice that are likely to improve psychopharmacologic prescription practices among poor and vulnerable youth. View video of the event.

Over 300,000 immigrants a year are detained by United States Immigration and Customs Enforcement (USICE), a branch of the Department of Homeland Security. These immigrants are held at facilities both run by, or under contract with, USICE and are wholly dependent on the facilities for the provision of healthcare. In recent years, studies by community-based organizations, the government, and media have uncovered systemic deficiencies in healthcare that have led to suffering and even death for persons held in immigration detention.

The Sparer Public Interest Law Forum, "Finding a Cure: Providing Adequate Health Care to Immigrants in Detention," was held at the Law School on March, 5, 2010. Experts from the government, medical doctors, and community-based immigrant advocacy organizations discussed the complex nature of the problem of providing healthcare to such a transient population including language barriers, costs, and government and institutional perceptions of the level of care appropriate for this population of detainees. View video of the event.

January 20, 2010

On January 20, 2010, the Center and SUNY Downstate Medical Center sponsored a roundtable discussion at the Law School on Medical Orders for Life Sustaining Treatment (MOLST). The primary purpose of the meeting was to gather information about this legal document on clinical care and its impact on public understanding of others, such as the healthcare proxy. Participants included an interdisciplinary mix of health lawyers, physicians, policy analysts, palliative care professionals, students, and academics. 

MOLST is a form that represents the legal equivalent of an inpatient do not resuscitate (DNR) form. The form is used to communicate physician orders regarding cardiopulmonary resuscitation and life-sustaining treatment at the end of life. Dr. Patricia A. Bomba, Vice President and Medical Director of Geriatrics at Excellus Blue Cross Blue Shield, gave a presentation that described the launch of the MOLST initiative, emphasizing the value of this legal document to patients and families that face difficult decisions at the end of life. Useful information was gathered about perceptions of the value of the form and geographic differences in its acceptance and usage. 

Not long after this meeting, Governor Paterson signed the Family Healthcare Decisions Act (FHCDA) into law. The law creates a legal mechanism for the appointment of a healthcare surrogate to make healthcare decisions for individuals who become incapacitated and have not prepared advance directives regarding their wishes. It empowers family members and others close to patients to make medical decisions for them in the event that they cannot do so themselves. In light of the new law, a follow-up meeting was held in early May to discuss proposed changes to the MOLST form and questions raised by the FHCDA.

October 8, 2009

The economic stimulus package, signed into law last February, will pour an unprecedented $19 billion into health information technology. Many policymakers believe that broad use of this technology has the potential to improve health care quality, reduce costs, increase patient participation in decision-making, and prevent medical errors. However, it raises many concerns about the security and privacy of medical records.

On October 8, 2009, Brooklyn Law School's Center for Health, Science and Public Policy sponsored a theory-practice seminar, “eHealth? New Challenges for Information Privacy and Security.” Professors Karen Porter and Derek Bambauer introduced a panel of experts to discuss a range of policy changes that could enhance privacy protections.

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April 7, 2009 

Jennifer L. Mnookin, Vice Dean for Faculty and Research and Professor of Law at the UCLA School of Law, delivered the Ira M. Belfer Lecture on April 7, 2009. Her talk, “The Future of Forensic Science,” discussed the systemic shortcomings of forensic evidence and the steps the legal and scientific communities must take to justify its admission in the courtroom. Traditional forensic science techniques – such as latent fingerprint evidence, handwriting identification evidence, and ballistics evidence – have increasingly been challenged as lacking a rigorous empirical foundation or an adequate scientific basis. Another concern is that expert testimony with respect to such evidence can be frequently both overstated and unproven. Courts have often resorted to dramatic doctrinal legerdemain in their rejection of these challenges, and academics and institutions such as the National Academy of Sciences have joined the debate. Recent scandals involving fingerprints, such as the FBI’s incorrect identification of a man wrongly linked to a train bombing in Madrid and the LAPD’s erroneous identification of suspects, show that these concerns are not merely theoretical or academic. 

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October 2, 2008

The Center for Health, Science and Public Policy sponsored a theory-practice seminar, “Preventing a Disaster: Guidelines for Dealing with Epidemics,” on October 2, 2008 to address the legal and policy issues that are likely to arise in an influenza pandemic — an issue that gained importance in the spring of 2009 with the emergence of the H1N1 influenza virus.

The purpose of the program, said Professor Karen Porter, was to “provide a forum that covers an issue of significant importance to the public, where there hasn’t been enough public discourse.” Recent outbreaks of avian influenza have generated concern about, and prompted health officials to plan for, the possibility of a pandemic that could overwhelm the health care system and its resources. Professor Porter organized the event and moderated the program, while Professor Marsha Garrison, a bioethics expert at Brooklyn Law School, introduced the panel participants.

In 2006, the New York State Department of Health released its draft preparedness plan for a possible influenza pandemic. Shortly thereafter, the New York State Task Force on Life and the Law, at the request of the Department of Health, convened a workgroup to consider the clinical and ethical issues involved in the allocation of mechanical ventilators in the event of such a pandemic. The group brought together distinguished experts in the fields of bioethics, law, medicine, and policy, with representatives from medical facilities and government agencies to address necessary alterations in the standard of care in an emergency.

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