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Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics

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https://www.readbyqxmd.com/read/30147007/fentanyl-a-whole-new-world
#1
Rachel L Rothberg, Kate Stith
This article seeks to document the latest danger in the opioid crisis: fentanyl and related synthetic opioids. Fifty times more potent than pure heroin, cheaper to manufacture in laboratories worldwide, and easily distributed by mail and couriers, fentanyl is flooding the illicit opioid markets throughout the country.
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30147006/the-opioid-crisis-and-federal-criminal-prosecution
#2
Rachel L Rothberg, Kate Stith
This article examines how federal law enforcement has responded to the opioid epidemic nationally and in a variety of locales. We focus in depth on two initiatives, including prosecution in opioid-death cases, undertaken by the U.S. Attorney's Office in Connecticut.
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30147005/buprenorphine-mat-as-an-imperfect-fix
#3
Brian Mund, Kate Stith
Expanding buprenorphine access in the United States requires evidence-based decision-making that considers both the drug's potential dangers and its potential benefits. Risks associated with buprenorphine misuse and diversion highlight the need for careful, ongoing evaluation during each stage of increased access.
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30147004/the-boundaries-of-good-behavior-and-judicial-competence-exploring-responsibilities-and-authority-limitations-of-cognitive-specialists-in-the-regulation-of-incapacitated-judges
#4
Brandon Hamm, Bryn S Esplin
Both law and medicine rely on self-regulation and codes of professionalism to ensure duties are performed in a competent, ethical manner. Unlike physicians, however, judges are lawyers themselves, so judicial oversight is also self-regulation. As previous literature has highlighted, the hesitation to report a cognitively-compromised judge has resulted in an "opensecret" amongst lawyers who face numerous conflicts of interest. Through a case study involving a senior judge with severe cognitive impairment, this article considers the unique ethical dilemmas that cognitive specialists may encounter when navigating duties to patient, society, and the medical profession, without clear legal guidance...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30147003/the-ethical-case-for-mandating-hpv-vaccination
#5
Michelle J Bayefsky
When the HPV vaccine was released over a decade ago, there was intense opposition to mandating the vaccine, including among bioethics and legal scholars. Some of the original concerns are now obsolete, while other objections continue to present an obstacle to mandating the vaccine. This essay responds to earlier critiques of mandatory HPV vaccination and offers a series of arguments in support of a vaccine mandate. The first section briefly addresses initial concerns that are no longer relevant. The second section makes the ethical case for mandating HPV vaccination, based on three principles: 1) the best interests of children, 2) solidarity, and 3) health equity...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30147002/buprenorphine-supply-access-and-quality-where-we-have-come-and-the-path-forward
#6
Christopher T Breen, David A Fiellin
Buprenorphine is a form of opioid agonist treatment that has been demonstrated to be an effective medication for opioid addiction. It is available in different formulations and marketed under various trade names, including commonly as a buprenorphine/naloxone combination. This paper provides an overview of existing literature on the supply of buprenorphine treatment, the ability of people to access treatment with buprenorphine, and the quality of treatment received. We argue that better data for each of these aspects of treatment could inform policy to expand effective treatment with buprenorphine, and we suggest steps to obtain and act on such data...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30147001/hpv-vaccination-a-public-good-and-a-health-imperative
#7
Lawrence O Gostin
No abstract text is available yet for this article.
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30147000/the-proactive-patient-long-term-care-insurance-discrimination-risks-of-alzheimer-s-disease-biomarkers
#8
Jalayne J Arias, Ana M Tyler, Benjamin J Oster, Jason Karlawish
Previously diagnosed by symptoms alone, Alzheimer's disease is now also defined by measures of amyloid and tau, referred to as "biomarkers." Biomarkers are detectible up to twenty years before symptoms present and open the door to predicting the risk of Alzheimer's disease. While these biomarkers provide information that can help individuals and families plan for long-term care services and supports, insurers could also use this information to discriminate against those who are more likely to need such services...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146999/the-opioid-epidemic-in-indian-country
#9
Robin T Tipps, Gregory T Buzzard, John A McDougall
The national opioid epidemic is severely impacting Indian Country. In this article, we draw upon data from the Centers for Disease Control and Prevention to describe the contours of this crisis among Native Americans. While these data are subject to significant limitations, we show that Native American opioid overdose mortality rates have grown substantially over the last seventeen years. We further find that this increase appears to at least parallel increases seen among non-Hispanic whites, who are often thought to be uniquely affected by this crisis...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146998/discrimination-risks-of-alzheimer-s-as-support-for-social-insurance-for-long-term-care
#10
Allison K Hoffman
No abstract text is available yet for this article.
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146997/the-impact-of-prescription-drug-monitoring-programs-on-u-s-opioid-prescriptions
#11
Ian Ayres, Amen Jalal
This paper seeks to understand the treatment effect of Prescription Drug Monitoring Programs (PDMPs) on opioid prescription rates. Using county-level panel data on all opioid prescriptions in the U.S. between 2006 and 2015, we investigate whether state interventions like PDMPs have heterogeneous treatment effects at the sub-state level, based on regional and temporal variations in policy design, extent of urbanization, race, and income. Our models comprehensively control for a set of county and time fixed effects, countyspecific and time-varying demographic controls, potentially endogenous time-series trends in prescription rates, and other state-level opioid interventions such as Naloxone Access and Good Samaritan laws, Medicaid expansion, and the provision of Methadone Assistance Treatment...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146996/the-opioid-crisis-in-black-communities
#12
Keturah James, Ayana Jordan
While much of the social and political attention surrounding the nationwide opioid epidemic has focused on the dramatic increase in overdose deaths among white, middle-class, suburban and rural users, the impact of the epidemic in Black communities has largely been unrecognized. Though rates of opioid use at the national scale are higher for whites than they are for Blacks, rates of increase in opioid deaths have been rising more steeply among Blacks (43%) than whites (22%) over the last five years. Moreover, the rate of opioid overdose deaths among Blacks already exceeds that of whites in several states...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146995/cracking-the-code-using-data-to-combat-the-opioid-crisis
#13
Catherine Martinez
The goal of this article is to understand the value of data and to call for efforts to explore improved data sharing and collection among local, state, and federal agencies. It discusses the data available and existing barriers to sharing it. It also looks at examples of data sharing initiatives and analysis, such as mapping and visualization tools. The article then examines relevant regulations and calls for reforms. Finally, the article considers objections, including privacy interests, data security, and the costs and benefits of data sharing initiatives...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146994/big-data-and-the-opioid-crisis-balancing-patient-privacy-with-public-health
#14
John Matthew Butler, William C Becker, Keith Humphreys
Parts I through III of this paper will examine several, increasingly comprehensive forms of aggregation, ranging from insurance reimbursement "lock-in" programs to PDMPs to completely unified electronic medical records (EMRs). Each part will advocate for the adoption of these aggregation systems and provide suggestions for effective implementation in the fight against opioid misuse. All PDMPs are not made equal, however, and Part II will, therefore, focus on several elements - mandating prescriber usage, streamlining the user interface, ensuring timely data uploads, creating a national data repository, mitigating privacy concerns, and training doctors on how to respond to perceived doctor-shopping - that can make these systems more effective...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146993/government-patent-use-to-address-the-rising-cost-of-naloxone-28-u-s-c-%C3%A2-1498-and-evzio
#15
Alex Wang, Aaron S Kesselheim
The rising cost of the opioid antagonist and overdose reversal agent naloxone is an urgent public health problem. The recent and dramatic price increase of Evzio, a naloxone auto-injector produced by Kaléo, shows how pharmaceutical manufacturers entering the naloxone marketplace rely on market exclusivity guaranteed by the patent system to charge prices at what the market can bear, which can restrict access to life-saving medication. We argue that 28 U.S.C. § 1498, a section of the federal code that allows the government to use patent-protected products for its own purposes in exchange for reasonable compensation, could be used to procure generic naloxone auto-injectors, or at least bring Kaléo to the negotiating table...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146992/our-ethical-obligation-to-treat-opioid-use-disorder-in-prisons-a-patient-and-physician-s-perspective
#16
Curtis Bone, Lindsay Eysenbach, Kristen Bell, Declan T Barry
The opioid epidemic has claimed the lives of more than 183,000 individuals since 1999 and is now the leading cause of accidental death in the United States. Meanwhile, rates of incarceration have quadrupled in recent decades, and drug use is the leading cause of incarceration. Medication-assisted treatment or MAT (i.e. methadone, buprenorphine) is the gold standard for treatment of opioid use disorder. Incarcerated individuals with opioid use disorder treated with methadone or buprenorphine have a lower risk of overdose, lower rates of hepatitis C transmission, and lower rates of re-incarceration...
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146991/improving-rural-access-to-opioid-treatment-programs
#17
Quentin Johnson, Brian Mund, Paul J Joudrey
This article explores challenges to accessing opioid treatment programs in rural areas, and offers solutions that would ease these problems.
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146990/defining-true-and-non-misleading-for-pharmaceutical-promotion
#18
Spencer Phillips Hey, Aaron S Kesselheim
No abstract text is available yet for this article.
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146989/state-responses-to-the-opioid-crisis
#19
Andrew M Parker, Daniel Strunk, David A Fiellin
This paper focuses on the most common state policy responses to the opioid crisis, dividing them into six broad categories. Within each category we highlight the rationale behind the group of policies within it, discuss the details and support for individual policies, and explore the research base behind them. The objective is to better understand the most prevalent state responses to the opioid crisis.
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/30146988/case-study-county-level-responses-to-the-opioid-crisis-in-northern-kentucky
#20
Quentin Johnson
This article highlights local government responses to the opioid crisis in Northern Kentucky through a series of interviews with county-level officials. The author's discussions with civic leaders reflect the challenges faced by local communities and the new approaches implemented to stem the epidemic.
June 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
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