Health Law, Bioethics & Human Rights
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SPH LW 709: Healthcare Rationing: Medicine, Markets and Morals
Graduate Prerequisites: The MPH health law core course requirement
Although health care is rationed in a variety of ways in the United States, Americans, and American politicians in particular, make believe that rationing does not exist. Indeed, efforts at health care reform have often been criticized for leading to "rationing' health care resources, implying that rationing is something evil. The idea that all Americans get the health care they need or that we have limitless resources is obviously not so. What health care is available and to whom is the result of the often invisible choices policy makers make. This course critically explores the health care allocation choices that have been made and will be made in the future. It analyzes the advantages and disadvantages of various rationing methods, the values and moral judgments reflected in each, and the political and financial factors influencing the choice of approach, as well as who should make such choices. Examples of rationing to be discussed include the distribution of organs for transplantation, determining what constitutes "necessary" care under insurance schemes, the use of markets and lotteries as rationing methods, limitations on population screening, the use of age and "social worth" to limit health care to individuals, triage in emergencies, and the utility (or disutility) of cost-benefit analysis for making decisions about the availability and distribution of health care. By the end of the course, students will be able to articulate the range of possible rationing methods and to appropriately apply these methods to different scarce resource circumstances.
SPH LW 725: Ethical Issues in Medicine and Public Health
This course reviews the nature and scope of moral dilemmas and problematic decision making in public health, medicine, and health care. After a survey of ethical theory, the course focuses on a broad range of ethical concerns raised by the theory and practice of public health and medicine: the nature of health, disease and illness, health promotion and disease prevention; rights, access, and the limits of health care; the physician-patient relationship; truthtelling and confidentiality. Through a series of case studies, the course examines specific topics: the bioethics movement and its critiques; human experimentation; the role of institutional review boards; the concept and exercise of informed, voluntary consent; abortion, reproduction, genetic counseling and screening; euthanasia, death and dying; ethics committees; and international and cross-cultural perspectives.
SPH LW 739: Jewish Bioethics and Holocaust Studies
The aim of this course is to provide an introduction to resources for and approaches to Jewish biomedical ethics. Selected issues will be studied in some depth to develop the ability to interpret relevant primary sources and evaluate competing readings of these sources. Attention will be given to different approaches in interpreting and applying Jewish texts and values in addressing contemporary issues. We will then focus on medical ethics and the Holocaust. The historical experience of the Holocaust has had a major impact on contemporary Jewish ethicists. We will examine the relevance of the Nazi doctors, racial hygiene, euthanasia, and genocide for contemporary bioethics. The field of Jewish bioethics affords us the opportunity to explore the complex interface of philosophy, theology, halakha (Jewish law), and secular law and ethics. Students will also consider philosophical approaches in bioethics and their significance for Judaism. This course is taught with CAS RN 439/ GRS RN 739/ STH TX859 at Charles River Campus.
SPH LW 740: Health and Human Rights
This course is appropriate for graduate, 4+1, and undergraduate students and is taught at the Medical Campus. Health is closely linked to the realization of human rights. Preventable illness, infant mortality, and premature death, for example, are closely tied to societal discrimination and violation of human rights. This course explores the relationship between human rights and health by examining relevant international declarations in historical context, exploring the meaning of "human rights" and "health," and analyzing specific case studies that illuminate the problems, prospects, and potential methods of promoting health by promoting human rights on the national and international levels.
SPH LW 830: Health Insurance and the Affordable Care Act
Graduate Prerequisites: LW751 or JD867.
This seminar offers an in-depth examination of the pivotal role of public and private insurance in US health policy. Health insurance pays for almost all health care in the US, strongly influencing (often dictating) who gets what care and on what terms. The class explores how the Affordable Care Act affects the design, operation, and regulation of health benefit plans, including Medicare, Medicaid, employer-sponsored group plans, and commercial insurance. Investigating contemporary regulations, students learn fundamentals of insurance, where reforms do and do not alter such fundamentals, and whether reforms affect larger principles of law. Topics include state and federal regulation; ERISA plan requirements; ERISA preemption of certain state laws; accepting, managing and shifting financial risk; designing health insurance exchanges; contracting with providers, Accountable Care Organizations, employers, and individuals; designing and administering plans; defining benefits, including Essential Health Benefits; appeals and remedies; and state adaptations of health insurance exchanges, subsidy wrap-arounds, risk corridors, and Medicaid expansions.
SPH LW 840: Health Law, Bioethics, and Human Rights
Graduate Prerequisites: SPH PH719
Health law, bioethics, and human rights are converging in challenging ways, especially at the national level (in both legislation and constitutional adjudication), and the international law level. This seminar will explore the convergence and its meaning for the law and society through specific case studies including post-9/11 proposals for mass quarantine; torture and force-feeding justifications in the GWOT; genetic engineering and the new reproductive technologies; the relationship between abortion and the death penalty; and the meaning of the ?right to health.? This class is taught at BU School of Public Health and meets the Health Law, Bioethics, and Human Rights Department captone requirement.
SPH LW 850: Public Health Law
Graduate Prerequisites: SPH PH719
This problem-oriented research seminar enables students to confront questions about health risks as such questions typically arise in practice -- in all their messy complexity and without doctrinal labels. The seminar offers a systematic framework for identifying health risks, drawing on theories of risk perception, cognitive reasoning, and empirical evidence. Using contemporary examples of risks from firearms, tobacco, drugs, foods and other consumer products, genetics, personal behavior, contagious and chronic diseases, bioterrorism, surveillance, and the social environment, students analyze and compare the applicability and effectiveness of different legal strategies to control different types of risks. Strategies include criminal and civil prohibitions, mandatory product standards, tort liability, mandatory data collection, biometric testing, wellness programs, conditions of employment, advertising and marketing restrictions, isolation and quarantine, involuntary treatment, taxation, and limits on liability. Emphasis is on the different requirements for and limits of laws regulating personal behavior and laws regulating products and commercial activities. Students conduct independent research to develop a legal strategy to address a contemporary risk to health.
SPH LW 854: Mental Health Law, Policy & Ethics
Graduate Prerequisites: The MPH health law core course requirement or permission of instructor
Subjects discussed include an overview of clinical psychiatry, institutionalization, deinstitutionalization, the insanity defense, incompetence to stand trial, the right to treatment and the right to refuse treatment, involuntary commitment, dangerousness, the meaning of mental illness, the use of invasive treatments, psychotherapy, privacy, and professional ethics. Legal cases make up most of the course material.