Petrie-Flom Interns’ Weekly Round-Up: 2/09-2/22

By Hyeongsu Park and Kathy Wang

  • In an unexpected reversal of policy, Florida Governor Rick Scott announced his support for a three year expansion of Medicaid in Florida. Once a critic of the federal health care proposals, Governor Scott joins a growing number of Republican officials who have swapped sides on the Medicaid expansion debate.
  • While considering the terms of health care packages, the Obama administration decided that mental health care coverage must be a component in health care insurance. This mandate was met with mixed reactions, as health insurance plans have been also split into multiple tiers offering varying degrees of services and provisions.
  • In a unanimous decision, the Supreme Court reinforced the authority of the Federal Trade Commission to block hospital mergers under antitrust legislation. While hospitals have been arguing that these mergers allow for a broader provision of services, the FTC pointed out it also increases hospital leverage with insurance companies, potentially raising prices.
  • A Kentucky hospital and 11 cardiologists are facing a lawsuit backed by hundreds of individuals over the use of unnecessary, risky procedures over more than two decades of operations.
  • The FDA recently released warnings strongly advising against the use of codeine for children. Codeine had been used as pain relievers after the removal of tonsils or adenoids, but there had been a series of overdoses and deaths even when it was prescribed within an acceptable range.
  • A controversial piece of legislation pending in Texas offers the possibility of allowing doctors to place do not resuscitate (DNR) orders on their patients if the patients are deemed “medically ineffective.”
  • A recent NPR debate showcased various experts considering the question of whether we should prohibit the genetic engineering of babies, and to what extent parents’ choices could constitute genetic engineering.

Israeli High Court of Justice Allows Sperm Donor to Take Back His Sample

As Ha’aretz reports, (H/T Melanie Mader and Nir Eyal) the Israeli High Court of Justice has just decided a fascinating reproductive technology case. As the article reports:

Galit is a 39-year-old single mother who has a three-year-old daughter conceived through a sperm donation. After giving birth, Galit (who preferred that her real name not be revealed) purchased five more samples of sperm from the same donor and paid an annual fee to store them for her. When Galit, who lives in Florida, decided to try to become pregnant again she bought a plane ticket to Israel for that purpose. But one night, she got a surprising phone call. “I was told coldly that the donor had changed his mind. He had changed his lifestyle, become religiously observant and had written a letter to the Health Ministry confirming this. The caller ended by saying, ‘Of course we will return the payment for storing the sperm’ – a small, negligible amount.” At first, Galit continues, “I thought someone was playing a prank on me. I felt that my feelings were being totally ignored. This was about my future children. Maybe I wouldn’t be able to have more children from that donor, and therefore my daughter would not have biological siblings.”

Galit launched a legal battle, which ended two weeks ago with a High Court of Justice ruling rejecting her request to receive the sperm she had paid for. The court found that the donor’s right to change his mind after making the donation takes precedence over the recipient’s right to use the sperm in order to give birth to biological siblings for her daughter.

As it happens, these are the exact issues I wrote about in 2008 in a pair of articles, The Constitution and The Rights Not to Procreate, 60 Stan. L. Rev. 1135 (2008) and The Right Not to Be a Genetic Parent, 81 S. Cal. L. Rev. 1115 (2008). I have yet to get a hold of a translation of the new judgment into English, but from the reporting it seems as though the Court agreed in part and disagreed in part with the analysis I offer in these papers (particularly the latter one):

They agree with me that there is a “Right Not to Be a Genetic Parent” and my argument that it is best conceived of as a right to avoid a kind of emotional distress from what I call “attributional parenthood” — the attribution by oneself, third parties, and/or the resulting child of unwanted parenthood. Where we seem to part ways is that I view this as a right capable of waiver, and argue that it should clearly be waiveable by contract, which there appears to be in this case, while the Israeli High Court appears to treat it more as an inalienable right.

I may have more to say once I’ve read the whole opinion in English, but for now one sociological fact: As Ellen Waldman among others has noted, and born out by my own time teaching there, Israel is an incredibly pro-natalist society that strongly funds and favors the use of reproductive technology and family formation in general. This case is thus interestingly at variance with others the Israeli judiciary has decided in the reproductive technology context, such as the Nachmani v. Nachmani case (involving a dispute over frozen pre-embryos) where the court has been more disposed to favoring the right to be a genetic parent and allowing reproduction despite disputes.

The article reports that Galit will seek rehearing in front of a larger panel of the High Court soon, so perhaps this is not the end of the litigation.

Twitter Round-Up (2/16-2/23)

By Casey Thomson

This week’s round-up discusses the upcoming cases relevant to bioethics in the Supreme Court, the benefits of the Physician Payment Sunshine Act, the surprisingly low effectiveness rate of this year’s flu vaccine, and the problems with ACA’s Accountable Care Organizations. See below for details and more summaries:

  • Frank Pasquale (@FrankPasquale) shared a post on what’s being called the “alcoholism vaccine” being developed at the Institute for Cell Dynamics and Biotechnology at Universidad de Chile. The vaccine, which would have to be administered every 6 months or year, would mimic the alcohol intolerance mutation that prevents the breaking down of acetaldehyde and produces an instant “hangover-type” state. (2/16)
  • Dan Vorhaus (@genomicslawyer) retweeted a timeline from the Center for Law and Bioscience at Stanford Law’s blog giving dates for the upcoming Supreme Court cases relating to biosciences. (2/17)
  • Frank Pasquale (@FrankPasquale) additionally included a piece on the Physician Payment Sunshine Act, a provision of the Affordable Care Act that would “[require] manufacturers of drugs, medical devices and biologics to report the monetary value of gifts and payments to doctors and teaching hospitals on a publicly accessible website.” The author of the piece, a family physician with 15 years of experience, discussed his support for the plan. (2/17)
  • Michelle Meyer (@MichelleNMeyer) retweeted a link explaining the scientific foundations of the Brain Activity Map Project, namely how it aims at “reconstructing the full record of neural activity across complete neural circuits” to better understand “fundamental and pathological brain processes.” (2/18)
  • Arthur Caplan (@ArthurCaplan) posted a news story on police arresting those involved in the illegal harvesting of eggs from women in Bucharest, Romania. The police reports claim that 11 suspects have been implicated in the trafficking, which would harvest the eggs to be sold to Israeli couples with fertility problems. (2/19)
  • Alex Smith (@AlexSmithMD) retweeted a link to his post on asking about a patient’s PPD (preferred place of death), noting that this is not one of the concerns often cited as part of advanced planning procedures. Such a practice was considered “vital” in the UK, in contrast. (2/20)
  • Alex Smith (@AlexSmithMD) shared a link to a post on the blog he co-runs, GeriPal, on “Five Things Patients and Physicians Should Question in Palliative Care and Geriatrics.” The post shares the two lists posted by the American Academy of Hospice and Palliative Medicine (AAHPM) and the American Geriatrics Society (AGS), which Smith claims “provide targeted, evidence-based recommendations to help physicians and patients have conversations about making wise choices about their care in order to avoid interventions that provide little to no benefit.” (2/21)
  • Arthur Caplan (@ArthurCaplan) also included a link reviewing the low effectiveness of this year’s flu vaccine: there was evidence that it was only effective in 56% of the cases, on the low end of the usual 50-70% effectiveness rate. His tweet noted that this was strong evidence in favor of mandating the vaccine for healthcare workers. (2/21)
  • Michelle Meyer (@MichelleNMeyer) posted an op-ed piece by The Wall Street Journal about the problems with Affordable Care Act’s Accountable Care Organizations (ACOs), namely their false assumptions: that success can come without changing doctor behavior, and without changing patient behavior, in a way that will save money. (2/23)