CHALLENGES IN LAW:
HARD CASES IN THE FIELD OF MEDICINE

Judit Sandor
Term: Winter 1994
Department of Political Science, Budapest
CENTRAL EUROPEAN UNIVERSITY



Course Summary

The aim of the course is to provide an introduction to the different social and legal concepts of medico-legal problems such as providing information for patients, social and medical decision making at the end of life, refusal of medical treatments, body identity and transplantation, human reproductivity and the law, expenmentation on human subjects, genetic testing and therapy. The course focuses on a comparative approach of readings and relevant cases with the intent to identify the scope and limits of individual autonomy and compelling state and social interests.

Medicine is one of the most challenged aerea of the society in the end of twentieth century. Physical inviolability as an inherent part of individual autonomy has long been respected by ethics and law. However, for centuries it did not seem to be evident that medical treatment -without having previously requested the patient's consent- is a case of 'prima facie' battery. New challenges appear day by day as a result of development of biotechnology and medicine which require the review of our ethical and legal standards applied in the field of health care.

Each topic includes lectures elaboradng the themes and discussions on the basis of the reading matenal and lecture. Every second lecture bases on the method of case analysis.

Course Syllabi:

Week 1. Modem medicine and personal autonomy - Introduction to the medical law and ethics
Required Readings:
Shapiro, Michael H. 1981 Cases Materials and Problems on Bioethics and Law Chapter Three: Managing Dilemmas: ethical theories p.72-92
Dworkin G, 1988, Theory and Practice of Autonomy, CUP p.l00-12l.

Week 2. Concept of privacy in Medicine
Required Readings
Brandeis, J.1890, The right to Privacy, Harvard Law Review Vol.IV. December 15,1890. No5. p.l93- 215.
Richards, 1986. Toleration and the Constitution The Jurisprudence of Constitutional privacy , 255.-281.
Griswold v. Connecticut 381 U.S. 479 (1965)

Week 3. Concept of dignity
Requierd Readings:
Kommers, D.P. 1989, Constitutional Jurisprudence of the Federal Republic of Germany. Human Dignity and Personhood p.305-366 Duke University Press
The doctor-patient relationship in: Kennedy,I.-Grubb ,A. 1989, Medical Law Butterworths, London p.33-70
Merrils, J.G.1988. The Development of International Law by the European Court of Human Rights Manchester University Press Chapter 3. The Court's Conception of the Strasbourg System p. 40- 62.;Chapter 10. Ideology and international human rights law p. 207- 219.

Weeks 4-5. Privacy and dignity in the health care
Informed consent
Required readings:
David W. Meyers,The Human body and the Law 1990.Consent to medical treatment 122-149.
Dworkin G, 1988, Theory and Practice of Autonomy, CUP 85.-99.

Origins of the Informed Consent Doctrine in: Furrow,Barry R Johnson,Sandra H. Jost,Timothy S. Schwartz,Robert L.l991 West Publishing Co. St. Paul, Minn.,l991: Health Law Cases, Materials and Problems Second Edition p.321.-323.
The Cantebury rule
Canterbury v. Spence (United States Court of Appeals, District of Columbia Circuit,1972.564 F.2d 772.)
:E

Week 6. Right to life v. human dignity
Required Readings:
Judith Jarvis Thomson: A defense of abortion in; Biomedical Ethics and the Law 2nd etition ed.. James M. Humber and Robert Almeder Plenum Press New York 1979. p.57-72.
Legal recognition of the beginning of human life in: Furrow,Barry R Johnson,Sandra H. Jost,Timothy S. Schwartz,Robert L.1991 West Publishing Co. St. Paul, Minn.,1991 Health Law Cases, Materials and Problems Second Edition ,Organizing Health Care Delivery,p.893.-898
Roe v. Wade (410 U.S.113,93 S Ct 705,35 L.Ed.2d 147(1973)
State v. Merrill Supreme Court of Minnesota ,1990 450 N.W.2d 318.
Planned Parenthood of Southeastern Pennsylvania, et al. v. Casey

Week 7. Reproductive freedom

Matter of Baby M Supreme Court of New Jersey, 1988 109 NJ. 396,537 A2d 1227
Matter of Grady Superior Court of New Jersey, Chancery Division, 1979 170 N.J.Super.98 405 A2d851
Doctors, Patients and the Law Edited by: Clare Dyer Chapter 5. Reproductive Medicine 89-106 Sheila McLean

Week 8. Refusal of medical treatment
Required Readings:
Persels, Jim. 1993, Forcing the Issue of the Physician-Assisted Suicide Irnpact of the Kevorkian case on the Euthanasia in: Journal of Legal Medicine,14:93-124
Veatch, Robeer M.Revised Edition Death, Dying and the Biological Revolution Yale University Press p.118.-136.
Bouvia v. Superior Court Court of Appeal of California, Second District ,1986 179 CalApp 3d 1127, 225 Cal Rptr 297. In re: A C533 A.2d 611(D.C.1987.)Mills v. Rogers Supreme Court of the United States,1982 457 U.S. 291,102 S. Ct 2442 73 L.Ed2d 16.

Week 9. End of life decisions
Required Readings:
Gervais, Karen Grandstrand, 1986, Redefining Death, Yale University Press, Chapter 4. p.75.- 110. Moral arguments
Have, Henk A.M.J. ten 1992, Euthanasia Normal Medical Practice? in: Hastings Center Report March-April 1992 pp. 34-38.
Cruzan v. Director, Missouri Department of Health (Supreme Court of the United States,1990. 492 U.S.-110 S. Ct.2841,111 L.Ed.2d 224.

Week 10. Dignity after death, cadaver transplantation
Required readings:
Barber v. Superior Court Court of Appeal, Second District,1983. 147 Cal App3d 1006,195 CalRptr.484.
Harmonisation of legislations of member states relating to removal, grafting and transplantation of human substances Resolution (78) 29 adopted by the Cornmittee of Ministers of the Council of Europe on 11 May 1978 and Explanatory memorandurn 1978

Week 11. Experimentation on human subjects

Required readings:
Nuremberg Code, Helsinki Dcclaration History of Research upon Human Subjects in the United States in:Furrow,Barry R. Johnson,Sandra H. Jost,Timothy S. Schwartz,Robert L.1991 West Publishing Co. St. Paul, Minn.,1991 Health Law cases, Materials and Problems Second Edition p. 1197-1211.
Mack v. Califano United Statews District Court, District of Columbia ,1978 447 F. Supp.668.
Moore v. Regents of the University of California Suprerne Court of California 1990. Cal 3d 793 P2.d 479,271 CalRptr 146.

Week 12. Right to health Care-Justice in health care
Required readings:
Allan Buchanan: Justice: A Philosophical Review p.3-21.in: Justice and the Health Care e.Earl E. Shelp D. Reidel Publishing Company 1981.
Frederick S. Carney: Justice and Health Care: A Theological Review p.37-49. in: Justice and the Health Care e.Earl E. Shelp D. Reidel Publishing Company 1981.

Week 12. Allocation of scarce resources

Required readings:
David Meyers: Distribution and Rationing of Scarce Medical Resources p.330.349.in:David W. Meyers .The Human body and the Law 1990
Furrow,Barry R. Johnson,Sandra H. Jost,Timothy S. Schwartz,Robert L.1991 West Publishing Co. St. Paul, Minn.,1991: Health Law Cases, Materials and Problems Second Edition ,Organizing Health Care Delivery,p.457-458.
Thompson v. Sun City Community Hospital, Inc. (Supreme Court of Arizona,1984.141 Ariz,597,688 P.2d 605.)

Week 13. Liability for the quality of health care

Required Readings:
Rodney Nelson-Jones M.A. Medical Negligence case Law London. Fournat Publishing 1990. p.3-23.
Reforming the Tort Sytem for Medical Injuries in Furrow,Barry R. Johnson,Sandra H. Jost,Timothy S. Schwartz,Robert L. l991 West Publishing Co. St. Paul, Minn.,l991 :Health Law cases, Materials and Problems Second Edition p.379- 389.
Roa v. Lodi Medical Group (Supreme Court of California 1985.37 Cal 3d 920,211 Cal.Rptr.77,695 P.2d 164.)


Additional compulsory readings:


Annas, George J. 1993, Standard of Care, Oxford University Press the U.S. Constitution of Bioethics p.15-115.
Bickel, Alexander M. The morality of consent Yale University Press p.33.-54.
Feinberg, Joel, 1973: Social Philosophy, Prentice-Hal1,Inc Englewood Cliff, New Jersey
Merrils, J.G. 1988. Development of international law by the European Court of Human Rights Chapter 3, Chapter 10.
Rosenfelt 1991. Affirmative action and justice, philosophical and constitutional inquiry Chapter 6. Constitutional Equality and the Equal Protection p.135-162.

Grading:
Activity on seminars: 25%
Mid-term essay: 25%
Final exam: 50%


Digitized version prepared by the Curriculum Resource Center (CRC)
CEU Budapest, Hungary
Revised: April, 1996

San_ChallLaw.W94PS.v5


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