Speech and Suicide-The Line of Legality.

While physician-assisted suicide legislation is being drafted and passed across the United States, a gray-area continues to exist in regard to the legality of a lay person's assistance with suicide. Several high-profile cases have been covered in the media, namely that of Michelle Carter in Massachusetts and William Melchert-Dinkel in Minnesota, but there is also a growing volume of anonymous pro-suicide materials online. Pro-suicide groups fly under the radar and claim to help those desiring to take their own lives. This paper aims to identify the point at which an individual or group can be held civilly or criminally liable for assisting suicide and discusses how the First Amendment can be used to shield authors from such liability.

Mandating Front-of-Package Food Labels in the U.S. - What are the First Amendment Obstacles?

Front-of-package (FOP) food labels are symbols, schemes, or systems designed to communicate concise and useful nutrition-related information to consumers to facilitate healthier food choices. FOP label policies have been implemented internationally that could serve as policy models for the U.S. However, the First Amendment poses a potential obstacle to U.S. government-mandated FOP requirements. We systematically reviewed existing international and major U.S.-based nutrition-related FOP labels to consider potential U.S. policy options and conducted legal research to evaluate the feasibility of mandating a FOP label in the U.S. We identified 24 international and 6 U.S.-based FOP labeling schemes. FOP labels which only disclosed nutrient-specific data would likely meet First Amendment requirements. Certain interpretive FOP labels which provide factual information with colors or designs to assist consumers interpret the information could similarly withstand First Amendment scrutiny, but questions remain regarding whether certain colors or shapes would qualify as controversial and not constitutional. Labels that provide no nutrient information and only an image or icon to characterize the entire product would not likely withstand First Amendment scrutiny.

Church Against State: How Industry Groups Lead the Religious Liberty Assault on Civil Rights, Healthcare Policy, and the Administrative State.

Industry-funded religious liberty legal groups have sought to undermine healthcare policy and law while simultaneously attacking the rights of sexual and gender minorities. Whereas past scholarship has tracked religiously-affiliated healthcare providers' growing political power and attendant transformations to legal doctrine, our account emphasizes the political donors and visionaries who have leveraged religious providers and the U.S. healthcare system's delegated structure to transform social policy and bureaucratic agencies more generally.

"In a Religious Celebration"? The Religious Defense of LGBT Rights in U.S. Federal Courts.

This article advances scholarship on the relationship between sexuality, religion, and the law within the United States by analyzing case summaries and court opinions of the federal appellate cases decided between 1990 and 2020 that involve a religion-based claim being used to advance or defend gay and lesbian rights. Contrary to dominant public narratives that position religion uniformly in opposition to progressive sexual values, these cases show how Americans' religious beliefs and practices include diverse sexual identities. We find that the courts' reactions to such cases, however, illustrate the tension within legal discourse and hesitancy for the courts to equate religious and moral values with affirming LGBT identities, people, and rights. Our findings suggest that the courts and litigants define what religion is-and what it is not-by positioning it in relation to sexuality.

United States: Protecting Commercial Speech under the First Amendment.

The First Amendment to the US Constitution protects commercial speech from government interference. Commercial speech has been defined by the US Supreme Court as speech that proposes a commercial transaction, such as marketing and labeling. Companies that produce products associated with public health harms, such as alcohol, tobacco, and food, thus have a constitutional right to market these products to consumers. This article will examine the evolution of US law related to the protection of commercial speech, often at the expense of public health. It will then identify outstanding questions related to the commercial speech doctrine and the few remaining avenues available in the United States to regulate commercial speech including the use of government speech and addressing deceptive and misleading commercial speech.

Food Marketing to - and Research on - Children: New Directions for Regulation in the United States.

As countries around the world work to restrict unhealthy food and beverage marketing to children, the U.S. remains reliant on industry-self regulation. The First Amendment's protection for commercial speech and previous gutting of the Federal Trade Commission's authority pose barriers to restricting food marketing to children. However, false, unfair, and deceptive acts and practices remain subject to regulation and provide an avenue to address marketing to young children, modern practices that have evaded regulation, and gaps in the food and beverage industry's self-regulatory approach.

Disestablishing Hospitals.

We argue that concentration of power in religious hospitals threatens disestablishment values. When hospitals deny care for religious reasons, they dominate patients' bodies and convictions. Health law should - and to some extent already does - constrain such religious domination.

Reproductive Technologies and Free Speech.

The Supreme Court and lower courts have not articulated a clear or consistent framework for First Amendment analysis of speech restrictions in health care and with respect to abortion. After offering a coherent doctrine for analysis of speech restrictions in the doctor-patient relationship, this piece demonstrates how potential legislation restricting patient access to information from reproductive testing intended to limit "undesirable" reproductive choices would violate the First Amendment.

From the Shadows: The Public Health Implications of the Supreme Court's COVID-Free Exercise Cases.

This article analyzes the Supreme Court's "shadow docket" Free Exercise cases relating to COVID-19. The paper highlights the decline of deference, the impact of exemptions, and the implications of the new doctrine for vaccine and other public health laws.

Assuming Access to Professional Advice.

Access to reliable health advice can make the difference between life and death. But good advice is hard to come by. Within the confines of the professional-client or doctor-patient relationship, the First Amendment operates in a way that protects good and sanctions bad advice. Outside of this relationship, however, the traditional protections of the First Amendment prohibit content- and viewpoint discrimination. Good and bad advice are treated as equal. A core assumption of First Amendment theory is the autonomy of speakers and listeners. Another assumption, as this Article demonstrates in the health context, is the availability of access to professional advice. This assumption, however, is erroneous because access to health advice in fact is unevenly distributed.This Article argues that assuming access to professional advice creates indefensible inequality. Lack of access to expert advice puts some listeners at much higher risk than others. Current First Amendment doctrine is largely unproblematic for those who can afford expert advice, and makes expert advice much costlier where health provider access is needed to obtain good advice. Those who lack access must place a higher degree of trust in widely-available information because they have no more reliable alternative. In other words, First Amendment doctrine places a higher burden on those who can least afford expert advice and who are most dependent on experts in public discourse.

Assessing potential legal responses to medical ghostwriting: effectiveness and constitutionality.

Pharmaceutical companies are extensively involved in shaping medical knowledge to market their products to physicians and consumers. Specialized planning is undertaken to produce scientific articles driven by commercial interests. Rather than the listed authors, hidden analysts and publication management firms hired by pharmaceutical companies are often responsible for the content of scientific articles. Such ghostwriting practices raise serious concerns regarding the integrity of knowledge and thus demand urgent attention. This paper analyses the strategies of legal regulation on medical ghostwriting and their comparative advantages and disadvantages. Many of regulatory proposals suffer from a lack of effectiveness, whereas others are subject to constitutional concerns. The analysis in this paper offers insights into framing adequate regulation; it supports the strategy for reforming the structure of information production while calling for cautiousness in shaping its regulatory outline. In addition, this paper contributes to the analysis of First Amendment jurisprudence, suggesting that the judiciary should allow a certain amount of leeway for political branches to develop effective regulation.

Unconscionable: how the U.S. Supreme Court's jurisprudence lags behind the world when it comes to contraception and conscience.

U.S. Supreme Court jurisprudence undermines access to contraception by permitting individuals, institutions, and even corporations to claim religious objections to ensuring contraceptive insurance coverage, thus imposing those beliefs on non-adherents and jeopardizing their access to essential reproductive-health services. This jurisprudence is not only harmful but also runs contrary to the laws and policies of peer nations, as well as international human rights principles, which are more protective of the rights of health-care recipients to make their own decisions about contraception free from interference. The United States should look to the practice and jurisprudence of other nations and ensure that religious exemptions are not permitted to deprive a third party of access to contraception.

Historic Leadership: One Courageous School Nurse's Heroic Journey-Part 3.

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 3 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 3 describes the publication of the Attorney General's opinion validating the illegality of the school district's medication administration policy, the lawsuit Ellen brought against the Broken Arrow Public Schools, and the appeal of the final decision in that lawsuit. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.

Historic Leadership: One Courageous School Nurse's Heroic Journey-Part 4.

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 4 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 4 offers lessons to be learned by reflecting on Ellen Johnsen's experience when she challenged the illegal and unsafe medication administration policy in the Broken Arrow Public Schools. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.

Historic Leadership.

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 1 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 1 describes the upbringing and early career experiences that molded Ellen into a courageous and tenacious child advocate who rose to the challenge when she found herself in a school setting where tradition and policy were at odds with the nurse practice act and professional standards regarding medication administration. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.

Historic Leadership.

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 2 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 2 describes how Ellen's actions led the Broken Arrow Public Schools to revise its unsafe and illegal medication administration policy, which brought the policy into partial compliance with the nurse practice act but culminated in Ellen losing her job. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.

Neuroscience cannot answer these questions: a response to G. and R. Murrow's essay hypothesizing a link between dehumanization, human rights abuses and public policy.

The Murrows' paper, 'A hypothetical link between dehumanization and human rights abuses', in which they propose that neuroscience may answer some difficult public policy questions, including questions about the First Amendment, is an unfortunate foray into law and public policy unjustified by the current state of neuroscience. Neuroscientific insights may one day have important implications for the law, and for some of the folk psychological assumptions embedded in the law, but they will never change the words of the written Constitution, or answer difficult policy questions in the interstices of those words. Suggesting that neuroscience can today inform these questions does a disservice to science, law and the complexity of the human condition.

Back to first principles: a new model for the regulation of drug promotion.

The US Food and Drug Administration's ('FDA' or the 'Agency') current regulatory framework for drug promotion, by significantly restricting the ability of drug manufacturers to communicate important, accurate, up-to-date scientific information about their products that is truthful and non-misleading, runs afoul of the First Amendment and actually runs counter to the Agency's public health mission. Our article proposes a New Model that represents an initial proposal for a modern, sustainable regulatory framework that comprehensively addresses drug promotion while protecting the public health, protecting manufacturers' First Amendment rights, establishing clear and understandable rules, and maintaining the integrity of the FDA approval process. The New Model would create three categories of manufacturer communications-(1) Scientific Exchange and Other Exempt Communications, (2) Non-Core Communications, and (3) Core Communications-that would be regulated consistent with the First Amendment and according to the strength of the government's interest in regulating the specific communications included within each category. The New Model should address the FDA's concerns related to off-label speech while protecting drug manufacturers' freedom to engage in truthful and non-misleading communications about their products.

Religious issues in the capacity evaluation.

The authors explore the difficulties present in the capacity evaluation of patients with strong religious beliefs. The article reviews the legal protection for treatment refusal on religious grounds as well as psychiatry's approach to religion. Clinical cases encountered in an urban hospital are presented to highlight how the conflicts among psychiatric, religious, and legal issues can be resolved. Suggestions are made for incorporating an exploration of religious values into the capacity assessment.