Denegación de cambio de sexo registral: comentario al Auto del Magistrado del Registro Civil Único de Las Palmas de Gran Canaria de 18/09/2023 / [Denial of change of registration sex: comment to the Order of the Magistrate of the Single Civil Registry of Las Palmas de Gran Canaria of 09/18/2023]

El presente trabajo analiza el Auto 1045/2023, de fecha 18 de septiembre. Resolución que iba a suponer, a la postre, la denegación de la solicitud de un ciudadano que había pretendido, amparándose en Ley 4/2023, del 28 de febrero, una rectificación registral de la mención relativa al sexo, de varón a mujer, conservando su nombre. (AU)

This work analyzes Auto 1045/2023, dated September 18th. This resolution was going to result in the denial of a citizen’s request who, relying on Law 4/2023, dated February 28th, had sought a registry correction regarding gender, from male to female, while retaining his name. (AU)

Vulneración de Derechos Fundamentales por práctica de la interrupción voluntaria del embarazo en una comunidad autónoma distinta a la de residencia: comentario a la Sentencia 78/2023, de 3 de julio de 2023, del Tribunal Constitucional / [Violation of Fundamental Rights due to the practice of voluntary interruption of pregnancy in an autonomous community other than that of residence: comment on Sentence 78/2023, of July 3, 2023, of the Constitutional Court]

El presente trabajo estudia la Sentencia 78/2023, de 3 de julio de 2023, del Tribunal Constitucional, que analiza la práctica de interrupción voluntaria del embarazo en una comunidad autónoma distinta a la de residencia. La cuestión principal radica en apreciar una vulneración a la garantía de interrumpir voluntariamente el embarazo dentro de los supuestos legales, como parte del contenido constitucionalmente protegido del derecho fundamental a la integridad física y moral (art. 15 CE). (AU)

This paper studies Judgement 78/2023, of 3 July 2023, of the Constitutional Court, which analyzes the practice of voluntary termination of pregnancy in an autonomous community other than that of residence. The main question lies in assessing a violation of the guarantee of voluntary termination of pregnancy within the legal circumstances, as part of the constitutionally protected content of the fundamental right to physical and moral integrity (art. 15 CE). (AU)

Free Speech Challenges to the Inflation Reduction Act.

This Viewpoint looks at the lawsuits brought by pharmaceutical companies to challenge the Inflation Reduction Act of 2022, in particular claims under the First Amendment's protection of free speech.

Thurgood Marshall, Hero of American Medicine.

One of the heroes in American history, Associate Supreme Court Justice Thurgood Marshall (1908-1993) sought legal remedies against racial discrimination in education and health care. As director of the Legal Defense Fund (LDF) of NAACP from 1940 to 1961, his success in integrating law schools in Texas led to the first black medical student admitted to a state medical school in the South. Representing doctors and dentists needing a facility to perform surgery, the LDF brought cases before the courts in North Carolina that moved the country toward justice in health care. His ultimate legal victory came in 1954, Brown v. Board of Education of Topeka, the decision that declared racial segregation in public schools unconstitutional. In 1964, the LDF under Jack Greenberg, Marshall's successor as director, won Simkins v. Moses H. Cone Memorial Hospital, a decision that held that hospitals accepting federal funds had to admit black patients. The two decisions laid the judicial foundation for the laws and administrative acts that changed America's racial history, the Civil Rights Act of 1964 and the Social Security Act Amendments of 1965 that established Medicare and Medicaid. His achievements came during the hottest period of the American civil rights movement of the 1950s and 1960s. Well past the middle of the twentieth century, black Americans were denied access to the full resources of American medicine, locked in a "separate-but-equal" system woefully inadequate in every respect. In abolishing segregation, Marshall initiated the long overdue remedy of the unjust legacies of slavery and Jim Crow.

Sífilis congênita e recusa terapêutica da gestante: análise jurídica e bioética / Congenital syphilis and treatment refusal by pregnant women: a bioethical and legal analysis / Sífilis congénita y rechazo terapéutico por las mujeres embarazadas: análisis legal y bioético

Resumo A infecção congênita pela sífilis é uma doença que, apesar dos esforços públicos, ainda se mantém na rotina do sistema de saúde. Embora haja métodos de prevenção efetivos e muito disseminados, tratamento com alto custo-benefício e disponível no Sistema Único de Saúde, além de assistência pré-natal com alta cobertura, as taxas epidemiológicas da enfermidade continuam relevantes e preocupantes. Umas das barreiras à erradicação desse cenário é a recusa terapêutica da genitora. Com isso, indagações importantes são levantadas, como a responsabilidade médica em relação à recusa, a responsabilidade da gestante para com o nascituro e as implicações jurídicas que perpassam essa problemática. O propósito deste artigo é responder a essas questões e suas repercussões bioéticas e jurídicas.

Abstract Despite public policies, congenital syphilis infection remains a reality in the health system routine. Moreover, its epidemiological rates continue to be relevant and worrisome despite widespread and effective preventive methods, highly cost-effective treatments available in the Unified Health System, and high-coverage pre-natal care. A major obstacle to eradicating this scenario is treatment refusal by the progenitor. Important questions regarding medical responsibility in relation to refusal, the pregnant woman's responsibility towards the unborn child, and the legal implications involved arise from this context. This article seeks to answer these questions and their legal and bioethical repercussions.

Resumen La sífilis congénita es una enfermedad que aún sigue en la rutina del sistema de salud a pesar de los esfuerzos públicos. Aunque existen métodos de prevención efectivos y generalizados, los tratamientos con alto costo-beneficio y disponibles en el Sistema Único de Salud, además de la atención prenatal con alta cobertura, las tasas epidemiológicas de la enfermedad siguen siendo relevantes y preocupantes. Una de las barreras para su erradicación es el rechazo terapéutico de la madre. Por lo tanto, se plantean cuestiones importantes, como la responsabilidad médica con relación al rechazo, la responsabilidad de la mujer embarazada por el feto y las implicaciones legales que impregnan este problema. El propósito de este artículo es responder a estos interrogantes y sus repercusiones bioéticas y legales.

Ruthless Utilitarianism? COVID-19 State Triage Protocols May Subject Patients to Racial Discrimination and Providers to Legal Liability.

As the coronavirus pandemic intensified, many communities in the United States experienced shortages of ventilators, intensive care beds, and other medical supplies and treatments. Currently, there is no single national response to provide guidance on allocation of scarce health care resources. Accordingly, states have formulated various "triage protocols" to prioritize those who will receive care and those who may not have the same access to health care services when the population demand exceeds the supply. Triage protocols address general concepts of "fairness" under accepted medical ethics rules and the consensus is that limited medical resources "should be allocated to do the greatest good for the greatest number of people."1 The actual utility of this utilitarian ethics approach is questionable, however, leaving many questions about what is "fair" unanswered. Saving as many people as possible during a health care crisis is a laudable goal but not at the expense of ignoring patients's legal rights, which are not suspended during the crisis. This Article examines the triage protocols from six states to determine whose rights are being recognized and whose rights are being denied, answering the pivotal question: If there is potential for disparate impact of facially neutral state triage protocols against Black Americans and other ethnic groups, is this legally actionable discrimination? This may be a case of first impression for the courts to resolve."[B]lack Americans are 3.5 times more likely to die of COVID-19 than [W]hite Americans … . Latinx people are almost twice as likely to die of the disease, compared with [W]hite people." 2 "Our civil rights laws protect the equal dignity of every human life from ruthless utilitarianism … . HHS is committed to leaving no one behind during an emergency, and this guidance is designed to help health care providers meet that goal." - Roger Severino, Office of Civil Rights Director, U.S. Department of Health and Human Services. 3.

Free Speech Skepticism.

If the free speech clause of the First Amendment is interpreted to mean that speech is to be granted special protection not accorded to other forms of conduct, then a free speech principle, distinct from a principle of general liberty, must be posited and must receive a distinct justification. A defense of a free speech principle must explain why the harm principle either does not apply in the case of speech or applies with less force than in the case of all other forms of human conduct. In this article, I argue that none of the defenses of the right to free speech on offer succeeds in showing why even significantly harmful speech is deserving of special protection not afforded non-speech conduct. More work needs to be done to justify a free speech principle and, until such work is done, the belief in the existence of a free speech principle that undergirds and justifies our current free speech practices is no more than an article of faith.

Kahler v. Kansas and the Constitutionality of the Mens Rea Approach to Insanity.

In 1995, the Kansas legislature adopted what is referred to as the "mens rea approach" and abolished the affirmative insanity defense. This approach allows a defendant to be acquitted who lacks the requisite mental state for the crime, without consideration of the defendant's understanding of wrongfulness. In Kahler v. Kansas, the U.S. Supreme Court recently held that this restrictive approach does not violate due process and that a state is not required to adopt an insanity test which considers a defendant's moral capacity at the time of the crime. Four other states currently follow the mens rea approach, or some form of it. In this article, we first discuss a brief history of insanity defense laws in the United States. We then outline relevant legislative history and precedent in Kansas and other states that have adopted the mens rea approach. We next discuss the Supreme Court's reasoning in Kahler The significance of this test is further discussed, including Eighth Amendment considerations. We advocate for continued education of the public, legislators, and the judiciary regarding the use, application, and necessity of an affirmative insanity defense.