Lawyers in suits and ties ransacked the Punjab Institute of Cardiology in Lahore, Pakistan, “beating up staff and smashing equipment…. The lawyers had been protesting over the alleged mistreatment of some of their colleagues by hospital staff last month. But the final trigger for the violence appears to have been a video posted on social media by a doctor on Tuesday night in which he poked fun at the lawyers.” Three patients died during the riot as medical staff could not care for them. [BBC]
“Maria Cvach, an alarm expert and director of policy management and integration for Johns Hopkins Health System, found that on one step-down unit (a level below intensive care) in the hospital in 2006, an average of 350 alarms went off per patient per day—from the cardiac monitor alone….
“Bed alarms have proliferated since 2008 when the Centers for Medicare and Medicaid Services declared hospital falls should ‘never’ happen and stopped paying for injuries related to those falls. After that policy change, the odds of nurses using a bed alarm increased 2.3 times, according to a study led by Dr. Ronald Shorr, director of the Geriatric Research, Education and Clinical Center at the Malcom Randall Veterans Affairs Medical Center in Gainesville, Fla. The alarms have become a standard feature in new hospital beds.” Meanwhile, in 2017 the same federal agency “began discouraging their widespread use in nursing homes, arguing that audible bed or chair alarms may be considered a ‘restraint’ if the resident ‘is afraid to move to avoid setting off the alarm.'” [Melissa Bailey, Kaiser Health News via Virginia Postrel; earlier here, here, and here]
From Institute for Justice’s Short Circuit newsletter: “How many times can an eye surgeon accidentally operate on the wrong eye before his surgical privileges are revoked? Three is the magic number at the Murfreesboro, Tenn. Veterans Affairs hospital. Sixth Circuit: And the revocation does not violate the due process of law.” [or constitute retaliation under employment discrimination law; Ahad v. Wilkie]
It is forbidden to save lives except in the prescribed location and manner: “In an effort to protect rural hospitals in Louisiana, state lawmakers have passed a bill that bans the creation of most freestanding emergency rooms.” [Alia Paavola, Becker’s Hospital Review]
- “How the Reformulation of OxyContin Ignited the Heroin Epidemic” [William N. Evans and Ethan Lieber, Cato Research Briefs in Economic Policy] Antiquated regulations on methadone need revision [Jeffrey Singer, Cato] Concept of addiction is constantly run together with that of dependence, and applied in such dubious areas as “social media addiction” [Singer]
- EEOC sues Tennessee hospital over lapse of religious accommodation in its mandatory flu shot policy (but is a mask as effective as the vaccine?) [EEOC press release]
- Free to Choose Medicine: a review [Thomas Hemphill, Cato Regulation magazine]
- Texas law limiting med-mal suits: “Fifteenth Anniversary of Proposition 12” [Texans Against Lawsuit Abuse]
- Time to include electronic components in the BAAA: “Biomaterials Access for the 21st Century” [Jim Beck]
- Affordable Care Act’s incentive program punishing hospitals for readmissions had unintended consequences, we know now. Were some of them lethal? [Tyler Cowen on Rishi K. Wadhera, Karen E. Joynt Maddox and Robert W. Yeh, New York Times]
- “Doctors as Data Entry Clerks for the Government Health Surveillance System” [Jeffrey Singer, Cato]
- “Judge Orders Spine Surgeon to Pay Discovery Fees Over Funding Model” [Greg Land, Daily Report Online (Atlanta); defense lawyer says case “throws a harsh light on the interaction between personal injury lawyers, healthcare providers and litigation funders”]
- What if feds’ enforcement policies on truthful off-label pharmaceutical promotion run aground on First Amendment considerations? [James Beck, Drug and Device Law]
- Chronic pain patients: “Civilian Casualties Continue to Mount in Governments’ War on Opioids” [Jeffrey Singer] Feds’ tightening of opioid scheduling cut refills, but increased number of pills initially prescribed [same] So sinister for psychiatrist to take cash payment and keep night hours in a rented office, or is it? [Ira Stoll]
- Certificate-of-need laws: “North Carolina Doctor Sues to Break Up State-Enforced Medical Cartels” [Christian Britschgi, Reason]
- Law firm of Morgan & Morgan, awarded contingency contract for Kentucky opioid suit, holds fundraiser for Kentucky AG Andy Beshear [Legal NewsLine]
- “Researchers from Duke and MIT… found that the possibility of a lawsuit increased the intensity of health care that patients received in the hospital by about 5 percent — and that those patients who got the extra care were no better off.” [Margot Sanger-Katz, New York Times]
- Cato Policy Analysis and podcasts (with Caleb Brown) by Terence Kealey: “The Feds’ Demonization of Dietary Fat” and “Why Does the Federal Government Issue Damaging Dietary Guidelines?” Related: Britain’s “food supply is being taxed, regulated and reformulated – on the pretext of a lie” [Christopher Snowdon, Spectator (U.K.)]
- New Jersey, a key state because of its volume of pharmaceutical liability litigation, joins national trend by adopting Daubert standard on expert evidence [Colleen O’Dea/N.J. Spotlight, Beck, John O’Brien/Legal NewsLine]
- “Criminal prosecution for violating HIPAA: an emerging threat to health care professionals” [Anne M. Murphy, Laura B. Angelini, and Jared Shwartz, STAT]
- Do-it-yourself workarounds for obtaining compounds blocked or restricted by FDA/pharma regulation, albeit entangled with IP issues. With bonus code-as-speech angle [Daniel Oberhaus, Vice Motherboard]
- “Hotels do want to tell you the real price. Until hospitals do too, they will find their way around disclosure regulations” [John Cochrane; related Cochrane on lack of price competition among air ambulances]
“Patients sitting in emergency rooms, at chiropractors’ offices and at pain clinics in the Philadelphia area may start noticing on their phones the kind of messages typically seen along highway billboards and public transit: personal injury law firms looking for business by casting mobile online ads at patients. The potentially creepy part? They’re only getting fed the ad because somebody knows they are in an emergency room.” [Bobby Allyn, NPR]
- Prisoners die of drug overdoses at a high rate in their first week after release. That’s in part a prohibition-related problem [Jeffrey Miron, Cato]
- “Drug testing kits can detect the presence of fentanyl and other contaminants — but in many places, including Illinois, they are classified as illegal drug paraphernalia.” [Steve Chapman]
- “Hospitalized Patients Are Civilian Casualties in the Government’s War on Opioids” [Jeffrey A. Singer, Cato, more]
- Texas: “Opioid lawyers pumped $110K into LaHood’s campaign after Bexar County DA hired them” [David Yates, Southeast Texas Record] “State senator working with Watts on home turf opioid lawsuit, lawyers billing Hidalgo County $3,800 an hour” [SE Texas Record]
- “Cities Vs. States: A Looming Battle For Control Of High-Stakes Opioid Litigation” [Daniel Fisher on Tennessee AG’s intervention]
- All 50 states have now adopted prescription drug monitoring programs, but do they work as intended? [Jeffrey Singer, Jacob Sullum]
The Equal Employment Opportunity Commission has announced that Mission Hospital in Asheville, N.C. will pay $89,000 for failing to accommodate employees “who declined flu vaccinations based on their religious beliefs.” [EEOC press release] Mission had in fact agreed to exempt employees from the flu shot based on religious objections, but required that they declare their intention ahead of time. And that turned out to be not accommodating enough, since not requiring that extent of advance notice would not in the EEOC’s view have posed an undue hardship on the employer — hence the expensive lesson.
At our religious discrimination tag can be found cases of employees who claimed a Title VII religious discrimination right not to serve alcoholic drinks as part of the duties of a flight attendant, not to haul beer as part of a job as a trucker, not to participate in an employer’s hand-scanner system for fear that it was connected to the Biblical “Mark of the Beast,” and to take prayer breaks in groups as large as 11 at an employer that did not think it could spare that many workers off the floor at the same time.
Under federal law enacted in 1972, employers regularly come under legal constraint to grant such accommodations to workers of many different religious sects. Although from much of the current debate one might imagine that liberals were historically skeptical of accommodation requirements, the actual history is more complicated. As I wrote a while back, “Surprisingly or otherwise, the pressure for federal law to become more indulgent toward private employees’ demands for religious accommodation [has] come both from liberal lawmakers like John Kerry and Hillary Clinton and from conservatives like Rick Santorum and Bobby Jindal.”
Under the elastic “undue hardship” standard, employers may face much uncertainty as to how much disruption of their business they must put up with in the name of accommodation. The flu-shot example suggests that risks to co-workers, customers, and the general public might sometimes enter the calculus as well — an expensive guessing game at best.
P.S. I’ve got a post at Cato making a related point: is it really libertarians who should catch flak for being too indulgent toward persons who want to be excused from vaccination?