Public health issues

Public health issuesQuestion 1 Your state has seen falling vaccination rates and public health officials are very concerned about the risks out outbreaks of diseases like pertussis and measles. Currently your state law provides philosophical and religious exemption to vaccination. The exemptions are easy to obtain. With the support of the state Bureau of Health, several legislators are interested in introducing a bill this session t hat would eliminate all non- medical exemptions to vaccination as a means to protect the public?s health. They have asked you, as Assistant Attorney General , to provide a memo outlining any constitutional problems that might arise in changing the law in this way. Please answer the following questions as part of your memo: 1.What are the First Amendment implications in both retaining or eliminating the exemptions? 2. Are there any states that allow only medical exemptions ? What have the courts said about these laws? 3. Consider how Jacobson v Massachusetts or other caselaw apply to this situation? Question 2 Y ou have been appointed by the Governor to a Blue Ribbon Commission on Ethics and Human Genetic Technologies to study and report on genetics issues in state health policy, as well as related issues in genetic reproductive technologies. The Governor has asked the commission to explore the ethical issues and make recommendations on the major issue currently pending in the state legislature: Should parental informed consent be required for the state newborn screening program? Given that the legislature is expected to hold hearings within the month, each member of the Commission is asked to bring a statement of ethical concerns and a short position statement to the first commission meeting.You have consulted the director of the city?s department of maternal and child healt h and learned the following:The current state law authorizes the state department of health to establish, maintain and carry out a newborn screening program to detect hypothyroidism, PKU, hemoglobinopathy, congenital adrenal hyperplasia (CAH), and maple syrup urine disease; and additionally to provide each infant determined to be at risk with a screening test for sickle cell diseases. The state legislature currently determines which tests will be administered under the newborn screening program, with consultation from an advisory board of the state health department. The newborn screening requirements do not apply to infants whose parents object for religious or personal reasons. However, parental consent for newborn screening currently is not required, an d even though newborn testing may not be conducted over parental objection, virtually no parents raise the issue or object to testing. Currently only a few states require informed consent (that is, parental permission) for newborn screening, while about a dozen other states require that before testing is done, parents must be explicitly informed about newborn screening.Your health policy analyst provided the following background information about informed consent.Analysis of informed consent generally focuses on five elements: competence, disclosure, understanding, voluntariness, and consent. Ethicists have acknowledged that in some circumstances obtaining consent that satisfies these rigorous standards may be excessive or impossible to implement and that an alternate framework based on social or institutional rules of consent may be appropriate. We can evaluate institutional rules not only in terms of respect for autonomy but also in terms of the probable consequences of imposing burdensome requirements on institutions and on professionals, the effect of alternative consent requirements on efficiency and effectiveness in delivering health care and advancing science, and the effect of consent requirements on the welfare of patients. In some circumstances, patients do not expect to be asked for or to give full and rigorous informed consent, for example, as with a routine battery of blood tests; consent in these circumstances is presumed or implied because testing is routine.Further background: Warrants fo r Screening Programs: Public Heath, Legal and Ethical Frameworks Faden, Kass and Powers. Public Health Law and Ethics, pp 390 -393.Question 3Gun violence is a major public health problem in your community. A recent Supreme Court case, District of Columbia v. Heller (2008), summarized below, is one of few Supreme Court Second Amendment cases in recent years. Your city health department has asked you to review the Heller case and offer your opinion about the implications of this case for potential gun control efforts. Please answer the following questions:1. Why was the D.C. handgun ban found unconstitutional in this case? 2. Do you agree with the majority or dissent (s) in this case? Please base your position on the court?s interpretation of the law and constitution. This is not a political position paper. 3. Based on the decision in Heller, what kinds of gun control laws would be constitutional in your community.Summary of District of Columbia v. Heller , 554 U.S. 570, 128 S. Ct. 2783, 171 L. Ed. 2d 637 (2008) Handgun possession is banned under District of Columbia (D) law. The law prohibits the registration of handguns and makes it a crime to carry an unregistered firearm. Furthermore all lawfully owned firearms must be kept unloaded and dissembled or bound by a trigger lock unless they are being used for lawful recrea tional activities or located in a place of business. Dick Heller (P) is a special police officer in the District of Columbia. The District refused Heller?s application to register a handgun he wished to keep in his home. Heller filed this lawsuit in the Fe deral District Court for the District of Columbia on Second Amendment grounds. Heller sought an injunction against enforcement of the bar on handgun registration, the licensing requirement prohibiting the carrying of a firearm in the home without a license , and the trigger -lock requirement insofar as it prohibits the useof functional firearms within the home. The District Court dismissed Heller?s complaint. The Court of Appeals for the District of Columbia Circuit reversed and held that the total ban on handguns violated the individual right to possess firearms under the Second Amendment. The Supreme Court granted certiorari. Issue:What rights are protected by the Second Amendment? Holding and Rule (Scalia): The Second Amendment protects an individual right to possess a firearm unconnected with service in a militia, and to use that arm for traditionally lawful purposes, such as self -defense within the home. Text of the Second Amendment:A well regulated Militia, being necessary to the security of a free State , the right of the people to keep and bear Arms, shall not be infringed. Constitutional Construction (Scalia for the majority): The prefatory clause A well regulated Militia, being necessary to the security of a free State merely announces a purpose. It does not limit or expand the scope of the operative clause the right of the people to keep and bear Arms, shall not be infringed. The operative clause?s text and history demonstrate that it connotes an individual right to keep and bear arms. The militia consisted of all males capable of acting together for the common defense. The Antifederalists feared that the Federal Government would disarm the people in order to disable citizen militias, thereby enabling a politicized standing army or a select militia to rule. The Antifederalists therefore sought to preserve the citizens? militia by denying Congress the power to abridge the right of individuals to keep and bear arms. This interpretation is confirmed by analogous arms-bearing rights adopted in state constitutions immediately preceding and following the Second Amendment. Furthermore, the drafting history reveals three proposals that unequivocally referred to an individual right to bear arms. Interpretation of the Second Amendment by scholars, courts, and l egislators from ratification through the late 19th century also supports the Court?s interpretation. No precedent forecloses this interpretation. United States v. Miller limits the type of weapons to which the right applies to those in common use for lawful purposes, but does not limit the right to keep and bear arms to militia purposes. The Second Amendment right is not a right to keep and carry any weapon in any manner and for any purpose. The Court has upheld gun control legislation including prohibitions on concealed weapons and possession of firearms by felons and the mentally ill, laws forbidding the carrying of firearms in sensitive places such as schools and government buildings, and laws imposing conditions and qualifications on the commercial sale of arms. The historical tradition of prohibiting the carrying of dangerous and unusual weapons supports the holding in United States v. Miller that the sorts of weapons protected are those in common use at the time. The handgun ban and the trigger-lock requirement (as applied to self-defense) violate the Second Amendment. The total ban on handgun possession in the home amounts to a prohibition on an entire class of arms that Americans overwhelmingly choose for the lawful purpose of self -defense. This prohibition would fail constitutional musterunder any standard of scrutiny. Similarly, the requirement that any lawful firearm in the home be disassembled or bound by a trigg er lock makes it impossible for citizens to use arms for the core lawful purpose of self-defense and is therefore unconstitutional. The Court assumes that a license will satisfy Heller?s prayer for relief and therefore does not address the constitutionality of the licensing requirement. Assuming Heller is not otherwise disqualified from exercising Second Amendment rights, the District of Columbia must permit him to register his handgun and must issue him a license to carry it in the home. Disposition :Affirmed. Dissent (Stevens): The Second Amendment was adopted to protect the right of the people to maintain a well regulated militia. It was a response to the concern that the power of Congress to disarm the state militias and create a national standing army posed an intolerable threat to state sovereignty. Neither the text of the Second Amendment nor the arguments advanced by its proponents evidence the slightest interest by the Framers in limiting any legislature?s authority to regulate private civilian uses of firearms. There is no indication that the Framers intended to enshrine the common law right of self -defense in the Constitution. The view in Miller that theSecond Amendment protects the right to keep and bear arms for certain military pu rposes, but does not curtail the Legislature?s power to regulate the nonmilitary use and ownership of weapons, is both the most natural reading of the Amendment?s text and the interpretation most faithful to the history of its adoption. The majority fails to identify any new evidence supporting the view that the Amendment was intended to limit the power of Congress to regulate civilian uses of weapons. Dissent (Breyer) : The Second Amendment protects militia-related interests, not self -defense-related interests. Furthermore, the Amendment permitsgovernment to regulate the interests that it serves. Colonial history itself offers important examples of the kinds of gun regulation that citizens would then have thought compatible with the right to keep and bear arms, including substantial regulation of firearms in urban areas, and regulations that imposed limitations on the use of firearms for the protection of the home. Adoption of a true strict scrutiny standard for evaluating gun control regulations would be impossible and I would adopt an interest-balancing inquiry. In applying this kind of standard the Court normally defers to a legislature?s empirical judgment in matters where a legislature is likely to have greater expertise and greater institutional fact fi nding capacity.Question 4Please read Who Should Get Influenza Vaccine When Not All Can by Ezekiel Emanuel and Alan Wertheimer, Public Health Law and Ethics, pp. 433 -435. This article presents 3 ethical approaches for distributing scarce vaccines.Choose one of the approaches for vaccine allocation and support your choice using one of the ethical frameworks from Chap. 1, Case Studies in Public Health Ethics (Coughli n).PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET AN AMAZING DISCOUNT :

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