David Orentlicher | University of Nevada, Las Vegas (original) (raw)

Papers by David Orentlicher

UC Irvine law review, 2018

While questions of law, religion, and health care have engaged scholars, policymakers, and the ge... more While questions of law, religion, and health care have engaged scholars, policymakers, and the general public for decades, society continues to struggle over the conflict between patient access to care and conscience-based objections to the provision of care. To what extent can physicians, religiously-affiliated hospitals, or employers deny patients access to abortion, contraception, or end-of-life care that will hasten death? What about denying fertility services to a same-sex couple? Or when can parents refuse medical care for their children because of religious belief? In this paper, I aim to articulate an overarching framework that can address the balance between access to care and conscience-based objections to care in the full range of situations in which the conflict between access and religious conscience arises. In considering the different ways in which the conflict arises, I identify a key principle: For issues in which conscience is important, religious objections to pro...

JAMA: The Journal of the American Medical Association, 1991

Much has been written about whether end-of-life law should change and what that law should be. Ho... more Much has been written about whether end-of-life law should change and what that law should be. However, the barriers and facilitators of such changes – law reform perspectives – have been virtually ignored. Why do so many attempts to change the law fail but others are successful? International Perspectives on End-of-Life Law Reform aims to address this question by drawing on ten case studies of end-of-life law reform from the United Kingdom, the United States, Canada, the Netherlands, Belgium and Australia. Written by leading end-of-life scholars, the book's chapters blend perspectives from law, medicine, bioethics and sociology to examine sustained reform efforts to permit assisted dying and change the law about withholding and withdrawing life-sustaining treatment. Findings from this book shed light not only on changing end-of-life law, but provide insight more generally into how and why law reform succeeds in complex and controversial social policy areas.

Enactment of the Patient Protection and Affordable Care Act (ACA) in 2010 marked the most importa... more Enactment of the Patient Protection and Affordable Care Act (ACA) in 2010 marked the most important accomplishment in U.S. health care reform in decades. Not since Medicare and Medicaid were passed in 1965 have so many Americans been given access to insurance coverage for their health care. Though the goal of universal health care was not achieved, ACA brought coverage to millions of uninsured Americans and provided assurance to the already-insured that if they lost their insurance through job loss or job change, they could turn to an expanded Medicaid program or a government-subsidized insurance policy for affordable coverage. But while ACA has had a major impact on the U.S. health care system, its promise has been limited by its design. Rather than replacing the U.S. system with a more effective, less costly, and politically sustainable model, lawmakers decided to build on top of an inefficient, expensive, and politically insecure, existing model. A health care system that rested ...

The legislation "puts into place virtually every cost-control reform proposed by physicians, econ... more The legislation "puts into place virtually every cost-control reform proposed by physicians, economists, and health policy experts."-Peter Orszag and Ezekiel Emanuel' "The job of figuring how to cover uninsured people used up all the political oxygen that was available. They didn't have the energy for costs."-Alan Sager 2 For decades, the U.S. health care system has grappled with two key problemsinadequate access to coverage and increasingly unaffordable health care costs. Paradoxically, the U.S. spends far more of its gross domestic product (GDP) on health care than do other economically-advanced democracies, yet provides health care insurance to fewer of its citizens.' During the debate that led to the enactment of the Patient Protection and Affordable Care Act, public officials recognized the need to address the problems of both access and cost, but in the end, the Act does far more about increasing access than it does about cutting

The Journal of Law, Medicine & Ethics, 2018

The medicalization model of poverty leads us to devote considerable resources to treating the hea... more The medicalization model of poverty leads us to devote considerable resources to treating the healthcare problems caused by poverty while neglecting the root cause of those problems — the poverty itself. Treating symptoms rather than causes is far less effective than treating causes. When correctly understood, poverty is a major public health problem that needs to be addressed directly with effective anti-poverty programs. Only then can we properly serve the healthcare needs of the poor.

Journal of the American Geriatrics Society, 1998

American journal of law & medicine, Jan 8, 1990

Specialty law digest. Health care (Monthly), 1990

JAMA: The Journal of the American Medical Association, 1992

According to U.S. Department of Education statistics, during the 1999-2000 school year, 342,048 c... more According to U.S. Department of Education statistics, during the 1999-2000 school year, 342,048 children, or almost one percent of the total public school population, were hit as a form of disciplinary action at school. 1 The United States is one of only three industrialized nations that still permit the use of corporal punishment in its public schools. Schools are the only American institution Where this practice is allowed. It has been banned in our correctional institutions, military settings and psychiatric facilities. The United Nations Convention on the Rights of the Child has called for an end to corporal punishment worldwide. 2 More than 40 national organizations are in favor of banning corporal punishment in the United States including the

Hastings Center Report, Nov 1, 2011

We would like to thank all manuscript reviewers for their thoughtful and thorough advice to the e... more We would like to thank all manuscript reviewers for their thoughtful and thorough advice to the editors and to authors over the previous year. Manuscripts are screened editorially and blind-reviewed by research scholars at The Hastings Center, as well as by outside readers. In addition to the reviewers listed below, we would like to thank our colleagues at The Hastings Center for their generous help with these reviews. We apologize in advance if we've missed anyone in the following list. ... Hastings Center Report 41.6 (2011) Project MUSE. Web. ...

Indiana law review, 1999

Harvard Law School. I am grateful for the comments of Judy Failer and the research assistance of ... more Harvard Law School. I am grateful for the comments of Judy Failer and the research assistance of Will Binder.

Brooklyn law review, 2000

As the gap between the need for organ transplants and the supply of organs has increasingly widen... more As the gap between the need for organ transplants and the supply of organs has increasingly widened, many scholars have urged the adoption of presumed consent to organ donation. Under a presumed consent regime, the state would assume that a person agreed to organ donation after death unless the person (or a family member) had lodged an objection to posthumous organ donation. Such an assumption would reverse existing law - currently, it is generally the case that organ donation requires actual consent from the donor or a family member of the donor. For some forty years in a little-known experiment, the United States tried presumed consent on a limited basis. In many states, when dead persons came under the custody of coroners or medical examiners, those officials could authorize cornea donation - or even organ donation - in the absence of a known objection to the donation by the decedent or a family member. However, in 2006, the Revised Uniform Anatomical Gift Act recommended against...

When the U.S. Supreme Court issued its landmark “right to die” decision in Cruzan v. Director, Mi... more When the U.S. Supreme Court issued its landmark “right to die” decision in Cruzan v. Director, Missouri Department of Health thirty years ago, the dissenting Justices and many observers criticized the Court for rejecting a right of Nancy Cruzan’s parents to refuse medical care on her behalf. Ms. Cruzan had not written a living will or a durable power of attorney, nor did it appear that she had left clear oral instructions about her wishes. But she did have loving parents who were dedicated to doing what was best for her. Nevertheless, according to the Cruzan Court, “If the State were required by the United States Constitution to repose a right of ‘substituted judgment’ with anyone, the Cruzans would surely qualify. But we do not think the Due Process Clause requires the State to repose judgment on these matters with anyone but the patient herself.” This article argues that the Cruzan Court neglected an important justification for the right of patients to have medical decisions made ...

of the future, especially if Medicare plays a larger role in insurance. Surprisingly, in the poli... more of the future, especially if Medicare plays a larger role in insurance. Surprisingly, in the political maneuvering to date, the hospitals and physician organizations have decided not to ally themselves with the insurers. Indeed, the 2 groups played off each other last year in the debate over Medicare Advantage funding. 14 Conclusion Reform proposals based on twinning Medicare expansions with connector-based oversight of the individual and smallgroup markets suggest an incremental approach to reform that does not abandon market competition, and hence may be more politically viable than fundamental reform has been in the past. But the reform's passage is not imminent and indeed will be challenging. Because the goal is to cover more individuals while spending less, reform will involve losses for some, sparking resistance. 15 Moreover, many who share the goal of universal access are nonetheless committed to market efficiencies and innovations and will fear these will be lost in a government-dominated approach. This philosophical/political difference will be the critical basis for debate even for an apparently incremental reform plan.