In 1973 the Supreme Court of the United States established that women have a constitutionally protected right to choose whether to terminate their pregnancies. The right, however, is not absolute. It must be weighed against competing State interests. As the title of Dov Fox’s excellent essay points out, one of the primary competing interests asserted in Roe was The State’s Interest in Potential Life. But the Roe Court determined that this interest in potential life alone was insufficient to justify regulation of the procedure pre-viability. Then, 17 years later, the Court stated in Casey that Roe’s framework “undervalue[d] the State’s interest in potential life,” and instead of just discussing potential life, the Court also referenced the State’s “legitimate interest from the outset of pregnancy in protecting…the life of the fetus that may become a child.”

Used appropriately, reliance on science distinguishes public health from policymaking driven more by theory and opinion and enhances trust in public health interventions. Evidence-based vaccine policymaking aims to control communicable disease by urging decision makers to base policies on the best available evidence rather than politics or personal views. The results of this approach, such as smallpox eradication, have been dramatic. Historically, mandatory childhood vaccination has been perhaps the most successful evidence-based tool in combating many epidemics. Philosophically, vaccination mandates correspond to the legal system’s dual role in codifying what society deems undesirable behavior (non-vaccination) and declaring beneficial social norms and values consistent with understandings of the social contract. Despite their effectiveness and philosophical grounding, vaccination mandates present serious legal and ethical questions. Public health policymakers have a continuing responsibility to rely on evidence not only as a basis for generating policy, but also for evaluating and improving elements of its legal design.

Of the many global health challenges facing the world today, only a small number require global collective action. Most health challenges can be fully addressed through action at local, regional or national levels.

What kind of actions must be taken to address the global threat of antibiotic resistance (ABR)? What legal, political and economic tools might be needed to achieve this level of action?

In March 2015 the Dag Hammarskjöld Foundation convened a workshop in Uppsala, Sweden to address these questions in partnership with the Global Strategy Lab, the Journal of Law, Medicine & Ethics (JLME), the Norwegian Institute of Public Health, and ReAct — Action on Antibiotic Resistance. Eleven concise articles were commissioned to explore whether ABR depended on global collective action, and if so, what tools could help states and non-state actors to achieve it.

In an increasingly interconnected global community, severe disasters or disease outbreaks in one country or region may rapidly impact global health security. As seen during the responses to the earthquakes in Haiti and Japan, Typhoon Haiyan in the Philippines, and the current Ebola outbreak in West Africa, local response capacities can be rapidly overwhelmed and international assistance may be necessary to support the affected region to respond and recover and to protect other countries from the spread of disease. For example, President Obama stated on September 16, 2014, that “if the [Ebola] outbreak is not stopped now, we could be looking at hundreds of thousands of people infected, with profound political and economic and security implications for all of us…. [T]his…is not just a threat to regional security — it’s a potential threat to global security if these countries break down…. And that’s why…I directed my team to make this a national security priority.”

In July 2013, parents in Ohio objected to their 21-year-old son becoming an organ donor. Elijah Smith was involved in an accident and pronounced dead using neurological criteria. The organ procurement organization (OPO) went to court and argued that because the young man was brain dead and because his driver's license indicated that he wished to be a donor, the court should allow them to use his organs. The mother argued that her son did not understand what he was signing when he signed his license and that his signature did not reflect an informed decision. The court disagreed with her, saying that he had indicated a wish to donate his organs and that no one but Elijah could revoke that wish. His organs were removed.

Elijah's mother suspected that he did not understand what he was signing. She might have been right, given what we know about the process for obtaining permission for organ donation and the limited public understanding of brain death.

Consulting relationships between medical school faculty and the biopharmaceutical and medical device industries offer the potential to advance research and promote the translation of academic discoveries into technologies that can benefit the health of individuals and populations. Such relationships are common, and studies suggest that faculty with industry relationships are more productive than their peers without such relationships. These benefits notwithstanding, numerous academic studies, government hearings, and litigation have called attention to the potential risks associated with these relationships.

Consulting includes a broad range of activities in which a faculty member provides advice or services to a company related to his/her area of professional expertise, typically in exchange for payment. Many universities permit faculty members to devote a portion of their faculty time to consulting (e.g., one business day per week), and faculty members are typically paid directly by the company, rather than through the university.

Technological innovation has led to important advancements in medical care. Nonetheless, patients continue to receive many health services for which the evidence regarding whether the service is effective is inadequate. Recognizing the need for robust evidence to support clinical and health policy decision-making, increasing attention has focused on comparative effectiveness research (CER). To support such efforts and to underscore the public's interest in having such evidence, the federal government has recently devoted substantial resources to support CER.

CER has been defined as “the conduct and synthesis of research comparing the benefits and harms of different interventions and strategies to prevent, diagnose, treat and monitor health conditions in “real world” settings.” Understanding how different interventions work in the real world generally requires that CER studies be closely integrated with clinical practice. Further, although some CER questions can be answered with observational studies, generating robust evidence will, at times, require randomized controlled trials (RCTs).

Assisted reproductive technology (ART) is a multibillion dollar market in the United States (U.S.), generating a continual demand for oocyte donors whose gametes contributed to 12.6% of all ART cycles in 2012. Oocyte donation is a variant of in vitro fertilization (IVF) that is typically used when an intended mother cannot produce healthy oocytes of her own and instead uses oocytes provided by a third party in an attempt to produce one or more children. When oocyte donation was first developed, oocyte donors were selected among family and friend groups but, increasingly, active solicitation of anonymous donors and brokering the relationship between donor and recipient has become part of the services offered by fertility clinics. In addition, recipients may choose to work with an independent donor agency to find a suitable donor before completing the IVF procedure at a fertility clinic.