Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations

Ogbu-Nwobodo, L., Shim, R.S., et al.

October 27, 2022

N Engl J Med 2022; 387:1613-1617

DOI: 10.1056/NEJMms2211124

Here is an excerpt:

Abortion and Mental Health

To begin with, abortion does not lead to mental health harm — a fact that has been established by data and recognized by the National Academies of Sciences, Engineering, and Medicine and the American Psychological Association The Turnaway Study, a longitudinal study that compared mental health outcomes among people who obtained an abortion with those among people denied abortion care, found that abortion denial was associated with initially higher levels of stress, anxiety, and low self-esteem than was obtaining of wanted abortion care. People who had an abortion did not have an increased risk of any mental health disorder, including depression, anxiety, suicidal ideation, post-traumatic stress disorder, or substance use disorders. Whether people obtained or were denied an abortion, those at greatest risk for adverse psychological outcomes after seeking an abortion were those with a history of mental health conditions or of child abuse or neglect and those who perceived abortion stigma (i.e., they felt others would look down on them for seeking an abortion). Furthermore, people who are highly oppressed and marginalized by society are more vulnerable to psychological distress.

There is evidence that people seeking abortion have poorer baseline mental health, on average, than people who are not seeking an abortion. However, this poorer mental health results in part from structural inequities that disproportionately expose some populations to poverty, trauma, adverse childhood experiences (including physical and sexual abuse), and intimate partner violence. People seek abortion for many reasons, including (but not limited to) timing issues, the need to focus on their other children, concern for their own physical or mental health, the desire to avoid exposing a child to a violent or abusive partner, and the lack of financial security to raise a child.

In addition, for people with a history of mental illness, pregnancy and the postpartum period are a time of high risk, with increased rates of recurrence of psychiatric symptoms and of adverse pregnancy and birth outcomes. Because of stigma and discrimination, birthing or pregnant people with serious mental illnesses or substance use disorders are more likely to be counseled by health professionals to avoid or terminate pregnancies, as highlighted by a small study of women with bipolar disorder. One study found that among women with mental health conditions, the rate of readmission to a psychiatric hospital was not elevated around the time of abortion, but there was an increased rate of hospitalization in psychiatric facilities at the time of childbirth. Data also indicate that for people with preexisting mental health conditions, mental health outcomes are poor whether they obtain an abortion or give birth.

The Role of Structural Racism

Structural racism — defined as ongoing interactions between macro-level systems and institutions that constrain the resources, opportunities, and power of marginalized racial and ethnic groups — is widely considered a fundamental cause of poor health and racial inequities, including adverse maternal health outcomes. Structural racism ensures the inequitable distribution of a broad range of health-promoting resources and opportunities that unfairly advantage White people and unfairly disadvantage historically marginalized racial and ethnic groups (e.g., education, paid leave from work, access to high-quality health care, safe neighborhoods, and affordable housing). In addition, structural racism is responsible for inequities and poor mental health outcomes among many diverse populations.

The information is here.

Frequently asked questions about abortion laws and psychology practice

American Psychological Association

Updated 1 SEPT 2022

Since the U.S. Supreme Court issued its decision to overturn Roe v. Wade, many states have proposed, enacted, or resurrected a range of laws to either prohibit, significantly restrict, or protect reproductive rights and health care. Currently, the main targets of these laws appear to be medical providers who provide abortions or individuals seeking to obtain an abortion.

APA and APA Services Inc. are striving to provide psychologists with accurate and adequate information about the potential impact on them of reproductive health care laws. Since psychologists have embraced telehealth and many use technology to provide services across state lines, it’s important to be familiar with the laws governing the jurisdiction(s) where you are licensed as well as the jurisdiction(s) where your patients live.

In addition to this FAQ and other APA resources, psychologists will want to be familiar with guidance issued by federal and state agencies, their state licensing board(s), and their liability carrier. Some frequently asked questions follow.

While the situation is dynamic, good psychological practice remains unchanged. The changing landscape in states regarding access to reproductive health care does not change the fundamental approach to psychological care. Psychologists should continue to prioritize the welfare of their patients, protect confidentiality, and ensure their patients’ safety.

Practicing in states with changing abortion laws

Am I practicing in a state where abortion is, or is soon to be, illegal under all or certain circumstances?

The Supreme Court’s decision to overturn Roe v. Wade has put the regulation of abortion in the hands of states. In anticipation of the ruling, 13 states enacted “trigger laws,” designed to ban or restrict abortion upon the Supreme Court’s reversal of Roe v. Wade. Not all trigger laws immediately kicked in, and some that did were immediately challenged in court, delaying their enforcement.

Staying current on laws affecting the states where you practice is important. For a list of existing abortion bans and restrictions within each state, the Center for Reproductive Rights has provided a map that is updated in real time. The Guttmacher Institute, a well-respected research group that collects information on abortion laws across the United States, also tracks current state abortion-related laws.

The information is here.

9th Circuit Upholds Ban on Conversion Therapy for Minors in First Amendment Challenge

Debra Cassens Weiss

ABA Journal

Originally published 7 SEPT 22

Washington state’s ban on conversion therapy for minors does not violate the First or 14th Amendments, a federal appeals court ruled on Tuesday.

The San Francisco-based 9th U.S. Circuit Court of Appeals upheld the law, which subjects licensed therapists to discipline if they practice therapy that seeks to change the sexual orientation or gender identity of a person under age 18.

The appeals court said the law was intended to prevent psychological harm to LGBTQ minors subjected to conversion therapy, including depression, self-stigma and emotional distress.

The appeals court ruled against Christian marriage and family counselor Brian Tingley, who claimed the ban on conversion therapy for minors violated his free speech and free exercise rights under the First Amendment. He also claimed the Washington state law was unconstitutionally vague under the 14th Amendment.

The appeals court noted its 2014 decision, Pickup v. Brown, upheld a nearly identical law in California. Tingley had argued, however, that the U.S. Supreme Court abrogated the Pickup decision in 2018 when it ruled for anti-abortion crisis pregnancy centers challenging California’s required notice on the availability of state-subsidized abortions.

The Supreme Court held the abortion-notice law was a content-based restriction that was likely unconstitutional. The case was National Institute of Family & Life Advocates v. Becerra.

The info is here.

Professional Civil Disobedience — Medical-Society Responsibilities after Dobbs

Matthew K. Wynia

The New England Journal of Medicine

September 15, 2022, 387:959-961

Here are two excerpts:

The AMA called Dobbs “an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient–physician relationship, and a brazen violation of patients’ rights to evidence-based reproductive health services.” The American Academy of Family Physicians wrote that the decision “negatively impacts our practices and our patients by undermining the patient–physician relationship and potentially criminalizing evidence-based medical care.” The American College of Physicians stated, “A patient’s decision about whether to continue a pregnancy should be a private decision made in consultation with a physician or other health care professional, without interference from the government.” And the CEO of the American College of Obstetricians and Gynecologists called Dobbs “tragic” for patients, “the boldest act of legislative interference that we have seen in this country,” and “an affront to all that drew my colleagues and me into medicine.”

Medical organizations are rarely so united. Yet even many physicians who oppose abortion recognize that medically nuanced decisions are best left in the hands of individual patients and their physicians — not state lawmakers. Abortion bans are already pushing physicians in some states to wait until patients become critically ill before intervening in cases of ectopic pregnancy or septic miscarriage, among other problems.

Beyond issuing strongly worded statements, what actions should medical organizations take in the face of laws that threaten patients’ well-being? Should they support establishing committees to decide when a pregnant person’s life is in sufficient danger to warrant an abortion? Should they advocate for allowing patients to travel elsewhere for care? Or should they encourage their members to provide evidence-based medical care, even if doing so means accepting — en masse — fines, suspensions of licensure, and potential imprisonment? How long could a dangerous state law survive if the medical profession, as a whole, refused to be intimidated into harming patients, even if such a refusal meant that many physicians might go to jail?

(cut)

Proposing professional civil disobedience of state laws prohibiting abortion might seem naive. Historically, physicians have rarely been radical, and most have conformed with bad laws and policies, even horrific ones — such as those authorizing forced-sterilization programs in the United States and Nazi Germany, the use of psychiatric hospitals as political prisons in the Soviet Union, and police brutality under apartheid in South Africa. Too often, organized medicine has failed to fulfill its duty to protect patients when doing so required acting against state authority. Although there are many examples of courageous individual physicians defying unjust laws or regulations, examples of open support for these physicians by their professional associations — such as the AMA’s offer to support physicians who refused to be involved in “enhanced” interrogations (i.e., torture) during the Iraq War — are uncommon. And profession-wide civil disobedience — such as Dutch physicians choosing to collectively turn in their licenses rather than practice under Nazi rule — is rare.

The info is here.

Seven years of sex abuse: How Mormon officials let it happen

Michael Rezendes

The Associated Press

Originally posted 4 AUG 22

Here is an excerpt:

When it comes to child sexual abuse, the Mormon church says “the first responsibility of the church in abuse cases is to help those who have been abused and protect those who may be vulnerable to future abuse,” according to its 2010 handbook for church leaders. The handbook also says, “Abuse cannot be tolerated in any form.”

But church officials, from the bishops in the Bisbee ward to officials in Salt Lake City, tolerated abuse in the Adams family for years.

“They just let it keep happening,” said MJ, in her AP interview. “They just said, ‘Hey, let’s excommunicate her father.’ It didn’t stop. ‘Let’s have them do therapy.’ It didn’t stop. ‘Hey, let’s forgive and forget and all this will go away.’ It didn’t go away.”

A similar dynamic played out in West Virginia, where church leaders were accused of covering up the crimes committed by a young abuser from a prominent Mormon family even after he’d been convicted on child sex abuse charges in Utah. The abuser, Michael Jensen, today is serving a 35- to 75-year prison sentence for abusing two children in West Virginia. Their family, along with others, sued the church and settled out of court for an undisclosed sum.

“Child abuse festers and grows in secrecy,” said Lynne Cadigan, a lawyer for the Adams children who filed suit. “That is why the mandatory reporting came into effect. It’s the most important thing in the world to immediately report to the police.”

The lawsuit filed by the three Adams children accuses The Church of Jesus Christ of Latter-day Saints and several members, including Bishops Herrod and Mauzy, of negligence and conspiring to cover up child sex abuse to avoid “costly lawsuits” and protect the reputation of the church, which relies on proselytizing and tithing to attract new members and raise money. In 2020, the church claimed approximately 16 million members worldwide, most of them living outside the United States.

“The failure to prevent or report abuse was part of the policy of the defendants, which was to block public disclosure to avoid scandals, to avoid the disclosure of their tolerance of child sexual molestation and assault, to preserve a false appearance of propriety, and to avoid investigation and action by public authority, including law enforcement,” the suit alleges. “Plaintiffs are informed and believe that such actions were motivated by a desire to protect the reputation of the defendants.”

Very few of the scores of lawsuits against The Church of Jesus Christ of Latter-day Saints mention the help line, in part because details of its operations have been a closely guarded secret. The documents in the sealed court records show how it works.

“The help line is certainly there to help — to help the church keep its secrets and to cover up abuse,” said Craig Vernon, an Idaho attorney who has filed several sex abuse lawsuits against the church.

Vernon, a former member, routinely demands that the church require bishops to report sex abuse to police or state authorities rather than the help line.

The sealed records say calls to the help line are answered by social workers or professional counselors who determine whether the information they receive is serious enough to be referred to an attorney with Kirton McConkie, a Salt Lake City firm that represents the church.

The info is here.

Can you really do more than what duty requires?

Roger Crisp

The New Statesman

Originally posted 8 JUN 22

Here is an excerpt:

Since supererogation involves the paradox of accepting moral duties that do not require one to do what is morally best, why do we continue to find the idea so compelling?

One reason might be that we think that without supererogation the dictates of morality would be unacceptably demanding. If each of us has a genuine duty to benefit others as much as we can, then, given the vast number of individuals in serious need, most of the better-off would be required to make major sacrifices to live a virtuous life. Supererogation puts a limit on such requirements.

The idea that we can go beyond our duty in a praiseworthy way may be attractive, then, because we need to balance morality with self-interest. Here we ought to remember that each of us reasonably attaches a certain amount of importance to how our own lives go. So, each of us has reason to advance our own happiness independent of our duty to benefit others (which is why we describe some cases of helping others as a “sacrifice”). The need to strike a balance between our moral duties and our self-interest may explain why the notion of supererogation is so appealing.

But this doesn’t get us out of Sidgwick’s paradox: anyone who knows the morally best thing to do, but consciously decides not to do it, seems morally “lazy”.

Given the current state of the world, this means that morality is much more demanding than we typically think. Many of us should be doing a great deal more to alleviate the suffering of others, and doing this may cost us not only resources, but to some extent our own happiness or well-being.

In making donations to help strangers, we must ask when our reasons to keeping resources for ourselves are outweighed by reasons of beneficence. Under a more demanding view of morality, I should donate the money I could use to upgrade my TV to a charity that can save someone’s sight. Similarly, if the billionaire class could eradicate world poverty by donating 50 per cent of their wealth to development agencies, then they should do so immediately.

This may sound austere to our contemporary ears, but the Ancient Greeks and their philosophers thought morality could be rather demanding, and yet they never even considered the idea that duty was something you could go beyond. According to them, there are right things to do, and we should do them, making us virtuous and praiseworthy. And if we don’t, we are acting wrongly, we deserve blame, and we should feel guilty and ashamed.

It’s plausible to think that, once our health and wealth have reached certain thresholds, the things that really matter for our well-being – friendship, family, meaningful activities, and so on – are largely independent of our financial position. So, making much bigger sacrifices than we currently do may not be nearly as difficult or demanding as we tend to think.

The info is here.

Editor's note: For psychologists, supererogatory actions may include political advocacy for greater access to care, pro bono treatment for underserved populations, and volunteering on state and national association committees.

Justice Alito's bad theology: Abortion foes don't have "morality" on their side

E. M. Freese & A. T. Taylor

Salon.com

Originally posted 26 JUL 22

Here is an excerpt:

Morality has thus become the reigning justification for the state to infringe upon the liberty of female Americans and to subjugate their reproductive labor to its power. An interrogation of this morality, however, reveals that it is underpinned by a theology that both erases and assumes the subjugation of female gestational labor in procreation to patriarchy. We must shatter this male-dominant moral logic and foreground female personhood and agency in order for every American to be equally free.

According to Alito, moral concern for "an unborn human being" apparently exempts pregnant people from the right to "liberty" otherwise guaranteed by the 14th Amendment. In other words, the supposed immorality of abortion is weighty enough to restrict bodily autonomy for all pregnant people in this country and to terrorize potentially pregnant females more broadly. This logic implies that pregnant people also lack 13th Amendment protection from "involuntary servitude," contrary to the strong argument made by legal scholar Michele Goodwin in a recent New York Times op-ed. Consequently, the court has now granted permission to states to force pregnant people to gestate against their will.

To be clear, the 13th and 14th Amendments are specifically about bodily autonomy and freedom from forced labor. They were created after the Civil War in an attempt to end slavery for good, and forced reproduction was correctly understood as a dimension of slavery. But Justice Alito asserts that abortion morality puts pregnant bodies in a "different" category with fewer rights. What, exactly, is the logic here?

At its heart, the theological premise of the anti-abortion argument is that male fertilization essentially equals procreation of a "life" that has equal moral and legal standing to a pregnant person, prior to any female gestation. In effect, this argument holds that the enormous female gestation labor over time, which is literally fundamental to the procreation of a viable "new life," can be ignored as a necessary precursor to the very existence of that life. On a practical level, this amounts to claiming that a habitable house exists at the stage of an architectural drawing, prior to any material labor by the general contractor and the construction workers who literally build it.

Abortion opponents draw upon the biblical story of creation found in the book of Genesis (chapters 1-3) to ostensibly ground their theology in tradition. But Genesis narrates that multiple participants labor at God's direction to create various forms of life through a material process over time, which actually contradicts a theology claiming that male fertilization equals instant-procreation. The real political value is the story's presumption of a male God's dominance and appropriation of others' labor for "His" ends. Using this frame, abortion opponents insert a "sovereign" God into the wombs of pregnant people — exactly at the moment of male fertilization. From that point, the colonization of the female body and female labor becomes not only morally acceptable, but necessary.

The info is here.

Dangerous as the Plague

Samuel Huneke

The Baffler

Originally posted 23 JUN 22

Here is an excerpt:

There is not enough space here to enumerate all of the similarities and differences between National Socialism and today’s right, but the place of Christianity in each movement is instructive. The churches were always on tenuous terms at best with Hitler’s state. Many Nazi leaders were openly hostile to Christianity and to the “traditional” family. Homosexuality posed a threat to Nazism not in moral terms, but rather in social and political terms, threatening to undermine its homosocial order. In stark contrast, the American right today remains in thrall to white Christian nationalism, which openly seeks to impose its own version of morality on the nation. The threat queerness poses to this version of patriarchal Christianity, coupled with broader anxieties about loss of social status, is what appears to motivate the new right’s transphobia and homophobia.

The endurance of these tropes also highlights the limits of the professionalized LGBTQ political movement in this country, which has prioritized visibility and assimilation—eschewing more revolutionary strategies that would encompass the needs of the most marginalized. Groups like the Human Rights Campaign have been successful up to a point, but their strategies were always predicated on the notion that if queer people were visible and showed that they weren’t actually that different, prejudice would seep away. Because its aim was assimilation, this tactic fundamentally upheld the division between normal and abnormal on which animus rests. Instead of contesting that very division, it sought to put certain queer people on the “right” side of it. In this way, it also misunderstood hatred as a product of ignorance rather than a political strategy or an expression of sublimated anxieties.

Now animus against queer people—especially trans people—is back with a vengeance. From the conspiracy-addled world of QAnon, in which a shadowy cabal of pedophiles, juiced on the blood of children, runs the world, to the mendacity of trans-exclusionary radical feminists (or TERFs), a growing segment of the population seems willing to entertain the notion that lesbians, gay men, and trans people are “recruiting” children. The bestseller Irreversible Damage, published in 2020 and reaching audiences well beyond the fringe right, insisted that girls were being seduced by a “transgender craze” that it termed a “contagion.” Just before Pride month, U.S. Representative Marjorie Taylor Greene, who has embraced the rhetoric of “grooming,” predicted that in “four or five generations, no one will be straight anymore.”

The info is here.

Confidence in U.S. Supreme Court Sinks to Historic Low

Jeffrey Jones

Gallup.com

Originally posted 23 JUN 22

Story Highlights

• 25% of Americans have confidence in Supreme Court, down from 36% in 2021
• Current reading is five percentage points lower than prior record low
• Confidence is down among Democrats and independents this year

With the U.S. Supreme Court expected to overturn the 1973 Roe v. Wade decision before the end of its 2021-2022 term, Americans' confidence in the court has dropped sharply over the past year and reached a new low in Gallup's nearly 50-year trend. Twenty-five percent of U.S. adults say they have "a great deal" or "quite a lot" of confidence in the U.S. Supreme Court, down from 36% a year ago and five percentage points lower than the previous low recorded in 2014.

These results are based on a June 1-20 Gallup poll that included Gallup's annual update on confidence in U.S. institutions. The survey was completed before the end of the court's term and before it issued its major rulings for that term. Many institutions have suffered a decline in confidence this year, but the 11-point drop in confidence in the Supreme Court is roughly double what it is for most institutions that experienced a decline. Gallup will release the remainder of the confidence in institutions results in early July.

The Supreme Court is likely to issue a ruling in the Dobbs v. Jackson Women's Health Organization case before its summer recess. The decision will determine the constitutionality of a Mississippi law that would ban most abortions after 15 weeks of pregnancy. A leaked draft majority opinion in the case suggests that the high court will not only allow the Mississippi law to stand, but also overturn Roe v. Wade, the 1973 court ruling that prohibits restrictions on abortion during the first trimester of pregnancy. Americans oppose overturning Roe by a nearly 2-to-1 margin.

In September, Gallup found the Supreme Court's job approval rating at a new low and public trust in the judicial branch of the federal government down sharply. These changes occurred after the Supreme Court declined to block a Texas law banning most abortions after six weeks of pregnancy, among other controversial decisions at that time. Given these prior results, it is unclear if the drop in confidence in the Supreme Court measured in the current poll is related to the anticipated Dobbs decision or had occurred several months before the leak.

The info is here.

Thousands of Medical Professionals Urge Supreme Court To Uphold Roe: ‘Provide Patients With the Treatment They Need’

Phoebe Kolbert

Ms. Magazine

Originally posted 21 JUN 22

Any day now, the Supreme Court will issue its decision in Dobbs v. Jackson Women’s Health Organization, which many predict will overturn or severely gut Roe v. Wade. Since the start of the Dobbs v. Jackson hearings in December, medical professionals have warned of the drastic health impacts brought on by abortion bans. Now, over 2,500 healthcare professionals from all 50 states have signed a letter urging the Supreme Court to scrap their leaked Dobbs draft opinion and uphold Roe.  

Within 30 days of a decision to overturn Roe, at least 26 states will ban abortion. Clinics in remaining pro-abortion states are preparing for increased violence from anti-abortion extremists and an influx of out-of-state patients. The number of legal abortions performed nationwide is projected to fall by about 13 percent. Many abortion clinics in states with bans will be forced to close their doors, if they haven’t already. The loss of these clinics also comes with the loss of the other essential reproductive healthcare they provide, including STI screenings and treatment, birth control and cervical cancer screenings.

The letter, titled “Medical Professionals Urge Supreme Court to Uphold Roe v. Wade, Protect Abortion Access,” argues that decisions around pregnancy and abortion should be made by patients and their doctors, not the courts.

The info from Ms. Magazine is here.

Here is how the letter begins:

Medical Professionals Urge Supreme Court to Uphold Roe v. Wade, Protect Abortion Access

As physicians and health care professionals, we are gravely concerned that the U.S. Supreme Court appears prepared to end the constitutional right to an abortion. We urge the Supreme Court to to scrap their draft opinion, uphold the constitutional right to an abortion, and ensure that abortions remain legal nationwide, as allowed for in Roe v. Wade. In this moment of crisis, we want to make crystal clear the consequences to our patients’ health if they can no longer access abortions.

Abortions are safe, common and a critical part of health care and reproductive medicine. Medical professionals and medical associations agree, including the American Medical Association, the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, the American College of Nurse Midwives and many others.

Prohibiting access to safe and legal abortion has devastating implications for health care. Striking down Roe v. Wade would affect not just abortion access, but also maternal care as well as fertility treatments. Pregnancy changes a person’s physiology. These changes can potentially worsen existing diseases and medical conditions.

As physicians and medical professionals, we see the real-life consequences when an individual does not get the care that they know they need, including abortions. The woman who has suffered the violation and trauma of rape would be forced to carry a pregnancy.

Denying access to abortion from people who want one can adversely affect their health, safety and economic well-being, including delayed separation from a violent partner and increased likelihood of falling into poverty by four times. These outcomes can also have drastic impacts on their health.

The entire letter is here.

The death penalty: The past and uncertain future of executions in America

C. Geidner, J. Lambert & K. Philo

Grid News

Originally posted 28 APR 22

Overview

South Carolina may soon carry out the United States’ first executions by firing squad in more than a decade. State officials have said that they plan to execute Richard Moore and Brad Sigmon using guns, the first such use of a firing squad since Ronnie Gardner was shot to death by the state of Utah on June 18, 2010.

Last week, nine days before Moore was to be executed, South Carolina’s Supreme Court put the execution on hold, but there’s no way of knowing how long that will last. Days later, the court also put Sigmon’s execution — scheduled for May — on hold. Although the court did not explain its reasoning, both men have an ongoing challenge to the state’s execution protocol, including its planned use of a firing squad.

How did we get here?

More than 45 years after the Supreme Court allowed executions to resume in the United States after a four-year hiatus, America is in a monthlong period in which five states planned to carry out six executions — the most in several years.

The situation offers a window into changing attitudes toward the death penalty and the complex brew of factors that have made these executions harder to carry out but also harder to challenge in courts. And the individual stories behind some of these current cases serve as a reminder of the well-documented racial bias in the way death sentences are handed down.

The death penalty’s popularity with the public has diminished in recent decades, and the overall number of new death sentences and executions has dropped significantly.

That’s due in part to the increased difficulty of carrying out lethal injection executions after death penalty opponents made it substantially harder for states to obtain the necessary drugs. States responded in part by adopting untried drug combinations. A series of botched executions followed — including the longest execution in U.S. history, when Arizona spent nearly two hours trying to kill Joseph Wood by using 15 doses of its execution drugs on the man before he died.

During that same time, the Supreme Court has made it more difficult to challenge any method of execution, setting a high bar for a method to be disallowed and by requiring challengers to identify an alternative method of execution.

Robert Dunham, the executive director of the Death Penalty Information Center, a nonpartisan organization that maintains a comprehensive database of U.S. executions, told Grid that part of the current influx of execution dates is a result of most states halting executions during the first year of the pandemic, before a covid vaccine was available.

This past week, Texas carried out its first execution of the year when it executed 78-year-old Carl Buntion. Tennessee also had planned an execution for last week, but it was called off with an announcement that highlighted two key elements of the modern death penalty: secrecy and errors. Hours before the state was slated to execute Oscar Franklin Smith by lethal injection, Gov. Bill Lee (R), citing “an oversight in preparation for lethal injection,” announced a reprieve. The execution will not happen before June, but state officials have not yet said anything more about what led to the last-minute reprieve.

The info is here.

U.S. judge tosses $4.5 B deal shielding Sacklers from opioid lawsuits

Brendan Pierson & Mike Spector, Maria Chutchian

Reuters

Originally posted 16 DEC 21

A federal judge overturned a roughly $4.5 billion settlement that legally shielded members of the Sackler family who stand accused of helping fuel the U.S. opioid epidemic, a decision that threatened to upend the bankruptcy reorganization of their company, OxyContin maker Purdue Pharma LP.

U.S. District Judge Colleen McMahon said in a written opinion on Thursday the New York bankruptcy court that approved the settlement did not have authority to grant the Sacklers the legal protection from future opioid litigation that formed the linchpin of Purdue’s reorganization.

Purdue said it would appeal the decision.

"While the district court decision does not affect Purdue’s rock-solid operational stability or its ability to produce its many medications safely and effectively, it will delay, and perhaps end, the ability of creditors, communities, and individuals to receive billions in value to abate the opioid crisis," Purdue Chairman Steve Miller said in a statement.

The Sacklers had insisted on the legal shields, known as nondebtor releases because they protect parties that have not filed for bankruptcy themselves, in exchange for contributing $4.5 billion toward resolving widespread opioid litigation.

The Sacklers threatened to walk away from the settlement absent the guaranteed legal protections.

Representatives for the Sacklers did not immediately respond to a request for comment late on Thursday.

Attorney General Merrick Garland said in a statement he was pleased with the ruling.

"The bankruptcy court did not have the authority to deprive victims of the opioid crisis of their right to sue the Sackler family," Garland said.

The info is here.

Note: If you have not watched Dopesick on Hulu, please do.  Excellent portrayal of the level of harm and psychopathology with members of this family.

APF Gold Medal Award for Life Achievement in the Practice of Psychology: Samuel Knapp

American Psychologist, 76(5), 812–814. 

https://doi.org/10.1037/amp0000894

This award recognizes a distinguished career and enduring contribution to the practice of psychology. Samuel Knapp’s long, distinguished career has resulted in demonstrable effects and significant contributions to best practices in professionalism, ethics education, positive ethics, and legislative advocacy as Director of Professional Affairs for the Pennsylvania Psychological Association and as an ethics educator extraordinaire. Dr. Knapp’s work has modified the way psychologists think about professional ethics through education, from avoiding disciplinary consequences to promoting overarching ethical principles to achieve the highest standards of ethical behavior. His focus on respectful collaboration among psychologists promotes honesty through nonjudgmental conversations. His Ethics Educators Workshop and other continuing education programs have brought together psychology practitioners and faculty to focus deeply on ethics and resulted in the development of the APA Ethics Educators Award.

From the Biography section

Ethics education became especially important in Pennsylvania when the Pennsylvania State Board of Psychology mandated ethics as part of its continuing education requirement. But even before that, members of the PPA Ethics Committee and Board of Directors, saw ethics education as a vehicle to help psychologists to improve the quality of their services to their patients. Also, to the extent that ethics education can help promote good decision-making, it could also reduce the emotional burden that professional psychologists often feel when faced with difficult ethical situations. Often the continuing education programs were interactive with the secondary goals of helping psychologists to build contacts with each other and an opportunity for the presenters to promote authentic and compassion-driven approaches to teaching ethics. Yes, Sam and the other PPA Ethics educators, such as the PPA attorney Rachael Baturin, also taught the laws, ethics codes, and the risk management strategies. facts.  But these were only one component of PPA’s ethics education program. More important was the development of a cadre of psychologists/ethicists who taught most of these continuing education programs.

The full award is here.

Attorney General James and U.S. Department of Labor Deliver $14 Million to Consumers Who Were Denied Mental Health Care Coverage

Press Release

NY Attorney General

Posted 12 August 21

New York Attorney General Letitia James and the U.S. Department of Labor (USDOL) today announced landmark agreements with UnitedHealthcare (United), the nation’s largest health insurer, to resolve allegations that United unlawfully denied health care coverage for mental health and substance use disorder treatment for thousands of Americans. As a result of these agreements, United will pay approximately $14.3 million in restitution to consumers affected by the policies, including $9 million to more than 20,000 New Yorkers with behavioral health conditions who received denials or reductions in reimbursement. New York and federal law requires health insurance plans to cover mental health and substance use disorder treatment the same way they cover physical health treatment. The agreements — which resolve investigations and litigation — address United’s policies that illegally limited coverage of outpatient psychotherapy, hindering access to these vital services for hundreds of thousands of New Yorkers for whom United administers behavioral health benefits. In addition to the payment to impacted consumers, United will lift the barriers it imposed and pay more than $2 million in penalties, with $1.3 million going to New York state.  

“In the shadow of the most devastating year for overdose deaths and in the face of growing mental health concerns due to the pandemic, access to this care is more critical than ever before,” said Attorney General James. “United’s denial of these vital services was both unlawful and dangerous — putting millions in harm’s way during the darkest of times. There must be no barrier for New Yorkers seeking health care of any kind, which is why I will always fight to protect and expand it. I thank Secretary Walsh for his partnership on this important matter.” 

“Protecting access to mental health and substance use disorder treatment is a priority for the Department of Labor and something I believe in strongly as a person in long-term recovery,” said U.S. Secretary of Labor Marty Walsh. “This settlement provides compensation for many people who were denied full benefits and equitable treatment. We appreciate Attorney General James and her office for their partnership in investigating, identifying, and remedying these violations.” 

New York’s behavioral health parity law — originally enacted as “Timothy’s Law” in 2006 — and the federal Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) require insurance coverage for mental health and substance use disorder treatment to be no more restrictive than insurance coverage for physical health conditions. The agreements are the product of the first joint state-federal enforcement of these laws.  

The pressor is here.

New York City’s new sex work policy isn’t only about changing morals

Noah Feldman

Milford Daily News

Originally published 27 April 21

Here is an excerpt:

Sexual morality from the early modern period into recent decades tended to condemn the people — especially women — who accepted money in exchange for sexual services, depicting them as morally corrupt. Those who paid for sex — especially men — were often let off the hook by the same (hypocritical) standard. In this now out-moded worldview, taking money for sex amounted transformed a woman’s social status, while paying for sex had little or no effect on a man’s.

Today, we are increasingly willing to acknowledge that people who accept money for sex may often have had little or no choice in the decision. We recognize the realities of trafficking and substance dependence. We’re more aware of power disparities based on sex, race, gender identity and income. It has come to seem primitive to blame those who sell sex rather than those who purchase it.

To be sure, Manhattan — like Baltimore and Philadelphia, which have adopted similar policies — has not adopted the view promoted by some activists, namely that we should take morality out of the equation altogether and simply legalize and regulate all forms of sex work. The association between sex and morals remains as strong as ever in the new policy. But the moral calculus has changed.

On its own, however, this change in beliefs probably would not have sufficed to bring about a policy change. For that, what was required was a major reduction in the geographical prominence of sex work in Manhattan. Long-time residents of the island know this story well. As late as the 1980s, sex work, including prostitution, played a major role in the economy of the extended Times Square area. (The short-lived HBO series "The Deuce" sought to capture the atmosphere of this urban phenomenon in its late heyday.)

Over time, aggressive policing coupled with rezoning and extensive development moved sex work out of midtown. As Manhattan grew ever wealthier in the 1980s, and property values rose, sex work was also pushed out of other neighborhoods, like the Meatpacking District. Eventually, sex work in Manhattan reached the point where it is today: peripheral and relatively invisible rather than openly flourishing in particular neighborhoods.

The info is here.

Surprise: 56% of US Catholics Favor Legalized Abortion

Dalia Fahmy

Pew Research Center

Originally posted 20 Oct 20

Here are two excerpts:

1. More than half of U.S. Catholics (56%) said abortion should be legal in all or most cases, while roughly four-in-ten (42%) said it should be illegal in all or most cases, according to the 2019 Pew Research Center survey. Although most Catholics generally approve of legalized abortion, the vast majority favor at least some restrictions. For example, while roughly one-third of Catholics (35%) said abortion should be legal in most cases, only around one-fifth (21%) said it should be legal in all cases. By the same token, 28% of Catholics said abortion should be illegal in most cases, while half as many (14%) said it should be illegal in all cases.

Compared with other Christian groups analyzed in the data, Catholics were about as likely as White Protestants who are not evangelical (60%) and Black Protestants (64%) to support legal abortion, and much more likely than White evangelical Protestants (20%) to do so. Among Americans who are religiously unaffiliated – those who say they are atheist, agnostic or “nothing in particular” – the vast majority (83%) said abortion should be legal in all or most cases.

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6. Even though most Catholics said abortion should generally be legal, a majority also said abortion is morally wrong. In fact, the share who said that abortion is morally wrong (57%), according to data from a 2017 survey, and the share who said it should be legal (56%) are almost identical. Among adults in other religious groups, there was a wide range of opinions on this question: Almost two-thirds of Protestants (64%) said abortion is morally wrong, including 77% of those who identify with evangelical Protestant denominations. Among the religiously unaffiliated, the vast majority said abortion is morally acceptable (34%) or not a moral issue (42%).

The info is here.

Robot sex and consent: Is consent to sex between a robot and a human conceivable, possible, and desirable?

Frank, L., Nyholm, S. 

Artif Intell Law 25, 305–323 (2017).

https://doi.org/10.1007/s10506-017-9212-y

Abstract

The development of highly humanoid sex robots is on the technological horizon. If sex robots are integrated into the legal community as “electronic persons”, the issue of sexual consent arises, which is essential for legally and morally permissible sexual relations between human persons. This paper explores whether it is conceivable, possible, and desirable that humanoid robots should be designed such that they are capable of consenting to sex. We consider reasons for giving both “no” and “yes” answers to these three questions by examining the concept of consent in general, as well as critiques of its adequacy in the domain of sexual ethics; the relationship between consent and free will; and the relationship between consent and consciousness. Additionally we canvass the most influential existing literature on the ethics of sex with robots.

Here is an excerpt:

Here, we want to ask a similar question regarding how and whether sex robots should be brought into the legal community. Our overarching question is: is it conceivable, possible, and desirable to create autonomous and smart sex robots that are able to give (or withhold) consent to sex with a human person? For each of these three sub-questions (whether it is conceivable, possible, and desirable to create sex robots that can consent) we consider both “no” and “yes” answers. We are here mainly interested in exploring these questions in general terms and motivating further discussion. However, in discussing each of these sub-questions we will argue that, prima facie, the “yes” answers appear more convincing than the “no” answers—at least if the sex robots are of a highly sophisticated sort.Footnote4

The rest of our discussion divides into the following sections. We start by saying a little more about what we understand by a “sex robot”. We also say more about what consent is, and we review the small literature that is starting to emerge on our topic (Sect. 1). We then turn to the questions of whether it is conceivable, possible, and desirable to create sex robots capable of giving consent—and discuss “no” and “yes” answers to all of these questions. When we discuss the case for considering it desirable to require robotic consent to sex, we argue that there can be both non-instrumental and instrumental reasons in favor of such a requirement (Sects. 2–4). We conclude with a brief summary (Sect. 5).

The research is here.

Internal Google document reveals campaign against EU lawmakers

Javie Espinoza

ft.com

Originally published 28 OCT 20

Here is an excerpt:

The leak of the internal document lays bare the tactics that big tech companies employ behind the scenes to manipulate public discourse and influence lawmakers. The presentation is watermarked as “privileged and need-to-know” and “confidential and proprietary”.

The revelations are set to create new tensions between the EU and Google, which are already engaged in tough discussions about how the internet should be regulated. They are also likely to trigger further debate within Brussels, where regulators hold divergent positions on the possibility of breaking up big tech companies.

Margrethe Vestager, the EU’s executive vice-president in charge of competition and digital policy, on Tuesday argued to MEPs that structural separation of big tech is not “the right thing to do”. However, in a recent interview with the FT, Mr Breton accused such companies of being “too big to care”, and suggested that they should be broken up in extreme circumstances.

Among the other tactics outlined in the report were objectives to “undermine the idea DSA has no cost to Europeans” and “show how the DSA limits the potential of the internet . . . just as people need it the most”.

The campaign document also shows that Google will seek out “more allies” in its fight to influence the regulation debate in Brussels, including enlisting the help of Europe-based platforms such as Booking.com.

Booking.com told the FT: “We have no intention of co-operating with Google on upcoming EU platform regulation. Our interests are diametrically opposed.”

The info is here.

Do criminals freely decide to commit offences? How the courts decide?

J. Kennett & A. McCay

The Conversation

Originally published 15 OCT 20

Here is an excerpt:

Expert witnesses were reportedly divided on whether Gargasoulas had the capacity to properly participate in his trial, despite suffering from paranoid schizophrenia and delusions.

A psychiatrist for the defence said Gargasoulas’ delusional belief system “overwhelms him”; the psychiatrist expressed concern Gargasoulas was using the court process as a platform to voice his belief he is the messiah.

A second forensic psychiatrist agreed Gargasoulas was “not able to rationally enter a plea”.

However, a psychologist for the prosecution assessed him as fit and the prosecution argued there was evidence from recorded phone calls that he was capable of rational thought.

Notwithstanding the opinion of the majority of expert witnesses, the jury found Gargasoulas was fit to stand trial, and later he was convicted and sentenced to life imprisonment.

Working from media reports, it is difficult to be sure precisely what happened in court, and we cannot know why the jury favoured the evidence suggesting he was fit to stand trial. However, it is interesting to consider whether research into the psychology of blame and punishment can shed any light on their decision.

Questions of consequence

Some psychologists argue judgements of blame are not always based on a balanced assessment of free will or rational control, as the law presumes. Sometimes we decide how much control or freedom a person possessed based upon our automatic negative responses to harmful consequences.

As the psychologist Mark Alicke says:

we simply don’t want to excuse people who do horrible things, regardless of how disordered their cognitive states may be.

When a person has done something very bad, we are motivated to look for evidence that supports blaming them and to downplay evidence that might excuse them by showing that they lacked free will.

The info is here.

Artificial Intelligence and Legal Disruption: A New Model for Analysis

Hin-Yan Liu,  et .al (2020) 

Law, Innovation and Technology, 

12:2, 205-258

DOI: 10.1080/17579961.2020.1815402

Abstract

Artificial intelligence (AI) is increasingly expected to disrupt the ordinary functioning of society. From how we fight wars or govern society, to how we work and play, and from how we create to how we teach and learn, there is almost no field of human activity which is believed to be entirely immune from the impact of this emerging technology. This poses a multifaceted problem when it comes to designing and understanding regulatory responses to AI. This article aims to: (i) defend the need for a novel conceptual model for understanding the systemic legal disruption caused by new technologies such as AI; (ii) to situate this model in relation to preceding debates about the interaction of regulation with new technologies (particularly the ‘cyberlaw’ and ‘robolaw’ debates); and (iii) to set out a detailed model for understanding the legal disruption precipitated by AI, examining both pathways stemming from new affordances that can give rise to a regulatory ‘disruptive moment’, as well as the Legal Development, Displacement or Destruction that can ensue. The article proposes that this model of legal disruption can be broadly generalisable to understanding the legal effects and challenges of other emerging technologies.

From Concluding Thoughts

As artificial intelligence is often claimed to be an exponential technology, and law progresses incrementally in a linear fashion, there is bound to be a point at which the exponential take off crosses the straight line if these assumptions hold. Everything to the left of this intersection, where AI is below the line, is where hype about the technology does not quite live up to expectations and is generally disappointing in terms of functioning and capability. To the right of this intersection, however, the previously dull technology takes on a surprising and startling tone as it rapidly outpaces both predictions about its capacities and collective abilities to contextualise, accommodate or situate it. It is widely claimed that we are now nearing this intersection. If these claims hold up, the law is one of the institutions that stands to be shocked by the rapid progression and incorporation of AI into society. If this is right, then it is important to start projecting forward in an attempt to minimise the gap between exponential technologies and linear expectations. The legal disruption framework we have presented does exactly this. Furthermore, even if these claims turn out to be misguided, thinking though such transformations sheds different light upon the legal enterprise which hopes to illuminate the entire law.

A pdf of the article is here.