Browsing by Author "Mohapatra, Seema"

Now showing 1 - 10 of 23
  • Thumbnail Image
    Item
    Achieving Reproductive Justice in the International Surrogacy Market
    (2012) Mohapatra, Seema
    Men and women are increasingly seeking surrogacy arrangements outside of their home country, mainly due to legal restrictions or the high cost of surrogacy in their home countries. Global surrogacy raises numerous issues including the economic status of women involved in surrogacy arrangements, poverty, issues related to what motherhood means and how women from different ethnic, socioeconomic, class, and national backgrounds interact in the global surrogacy market. This essay briefly analyzes whether reproductive justice exists in the current international surrogacy market.
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    An ethics framework for consolidating and prioritizing COVID-19 clinical trials
    (Sage, 2021) Meyer, Michelle N.; Gelinas, Luke; Bierer, Barbara E.; Chandros Hull, Sara; Joffe, Steven; Magnus, David; Mohapatra, Seema; Sharp, Richard R.; Spector-Bagdady, Kayte; Sugarman, Jeremy; Wilfond, Benjamin S.; Fernandez Lynch, Holly; Robert H. McKinney School of Law
    Given the dearth of established safe and effective interventions to respond to COVID-19, there is an urgent ethical imperative to conduct meaningful clinical research. The good news is that interventions to be tested are not in short supply. Unfortunately, the human and material resources needed to conduct these trials are finite. It is essential that trials be robust and meet enrollment targets and that lower-quality studies not be permitted to displace higher-quality studies, delaying answers to critical questions. Yet, with few exceptions, existing research review bodies and processes are not designed to ensure these conditions are satisfied. To meet this challenge, we offer guidance for research institutions about how to ethically consolidate and prioritize COVID-19 clinical trials, while recognizing that consolidation and prioritization should also take place upstream (among manufacturers and funders) and at a higher level (e.g., nationally). In our proposed three-stage process, trials must first meet threshold criteria. Those that do are evaluated in a second stage to determine whether the institution has sufficient capacity to support all proposed trials. If it does not, the third stage entails evaluating studies against two additional sets of comparative prioritization criteria: those specific to the study and those that aim to advance diversification of an institution’s research portfolio. To implement these criteria fairly, we propose that research institutions form COVID-19 research prioritization committees. We briefly discuss some important attributes of these committees, drawing on the authors’ experiences at our respective institutions. Although we focus on clinical trials of COVID-19 therapeutics, our guidance should prove useful for other kinds of COVID-19 research, as well as non-pandemic research, which can raise similar challenges due to the scarcity of research resources.
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    COVID-19 and the Conundrum of Mask Requirements
    (Washington and Lee University School of Law, 2020-05-28) Gatter, Robert; Mohapatra, Seema; Robert H. McKinney School of Law
    As states begin to loosen their COVID-19 restrictions, public debate is underway about what public health measures are appropriate. Many states have some form of mask-wearing orders to prevent the spread of COVID-19 infection. Public health guidance from the Centers for Disease Control and Prevention and the World Health Organization has conflicted. From a public health point of view, it is not clear what the right answer is. In the absence of directives, individuals are also making their own choices about mask use. At a time when public health measures, like shelter-in-place orders and social distancing, are being used to stop the spread of coronavirus, wearing masks can be seen as a form of solidarity and desire to not infect others. Similarly, not wearing a mask can also be a political statement of sorts. Additionally, black men wearing masks have reported being asked to leave stores and fearing for their own safety. This essay provides an overview of the legal and policy landscape and focuses on the potential for policing against African Americans when mask mandates are in place. Despite the public health benefits of mask usage, due to mask mandates likely being enforced discriminatorily, we advise caution against mask mandates.
  • Thumbnail Image
    Item
    Cutting the Cord to Private Cord Blood Banking: Encouraging Compensation for Public Cord Blood Donations after Flynn v. Holder
    (2013) Mohapatra, Seema
    This Article argues that the Ninth Circuit's recent ruling in Flynn v. Holder, which allowed compensation for peripheral blood stem cells ("PBSCs") obtained via apheresis] under the National Organ Transplant Act ("NOTA'), also opens up the possibility for compensation for umbilical cord blood ("cord blood"). The holding in Flynn applies to cord blood for several reasons. First, Flynn held that bone marrow was subject to NOTA's prohibition on compensation because bone marrow was explicitly mentioned in the statute. In contrast, no mention of cord blood appears in NOTA or its applicable regulations. Also, the procedure to utilize cord blood was not in practice at the time of NOTA passage and could therefore not have been contemplated by Congress. Additionally, similar to PBSCs, when Congress revisited NOTA and passed later amendments adding fetal organs to the prohibition on payment, it chose not to modify the statute to explicitly include cord blood. Finally, there is a longstanding view that blood should not be covered by NOTA's prohibitions and this should apply equally to cord blood. Until recently, bone marrow transplants and PBSC transplants were the only two options for individuals suffering from diseases that damaged bone marrow, such as leukemia and lymphoma. However, advances in technology have allowed cord blood transplants to become a viable alternative to marrow and PBSC transplants for patients who have been unsuccessful in finding a PBSC or bone marrow match. This Article contends that rather than focusing only on increasing the numbers of bone marrow and PBSC donors, it is prudent to focus on increasing cord blood donations as a method of overcoming this problem. The lack of minority or mixed-race bone marrow, PBSC, and cord blood donors in the United States is a significant public health problem that has not been addressed adequately. Cord blood is taken from the umbilical cord of a newborn after the cord has been detached from the baby. Cord blood can be used to treat more than seventy diseases. Expectant mothers are not well-informed about the option to donate cord blood. Often, a pregnant woman's sole source of information about cord blood is from marketing materials provided by private cord blood banks. These private banks offer to store a baby's cord blood for a hefty yearly fee, selling this service as a sort of life insurance policy that could be cashed in should the child get sick in the future. The American Academy of Pediatrics and the American College of Obstetrics and Gynecology advise against private cord blood banking because stored cord blood is of very little value to the individual from whom it was retrieved. In contrast, cord blood that is donated to a public bank can be very useful to individuals requiring a bone marrow transplant. Additionally, recipients of cord blood transplants are able to withstand an imperfect match compared to recipients of bone marrow or PBSC transplants. This is significant because it is difficult to find exact matches for racial minorities and mixed race individuals. Currently, almost 97 percent of cord blood is discarded as medical waste. In addition to compensation, this Article also suggests other methods of making public cord blood donation a more common practice.
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    Feminist Perspectives in Health Law
    (2019) Wiley, Lindsay F.; Mohapatra, Seema
  • Thumbnail Image
    Item
    Fertility Preservation for Medical Reasons and Reproductive Justice
    (2014) Mohapatra, Seema
    This Article addresses the issues related to fertility preservation in the emerg- ing area of fertility preservation for medical reasons using a reproductive justice framework. Fertility preservation for medical reasons refers to the process of pre- serving the fertility of women (and men) who need to undergo treatments that may cause reduced fertility or sterility. This process typically involves counsel- ing a patient about the potential fertility consequences of their cancer treatment, and then if a patient so chooses (and can afford it), freezing the eggs (or sperm) to potentially use later via in vitro fertilization or using a gestational surrogate. As cancer survival rates improve, the ability to bear children after therapy is increas- ingly a concern for many patients. Some patients may choose their cancer ther- apy based on the risk of fertility loss rather than on its effectiveness to cure the cancer. Unfortunately, a patient's race and insurance status often determines if and when they are told about the fertility consequences of their treatment. Those without insurance are often already financially challenged after a cancer diagno- sis, so physicians may not inform them about fertility preservation due to the high costs.
  • Thumbnail Image
    Item