Supreme Court of the United States

Including race in clinical algorithms can both reduce and increase health inequities – it depends on what doctors use them for

Retrieved on: 
Saturday, May 27, 2023

Health practitioners are increasingly concerned that because race is a social construct, and the biological mechanisms of how race affects clinical outcomes are often unknown, including race in predictive algorithms for clinical decision-making may worsen inequities.

Key Points: 
  • Health practitioners are increasingly concerned that because race is a social construct, and the biological mechanisms of how race affects clinical outcomes are often unknown, including race in predictive algorithms for clinical decision-making may worsen inequities.
  • A higher eGFR value means better kidney health.
  • My recently published research suggests that excluding race from certain diagnostic algorithms could worsen health inequities.

Different approaches to fairness

    • Researchers use different economic frameworks to understand how society allocates resources.
    • This approach allocates resources to those with the most opportunities to generate positive outcomes or mitigate negative ones.
    • Although utilitarian approaches do not take fairness into account, an approach that does would ask two questions: How do we define fairness?
    • Are there conditions when maximizing an algorithm’s prediction power and accuracy would not conflict with fairness?

Equality of opportunity

    • There are two fundamental principles in equality of opportunity.
    • However, differences in individual effort that occur because of circumstances, such as living in an area with limited access to healthy food, are not addressed under equality of opportunity.
    • Equality of opportunity implies that if algorithms were to be used for clinical decision-making, then it is necessary to understand what causes variation in the predictions they make.

Evaluating clinical algorithms for fairness

    • To hold machine learning and other artificial intelligence algorithms accountable to a standard of equity, I applied the principles of equality of opportunity to
      evaluate whether race should be included in clinical algorithms.
    • The first, diagnostic algorithms, makes predictions based on outcomes that have already occurred at the time of decision-making.
    • The second, prognostic algorithms, predicts future outcomes that have not yet occurred at the time of decision-making.
    • For example, prognostic algorithms are used to predict whether a patient will live if they do or do not obtain a kidney transplant.

Unanswered questions and future work

    • My colleagues and I are exploring many of these unanswered questions to reduce algorithmic discrimination.
    • We believe our work will readily extend to other areas outside of health, including education, crime and labor markets.

On the 127th Year Anniversary of the "Separate But Unequal" Plessy v. Ferguson Case, The U.S Supreme Court Will Vote On the Women of Color for Equal Justice Application That Asks to Forever Ban ALL Vaccine Mandates

Retrieved on: 
Tuesday, May 16, 2023

30 years ago, the Occupation Safety & Health Act (OSH Act) abrogated federal, state, and private sector authority to mandate any vaccine to control airborne communicable diseases even during a pandemic.

Key Points: 
  • 30 years ago, the Occupation Safety & Health Act (OSH Act) abrogated federal, state, and private sector authority to mandate any vaccine to control airborne communicable diseases even during a pandemic.
  • 5 General Duty Clause because vaccines are manufactured for medicinal internal personal use only.
  • The OSH Act protects the fundamental right of all citizens to refuse vaccines and bans employer wrongful separation of employees for exercising their right.
  • Press Conference and rally scheduled on May 18th at 9:00am on the U.S Supreme Court sidewalk.

NCLA Clients Vindicated as Biden Ends Covid Vaccine Mandates that Federal Courts Already Enjoined

Retrieved on: 
Thursday, May 11, 2023

While portraying the end of the mandates as a “good news” story, federal courts had already ruled the federal employee and federal contractor vaccine mandates illegal earlier this year.

Key Points: 
  • While portraying the end of the mandates as a “good news” story, federal courts had already ruled the federal employee and federal contractor vaccine mandates illegal earlier this year.
  • Hence, this decision appears to be a cynical ploy seeking to evade the precedents set by the Administration’s mounting losses in federal court.
  • In addition to private employer, healthcare facility, and federal employee mandates, the announcement covered those working for federal contractors.
  • The Administration has not announced plans to re-hire federal employees, contractors, soldiers, and healthcare providers who were fired after refusing the Covid-19 vaccine.

Supreme Court Upholds California’s Prop 12, Protects Rights of States to Set Humane Treatment, Food Safety Rules

Retrieved on: 
Thursday, May 11, 2023

“The pork industry has for decades blocked any rules at the federal level to promote the humane treatment of farm animals and this was their attempt to gut state rules, too.

Key Points: 
  • “The pork industry has for decades blocked any rules at the federal level to promote the humane treatment of farm animals and this was their attempt to gut state rules, too.
  • State authorities in Massachusetts had put a hold on implementation of a very similar law there pending the Supreme Court’s ruling on the matter.
  • “The Court recognized that the doomsday forecasting of extraterritorial effects for the pig industry was a contrivance and a charade,” added Pacelle.
  • The Center for a Humane Economy is a non-profit organization that focuses on influencing the conduct of corporations to forge a humane economic order.

George Santos indicted on fraud, money laundering and other criminal charges -- 3 essential reads

Retrieved on: 
Wednesday, May 10, 2023

Santos surrendered to federal authorities at a courthouse in suburban Long Island on May 10.

Key Points: 
  • Santos surrendered to federal authorities at a courthouse in suburban Long Island on May 10.
  • Lies, lies and more lies
    Professor Sarah Webber is a nonprofit accounting scholar, and what drew her attention to Santos were reports that he fabricated a charity.
  • Regardless of what the stakes are in Santos’ case, Webber wrote that fake charities are a serious problem.
  • Read more: Allegations that the charity George Santos claims to have run was fake highlight how scams divert money from worthy causes
    2.

You might think Trump being found liable for sexual abuse and defamation would derail his re-election campaign. But it's not that simple

Retrieved on: 
Wednesday, May 10, 2023

In varying states of fury and disbelief, millions of women and their supporters participated in the first Women’s March.

Key Points: 
  • In varying states of fury and disbelief, millions of women and their supporters participated in the first Women’s March.
  • To date, 26 women have accused the former and once again aspiring president of abuse.
  • Overnight, for the very first time, five years after that first protest, Trump has been held accountable to one of them.
  • Carroll described meeting Trump at the Bergdorf Goodman department store in Manhattan the mid-1990s, where Trump had attacked and, she alleged, raped her in a dressing room.
  • The president accused her of fabricating the story in order to promote her book, and in response, she sued for defamation.
  • Carroll sued him again in late 2022, this time over posts Trump had made on social media.

Jameson Shapiro shooting trial: Why police trials perform a vital public service

Retrieved on: 
Thursday, May 4, 2023

They are accused of shooting and killing an 18-month-old baby, Jameson Shapiro, and his father William Shapiro in November 2020 in the Kawartha Lakes area northeast of Toronto.

Key Points: 
  • They are accused of shooting and killing an 18-month-old baby, Jameson Shapiro, and his father William Shapiro in November 2020 in the Kawartha Lakes area northeast of Toronto.
  • Police officer trials are important for reasons other than simply holding an individual officer accountable for a particular act.
  • Police trials also spur public debate on how repressive state force is administered.

Shifting public policy

    • A prime example of trials changing public policy is the 1985 United States Supreme Court ruling in Tennessee v. Garner that effectively prohibited the practice of shooting fleeing suspects in the back.
    • Courts in Canada have stopped or clarified when police can use overly invasive investigative techniques such as telephone wiretaps.
    • But there have been few occasions for police use-of-force practice and policy to be openly interrogated so that jurors could decide the “reasonableness” of officer conduct.

Regis Korchinski-Paquet death

    • A case that could have gone to trial involved the falling death of 29-year-old Regis Korchinski-Paquet in Toronto in May 2020.
    • She soon fell to her death.
    • The Special Investigations Unit’s report into Korchinski-Paquet’s death states that the decision-making officer told investigators he believed the best option was to refer the matter to the Emergency Task Force.

Jameson Shapiro’s death

    • The Kawartha Lakes OPP officers will be tried for manslaughter and criminal negligence causing death.
    • What happened next will likely become clear at trial as officers opened fire, striking William and killing Jameson on the scene.
    • William was suspected of being armed — a gun was recovered at the scene — and officers were told Jameson was in the car’s back seat.

Not just about convictions

    • Increasing the number of criminal trials for police officers won’t necessarily result in convictions.
    • But convictions aren’t their only purpose.
    • While public trust in police is eroding across the country, most Canadians still trust police.

National Tax Lien Association (NTLA) File U.S. Supreme Court Amicus Brief in Tyler v. Hennepin County for Supporting State's Rights on Property Tax Collection Method

Retrieved on: 
Wednesday, May 3, 2023

Washington, D.C., May 3, 2023 /PRNewswire-PRWeb/ -- NTLA Executive Director Bradley Westover announced the NTLA filed a U.S. Supreme Court amicus (friend-of-the-court) brief in Tyler v. Hennepin County (No. 22-166). Joined by the Arizona County Treasurers Association and the Tax Collectors & Treasurers Association of New Jersey, the NTLA argued against a Court-instituted national tax collection mechanism. Law firm Nelson Mullins Riley & Scarborough LLP of Columbia, South Carolina, authored and filed the brief on March 31, 2023.

Key Points: 
  • Despite numerous pre-sale notices, the delinquent taxpayer and her lienholders declined to redeem the property, necessitating the tax lien foreclosure as a remedy of last resort.
  • Washington, D.C., May 3, 2023 /PRNewswire-PRWeb/ -- NTLA Executive Director Bradley Westover announced the NTLA filed a U.S. Supreme Court amicus (friend-of-the-court) brief in Tyler v. Hennepin County (No.
  • Joined by the Arizona County Treasurers Association and the Tax Collectors & Treasurers Association of New Jersey, the NTLA argued against a Court-instituted national tax collection mechanism.
  • The case arises from a condo forfeited to Hennepin County, Minnesota after the property owner failed to pay taxes over roughly five years.

Mifepristone is under scrutiny in the courts, but it has been used safely and effectively around the world for decades

Retrieved on: 
Wednesday, April 26, 2023

A flurry of court rulings in April 2023 has left the future of the abortion pill mifepristone in question.

Key Points: 
  • A flurry of court rulings in April 2023 has left the future of the abortion pill mifepristone in question.
  • Depending on the outcome, the pill could face a ban or tightened restrictions on its usage, a possibility that has many health care providers concerned.

What is mifepristone, and how does it work?

    • It can be taken as one part of a two-part pill regimen for medication abortion.
    • Mifepristone acts by blocking the hormone progesterone, which is necessary for a pregnancy to develop.
    • But it is commonly used off-label for things like cervical ripening, or softening, to induce or help with labor.
    • Both protocols are very effective, with the two-drug regimen up to 99.6% effective and the misoprostol-alone regimen between 84% to 96% in medication abortions.

Why would a person opt for one regimen or the other?

    • Patients should feel assured that guidelines for medication abortion support the safety and efficacy of both medication regimens.
    • The American College of Obstetricians and Gynecologists, the Society for Family Planning and the World Health Organization all support both types of medication abortion.

How widely accessible is mifepristone?

    • The change means that the drug is available both by mail or at brick-and-mortar pharmacies, as long as that retail pharmacy has been certified.
    • While the January 2023 FDA ruling theoretically increases the ways that a person can get mifepristone, so far it has not been widely available at retail pharmacies.

Can I still get mifepristone?

    • The Supreme Court’s April 21, 2023, ruling means that there will be no changes to mifepristone access for now.
    • As of April 2023, 27 states have some restriction on medication abortion according to the Guttmacher Institute, a reproductive health policy organization.

Evidence-based health care

    • Medication abortion using mifepristone and misoprostol is exceptionally safe and highly effective, as is medication abortion using misoprostol alone.
    • But percentage points mean very little to an individual’s health – what matters is that people get the care they need.
    • I will continue working, providing and advancing care that is based on science.

The Supreme Court rules mifepristone can remain available – here's how 2 conflicting federal court decisions led to this point

Retrieved on: 
Saturday, April 22, 2023

The U.S. Supreme Court issued an emergency ruling on April 21, 2023, that allows continued access to the abortion pill mifepristone in states where abortion is legal.

Key Points: 
  • The U.S. Supreme Court issued an emergency ruling on April 21, 2023, that allows continued access to the abortion pill mifepristone in states where abortion is legal.
  • On April 7, two federal district court judges halfway across the country from each other issued conflicting rulings about the validity of the Food and Drug Administration’s approval of mifepristone.
  • Within a week, yet another court issued a third opinion, which allowed mifepristone to continue to be prescribed, but under more limited circumstances.

The federal system

    • It’s first useful to understand how the federal court system in the U.S. works.
    • State-run court systems are entirely separate from the federal judicial system, which is where the mifepristone rulings are playing out.
    • Federal courts handle a variety of issues, including those relating to the United States government, the Constitution or federal laws, or controversies between states or between the U.S. government and foreign governments.
    • There are 94 federal district courts, organized into 12 regional circuits.

Other examples

    • There are many other examples where federal circuit courts disagree.
    • In 2018, the 7th Circuit Court of Appeals, which serves Illinois, Indiana and Wisconsin, ruled that an Indiana state law that banned abortions based on genetic anomalies was not constitutional.
    • But in 2021, the 6th Circuit Court of Appeals upheld an Ohio law banning abortions based on one kind of genetic anomaly, Down syndrome.

The case of mifepristone

    • With this latest example of courts butting heads, Federal District Judge Matthew Kacsmaryk in Texas ruled first, on April 7.
    • His decision took the form of a preliminary injunction, which is essentially a temporary ruling, until the court has a chance to go through a full trial.
    • Kacsmaryk concluded that the FDA had exceeded its authority in approving mifepristone in 2000 and in loosening the prescribing restrictions over the years.

Where the issues stand

    • But that decision is only in effect while the case is being decided by the 5th Circuit.
    • And the situation gets even more complicated, with a third lawsuit filed in a federal court in Maryland on April 19.
    • That case was brought by GenBioPro, the manufacturer of a generic version of mifepristone, which the FDA approved in 2019.