Dissertation Title："Essays in Ethics and Health Policy"
In 1999 New York enacted Kendra’s Law, in memory of Kendra Webdale, a young woman who was pushed to her death in front of an oncoming train by a man with untreated schizophrenia. Under Kendra’s Law a court can order a person with a mental illness to participate in an "assisted outpatient treatment" (AOT) program. Kendra’s Law includes a number of procedural due process protections including the right to a hearing and the right to counsel. Still critics argue that people with mental illnesses are routinely ordered to participate in the AOT program based on no more than "a bare recital of the statutory criteria."
The first essay in this dissertation, "Outpatient Commitment and Procedural Due Process," reports the findings from a study on procedural due process and assisted outpatient treatment hearings under Kendra’s Law. Findings from this study suggest that despite the shift from a medical model of civil commitment to a judicial model in the late 1970s, by and large judges continue to accord great deference to clinical testimony.
A second paper, "Rethinking Kendra’s Law," addresses the ethical dilemmas that arise when courts impose AOT over the patient’s objection.
The third paper of this dissertation, "Public Assistance, Drug Testing and the Law," addresses the Fourth Amendment questions that arise when states condition public assistance benefits on passing a suspicionless drug test. To date eight states—including Florida, Georgia and Missouri—condition public assistance benefits on passing a drug test. Proposals to condition public assistance on passing a drug test have also appeared in Congress. However, without a genuine threat to public health or public safety, proposals to condition public assistance on passing a drug test without individualized suspicion of drug use are unreasonable under the Fourth Amendment. Even if the Supreme Court were to recognize special needs beyond a genuine threat to public health or public safety, policies that result in withholding public assistance benefits from people who abuse illegal drugs are likely to make many social problems much worse.