Topic: Constitution, the Law, and the Courts

Is Bioethics an Oxymoron?

An emailer forwarded me a copy of an article in The New Republic by Ezekiel J. Emanuel, “a bioethicist and oncologist.” Emanuel argues against a recent DC Circuit Court ruling on a suit brought by a group called the Abigail Alliance. The ruling gives dying patients access to experimental drugs after they have passed some minimum safety tests but before they have been proven effective.

It would make it much harder to get people to enroll in research studies and get the data necessary to show whether a drug really was effective or not. Why should people enroll in a randomized, controlled study–where they could be put in the group receiving only conventional treatment–when they could just get their insurance to pay for whatever drug they thought was best?

…Expanded access would also rob the rest of us who may never need a cancer treatment. Individuals and society in general are struggling to pay the nation’s $150 billion-plus drug bill. And that is for medications proven to work. Now add the requirement that insurance companies pay for drugs we don’t know work, and you have a formula for financial disaster. Costs would skyrocket as we pay billions through our insurance premiums and Medicare taxes for worthless drugs.

I agree that it would be wrong to force insurance companies to cover unproven medications–otherwise, there would be no reason to stop individuals from choosing their preferred method of treatment–but the relevant alternative to these patients is not participating in randomized trials. The relevant alternative is death.

Dr. Emanuel describes his approach in a similar case:

Getting Virginia another experimental drug was not going to stop her breast cancer from growing and eventually killing her. I gently explained to her that investing all her energy chasing after another unproven drug was not going to help her and her family. Virginia was disappointed and refused to consider hospice, because she saw it as giving up. Holding her hand, I talked to her about spending time with her husband and daughters and making a videotape for her future grandchildren. We also discussed getting visiting nurses to come to her house. I saw her once more in my office. She was more accepting and found at least some of the activities meaningful. Because of her failing liver, less than three months later, she lapsed into a coma and died with her family present.

If I decide that I want to fight rather than go down graciously with a terminal illness, I will look for a doctor who is not a bioethicist. I found this article so chilling that it leaves me nearly speechless.

Jefferson Was a Great Man, But He Didn’t Write the Constitution

Quotations from respected sources, such as the Founders and Tocqueville and Churchill, are often apocryphal. George Washington apparently didn’t say, “Government is not reason, it is not eloquence – it is force! Like fire, it is a dangerous servant and a fearsome master.” Jefferson, alas, doesn’t seem to have said, “That government is best that governs least,” though he certainly believed it. A tip: If you find the quote on the Internet without any source given other than the alleged speaker, then he probably didn’t say it.

Some quotations are hard to trace, and it’s hard to prove a negative. But this month some of our national leaders have revealed that they don’t know who wrote our most basic founding documents – and neither they nor their speechwriters apparently have access to Google.

At the Southern Baptist Convention two weeks ago, Secretary of State Condoleezza Rice said, “My ancestors in Mr. Jefferson’s Constitution were three-fifths of a man.” Then yesterday Senate minority whip Dick Durbin opposed a flag-burning amendment by saying, “In fact, [flag-burning] rarely, if ever, happens. And so why are we about to change the handiwork and fine contribution to America of Thomas Jefferson?”

Wrong again. Jefferson did not write the Constitution or the Bill of Rights. He was in France during the Constitutional Convention and during the congressional debate over the Bill of Rights.

As every schoolboy knows or should know, James Madison is known as the Father of the Constitution. He also introduced the Bill of Rights into the House of Representatives in 1789. So Rice and Durbin should have referred to “Mr. Madison’s Constitution” and “the handiwork of James Madison.” Perhaps someone should send them a Madison biography or a copy of James Madison and the Future of Limited Government.

Some Good News from the Court for a Change

The U.S. Supreme Court this morning struck down a set of restrictions on campaign finance enacted by Vermont. Six members of the court believed Vermont’s spending limits and extremely low contribution limits violated the First Amendment.

The six justices agreed that the Vermont law was invalid. But they disagreed about quite a bit, too. Justices Breyer, Roberts and Alito focused on the shortcomings of the Vermont law. Breyer and Roberts also rejected Vermont’s demand that Buckley v. Valeo be overturned. Justices Thomas and Scalia concurred in the opinion but rightly called for overturning Buckley in order to offer better protections for political speech. Justice Kennedy rightly expressed dismay with the Court’s recent campaign finance jurisprudence. In the larger picture, he seems closer to Thomas and Scalia than the other three in the majority.

This ruling was expected, but nonetheless good news. The majority opinion shows that we now have a majority of the court who recognize some limits on the power of the state over political speech. After McConnell v. FEC, it was far from clear than the judiciary would draw any lines limiting state restrictions on speech.

Still, this is hardly a robust affirmation of the First Amendment, and it is somewhat discouraging that the new justices, Roberts and Alito, were unwilling to overturn past errors by earlier majorities on the Court.

Bush and Kelo

Per David’s Kelo anniversary posts below, skeptics are probably right to question the sincerity of the White House’s halfhearted embrace of property rights last week. Back in 2004, when Kelo was pending before the Supreme Court, the Bush administration not only refused to file an amicus brief on behalf of the property owners, but was actually on the verge of filing a brief on behalf of the land-seizing local governments.

The Institute for Justice’s Clint Bolick wrote at the time:

One would expect the Bush administration, with its professed support for strict constitutional construction and for property rights, to join the dozens of conservative and libertarian groups arrayed in this effort, or at worst to sit on the sidelines. But for reasons unfathomable to President Bush’s core constituency, the administration is seriously considering filing a brief opposing property rights.

[…]

So what is it that is impelling the administration to betray its principles?

Is it succumbing to pressure from federal bureaucrats born of solidarity with state and local power? Is it seeking to shelter big business interests that are beneficiaries of eminent domain abuse?

We can’t know because no one in the administration is saying. Even worse is the brazen disdain with which the administration has dismissed pleas from some of its staunchest allies to stay out of the case.

On Oct. 29, a letter signed by 44 conservative and libertarian luminaries — ranging from Grover Norquist to Paul Weyrich and David Keene, and encompassing such groups as the Free Congress Foundation, Family Research Council and National Taxpayers Union — sent the president a letter imploring him to stay on the sidelines. It would be nice to have the administration on the playing field on the side of its friends; but at this point, agnosticism is preferable to adopting the wrong religion.

When property-rights advocates presented a copy of the letter to Timothy Goeglein, the administration’s emissary to the conservative movement, he dismissively dropped it to the ground.

[…]

So when the arguments are submitted in the New London case, it will be jarring if we see the administration standing with the foes of property rights. Perhaps by then the administration will explain its betrayal — or maybe not, for its actions appear truly inexplicable.

Sadly, we now know that advocating for limitless government power isn’t “bizarre” for this administration, it’s routine.

Sam Walker in the L.A. Times

Last week I wrote about a conversation I had with Sam Walker, the University of Nebraska criminology professor whose research was abused by Justice Scalia in the Hudson case. I mentioned that conversation to ex-Reason associate editor Matt Welch, who’s now at the L.A. Times.

That turned into an op-ed for Walker in today’s paper. Excerpt:

The misuse of evidence is a serious offense — in academia as well as in the courts. When it’s your work being manipulated, it is a violation of your intellectual integrity. Since the issue at stake in the Hudson case is extremely important — what role the Supreme Court should play in policing the police — I feel obligated to set the record straight.

Scalia quotes my book, “Taming the System: The Control of Discretion in American Criminal Justice,” on the point that there has been tremendous progress “in the education, training and supervision of police officers” since the 1961 Mapp decision, which imposed the exclusionary rule on local law enforcement.

My argument, based on the historical evidence of the last 40 years, is that the Warren court in the 1960s played a pivotal role in stimulating these reforms. For more than 100 years, police departments had failed to curb misuse of authority by officers on the street while the courts took a hands-off attitude. The Warren court’s interventions (Mapp and Miranda being the most famous) set new standards for lawful conduct, forcing the police to reform and strengthening community demands for curbs on abuse.

Scalia’s opinion suggests that the results I highlighted have sufficiently removed the need for an exclusionary rule to act as a judicial-branch watchdog over the police. I have never said or even suggested such a thing. To the contrary, I have argued that the results reinforce the Supreme Court’s continuing importance in defining constitutional protections for individual rights and requiring the appropriate remedies for violations, including the exclusion of evidence.

I’m not familiar enough with legal scholarship to know just how much of an ethical breach it is for a judge to misuse academic research in an opinion. But Scalia was an academic before coming to the bench, so it seems to me awfully untoward — or awfully careless — to have invoked Walker’s research to further a point that the research pretty clearly disputes. Moreover, Scalia cited Walker in advancing a key argument in a case that could have some pretty significant repercussions.

Walker seems to think it’s a big deal. I find him convincing.

A Legacy of Bias

Last week on my personal weblog, I ran an excerpt from Dan Baum’s essential book Smoke and Mirrors about how the 1986 overdose death of Maryland University basketball star Len Bias led to the 1986 Anti-Drug Abuse Act. The act is arguably the most militant, draconian crime-fighting bill ever passed by Congress.

Much of Baum’s book is told from the point of view of Eric Sterling, a congressional staffer who helped write most of the 1980s drug laws, but who has since become a vocal opponent of those laws, and of the drug war in general.

Yesterday, Sterling and Julie Stewart of Families Against Mandatory Minimums had an op-ed in the Washington Post arguing that, sadly, the legacy of Bias’s death isn’t an end to the use of illicit drugs, but an exploding prison population, violence, and increased drug use — all caused not by Bias’s death, but by Congress’s overreation to it.

Chicago Tribune columnist Clarence Page covered similar ground this week.

A Footnote on Kelo

I’m still amused at conservatives who call the Kelo decision “activist” and make it an exhibit in their jihad against “activist” judges. See the House Republicans, the Alabama Policy Institute, or the American Conservative Union.

But the Kelo decision wasn’t wrong because the Court was activist. It was wrong because the Court failed to actively enforce the Constitution’s restrictions on government. As Richard Epstein wrote in a Wall Street Journal column, “Justice Stevens’s lamentable opinion was the polar opposite of judicial activism. Indeed, it represented a deadly form of judicial deference to legislative action that makes a mockery of both the text and purposes of the ‘Public Use’ Clause.”

Of course, just to complicate the matter, one could say that a court is activist when it finds powers for government that are nowhere granted in the Constitution. In that case, the Kelo Court was activist.

That’s the kind of activism Randy Barnett was getting at when he wrote:

Is discovering and enforcing the original meaning of the Ninth Amendment activism? Or is it activism to characterize this inconvenient piece of text as an “ink blot” on the Constitution, as Robert Bork did in his infamous confirmation testimony? …

Is it activism to construct a doctrine to define the wholly unenumerated “police power” of states in a manner that is consistent with the limits on state power enumerated in the Fourteenth Amendment? Or is it activism to give states unchecked power, notwithstanding the Fourteenth Amendment? 

But conservatives cannot complain that the Kelo decision was another example of judges overriding the decisions of elected officials, which is their usual definition of “judicial activism.” In this case, the judges lamentably deferred to local elected officials, ignoring the property rights protections in the Constitution.