Tokens and tiers in corrections: an analysis of legal issues in behavior modification.
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A group of taxpayers and religious leaders challenged the constitutionality of the Adolescent Family Life Act, which authorizes federal grants to public and nonpublic private organizations for services and research in the area of premarital adolescent sexual relations and pregnancy. They claimed that the Act violated the Establishment Clause of the First Amendment of the US Constitution because the Act provides that the complexity of the problem requires the involvement of religious organizations, and funds had been given to institutions with ties to religious organizations. The Court held that the Act does not violate the Establishment Clause since 1) the passage of the Act was motivated primarily by the legitimate secular purpose of eliminating or reducing social and economic problems caused by teenage sexuality, pregnancy, and parenthood; 2) the Act does not have the primary effect of advancing religion because the services provided are not religious in character; and 3) the Act does not create excessive entanglement of church and state. It remanded the case to the lower court to determine whether the Act was unconstitutional as applied to specific organizations.
The plaintiffs, a consortium of private clubs, sought an order declaring unconstitutional New York City Local Law 63. This Law stipulates that clubs with more than 400 members that provide regular meal services and regularly receive payment directly or indirectly from or on the behalf of nonmembers for the furtherance of trade or business would not to be considered "distinctly private" and, thus, would be subject to the City's Human Rights Law prohibiting discrimination on the basis of race, creed, sex, and other grounds. The plaintiffs contended that the Law violated their First Amendment rights of free association and expression. The US Supreme Court upheld the constitutionality of the Law, concluding, among other things, that the plaintiffs did not show that the Law would be invalid as applied to all covered clubs and that individual clubs that believed that their rights had been infringed had ample opportunity to challenge the way the Law was applied to them.
The plaintiffs, anti-abortion protesters, challenged a Brookfield Wisconsin ordinance making it "unlawful for any person to engage in picketing before or about the residence or dwelling of any individual" and declaring that the primary purpose of the ban is to "protec[t] and preserv[e] the home" through assurance "that members of the community enjoy in their homes . . . a feeling of well-being, tranquillity, and privacy." They claimed that the ordinance violated their First Amendment rights of free speech. The Court reversed lower court rulings finding the ordinance unconstitutional. It held that the ban on picketing did not ban all picketing in residential areas, but, rather, only "focused picketing" taking place solely in front of a specific residence, and that the ordinance left ample means of alternative channels of communication. It concluded that the ordinance served a significant government interest of protecting residential privacy and that there was no constitutional right to force speech into the home of an unwilling listener. In 1988, US courts reached the following decisions with respect to the activities of anti-abortion protesters: 1) action charging anti-abortionists with conspiracy under federal laws is allowed (Portland Feminist Women's Health Center vs. Advocates for Life, US District Court, D. Oregon, 28 June 1988 [712 F.Supp. 165]); 2) action charging anti-abortionists with conspiracy under federal laws not allowed, but action charging anti-abortionists with violation of racketeering laws allowed (Feminist Women's Health Center vs. Roberts, US District Court, W.D. Washington, 11 March 1988 [1988 US Dist. Lexis 16325]); 3) action charging anti-abortionists with violation of racketeering laws allowed (Northeast Women's Center, Inc. vs. McMonagle, US District Court, E.D. Pennsylvania, 31 March 1988 [689 F.Supp. 465]); and 4) action charging anti-abortionists with conspiracy under federal laws and with violation of racketeering laws is allowed (Roe vs. Operation Rescue, US District Court for the Eastern District of Pennsylvania, 19 December 1988 [1988 US District Lexis 14484]).
The Court held that the US Government cannot punish its employees for exercising their First Amendment right to free assembly by attending a hearing on the subject of the use of public funds for abortions.
Without comment on December 12, the US Supreme Court denied two requests for review from anti-choice activists in Scheidler vs Delaware Women's Health Organization and Miller vs Delaware Women's Health Organization, which grew out of a class action suit filed by women's health clinics under the federal anti-racketeering statute. Since the US Supreme Court decision in NOW vs Scheidler last January (see RFN III/2), the anti-choice defendants have made at least a dozen attempts to prevent a trial that would determine whether they violated the Racketeering Influenced and Corrupt Organizations Act (RICO). In NOW vs Scheidler, the High Court rejected their claim that RICO cannot be applied to organized, illegal anti-choice activities because the defendants are not motivated by an economic gain. In this latest round, the two petitions asserted that unlawful actions, including blockades and property destruction, do not constitute extortion and are protected by the First Amendment. Under RICO, private plaintiffs can file suit against individuals who conspire to use an organization to engage in a pattern of racketeering, including acts of extortion. Extortion is defined under the Hobbs Act as the use of force, threats, or other wrongful means to deprive the plaintiff of a property interest, such as engaging in a legal business. Plaintiffs in these cases are the National Organization for Women (NOW) and two women's health facilities--Delaware Women's Health Organization and Summit Women's Health Organization (Milwaukee)--which represent a class of clinics across the country. Defendants Operation Rescue, Project Life, and Pro-Life Action League, are also joined by several anti-choice activists including Joseph Scheidler and Randall Terry.
In a unanimous decision issued on February 13, (1995) a three-judge panel of the U.S. Court of Appeals for the Fourth Circuit upheld the dismissal of two anti-choice challenges to the Freedom of Access to Clinic Entrances Act (FACE). The first mid-level federal bench to rule on FACE's validity, the appeals court held that the law "strikes a balance among competing rights holders. It protects those who seek or provide reproductive health services without suppressing robust debate about abortion. Those opposed to abortion or any other reproductive health service retain the freedom to express their deeply-held moral or religious views in a peaceful, non-obstructive way." In mid-June of last year in American Life League v. Reno, U.S. District Court Judge Leonie Brinkema in Alexandria, Virginia, found that FACE did not violate abortion opponents' First Amendment rights. In open court the next month, Judge Brinkema dismissed Woodall v. Reno, which was filed by an abortion opponent in concert with Concerned Women for America. The cases were consolidated on appeal. Attorneys for the plaintiffs have indicated that they will seek U.S. Supreme Court review. Every other federal court to rule on FACE since its May 1994 enactment has also found the measure constitutional.
The plaintiffs, federal taxpayers, challenged the constitutionality of the Adolescent Family Life Act, 42 U.S.C. Sections 300z-300z-10 (1981), provisions of which allow religious organizations to use government funds for, among other things, the counseling and teaching of adolescents on matters related to premarital sexual relations and teenage pregnancy. They claimed that these provisions violated the Establishment Clause of the First Amendment, which provides that "Congress shall make no law respecting the establishment of religion." While the Court held that the Act had a valid secular purpose of combating teenage pregnancy and associated ills, it also ruled that it violated the Constitution because on its face and as applied it had the primary effect of advancing religion. It pointed to the fact that the Act funded the teaching and counseling of adolescents by religious organizations on matters related to religious doctrine, that Act grantees included several organizations with institutional ties to religious denominations, and that some grantees established programmes in which Act-funded staffer presentations were immediately followed in the same room and in the staffers' presence by programs presented by members of religious orders and dedicated to the presentation of religious views.
The plaintiff anti-abortion demonstrators challenged a city ordinance proscribing picketing a residence or dwelling place. The ordinance had been enacted after complaints of the neighbors of a physician whose home had been picketed. The Court held that the ordinance was over-broad and in violation of First Amendment free speech rights, since it dealt with picketing in a public area and did not distinguish between picketing in neighborhoods near commercial areas and purely residential neighborhoods.
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The movement toward private sector involvement in our correctional services and programs is growing. Before our focus is turned completely to privatization of these services, it would be prudent to analyze the "policy impact of such change. It is evident that the diverse and incompatible policies guiding the government approach to corrections and the absence of any rational planning to answer public interest goals is costly. Moreover, despite the increasing complexity of problems now confronting public authorities, little change has been made in their approach to resolving them. However, is it realistic to assume that the profit/loss barometer of the private sector can be applied in an area of social problems that are so pluralistic and ill defined? What of the many areas of potential legal concern, that is, vicarious litigation, First Amendment right of prisoners, and so forth? These are all areas that need to be researched so that any judgements or decisions made will be sound.
The law regarding refusal of psychiatric patients to take psychotropic medication is reviewed. The law in this area is traced through its evolution beginning in the 1960s when failure to administer medication to psychiatric patients was considered mistreatment of the patient. The legal basis for forcible administration of drugs is reviewed, and a discussion of cases in which patients refused to accept treatment on religious grounds is presented. When children are involved, the courts are generally in accord that the parents' right to freedom of religion ends where the child's right to life begins or when there is a threat to public health and safety. In cases involving adults, without a threat to public health or safety, relevant opinions rule that medical treatment should not be ordered against the patient's religious beliefs because it would constitute a violation of the First Amendment. Two leading cases involving the forcible administration of medication, Rennie v. Klein and Rogers v. Okin, held that administration should be limited to emergency situations when there is substantial risk of injury to the patient or others in the hospital. The Supreme Court made it clear that the right to refuse must be derived from state law, not from the federal Constitution, apparently giving health-care professionals broad leeway in exercising professional judgment in this area.
This Article explores the antitrust and other implications of private credentialing and accrediting programs in the health care industry. Although such programs are usually sponsored by powerful competitor groups, they serve the procompetitive purpose of providing useful information and authoritative advice to independent decision makers. Part One examines the risk that credentialing will sometimes be unfair to competitors and deceive consumers. Its survey of common-law, antitrust, and regulatory interventions to correct such unfairness and deception seeks to determine the degree of oversight to which credentialing and similar activities have been and should be subjected. In recommending that judicial or regulatory scrutiny should be limited to discovering whether standards and practices have a rational relation to a procompetitive purpose, the Article argues that greater intrusion into credentialing schemes would be inconsistent with market theory and first amendment values and would discourage line-drawing efforts that stimulate competition and facilitate consumer choice. By emphasizing throughout that personnel certification and institutional accreditation embody ideology and opinion as well as factual information, Part One sets the stage for the argument in Part Two that antitrust law can and should be used to contest the dominance of a single ideology of health care and to facilitate the development of alternative sources of consumer information. The Article's overall thesis is that, whereas the quality of advice given to the public about health care personnel and similar matters should not be closely regulated, neither should the supply of competing information and opinion be artificially curtailed.
This Article analyzes the possible antitrust liability of medical credentialing programs by dividing their potentially anticompetitive acts into three categories: (1) communicative behavior--for example, credentialing agencies' promulgation of standards--designed primarily to influence government decision making; (2) communicative behavior designed to influence private decision makers, such as consumers, hospitals, and training programs; and (3) noncommunicative behavior--for example, an agreement by the credentialing agency and others to boycott a group of professionals--that might be used to exclude competitors from various fields of medical care. The author argues that the first amendment of the U.S. Constitution, together with the related Noerr-Pennington doctrine, should exempt from antitrust law any credentialing standard that has been adopted for a good-faith purpose and is at least arguably reasonable. On the other hand, the author also argues that antitrust law should condemn any "sham" standard that in fact is designed to eliminate or to punish competitors, and any other noncommunicative behavior by credentialing agencies for the same purpose.