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Public Health Law Map - Beta 5 - Medical and Public Health Law Site

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y the now proscribed conduct.<br />

1. The Importance of Precedent<br />

In a common law system, judges are obliged to make their rulings as consistent as<br />

reasonably possible with previous judicial decisions on the same subject. The<br />

Constitution accepted most of the English common law as the starting point for<br />

American law. Situations still arise that involve rules laid down in cases decided<br />

more than 200 years ago. Each case decided by a common law court becomes a<br />

precedent, or guideline, for subsequent decisions involving similar disputes. These<br />

decisions are not binding on the legislature, which can pass laws to overrule<br />

unpopular court decisions. Unless these laws are determined to be unconstitutional<br />

by the Supreme Court, they preempt the common law precedent cases. Judges<br />

deciding cases are bound by the new law, rather than the precedent cases.<br />

To better underst<strong>and</strong> how the common law works, assume that there is a hypothetical<br />

drug, Zoneout, that is a psychoactive drug with some medical uses but a high<br />

potential for abuse: It is addictive <strong>and</strong> users lose their interest in going to work.<br />

If Congress writes the statute regulating Zoneout very clearly <strong>and</strong> specifically—a<br />

complete ban on prescribing or using Zoneout—then the court’s role is limited; if the<br />

physician prescribes Zoneout, then the physician has violated the statute <strong>and</strong> is guilty<br />

of a crime. All the cases involving prescriptions for Zoneout will look the same <strong>and</strong><br />

the law will not evolve. But assume the statute is vague: no prescriptions for<br />

dangerous drugs. Then the court will have to decide under which circumstances<br />

Zoneout is a dangerous drug <strong>and</strong> when it is permissible to use it.<br />

Assume that the court decides that Zoneout is a dangerous drug for treating<br />

workplace stress. That decision is then published <strong>and</strong> made available to the public.<br />

When the next case of a prescription for Zoneout comes before the court, the judge<br />

would be expected to follow the previous decision (the precedent) or to explain why<br />

it did not apply. The next case involves a Zoneout prescription for a patient with<br />

severe anxiety secondary to cancer treatment. The judge rules that Zoneout is not a<br />

dangerous drug under these facts because the risk of addiction is outweighed by the<br />

benefits of suppressing the anxiety. As more judicial opinions are written on<br />

prescribing Zoneout, it will become clearer when it is legal to use it <strong>and</strong> when it is<br />

prohibited. These opinions are the common law precedent on the prescription of<br />

Zoneout. They tell a physician when it is permissible to use Zoneout.<br />

The value of a common law system is that the law can be adapted to situations that<br />

were not contemplated by the legislature. There are two disadvantages. First, judges<br />

must follow the precedent cases. If they do not, then it is impossible to predict what<br />

the law is. The second is that with hundreds of cases being decided every day, it is<br />

hard to keep up with the relevant decision. It is not unusual for several courts to be<br />

deciding cases on the same subject at the same time, with no good way to coordinate<br />

their opinions. Frequently the courts will reach different conclusions about the law.<br />

The state court in San Francisco might ban the use of Zoneout in the workplace, but<br />

13

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