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Student Series: Taking on Hospital Debt

As the week gets started, here’s another taste of what students working on one of the A2J Lab’s signature study, the Financial Distress Research Project, are doing. The students who have been blogging thus far have talked about their experiences in Small Claims Court as well as tackling self-help materials for complicated bankruptcy forms. And those aren’t the only two focus areas of the project; students are also entering more uncharted territory, trying their hand at creating self-help materials for hospital debt.

Today, we’ll hear from 2L Rachel Finkel, who works on the Hospital Debt team of the Financial Distress Research Project.

Student Series: Show Me Your Proof

If you’ve been following our student series, you’ve learned a bit about the math involved in filling out bankruptcy forms, the complicated world of wildcard exemptions, and the reality of Small Claims Court for many defendants. Students are tackling all of these issues as part of student teams working on the Lab’s Financial Distress Research Project, creating self-help materials and legal briefs for small claims cases and bankruptcy filings.

This week, Lauren Mercer brings us back to Small Claims Court to talk about how defendants should ask for, and then evaluate, plaintiffs’ evidence.

Student Series: It’s Not That Simple

Last week the student teams had their first meeting of the semester for the Financial Distress Research Project. And they’re pushing ahead on self-help materials! In addition to tackling the Lab’s mission to bring empirical thinking to the legal profession, students are trying their hand at understanding the alphabet soup of bankruptcy forms in order to craft the best self-help materials. It turns out, this can involve a lot of math (sometimes more math than law). Whether it’s calculating home costs, income and benefits to figure out how to apply for fee waivers, or determining what exemptions to claim, students are trying to navigate how best to represent these tasks, concisely and clearly, in self-help materials. Throughout the semester we’ll be continuing this series of student blog posts where students will talk about their work on A2J Lab projects.

Our fourth student blogger is 2L Zain Rifat, who works on the Bankruptcy team of the Financial Distress Research Project.

Student Series: From Theoretical Lectures to Field Research

One of the A2J Lab’s signature studies, the Financial Distress Research Project, has numerous moving parts and as the project has grown has brought new challenges for researchers and students. The Lab’s research seeks to bring empirics to the legal profession and persuade others of the value of rigorous evaluations, including RCTs, to figure out what works and what doesn’t in legal services. To do so our research tackles hard questions of triage, as well as new challenges like using adult education literature to push at the question of what exactly is effective self-help material. And to do so we have the help of many not-yet legal professionals, or law students, who are at a unique juncture to be able to craft self-help materials, bringing their outside knowledge before they are engaged in the profession, along with everything they are learning in the classroom. Throughout the semester we’ll be continuing this series of student blog posts where students will talk about their work on A2J Lab projects.

Our third student blogger is 2L Amanda Lee.  Amanda works on Financial Distress Research Project, creating a legal brief on small claims debt collection cases for judges to use in the proceedings. In this post Amanda talks about why she got involved in this project, what she learned when she did, and how law works in “the real world” for pro se litigants.

Student Series: Wildcard Exemptions

Students are back from break! And ready to tackle some more bankruptcy forms and self-help materials.

As we mentioned last week in our first student blog posts, there a quite a few students working on the Lab’s Financial Distress Project. They are constructing self-help materials, and in doing so learning the ins and outs of the bankruptcy process, interacting with court users, and drawing on literature from other fields.

Last week, Seth Motel talked about what he had learned from a small sample bankruptcy filings from Connecticut. This week, Alvina Pillai, also on the Bankruptcy Team of the Financial Distress Project, talks about how to navigate the complicated assessment of household items and federal “wildcard” exemptions.

Let’s Hear from Students!

The A2J Lab produces quality research on A2J issues and seeks to change hearts and minds about the value of rigorous empirical study, including RCTs, to the legal profession.  It also has a symbiotic relationship with students.  Lots of students.  Currently, over four dozen law students work on A2J Lab projects.  Some of these students will be writing blog entries to show how their work furthers Lab projects, and how the Lab provides them with opportunities to experience the real world of law.

Our first student blogger is Seth Motel.  Seth works on the Bankruptcy Team for the Financial Distress Research Project.  That means he works with several student team members to create self-help materials to allow low-income Connecticut individuals and families to file for Chapter 7 bankruptcy.  Self-help materials are one of the primary interventions that the Project will evaluate.

Seth’s post shows that a great deal of empiricism involves good, old-fashioned spadework.

The Gift of RCTs Keeps on Giving



Just before the holidays, a monumental RCT delivered an early gift. In what is being hailed as a “scientific triumph,” a vaccination trial documented 100% protection against the Ebola virus. You read that correctly: 100%. In several prior posts, I’ve discussed how RCTs have transformed the medical profession. In this case, one can’t help but be overwhelmed by the tremendous success of randomized evaluation.

Although the drug has not yet been formally approved for widespread use, the results of the 2015 trial suggest that it could be soon. The study, which covered 11,841 people in the West African nation of Guinea, already has prompted increased production and storage of the vaccine. Why? Of the 5,837 people treated with the vaccine, none came down with Ebola after the standard 10-day waiting period for positive tests. Among the control group that did not receive the vaccination, only 23 people contracted Ebola.

The Ebola outbreak and the development of a vaccine amidst crisis makes for an intriguing case study. The 23 positive diagnoses among the control group, compared to the 11,000 lost lives in 2014, probably are a function of other drastic efforts at containing the virus. Although the disease had been around for some time, most attempts to combat Ebola’s spread followed a “contain and stifle” approach. But when thousands of people in Guinea and surrounding countries started contracting the disease, that resource-intensive strategy did not prove scalable.

Ebola dominated the news, and cases outside of Africa stoked additional fear. With the outbreak came a “[u]nique opportunity: Never before had the disease affected enough people to allow researchers to test Ebola drugs and vaccines in a real-world setting. As the number of cases exploded in mid-2014, they set in motion a vast research program that operated at breakneck speed.” The clinical trials encountered their own problems. Money dried up, and patient numbers fell as the outbreak waned. In other words the trials suffered from so-called “thin harvest,” making it difficult to conduct studies with adequate sample sizes.

The researchers who developed the new vaccine responded to this challenge with an innovative research method focused on randomizing “ring clusters,” by which entire circles of people closely connected to an Ebola patient are sorted into treatment and control groups. This study design not only increased the sample size, it also made sense in the light of how Ebola affects populations. The virus is communicated mainly through family and social networks, even among mourners who attend a deceased patient’s funeral. This approach “ensured that the study was undertaken in pockets of high incidence . . . despite the declining epidemic and an overall low attack rate.”

Funding and pooling service providers to conduct RCTs in the legal field of course encounter similar obstacles. Variation in the numbers of cases and types of services offered is analogous to the fluctuating numbers of Ebola patients for a drug trial. As mentioned in our series on triage, legal resources and services will always be scarce. More people than the system can accommodate need legal services. This fact will remain a constant. The silver lining is that, as resources are spread thin or do not reach everyone in need, such scarcity lays some of the ethical foundation for experimentation. And randomized methodologies, as we know, are the optimal strategies for discovering how best to help the underserved.

In addition, when considering the phenomenal Ebola vaccine account, legal RCTs might present opportunities beyond just learning about a specific intervention. We might also gain insight into new legal rules and how to construct preventative (or ex ante), rather than just prescriptive services. That said, we don’t kid ourselves by hoping for 100% effectiveness in any A2J Lab study, but we are heartened by the continued success of medical RCTs and the promise of similar discovery in our randomized legal studies. 

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New Year, New Activity


Blob celebrating all the access to justice related RCTs that 2017 may bring.

Happy New Year from the A2J Lab! The start of 2017 coincides with many exciting research developments and a longer-term campaign to introduce our work more broadly. Practitioners and scholars often ask us about the issues that we care about and how we commit ourselves to randomized interventions in legal services. Thankfully, the Center for Court Innovation, an organization committed to justice reform through rigorous experimentation and data analysis, shared the same questions. Aubrey Fox hosted our very own Jim Greiner on the New Thinking podcast to discuss the A2J Lab’s mission and current projects. Listen here:

On Your Mark, Get Set, Triage

Part 2 of “To Triage of Not to Triage? That is NOT the Question.”

Last week I took another dive into the world of triage- specifically focusing on some common questions and sticking points that were raised in RadioLab podcast entitled “Playing God.” As was mentioned in the previous blog post, we don’t think triage is really about playing god, rather about facing limited resources and making decisions. Last week we talked mostly about the value implications of such discussions of who lives and who dies. This week we’ll touch upon two other points. First, the reaction to not want to make triage decisions, and the second is the multitude of ways to triage and therefore the importance of RCTs in knowing which way is best in a given situation.

“To Triage or Not to Triage?” That is NOT the Question

Part 1

The Radiolab podcast from WNYC Studios is as close to appointment listening as we have in 2016. One of the show’s recent episodes, entitled “Playing God,” takes up a topic directly in the A2J Lab’s wheelhouse: triage. In a stark bit of commentary, the host characterizes the practice not as deciding how to allocate scarce resources; rather he described it as an “inhuman act which humans are trying to do.”