The state legal systems are quite diverse. Many predate the formation of the
United States. The East Coast states derive from the English common law, many
of the western states were influenced by the Spanish civil law, Louisiana
follows the French civil law, and Texas entered the Union as an independent
nation with a strong Mexican heritage.
Despite the diverse backgrounds, the state court systems tend to follow the
three levels of the federal courts. The levels have different names, but the
process of starting in a trial court, progressing to an appeals court, and
ending up in a state supreme court is common to most of the states. In some
cases that involve federal laws or constitutional rights, it is possible to
appeal the state supreme court decision directly to the U.S. Supreme Court.
With these exceptions, most litigation is brought directly in the state courts.
Even in medical cases brought in the federal courts, the federal court will
apply state law unless the case involves a specific federal statute or a
constitutional right. For example, if a Veterans' Administration physician
working in Maryland is sued for medical malpractice, the case would be brought
in federal court because the physician is an employee of the government. The
federal court would then apply Maryland's law to determine if the physician was
negligent.
One of the difficulties in writing a law book is that the laws vary greatly
among the states. This is most pronounced in laws that govern financial matters
and tax, but it extends to some of the laws that affect medical practice. For
example, in some states, hypodermic syringes are a prescription item.
Possessing them without the requisite prescription violates the state's drug
paraphernalia law. In other states, these same syringes are legal to buy
without a prescription and may be possessed without violating the law.
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