bluuebunny/crossref_metadata_2025 huggingface dataset:
Cash Flows and Discount Rates, Industry and Country Effects and Co‐Movement in Stock Returns
Authors: Ammer John , Wongswan Jon
Published: June 2007

We apply the Campbell decomposition to industry‐by‐country, national, global industry, and world stock index returns using 1995–2003 data. World, global industry, and country factors are all important for each of the two key components of stock returns: news about future dividends and news about future discount rates. Furthermore, the world component of future discount rates is more important than the idiosyncratic component, while the reverse is true for news about future dividends. Our results are broadly consistent with co‐movement in future discount rates arising from perceptions of common elements of risk in international equity markets.
The Agency Structure of Loan Syndicates
Authors: François Pascal , Missonier‐Piera Franck
Published: June 2007

Leaders of loan syndicates often delegate some administrative tasks to banks known as co‐agents. One reason is that co‐agents are specialized banks that help split the costs of managing the syndicate. Another reason is that co‐agents monitor the leader on behalf of syndicate members to mitigate informational asymmetry problems. Large sample tests on the Dealscan database provide support for both arguments. Evidence of repeated contracting between the same banks explains the moderate magnitude of monitoring effects.
Discounting Mean Reverting Cash Flows with the Capital Asset Pricing Model
Authors: Giaccotto Carmelo
Published: June 2007

Discounting cash flows requires an equilibrium model to determine the cost of capital. The CAPM of Sharpe and the intertemporal asset pricing model of Merton (1973) offer a theoretical justification for discounting at a constant risk adjusted rate. Two problems arise with this application. First, for mean reverting cash flows the risk adjustment is unknown, and second, if the present value is compounded forward then the distribution of future wealth is likely right skewed. I develop equilibrium discount rates for cash flows whose level or growth rate is mean reverting. Serial correlation also largely eliminates the skewness problem.
Dysferlin in Membrane Trafficking and Patch Repair
Authors: Glover Louise , Brown Robert H.
Published: June 2007

The muscular dystrophies are a heterogeneous group of inherited disorders, defined by progressive muscle weakness and atrophy. Following the discovery of dystrophin, remarkable progress has been made in defining the molecular properties of proteins involved in the various dystrophies. This has underlined the importance of the dystrophin‐associated protein complex as a cell membrane scaffold, providing structural stability to muscle cells (McNeil PL, Khakee R. Disruptions of muscle fiber plasma membranes. Role in exercise‐induced damage. Am J Pathol 1992;140:1097–1109). While the dystrophies linked to loss of function of dystrophin and its associated proteins are caused by diminished membrane integrity, it is now believed that a new class of dystrophies arises because of a diminished capacity for rapid muscle membrane repair after injury. Dysferlin is the first identified member of a putative muscle‐specific repair complex that permits rapid resealing of membranes disrupted by mechanical stress. Membrane resealing is a function conserved by most cells and is mediated by a mechanism closely resembling regulated, Ca2+‐dependent exocytosis. A primary role for dysferlin in this pathway, as a Ca2+‐regulated fusogen, has been suggested, and a number of candidate partner proteins have been identified. This review outlines the current understanding of the role of dysferlin in membrane repair and the evolving picture of dysferlin‐related signaling pathways in muscle cell physiology and pathology.
A Family of Aspartic Proteases and a Novel, Dynamic and Cell‐Cycle‐Dependent Protease Localization in the Secretory Pathway of Toxoplasma gondii
Authors: Shea Michael , Jäkle Ursula , Liu Qing , Berry Colin , Joiner Keith A. , Soldati‐Favre Dominique
Published: June 2007

Aspartic proteases are important virulence factors in pathogens like HIV, Candida albicans or Plasmodium falciparum. We report here the identification of seven putative aspartic proteases, TgASP1 to TgASP7, in the apicomplexan parasite Toxoplasma gondii. Bioinformatic and phylogenetic analysis of the TgASPs and other aspartic proteases from related Apicomplexa suggests the existence of five distinct groups of aspartic proteases with different evolutionary lineages. The members of each group share predicted biological features that validate the phylogeny. TgASP1 is expressed in tachyzoites, the rapidly dividing asexual stage of T.
gondii. We present the proteolytic maturation and subcellular localization of this protease through the cell cycle. TgASP1 shows a novel punctate localization associated with the secretory system in non‐dividing cells, and relocalizes dramatically and unambiguously to the nascent inner membrane complex of daughter cells at replication, before coalescing again at the end of division.
Annexins and Endocytosis
Authors: Futter Clare E. , White Ian J.
Published: June 2007

Annexins are calcium‐ and phospholipid‐binding proteins that have been proposed to have multiple roles in membrane traffic. Historically, this has been based on the in vitro properties of annexins and their localization to specific membrane compartments. However, recent functional evidence supports a role for annexins in specific membrane traffic steps, although the requirement for annexins may be highly dependent on the cellular context. Here we review the roles of annexins in traffic within the endocytic pathway, focusing on clathrin‐dependent internalization from the plasma membrane, multivesicular endosome/body (MVB) biogenesis and MVB–lysosome fusion.
Endocytosis at Ribbon Synapses
Authors: LoGiudice Lisamarie , Matthews Gary
Published: June 2007

Unlike conventional synaptic terminals that release neurotransmitter episodically in response to action potentials, neurons of the visual, auditory and vestibular systems encode sensory information in graded signals that are transmitted at their synapses by modulating the rate of continuous release. The synaptic ribbon, a specialized structure found at the active zones of these neurons, is necessary to sustain the high rates of exocytosis required for continuous release. To maintain the fidelity of synaptic transmission, exocytosis must be balanced by high‐capacity endocytosis, to retrieve excess membrane inserted during vesicle fusion. Capacitance measurements following vesicle release in ribbon‐type neurons indicate two kinetically distinct phases of compensatory endocytosis, whose relative contributions vary with stimulus intensity. The two phases can be independently regulated and may reflect different underlying mechanisms operating on separate pools of recycling vesicles. Electron microscopy shows diversity among ribbon‐type synapses in the relative importance of clathrin‐mediated endocytosis versus bulk membrane retrieval as mechanisms of compensatory endocytosis. Ribbon synapses, like conventional synapses, make use of multiple endocytosis pathways to replenish synaptic vesicle pools, depending on the physiological needs of the particular cell type.
The noncatalytic C‐terminus of AtPOLK Y‐family DNA polymerase affects synthesis fidelity, mismatch extension and translesion replication
Authors: García‐Ortiz María Victoria , Roldán‐Arjona Teresa , Ariza Rafael R.
Published: June 2007

Cell survival depends not only on the ability to repair damaged DNA but also on the capability to perform DNA replication on unrepaired or imperfect templates. Crucial to this process are specialized DNA polymerases belonging to the Y family. These enzymes share a similar catalytic fold in their N‐terminal region, and most of them have a less‐well‐conserved C‐terminus which is not required for catalytic activity. Although this region is essential for appropriate localization and recruitment in vivo, its precise role during DNA synthesis remains unclear. Here we have compared the catalytic properties of AtPOLK, an Arabidopsis orthologue of mammalian pol κ, and a truncated version lacking 193 amino acids from its C‐terminus. We found that C‐terminally truncated AtPOLK is a high‐efficiency mutant protein, the DNA‐binding capacity of which is not affected but it has higher catalytic efficiency and fidelity than the full‐length enzyme. The truncated protein shows increased propensity to extend mispaired primer termini through misalignment and enhanced error‐free bypass activity on DNA templates containing 7,8‐dihydro‐8‐oxoGuanine. These results suggest that, in addition to facilitating recruitment to the replication fork, the C‐terminus of Y‐family DNA polymerases may also play a role in the kinetic control of their enzymatic activity.
Oxygen binding and its allosteric control in hemoglobin of the primitive branchiopod crustacean Triops cancriformis
Authors: Pirow Ralph , Hellmann Nadja , Weber Roy E.
Published: June 2007

Branchiopod crustaceans are endowed with extracellular, high‐molecular‐mass hemoglobins (Hbs), the functional and allosteric properties of which have largely remained obscure. The Hb of the phylogenetically ancient Triops cancriformis (Notostraca) revealed moderate oxygen affinity, cooperativity and pH dependence (Bohr effect) coefficients: P50 = 13.3 mmHg, n50 = 2.3, and ϕ = −0.18, at 20 °C and pH 7.44 in Tris buffer. The in vivo hemolymph pH was 7.52. Bivalent cations increased oxygen affinity, Mg2+ exerting a greater effect than Ca2+. Analysis of cooperative oxygen binding in terms of the nested Monod–Wyman–Changeux (MWC) model revealed an allosteric unit of four oxygen‐binding sites and functional coupling of two to three allosteric units. The predicted 2 × 4 and 3 × 4 nested structures are in accord with stoichiometric models of the quarternary structure. The allosteric control mechanism of protons comprises a left shift of the upper asymptote of extended Hill plots which is ascribable to the displacement of the equilibrium between (at least) two high‐affinity (relaxed) states, similar to that found in extracellular annelid and pulmonate molluscan Hbs. Remarkably, Mg2+ ions increased oxygen affinity solely by displacing the equilibrium between the tense and relaxed conformations towards the relaxed states, which accords with the original MWC concept, but appears to be unique among Hbs. This effect is distinctly different from those of ionic effectors (bivalent cations, protons and organic phosphates) on annelid, pulmonate and vertebrate Hbs, which involve changes in the oxygen affinity of the tense and/or relaxed conformations.
Physiological responses of lupin genotypes to terminal drought in a Mediterranean‐type environment
Authors: Palta J.A. , Turner N.C. , French R.J. , Buirchell B.J.
Published: June 2007

Field experiments concerning lupin grown in a low‐rainfall environment of the Mediterranean climatic region of Western Australia were conducted over three seasons to identify and evaluate the characteristics that maximise yield per unit of rainfall. The characteristics of early flowering and podding, high pod retention, fast rates of seed filling, osmotic adjustment and the degree of dry matter transfer from stem to the seed were studied in 12 lupin genotypes differing in seed yield under conditions of terminal drought. To allow recently released cultivars and advanced breeding lines to be evaluated, five to six genotypes were included in the first and the third year and nine in the second year. The genotypes were grown rainfed until pod set and then under a rainout shelter. Flowering and podding dates, pod retention, seed growth rate and osmotic adjustment were measured in detail, together with leaf water potential, seed yield and its components. The timing and intensity of development of the terminal drought varied from average in 1998 and 1999 to extreme in 2000. In each year, the seed yield under terminal drought showed genotypic differences, which appeared consistent with the timing and intensity of the development of terminal drought. Early flowering and podding were significantly correlated with seed yield. Fast rates of seed growth were highly and significantly correlated with high yields regardless of the intensity of development of terminal drought. Pod retention was highly correlated with yield in seasons in which the intensity of the development of terminal drought was average but not under extreme conditions of terminal drought. This was because the seed number per pod was markedly reduced to compensate for the high number of pods retained. Osmotic adjustment did not occur during the development of terminal drought in any of the genotypes. Dry matter transfer from stems to seeds was insignificant and not related to seed yield, suggesting that it is not a useful characteristic in screening for high yield under terminal drought.
Water use efficiency in C3 cereals under Mediterranean conditions: a review of physiological aspects
Authors: Tambussi E.A. , Bort J. , Araus J.L.
Published: June 2007

In this review, we will discuss physiological traits of C3 cereals related to water use efficiency (WUE) in Mediterranean environments, from leaf (WUEinstantaneous) to crop level (WUEyield or ‘water productivity’). First, we analyse the WUEinstantaneous and the possible trade‐off between improving this parameter and growth/yield performance. Ways to ameliorate WUE without penalties are discussed. We also analyse in what cases breeding by high or low WUEinstantaneous is a suitable criterion to maintain grain yield under drought (Mediterranean) conditions. This question is approached in the framework of carbon isotope discrimination, (Δ13C), the main indirect parameter used to integrate (at time and space scale) the WUEinstantaneous in C3 plants. A negative correlation between these two parameters has been confirmed by several studies. The relationship between Δ13C and grain yield, however, is more complex, and may differ from one environment to another. In Mediterranean conditions with moderate or no water stress, a positive correlation between Δ13C and grain yield is found in barley and wheat, whereas in ‘stored‐water’ crops (such as in some regions of Australia), lower Δ13C (i.e. higher WUEinstantaneous) is associated with higher grain yield, particularly in more stressful conditions. These apparent inconsistencies and their possible implications for plant breeding are discussed. One physiological trait that has received minor attention in attempts to improve WUEinstantaneous is the role of ear photosynthesis. Ears of barley and durum wheat have a higher WUEinstantaneous than the flag leaf, both in well‐watered and in drought conditions. The underlying causes of the higher WUEinstantaneous of ears are not fully understood, but their refixation capacity (i.e. the capacity to re‐assimilate respired carbon dioxide) could be important. Although the genotypic variability of this trait has not been extensively studied, some data support the idea that variation in refixation capacity may be attributable to genetic factors. At the crop level, decreasing soil evaporation is a crucial factor in efforts to improve the WUEyield in Mediterranean conditions, and fast initial growth of the crop (i.e. early vigour) seems to be relevant. In wheat, modern varieties with dwarfing genes (giberellic acid – insensitive) have higher yields but, concomitantly, they have lower initial growth performance. Recently, semi‐dwarf cultivars (giberellic acid – sensitive) with high grain yield and simultaneously high early vigour were found, opening new avenues to increase WUEyield in wheat. The negative effects of futile water loss by cuticular and nocturnal transpiration are also commented. Finally, we discuss some agronomic practices (in particular, ‘deficit irrigation’ systems) linked to physiological traits that confer higher WUEyield,, in particular, in the cases of Mediterranean regions.
“Informed Consent”: When “Good Medicine May Not Be Good Law”
Authors: Annas George J.
Published: June 2007

As recently as 1970 a legal commentator felt certain enough of his ground to say about informed consent: Good medical practice is good Iaw.' Whatever the validity of that statement then, reliance on it in 1973 is dangerous at best. Three opinions in the last year, in the District of Columbia, California and Rhode Island. have specifically repudiated this view and put the medical profession on notice that they can no longer rely on self. imposed standards to determine what constitutes informed consent.

In Canterbury v. Spence, the defendant doctor had informed both his 19 year old patient who suffered back pain and the patient's mother that a laminectomy was no more serious than any other operation. He did not mention that the procedure carried a 1% risk of paralysis. Following surgery, the patient suffered total paralysis from the waist down. Tho court decided specifically that the physician was under an affirmative obligation to disclose this risk information regardless of what was medically customary. The court held that the law, not medical custom, defines the standard of disclosure according to the patient's needs.
Law & Psychiatry: When Must the Doctor Warn others of the Potential Dangerousness of His Patient's Condition?
Authors: Annas George J.
Published: June 2007

In late December 1974, the Cailfornia Supreme Court considerably broadened a physician's duty to disclose Information gained in the course of treatment by enunclating the following rule: “When a doctor or a psychotherapist, in the exercise of his professional skill and knowledge, determines, or should determine, that a warning is essential to avert danger arising from the medical or psychological condifion of his patient. he incurs a legal obligation to give that warning.” (emphasis mine)

Prior to this case most lawyers would probably have assumed that such a “legal obligation” would have only been imposed by statute. such as contagious disease, child abuse and gunshot wound reporting statutes, and that giving of such warnings in the absence of a specific statute mandating reporting or warning was optional with the physician. While this case involved a psychologist, and is most relevant to psychlatric care, the broad language used by the court makes it clear that, in California at least. Its conclusions apply to all types of physicians. Because of its broad implications. It is worth taking a careful look at the facts which prompted the court to enunciate this expansive rule.
Survey of Regional Medical Libraries Raises Important Issues
Authors: Annas George J.
Published: June 2007

The Boston University Center for Law and Health Sciences has recently completed a questionnaire survey of the country's eleven regional medical libraries (RML's). These libraries were so designated following passage of the Medical Library Assistance Act of 1965. The purpose of the program is to make the growing medical and scientific literature available to all “qualified persons” regardless of their geographical location. The statute provides, inter alia, that “qualilied persons and organizations shall be entitled to free loan services.“

The Center undertook this survey to determine what steps these libraries, which receive federal funding to help them perform as regional resources, were taking to make their collections available to those who needed to use them. All eleven libraries responded in some way to the questionnaire, although one, listed by H.E.W. as the “Midcontinental Regional Medical Library” in Omaha, Nebraska, responded that it was not a library at all, but only involved in “planning and coordinating” a library program.
The Physician Countersuit: ‘More Than Having to Say You're Sorry’
Authors: Tillotson Madeline J. , Sagall Elliot L.
Published: June 2007

Growing dissatisfaction with traditional bar association grievance mechanisms as a deterrent against the institution of “frivolous” medical malpractice suits has promoted physicians to explore other methods of legal redress against “unscrupulous” lawyers. One avenue of recourse now being popularized among physicians is a countersuit by defendant physician against plaintiff patients and attorneys. The reasoning behind this approach has been bluntly expressed by a recent successful countersuitor, Dr. Leonard Berlin, “The school bully who harasses innocent children in the playground isn't stopped by reporting to his parents—he's stopped only by a punch in the face. Lawyers who abuse the court systems similarly can only be stopped through the same court system.”

Attractive as the countersuit attack may appear on the surface, the effectiveness of such a retaliatory measure in stemming medical malpractice litigation is questionable and doubtful.
News from the Society
Authors: Sagall Elliot L.
Published: June 2007

Fall 1977

With this issue, MEDICOLEGAL NEWS inaugurates a number of new features and a new internal appearance intended to give our readers the type of articles and information believed of interest to the many persons concerned with medicolegal problems. To improve this service, the comments and suggestions of our readership are earnestly sought. Additionally, guest editorials are invited and in this area, Leonard Berlin, M.D., a successful countersuitor and participant at the recent Controversies in Law & Medicine symposium, leads off with a response to last issue's article entitled, The Physician Countersuit: More Than Having To Say You're Sorry. Other new features include, Medicolegal Update, a regularly planned column designed to bring relevant developments in medicolegal areas to the attention of MEDICOLEGAL NEWS readers, and Hospital Forum, edited by James F. Holzer, J.D., formerly MEDICOLEGANLE WS Managing Editor. In this column, Mr. Holzer will address timely legal issues and developments affecting the hospital and its personnel.
A Practical Guide to Assist Hospitals and Physicians Obtain Fellowship Tax Exclusion
Authors: Stuart William W.
Published: June 2007

This article concerns the exclusion from taxable income of scholarship and fellowship grants received by residents and research assistants under Section 117 of the Internal Revenue Code. As is often the case, frequent litigation has resulted in confusion, and it has become difficult for the individual physician or institution to determine the extent and scope of exclusions that are possibly available.

The enactment of Section 117 in 1954 was intended by Congress to provide an exclusion from taxable income to students for all scholarship and fellowship income received. However, the courts, which had to interpret the intended meaning of “scholarship” and “fellowship” income, developed three often inconclusive and contradictory tests — the primary purpose, compensation, and control tests. 1969, the United States Supreme Court, in the case of Bingler v. Johnson, synthesized these three tests into a single standard, the quid pro quo test. The Court held that the meaning of “scholarship” and “fellowship” intended by Congress comported with the ordinary understanding of the terms, that is, as relatively disinterested, “no-strings” educational grants, with no requirement of any substantial quid pro quo from the recipient.
“Good Samaritan” Statutes: Do They Protect the Emergency Care Provider?
Authors: Zaremski Miles J.
Published: June 2007

In 1959, California became the first state to enact legislation protecting good Samaritans from tort liability under certain circumstances. While previously a good samaritan giving aid in an emergency could be held liable only if he acted unreasonably, there was no legislative mandate to affirmatively discourage an injured party from bringing suit against the good samaritan. Although few such cases can be documented, the absence of legislative protection was thought to work a serious detriment to the prompt rendition of aid in emergency conditions, since some medical practitioners might refrain from giving emergency aid for fear of being subjected to legal action. In response to this perceived situation, California enacted its legislation to encourage the giving of emergency aid and to “sufficiently allay [the good samaritan's] fears of legal action:”

Currently, good samaritan statutes exist in all fifty states, the District of Columbia, and the Virgin Islands. These statutes range from the very broad to the very specific, and each is supposedly designed to protect the good samaritan emergency care provider from frivolous litigation. However, developments in recent years have caused commentators to question whether the central purpose behind these statutes—to discourage legal action—has actually been achieved.
Patient Privacy and the Media
Authors: Holzer James F.
Published: June 2007

“Whatsoever things I see or hear concerning the life of man, in any attendance on the sick or even apart therefrom which ought not be noised about, I will keep silent thereon, counting such things to be professional secrets.”

Hippocratic Oath

There can be no doubt that a tremendous amount of information is collected within the lifetime of all health care consumers, and today, people who are admitted to hospitals are seeking greater assurances that their relationship with the hospital and the physician is one of confidence and trust.

With the vast amount of personal information collected by hospitals and federal or state agencies, the effort to protect privacy has been gaining great momentum. Although Hippocrates attempted to address the issue within the ethical sphere of medicine, the legal right was first conceptually argued by U.S. Supreme Court Justices Louis Brandeis and Samuel Warren in an 1890 HARVARD LAW REVIEW article. The so called “right to privacy,” while not found directly in the Constitution, has served as the basis for numerous privacy decisions by the high court since that time.
Experimentation with Children: The “Pawns” of Medical Technology
Authors: Porcaro Edward T.
Published: June 2007

Without the use of human subjects in pediatric research, medical science would not have made many of its advances in the diagnosis and treatment of children's diseases. However, scientifically valid experimental trials require healthy subjects as controls and the use of healthy children raises many complex moral and legal questions.

The need to experiment on normal, healthy children has blocked full recognition of their legal rights. Currently, as in the past, parents are allowed to volunteer their children as research subjects by means of “proxy consent.” This doctrine is, however, the only legal justification offered for submitting children to the often potentially damaging procedures they may be subject to as unknowing and perhaps unwilling subjects. While such third party consent appears to satisfy everyone's conscience, its use in non-therapeutic experimentation is inconsistent with established legal principles.
Licensing for Athletic Trainers: A Call for Action
Authors: Redfearn Richard W.
Published: June 2007

Approximately 45 million children engage in interscholastic athletics in the United States annually. The exact figure varies from year to year, and the growth of athletic participation indicates that the estimate may be low. Perhaps one percent of that number will receive medical care other than simple physical examinations or episodic treatment for trauma. In Michigan and Maryland, research has shown that fewer than 50 percent of the high schools have physicians in attendance for contact sports. Attendance by physicians at junior varsity and junior high school athletic contests is considerably less frequent. School-based physicians are vanishing, and other health professionals have not assumed responsibility for preventive medical care for scholastic athletes. Rather, in many instances, the “athletic trainer” has assumed responsibility for the health and condition of the athlete.
Ethical Considerations in the Prevention of Smoking in Adults and Children
Authors: Gilbert Richard M.
Published: June 2007

In a recent issue of MEDICOLEGAL NEWS, Christoffel and Stein reviewed and lamented the “lack of legislative action” against smoking, and blamed the “political and economic strength of the tobacco industry” for “this failure” to protect the public from the costs attributable to death, disease, and disability associated with cigarette smoking, described as the “primary preventable health risk” in the United States. An editorial rebuttal by Matthews noted that cigarette use may have other causes than the tobacco industry, that there may be little consensus as to the need to condemn smoking, and that “moral entrepreneurs” such as Christoffel and Stein could “buoy their spirits” by confining themselves initially to the business of protecting non-smokers from the consequences of people smoking in their presence.
The Medicolegal Physical Examination
Authors: Sagall Elliot L.
Published: June 2007

Medical examinations and evaluations by physicians specifically undertaken to provide information for the processing of insurance and legal claims are essential to the proper functioning of our insurance and legal systems. Since such evaluations often emphasize aspects of the medical examination and employ reasoning not customarily addressed by physicians who are primarily concerned with diagnosis and treatment, the distinguishing features of these medicolegal examinations should be appreciated by physicians asked to perform this type of examination. Similarly, these features should also be understood by persons who interpret medical data and physicians' opinions in resolving claims involving such medical issues as cause-and-effect relationships and disability ratings.
The Case against Medical Licensing
Authors: Locke Edwin A. , Mode Arthur S. , Binswanger Harry
Published: June 2007

The recent general disenchantment with government control has focussed attention on the concept of occupational licensing. The logical place to begin a reappraisal of occupational licensing is in the field of medicine, where such licensing originated and where it has been most fully accepted.

Our position is that no rational or moral foundation for medical licensure exists and, therefore, we recommend the total abandonment of governmental licensing and the substitution of free market protections, including private certification. Medical licensing, and occupational licensing in general, is morally wrong and ineffectual in practice.
What's Right with Patients' Rights
Authors: Carroll Patrick R.
Published: June 2007

After eight years of review, analysis, several rejections, at least one near passage, and little or no floor debate in 1979, the Massachusetts Legislature enacted a patients' rights statute. Its passage was generally greeted with rising apathy except for one section which requires physicians treating female patients to make available “in the case of a patient suffering from any form of breast cancer, complete information on all alternative treatments which are medically viable.” The enactment of the patients' rights statute has imposed no major burdens on hospitals since the majority of the provisions of the act were already general practice among most institutions.
Antitrust and Health Planning
Authors: Berriman W. Thomas
Published: June 2007

The goals of the federal and state antitrust laws and of the federal and state health planning laws often appear to be in conflict. The health planning laws encourage cooperation among providers of health care services and the sharing of facilities and services, based upon the premise that competition in the health care field has not succeeded in containing costs or adequately distributing resources. Generally, it can be said that the health planning laws, by establishing controls to prevent the unnecessary duplication of services, protect service monopolies. In contrast, antitrust laws are designed to prevent the establishment of monopolies which are able to control the supply of services. The antitrust laws are intended to promote a vigorous and competitive economy, in which businesses have a full opportunity to compete on the basis of price, quality and service. As a result of this conflict, those involved in health planning have become concerned about the legal environment in which they act.
Understaffing: Living with the Reality
Authors: Greenlaw Jane
Published: June 2007

The nursing shortage has gained national attention, generating a television network special as well as a lengthy article in the NEW YORK TIMES SUNDAY MAGAZINE, ith much speculation as to causes and solutions. And, while some health care institutions are trying new and creative ways to attract nurses (such as the much-publicized work-everyweekend- have the-rest-of-the-weekoff plan developed by one Texas hospital), others are reducing their bed capacities or attempting to fill the gaps with overtime or temporary personnel.
Medical Care for Prisoners: The Evolution of a Civil Right
Authors: Mariner Wendy K.
Published: June 2007

“Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted.”

The standard of medical care provided in prisons has emerged recently as an important issue in the areas of public health and prisoners' rights. Prison conditions have long been of concern to both the medical and legal professions. However, little progress was made in prison health care until the early 1970s when the federal courts began to recognize civil rights actions by prisoners pressing for adequate medical care. This article discusses the problems involved with providing medical care in prisons, the development of constitutional standards for prison medical services, and, collaterally, the difficulties encountered when pursuing prison reform by means of federal litigation.
Conditions on Certificates of Need: Approval at What Price?
Authors: Berriman W. Thomas
Published: June 2007

Providers and health planning agencies familiar with the federaily mandated Section 1122 and certificate of need (CON) programs had mixed reactions to the passage of the 1979 amendments to the National Health Planning and Resources Development Act (the 1979 Planning Act Amendments), especially the addition of Section 1527 which prescribes specific federal requirements for state CON programs. One of the most controversial provisions of Section 1527 is the so-called conditions amendment, often referred to as the “Satterfield amendment.” The conditions amendment has crystalized by statute a power that many planning agencies had previously assumed and that most hospitals had feared: state health planning and development agencies (SHPDAs) have the legal authority to issue CONs subject to conditions that require applicants to undertake actions unrelated to those for which they sought approval. At the same time, however, the conditions amendment vindicates a notion long held by providers and rejected by some planning agencies: the SHPDA's conditioning power is not unlimited; while some conditions are permissible, others are not.
The Psychiatric Nurse’s Duty to Warn Potential Victims of Homicidal Psychotherapy Outpatients
Authors: Kjervik Diane K.
Published: June 2007

During the 1960s, master's level programs evolved to educate psychiatric nurses to become teachers, administrators and clinicians. Prior to this time, psychiatric nurses had functioned primarily in inpatient settings, but gradually these nurses began working as primary therapists in outpatient clinics, community mental health centers and independent practices. In 1976, the American Nurses’ Association (ANA) published its Statementon Psychianic and Mental Health NursingPractice which identified the master's prepared psychiatric nurse as a “psychiatric and mental health nursing specialist.” Nurses at this level were expected to be experts in psychotherapeutic methodologies and could practice psychotherapy independently.

Nursing practice acts have changed to allow for the expanding nurse role. Prohibitions against diagnosis and treatment that were recommended by the ANA in 1955 were eliminated in the ANA's 1976 Model Practice Act. In 1980, the ANA suggested legislation that would include diagnosis, counseling, intervention and the management of illness within the definition of nursing
Recovery for Psychic Injuries under Workers’ Compensation
Authors: Miller Charles N.
Published: June 2007

In early common law, the courts refused all remedy for emotional disturbance or mental suffering unless it could be pigeonholed within the scope of one of the existing torts, such as assault, battery, false imprisonment, seduction, defamation and the like. The difficulty in reducing such injuries to compensable terms made courts reluctant to recognize and remedy those disabilities. As Lord Wensleydale said in 1861: “Mental pain or anxiety the law cannot value, and does not pretend to redress, when the unlawful act complained of causes that alone.” But appealing as this generalization might be, it flies in the face of reality. As a practical matter, courts have long since allowed damages in tort for such injuries as the loss of limbs or organs and, more recently, have permitted juries to assess money damages by way of subjective Compensation for mental anguish, humiliation, or other emotional loss resulting from defendant’s alleged misconduct. Such compensable events arise within many facets of the law and are especially noteworthy in the area of workers’ compensation.
Delivery Rooms: For Women Only?
Authors: Greenlaw Jane
Published: June 2007

Does a hospital have the right to prevent a qualified male nurse from working in its labor and delivery section? In Backus v. Baptist Medical Center, this question was answered in the affirmative by a United States District Court in Arkansas. The case, now on appeal, serves as an obstacle to professional nursing and an affront to the rights of female patients.

The plaintiff, Gregory Backus, is a registered nurse who, while employed by the defendant hospital, twice requested and was refused full time placement in its labor and delivery section. The refusals were based upon an unwritten policy that the hospital “did not employ male R.N.s in OBGI” positions because of the concern of our female patients for privacy and personal dignity which make it impossible for a male employee to perform the duties of this position effectively.”
Diminished Lives and Malpractice: Courts Stalled in Transition
Authors: Furrow Barry R.
Published: June 2007

Medicine is still largely a pre-Darwin, pre-Newton enterprise.. . . We do not yet understand the underlying mechanisms of the major illnesses which plague humanity, and therefore much of what is done in the treatment of illness must still be empirical, trial and error therapy. We are compelled by our limitations to resort to shoring things up, applying halfway technology, trying to fix things after the fact.

The judicial debate continues to rage over the right of a child born suffering from genetic impairments to recover on his own behalf against a physician or laboratory which failed to give his parents correct information about the defect. These “wrongful life” suits are brought by parents on behalf of their child, who in most cases is born suffering from mental or physical defects which could have been detected by genetic screening. In contrast, “wrongful birth” suits are actions brought by parents of a child born as the result of a defendant’s negligence, seeking damages for either the costs incident to the unwanted pregnancy and birth of a normal child, or the costs related to the unexpected birth and care of an impaired child.
TheEichner/StorarDecision: A Year's Perspective
Authors: Dunn Lee J.
Published: June 2007

On March 31,1981, the New York Gurt of Appeals handed down its decision in the consolidated cases of Brother Joseph Fox and John Storar. The Eichner case was generally well known, having excited considerable national publicity both before and after the Appellate Division of the Supreme Court of New York handed down its opinion on March 17,1980. TheStorarcase,) conversely, was not as well known and was consolidated with the Eichner case, in the words of the Court of Appeals, because future similar cases would arise. As will be discussed more fully in this article, the consolidation of these two markedly dissimilar cases not only has created confusion, but also has served to obscure the position taken by the court of Appeals relative to other similar cases both in New York and other jurisdictions.

Brother Joseph Fox was an 83 year old member of a Catholic religious order who enjoyed good health until he suffered cardiac arrest during the performance of a hernia operation. As a result of the cardiac arrest, he became anoxic, suffered permanent brain damage, and became respirator-dependent.
Current Trends in Workers' Compensation
Authors: Stander Irvin
Published: June 2007

The Report of the National Commission on State Workers’ Compensation Laws heralded a new era for workers’compensation in the United States. Appointed by the President in 1970, the Commission issued its report in 1972, and pointed out the gross inadequacies of all the state systems. To compel the states to modernize their compensation laws, the Commission established 19 essential recommendations, and placed time limitations on the adoption of these standards by the states, with the threat that if these recommendations were not met by July 1975, the Commission would recommend to Congress that the non-complying state systems be taken over by the federal government and operated under the generally more liberal provisions of the Longshoremen's and Harbor Workers’ Compensation Act.
Nurse-Midwifery: A Developing Profession
Authors: Tom Sally
Published: June 2007

Consumer demand and federal support has caused the number of certified nurse-midwives to quadruple in the last decade, from 629 in 1970 to 2500 in 1982. Despite their record of reducing infant mortality and satisfying consumers, nurse-midwives are still an underutilized health resource. This article provides a brief history of nurse-midwifery. describes nurse-midwives’ education and current legal status, discusses obstacles to wider use of nurse-midwives, and examines the issues of safety and cost-effectiveness of nurse-midwifery practice.

The word “midwife” often evokes images of home births attended by “granny” or “lay” midwives who lack formal education in obstetrics. Yet, professionally educated nurse-midwives have practiced in this country since 1925, when an American nurse, educated in nurse-midwifery in England, came to the mountains of eastern Kentucky.
Wrongful Life — Its Problems are Not Just Semantic: A Reply to Furrow
Authors: Taub Sheila
Published: June 2007

In an article in the June, 1982 issue of this journal, Barry Furrow suggested that changing the name of the tort of “wrongful life” to “diminished life” would overcome the reluctance that many courts have shown to recognize its existence. Others have made similar suggestions, differing only in the names which they proposed as a replacement for “wrongful life.” It is my belief, however. that the problems that many courts and commentators have had with “wrongful life” are inherent in the nature of the action and will not be resolved by simply changing its name.

In the remainder of this article, 1 will employ the neutral term “X” to refer to any action brought by a child for having been born with some defect or handicap which could only have been prevented, given the current state of medical knowledge, by either aborting the child or preventing its conception. It is hoped that this device will avoid the danger of “semantic overload,” of which Professor Furrow wrote.
Cognitive Moral Development Theory And Moral Decisions in Health Care
Authors: Allen David F. , Fowler Marsha D.
Published: June 2007

During the past few years, health care professions haw received strong criticism for seemingly ethically wrong or inhumane practices. The Tuskegee syphilis study, experimentation on mentally retarded persons at Willow-brook, forced sterilizations of retarded individuals, and alleged malpractice and Medicaid abuses are a few examples of those instances that have received publicity. Incidents such as these, coupled with the development of an aggressive consumerism and with escalating scientific technological advances, haw created an urgent and widespread concern about medical ethics or bioethics. The Hastings Institute, two presidentially appointed commissions on issues in medical ethics, and the introduction of ethics courses in the curricula of medical and nursing schools are responses to ethical concerns in health care.

Although numerous texts and articles on specific bioethical issues haw been published in recent years, troubling questions remain about the normative ethics that form the foundation of responses to these issues.
Documentation of Patient Care: An Often Underestimated Responsibility
Authors: Greenlaw Jane
Published: June 2007

There is increasing societal concern about retention and retrieval of information about individuals; advances in technology have enlarged the means for storing and communicating personal information. Not surprisingly, some of this concern is directed toward medical records. Questions have arisen about ownership of and access to medical records, as well as their content. This column focuses solely on some basic issues pertaining to the content of medical records.

Information in a patient's medical record can be used as a basis for decisions concerning his insurance coverage or payments, employment, eligibility for educational or benefit programs, or the outcome of a lawsuit. Thus, the law generally recognizes the patient's right to control the access to his medical record by third parties.

Because of the permanence and potential importance of a patient's medical record, health professionals frequently raise questions about what to include in the record, who should write in a patient's chart, where and how to make corrections, and how to document specific problems such as patient injury or concerns about the quality of care the patient is receiving.
The Emergicenter: Has its Time Arrived?
Authors: Zaremski Miles J. , Fohrman Darryl M.
Published: June 2007

Skyrocketing health care costs are endemic during inflationary periods, affecting not only health care consumers, but also health care providers. Virtually all governmental policymakers recognize spiraling health care costs, but hospital costs continue to escalate faster than the general rate of inflation. In response, alternatives to the traditional physician-patient and hospital-patient relationships have experienced a dramatic resurgence in the last decade, competing for the health care dollar. Two health care alternatives, the health maintenance organizstion (HMO) and the ambulatory surgical center (surgicenter) at which minor surgical procedures can be performed on an out-patient basis. have emerged to provide health care services in a more cost-efficient manner, thereby increasing price competition in the health care sector. The most recent alternative health care system on the health care horizon is the free standing emergency center or “emergicenter.” The growth of these emergicenters within the last few years has heen dramatic—500 in existence as of March 1982.
More on the Right to Refuse Treatment: Brother Fox and the Mentally Ill in New York
Authors: Rockford Susan Haberstroh
Published: June 2007

The idea for this article first occurred to me more than one year ago when the Brother Fox case was decided by the New York Court of Appeals, the highest court in New York. At the same time, debate was raging among, and between, lawyers and psychiatrists about the right of involuntary psychiatric patients to refuse antipsychotic medication. Thus. I was led to consider the philosophical and legal relationship between the so-called right to die and the right to refuse psychiatric treatment.