bluuebunny/crossref_metadata_2025_split huggingface dataset:
Construction Picketing Notices to Health Care Institutions: The National Labor Relations Board Alters its Approach
Authors: King G. Roger 
Published: June 2007

In the health care field, the concept of protected employee activity under the National Labor Relations Act (NLRA) must be balanced against the need to avoid the disruption of patient care. Congress acknowledged the need to balance these competing concerns when it included Section 8(g) within the 1974 Health Care Institution Amendments to the NLRA.Section 8(g) establishes a notification procedure with which a labor organization must comply before commencing a strike or other concerted work-stoppage. In an effort to ameliorate the threat which an unannounced and unanticipated stoppage of work poses to the delivery of health care, Section 8(g) requires that a labor organization provide the health care institution and the Federal Mediation and Conciliation Service with written notice specifying the date and time of any strike, picketing, or other work-stoppage at least ten days in advance of the planned activity.
IPAs and

Per Se

Rules:

Arizona v. Maricopa County Medical Society
Authors: Cohen Harry Philip 
Published: June 2007

The recent flurry of antitrust litigation in the health care industry is forcing the courts to reevaluate the legality of existing health care institutions under the Sherman Antitrust Act. One type of institution that poses significant antitrust questions is the independent practice association (IPA), an arrangement which consists of a contractual relationship between subscribers, physicians and an IPA corporate entity. The physicians agree to provide medical services to the IPA's subscribers, who pay a flat rate. In exchange, physicians are reimbursed at rates usually established by a fee schedule.The Health Maintenance Organization Act of 1973 requires that an IPA, like an HMO, must “assume full financial risk on a prospective basis for the provision of basic health services…” This ensures that the IPA bears the risk that the cost of the services it renders will not exceed the value of the premiums it collects, giving it an incentive to contain costs.
The Patient's Right to Refuse Anti-Psychotic Drugs: The Court of Appeals Decision in Rogers v. Okin
Authors: Cole Richard 
Published: June 2007

On October 29, 1979, Judge Joseph Tauro of the United States District Court for Massachusetts issued a nationally publicized decision in a case entitled Rogers v. Okin, declaring that voluntary and involuntarily committed patients at Boston State Hospital had a constitutional right to refuse treatment in non-emergency situations. The suit, brought as a class action, was filed on April 25, 1975, by seven patients who were either voluntarily admitted or involuntarily committed to the May and Austin Units at Boston State Hospital. On April 30, 1975, a temporary restraining order was issued by the District Court enjoining the doctors at Boston State Hospital from continuing their practice of forcibly medicating patients in non-emergencies. This temporary order remained in effect through the trial and until the District Court issued its permanent order in October 1979.The ruling was widely criticized by some psychiatrists as an unwarranted intrusion by the courts into the practice of medicine. However, others within the medical and the legal communities considered the decision a major victory for the civil and human rights of institutionalized patients.
Malpractice Countersuits: Succeeding at Last?
Authors: Taub Sheila 
Published: June 2007

From time to time physicians have attempted to retaliate against malpractice suits which they perceive as groundless by filing countersuits against the suing patient, his attorney, or both. In recent years the number of such countersuits filed has risen dramatically, amounting to what one author has called a “legal fad.” A Dallas attorney has reportedly formed an organization, Lawyers for Protecting People From Malicious and Unjustified Lawsuits, Inc., to assist those who countersue attorneys. Until recently, however, such countersuits were nearly always unsuccessful because of the formidable burden of proof placed on the plaintiffs by the applicable legal doctrine. This article will discuss a handful of recent appellate court decisions which suggest that the countersuit may yet prove to be a potent weapon in the physician's arsenal against groundless claims.In Bull v. McCuskey, a 1980 case, the Supreme Court of Nevada upheld an $85,000 countersuit award. This appears to be the first such decision upheld by a state supreme court and the largest countersuit award to date.
Trends in National Labor Relations Board Decisions for the Health Care Industry
Authors: Zimmerman Don A. 
Published: June 2007

The 1974 health care amendments to the National Labor Relations Act (NLRA or the Act) have given rise to several significant developments in the case law. This article focuses on the subjects of appropriate bargaining units, the inclusion — or exclusion — of house staff under the NLRA, and, briefly, the special strike notice requirements under section 8(g) of the Act. These areas have been the subject of substantial controversy and conflict among the federal courts.In 1947, the Taft-Hartley Act excluded from the term “employer” as defined in the NLRA, “any corporation or association operating a hospital, if no part of the net earnings inures to the benefit of any private shareholder or individual.” In 1974, Congress removed the exclusion for voluntary, nonprofit hospitals and added the new term “health care institution.” In so doing, it found “no acceptable reason why 1,427,012 employees of … non-profit, nonpublic hospitals … should continue to be excluded from the coverage and protections of the Act.
Prescribing Approved Drugs for Nonapproved Uses: Physicians’ Disclosure Obligations to Their Patients
Authors: Kapp Marshall B. 
Published: June 2007

A large part of the everyday practice of medicine consists of prescribing drugs for the purpose of curing or alleviating patient ills. In most cases, a drug must be approved for specific uses by the federal government before it becomes available to be prescribed by a physician. However, once a drug has received regulatory approval for a specific medical use, the physician may prescribe it for any purpose, approved or not. The prescribing of drugs for nonapproved uses is a common medical practice. This article discusses the informed consent implications raised by this practice, and argues that the physician should disclose to the patient the legal status of a drug prior to prescribing it for a purpose which has not been governmentally approved.Relying upon the Constitution's Commerce Clause, Congress has vested jurisdiction over all “drugs” involved in “interstate commerce” in the federal Food and Drug Administration (FDA), a division of the Public Health Service (PHS) of the Department of Health and Human Services (DHHS).
Notions of Teams and Team Talk in Health Care: Implications for Responsibilities
Authors: Erde Edmund L. 
Published: June 2007

The use of the phrase “health care team” raises a number of philosophical questions — the fundamental one being whether it is appropriate to apply the word “team” to groups of health care professionals. This column will argue that answering that first question affirmatively will raise other ethical issues. For example, team rhetoric, drawn upon metaphors of athletic teams, is deceptive in the context of health care and can lead to incorrect concepts of the ethical responsibilities of the health care team and its members. Specifically discussed here will be the normative conflict between an individual’s loyalty to the health care team and that person's responsibility to “blow the whistle” on team members who have acted improperly.One way to answer these questions is to use a general definition of “team” to determine whether there are any “teams” in health care based on that definition. Alternatively, one could look at several uses of the term outside the context of health care, and then see whether the health care situation is sufficiently analogous to these uses to justify the use of the term.
Emergicenters and the Need for a Competitive Regulatory Approach
Authors: Michaels Joel L. , Crouter Mary Jean 
Published: June 2007

Third party payment for health services in the United States has created an environment which offers little incentive to health care providers to be efficient. In response, health care policymakers have suggested that increased competition in the health care sector would encourage good managerial practices and improved cost efficiency. In recent years, health care providers that have the ability to provide services in a more cost-efficient manner have emerged; some, including health maintenance organizations and ambulatory surgical centers, have been encouraged by regulatory policy. In addition, a new alternative for the provision of emergency medical services has developed and has generated substantial controversy among physicians, hospitals, government officials, and the public. The entities that comprise this alternative are often collectively referred to as freestanding emergency care centers or “emergicenters.”Much of the controversy surrounding emergicenters is caused by the lack of a definition which can be applied to the various emergicenter structures and operations.
Physicians and Nurses: Roles and Responsibilities in Caring for the Critically Ill Patient
Authors: Corless Inge B. 
Published: June 2007

Most health professionals today would agree about the necessity of interdisciplinary health care for clients. The optimal division of labor, however, has been a source of concern if not outright disagreement.Literature on “professional status” and on the interrelationships of health professionals abounds, possibly leading one to the impression that everything worth saying has already been said. However, developments in health care and in professional education are of a dynamic rather than of a static nature. For this reason alone a reconsideration of the roles and relationships of health care team members is justified from time to time.Determining whether the health care system meets the needs of service recipients is only one important reason for studying role interactions.
Mississippi University for Women v. Hogan: The Supreme Court Rules on Female-Only Nursing School
Authors: Greenlaw Jane 
Published: June 2007

On July 1, 1982, the United States Supreme Court issued its opinion in Mississippi University for Women v. Hogan, ruling that the “female only” admission policy of a state-supported nursing school violated the equal protection clause of the fourteenth amendment. The case has political and legal implications not only for nursing education, but for the nursing profession as well.Joe Hogan, a registered nurse, worked as a nursing supervisor in a medical center in Columbus, Mississippi. In 1979, he applied for admission to the baccalaureate program at Mississippi University for Women (MUW) School of Nursing, located in Columbus. Although he met all of the school’s substantive admission criteria, Hogan was denied admission solely because MUW has, since its inception, admitted only females. The school’s policies would, however, permit him to audit nursing courses and to attend continuing ed,ucation courses.
Liability for Nursing Negligence in the Operating Room
Authors: Greenlaw Jane 
Published: June 2007

In a lawsuit involving nursing negligence in the course of an operative procedure, generally the question arises as to whether liability for the nurse's negligence will rest on the nurse's employer or on the operating physician.Imposition of vicarious liability for a plaintiff's injury is based upon a master-servant relationship between the negligent actor and a third party, such as a hospital or surgeon. Under the doctrine of respondeat superior, liability is imposed upon an employer for the negligent acts of employees, which arise in the course and scope of employment. The operating physician, however, may also be declared liable through the application of two legal mechanisms: the doctrines of captain of the ship and borrowed servant.Under the captain of the ship doctrine, responsibility is imposed upon the physician because he is the one who is looked to by the patient as responsible for the patient's welfare and safety generally.
Does Hospital Corporate Liability Extend to Medical Staff Supervision?
Authors: Hollowell Edward E. 
Published: June 2007

Corporate liability has proven to be fertile ground for claimants against hospitals. Charitable hospitals’ loss of immunity has produced a sudden and often traumatic change in hospital liability. The impact of corporate liability has been slower, but has produced the same result—extended hospital liability.In the October 1980 issue of Medicolegal News, Lee J. Dunn, Jr., discussed the then-current tendency of courts to find hospitals culpable in tort litigation under the theory of corporate liability. That article concentrated on two decisions: Johnson v. Misericordia Community Hospital, and Bost u. Riley. Six months later, an article by Miles J. Zaremski discussed the continuing trend to hold hospitals accountable for the selection and maintenance of physicians on their medical staffs, and examined the Johnson decision, Fridena v. Evans, and Capan v. Divine Providence Hospital.
Withholding Treatment from Defective Newborns
Authors: Taub Sheila 
Published: June 2007

The birth of Siamese twins to a Danville, Illinois physician and his wife on May 5,1981, renewed the recurrent debate on the morality, ethics, and legality of euthanasia for severely defective newborns. The twins, Jeff and Scott Mueller, were joined below the waist and shared the lower part of their digestive tract and three legs. Later studies revealed internal anomalies as well. At birth they were in critical condition, suffering from respiratory distress, and were not expected to survive more than a few days.A note written by a nurse, and countersigned by Dr. Petra Warren, reading “do not feed in accordance with parents’ wishes” was entered on their hospital chart. Several nurses disobeyed the order and fed the infants. As the twins continued to live, against expectations, word of their birth spread. An anonymous caller informed the Illinois Department of Children and Family Services that they were being starved to death.
Standards of Medical Care: How Does an Innovative Medical Procedure Become Accepted?
Authors: Necheles Thomas 
Published: June 2007

The question of how and when a novel medical procedure becomes accepted as standard practice has important legal implications. It may in certain situations be determinative of whether third-party reimbursement is available for such procedures. It may also affect the standard used in determining a physician’s liability for negligence. This article discusses several innovative medical procedures and the process of their acceptance by the medical community. It will be seen that none of these examples effectively delineates the process by which an innovative procedure becomes the accepted standard of care. Finally, the article suggests a system based upon consensus among recognized medical experts, and recommends that this system supplant the traditional cost-benefit analysis which is currently used to determine the accepted standard of care.No formal mechanism currently exists for the introduction of innovative medical technologies, in contrast to the complicated procedures developed for the orderly introduction of new drugs into the marketplace.
The Emerging Stowaway: Patients' Rights in the 1980s
Authors: Annas George J. 
Published: June 2007

At one point in Edgar Allan Poe’s Narrative of Arthur Gordon Pym of Nantucket, Pym, who has stowed away in the hold of a whaling vessel, believes he has been abandoned and that the hold will be his tomb. He expressed sensations of “extreme horror and dismay,” and “the most gloomy imagining, in which the dreadful deaths of thirst, famine, suffocation, and premature interment, crowded in as the prominent disasters to be encountered.”It is probably uncommon for hospitalized patients to feel as gloomy as Pym. Nevertheless, installed in a strange institution, separated from friends and family, forced to wear a degrading costume, confined to bed, and attended to by a variety of strangers who may or may not keep the patient informed of what they are doing, the average patient is intimidated and disoriented. Such an environment encourages dependence and discourages the assertion of individual rights.As the physician-director of Boston’s Beth Israel Hospital has warned: “today’s hospital stands increasingly to become a jungle, whose pathways to the uninitiated are poorly marked and fraught with danger. . . .”
Damage Remedies and Institutional Reform: The Right to Refuse Treatment
Authors: Furrow Barry R. 
Published: June 2007

The articulation by a court of a new constitutional norm serves a valuable function: the right, as elaborated by judicial opinion, provides a standard for critically evaluating current social practices. The “right to refuse treatment,” that “newly created constitutional right of personal autonomy,” draws attention to the problems of institutionalized mental patients and their desires to make their own decisions to accept or reject drug therapies, particularly where severe side effects are involved. The enunciation of the right to refuse treatment, with its hard-edged overtones, forces us to look at the tension created by the conflict between institutional attempts to treat these patients, the sometimes antithetical desire of those within the institution to control them without regard for treatment impact, and the patient's desire to retain whatever control is left to him in such settings.The right to refuse treatment-like its common law analogue in tort, informed consent doctrine-draws its roots from concepts of personal autonomy that pervade both tort doctrine and constitutional law.
Allied Health Professionals and Hospital Privileges: An Introduction to the Issues
Authors: Grad John D. 
Published: June 2007

The concept of allied health professionals practicing in hospitals arouses the opposition of many in the medical establishment. What is the nature of this conflict, and how can it be resolved? This article gives an overview of the reasons that allied health professionals are demanding hospital privileges, as well as the reasons that such privileges are opposed by physicians. In the author's opinion, the medical establishment should learn to accept practice in hospitals by non-physician providers, and can expect considerable legal opposition if it does not.The first problem is to define what is meant by “allied health professional.” Generally, the term is applied to any health care provider who is not in the “MOD” group, which traditionally has included medicine (MD), osteopathy, and dentistry, although pursuant to certain federal regulations podiatry also falls within the MOD group. Thus, in a general sense, “allied health professionals” means everyone else who directly provides health care services.
Ethical Dilemmas and the Practice of Infection Control
Authors: Chavigny Katherine Hill , Helm Ann 
Published: June 2007

To be a nurse involves the assumption of ethical responsibility in all areas of practice. Infection control practice is a nursing specialty which exemplifies two ethical issues: the nurse's duty or moral obligation for patient advocacy and the right of patients to safe care. Individual moral responsibility is an important issue for the nurse epidemiologist because epidemiologic fact-finding provides information that may present ethical problems as well as suggest solutions. This paper discusses ethical dilemmas arising in infection control practice, as illustrated by three actual situations.In the course of practice, questions may arise concerning the ethical responsibilities of a nurse epidemiologist to provide facts that may be used in cases of dispute. This discussion shall be limited to institutionally acquired or nosocomial infections.
Will the Tort of Bad Faith Breach of Contract Be Extended to Health Maintenance Organizations?
Authors: Stern Joanne B. 
Published: June 2007

In the past several years, a new tort has emerged, one which has been used primarily against insurance companies and which has resulted in an enormous number of damage claims—the tort of bad faith breach of contract. At this time, the tort of bad faith breach of contract has rarely been extended beyond the insurance industry. It is very likely, however, that in the near future, this tort will be extended to other industries that serve the public interest, particularly to health maintenance organizations (HMOs). Currently. many bad faith breach of contract cases against HMOs are being litigated at the trial level. In addition, publicity relating to such suits has appeared in various newspapers and periodicals.This article discusses the application of this relatively new cause of action to HMOs, and deals with the followng issues: the basis for the analogy between the insurers and HMOs; the grounds for bringing a suit for bad faith breach; and the implications, for HMOs and consumers, of the emergence of this cause of action.
Professional and Agency Liability for Negligence in Child Protection
Authors: Bross Donald C. 
Published: June 2007

Suits for negligence in the area of child protection have become frequent as reporting of child abuse and neglect has increased. This article begins with various theories and defenses raised in specific cases, and briefly examines the problem of inadequate legal representation for the child. An additional section notes various policy issues for lawyers and the courts.Child protection has become a multidisciplinary field, and therefore social workers, doctors, police officers and mental health professionals have been held to be negligent in carrying out duties to children. The diagnostic professions of medicine and mental health are often involved early in child protection proceedings because of legal requirements for diagnosis and reporting. Social workers and police officers have been charged with failure to respond appropriately to reports of child abuse. Cases of inadequate selection of, or monitoring of placements into, foster homes are also associated with social workers. This section will consider these cases, and discuss various defenses raised.
Psychiatric Malpractice in the 1980s: A Look at Some Areas of Concern
Authors: Taub Sheila 
Published: June 2007

Lawsuits alleging malpractice in psychiatric diagnosis or treatment, once rather rare, appear to be growing in number. The low incidence of such claims in the past has been attributed to the difficulty of proving the applicable standard of care and a causal relationship between the breach of the standard of care and the alleged injury, the patient's reluctance to publicize his psychiatric history, the patient's inability either to formulate cleat expectations for the results of treatment or to assess the results, and the belief that the success of psychotherapy depends to a great extent on the cooperation of the patient.Nonetheless, the number of claims against psychiatrists is rising, in part because of a more open attitude about psychiatric treatment coupled with increased expectations of its efficacy. Other factors which may be contributing to this trend are the emphasis on mental patients rights in recent court decisions and the popular literature, the emergence of legal doctrines finding new legal duties arising out of the therapist-patient relationship, and the publication of several sizable verdicts in suits based on psychiatric malpractice.