bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parental Autonomy and the Obligation Not to Harm One's Child Genetically
Authors: Green Ronald M. 
Published: June 2007

Until recently, genetics counselors and medical geneticists considered themselves lucky if they could provide parents with predictive information about a small number ofsevere genetic disorders. Testing and counseling were indicated primarily for conditions of thithis s sort. Out of respect for the autonomy of parental reproductive decision making, the prevailing ethic of genetic counseling stressed nondirectiveness and value neutrality As summarized by Arthur Caplan, the hallmarks of this stance includea willingness to provide testing and counseling to all who voluntarily seek it, the presentation of information concerning findings in a manner that is balanced and comprehensible to patients or clients, the fair and balanced presentation of all options for action if a problem is discovered, a willingness to answer all questions asked by those seeking services, and an obligation to protect privacy and confidentiality at all times regardless of societal needs or benefits.
Medicaid, Managed Care, and America's Health Safety Net
Authors: Manski Richard J. , Peddicord Douglas , Hyman David 
Published: June 2007

During the past decade, Medicaid has experienced extraordinary growth, in both number of beneficiaries and total expenditures. Between 1988 and 1993, the number of Medicaid beneficiaries grew from 22 million to 32 million. While the number of Medicaid beneficiaries increased by 45 percent, expenditures increased by 145 percent, from 51 billion to 125 billion. Expressed in terms of its percentage of state budgets, Medicaid doubled from 10 percent to 20 percent over the same time period, to the point that it is currently the second largest budget item for most states.Faced with unsustainable rates of program budget growth and serious concerns about the level of access and the continuity of care afforded by the Medicaid program, states have turned to managed care. Almost every state has introduced some form of managed care for a subset of their Medicaid beneficiary population. Twenty-three states have gone farther, and implemented, proposed, or are developing section 1115 waivers to overhaul their Medicaid programs. These waivers allow states to develop and introduce nonstandard approaches to benefits, eligibility, service delivery, and financing for the Medicaid beneficiary population.
Weaving Technology and Policy Together to Maintain Confidentiality
Authors: Sweeney Latanya 
Published: June 2007

Organizations often release and receive medical data with all explicit identifiers, such as name, address, telephone number, and Social Security number (SSN), removed on the assumption that patient confidentiality is maintained because the resulting data look anonymous. However, in most of these cases, the remaining data can be used to reidenafy individuals by linking or matching the data to other data bases or by looking at unique characteristics found in the fields and records of the data base itself. When these less apparent aspects are taken into account, each released record can map to many possible people, providing a level of anonymity that the recordholder determines. The greater the number of candidates per record, the more anonymous the data.I examine three general-purpose computer programs for maintaining patient confidentiality when disclosing electronic medical records: the Scrub System, which locates and suppresses or replaces personally identifying information in letters between doctors and in notes written by clinicians; the Datafly System, which generalizes values based on a profile of the data recipient at the time of disclosure; and the μ-Argus System, a somewhat similar system which is becoming a European standard for disclosing public use data.
Scientific Commentary: The Scientific Foundations and Medical and Social Prospects of the Human Genome Project
Authors: Lander Eric S. 
Published: June 2007

We are living through one of the greatest scientific revolutions in history: the “information revolution” in genetics. The revolution is leading to a deep understanding of biological processes and is uncovering the molecular basis of many human diseases and susceptibilities. It is also confronting society with a vast array of choices, and presenting each individual with the question of what knowledge to seek and how to act on that knowledge, My purpose is to discuss the scientific foundations of this revolution and to foreshadow its consequences.The current scientific revolution has perhaps one appropriate historical precedent: the chemical revolution that followed Dmitri Mendeleev's key insight in 1869 that the elements could be organized in a simple periodic table.
The Collision of Confinement and Care: End-of-Life Care in Prisons and Jails
Authors: Dubler Nancy Neveloff 
Published: June 2007

In 1997, the United States incarcerated over 1.7 million persons in local jails and in state and federal prisons. These inmates are disproportionately poor and persons of color. Many lack adequate access to health care before incarceration and present to correctional services with major unaddressed medical problems.Convictions for drug possession and use have increased the number of injection drug users with HIV and AIDS in prisons. Determinate sentencing and “three strikes and you’re out” laws have increased the number of inmates who are aging and dying during their sentences. Their feelings reflect those of Larry Rideau, sentenced to life without parole and founder of The Angolite—an award-winning prison newspaper at Louisiana's Angola Prison—“The dream of getting out, you equate with heaven. Dying in prison you equate with hell.”
Criminal Act or Palliative Care? Prosecutions Involving the Care of the Dying
Authors: Alpers Ann 
Published: June 2007

Two significant, apparently unrelated, trends have emerged in American society and medicine. First, American medicine is reexamining its approach to dying. The Institute of Medicine, the American Medical Association and private funding organizations have recognized that too many dying people suffer from pain and other distress that clinicians can prevent or relieve. Second, this past decade has marked a sharp increase in the number of physicians prosecuted for criminal negligence based on arguably negligent patient care. The case often cited as a watershed isPeople u. Einaugfer,which involved a New York nursing home patient whose physician was convicted in 1993 of two criminal misdemeanors after he ordered an elderly dialysis patient to be tube fed through a peritoneal dialysis Catheter.How is the growing awareness of dying patients’ pain and the increasing willingness of prosecutors to charge physicians with crimes connected? Pain at the end of life is frequently treated with narcotics, prescription drugs that are closely regulated by state and federal law. That complex web of laws—and a growing fear of legal sanctions—has deterred physicians from prescribing controlled substances. As those legal sanctions move from disciplinary actions to criminal charges, physicians’ fears may expand.
Genetic Research as Therapy: Implications of “Gene Therapy” for Informed Consent
Authors: Churchill Larry R. , Collins Myra L. , King Nancy M.P. , Pemberton Stephen G. , Wailoo Keith A. 
Published: June 2007

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy.
Advertising Policies of Medical Journals: Conflicts of Interest for Journal Editors and Professional Societies
Authors: Orentlicher David , Hehir Michael K. 
Published: June 2007

As the medical profession becomes more and more of a commercial enterprise, commentators are subjecting conflicts of interest in medicine to increasing scrutiny. However, one critical area of conflict has largely escaped discussion—the conflicts of interest raised by the advertising policies of medical journals. Moreover, when these conflicts are discussed, they are examined almost exclusively in terms of the concerns that they pose for journal editors. Yet, there is a second critical concern with journal advertising policies. The policies also create serious conflicts of interest for the professional societies that own medical journals.In this article, we will discuss the conflicts of interest that are raised for journal editors and professional societies by journal advertising policies, and we will conclude that the policies are exactly backward. Currently, medical journals rely on advertisements from pharmaceutical companies and other health-related businesses and avoid—indeed exclude—advertisements from consumer-oriented companies, like producers of automobiles, golf equipment, or jewelry. We submit that the medical journals, the medical profession, and the public would be better served if consumeroriented advertisement were preferred over health-related advertising.
This Little Piggy Went to Market: The Xenotransplantation and Xenozoonose Debate
Authors: Clark Margaret A. 
Published: June 2007

New technologies are changing our lives radically and quickly. New biotechnologies are moving to commercial uses faster than government regulators or private citizens can monitor. This tension manifests itself in the current debates over xenotransplantation technologies in medicine. The possibility of removing cells, tissues, and organs from animals and transplanting them into human beings is startling and unnerving. Natural immunesystem barriers between species, and even between individuals within a species, are formidable. Typically, transplantation results in violent rejection and death of the grafted organ. But despite the natural barriers to transplantation, xenotransplantation aims specifically to overcome them.In this paper, I will discuss applications of xenograft technology, which raises clinical risks, ethical concerns, and policy issues. I conclude with a set of specific recommendations. As a recent letter to the journalNatureputs it, there is a “split between those who want to get it right, and those who want to get it right now.” No one knows what all the risks, benefits, and unintended consequences of xenotransplantation will be.
Jehovah's Witnesses, Pregnancy, and Blood Transfusions: A Paradigm for the Autonomy Rights of All Pregnant Women
Authors: Levy Joelyn Knopf 
Published: June 2007

The liberty of the woman is at stake in a sense unique to the human condition and so unique to the law. The mother who carries a child to full term is subject to anxieties, to physical constraints, to pain that only she must bear. That these sacrifices have from the beginning of the human race been endured by woman with a pride that ennobles her in the eyes of others and gives to the infant a bond of love cannot alone be grounds for the State to insist that she make the sacrifice. Her suffering is too intimate and personal for the State to insist, without more, upon its own vision of the woman's role ….For years, Jehovah's Witnesses have posed a challenge to the medical profession. Bound by religious belief to refuse blood and blood products, they can frustrate physicians who, since World War II, have utilized transfusions when indicated in the course of treatment.
Informed Consent and the Refusal of Medical Treatment in the Correctional Setting
Authors: Parker Frederick R. , Paine Charles J. 
Published: June 2007

It was not until the nineteenth century that Western nations came to replace mutilation, corporal punishment, and banishment as the favored method of criminal punishment with the more humane concept of imprisonment. Even then, however, a convicted inmate was viewed as nothing more than a slave of the state, entitled only to the most basic of human rights and subject to the whim and peril of his jailor's desire. The shift to imprisonment gradually was accompanied by the additional humanitarian demand that prisons avail their charges of some minimum standard of human decency and necessity, which, by the early part of the twentieth century, had come to encompass the provision of medical care. The courts later came to acknowledge this as a fundamental right grounded in the Eighth Amendment's proscription against cruel and unusual punishments.Although the scope of a prisoner's constitutional right to medical care has been the subject of much debate before the courts, the majority of cases have focused only on the circumstances under which the deprivation of care will amount to a violation of the rights guaranteed by the Eighth Amendment.
The Ethics of End-of-Life Care for Prison Inmates
Authors: Cohn Felicia 
Published: June 2007

Terminally ill elderly and long-term disabled persons under our system of health care are eligible for Medicare and may qualify for the hospice care benefit. Despite such provisions, research shows that individuals still frequently do not receive the health care they need. But, as inadequate as end-of-life care can be for the general population, these inadequacies are exacerbated for individuals incarcerated in U.S. prisons and jails. Although inmates are guaranteed a basic level of health care under the Eighth Amendment and Due Process Clause, they lack the mobility or freedom to choose their health care coverage, and they are dependent on an institutional system for such care. Inside prison, security and access issues affect the care inmates receive. Further, the availability of adequate clinical resources, especially for high-cost procedures, may be problematic in some jurisdictions.In addition to the practical, institutional, and legal barriers to providing and improving general end-of-life care, efforts to improve end-of-life care for prisoners may also encounter a lack of public sympathy.
From Smallpox to SARS: Is the Past Prologue?
Authors: Hamre John J. , Young James G. , Shurtleff Mark 
Published: June 2007

I am really quite honored to have a chance to be here. Also let me say how much I appreciate what all of you public health professionals do. One of the unfortunate dimensions of modern American life is that we have chosen to privatize all aspects of life. People do not live on their front porches anymore and watch their neighbors in the evening. They go out back in their wall-enclosed backyards. And we have done the same with medicine.Medicine has been privatized in America. We have lost a sense of the public obligations of health and hygiene and sanitation. So I thank you for keeping the flame alive on what we clearly now know is the far bigger issue of health care in modern society.
Legal Preparedness for Public Health Emergencies: TOPOFF 2 and other Lessons
Authors: Heaton John A. , Murphy Anne M. , Allan Susan , Pietz Harald 
Published: June 2007

There is a fine balance between civil liberties and protection of the public’s health.Legislators, especially those in the western United States, are concerned about selling the Model State Act (“Act”) because of the loss of civil liberties. State constitutions give governors broad powers, such as declaring martial law and giving public health leaders the authority to act. State laws should consider issues such as property rights; taking of businesses and supplies; quarantine and isolation; due process; coordination among states, counties and cities; communication systems; conscription of doctors and nurses; and compensation. When two mock emergency response drills were held in New Mexico, concerns arose regarding opening records associated with dams, national laboratories, waste repositories, and three air force bases.
The Challenge of For-Profit Health Care Conversions
Authors: Fremont-Smith Marion R. , Urban Mark , Praeger Sandy 
Published: June 2007

Most hospitals are considered charities under common law because they were established for the benefit of the public. The law granted them benefits, but also imposed duties. Under the cy-pres doctrine, if a charitable purpose becomes obsolete or incapable of being carried out, the court could modify those purposes to meet current needs of the organization and the community. Modern laws attempt to find a purpose as near as possible to original purposes set up by donors. In the case of hospital conversion, some regulators say assets must be used to support hospital health care, while others say they can be used in the broad sense of health care. That has been a continuing conflict between communities and regulators.Since 1996, 30 conversion statutes have been enacted, covering hospitals, HMOs, and insurers.
New Directions in Health Insurance Design: Implications for Public Policy and Practice
Authors: Pollitz Karen , Imhoff Donna , Scott Charles , Rosenbaum Sara 
Published: June 2007

This is a volatile time for health insurance policy. Medicare and Medicaid are in turmoil, as is the private health insurance market. Public and private health insurance costs constitute eighty percent of healthcare spending in the United States. Public health professionals depend on the insurance system to behave in ways that are responsive to public health in prevention and crisis management.Seventy-five percent of the American population, excluding the elderly, has coverage through the private health insurance system. Ninety percent of this group receives their insurance through employer-sponsored programs, and the remaining ten percent buy their own coverage. Approximately ten percent of the non-elderly population has insurance through a government program, and fifteen percent of the non-elderly population, almost forty-one million Americans, is uninsured.
Quarantine in Severe Acute Respiratory Syndrome (SARS) and other Emerging Infectious Diseases
Authors: Speakman Jane , González-Martin Fernando , Perez Tony 
Published: June 2007

SARS and monkeypox have given the public health community a unique opportunity to examine the use of quarantine measures. Until recently, the word “quarantine”was not used in polite conversation, and evoked unsavory images. The recent SARS epidemic illustrated the important role of quarantine and isolation as a public health response to communicable disease.As public health officials in Toronto began to take control of the SARS epidemic, a second wave of the disease (SARS II) emerged. In the first SARS epidemic, approximately 8,200 individuals were isolated. There were approximately 82 probable cases, 66 suspect cases, and 24 deaths. On May 22, 2003, SARS II emerged. In total, approximately 13,000 people were quarantined. SARS II saw the onset of difficult questions being asked about the control and spread of SARS.The province of Ontario establishes the public health policies and legislative framework for the entire province.
School-Based Policies: Nutrition and Physical Activity
Authors: Louie Dexter , Sanchez Eduardo J. , Faircloth Sean , Dietz William A. 
Published: June 2007

In spite of laws in many states regulating the nutritional content of foods and the availability of “junk food” and soda, a 2001 Surgeon General’s Report indicated that 15% to 20% of the nation’s children are overweight or obese. In areas that are predominately Hispanic and African American, the numbers rise to between 40% and 50%. Although there are continuing efforts to educate the adult population, many school systems and public health jurisdictions have had little impact on the rising numbers of overweight and obese children. This session described the process of initiating a student-based, student driven approach to obesity, junk food, and diabetes and disease prevention.A need existed for a grassroots approach at the student level to raise awareness of increasing obesity rates and diabetes and other related diseases in the adolescent population.
Who Will Keep the Public Healthy? Assuring a Legally Prepared Workforce
Authors: Viverette Mary Anne , Leaning Jennifer , Steeg Susan K. , Gebbie Kristine M. , Litchveld Maureen 
Published: June 2007

The Commission on the Accreditation of Law Enforcement (CALEA) employs rigorous evaluation techniques. Objective accreditation, such as made possible by CALEA, is important from the public’s perspective and in the national community of law enforcement.To counteract a general distrust of law enforcement agencies, the Law Enforcement Assistance Administration (LEAA) developed a grant to develop standards by which the quality and performance of law enforcement could be measured. LEAA developed 107 standards and, though well received by the law enforcement community, no single group or agency took the initiative to begin a program to evaluate and implement the standards. In 1979, the Department of Justice established an additional grant that effectively organized the four major law enforcement groups: the International Association of Chiefs of Police, the National Sheriff’s Association, the National Organization of Black Law Enforcement Executives, and the Police Executive Research Forum.
Sociolinguistic Folklore in the Study of African American English
Authors: Wolfram Walt 
Published: June 2007

AbstractAlthough sociolinguists have performed a valuable service in challenging folk theories about African American English (AAE), they also have unwittingly participated in the construction of sociolinguistic folklore about variation and change in AAE. Several examples of sociolinguistic myths are presented, including the supraregional myth, the change myth, and the social stratification myth. Data used to challenge the canon of AAE description include empirical studies of different types of rural Southern African American communities as well as ethnographic observation. Historical circumstance, social and professional enculturation, and academic exclusivity are considered in explaining the construction of these questionable axioms about AAE. The examination indicates that unchallenged assumptions, unilateral explanations, and imagined dichotomies need to be scrutinized more critically with regard to the canon of AAE description.
Linguistics in a Primary School
Authors: Denham Kristin 
Published: June 2007

AbstractIn this article, I discuss a linguistics course that I have been teaching for the past 3 years in a multiage primary school classroom. This experience has led to work in other schools, has changed the way I teach introductory linguistics courses for teachers, and has led to the development of materials and curricula for use in K‐12 classrooms. I hope the sharing of these experiences will help to effect real change in the way in which knowledge about language is taught in K‐12 classrooms in the USA.
The Language of Psychotherapy: Metaphor, Ambiguity, Wholeness
Authors: Holmes Jeremy 
Published: June 2007

SummaryPsychoanalysis is approached from the perspective of linguistics. It is argued .hat analysis is concerned with a type of communication different in nature and logic from that of the natural sciences. The characteristics of analytic language are illustrated by comparing poetry and psychoanalysis. Transference is discussed as a special type of metaphor; ambiguity is seen as an intrinsic aspect of aesthetic language; wholeness is held to be a goal of both therapy and the arts. The relevance of this view to recent findings in neurophysiology and ethology is discussed.