bluuebunny/crossref_metadata_2025_split huggingface dataset:
Entrepreneurial Practice for Nurses: An Assessment of the Issues
Authors: Hershey Nathan 
Published: June 2007

For a number of years, some non-physician health service providers have moved to secure status as independent, autonomous providers of health services. In addition, non-physician providers have sought, often through the state legislatures, eligibility to receive payment directly, on a fee-for-service basis, from private and governmental third party payers; alternatively, they have sought for their charges to be reimbursed to their patients by insurers on such a basis. The struggle for autonomy is related to, and is preliminary to, the struggle for access to, or eligibility for, payment through third party payment mechanisms.The purpose of this article is to explore the implications of access to such payment in the current economic climate concerning the delivery of health services. The primary focus is on the nursing profession, in light of its continuing struggle to secure greater autonomy and to improve the economic rewards for nurses. The nursing profession is waging this struggle because it recognizes that gaining direct access to third party payment would increase the potential for economic success in developing private, independent nursing practices.
Court Upholds Expanded Practice Roles for Nurses
Authors: Wolff Michael A. 
Published: June 2007

In the first reported judicial interpretation of modern nursing practice acts, Sermchief v. Gonzales, the Missouri Supreme Court has decided that “new functions for nurses delivering health services” may evolve without statutory constraints.’ The notion that nurses in expanded roles are practicing medicine without a license was cast aside, as the court specifically held that nurses may render diagnosis and treatment in accordance with standing orders and protocols. While directly affecting only nurses in Missouri, the court's recognition of nursing as a profession with its own prerogatives and responsibilities has important implications for the future of nursing.At issue was Missouri's nursing practice act which had been drafted with the assistance of members of the Missouri Nurses Association and passed by the legislature in 1975.
The Contract in Surrogate Motherhood: A Review of the Issues
Authors: Gersz Steven R. 
Published: June 2007

When Abraham's wife, Sarah, was unable to conceive a child for their marriage, she arranged for her handmaiden, Hagar, to bear a child for them. Abraham consummated this arrangement by making a visit to Hagar's tent.Surrogate motherhood, as it is practiced today, differs only in insemination technique from this biblical effort. A married couple, unable to conceive because of female infertility, or, perhaps, a single male who desires a child would, as did Sarah, seek out a woman willing to act as a surrogate mother It is likely that the couple would make the initial contact through a classified advertisement and negotiate a contract with a fertile woman through their attorneys. The contract, in its most basic terms, would provide that the surrogate be artificially inseminated with the husband's semen, carry the child to term, and relinquish her parental rights upon birth of the child. Although there have been cases where a woman becomes a surrogate mother without payment, the surrogate mother typically receives a fee for her services as a carrier.
Surrogate Motherhood: Babies for Fun and Profit
Authors: Holder Angela R. 
Published: June 2007

Surrogate motherhood has captured the attention of both the media and the legal profession in the past several years. Courts faced with litigation on surrogate motherhood have uniformly taken the position that these arrangements are contrary to public policy, and have refused to compel the specific performance of these contracts? It is my position that these rulings have been correct, and that if surrogate motherhood is to be considered legally acceptable in this country (which I think it should not be ) then state legislatures must act to legalize the contracts drawn up for these arrangements.The procedure for surrogate motherhood is usually initiated by either a married couple, of whom the wife is infertile, or by a single man. In either case, a contract is made with a fertile woman; the woman is to be artificially inseminated with the man's sperm. Generally, this is done in exchange for a large sum of money. At the time that the baby is born, the surrogate mother surrenders the child for adoption by the wife (in the case of a married couple) and presumably by the father to regularize his relationship with the child.
Definition and Regulation of Nursing Practice: An Historical Survey
Authors: Greenlaw Jane 
Published: June 2007

The definition and regulation of nursing practice are issues of growing national interest. A variety of factors, including rising health care costs and consumer awareness, have combined to catalyze changes in health care delivery, with an increasing emphasis on disease prevention and cost-effectiveness. These goals have necessarily focused attention on the respective roles of non-physicians—most prominently, nurses—as providers of lower cost, quality health care. In a climate of professional and economic competition, state legislatures, state nursing boards, courts, and professional nursing organizations are engaged in a process of changing, adapting, or interpreting existing nursing practice laws to meet the needs of the changing health care system.This article reviews the history and evolution of nursing practice legislation, examines the present stage in its development, and highlights some important issues affecting contemporary nursing practice acts.
State Regulation of Long-Term Care: A Decade of Experience with Intermediate Sanctions
Authors: Johnson Sandra H. 
Published: June 2007

Recent reforms in state nursing home regulations have created an-array of enforcement tools that relate the severity of the penalty to the severity of the violation. These intermediate sanctions, intended to be flexible and effective in enforcing state standards, include civil fines, receiverships, public disclosure, monitors. and suspension of admissions. As supplements to the more traditional remedy of license revocation, intermediate sanctions can enforce standards without closing facilities unnecessarily, thus avoiding trauma to the residents, aggravation of the shortage of nursing home beds, and lengthy administrative proceedings and litigation.The study of nursing home regulation by the Institute of Medicine of the National Academy of Sciences offers a unique opportunity to evaluate the implementation of intermediate sanctions by the states over the past decade. Because of the high degree of similarity among the state statutes authorizing these sanctions, comparisons can be drawn.
Empirical Assessment of Innovation in the Law of Civil Commitment: A Critique
Authors: Appelbaum Paul S. 
Published: June 2007

The history of commitment law in the United States has been marked by a series of pendular swings corresponding to popular concerns of the day. From the inception of civil commitment law in the 1830s and 1840s. with a system in which discretion was lodged primarily in family members and physicians, there have been moves to restrict the ease of commitment when concerns about inappropriate admissions or institutional abuses were at their height (e.g., in the 1870s, 1930s, and 1970s) and countervailing efforts to increase the ease of commitment when concerns about the ready availability of treatment predominated (e.g., around the turn of the century and in the 1950s).Students of the history of civil commitment will quickly recognize that these shifts in policy were based almost entirely on theoretical arguments about the relative desirability of one or the other approach, fueled by horror stories illustrating the pitfalls of the competing orientation.
A View from the Clapham Omnibus
Authors: Cowen Zelman 
Published: June 2007

The man on the Clapham omnibus, as common lawyers know, was a late nineteenth and early twentieth century image of the ordinary reasonable man who played an important part in fixing common law standards. As a lawyer with a continuing but general interest in medicine, biotechnology, ethics, and the law, I offer the following comments on the conference's topic of “Health Resource Allocation” from what may approximate the standpoint of an ordinary reasonable man.How much “health” can a society afford? I do not think that it is possible to maintain that there is a right to health, expressed as an unqualified right to treatment—though I understand that the argument has been raised in the United States that there is a constitutional basis for a claim of entitlement to treatment for civilly committed mental health patients. So far as English law is concerned, the answer to this question is clear. In 1980 the English Court of Appeal dealt with a case in which four people in Staffordshire argued that the health services were insufficient in their area.
2. New Law for Laboratory Life
Authors: Waller Louis 
Published: June 2007

Over the past three years there has been a flurry of legislation in Australia to provide answers for some of the legal questions and issues emanating from the new birth technologies. The chief of these is in vitro fertilization: the formation, in the laboratory, of a human zygote. The final result is, sometimes, a live birth. The test-tube baby process, as it is usually described in the media, has developed to include not only fertilization of a wife's ova with her husband's sperm but also the employment of donated gametes; cryopreservation of ova, sperm, and embryos; and, in terms of the possible, the employment of women to bear, deliver, and surrender a baby developed from a couple's laboratory embryo.The publicity given to the new birth technologies, and the concern (and sometimes consternation) they have aroused, has been accompanied by renewed examinations of those older responses to infertility: AID (artificial insemination by donor) and surrogate mother arrangements effected either by the euphemistically and misleadingly labeled NID (natural insemination by donor) or by artificial insemination.
3. Debate: Severely Handicapped Newborns: For Sometimes Letting—and Helping—Die
Authors: Kuhse Helga , Singer Peter 
Published: June 2007

It is often said that all human life, irrespective of its quality or kind, is equally valuable and that our life-and-death decisions for seriously ill or handicapped infants must not be based on the quality or kind of life in question. As the Protestant theologian Paul Ramsey has put it:
[T]here is no reason for saying that [six months in the life of a baby born with the invariably fatal Tay Sachs disease] are a life span of lesser worth to God than living seventy years before the onset of irreversible degeneration.… All our days and years are of equal worth whatever the consequence; death is no more a tragedy at one time than at another time.The view that all human life—irrespective of its quality or kind—has equal worth may well be the simplest answer to the difficult issues raised about the treatment of infants born seriously ill or with major handicaps; but there are two questions that need to be asked about this simple answer.
1. “Should the Grandparents Die?”: Allocation of Medical Resources with an Aging Population
Authors: Somerville Margaret A. 
Published: June 2007

The question in my title—a deliberate inversion of Kuhse and Singer's now-famous question, “Should the baby live?”—is one that is being asked more and more frequently. As Gerald Gruman has observed:
It is questionable if today the young comatose patient is the prototype for the discussion of issues of death and dying. A more probable crucial issue is that of the elderly: a reservoir of relatively defenseless persons, perceived, through bigoted “ageism,” as unproductive and pejoratively dependent. In them, modernization has created a population stratum that, in a state of nature or conditions of scarcity economics, “ought” to be dead.The medical care needs of aged persons, and how we, as individuals and societies, will fulfill these needs in an era of a perceived scarcity of medical resources, are a frequent topic of discussion today. The “scarcity” of medical resources is frequently a given in discussions of allocation priorities.
The Epidemiology of the Human Immunodeficiency Virus Infection
Authors: Mueller Nancy 
Published: June 2007

It is nearly six years since the first evidence of the AIDS epidemic was seen, with the report of five cases of Pneumocystis carinii pneumonia diagnosed in young, otherwise healthy homosexual men in Los Angeles. The report was surprising, for although P. carinii is a common human commensal, the pneumonia essentially occurs only in the presence of severe immune suppression. Similar reports quickly followed from New York City and San Francisco, with the additional observation that Kaposi's sarcoma—a malignancy usually seen only in elderly men in this country—was also occurring epidemically among young homosexual men.Since then, the epidemic has evolved at a relentless pace to a reported 32,000 cases in the United States by March 1987. The epidemic has sparked a massive multidisciplinary scientific effort, resulting in the successful identification of the causal agent—the human immunodeficiency virus (HIV)—within two years from the first report and producing a commercially available antibody test within four years.
Prevention of Patient Falls through Perceived Control and other Techniques
Authors: Halpert Aviva , Connors James P. 
Published: June 2007

Every year thousands of patients suffer injury while attempting to make use of bathroom facilities. In addition to the suffering and protracted inpatient care that these incidents cause, hospitals have been faced with staggering costs in the form of increased insurance premiums arising directly out of an increased number of lawsuits. This problem has reached a proportion such that it clearly deserves careful and indepth industry study.This article, while far from a comprehensive study, will attempt to draw certain conclusions and perhaps dispel certain myths based upon a study of 181 patient falls at a 200+-bed community hospital in the Northeastern United States.In the not too distant past, hospitals could not generally be held legally responsible for failure to raise bedrails absent specific medical direction. Such was the case because few, if any, hospitals had guidelines or procedures for the placement of bedrails in the absence of a physician's order.
The Psychiatrist–Patient Privilege and Third-Party Payers: Commonwealth v. Kobrin
Authors: Taranto Richard G. 
Published: June 2007

Virtually every state gives psychiatrists’ patients a broad statutory privilege to prevent the disclosure in legal proceedings of information about their diagnosis and treatment. Although the precise scope of the privilege varies from state to state, and a variety of exceptions are widely recognized, the contents of therapy sessions—and hence of psychiatrists’ written records of therapy sessions—are ordinarily protected by the privilege. Patients thus are gmerally entitled to prevent the courts and other government authorities from using their coercive evidencr-gathering powers to obtain psychiatric records or testimony about therapy. In conjunction with psychiatrists’ ethical and legal duties of confidentiality toward their patients outside legal proceedings, the privilege renders the privacy of the psychiatric relationship to a large degree sacrosanct.The cloak of secrecy around the psychiatrist-patient relationship, however, must inevitably be lifted to some extent when third parties pay for psychiatric diagnosis and treatment. Any third-party payer, be it a private insurer or a government agency (such as Medicaid or Medicare), must be able to obtain enough information about psychiatric services to determine the propriety of claims for payment for those services.
Fourth-Party Audit Organizations: Practical and Legal Considerations
Authors: Hershey Nathan 
Published: June 2007

Fourth-party audit organizations (FPAOs) conduct utilization review and control programs, usually on behalf of employers that provide health benefits programs to employees. The existence of FPAOs and their increasing range of activity reflect the business community's great concern about the rising cost of health care. Over the past decade the business community has taken an increasingly active role in seeking to influence federal and state policies regarding health services, and in stimulating the development of new mechanisms of health delivery, with the goal of making its expenditures for health benefits more costeffective. Businesses rely on FPAOs to assist them in controlling the costs of health benefits programs for employees.As desirable as cost containment in the health field is, however, the various means used to help reach that goal must be evaluated in terms of their practical effects and the relevant legal considerations. This article will (1) describe the functions performed by FPAOs; (2) provide an illustration of the impact of an FPAO in a patient care situation; (3) examine some of the practical problems created by the use of FPAOs; (4) indicate some of the legal questions presented by the activities of FPAOs; and (5) assess the role and likely impact of FPAOs in the future.
Liability Related to Diagnosis and Transmission of AIDS
Authors: Hermann Donald H.J. 
Published: June 2007

Given the pain, incapacity, and death that afflict persons with AIDS, it is not surprising that those exposed to HIV or those who have developed AIDS may sometimes feel themselves wronged and entitled to legal damages. There are two main areas of potential AIDS-related litigation: liability related to medical malpractice and liability related to transmission, whether via contaminated blood or blood products, needle-sharing, childbirth, or sexual intercourse.This article will examine the precedents, arguments, and possible defenses in these areas and in relationship to a variety of potential defendants.A cause of action for medical malpractice in AIDS-related diagnosis may arise in several ways: failure to diagnose, failure to inform a patient of a diagnosis, failure to provide proper counseling and treatment when patients test positive for HIV antibodies, and failure to report AIDS diagnoses to health authorities or at-risk sexual partners.
Cesareans and Samaritans
Authors: Rhoden Nancy K. 
Published: June 2007

Until recently, if one asked the proverbial person on the street to list maternal-fetal conflicts, he or she would have mentioned abortion and, when pressed to continue, looked at the questioner blankly. Now, however, the populace is becoming aware of a host of maternal-fetal conflicts. Indeed, mother-and-child, long a somewhat romanticized unity, are increasingly being treated by physicians, courts, and the media as potential adversaries, locked in battle on the rather inconvenient battleground of the woman's belly.Some of these newly publicized conflicts—pregnant women abusing drugs or alcohol, or continuing to work in occupations hazardous to fetal health—are not all that new: the hazards of various substances have been known for years. Other of the conflicts are new, inasmuch as doctors could not recommend Cesareans or other procedures for the fetus benefit until they could detect fetal problems during or before labor. But probably what is most unprecedented is that now, suddenly, physicians are seeking court intervention to protect these imperiled fetuses—intervention that, inevitably, constitutes a significant intrusion into the woman's conduct during pregnancy or birth.
AIDS Cost Analysis and Social Policy
Authors: Fox Daniel M. , Thomas Emily H. 
Published: June 2007

Debates about how much it costs to treat persons with AIDS and how the burden of these costs is and ought to be distributed raise fundamental questions about social policy in the United States. The most important questions concern entitlement: Who has what obligations to provide what services to whom, under what conditions and at whose expense?As a result of our political history, we were unprepared for the challenge of AIDS to social policy in the 1980s. We had, over a half-century, linked entitlement to medical care to age, disability, employment, and, for people with end-stage renal disease, to diagnosis. Our policies proved inadequate to pay for medical care for persons who died at considerably younger ages than normal, who were disabled for a brief period that was still long enough to end their employability, and whose condition progressed with unusual rapidity from diagnosis to death. By early 1988, it was clear that we would, as a society, assume the substantial costs of caring for persons with AIDS. Who would pay, and how equitably we would provide care, remained in debate.
The Courts and Euthanasia
Authors: Fletcher Joseph 
Published: June 2007

Most of us, I think, supposed that the debate over euthanasia (doing something to end a life that could otherwise continue) had been pretty well settled. For a long time a minority favored it and a majority opposed it—at least in principle, although not always in practice. Recent court decisions, however, have thrown the whole question open again, while public opinion polls reflect a marked increase in tolerance, if not positive approval. What follows is a lay discussion of the issue—not legally or medically professional but still, it is hoped, acceptable intellectually.My own role in the ethical defense of euthanasia goes back a long way. I began to expound it in the early 1930s. The British organized a euthanasia society in 1935. The Euthanasia Society of America came three years later. It started out with a petition by 1,776 physicians addressed to the New York State Assembly, which promptly rejected it.
A Civil Liberties Analysis of Surrogacy Arrangements
Authors: Gostin Larry 
Published: June 2007

Proponents of surrogacy arrangements assert that a married couple's right to procreative autonomy includes the right to contract with consenting collaborators for the purposes of bearing a child. The right to genetic continuity and to rear offspring are all part of the right of reproductive choice for the contracting father and his partner.Critics of surrogacy arrangements similarly cite reproductive autonomy as the basis for their claim that women cannot be compelled by contract to use their bodies in particular wayeither to forgo the right to abortion or to be fetal containers. The right to autonomy over her own body and to rear the offspring she has borne are all part of the mother's reproductive freedom.Both proponents and critics of surrogacy arrangements, therefore, claim that their positions maximize freedom and liberty. Each position, of course, focuses on the autonomy of the party the commentator favors; the analysis is invariably outcome-determinative, without enunciating a neutral civil liberties framework. Neither proponents nor critics define clearly what the right to procreate entails, or what resolution is warranted when there is a conflict.