bluuebunny/crossref_metadata_2025_split huggingface dataset:
Communication Failure: Some Case Examples
Authors: Greenlaw Jane 
Published: June 2007

Communication is an essential component of effective health care. Ideally, information to ensure continuous safe treatment and to prevent decisions or actions that can be harmful is transmitted among all who are involved in a patient's care, including the patient.In the course of a normal day, a nurse processes a great volume of information about a patient. The nurse must decide which information calls for further action, which should be recorded in the patient's record, which should be reported to others involved in the patient's care, and which should be told to the patient or his family. Making such decisions about communication can present serious problems. A recent California case, Sanchez v. Bay General Hospital, illustrates what can happen when nurses fail to recognize the significance of certain patient information and therefore fail to communicate it or react to it properly.
The Impact of Recent Antitrust Case Law on Health Care Professionals
Authors: Fried Jules M. 
Published: June 2007

The application of the antitrust laws to the health care field has generated intense debate over the last few years. Responsible for this debate in no small measure are the numerous health care antitrust cases that have reached and been decided by the United States Supreme Court. In the final weeks of the October 1981 term, the Court decided three such cases which should be of great interest to health care professionals. Although each involves a different point of law, collectively the decisions underscore the increasing amount of litigation that challenges joint conduct by health care providers, and the increasingly rigorous scrutiny that courts are giving such conduct under the antitrust laws.The case that has received the most recent attention is Arizona v. Maricopa County Medical Society,’ which involved an alleged price-fixing agreement among physicians. Defendants were the county medical societies in Maricopa and Pima Counties in Arizona, and the foundations for medical care which each society had created.
Pharmacists Challenge Third Party Prescription Programs: A Legal Analysis
Authors: Abood Richard R. 
Published: June 2007

Rare is the pharmacist today who does not participate as a service provider in one or several third party prescription insurance programs. Latest figures indicate that 372.7 million prescriptions or 25.4 percent of all prescriptions dispensed in this country were paid for at least in part by some form of prescription drug insurance.’ The economic impact which these third party programs are having on the retail pharmacist has caused their prominence as one of the most serious and important issues in pharmacy today.Most third party prescription programs (TPPPs) are similar in structure and include a program administrator or insurance company, a sponsor (often an employer or labor union), subscribers or beneficiaries. and the participating pharmacies. Typically, the insurer or program administrator (hereinafter. the administrator) offers a contract or a “pharmacy agreement” to each pharmacy in a particular area. Each pharmacy must then decide whether or not to accept the agreement and become a participating pharmacy.
In-House Hospital Law Offices: How Healthy are They?
Authors: Brown Max Douglas 
Published: June 2007

Medical centers. with increasing frequency, are employing their own in-house attorneys. The express purpose for this is to avoid the cost of large corporate law firms, as well as to secure greater control over costs connected with medical malpractice litigation, such as loss control, risk management, and self-insurance programs. But are these offices appropriately and competently providing the full spectrum of legal services to the medical centers they serve?This past spring, a conference in Chicago explored the role of in-house counsel in controlling corporate legal costs. The general consensus was that corporate clients, who consume from 65 to 85 percent of the legal services in the country, have allowed themselves to be “cowed by the demands of prestigious outside counsel.” According to press reports, ineffectual in-house counsel were criticized for their inability to curb excessive corporate legal fees and expenditures. The legal fees of outside firms were characterized as “just plain unnecessary.”
The Legal Status of Unapproved Generic Drugs
Authors: Abood Richard R. 
Published: June 2007

Generic drugs that have not been specifically approved by the Food and Drug Administration (FDA) are today being marketed, and considerable legal controversy surrounds the issue of whether the FDA can require premarketing approval of generic copy drugs (“me-toos”).Prescribers and dispensers of drugs cannot blindly assume that every drug on the market has been approved by the FDA, and that it will be safe and effective, as can be seen from the following incident. In September 1981, in an unprecedented action, an Ohio grand jury indicted a pharmacist for manslaughter in the death of a woman to whom he sold a furosemide product unapproved by the Food and Drug Administration. The woman died of congestive heart failure and the grand jury found probable cause that the death was caused by the diuretic. The drug was dispensed despite a March 30,1979,news release from the Department of Health, Education and Welfare warning that unapproved furosemide tablets were being marketed and that these drugs might be ineffective and could possibly be harmful.
Health Law Teachers and ASLM: A New Alliance
Authors: Canny Julie 
Published: June 2007

In an effort to broaden its scope in the area of medicolegal education, the Executive Committee of the American Society of Law & Medicine voted in Cktober 1981 to establish a Health Law Teachers Section for its members who teach health law related courses in any school of law, medicine, public health, health administration, or nursing.Angela R. Holder, J.D., LL.M., Treasurer of the Society and Counsel for Medicolegal Affairs and Associate Professor at Yale University School of Medicine, recommended that the Society expand its efforts to assist multidisciplinary individuals who share a common interest—education. While the Society was a co-sponsor of a 1980 Health Law Teachers Workshop, chaired by George J. Annas, J.D., M.P.H., of Boston University School of Medicine, the Society had not given formal, organized attention to the specialized needs of health law teachers.
Antitrust Law and Exclusive Contracts: Obstacles to Patients' Benefits?
Authors: Nord Robert E. 
Published: June 2007

Antitrust challenges to agreements between hospitals and physicians who provide patient services have become one of the most common types of antitrust litigation in the past few years. Two recent decisions by different circuit courts of appeal highlight the legal and medical principles on which such disputes will be decided.In August 1982, the United States Court of Appeals for the Seventh Circuit vacated a preliminary injunction entered in favor of an individual anes-thesiologist who had complained that after an anesthesia group terminated her employment, the hospital wrongfully refused to allow her to continue to serve patients. The Seventh Circuit, in Dos Santos v. Columbus-Cuneo- Cabrini Medical Center, expressed serious doubt whether under antitrust analysis, a single hospital could ever be treated as a distinct market for the purchase and sale of health care services. The court remanded the case to the federal district court, where it is still pending.
Reporting and Review of Patient Care: The Nurse's Responsibility
Authors: Katz Barbara F. 
Published: June 2007

The guidelines for the nursing staff of a health care facility in Boston include the following statement:
It is the intent of Massachusetts Law that physicians (and their employers when applicable) are ultimately responsible for the practice of medicine. Consistent with the Law it ispolicy that medical orders by the physician members of the staff are to be questioned by other members of the staff only if they are incomplete and inconsistent with accepted standards of practice or there is sound basis for believing that carrying out the orders would cause severe and ineversible ham to the patient. Normally, any questions about the manner in which medicine is practiced are to be brought to the attention of the Executive Director (a nonphysician) through the appropriate coordinators/supervisors. The Director will adequately consider all such questions and take any necessary action.
Considering a New Structure: The Health Services Holding Company
Authors: Kerr Frederick H. 
Published: June 2007

American hospitals are in turmoil, experiencing declines in community esteem, reductions in Medicare payments, pressure for cost control by employers and insurers, and internal conflict between managements and medical staffs. Each of these conflicts is simply another facet of an overall problem: American society's recently conceived notion that unlimited access to the best available health services constitutes a right. Americans have adopted this idea, however, without considering the economic consequences in an environment of rapidly advancing technology and an aging population. Costs have escalated rapidly, reaching ten and one-half percent of the gross national product; the health services system is in strong competition with other important societal segments for scarce resources. The money may not be running out, but a rather naive institution, the community hospital, has suddenly found itself in an environment for which it is ill-prepared.Governmental licensure of health professionals has a long history, but significant federal intervention in hospital financing did not begin until after World War II with the advent of the Hill-Burton program, which provided funds for hospital expansion. Medicare introduced federal payment for hospital care provided to the elderly and used formulas for cost reimbursement in 1966.
Preventive Medicine and Preventive Law: An Essay That Belongs to My Heart
Authors: Brown Louis M. 
Published: June 2007

This essay reflects my experiences as an open heart surgery patient. It also makes some comparisons of the roles of lawyers and doctors. The skills of the medical profession in pursuing the concept of preventive medicine have for more than three decades stirred my interest in developing the concept of preventive law.As is my custom, aided by the good practices of my personal physician for a decade, I received an annual medical examination on Tuesday, June 8, 1982. The preliminary results were reported to me with the customary comment that I would receive the complete results in a few days. I did notice a slight downcast expression on the good doctor's face as he looked at the electrocardiogram, but I remained silent. The E.K.G. included a four-minute bicycle exercise. For most previous years, the exercise was the Master's two-step test so I did not have a good basis of comparison of this year's test with my previous E.K.G.s. I excused the slight difference that I felt this year on the basis that each year I am getting older.
The Liability of the Occupational Health Nurse
Authors: Bowyer Elizabeth A. 
Published: June 2007

Occupational health nurses exercise their professional skills in positions of enormous responsibility. An occupational health nurse works in industry or business, either alone or as part of a team, to ensure workers’ health and safety. Management is ultimately responsible for providing a safe and healthful work environment, and employs nurses and other professionals to provide health services for workers and to meet the mandates of the Occupational Health and Safety Act of 1970, which has imposed many responsibilities on employers and occupational health professionals.Highly specialized professional nurses in recent years have gained recognition of their expanded responsibility, autonomy, and accountability. At the same time, an increased number of nurses have been named individually as defendants in negligence or malpractice actions. Occupational health nurses may become particularly vulnerable to a disproportionate number of malpractice suits, as a result of factors ranging from the independent setting in which occupational nurses work to the interplay of laws affecting workers and employers.
Reporting Incompetent Physicians: A Comparison of Requirements in Three States
Authors: Fama Andrew J. 
Published: June 2007

Physician incompetence and impairment have become one of the most controversial issues of recent years in the health care industry. Legislators, attorneys, and the general public have become actively involved in an area which had previously been within the exclusive (and oftentimes clandestine) province of hospital administrators and medical staffs. As a result of increasing public awareness, the informal and unstructured system of the past has been transformed into a more organized, results-oriented, and equitable approach to a problem which, many now realize, cannot be ignored.Several state legislatures have enacted statutory provisions relating to the investigation and reporting of incompetent physicians. Some, like New York, have begun working closely with the state medical societies to ensure what these physicians are not only disciplined, but also treated and made to realize that their impairment can be resolved by cooperating with those who want to help. Other states, like Massachusetts, have devised regimented reporting requirements, but have overlooked the need for early investigations of, and assistance to, impaired physicians.
The Living Will from the Nurse's Perspective
Authors: Cohn Sarah D. 
Published: June 2007

A living will is a directive from a competent, seriously ill individual to medical personnel and family members regarding the treatment he wishes to receive when he becomes incompetent to make decisions for himself. It is important to remember that a living will is not necessary when an adult is competent and chooses to refuse treatment since it is clear that generally, an adult, whether critically ill or not, may refuse any treatment for any reason. A living will is applicable only when a previously competent patient is seriously ill and incompetent.Recent concern about new medical technologies which can prolong the dying process without improving the quality of life has sparked interest in rhe living will. More than five million copies of sample living wills have been distributed throughout the country, often by churches and senior citizens groups. State governments have also responded to this interest; the first Natural Death Act was signed into law in California in 1976. Since then, thirteen states and the District of Columbia have passed similar legislation, sometimes referred to as right-to-die statutes (see table accompanying this column).
Biological Monitoring and Genetic Screening in the Industrial Workplace: A Synopsis and Analysis
Authors: Field Robert I. 
Published: June 2007

Can new medical technologies decrease the incidence of occupational disease? Do they work to the detriment of other worker interests? Do they shift the burden of maintaining a healthy workplace from employers to employees, by keeping sensitive individuals from jobs that they are otherwise qualified to perform? These are among the central issues presented by the emerging occupational use of biological monitoring and genetic screening, as highlighted at the conference on Biological Monitoring and Genetic Screening in the Industrial Workplace, held in Washington, D.C., on May 12-13, 1983. The meeting was sponsored by the American Society of Law & Medicine and the Boston University Schools of Law, Medicine, and Public Health.Research in progress on these issues, at the Center for Law and Health Sciences at Boston University School of Law, was one of the motivating forces for the conference. With funding from the National Science Foundation and the National Endowment for the Humanities, the study, led by Professor Michael Baram, LL.B., of Boston University School of Law, is providing a comprehensive overview and analysis of the major philosophical, ethical, and legal issues involved.
Adult Protective Services: Convincing the Patient to Consent
Authors: Kapp Marshall B. 
Published: June 2007

Adult protective service systems in many of our states have been subjected to a good deal of public criticism. Much of this denunciation, particularly that emanating from civil libertarians who advocate on behalf of the legal and ethical rights of older citizens, centers on the legal aspects of protective services, and especially on the legal authority of the state to intervene unilaterally in the private life of an unwilling, protesting older individual.Except in the most compelling of circumstances, society should avoid the coercive elements of protective services. Often overlooked, however, by commentators, policy-makers, and caregivers alike, is that protective services may be, and in the vast majority of instances are, accepted voluntarily (and gratefully) by the older recipient. A mentally competent individual may voluntarily give informed consent in the medical sphere, as well as in others, to the receipt of services that he or she currently needs. Additionally, legal mechanisms frequently enable a competent independent adult to foresee and prepare for the possibility that he or she might become incompetent and dependent, by providing for a substitute decisionmaking process of the individual's own choosing.
Mandated Benefits: Their Social, Economic, and Legal Implications
Authors: Heitler George 
Published: June 2007

Expenditures for health care have reached a point where they represent almost 10 percent of the gross national product; health care has become one of the country's largest industries. Moreover, the cost of health care continues to increase more rapidly than inflation. Many policy makers and critics of the health care system believe that the promotion of competition among health care providers can be instrumental in keeping the price of health services down.The health care boom and ever accelerating health care expenditures have stimulated the availability of new providers, and many hope that these alternative providers will enhance competition in the health care system. Non-physician practitioners, such as podiatrists, optometrists, chiropractors, and nurse-midwives, and such non-traditional delivery mechanisms as health maintenance organizations (HMOs), preferred provider organizations (PPOs), ambulatory surgical centers, and birthing centers, have been gaining increasing support at both the federal and state levels of government. Proponents believe that these alternative providers and mechanisms not only produce more options for consumers but also help contain the cost of health care in the United States.
Hospital-Sponsored Preferred Provider Organizations
Authors: Roble Daniel T. , Knowlton William A. , Rosenberg Gary A. 
Published: June 2007

The recent growth of new forms of health care delivery has been encouraged by the increase in competition in the health care industry. Several factors account for this increase in competition. First, there is an overabundance of physicians in many areas of the United States. In addition, many overbedded hospitals now compete for the same patients to fill their beds. Finally, health maintenance organizations and other alternative delivery systems, such as ambulatory surgical care centers, ‘surgicenters,” and birthing centers, are capturing more of the patient market and reducing hospital inpatient utilization.Employers, insurers, and the government, as the third-party payers who most often pay for an individual's medical care, hope to take advantage of this new competitive environment and to moderate the increase in their health care expenditures.
Nursing Negligence in the Hospital Emergency Department
Authors: Greenlaw Jane 
Published: June 2007

The hospital emergency department- those who receive care there and those who provide it-has changed rapidly in recent years. The number of patients going to emergency departments is steadily increasing, and the care which they seek is not confined to traditional emergency care. More and more patients utilize the hospital emergency department for routine health problems, either as substitutes for personal health care providers or as replacements when their own providers are unavailable.Physicians, nurses, and other health care providers in the hospital emergency department have changed from generalists to emergency care specialists. The rotating, on-call staff physician serving in a department with low priority is being replaced by the emergency medicine practitioner. Since 1980, the American Board of Emergency Medicine has been certifying physicians qualified in this new specialty, and the Emergency Department Nurses’ Association has been administering an examination for certification in emergency nursing.
Regulating Heart and Liver Transplants in Massachusetts: An Overview of the Report of the Task Force on Organ Transplantation
Authors: Annas George J. 
Published: June 2007

Organ transplantation has been a favorite topic of health lawyers since its inception. Organ procurement was addressed with the adoption of the Uniform Anatomical Gift Act in all fifty states, and “brain death” has been recognized both judicially and legislatively across the country. Nonetheless, it is now apparent that the major problems in organ transplantation are not legal and thus neither are their solutions. Heart and liver transplants are extreme and expensive interventions that few individuals can afford and few hospitals can offer. In an era of economic scarcity, how (if at all) should organ transplant procedures and other extreme and expensive treatment he introduced into the health delivery system?Although it seems reasonable to expect federal leadership to establish a limited number of high-quality transplant centers, federal efforts to date have focused almost exclusively on trying to help the scattered organ procurement agencies become more efficient.
Equity and Costs
Authors: Pauly Mark V. 
Published: June 2007

The task of determining who should or should not have access to a life-prolonging procedure would not be easy even if cost were no consideration. In an era in which rhe health industry has largely converted to the cost cutting religion, or at least the religion of budget limitation, a conversion for which health economics is partly responsible-the task becomes doubly difficult.At one level, the Massachusetts Task Force on Organ Transplantation has dealt with this task simply by recommending that the final decision be postponed, and that a limited program of organ transplantation he introduced in an “Initial Social Assessment” phase.
The Dog and His Shadow: A Response to Overcast and Evans
Authors: Annas George J. 
Published: June 2007

Aesop‘s Fable, “The Dog and the Shadow,” begins with a dog walking over a bridge with a piece of meat in his mouth. Looking down into the stream, he sees his shadow. Thinking it is a bigger dog, with a piece of meat twice the size of his own, the greedy dog decides to get it. Snarling, he opens his mouth to attack. At that moment the meat falls from his mouth, into the stream. The dog realizes his mistake, and sadly says to himself, “Grasp at the shadow and lose the substance.“Drs. Overcast and Evans have not yet realized their mistake, but this response may help them see that what they characterize as their “strong exception” to “procedural and substantive” points made by the Massachusetts Task Force on Organ Transplantation and the “major shortcomings” they purport to identify really involve insubstantial “shadows.” Their “appraisal” indicates no disagreement of substance with any of the Task Force's policy recommendations. and their tangential quibbles shrink when their content and context is understood.