bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wrongful Life — Its Problems are Not Just Semantic: A Reply to Furrow
Authors: Taub Sheila 
Published: June 2007

In an article in the June, 1982 issue of this journal, Barry Furrow suggested that changing the name of the tort of “wrongful life” to “diminished life” would overcome the reluctance that many courts have shown to recognize its existence. Others have made similar suggestions, differing only in the names which they proposed as a replacement for “wrongful life.” It is my belief, however. that the problems that many courts and commentators have had with “wrongful life” are inherent in the nature of the action and will not be resolved by simply changing its name.In the remainder of this article, 1 will employ the neutral term “X” to refer to any action brought by a child for having been born with some defect or handicap which could only have been prevented, given the current state of medical knowledge, by either aborting the child or preventing its conception. It is hoped that this device will avoid the danger of “semantic overload,” of which Professor Furrow wrote.
Cognitive Moral Development Theory And Moral Decisions in Health Care
Authors: Allen David F. , Fowler Marsha D. 
Published: June 2007

During the past few years, health care professions haw received strong criticism for seemingly ethically wrong or inhumane practices. The Tuskegee syphilis study, experimentation on mentally retarded persons at Willow-brook, forced sterilizations of retarded individuals, and alleged malpractice and Medicaid abuses are a few examples of those instances that have received publicity. Incidents such as these, coupled with the development of an aggressive consumerism and with escalating scientific technological advances, haw created an urgent and widespread concern about medical ethics or bioethics. The Hastings Institute, two presidentially appointed commissions on issues in medical ethics, and the introduction of ethics courses in the curricula of medical and nursing schools are responses to ethical concerns in health care.Although numerous texts and articles on specific bioethical issues haw been published in recent years, troubling questions remain about the normative ethics that form the foundation of responses to these issues.
Documentation of Patient Care: An Often Underestimated Responsibility
Authors: Greenlaw Jane 
Published: June 2007

There is increasing societal concern about retention and retrieval of information about individuals; advances in technology have enlarged the means for storing and communicating personal information. Not surprisingly, some of this concern is directed toward medical records. Questions have arisen about ownership of and access to medical records, as well as their content. This column focuses solely on some basic issues pertaining to the content of medical records.Information in a patient's medical record can be used as a basis for decisions concerning his insurance coverage or payments, employment, eligibility for educational or benefit programs, or the outcome of a lawsuit. Thus, the law generally recognizes the patient's right to control the access to his medical record by third parties.Because of the permanence and potential importance of a patient's medical record, health professionals frequently raise questions about what to include in the record, who should write in a patient's chart, where and how to make corrections, and how to document specific problems such as patient injury or concerns about the quality of care the patient is receiving.
Revocation of Nurses’ Licenses: How Does it Happen?
Authors: Cohn Sarah D. 
Published: June 2007

Even though physicians, lawyers, dentists, school teachers, life insurance brokers, and peddlers were licensed in the United States as early as 1890, nursing occupational licensure did not begin until 1938, when New York became the first state to pass such a law. By 1962, eight states had mandatory licensing laws, and sixteen more had nursing boards which claimed that licensure was mandatory.Today every state requires that nurses who practice within its jurisdiction possess licenses. Since the purpose ofnursing licensureis protection of the public, the state may require qualifications which are reasonably related to the practice of nursing. A license, because it is granted upon condition, is not a permanent right, and the state may revoke it if the licensee does not continue to meet licensing standards. The state also has discretion to use remedies less extreme than revocation. It may limit or suspend the license, and/or fine or reprimand the nurse.
Infant Doe Regulations and the Absolute Requirement to Use Nourishment and Fluids for the Dying Infant
Authors: Paris John J. , Fletcher Anne B. 
Published: June 2007

On July 5, 1983. the Department of Health and Human Services (HHS) issued a revised version of its Proposed Rules for the so-called Infant Doe Regulations. The regulations are designed to prevent discriminatory denial of medical treatment to handicapped infants. An earlier version published last March had been struck down for procedural defects by Federal District Court Judge Gerhard Gesell. In the course of his opinion, Judge Gesell noted that the regulations touch upon one of the most difficult and sensitive medical and ethical problems facing society—the question of what, if any, life-sustaining medical treatment should be utilized to preserve the lives of severely mentally or physically defective newborn infants.In his view not only were the original regulations procedurally flawed, but they also were substantively deficient. Arbitrary and capricious was Gesell's phrase to describe HHS's actions in establishing a toll-free 24-hour-a-day hotline on which anonymous tipsters could trigger an investigation of alleged nontreatment.
Dilemma of Tarasoff: Must Physicians Protect the Public or Their Patients?
Authors: Roth Michael D. , Levin Laurie J. 
Published: June 2007

Physicians nationwide, already worried by an increasing number of professional liability lawsuits and an expanding scope of liability, now face a new and potentially more troublesome development that had its genesis in what many thought was an extraordinary court decision. In Tarasoff v. Regents of the University of California, a psychiatrist was held, in a suit brought by the victim's parents, to be liable for negligence in the death of a woman who was murdered by a patient of that physician. The court held that even though the physician had complied with the traditional duty of protecting the patient's confidentiality, he nonetheless had a duty to warn the victim of the potential threat against her life. Tarasoff was eventually followed by a number of decisions that imposed liability on physicians under similar circumstances.This article reviews and analyzes the original Tarasoff decision and subsequent judicial rulings on this subject. In addition, the authors briefly explore the historical backdrop of this decision and suggest practical steps that physicians can take to deal with the conflicting duties of protecting confidentiality and protecting potential victims from the danger posed by patients.
Revising Medical Consent Forms: An Empirical Model and Test
Authors: Kaufer David S. , Steinberg Erwin R. , Toney Sarah D. 
Published: June 2007

Recent years have brought increasing pressure from the public and the courts for truly informed patient consents to medical treatment and surgical procedures. Many courts have recognized that a patient's signature on a consent form is no assurance that the patient has received sufficient information, much less that he or she truly understood the information. A Pennsylvania court articulated this principle this way:
[S]ince the patient must rely on the physician to tell her of all the appropriate risks, the physician cannot discharge this duty by having the patient execute a form which states that the risks have been explained. The courts will look beyond forms signed by patients to determine if the duty to inform has been discharged.
Standards of Medical Care Based on Consensus Rather than Evidence: The Case of Routine Bedrail Use for the Elderly
Authors: Rubenstein Howard S. , Miller Frances H. , Postel Sholem , Evans Hilda B. 
Published: June 2007

“An 88-year-old male patient was found on his hands and knees on the floor beside his bed. The bedrails were up.”—From an indent report filed by a nurse at the Stillman Infirmary, University Health Services, Harvard University, in May 1980.Finding elderly patients lying on the floor beside their beds despite the presence of elevated bedrails seems paradoxical: how can a patient fall out of bed when the bedrails are up? Surprisingly, this paradox constitutes one of the leading incidents plaguing hospitals in the United States today. It exemplifies a much larger problem created, we believe, by the uncritical adoption of measures designed to enhance patient welfare, but which may in fact undermine it. This article documents our experience with bedrails, reviews the literature, and comments on the rationale for routine adoption of bedrails for the hospitalized elderly. It concludes by advocating that a randomized, controlled study be conducted to determine whether bedrails constitute protection or a hazard to the average elderly patient.
The Predisposition to File Claims: The Patient's Perspective
Authors: Press Irwin 
Published: June 2007

The past dozen years have witnessed an astounding rise in costs relating to the prevention and management of medical malpractice claims. Not surprisingly, a crisis of trust has also been building over the same period. Public interest in alternatives to traditional health care has increased as has the plethora of defensive medical procedures in hospitals. In addition, the past decade has seen the rise of such hospital professions as risk management, patient representation, quality assurance, and utilization review. The current high interest in “patient services” and “patient relations” is just that-current: a reflection of low priority until gathering crises made such interests relevant.The cost crisis has led to both reactive and preventive behaviors on the part of hospital personnel. Reactive behaviors are those designed to respond to errors and claims after they occur. Examples are incident investigation, adjustment decisions, and insurance reserve manipulation. Preventive behaviors are designed to head off incidents before they occur, by identifying and reducing sources of clinical error, legal liability, and patient aggravation.
The New Reproductive Possibilities: Seeking a Moral Basis for Concerted Action in a Pluralistic Society
Authors: Capron Alexander Morgan 
Published: June 2007

As the media have recently reminded all Americans, biomedical capabilities that are being developed in this country and around the world present us with unfamiliar possibilities in human reproduction, from which flow unprecedented ethical, social and legal issues.The transfer of a human embryo from one woman to another is one such possibility, though far from the only one. The time has come for a public examination of the full range of developments in reproduction from artificial insemination through in vitro fertilization to the freezing and banking of sperm, eggs, and embryos.
The Professional Advertiser: How Do We Draw the Line (If There is a Line)?
Authors: Grad John D. 
Published: June 2007

A half-page advertisement in the 1982 Yellow Pages of a large East Coast metropolis read: “The Podiatry Center. For information on foot health, call the following numbers….” The advertisement contained an address and some other information pertinent to foot health, but did not contain the names of any individual podiatrists.Many podiatrists were angry be cause the “Podiatry Center” was not a hospital, podiatry school or any other kind of institution; instead, it was a doctors’ office. The advertisement, many podiatrists felt, was purposely misleading to the public, suggesting that the ‘Podiatry Center” was something more than just an office of individual podiatrists.
Therapeutic Privilege: Variation on the Theme of Informed Consent
Authors: Somerville Margaret A. 
Published: June 2007

Since 1980. the Supreme Court of Canada has handed down two judgments which have had a major impact on the law of informed consent in this country. These are Reibl v. Hughes and Hoppv.Lepp. The doctrine of therapeutic privilege, the subject of this article, was discussed in both cases. But, in order to examine this doctrine, first, a brief explanation of the Court's more fundamental ruling on the doctrine of informed consent is needed.The Basic Structure of Informed Consent and Therapeutic PrivilegeCiting and relying on the United States case of Canterburyv.Spence, the Supreme Court of Canada changed the reference point for establishing the standard to be used to determine the legally required scope of disclosure of information to a patient in order to obtain his or her informed consent. Previously, this standard had been set according to the information that “the reasonable physician in the same circumstances” would disclose. It became what “the reasonable patient in those circumstance? would want to know, which encompasses information concerning “the nature of the proposed operation, its gravity, any material risks and any special or unusual risks attendant upon the performance of the operation.”
Institutional Ethics Committees: Issues of Confidentiality and Immunity
Authors: Cranford Ronald E. , Hester F. Allen , Ashley Barbara Ziegler 
Published: June 2007

Institutional ethics committees (IECs) now exist at many health care facilities and are in the planning stages at others. Due in part to the recent origins of IECs and the continuing debate over their optimal composition, role, and status in health care institutions, legislatures and courts have yet to recognize or clarify their legal status. Neither reported cases nor statutes clearly explain whether the proceedings and records of IECs must be disclosed to prosecuting attorneys or to parties to civil lawsuits, whether such information can be introduced as evidence in a trial, or whether persons serving on IECs or those providing information to IECs may be held civilly or criminally liable for actions by the committees.This article sets forth some basic principles relating to the composition and functions of IECs, then examines the questions of confidentiality of IEC proceedings and immunity for persons serving on or providing information to the committees. Several reasons against and in favor of confidentiality and immunity are stated.
Consent Forms, Readability, and Comprehension: The Need for New Assessment Tools
Authors: Mariner Wendy K. , McArdle Patricia A. 
Published: June 2007

Recent efforts to evaluate the effectiveness of the informed consent process between physician and patient have focused on the ability of patients to understand written “informed consent” documents. Several researchers, employing traditional readability formulas to measure the reading level of such documents, have noted that many of these forms are written at a level too difficult for most people to understand. Readability formulas, such as those of Flesch and Fry, and the SMOG formula, have become convenient measures of the effectiveness of informed consent documents in conveying information to patients to enable them to make decisions about recommended therapies.Our experience, in a pilot study, with readability formulas to test an informed consent document used in childhood poliomyelitis immunizations led us to conclude that readability formulas are an inadequate measure of patients’ comprehension of written information about medical procedures.
Medical Uncertainty, Diagnostic Testing, and Legal Liability
Authors: Fortess Eric E. , Kapp Marshall B. 
Published: June 2007

Health care cost considerations exert increasing influence today over clinical decision-making. One way to help contain costs while maintaining the quality of health care may be to increase among both physicians and patients an acknowledgment of, and tolerance for, a reasonahle degree of medical uncertainty. By medical uncertainty we mean here those clinical situations in which, based on available data, absolute scientific proof regarding some aspect of a patient's heallh status cannot be obtained.To the extent that acceptance of medical uncertainty and a corresponding restraint among physicians can he encouraged without exposing the physicians to an undue risk of legal liability, all participants in the health care system would benefit from this tolerance. To help provide this encouragement. we will explore the legal implications of medical uncertainty, focusing on diagnostic testing, and argue that our legal system does now and will continue to recognize, tolerate, and perhaps even promote some medical uncertainty in the diagnostic realm.
The Lawyer's Perspective on the Use of Ultrasound in Obstetrics and Gynecology
Authors: Bundy Albert L. , James A. Everette 
Published: June 2007

Diagnostic sonography, also known as ultrasound, has become an invaluable aid in the practice of obstetrics and gynecology. Rapid improvements in instrumentation have caused the sonologist and sonography to assume a primary role in the care of these patients. Patient and physician expectations have increased with the technological advances. This paper will outline the advances and capabilities of diagnostic sonography in obstetrics and gynecology, while reflecting upon the foreseeable legal implications.The physics of ultrasound is rather complex. Briefly, ultrasound utilizes high-frequency, non-ionizing, mechanical waves, 2.25 to 10 megahertz, that require a molecular medium for propagation. The reflected energy is processed to produce an image. Because it employs non-ionizing waves, ultrasound is considered safe by most authorities when used at the intensities currently employed for diagnosis. No clinically significant adverse effects have been reported in humans to date.
Innovative Statutory Approaches to Civil Commitment: An Overview and Critique
Authors: Shuman Daniel W. 
Published: June 2007

The study of society's approach to civil commitment of the mentally ill is made particularly interesting by the strength of the values it finds in conflict. On one plane, “good” or “moral” people are supposed to provide care for those unable to care for themselves. The capacity to consider the needs of others helps define our “humanness.” In this context, this value manifests itself in the attempt to provide mental health care for those unable, because of their illness, to provide it for themselves.On another plane, however, the oppression that drove many to immigrate to America and that resulted in our own revolution has left us with an abiding fear of governmental limitations on individual autonomy. Cries of totalitarianism and “big brotherism” often accompany governmental attempts to restrict that autonomy. In this context, this value manifests itself in the attempt to permit individuals to choose whether to receive mental health care.
Against Infanticide
Authors: Keyserlingk E.W. 
Published: June 2007

I agree with Dr. Kuhse and Prof. Singer on many points. It is of course ethically defensible to decide sometimes that a seriously handicapped newborn baby may be better off dead, that medicine can do no more to help, and that to stop or not initiate medical treatment may be the best we can do. It is equally true and ethically defensible that these decisions are sometimes based at least in part on predictions about the baby's present and future quality of life. It would be foolish to pretend that quality-of-life considerations should be or can be excluded from these decisions. I argue that the interests and wishes of the family must be given serious consideration, if not that they should be decisive at the expense of the newborn's best interests.I do, however, seriously object to the claim that some infants with severe disabilities should be killed. I will not repeat the familiar philosophical and other arguments as to why there is arguably, given certain conditions, a significant moral difference between not treating and killing. Instead, my refutation of infanticide will take a more indirect route.
A Review of AIDS-Related Legislative and Regulatory Policy in the United States
Authors: Gostin Larry , Ziegler Andrew 
Published: June 2007

This article surveys proposals for public health statutes and regulations to control the spread of the human immunodeficiency virus (HIV). The data were collected by the Harvard School of Public Health in pursuance of a contract for the U.S. assistant secretary for health and by the Intergovernmental Health Policy Project at George Washington University. The intention is to provide a representative overview of legal and policy alternatives, not to offer a comprehensive account of statutes and proposals in all jurisdictions.The AIDS epidemic has refocused attention on public health law, raising anew questions about the application, effectiveness, and constitutionality of various disease control measures. State and local legislatures have considered a broad range of measures designed to control the spread of AIDS. Virtually every state legislature has debated AIDS-related bills; between January 1 and April 15, 1987, more than 360 AIDS-related bills were introduced in the United States. Thus far, approximately twenty-eight states have enacted AIDS-related legislation.
AIDS and the Limits of Discrimination Law
Authors: Parmet Wendy E. 
Published: June 2007

Throughout history, disease has been associated with bigotry and prejudice. Since biblical times the leper has been shunned and treated as an outcast. In the Middle Ages, the arrival of the plague brought with it violent social upheaval and persecution of the Jews. In the earlier part of this century, prostitutes thought to have venereal disease were quarantined en masse.Given this sorrowful history, it is not surprising that the AIDS epidemic has brought with it mistreatment of persons associated with AIDS, the term I shall use for people who either have or are thought to have AIDS, AIDS-related complex (ARC), or antibodies to the virus that causes the disease. Indeed, considering that AIDS is a sexually transmitted disease that has in this country primarily afflicted homosexual men and intravenous (IV) drug abusers, it is perhaps surprising that overt acts of prejudice have not been more common.
Federal Regulations for Fetal Research: A Case for Reform
Authors: Fletcher John C. , Ryan Kenneth J. 
Published: June 2007

In 1974 the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research considered many aspects of fetal research. The Commission received some detailed ethical, legal, and scientific analyses, invited public testimony, and recommended guidelines for biomedical research involving the human fetus. One of the authors of the present article (KJR) chaired the Commission. Many of its recommendations became federal regulations on fetal research issued in 1975.These regulations explicitly govern only research “conducted by the Department of Health and Human Services (DHHS) or funded in whole or in part by a Department grant, contract, cooperative agreement or fellowship.” However, as Baron pointed out in his legal review, they effectively cover all federally funded institutions, regardless of the source of the funds the institution may be using for fetal research.