Health Law and Policy Commons^™

The Care Of Private Patients In Teaching Hospitals: Legal Implications, George J. Annas

Faculty Scholarship

In Herman Melville's novel Moby Dick Ishmael searches for knowledge in diverse ways; he views the world not only through his senses but symbolically and metaphorically. At one point, he is tied to the pagan harpooner Queequeg by a "monkey-rope," and it is his duty to use this rope to pull Queequeg free from the sharks surrounding the dead whale that Queequeg is butchering when Queequeg slips from his perch atop the whale. Should he fail, Queequeg's weight will pull them both into the shark-filled waters. Ishmael ponders: "I seemed distinctly to perceive that my own individuality was now merged …

Laetrile: The Battle Moves Into The Courtroom, Robert L. Schwartz

Faculty Scholarship

Controversy over the supposed cancer-curing drug laetrile continues to rage. Now it's up to the courts. substance that was used by ancient Greek physicians, has been available in the United States, legally or illegally, for a quarter of a century. The government's increased efforts to eliminate laetrile "pushing" by what are seen to be profiteering physicians has created a strengthened laetrile lobby that has successfully fought the medical establishment and succeeded in making the drug legal in more than a dozen states. The pro-laetrile lobby an assortment of cancer patients and their families, medical professionals, and conservative politicians -threatens to …

Reconciling Quinlan And Saikewicz: Decision Making For The Terminally Ill Incompetent, George J. Annas

Faculty Scholarship

One of the most perplexing problems in the medicolegal field concerns the criteria on which decisions not to treat terminally ill incompetent patients should be made. These decisions traditionally have been made by physicians in hospitals-sometimes with the assistance of the patient's family-on the basis of their perceptions of the patient's "best interests." Recently, two state supreme courts have ruled on this question. The New Jersey Supreme Court, in the Quinlan case, developed a medical prognosis criterion, and permitted the patient's guardian, family, and physicians to apply it with the concurrence of a hospital "ethics committee." The Massachusetts Supreme Judicial …

Where Are The Health Lawyers When We Need Them, George J. Annas

Faculty Scholarship

A momentous event in the field of health law occurred in April of 1978: the first national meeting of teachers of health law was held at Boston University. Of sixty individuals invited, almost all of whom teach health law as a full-time profession in various graduate schools, forty-five participated in the two-day workshop. While that response alone may have revealed the answer, the first topic on the agenda was: "Is health law a discipline?"

Judges At The Bedside: The Case Of Joseph Saikewicz, George J. Annas

Faculty Scholarship

In what may prove to be the most controversial medicolegal decision of the year, the Massachusetts Supreme Judicial Court has ruled that, in certain cases, courts are the proper forum in which life-sustaining medical decisions should be made.1 The controversy goes deep. It involves questions of who should make life-prolonging decisions, in what forum, and on what criteria. Until the last few years, these questions arose almost exclusively in the context of Jehovah's Witnesses cases - cases in which life-saving blood transfusions were being refused for religious reasons. But with society's increasing consciousness about the way people die in hospitals, …

More On Regulation: A Reply To Stephen Weiner, Clark C. Havighurst

Faculty Scholarship

In Volume 3, Number 3 of this journal, Professor Havighurst* wrote a brief Comment in which he observed that the function of health care cost-containment regulation is the rationing of health care resources, and argued that the fostering of health care consumers' and providers' free choice in the competitive marketplace is preferable to conventional cost-containment regulation as a mechanism for such rationing. He briefly outlined various reforms, including changes in federal tax treatment of health insurance premiums, aimed at implementing his ap- proach. Subsequently, in a Comment in Volume 4, Number 1, Stephen M.Weiner, then Chairman of the Massachusetts Rate …

The Rights Of The Employee As Patient, Frances H. Miller

Faculty Scholarship

No abstract provided.

Scientific Research With Children: Legal Incapacity And Proxy Consent, Leonard H. Glantz, George J. Annas, Barbara Katz

Faculty Scholarship

Before an investigator can use any person as a subject in biomedical or behavioral research, he must obtain that person's informed consent. This consent must be voluntary, competent, and understanding.¹ There are two questions that arise in regard to experimentation on children. First, is a child legally capable of giving an informed and understanding consent? Second, do parents have the legal capacity to consent to the performance of research on their children? This article will attempt to answer both of these questions.

Allocation Of Artificial Hearts In The Year 2002: Minerva V. National Health Agency, George J. Annas

Faculty Scholarship

The rapid growth of medical technology gives rise to difficult dilemmas concerning the appropriateness of, and access to, new equipment and devices capable of maintaining life or improving its quality. Such a dilemma already exists, for example, with regard to kidney dialysis machines. In 1972, Congress amended the Social Security Act to make such machines available under Medicare to all who needed them. But almost immediately the overwhelming cost of such equipment-in the billions of dollars-made the original appropriations totally inadequate, and prompted serious questions of whether access to kidney dialysis should be made available at public expense-and, if so, …

Health Care Cost-Containment Regulation: Prospects And An Alternative, Clark C. Havighurst

Faculty Scholarship

Regulation of the health care system to achieve appropriate containment of overall costs is characterized by Professor Havighurst as requiring public officials to engage, directly or indirectly, in the rationing of medical services. This rationing function is seen by the author as peculiarly difficult for political institutions to perform, given the public's expectations and the symbolic importance of health care. An effort on the part of regulators to shift the rationing burden to providers is detected, as is a trend toward increasingly arbitrary regulation, designed to minimize regulators' confrontations with sensitive issues. Irrationality and ignorance are found to plague regulatory …

Psro Data And Information: Disclosure To State Health Regulatory Agencies, Frances H. Miller

Faculty Scholarship

No abstract provided.

Regulation Of Electroconvulsive Therapy, Carol Sanger

Faculty Scholarship

Electroconvulsive therapy (ECT) is a psychiatric procedure that induces a convulsive seizure in the patient in order to treat severe depression. Recently, courts, legislatures, and the medical profession have paid increasing attention to the regulation of ECT. Their interest has been stimulated by the growing recognition of the rights of mental patients, the developing role of consent in medical transactions, and the results of recent scientific research on the efficacy and consequences of ECT.

Regulation of ECT has generally focused on whether the patient or his representative effectively consented to the treatment. The highly intrusive nature of ECT and the …

When You Enter The Hospital Check Your Rights At The Door, George J. Annas

Faculty Scholarship

Civil libertarians have little difficulty appreciating the plight of prisoners or mental patients. But tell the average civil libertarian that there are significant and unnecessary restrictions on the individual rights and liberties of patients in general hospitals, and you are likely to encounter a blank stare. There are a number of reasons for this lack of attention to hospitals. One is the general misconception that the problems are minor, or that certain temporary restrictions on individuals are essential if hospitals are to treat sick people properly. An unconscious desire not to perceive ourselves as being at risk may be another …

Medical Malpractice Litigation Under National Health Insurance: Essential Or Expendable, George J. Annas, Barbara F. Katz, Robert G. Trakimas

Faculty Scholarship

"Medical malpractice" denotes the basis for a civil action brought by a patient against a physician for injuries resulting from negligence. The current method for compensating victims of these occurrences is primarily a fault-and-liability insurance system. The first principle of tort liability is that the party at fault pays for the damage inflicted upon an innocent victim. Whether a doctor is at fault is determined in an adversary proceeding, with both the doctor and the patient represented by counsel. The triers of fact have the task of ascertaining whether the defendant was at fault, and if so, what compensation he …

Blue Cross: What Went Wrong?, Frances H. Miller

Faculty Scholarship

No abstract provided.

The Patient Rights Advocate: Redefinig The Doctor-Patient Relationship In The Hospital Context, George J. Annas, Joseph M. Healey Jr.

Faculty Scholarship

As Western man approaches the last quarter of the twentieth century, he is developing the power to control the forces of nature. Few areas of human behavior have not been affected by new technologies. In health care, progress has been dramatic in such areas as the determination of prenatal genetic defects through amniocentesis, asexual reproduction through artificial insemination, the use of an artificial placenta, cloning,artifical modification of man-especially through transplantation, ' modification of human behavior through psychosurgery and chemotherapy,' and the mechanical postponement of death. No aspect of health care has escaped the impact of technology.

Debate, The Right To Treatment: Encounter And Synthesis, Aaron Twerski

Faculty Scholarship

No abstract provided.

Medical Remedies And Human Rights: Why Civil Rights Lawyers Must Become Involved In Medical Decision-Making, George J. Annas

Faculty Scholarship

As recently as the turn of the century a random patient meeting a random physician had less than a 50:50 chance of benefiting from the encounter. Physicians were just beginning to emerge from the era when they were essentially tradesmen, often with little more to offer their patients than comfort and company during illness and death. The principal causes of mortality were the infectious diseases against which the medical community stood impotent. There were few medical schools, few diagnostic tests, no specific treatment of disease, and no specialization of physicians. In the words of former AMA president Dwight L. Wilbur, …

Treating The Untreatable: A Critique Of The Proposed Pennsylvania Right To Treatment Law, Aaron Twerski

Faculty Scholarship

No abstract provided.

The Community Development Coporation, Robert L. Schwartz, Raymond G. Sanchez

Faculty Scholarship

Review of Community Development Corporation (CDC) Model, its role as a community action agency, and the Community Self-Determination Act of 1968.