Two recent court decisions clarified whether and under what circumstances a patient may refuse life-sustaining medical treatment, including food and water. The Nancy Cruzan case, decided by the U.S. Supreme Court on June 25, 1990, and the case of Shirley Crabtree, decided by Family Court Senior Judge Daniel G. Heely ...

After a period of unrest in Caracas, Venezuela, in February/March 1989, Amnesty International (AI) received information about torture applied by security forces to people thought to have participated in or organised riots and lootings. In May 1989 a delegation from AI went to Caracas to collect and appraise testimonies of ...

National experts in the field of developmental toxicology were interviewed in order to elicit the principles, or rules-of-thumb, they use in determining if a compound or agent is likely to be a developmental hazard during pregnancy. Several levels of individual and cumulative consensus activity were carried out that resulted in ...

Three court decisions reviewing medical peer review conducted in hospitals were discussed at length in part III of this article. In their opinions the courts gave at least tacit approval to the procedures followed in the hospitals, and they accepted that an evidentiary basis for adverse action against the physicians ...

In its Cruzan v. Director, Missouri Department of Health, decision the U.S. Supreme Court addressed only states' authority in the refusal of medical treatment. But the case itself drew national attention to the issue, and physicians and healthcare facilities should expect to see living wills and durable powers of attorney ...

The rewards for suits for medical negligence have generated a service industry for plaintiff's lawyers. The provision of "experts" for a contingency fee and the solicitation of plaintiff's attorneys by some physicians to serve as "experts" for large fees may result in highly biased and inaccurate testimony. Ethical expert witness ...

2 legal cases involving hypnosis have recently been adjudicated by American courts. In Rock v. Arkansas (1987), the United States Supreme Court ruled that the hypnotically elicited testimony of a criminal defendant was admissible in court. This decision was grounded upon the constitutional right of a defendant both to testify, ...

In the last two decades medical and social changes have occurred to shift the focus from the dying patient to the chronically impaired, from voluntary to involuntary and from euthanasia to withholding/withdrawal of life-prolonging treatments. Acceptance by the courts of various theories and devices, such as "surrogate" decision-makers, medical/judicial review ...

The legal situations of a medical practitioner who breaches the rule of medical confidentiality in warning an endangered third party on the one hand, and on the other a doctor who fails to warn an endangered third party (who subsequently suffers illness or other damages as a result) are addressed. ...

A definition and an explanation of the legal standard for imposition of legal liability in a toxic tort case are set forth. The focus is on how expert witnesses utilize the applicable medical and scientific data in order to provide opinion evidence of the causal relation between exposure to a ...

The Osheroff litigation, which is central to Klerman's paper, ended in an out-of-court settlement. The author states that there is no legal precedent for the so-called right to effective treatment and that the case history was a much more complicated clinical scenario than Klerman reports. He concludes that there is ...

The civil rights and deinstitutionalization movements of the 1960s gave rise to legal and ethical challenges to the physician's authority to prescribe psychoactive medication to patients who refuse such medication. While no definitive legal ruling has been rendered in this area--and may never be rendered--a review of the important cases ...

Forensic psychiatry has come under mounting criticism from the press and other medical professionals, largely for its participation in the insanity defense. The author argues that the expertise available from the specialty is of increasing importance to psychiatry as a whole, as more and more legal issues become relevant to ...

This article examines the impact of the New York court decision, Rivers v. Katz, which in June 1986 dramatically changed the state procedure for responding to involuntarily committed psychiatric patients who formally refused psychopharmacologic treatment. The court rejected the medically administered review process that had been used to respond to ...

The law of December 20, 1988 states that a participant in a clinical test without direct therapeutic benefit is not entitled to receive remuneration. Professionalism may be the strongest reason for participating. The law prohibits some participants from receiving an indemnity, not on the basis of healthy vs sick discrimination ...

The increasing employment of gene technological procedures in medical diagnostics and criminal procedure has forced both the medical and the legal professions to focus their attention on the complex question of liability of physicians, lab technicians, and other personnel involved in applying these measures. This article gives an outline, by ...

The law on automatism is undergoing change. For some time there has been a conflict between the medical and the legal views. The medical profession believes that the present division between sane and insane automatism makes little medical sense. Insane automatism is due to an internal factor, that is, a ...

Over the last twenty years, state legislatures have enacted statutes incorporating medically and legally established criteria to be utilized in the determination of death. Similarly consistent criteria for determining the onset of life have yet to be established. As a result, unacceptably conflicting statutory language defining life and the state's ...

On the third of October 1845, in a small mountain community in Kentucky, Abner Baker, Jr., MD, was executed for the murder of his brother-in-law Daniel Bates. At the trial Baker's attorney argued unsuccessfully that at the time of the crime the accused suffered from monomania, a form of mental ...

Sales of medical practices and physician employment contracts may contain covenants not to compete, also known as restrictive covenants. These covenants prohibit sellers from competing with buyers and employees from competing with former employers for a specified period of time. As a result of a call for legislative action to ...

Active euthanasia in the Netherlands remains a topic for both professional and public debate. However, many aspects of the medical practice of active euthanasia remain unclear, and no figures on the actual incidence of this practice exist. Legally, active euthanasia is a criminal offense, but a pattern of jurisprudence has ...

Successful management of compensable occupational disorders requires an understanding of both the medical and social models of illness. In addition to the usual roles of medical diagnosis and treatment, the physician must assume a number of hidden roles, including assessing job hazards, arriving at an opinion of work-relatedness, identifying unrealistic ...

Automation of medical records poses special legal questions and creates some unique legal risks. However, legal barriers to automation can usually be overcome and legal risks managed in such a way as to permit a provider to take advantage of the efficiencies and the information gain of automating medical records.

In 1920, in the case of Simonsen v. Swenson, the Nebraska Supreme Court recognized in principle that a patient could file suit for money damages against his physician for the wrongful disclosure of confidential information. Since then a growing number of American states have allowed patients to bring such claims. ...

The application of medical expert systems is likely in some instances to result in patient injury litigation. Such legal action will be based on the same principles now applicable to medical practice and products liability. These principles define legally wrongful acts, product defects, and theories of recovery: negligence, breach of ...

Acquiring a new software package for a healthcare institution is a complicated process. This article, part one of a three-part series, addresses how to investigate the software options. Because the entire structure of contract negotiations may be irrevocably established during this early phase of the process, the institution must assemble ...

Although tools may be one of the major progenitors of civilization, they certainly can, in the medical arena, give rise to a wide variety of legal controversies, including malpractice claims, suits for lack of informed consent, and actions against manufacturers for breaches of warranty and strict liability. This article has ...

In a state in which patient refusal of antipsychotic medication in all nonemergency situations must be respected, lawyers and psychiatrists in western Massachusetts have employed probate court decisions as involuntary outpatient treatment orders. The legal, administrative, and clinical issues in sustaining court-ordered outpatient treatment are discussed by focusing on case ...

In this article the author reviews the scope and magnitude of the problem currently faced by medical and investigative personnel in detecting and proving the sexual molestation of children. The legal effects of poor medical records are discussed in detail. Various medical and legal issues that may present pitfalls for ...

A terminally ill individual may sign a living will, which is a document requesting to be allowed to die a natural death, have it witnessed and address this wish to a relative, physician, lawyer or medical facility. No legislation, however, exists in Canada concerning living wills. Consequently, establishing the legal ...

Although delusions are prima facie evidence of psychosis, their mere presence is not a sufficient condition for exculpation on the grounds of insanity. In most cases, a determination of insanity will depend on the specific content of the delusions and whether, as a result of these delusions, the defendant was ...

This paper presents statistical and explanatory analyses of 637 forensic psychiatry cases in a private practice setting during the past 12 years, highlighting the remarkable variety of clinical and legal issues addressed by forensic psychiatrists. Emphasis is on how and why forensic psychiatrists need to be expert diagnosticians and clinicians, ...

Alcohol and drug abuses complicate medicolegal issues in psychiatry by blurring the boundaries between medicine and law. Furthermore, the usual tests for the applicability of either legal or medical measures often cannot be applied to the dually diagnosed. Specific quandaries arise with involuntary hospitalization and treatment, and with evaluating patients ...

In cases involving the "right to die," courts are faced with the agonizing task of developing legal standards governing termination of an incompetent patient's medical treatment. In this Article, Professor Rhoden criticizes the two dominant approaches courts have developed--the "subjective" and "objective" tests--and proposes that these standards be abandoned for ...

District surgeons have a statutory duty to provide medical treatment to detainees held in terms of the State of Emergency. District surgeons enjoy no special protection or immunity by reason of their position. Accordingly, they may be held legally liable for the consequences of negligent treatment or the failure to ...

One hundred fifty-three closed claims involving perinatal injury or death filed from 1980 through 1982 with the St. Paul Fire and Marine Insurance Company were studied. The claims included were those in which an indemnity was paid or $1,000 or more was expended on the legal defense. Five obstetricians reviewed ...

In its original expression as a medical value confidentiality may have been absolute; this concept has become eroded by patient consent, legal actions and change in the climate of public opinion. In particular requirements arising out of legal statutes and common law judgements have greatly modified the confidentiality of the ...

To study the influence of the delegation of sealant procedures to auxiliaries on sealant use, we queried a national sample of general dentists and pedodontists. A large percentage (34-58 per cent) of both groups were unaware or mistaken in their perception of the legality of delegating sealants. Although perception of ...

Like so many other medicolegal issues, the legal procedure and legal consequences when a child is stillborn may seem simple and straightforward. However, in practice this is anything but the case. The legislative definitions of the terms 'stillborn' and 'viable' cause inordinate problems. Various legal, medical and social difficulties will ...

Blood transfusions have almost always been confined to hospital settings in the past. Recent medical care trends have shifted some therapies (e.g., renal dialysis, hemophilia treatment) into the patient's home. Transfusions are now being given in increasing numbers to stable patients in their homes. This paper examines the medical aspects, ...

Confidentiality in the medical relationship is an important, but by no means absolute, concept. It is a means by which the law protects the patient's privacy. But there are sometimes more important ideals than the protection of privacy. In order to determine whether confidentiality is to be recognised, the patient's ...

Physicians who care for patients with epilepsy may function as agents or targets of social control. As agents, they may assist in the identification and control of epileptic drivers, may provide information that enables fair and appropriate job placements for epileptic persons, and give testimony that helps the legal system ...

Forensic specialists are well standardised throughout the world and their opinions are respected by the courts. Doctors involved in the immediate clinical forensic assessment of persons in police custody are not, however, so well standardised. Some countries employ trained police surgeons or police medical officers, other countries rely on hospital ...

The accused was charged with violation of Section 233 of the Nigerian Penal Code by administering medical treatment to a woman which caused a miscarriage resulting in her death. The accused had treated a woman who had come to him after attempting to terminate her pregnancy; he had removed manually ...

One hundred medicolegal cases were analysed to obtain quantitative data about diagnoses and the causes of litigation that affect hospital doctors in the National Health Service. Sixteen actions concerned minor problems that are an unavoidable risk of treatment, and 39 were due to natural causes. In other cases it was ...

This paper examines the clinical and legal outcomes of a consecutive series of 52 schizophrenic patients remanded to a Forensic Assessment Unit. Typically patients were isolated single males who were unemployed, living on Social Security and had a history of multiple psychiatric hospitalizations. Less than half had previous convictions and ...

Every dog, they say, must have its day. When yours comes up in court as an "expert witness" you may be glad of some very practical advice.

"This article examines the extent to which undocumented status lowers wage rates among immigrants to the United States from four Mexican communities. Regression equations were estimated to determine the effect of legal status on wages independent of other demographic, social and economic variables, and special efforts were made to control ...

The Court overturned the ruling of a single High Court Judge 1986) and held that the government of Punjab could discriminate in admissions to medical school with respect to sex when coupled with other admission considerations. It rejected the argument that such discrimination was prohibited by Article 25(2) of the ...

This article compares HEALTHLAWYER with other legal and medical databases in an informal study. Local network building is an important element of this work. The memo format is used to illustrate the working style of the study group. Using a sample question, each author includes HEALTHLAWYER in a multi-database search ...