The case for a statutory 'definition of death'.
Karen Quinlan, the American girl who has lain in deep coma for many months, is still 'alive', that is to say, her heart is still beating and brain death has not occurred. However, several other cases have raised difficult issues about the time of death. Dr Skegg argues that there is a case for a legal definition of death enshrined in statutory form. He suggests that many of the objections to a statutory provision on death are misplaced, and that a statute concerning the occurrence of death could remove all doubts in the minds of both doctors and public as to whether a 'beating heart cadaver' was dead or alive for legal purposes. (+info)
Rapid gas chromatographic analysis of drugs of forensic interest.
High-speed gas chromatographic (GC) screening for drugs of forensic relevance is performed using a commercial Flash GC instrument in which the chromatographic column is resistively heated at rates of up to 30 degrees C/s. Temperature programming conditions are varied in an experiment designed to evaluate trade-offs between resolution and analysis time for a mixture of 19 drugs of abuse. All 19 components can be separated with excellent resolution in 90 s. Specific analytes can be analyzed even faster; for example, amphetamine analysis is completed in less than 20 s. Case studies of confiscated street drugs containing amphetamine, cocaine, and heroin are analyzed to evaluate the retention time repeatability. Ten replicate injections over a 2-day period for 3 different drug samples achieved retention time relative standard deviations in the range of 0.48 to 0.81%. (+info)
Equipment standards: history, litigation, and advice.
The authors present a concise history of the development of national and international standards for surgical equipment. Standards-writing organizations, surgical and other specialty societies, universities, test houses, and the U.S. government have influenced this process, which is now manifested in complex interactions between national and international standards-writing organizations, and in CE (Conformite Europeene) marks being placed on surgical equipment in the United States and elsewhere. The history of litigation in standards development is also reviewed. Recommendations to maximize patient safety and to help ensure successful, cost-effective defense in litigation for surgeons who use equipment and may suffer its malfunctions are given. Overall, the complicated oversight of surgical equipment standards and the approval process appears to be contributing to the improving and outstanding results of U.S. surgery reported by the U.S. government. (+info)
Self-reported legal needs of women with or at risk for HIV infection. The Her Study Group.
Women at risk for human immunodeficiency virus (HIV) infection are often poor and members of racial or ethnic minorities. In addition to legal concerns that might be common among persons with similar sociodemographic characteristics, HIV infection adds the potential of possible stigma and discrimination, as well as the prospect of illness and increased mortality. To determine women's perceptions of need for and access to legal services and whether such perceptions are affected by HIV infection, from November 1993 through September 1995 we interviewed 509 women with or at risk for HIV infection by virtue of injection drug use or high-risk sexual behaviors in New York and Baltimore, Maryland. A majority of women, regardless of HIV serostatus, reported current or future needs for legal assistance with government benefits. More than 25% reported needing current or future legal help with housing, debts, arrangements for care of children, a will, and advance directives. Substantial minorities of women reported other legal needs. HIV-positive women were significantly more likely to report anticipated future need for help with paternal custody or visitation, current need in making a will, and anticipated future assistance with advance directives. For most items, a majority of women thought they knew where to receive help. However, among women reporting a current need, only a minority actually were receiving legal assistance. This study suggests that the extent of legal needs among women with or at risk for HIV infection is substantial, and that few receive legal assistance. With few exceptions, at least for women early in the course of illness, HIV infection does not appear to alter the pattern or extent of legal needs. There are dramatic differences, regardless of HIV status, between expectation and reality in women's access to legal services. (+info)
Retreat from death?
The case of Terry Jenkins, a 15-year-old boy, who was found to have a sarcoma of bone, was discussed on television under the title of 'Inside Medicine'. The discussion revolved, not so much on the clinical details of the case or even of cancer of bone in a young person, as on the emotional disturbance that followed when the boy's mother refused to allow her son to be told about the nature of his illness or the proposed treatment. With hindsight, as is made clear in the discussion, the case should have been handled quite differently, with the general practitioner acting as the lynch pin and a psychiatrist and a social worker being brought into the emotional 'treatment' of the boy and his mother. As it was the boy was so disturbed about what he had guessed about his condition that he attempted suicide: fortunately he was rescued in time, and Terry is now stable, working, and mobile on his artificial leg. (+info)
Testicular tissue cryopreservation in boys. Ethical and legal issues: case report.
Sperm preservation prior to chemotherapy and radiotherapy is common practice in adult males. Spermatozoa are usually retrieved from an ejaculated sample although there are occasions when testicular tissue is used as the source. These techniques of sperm preservation present minimal ethical objections as the patients give their informed consent. Sperm preservation in children presents practical and ethical dilemmas in that the children cannot always give their informed consent, there are no regulatory guidelines and there is no guarantee that spermatogenesis is occurring. With the rapid advances in reproductive technology and the possible future use of immature germ cells by in-vitro maturation or transplantation, the demand for immature testicular tissue preservation is likely to increase. More information for the parents and oncologists with regard to this subject is needed to allow informed decisions to be made on behalf of the children. These issues are discussed using two cases of children having testicular tissue preservation. (+info)
Psychosocial aspects of abortion. A review of issues and needed research.
The literature on psychosocial aspects of abortion is confusing. Individual publications must be interpreted in the context of cultural, religious, and legal constraints obtaining in a particular society at a given time, with due attention to the status and availability of alternatives to abortion that might be chosen by a woman with an "unwanted" pregnancy. A review of the literature shows that, where careful pre- and post-abortion assessments are made, the evidence is that psychological benefit commonly results, and serious adverse emotional sequelae are rare. The outcome of refused abortion seems less satisfactory, with regrets and distress frequently occurring. Research on the administration of abortion services suggests that counselling is often of value, that distress is frequently caused by delays in deciding upon and in carrying out abortions, and by unsympathetic attitudes of service providers. The phenomenon of repeated abortion seeking should be seen in the context of the availability and cost of contraception and sterilization. The place of sterilization with abortion requires careful study. A recommendation is made for observational descriptive research on populations of women with potentially unwanted pregnancies in different cultures, with comparisons of management systems and an evaluation of their impact on service users. (+info)