International developments in abortion law from 1988 to 1998.
OBJECTIVES: In 2 successive decades since 1967, legal accommodation of abortion has grown in many countries. The objective of this study was to assess whether liberalizing trends have been maintained in the last decade and whether increased protection of women's human rights has influenced legal reform. METHODS: A worldwide review was conducted of legislation and judicial rulings affecting abortion, and legal reforms were measured against governmental commitments made under international human rights treaties and at United Nations conferences. RESULTS: Since 1987, 26 jurisdictions have extended grounds for lawful abortion, and 4 countries have restricted grounds. Additional limits on access to legal abortion services include restrictions on funding of services, mandatory counseling and reflection delay requirements, third-party authorizations, and blockades of abortion clinics. CONCLUSIONS: Progressive liberalization has moved abortion laws from a focus on punishment toward concern with women's health and welfare and with their human rights. However, widespread maternal mortality and morbidity show that reform must be accompanied by accessible abortion services and improved contraceptive care and information. (+info)
Withholding/withdrawing treatment from neonates: legislation and official guidelines across Europe.
Representatives from eight European countries compared the legal, ethical and professional settings within which decision making for neonates takes place. When it comes to limiting treatment there is general agreement across all countries that overly aggressive treatment is to be discouraged. Nevertheless, strong emphasis has been placed on the need for compassionate care even where cure is not possible. Where a child will die irrespective of medical intervention, there is widespread acceptance of the practice of limiting aggressive treatment or alleviating suffering even if death may be hastened as a result. Where the infant could be saved but the future outlook is bleak there is more debate, but only two countries have tested the courts with such cases. When it comes to the active intentional ending of life, the legal position is standard across Europe; it is prohibited. However, recognising those intractable situations where death may be lingering and unpleasant, Dutch paediatricians have reported that they do sometimes assist babies to die with parental consent. Two cases have been tried through the courts and recent official recommendations have set out standards by which such actions may be assessed. (+info)
Covert video surveillance continues to provoke debate.
When the editor invites comment on a response to an analysis of a criticism of a protocol already defended by the author in this journal, the issue is clearly contentious. I will comment briefly on Thomas's paper in this issue of the journal, and look at points of agreement as well as dissent. (+info)
Drug courts: a primer for the family physician.
BACKGROUND: Drug courts are a judicial response to drug-related crimes. They combine the coercive powers of the judiciary with drug treatment. This article is intended to familiarize physicians with the reasons why drug courts exist, what they are, and how physicians can assist their patients who are clients of a drug court. METHODS: Methods for this article are based upon personal experience and a search of the literature using the key words "drug rehabilitation," "drug abuse," and "criminal justice system." RESULTS: Using a three-phase approach, drug courts emphasize urine drug testing, rapid punishment for specific infractions, and therapeutic interventions. Drug courts have greatly reduced criminal and drug-using recidivism. CONCLUSION: Drug courts are effective in resolving the criminal and drug-using behaviors in drug-only, nonviolent offenders. Family physicians can become involved in the drug court process by providing treatment for patients with both drug addiction and mental health diagnoses. In addition, as patients withdraw from drugs, it is important to treat withdrawal symptoms to prevent recidivism and encourage participation in the program. (+info)
The rise of nursing home litigation: findings from a national survey of attorneys.
Lawsuits against nursing homes are a relatively recent phenomenon. Despite a growing sense of alarm among policymakers, little is known about these lawsuits' scale, dynamics, or outcomes. To describe these characteristics, we conducted a Web-based survey of attorneys nationwide who bring and defend this litigation. Our respondents and their firms were involved in 4,677 and 8,256 claims, respectively, in 2001; more than half of these claims were in Florida and Texas. The costs of nursing home litigation are substantial, both in the aggregate and per claim, especially in states where the litigation is most prevalent. These findings elevate concerns about quality of nursing home care and indicate that litigation diverts resources from resident care, which may fuel quality problems. (+info)