1
|
Assessment of Resident Physician Comfort in Screening for Social Determinants of Health in a Specialty Clinic Population. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2024; 51:874-879. [PMID: 38477267 DOI: 10.1017/jme.2024.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Through qualitative surveys, a team of law students, law professors, physicians, and residents explored the perceptions of neurology residents towards referral to appropriate legal resources in an academic training program. Respondents reported feeling uncomfortable screening their patients for health-harming legal needs, which many attributed to a lack of training in this area. These findings indicate that neurology residents would benefit from training on screening for social factors that may be impacting their patients' health.
Collapse
|
2
|
Demographic diversity of genetic databases used in Alzheimer's disease research. Hum Genet 2023; 142:1215-1220. [PMID: 37093293 DOI: 10.1007/s00439-023-02551-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/01/2023] [Indexed: 04/25/2023]
Abstract
For several years, experts have warned about the lack of diversity in genetic research databases, and researchers have devoted time and resources to recruiting subjects from underrepresented subgroups. In this study, we review published reports in academic journals of genetic studies of Alzheimer's disease to note whether demographic diversity was indicated in the reports and, if so, the extent of representation of non-European subjects over the period from 1997 to 2022. We use multivariate regression analysis to analyze changes over time and to explain variation across studies. Our analysis indicates that reported diversity has not changed over time. Rather, it appears to have remained relatively constant, since Genome-Wide Association Studies (GWASs) were first used in the 1990s. We find most variation to be across journals rather than within journals, suggesting that characteristics of journals are an important influence on the dissemination of research with diverse samples. Lack of racial diversity in genetic databases used to develop clinical applications could lead to disparities in the effectiveness of those applications for underrepresented groups.
Collapse
|
3
|
Whose Data Are They Anyway? Identification of Relatives and Genetic Exceptionalism. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:78-79. [PMID: 34806971 DOI: 10.1080/15265161.2021.1991036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
|
4
|
How to Motivate Equity in Health Decision Modeling. AMA J Ethics 2021; 23:E648-652. [PMID: 34459733 DOI: 10.1001/amajethics.2021.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
American health care is rife with inequity in access to services. Even among people with insurance, inequity can result from insurers' decisions about which services to cover. These decisions are often based on economic models that are seemingly objective but neglect factors affecting people who are economically disadvantaged. Laws and government programs designed to mitigate inequities in access have limited value in addressing bias in models that inform coverage decisions. As a reform, government agencies that fund research could require that studies on which decision models are based better account for factors affecting people who are economically disadvantaged, an approach this article explores.
Collapse
|
5
|
Measuring the COVID-19 Financial Threat to Hospital Markets. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2021; 58:469580211059985. [PMID: 34844471 PMCID: PMC8649449 DOI: 10.1177/00469580211059985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Many hospitals have been straining under the financial stress of treating COVID-19
patients. Those experiencing the greatest strain are in markets burdened with high levels
of debt and uncompensated care. We propose a new measure of financial risk in a hospital
market, combining both pre-existing financial vulnerability and COVID-19 severity. It
reveals the highest concentrations of risk in counties with high poverty, low population
density, and high shares of foreign-born and non-White populations. The CARES Act Provider
Relief Fund helped many of the hospitals in these regions, but it left many markets with
the same overall vulnerability to financial strain from the next health crisis.
Collapse
|
6
|
Can governments push providers to collaborate? A comparison of hospital network reforms in France and the United States. Health Policy 2020; 124:1100-1107. [DOI: 10.1016/j.healthpol.2020.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 06/12/2020] [Accepted: 07/09/2020] [Indexed: 10/23/2022]
|
7
|
Abstract
Along with the potential for breakthroughs in care and prevention, the search for genetic mechanisms underlying the spread and severity of coronavirus disease 2019 (COVID-19) introduces the risk of discrimination against those found to have markers for susceptibility. We propose new legal protections to mitigate gaps in protections under existing laws.
Collapse
|
8
|
Abstract
The objective of this study was to describe how a sample of pediatricians were impacted by and responded to the Disneyland measles outbreak in the United States. We conducted three repeated cross-sectional, online surveys in 2014 (before the outbreak), 2015, and 2016 (after the outbreak) among members of three state chapters of the American Academy of Pediatrics. We assessed pediatricians' level of willingness and length of time comfortable delaying the measles-mumps-rubella (MMR) vaccine before and after the outbreak. Frequency of alternative immunization schedule requests and creation of office immunization policies due to the outbreak were measured. The sample included 304 pediatricians in 2014, 270 in 2015, and 221 in 2016. We found no significant changes in willingness or comfort delaying the MMR vaccine before and after the outbreak. In 2015, 38% of pediatricians reported fewer requests for alternative immunization schedules and 20% created stricter office immunization policies. A subsample of pediatricians reported administering the MMR vaccine earlier in the recommended time frame and taking extra precautions in waiting rooms due to the outbreak. Our results suggest that this measles outbreak did not lead to significant changes in attitudes or practices among this sample, but did modestly affect office immunization policies and practices.
Collapse
|
9
|
Abstract
We conducted a cross-sectional online survey among 4 chapters of the American Academy of Pediatrics from July through October 2014 to describe characteristics of pediatricians and practices associated with practice-level responses to alternative immunization schedule requests. Among 374 pediatricians, 58% reported frequent alternative immunization schedule requests and 24% reported feeling comfortable using them. Pediatricians who work in practices that accommodate alternative immunization schedule requests have increased odds of having a high frequency of alternative immunization schedule requests, and beliefs that relationships with families would be negatively affected if they refused requests. Practices that discontinue care to families who request alternative immunization schedules have increased odds of being a private group practice and having a formal office vaccine policy. Pediatricians are frequently asked to use alternative immunization schedules and many are not comfortable using them. Practice-level responses to alternative immunization schedules are associated with characteristics of pediatricians and practices.
Collapse
|
10
|
Neighborhood Socioeconomic Status and Primary Health Care: Usual Points of Access and Temporal Trends in a Major US Urban Area. J Urban Health 2016; 93:1027-1045. [PMID: 27718048 PMCID: PMC5126022 DOI: 10.1007/s11524-016-0085-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Neighborhood socioeconomic status (SES), an overall marker of neighborhood conditions, may determine residents' access to health care, independently of their own individual characteristics. It remains unclear, however, how the distinct settings where individuals seek care vary by neighborhood SES, particularly in US urban areas. With existing literature being relatively old, revealing how these associations might have changed in recent years is also timely in this US health care reform era. Using data on the Philadelphia region from 2002 to 2012, we performed multilevel analysis to examine the associations of neighborhood SES (measured as census tract median household income) with access to usual sources of primary care (physician offices, community health centers, and hospital outpatient clinics). We found no evidence that residence in a low-income (versus high-income) neighborhood was associated with poorer overall access. However, low-income neighborhood residence was associated with less reliance on physician offices [-4.40 percentage points; 95 % confidence intervals (CI) -5.80, -3.00] and greater reliance on the safety net provided by health centers [2.08; 95 % CI 1.42, 2.75] and outpatient clinics [1.61; 95 % CI 0.97, 2.26]. These patterns largely persisted over the 10 years investigated. These findings suggest that safety-net providers have continued to play an important role in ensuring access to primary care in urban, low-income communities, further underscoring the importance of supporting a strong safety net to ensure equitable access to care regardless of place of residence.
Collapse
|
11
|
Erratum to: Neighborhood Socioeconomic Status and Primary Health Care: Usual Points of Access and Temporal Trends in a Major US Urban Area. J Urban Health 2016; 93:1046. [PMID: 27837407 PMCID: PMC5126027 DOI: 10.1007/s11524-016-0095-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Can Benefit Corporations Redeem the Pharmaceutical Industry? Am J Med 2016; 129:651-2. [PMID: 26965301 DOI: 10.1016/j.amjmed.2016.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 02/15/2016] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
|
13
|
The Ethics of Expanding Health Coverage through the Private Market. AMA J Ethics 2015; 17:665-671. [PMID: 26158815 DOI: 10.1001/journalofethics.2015.17.7.msoc1-1507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
14
|
An education in contrast: state-by-state assessment of school immunization records requirements. Am J Public Health 2014; 104:1993-2001. [PMID: 25122033 PMCID: PMC4167093 DOI: 10.2105/ajph.2014.302078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We reviewed the complexities of school-related immunization policies, their relation to immunization information systems (IIS) and immunization registries, and the historical context to better understand this convoluted policy system. METHODS We used legal databases (Lexis-Nexis and Westlaw) to identify school immunization records policies for 50 states, 5 cities, and the District of Columbia (Centers for Disease Control and Prevention "grantees"). The original search took place from May to September 2010 (cross-referenced in July 2013 with the list on http://www.immunize.org/laws ). We describe the requirements, agreement with IIS policies, and penalties for policy violations. RESULTS We found a complex web of public health, medical, and education-directed policies, which complicates immunization data sharing. Most (79%) require records of immunizations for children to attend school or for a child-care institution licensure, but only a few (11%) require coordination between IIS and schools or child-care facilities. CONCLUSIONS To realize the full benefit of IIS investment, including improved immunization and school health program efficiencies, IIS and school immunization records policies must be better coordinated. States with well-integrated policies may serve as models for effective harmonization.
Collapse
|
15
|
Abstract
Visual imagery can powerfully shape perceptions of risks as is clearly demonstrated by research on the use of graphic warnings on cigarette packs. Government efforts to counteract public fears of vaccines could harness this phenomenon by using public information campaigns that present visually the effects of vaccine-preventable diseases. Visual representations can also be used to communicate the relative risks of vaccines, which are generally negligible, and of the diseases they prevent. Such initiatives have the policy advantage of minimizing the sense of government intrusion that measures such as vaccine mandates and social restrictions could engender and the legal advantage of avoiding claims of infringement on civil liberties. Government policy should take advantage of this important and accessible tool.
Collapse
|
16
|
Integration can support clinical quality, technology efforts. Interview by Lois A Bowers. MEDICAL ECONOMICS 2013; 90:74. [PMID: 24066485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
17
|
Childhood immunization reporting laws in the United States: Current status. Vaccine 2012; 30:7059-66. [DOI: 10.1016/j.vaccine.2012.09.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Revised: 08/13/2012] [Accepted: 09/22/2012] [Indexed: 10/27/2022]
|
18
|
How genetic variant libraries effectively extend gene testing patents: implications for intellectual property and good clinical care. J Clin Oncol 2012; 30:2943-5. [PMID: 22802312 DOI: 10.1200/jco.2012.42.7757] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
|
19
|
Evidence-based decision making for vaccines: The need for an ethical foundation. Vaccine 2012; 30:1009-13. [DOI: 10.1016/j.vaccine.2011.12.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 12/08/2011] [Accepted: 12/09/2011] [Indexed: 10/14/2022]
|
20
|
Antipsychotic medications are spelling legal trouble for drugmakers. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2010; 35:621-622. [PMID: 21139818 PMCID: PMC2993073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
|
21
|
New court ruling may alter the legal landscape for gene patents. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2010; 35:322-323. [PMID: 20592875 PMCID: PMC2888548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
|
22
|
Physician utilization by insurance type among youth with type 2 diabetes. THE AMERICAN JOURNAL OF MANAGED CARE 2010; 16:55-64. [PMID: 20148606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To evaluate the relationship between insurance type (Medicaid vs private insurance) and access to physician care for youth with type 2 diabetes mellitus by quantifying whether these youth saw a physician during the year before their first diabetes documentation. STUDY DESIGN Retrospective cohort study. METHODS Youth with Medicaid or private insurance aged 5 to 19 years with type 2 diabetes were identified by an electronic medical record review. The first indication of type 2 diabetes defined the index date. Youth with type 1 diabetes and female patients with polycystic ovaries were excluded. Descriptive statistics evaluated differences in office visits before the index date between patients with the 2 insurance types. Multivariate logistic regression analysis evaluated the likelihood of having an office visit during the year before the index date among youth with Medicaid versus private insurance, controlling for youth characteristics. RESULTS Of 2496 included youth, 400 (16.0%) had Medicaid coverage. More than 60% were female, the mean age was 14.5 years, and 68.8% were obese. On average, youth had 1.9 office visits during the year before the index date. Medicaid-covered youth were not significantly less likely to have had an office visit (odds ratio, 0.77; P = .09) or fewer total office visits (incident rate ratio, 1.13; P = .16) during the year before the index date. CONCLUSIONS The likelihood of youth with type 2 diabetes and a source of physician care having a physician office visit during the year before the index date did not differ between patients with Medicaid versus private insurance. This suggests that the amount of physician care before diagnosis of type 2 diabetes does not differ for Medicaid-covered youth if they can establish a source of care. Additional research is investigating whether physician access before diagnosis is associated with access to diabetes-related care after diagnosis.
Collapse
|
23
|
Mandatory vaccination of health care workers: whose rights should come first? P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2009; 34:615-618. [PMID: 20140133 PMCID: PMC2810172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
24
|
Should Your Genes Be Subject To Patents? No, Says a New ACLU Lawsuit. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2009; 34:548-549. [PMID: 20140114 PMCID: PMC2799141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Accepted: 08/27/2009] [Indexed: 05/28/2023]
|
25
|
When can patients sue drug companies?: supreme court finds that FDA approval does not stand in the way. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2009; 34:243-244. [PMID: 19561869 PMCID: PMC2697102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
26
|
Physician rights to privacy of data prevail in two major court tests, but new questions lie ahead. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2009; 34:193-195. [PMID: 19561859 PMCID: PMC2697089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
27
|
Why is health care regulation so complex? P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2008; 33:607-608. [PMID: 19750043 PMCID: PMC2730786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
28
|
Vaccine declinations present new challenges for public health. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2008; 33:542-543. [PMID: 19750033 PMCID: PMC2730125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
29
|
A proposed ethical framework for vaccine mandates: competing values and the case of HPV. KENNEDY INSTITUTE OF ETHICS JOURNAL 2008; 18:111-24. [PMID: 18610781 DOI: 10.1353/ken.0.0011] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Debates over vaccine mandates raise intense emotions, as reflected in the current controversy over whether to mandate the vaccine against human papilloma virus (HPV), the virus that can cause cervical cancer. Public health ethics so far has failed to facilitate meaningful dialogue between the opposing sides. When stripped of its emotional charge, the debate can be framed as a contest between competing ethical values. This framework can be conceptualized graphically as a conflict between autonomy on the one hand, which militates against government intrusion, and beneficence, utilitarianism, justice, and nonmaleficence on the other, which may lend support to intervention. When applied to the HPV vaccine, this framework would support a mandate based on utilitarianism, if certain conditions are met and if herd immunity is a realistic objective.
Collapse
|
30
|
The FDA's New Guidance for Off-Label Promotion Is Only a Start. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2008; 33:220-249. [PMID: 19750166 PMCID: PMC2730097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
31
|
Abstract
PURPOSE The regulation of homeopathic drug products is discussed. SUMMARY Homeopathy is a system of medicine based on the observation that high doses of pharmacologically active substances cause symptoms when administered to healthy individuals. These same substances, when prepared in very dilute form, may relieve similar symptoms in conditions resulting from different etiologies. Unlike dietary supplements, homeopathic drugs are subject to the Food, Drug, and Cosmetic Act and regulations issued by FDA. Instead of the new-drug-approval process, premarket approval for homeopathic drugs is by way of monograph approval by the Homeopathic Pharmacopoeia Convention of the United States (HPCUS). Monographs are published in the Homeopathic Pharmacopoeia of the United States (HPUS). The criteria for inclusion in the HPUS require that a homeopathic drug product be determined by HPCUS to be safe and effective and to be prepared according to the specifications of the HPUS general pharmacy section. The long history and established nature of homeopathic drug regulation may provide a model for the regulation of dietary supplements. CONCLUSION Homeopathic drugs in the United States are subject to well-defined regulatory processes that more closely resemble those that apply to allopathic medications than to dietary supplements.
Collapse
|
32
|
What should Medicaid look like in 2010? MANAGED CARE (LANGHORNE, PA.) 2004; 13:1 p preceding table of contents. [PMID: 15484670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
|
33
|
Abstract
University of the Sciences in Philadelphia convened a symposium to discuss the roles of government, industry, and foundations in funding biomedical research. Government, no longer the largest funder of biomedical research, focuses on basic science. The pharmaceutical industry, now the largest sponsor, focuses on developing and testing new products. Foundations play a unique role in their ability to fund research overlooked by the other sectors. However, gaps remain in this infrastructure. Barriers, including lack of qualified investigators and administrative burdens, constrain discovery. Funders should collaborate to address these constraints and stimulate new sources of funding.
Collapse
|
34
|
New ethical relationships under health care's new structure: the need for a new paradigm. VILLANOVA LAW REVIEW 2001; 43:467-98. [PMID: 11660742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
|
35
|
Can health systems heal themselves? THE AMERICAN JOURNAL OF MANAGED CARE 2001; 7:995-7. [PMID: 11669363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
|
36
|
Sharing clinical data for provider profiling: protection of privacy versus the public's need to know. BEHAVIORAL HEALTHCARE TOMORROW 1995; 4:71-3. [PMID: 10143424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|
37
|
Overview: computerized medical records create new legal and business confidentiality problems. HEALTHSPAN 1994; 11:3-7. [PMID: 10137867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|
38
|
Gestational versus genetic mothers. N Engl J Med 1992; 327:287; author reply 287-8. [PMID: 1614488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
39
|
Screening and monitoring data as evidence in legal proceedings. JOURNAL OF OCCUPATIONAL MEDICINE. : OFFICIAL PUBLICATION OF THE INDUSTRIAL MEDICAL ASSOCIATION 1986; 28:946-50. [PMID: 2945912 DOI: 10.1097/00043764-198610000-00011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The greatest legal impact of medical screening and biological monitoring may be in proceedings to compensate workers for occupational disease. In workers' compensation, failure to demonstrate a disease's work-relatedness has often barred compensation. Screening and monitoring data can add a new causal link by demonstrating longitudinally a worker's reaction to a toxic exposure. Employers may also use the data to rebut claims. In tort suits, the data can help establish causation and aid the admissibility of expert testimony. Of most significance, it may create a higher legal standard of care for employers based on increased knowledge of their workers' health status, which may open up new grounds for suits. These legal implications of greater liability may make employers reluctant to collect medical test data. On the other hand, testing programs may aid them in legal proceedings by demonstrating good faith efforts to reduce disease risks.
Collapse
|
40
|
Biological monitoring and genetic screening in the industrial workplace: a synopsis and analysis. LAW, MEDICINE & HEALTH CARE : A PUBLICATION OF THE AMERICAN SOCIETY OF LAW & MEDICINE 1983; 11:125-9. [PMID: 11644183 DOI: 10.1111/j.1748-720x.1983.tb01724.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Can new medical technologies decrease the incidence of occupational disease? Do they work to the detriment of other worker interests? Do they shift the burden of maintaining a healthy workplace from employers to employees, by keeping sensitive individuals from jobs that they are otherwise qualified to perform? These are among the central issues presented by the emerging occupational use of biological monitoring and genetic screening, as highlighted at the conference on Biological Monitoring and Genetic Screening in the Industrial Workplace, held in Washington, D.C., on May 12-13, 1983. The meeting was sponsored by the American Society of Law & Medicine and the Boston University Schools of Law, Medicine, and Public Health.Research in progress on these issues, at the Center for Law and Health Sciences at Boston University School of Law, was one of the motivating forces for the conference. With funding from the National Science Foundation and the National Endowment for the Humanities, the study, led by Professor Michael Baram, LL.B., of Boston University School of Law, is providing a comprehensive overview and analysis of the major philosophical, ethical, and legal issues involved.
Collapse
|
41
|
Enhancement of high-rate disinfection by sequential addition of chlorine and chlorine dioxide. JOURNAL - WATER POLLUTION CONTROL FEDERATION 1977; 49:1652-8. [PMID: 881742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|