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G J Annas

Publications and source records attributed to G J Annas.

At least 19 recordsLinked to original sources
PubMed1992

Risky business: setting public health policy for HIV-infected health care professionals.

An analysis of the restrictive proposals provoked by the case of Kimberly Bergalis and four other patients apparently infected with HIV during the course of dental treatment reveals that they resulted from an inability to evaluate appropriately the infinitesimal risk of HIV transmission from practitioner to patient. The proposals also resulted from an effort to create risk prevention policy without appreciating the distinction between regulating things or procedures, which have no human rights, and regulating people, who have rights that should not be infringed without serious justification. This analysis demonstrates that the proposed restrictive policies are not justified because they do nothing to prevent the spread of HIV, and they cause unnecessary and substantial harm to health care practitioners.

American Medical Association↗
PubMed1992

Breast cancer screening in older women: law and patient rights.

Legal principles that apply to breast cancer in older women have been developed in judicial decisions related to other medical screening tests. There are no special legal rules for either mammography or older women, although older women seldom file malpractice suits. The general standard is that a screening test must be offered to any particular age group when it is considered "reasonably prudent" to do so, and this almost always means when the medical profession--usually speaking though its specialty boards--declares it the standard of care. The standard of care should be set by medical professionals, with open opportunity for public input, rather than by lawyers or risk managers. In actual practice, private regulation may not be sufficient to protect the public, and both state and federal regulation of mammography facilities now seems inevitable. Patients have the right to be fully informed prior to screening, the right to refuse screening, and the right to have full knowledge of the consequences of such refusal. Mammography is not a consumer good, but American women should be actively involved in determining issues of costs and benefits, as well as helping to develop the best strategies for counseling and informed consent.

Aged↗
PubMed1979

Reconciling Quinlan and Saikewicz: decision making for the terminally ill incompetent.

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 Court, in the Saikewicz case, adopted, on different facts, the test of "substituted judgment" to be applied by a probate court after an adjudicatory hearing. The two cases have been interpreted by many in the medical profession as representing conflicting viewpoints--one supportive of traditional medical decision making and the other distrustful of it. It is the thesis of this Article that Quinlan and Saikewicz are in fundamental agreement and can be reconciled by the next state supreme court that rules on this question. Both courts enunciate a constitutional right to refuse life-sustaining treatment, based on the right to privacy. They agree that incompetents should be afforded the opportunity to exercise this right, and that certain state interests can overcome it. They agree also that physicians should be permitted to make medical judgments, and that societal judgments belong in the courts. The differences in how the opinions are perceived result from the interplay of several factors: the differences in the facts of the cases; the inarticulate use of the term "ethics committee" by the Quinlan court; the literal interpretation of the role of such a committee by the Saikewicz court; a desire for 100 percent immunity on the part of physicians and hospital administrators in Massachusetts; and advice from their counsel on how such immunity can be guaranteed. It is the author's hope that this Article will help to dispel much of the misinformation surrounding these two cases, and to refocus the debate on how decisions should be made for the terminally ill incompetent patient on the real issues regarding criteria and the decision-making process that remain to be resolved.

Decision Making↗
PubMed1979

Patenting life.

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Bioethics↗
PubMed1978

Informed consent.

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Emergencies↗