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Biomedical subjects

J L Fink

Publications and source records attributed to J L Fink.

At least 37 records · Page 2Linked to original sources
PubMed1988

Testing for drug use, Part 1: Analytical methods.

Issues surrounding the screening and testing of individuals for drug use, including analytical and legal aspects of the procedures and social, political, and ethical problems and concerns, are reviewed. Historically, professional and societal debate regarding drug taking, drug-use problems, and the utility of drug testing programs occurs in cycles. Analytical methods commonly used to test for drug use include breath analysis for alcohol and urine drug assays. Blood alcohol concentrations are determined by laboratory assay methods or by portable devices used in the field. While poor laboratory procedures can invalidate test results for both breath and urine tests, urine screening test results can be further invalidated by improper handling of specimens or by tampering on the part of the subject. Also, test results are meaningful only if they are correlated with a clinical state. Legal issues have been raised concerning the validity of testing procedures used and the reliability of evidence obtained, especially in relation to pre-employment drug screening. From an ethical standpoint, drug testing tends to focus efforts to combat drug abuse on the drugs themselves instead of on the social context of the problem. With a recycled interest in drug-use testing and screening, primarily attributable to technological advances, little attention is being given to other approaches to controlling drug use. Additional research is needed to better describe the nature and extent of our drug-use problems and their impact on society.

Humans↗
PubMed1985

Pharmacy patronage among the elderly: selected racial and geographical patterns.

In the United States the number of elderly and their percentage of the total population continues to increase. The large majority will never require care in an institution, yet they are faced with increasing health problems and decreased mobility, and almost half require prescription drugs to pursue activities of daily living. In this paper selected patterns of pharmacy patronage among a sample of elderly are presented. Overall, the percentage of elderly requiring prescriptions reflects national estimates and no significant difference is found in the expressed need for prescriptions between black and respondents. 'Neighborhood' pharmacies are perceived as being very important, but relatively few use the most geographically convenient. Nevertheless, the large majority of elderly are satisfied with distances they presently have to travel to purchase prescriptions. The observed travel patterns for prescription purchases suggest that conventional wisdom pertaining to the nature of the pharmacy journey, the notion of convenience and the traditional concept of neighborhood among the elderly should be reexamined.

Aged↗
PubMed1985

Lawful uses of drugs purchased at preferential prices.

The issue of use of pharmaceuticals purchased at preferential prices by hospital pharmacies in competition with community pharmacies has received great attention in recent years. The U.S. Supreme Court has addressed such issues twice within the past 10 years. The statutory basis for the lawsuits is explained and the history and implications of the Supreme Court decisions are discussed, with emphasis on the various categories of permissible and impermissible uses under the court's decisions. Implications for the hospital pharmacy are described and discussed.

Drug Industry↗
PubMed1985

Tax aspects of outpatient drug transactions in nonprofit hospitals.

Tax issues related to sales of medications to outpatients by pharmacies in nonprofit hospitals are described. Hospitals are increasing their emphasis on development of ambulatory-care programs. Two aspects of the tax implications of such services are (1) whether revenue from sales of medications to ambulatory patients constitutes "unrelated business income" for the nonprofit hospital and thus is taxable and (2) whether engaging in dispensing of medications to ambulatory patients might jeopardize the tax-exempt status of the hospital. Various rulings from the Internal Revenue Service and court cases are reviewed. Sales of medications to members of the general public who are unrelated to the hospital are taxable. Sales of medications for the convenience of hospital patients, and irregular and intermittent sales to the public by a pharmacy that normally serves only "patients," are tax exempt. Sales of medications to the public probably do not jeopardize the tax-exempt status of a hospital so long as the primary purpose of the hospital is consistent with permissible tax-exempt purposes.

Hospitals, Voluntary↗
PubMed1985

Right to refuse treatment with psychotropic medication.

The law regarding refusal of psychiatric patients to take psychotropic medication is reviewed. The law in this area is traced through its evolution beginning in the 1960s when failure to administer medication to psychiatric patients was considered mistreatment of the patient. The legal basis for forcible administration of drugs is reviewed, and a discussion of cases in which patients refused to accept treatment on religious grounds is presented. When children are involved, the courts are generally in accord that the parents' right to freedom of religion ends where the child's right to life begins or when there is a threat to public health and safety. In cases involving adults, without a threat to public health or safety, relevant opinions rule that medical treatment should not be ordered against the patient's religious beliefs because it would constitute a violation of the First Amendment. Two leading cases involving the forcible administration of medication, Rennie v. Klein and Rogers v. Okin, held that administration should be limited to emergency situations when there is substantial risk of injury to the patient or others in the hospital. The Supreme Court made it clear that the right to refuse must be derived from state law, not from the federal Constitution, apparently giving health-care professionals broad leeway in exercising professional judgment in this area.

Humans↗