Withdrawing treatment.
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This article reviews and analyzes the current public health legislation in 17 states and the District of Columbia in the United States. These states were selected and grouped into high, medium, and low incidence based on their annual AIDS incidence rates. Data were collected through a combination of library research and direct communications with the various state health departments. Four major areas of legislation were reviewed: HIV antibody testing and reporting; confidentiality and partner notification; personal control measures: and AIDS antidiscrimination laws. In general, majority of the states have treated the AIDS epidemic as a public health problem and not as a moral or criminal issue. Some states with higher incidence such as New York and California have developed the least restrictive laws and responded with stronger AIDS antidiscrimination legislation. The states with medium incidence have more restrictive measures and the low incidence states have less legislation and fewer regulations related to AIDS. AIDS educators should be aware of the implications of the varied legislation and regulations on AIDS education and prevention. They should play a strong advocacy role in promoting the development and application of measures that will facilitate the prevention and control of AIDS.
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Public health laws intended to prevent children from smoking have been enacted in many states. We surveyed the relevant laws in all states and the District of Columbia. The efficacy of one such law prohibiting the sale of tobacco to individuals under the age of 18 years was assessed with the cooperation of an 11-year-old girl. She was successful in 75 of 100 attempts to purchase cigarettes. On the basis of this experience and a review of existing laws, we have made recommendations for a model law. These include a prohibition of the possession of tobacco by minors, a prohibition of the sale of tobacco to minors, a requirement for a warning sign at the point of sale, a ban on cigarette vending machines, and a reward for individuals reporting violators of vending laws.
In Bolger v. Youngs Drug Products Corp., the Supreme Court held that a statute prohibiting the mailing of unsolicited advertisements for contraceptives was unconstitutional as applied to Young's advertisements for condoms. The decision rested on a balancing of the first amendment's grant of free speech with the Government's interest in safeguarding an individual's privacy. The Court noted that the advertisements promoted the flow of information on contraception, and pertained to constitutionally protected private activity. This Case Comment argues that the Court's decision is sound and criticizes the view of the concurring opinion that shielding individuals from potentially offensive speech is a substantial governmental interest. The Comment concludes that the Court's decision expands upon precedent which established an individual's right of privacy regarding the use of contraceptives.
A survey of organ procurement programs and district attorneys' offices was undertaken in all 50 states and the District of Columbia to determine to what extent organ donor cards were effective in obtaining organs for purposes of transplantation. Results of the survey revealed that all 50 states and the District of Columbia have adopted some form of the Uniform Anatomical Gift Act (UAGA), but in 47 states, even when a signed donor card is available, surgeons still require family approval for removal of organs despite the fact that the provisions of the UAGA do not require this. In addition, it was found that while 44 states have a provision on their permanent drivers' licenses for organ donation, no state requires drivers to indicate whether they want to donate organs. While there is little information on the number of persons who actually carry donor cards, four states indicated that between 1.7% and 8.5% of their drivers were designated as donors. In Colorado, however, it was reported that 60% of all drivers are designated as donors. Nevertheless, in all states it was determined that few actual donors were carrying donor cards at the time of their death. It must therefore be concluded that while donor cards are an excellent educational medium and certainly facilitate the activities of transplant coordination, they are not an effective means of substantially increasing the supply of organs for transplantation.
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The Constitution protects, in some measure, each person's autonomy in making basic decisions about family, parenthood, and procreation. This Article examines the extent to which courts should protect from government intrusions a parent's access to technologies that influence specific characteristics of offspring. Beginning with Supreme Court opinions that articulate constitutional and social values regarding reproductive autonomy, the Article explores how important new insights from evolutionary biology may supplement an understanding of human procreation. Specifically, the Article explains how trait selection can constitute an important part of larger "reproductive strategies" that powerfully affect an individual's "inclusive fitness" (itself a measure of reproductive success). It concludes that access to trait-selection technologies should receive the same federal protection from government intrusions as that afforded access to abortion. It proposes the first limit to that protection, however, when a parent seeks to select for a trait, or to use a technique, that would be clearly and significantly damaging to the future child. The Article subsequently divides the use of trait-selection technologies (TSTs) into eight contexts and proposes a preliminary framework by which a regulatory system could legitimately distinguish among them.
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