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PubMed2005

Commercial agencies and surrogate motherhood: a transaction cost approach.

In this paper we investigate the legal arrangements involved in UK surrogate motherhood from a transaction-cost perspective. We outline the specific forms the transaction costs take and critically comment on the way in which the UK institutional and organisational arrangements at present adversely influence transaction costs. We then focus specifically on the potential role of surrogacy agencies and look at UK and US evidence on commercial and voluntary agencies. Policy implications follow.

Commerce↗
PubMedDate not supplied

Malpractice litigation reform: empirical approaches to establishing the legal standard of care.

This article proposes that the legal standard of care in malpractice cases should be established through empirical methods rather than only with experts'subjective opinions. The authors outline and critique two approaches for doing so and explain the legal advantages and barriers to implementing these legal reforms. Basing the legal standard of care on evidence of actual physician behaviors and views would help to improve medical practice by reducing the need to engage in defensive medicine and by making it safer to institute quality improvement measures.

Data Collection↗
PubMed1986

How did Tarasoff affect clinical practice?

The Tarasoff decisions of the California Supreme Court in 1974 and 1976 held that psychotherapists could be held liable for failing to protect the victims of their potentially violent patients. Our survey of psychiatrists, psychologists, and social workers in eight metropolitan areas showed that Californians were more likely to have heard of the case, to believe it required warning the likely victim, and actually to issue warnings in such cases than were psychotherapists from other jurisdictions. Therapists were more willing to take steps to protect victims in 1980 than in 1975, but willingness to warn increased more among Californians than among those in other states. We conclude that although Tarasoff has influenced therapists' attitudes and behavior more in California than elsewhere, the case has also affected psychotherapeutic practice nationally.

Awareness↗
PubMed1991

Post-Tarasoff legal developments and the mental health literature.

Since Tarasoff first established the duty of psychotherapists to warn or otherwise protect third parties when a patient is considered dangerous, the mental health literature has continued to address the two most controversial issues in that case: the questionable ability of clinicians to predict violent behavior, and the role of confidentiality in psychotherapy. The author examines recent trends in the law in light of this research and concludes that so-called anti-Tarasoff statutes recently passed by some states appropriately take into account the mental health literature and effectively balance competing public policy concerns.

Confidentiality↗
PubMed1996

Euthanasia on trial: examining public attitudes toward non-physician-assisted death.

This study investigated the influence of various contextual effects on the decisions of subjects evaluating a case of nonphysician-assisted suicide. Subjects viewed a videotaped deposition of an individual emotionally or nonemotionally describing how he assisted in the death of his terminally ill wife by disconnecting her respirator or shooting her in the head. The deposition was followed by jury instructions that outlined the duties of the subject and, in some cases, was followed by a nullification instruction that informed the subjects of their right to ignore the law in this case if they felt it would culminate in an unfair verdict. After viewing the videotape, subjects were asked to rate the guilt of the individual as well as their confidence in this rating. Results indicate that the means of death and the type of instruction significantly affect guilt ratings. The implications of these findings are discussed.

Adult↗
PubMed1996

Therapeutic jurisprudence and end-of-life medical care: physician perceptions of a statute's impact.

OBJECTIVE: Assess the perceptions of Ohio physicians regarding the impact of their state's 1990 advance directive legislation on their medical practices when decisions need to be made and implemented concerning use of life-prolonging medical interventions, and to draw public policy. DESIGN: A mailed survey to physicians, to be completed and returned anonymously. The form contained ten questions to be answered according to a five-point Likert scale, a request for demographic information, and an opportunity to write additional comments on the form. SETTING: Surveys mailed to every physician on the Wright State University continuing medical education mailing list who had designated a specialty in internal medicine, family practice, or surgery. MAIN OUTCOME MEASURES: Physicians' perceptions of the impact of Ohio's advance directive legislation on their communication with patients and families, anxieties about legal liability associated with end-of-life care, and willingness to limit life-prolonging medical interventions in specific situations. RESULTS: Mixed. While many physicians reported enhancements in relationships, communication, and willingness to respect patient and family wishes due to the statute, others reported an opposite effect. For many physicians, the statute made little impact on their practices. CONCLUSIONS: The Ohio statute could benefit from rewriting, but there are inherent problems with advance directive laws. Professional education about death and dying issues and the chance for physicians to practice end-of-life treatment techniques are essential.

Advance Directives↗