Health care decision making and physician-aid-in-dying in Hawaii.
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Currently, the decision concerning pediatric cochlear implantation for children remains a personal choice for parents to make. Economic factors, educational outcomes, and societal attitudes concerning deafness could result in an increased governmental interest in this choice. This article examines case law related to the issue of parental autonomy to determine whether the state, acting in the role of parens patriae, could use economic and social reasons to mandate the provision of cochlear implants for all eligible children. The author uses previous cases as a framework to develop an opinion on whether a constitutional protection for parents may exist.
An Advance Medical Directive is a fairly new legal, medical, ethical, and social concept. Advances in modern medical technology have prompted more interest in ordinary citizens having such a document. Today life can be prolonged in situations which 50 years ago would have resulted in death. This provides an opportunity for citizens (patients) to face choices about measures to prolong life.
As rapidly evolving technologies provide more information about disease-related genes in human DNA, there is an increase in genetic screening for predisposition for a variety of diseases. Knowledge of genetic information provides significant benefits and drawbacks. Potential misuse of genetic information, particularly by employers or insurance companies, is a realistic possibility. Genetic information is often attainable via electronic medical information databases, heightening concerns that these data will be accessed by third parties and used for discriminatory purposes. Many lawmakers believe that potential harm specifically resulting from misuse of genetic information is so great that legal protection is required.
As gene therapy research races to a first cure of a genetic-based disease, the research community has struggled with the aftermath of the well-publicized death of Jesse Gelsinger from complications of an experimental treatment. In a wrongful death lawsuit against the University of Pennsylvania and its researchers, Jesse Gelsinger's family alleged violations of federal regulations and research ethics. This article reviews gene therapy research, examines the role of the key players in this tragedy, and provides suggestions for preventing future misfortunes.
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Author examines criminal investigations and prosecutions of physicians and nurses in connection with their care of dying patients and concludes that the criminal law has failed to protect patients and families and has significant power to deter appropriate pain management for dying patients.
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