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Telemedicine: pediatric applications.

The newly developing field of telemedicine has the potential to benefit pediatric care by increasing access to pediatric specialists and services. This report explores the current uses and limitations of telemedicine in pediatrics.

Biomedical Research↗

Legal implications of treating patients with HIV.

The status of a patient with human immunodeficiency virus (HIV) often has significant impact on a physician's willingness and ability to provide quality medical care. A physician may face substantial penalties for refusing to treat a patient with HIV. Even the referral of a patient with HIV to a specialist in the disease may constitute a discriminatory act. The law provides certain guidelines which, if followed, may help keep the physician out of the courtroom.

HIV Infections↗

Confidentiality and the public interest in medical research--will we ever get it right?

Developments over the last decade in legislation and professional guidance on confidentiality and medical research in the UK are reviewed. Despite the General Medical Council's guidance, and recent changes to the common law on confidentiality in England and Wales, confusion remains about what is lawful and professionally acceptable in the handling of identifiable data. The GMC has contributed to this confusion. Professional bodies should jointly produce new guidance. The Health and Social Care Act 2001 is a temporary legislative solution. Public consensus is required on an acceptable balance between the citizen's right to privacy and the responsibility of society--to which all citizens belong--to protect the public health. The Government should survey public opinion, inform NHS patients better, initiate wide public debate, and legislate to protect both citizens' rights and medical research that is demonstrably in the public interest. Registration of cancer and communicable diseases should become statutory.

Access to Information↗

Medicaid program; eligibility groups, coverage, and conditions of eligibility; legislative changes under OBRA '87, COBRA, and TEFRA--HCFA. Final rule.

This rule amends the Medicaid regulations to incorporate or revise the following mandatory and optional eligibility groups of individuals for Medicaid coverage: (1) Pregnant women; (2) qualified children under a specified age; (3) children in adoptions and foster care; (4) certain disabled widows and widowers; and (5) certain disabled children being cared for at home. The rule also adds a condition of eligibility relating to third party liability for medical assistance expenditures. The amendments conform the regulations to certain statutory provisions of the Omnibus Budget Reconciliation Act of 1987, the Consolidated Omnibus Budget Reconciliation Act of 1985, and the Tax Equity and Fiscal Responsibility Act of 1982.

Centers for Medicare and Medicaid Services, U.S.↗

Medical malpractice: an empirical examination of the litigation process.

New data on medical malpractice claims against a single hospital in which a direct measure of the quality of medical care is available are used to investigate the roles of the negligence rule and incomplete information in the dispute settlement process in medical malpractice. We find that the quality of medical care (negligence) is an extremely important determinant of defendants' medical malpractice liability. More generally, we find that the data are consistent with a model in which plaintiffs are poorly informed ex ante about whether there has been negligence, file suit to gather information, and either drop the case if they find that negligence was unlikely or settle for a positive payoff if they find that negligence was likely. We also find that the cases are resolved earlier in the litigation process when the parties are more certain, one way or the other, about the likelihood of negligence.

Data Collection↗

Withholding resuscitation. The medical, legal and ethical concerns.

EMS training and system protocols have not kept pace with the changing perceptions of society and the medical community regarding patients' rights to die with dignity. Providers, therefore, often seem left to their own devices when deciding whether to initiate resuscitative measures.

Emergency Medical Services↗

The need for tail coverage in medical malpractice insurance.

In today's litigious society, it is more important than ever that physicians purchase "tail" coverage--that is, insurance for claims asserted after the period covered by their basic insurance arising from occurrences during the insured period. This article describes the tail of a medical malpractice insurance policy, the need for and purpose of tail coverage, the methods of pricing such coverage, and the problems associated with the tail coverage provisions of medical professional liability insurance.

Actuarial Analysis↗