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[Liability in failed sterilization from the legal viewpoint].

If a sterilization does not succeed and leads to the unintended birth of a child and if this is due to the physician's negligence, he has to compensate the parents' cost of maintenance for the child. This is a legal rule which has been developed and reaffirmed in several decisions of the German Federal Court (Bundesgerichtshof). Unexpected and without connexion with the real matter of the case which had to be decided the German Constitutional Court (Bundesverfassungsgericht) has criticized this legal doctrine in its decision on to the reform of the law of abortion. In the opinions of the court the rule has to be revised, because it is a violation of the child's dignity as a human being to regard its (wrongful) existence as a source of damage. However this part of the decision can only be understood as a obiter dictum which is not finding the Federal Court. Therefore it is not to be expected that the civil courts will undertake any substantial change of the rule laid down at the outset.

Female↗

Use of the vacuum extractor by midwives--what has changed in the last decade?

This article provides an update on use of vacuum extraction by certified nurse-midwives (CNMs) and certified midwives (CMs). Research findings from the last decade relevant to the training and use of vacuum extractors are reviewed along with professional guidelines and legal implications.

Cerebral Hemorrhage↗

Physician assisted suicide: new developments in the Netherlands.

Until recently, physician assisted suicide was dealt with on the same basis as active voluntary euthanasia in the Netherlands. Over the last years, several cases relating to assistance in suicide of mental patients did raise specific issues, not addressed so far in the debate on euthanasia. One of these cases resulted in a Supreme Court decision. The paper summarizes this decision and comments on it from a legal point of view.

Criminal Law↗

Legal concerns in tissue viability and wound healing.

In an age of increasing litigation, it is important for tissue viability practitioners to be aware of the legal issues surrounding their practice. Bridgit Dimond discusses some of the legal aspects that were raised as concerns by participants recently attending a post-graduate diploma course in tissue viability and wound healing. She clarifies the main legal requirements for healthcare professionals working in this field.

Clinical Competence↗

Year 2000 issues in the healthcare setting. Prepare now for worst-case scenarios.

Healthcare managers must ensure their organizations are addressing Year 2000 (YK2) computer concerns, which can affect both internal and external operations, from patient monitoring to accreditation. Strong planning initiatives and legal counsel are necessary to resolve YK2 and computer vendor issues. Directors and trustees should follow "prudent person" standards to avoid liability but must take an active role with managers to form a YK2 committee, retain professionals to prepare for operation failures, and explore insurance availability. As 2000 approaches, computer systems will start to malfunction on unpredictable dates. Catholic providers must act now or review their current efforts.

Accreditation↗

Domestic AIDS vaccine trials: addressing the potential for social harm to the subjects of human experiments.

In 1998, the FDA approved the first large-scale human trials of a candidate AIDS vaccine in our nation's history. While the legal issues raised by these trials are manifold, the academic literature has focused almost exclusively on the potential for mass tort liability and the resulting hesitancy of biotech and pharmaceutical firms to enter the field. This Comment argues that another issue of vital concern demands attention: the potential for social harm to the human subjects of AIDS vaccine trials. After providing an overview of the current epidemiology of HIV/AIDS and explaining why a safe, effective AIDS vaccine represents the best way to control the pandemic, this Comment analyzes the scientific and social obstacles to production of such a vaccine. In order to know whether a candidate AIDS vaccine is truly effective, researchers will have to test the product in HIV-negative volunteers at high risk of infection. Since these volunteers may subsequently test positive for HIV on standard blood tests, they will be vulnerable to discrimination on that basis in such areas as employment, insurance, immigration, and incarceration. Moreover, by participating in vaccine trials, volunteers will be marking themselves as people at high risk of HIV infection, another basis for disparate treatment. Researchers have suggested that federal disability discrimination law may afford protection against research-related social harms. Through close analysis of the Americans with Disabilities Act of 1990 and the Supreme Court's decision in Bragdon v. Abbott, this Comment demonstrates that optimistic reliance on federal disability law is misplaced. The unique issues raised by domestic AIDS vaccine trials must be addressed in their own right. The Comment accordingly concludes with a broad range of legislative and regulatory proposals to protect trial participants and advance the AIDS vaccine research agenda.

Animals↗

Dental sleep medicine: coming of age.

Millions of people worldwide suffer diminished quality of life due to the effects of sleep-disordered breathing (snoring and obstructive sleep apnea). The worst cases can be life-threatening. Recently, the medical and dental professions have partnered to provide essential relief for many of those afflicted with this widespread malady. As medical sleep specialists reach out to include dentists on the "sleep team," it is incumbent on the dental professional to have sufficient education and training. Presently, there are a multitude of opportunities and venues available to the dentist who may have an interest in this burgeoning new field. However, caution is required during the learning experience because different sources of educational material may not be congruent with legal or professional ethics.

Dentists↗

Facsimile transmissions.

Some provincial regulators of nursing are setting out professional standards for the use of facsimile transmissions. While the facsimile machine is a tool that can improve client care through the timely, accurate transmission of vital information, nurses should recognize the potential hazards. Clear policies and procedures for the usage and management of facsimile transmissions are necessary to ensure that legal and professional standards are met.

Canada↗