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PubMed1992

Confidentiality in the age of AIDS.

Confidentiality is a fundamental rule of medicine and has been specifically defined in many codes of medical ethics. A changing clinical environment both because of diseases such as AIDS, which were not anticipated when these clinical codes were created, and because of the changing relationship between the physician, the patient, and the payor for the physician's care creates dilemmas concerning the rule of confidentiality.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Compulsory alcoholism treatment in New South Wales.

The compulsory treatment of people with substance use disorders continues to attract interest in many countries, particularly in the medico-legal, policy and research communities. Beyond the current fashion for Drugs Courts within the criminal justice system, several jurisdictions have for many years had involuntary commitment regimes operating within the civil sphere. This paper offers a case-study of one such regime that operates in New South Wales, Australia. After backgrounding the introduction of the Inebriates Act in the early 1900s, and describing the major features of the legislation, the paper outlines how the Act is currently being used, and what little is known about treatment outcomes under this regime. The paper concludes by considering a number of criticisms that have been levelled against the Inebriates Act, and briefly assessing its prospects for the future.

Alcoholism↗
PubMed1992

Risky business: setting public health policy for HIV-infected health care professionals.

An analysis of the restrictive proposals provoked by the case of Kimberly Bergalis and four other patients apparently infected with HIV during the course of dental treatment reveals that they resulted from an inability to evaluate appropriately the infinitesimal risk of HIV transmission from practitioner to patient. The proposals also resulted from an effort to create risk prevention policy without appreciating the distinction between regulating things or procedures, which have no human rights, and regulating people, who have rights that should not be infringed without serious justification. This analysis demonstrates that the proposed restrictive policies are not justified because they do nothing to prevent the spread of HIV, and they cause unnecessary and substantial harm to health care practitioners.

American Medical Association↗
PubMed1992

The HIV epidemic. Ethical issues for the next decade.

The HIV epidemic and ethical issues will continue to be a major topic of discussion over the next decade. It is now evolving into a new phase and we are experiencing a change or shift in the populations that are affected. This article focuses on the issues of early intervention, access to care, and the continuum of care including a discussion of case management, the changing populations, drug trials, and issues surrounding confidentiality.

Clinical Trials as Topic↗
PubMed1992

Vaccinations.

Tetanus-diphtheria toxoid, influenza virus vaccines, and pneumococcal vaccine are recommended for older persons in the United States by the Centers for Disease Control. But most high-risk older persons remain unvaccinated, despite experiencing relatively high rates of tetanus, influenza-related complications, and pneumococcal disease, and having available effective, safe, and low-cost vaccines. Strategies for improving these vaccination rates require an intensive approach focused on (1) identifying older persons with high-risk conditions, (2) improving the delivery of vaccines, (3) improving the acceptance of vaccines by older persons, and (4) establishing mandatory immunization programs.

Aged↗
PubMedDate not supplied

Insurance for the insurers. The use of genetic tests.

Genetic testing raises concerns that individuals will be denied health insurance (and thus, effectively, access to health care), or that employers will screen to eliminate potentially costly workers. Although we as a society do not yet concur on the degree to which private businesses have a responsibility to promote social justice, several different policy alternatives might allow us to weigh the interests of insurers, as businesses, against the interests of citizens in a responsible manner.

Eligibility Determination↗
PubMed2002

Reconsideration of contemporary U.S. drug policy.

In their recent book Drug War Heresies: Learning From Other Vices, Times, and Places (Cambridge: Cambridge University Press, 2001), MacCoun and Reuter challenge the continuation of contemporary U.S. drug policy. Depenalization and legalization of illicit drugs are evaluated as alternatives to U.S. prohibition policy, with harm reduction (mitigation of social damages) as the criterion for guiding drug regime change. The appraisal encompasses an analysis of underlying philosophical and social mechanisms of current U.S. policy as well as drawing analogies from a comprehensive review of American vices and also Western European governmental interventions into illicit drug activities. What is apparent is that the evaluation and the available evidence entail substantial complexity and do not readily present unequivocal positions. The evaluation also strongly indicates that considerable difficulty would be encountered not only for the implementation of alternative regimes but also for the engagement in open political discussion of prohibition alternatives.

Criminal Law↗
PubMed2003

California bonanza? Providers and insurers cheer mandatory health insurance law, but business interests look at legal challenge to newly signed bill.

Consider it Gov. Gray Davis' going-away present to the state's hospitals, insurers and physician groups. The California Health Insurance Act of 2003 could mean increased revenue for hospitals. Doctors like Brian Johnston, left, say the bill has been a long time coming and are pleased with the legislation, but others are concerned about what effects the mandatory insurance law will have on small businesses.

California↗
PubMed1992

The epidemiology of HIV infection and AIDS in east and central Harlem, NY.

This report describes the AIDS epidemic in East and Central Harlem, among the hardest-hit communities in the nation. Information was obtained from two New York State mandatory reporting programs: anonymous HIV antibody testing of newborns, and physician and hospital reports of AIDS cases to city and county public health departments. One of 30 babies born in East Harlem and one of 46 newborns in Central Harlem are seropositive. The cumulative rate of reported AIDS cases in these communities is 10-15 times the national rate, and together, the communities reported 1.3% of all AIDS cases in the nation, although they have only 0.1% of the nation's population; 2.2% of all childhood AIDS cases have been reported from East and Central Harlem. Women, minorities, and injection drug users comprise a higher proportion of the cases than in the city, the state, and the nation. The consequences of the epidemic in these communities are enormous, including profound stresses on community institutions and exacerbation of the resurgence of tuberculosis.

Acquired Immunodeficiency Syndrome↗