You're currently on:

Back Issues and Articles
Back Issues and Articles

Contents - JLME - 2005 Volume 33: 3
Table of Contents
  1. Table of Contents
Letter From The Editor
  1. Letter From The Editor
Symposium Articles
  1. Managing Malpractice Crises
  2. Physician Responses to the Malpractice Crisis :From Defense to Offense
  3. Medical Indemnity Reform in Australia: "First Do No Harm"
  4. Is there a Medical Malpractice Crisis in the UK?
  5. Medical Malpractice in the People's Republic of China:The 2002 Regulation on the Handling of Medical Accidents
  6. Liability Reform Should Make Patients Safer:"Avoidable Classes of Events" are a Key Improvement
  7. Reconsidering the Harvard Medical Practice Study Conclusions about the Validity of Medical Malpractice Claims
  8. Are Medical Malpractice Damages Caps Constitutional? An Overview of State Litigation
Independent Articles
  1. Forensic Science
  2. Inclusiveness,Effectiveness and Intrusiveness:Issues in the Developing Uses of DNA Profiling in Support of Criminal Investigations
  3. Away from Exploitation and Towards Engagement: An Ethical Compass for Medical Researchers Working in Resource-Poor Countries
  4. A Normative Justification for Distinguishing the Ethics of Clinical Research from the Ethics of Medical Care
  5. The Physician/Investigator's Obligation to Patients Participating in Research: The Case of Placebo Controlled Trials
  6. The Clinical Investigator as Fiduciary: Discarding a Misguided Idea
Columns
  1. Currents in Contemporary Ethics
  2. The Ethical Health Lawyer
  3. Reviews in Medical Ethics
  4. The United States Supreme Court and Health Law: The Year in Review
  5. Recent Developments in Health Law
Calendar
  1. Calendar
Table of Contents
Table of Contents
ASLME - [PDF] (Free Download)
Table of Contents
Letter From the Editor
Letter From The Editor
ASLME - [PDF]

Letter From The Editor
Symposium Articles
Managing Malpractice Crises
Michelle M. Mello - [PDF]

Managing Malpractice Crises
Physician Responses to the Malpractice Crisis :From Defense to Offense
Allen Kachalia, Niteesh K.Choudhry, David M.Studdert - [PDF]

Physicians practice today in the midst of a malprac-tice crisis that is characterized by limited availabilityand affordability of liability coverage. The significantpsychological stress associated with the threat oflawsuits compounds these financial concerns. In thisclimate, it is not surprising that physicians seek toreduce liability risk. Traditional methods used topursue this goal include advocacy and lobbying forreform, practicing defensive medicine, and counter-suing for frivolous suits. In the current crisis, newerand more aggressive physician responses haveemerged. These include practicing without liabilitycoverage, conditioning the provision of medicaltreatment on waivers of the right to sue, and organ-izing work stoppages.
Medical Indemnity Reform in Australia: "First Do No Harm"
Fiona Tito Wheatland - [PDF]

Recent medical indemnity changes in Australia wereclaimed to be valid responses to a litigation crisis.However, the solutions were often misguided,rewarding poor business management, financiallypenalising the most seriously harmed patients andimposing significant extra costs on taxpayers.
Is there a Medical Malpractice Crisis in the UK?
Kay Wheat - [PDF]

This article concludes that claims of a medical mal-practice crisis need to be closely scrutinised andterms clearly defined, as statistics suggest that clinical negligence claims are falling. It acknowledges,however, that recent concerns regarding medicalmistakes and a number of medical "scandals" havemight have created the impression of a "malpractice"crisis.
Medical Malpractice in the People's Republic of China:The 2002 Regulation on the Handling of Medical Accidents
Dean M. Harris, Chien-Chang Wu - [PDF]

In China, there have been numerous reports thatdoctors or other health care workers have beenattacked by patients or members of patient's families. Those acts of violence have been attributed, inpart, to the inadequacy of the legal system for handling medical disputes that was in effect prior to2002. On February 20, 2002, the State Council ofthe People's Republic of China adopted theRegulation on the Handling of Medical Accidents.The new 2002 regulation increases the adequacyand fairness of compensation, makes some improve-ments in the procedure for resolving medical dis-putes, and has the potential to reduce medical errorsand improve quality of care. Therefore, the 2002regulation was an important step in the right direc-tion, but some problems remain to be solved in thecontinuing process of reform.
Liability Reform Should Make Patients Safer:"Avoidable Classes of Events" are a Key Improvement
Randall R. Bovbjerg, Laurence R. Tancredi - [PDF]

Medicine injures too many patients, and reformneeds to improve compensation and patient safety,neither of which is well served by tort liability,whether or not modified with caps and other con-ventional reforms. Better disclosure of injuriesshould be accompanied by reform of payouts, ofwhich the most promising is to list avoidable classesof events in advance to facilitate prompt compensa-tion and safety analysis.
Reconsidering the Harvard Medical Practice Study Conclusions about the Validity of Medical Malpractice Claims
Tom Baker - [PDF]

The HMPS findings regarding the frequency ofmedical malpractice and the infrequency of medicalmalpractice claims are well supported, but the findings regarding the invalidity of medical malpracticeclaims, particularly paid claims, are not well sup-ported and are contradicted by a large body ofresearch. This research shows a strong correlationbetween the merits of medical malpractice claimsand the size and likelihood of payment.
Are Medical Malpractice Damages Caps Constitutional? An Overview of State Litigation
Carly N. Kelly, Michelle M. Mello - [PDF]

Caps on noneconomic damages have been the dar-ling of tort reformers at both the federal and statelevels during the latest medical malpractice crisis,just as in previous crises. The question of whetherlimitations on damages are permitted under stateconstitutions has played importantly in tort reformdebates in a number of states. In this article, wereview case law addressing this issue and commenton the prospects for caps legislation going forward.
Independent Articles
Forensic Science
Forensic Science - [PDF]

Scientific evidence is often more reliable than othertypes of evidence commonly used in criminal trials -i.e., eyewitness identifications, confessions, andinformant testimony. Nevertheless, despite its obvious value, forensic science has not always meritedthe term "science." Three developments in the 1990sfocused attention on its shortcomings: the advent ofDNA profiling, the Supreme Court's "junk science" decision, and a number of well-publicized crime lab-oratory scandals. In light of these developments, andin order to take full advantage of the power of forensic science to aid in the search for truth, a number ofreforms are needed: crime laboratories should beaccredited, lab procedures should be standardized,and basic research needs to be conducted on manycommonly used techniques. Court procedures alsorequire improvement: defense experts should bemore readily available to indigent defendants, andmore comprehensive pretrial disclosure of the sub-stance of expert testimony should be provided.
Inclusiveness,Effectiveness and Intrusiveness:Issues in the Developing Uses of DNA Profiling in Support of Criminal Investigations
Robin Williams, Paul Johnson - [PDF]

The rapid implementation and continuing expan-sion of forensic DNA databases around the world has been supported by claims about their effective-ness in criminal investigations and challenged byassertions of the resulting intrusiveness into individ-ual privacy. These two competing perspectives pro-vide the basis for ongoing considerations about thecategories of persons who should be subject to non-consensual DNA sampling and profile retention aswell as the uses to which such profiles should be put.This paper uses the example of the current arrange-ments for forensic DNA databasing in England &Wales to discuss the ways in which the legislativeand operational basis for police DNA databasing isreliant upon continuous deliberations over these andother matters by a range of key stakeholders.
Away from Exploitation and Towards Engagement: An Ethical Compass for Medical Researchers Working in Resource-Poor Countries
Daniel W. Fitzgerald, Angela Wasunna - [PDF]

We believe that by setting a positive goal, interna-tional ethical guidelines can help people understandthe potential good that research does in resource-poor countries, and may thereby encourage investi-gators to conduct more research to address thehealth problems of these poor populations. We pro-pose that the positive point towards which interna-tional researchers should strive is engagement. Wedefine engagement as the polar opposite of exploita-tion. Engagement occurs when researchers and peo-ple in resource-poor communities work together in ajust way to improve the health of the host communi-ty and to decrease unfair health inequalities.
A Normative Justification for Distinguishing the Ethics of Clinical Research from the Ethics of Medical Care
Paul Litton, Franklin G. Miller - [PDF]

The central question in current debates about themoral appropriateness of randomized placebo-con-trol trials and the principle of clinical equipoise forresearch is whether physician-researchers owe pri-mary loyalty to their patient-subjects, as physiciansowe their patients under medical care. We arguethat they do not. First, because of the importance ofmedical research and the scientifically rigorousmeans needed to produce valid medical knowledge,there is prima facie reason to exclude the duty oftherapeutic beneficence from the duties onresearchers. Second, thatprima faciereason is nottrumped by the reasonable expectations of patient-subjects.
The Physician/Investigator's Obligation to Patients Participating in Research: The Case of Placebo Controlled Trials
Kathleen Cranley Glass, Duff Waring - [PDF]

This article addresses medical negligence as a causeof action for harm to a research participant occa-sioned by withholding established, effective therapyin the placebo arm of a clinical trial, and the insuffi-ciency of consent as a defense to such a claim.
The Clinical Investigator as Fiduciary: Discarding a Misguided Idea
E. Haavi Morreim - [PDF]

Many commentators insist that clinical investigatorsare fiduciares of research subjects, owing the sameduties that physicians owe their patients. This essayargues that investigators can not possibly be fiduci-aries. Nevertheless, they still have strong obligationsto protect volunteers' welfare, best understood as"side constraints."
Columns
Currents in Contemporary Ethics
Heather L. Hinds - [PDF]

Currents in Contemporary Ethics
The Ethical Health Lawyer
Amy L. McGuire, Mary A. Majumder, J. Richard Cheney - [PDF]

The Ethical Health Lawyer
Reviews in Medical Ethics
Margaret McDermott - [PDF]

Reviews in Medical Ethics
The United States Supreme Court and Health Law: The Year in Review
Theodore W. Ruger - [PDF]

The United States Supreme Court and Health Law: The Year in Review
Recent Developments in Health Law
Nicholas Beshara, Kelly Gabos, Eva Kwan, and Jung Lee - [PDF]

Recent Developments in Health Law
Calendar
Calendar
ASLME - [PDF]

Calendar