Physicians nationwide, already worried by an increasing number of professional liability lawsuits and an expanding scope of liability, now face a new and potentially more troublesome development that had its genesis in what many thought was an extraordinary court decision. In Tarasoff v. Regents of the University of California, a psychiatrist was held, in a suit brought by the victim's parents, to be liable for negligence in the death of a woman who was murdered by a patient of that physician. The court held that even though the physician had complied with the traditional duty of protecting the patient's confidentiality, he nonetheless had a duty to warn the victim of the potential threat against her life. Tarasoff was eventually followed by a number of decisions that imposed liability on physicians under similar circumstances.

This article reviews and analyzes the original Tarasoff decision and subsequent judicial rulings on this subject. In addition, the authors briefly explore the historical backdrop of this decision and suggest practical steps that physicians can take to deal with the conflicting duties of protecting confidentiality and protecting potential victims from the danger posed by patients.

The focus of the abortion debate in the United States tends to be on whether and at what stage a fetus is a person. I believe this tendency has been unfortunate and counterproductive. Instead of advancing dialogue between opposing sides, such a focus seems to have stunted it, leaving advocates in the sort of I did not—You did too impasse we remember from childhood. Also reminiscent of that childhood scene has been the vain attempt to break the impasse by appeal to a higher authority. Thus, the pro-choice forces hoped they had proved the pro-life forces wrong by having had the Supreme Court of the United States decide in Roe v. Wade that a fetus is not a person for purposes of the fourteenth amendment. Now the pro-life forces are trying to prove the pro-choice forces wrong by passing legislation or a constitutional amendment that declares a fetus to be a person after all

Suits for negligence in the area of child protection have become frequent as reporting of child abuse and neglect has increased. This article begins with various theories and defenses raised in specific cases, and briefly examines the problem of inadequate legal representation for the child. An additional section notes various policy issues for lawyers and the courts.

Child protection has become a multidisciplinary field, and therefore social workers, doctors, police officers and mental health professionals have been held to be negligent in carrying out duties to children. The diagnostic professions of medicine and mental health are often involved early in child protection proceedings because of legal requirements for diagnosis and reporting. Social workers and police officers have been charged with failure to respond appropriately to reports of child abuse. Cases of inadequate selection of, or monitoring of placements into, foster homes are also associated with social workers. This section will consider these cases, and discuss various defenses raised.

Antitrust challenges to agreements between hospitals and physicians who provide patient services have become one of the most common types of antitrust litigation in the past few years. Two recent decisions by different circuit courts of appeal highlight the legal and medical principles on which such disputes will be decided.

In August 1982, the United States Court of Appeals for the Seventh Circuit vacated a preliminary injunction entered in favor of an individual anes-thesiologist who had complained that after an anesthesia group terminated her employment, the hospital wrongfully refused to allow her to continue to serve patients. The Seventh Circuit, in Dos Santos v. Columbus-Cuneo- Cabrini Medical Center, expressed serious doubt whether under antitrust analysis, a single hospital could ever be treated as a distinct market for the purchase and sale of health care services. The court remanded the case to the federal district court, where it is still pending.

The guidelines for the nursing staff of a health care facility in Boston include the following statement:

Program Development Committees Established

The response was overwhelming to the recent announcement concerning the creation of the Society's new Program Development Committees. Over one hundred members have volunteered and those who expressed their thoughts agreed this was a significant step for the Society.

Committees are being formed to focus on the areas of: hospital law, medical malpractice, risk management and utilization review, health care for children, health care for the elderly, mental health, nursing, and workers compensation/occupational medicine.

Each committee is multidisciplinary and geographically diverse, and is charged with developing and organizing periodic educational meetings in its respective field. The focus of each meeting, its content, and faculty selection are the primary responsibilities. Complete rosters for each committee will be circulated in the near future.

In addition to their work in planning the Society's educational programs, it is hoped that these program development committees will identify problems and issues to which the Society could make significant contributions. Research and surveys on current problems could be organized by the committees, resulting in educational position papers issued in the name of the Society.

In addition to their work in planning the Society's educational programs, it is hoped that these program development committees will identify problems and issues to which the Society could make significant contributions. Research and surveys on current problems could be organized by the committees, resulting in educational position papers issued in the name of the Society.

Medical staff clinical privileges are usually granted, denied, reduced, suspended, or revoked because of clinical competence and performance. Generally accepted standards for evaluation of clinical competence and performance are published by the Joint Commission on Accreditation of Hospitals. In addition, some states have established standards by statute and by administrative regulations. Hospital medical staffs and governing boards, therefore, have standards to use in evaluating clinical competence and performance. Courts generally uphold hospitals’ employment of these standards as the basis of their decisions about a physician's clinical privileges. However, denial, reduction, suspension, or revocation of clinical privileges based on a physician's disruptive behavior presents a more difficult problem for hospitals because there are no generally accepted standards against which physicians’ behavior can be measured.

In the past several years, a new tort has emerged, one which has been used primarily against insurance companies and which has resulted in an enormous number of damage claims—the tort of bad faith breach of contract. At this time, the tort of bad faith breach of contract has rarely been extended beyond the insurance industry. It is very likely, however, that in the near future, this tort will be extended to other industries that serve the public interest, particularly to health maintenance organizations (HMOs). Currently. many bad faith breach of contract cases against HMOs are being litigated at the trial level. In addition, publicity relating to such suits has appeared in various newspapers and periodicals.

This article discusses the application of this relatively new cause of action to HMOs, and deals with the followng issues: the basis for the analogy between the insurers and HMOs; the grounds for bringing a suit for bad faith breach; and the implications, for HMOs and consumers, of the emergence of this cause of action.

Even though physicians, lawyers, dentists, school teachers, life insurance brokers, and peddlers were licensed in the United States as early as 1890, nursing occupational licensure did not begin until 1938, when New York became the first state to pass such a law. By 1962, eight states had mandatory licensing laws, and sixteen more had nursing boards which claimed that licensure was mandatory.

Today every state requires that nurses who practice within its jurisdiction possess licenses. Since the purpose of nursing licensure is protection of the public, the state may require qualifications which are reasonably related to the practice of nursing. A license, because it is granted upon condition, is not a permanent right, and the state may revoke it if the licensee does not continue to meet licensing standards. The state also has discretion to use remedies less extreme than revocation. It may limit or suspend the license, and/or fine or reprimand the nurse.