Under a variety of circumstances, courts of law have attempted to compel pharmacists to publicly disclose confidential information contained within the pharmacists’ prescription drug records. The disclosure of patient medication records maintained by a pharmacist has been sought in a civil action against a drug manufacturer, a child custody proceeding, a civil action against a physician, and criminal prosecutions of a pharmacist and a physician A request for production of clearly confidential information places the pharmacist in a dilemma. The Code of Ethics of the American Pharmaceutical Association allows for the unauthorized release of a pharmacist's professional records only where it is required in the best interests of the patient or demanded by the law. Therefore, pharmacists have sought judicial clarification of the circumstances under which the law demands the release of information contained within confidential patient medication records.

The treatment of severely handicapped newborns was, for a long time, an issue of concern only to medical practitioners and involved parents. Recently, however, it has drawn the interest of a much broader constituency. Philosophers, lawyers, politicians, and the clergy, as well as public interest groups, are but a few of the groups enmeshed in the controversy over whether all handicapped infants must be treated aggressively, regardless of their physical or mental condition. Similarly, the dispute has expanded beyond academic journals and medical rhetoric. The United States Department of Health and Human Services has issued several versions of regulations concerning the care of handicapped infants (the latest proposing voluntary Infant Care Review Committees to supplement federal and state review mechanisms).

The recent growth of new forms of health care delivery has been encouraged by the increase in competition in the health care industry. Several factors account for this increase in competition. First, there is an overabundance of physicians in many areas of the United States. In addition, many overbedded hospitals now compete for the same patients to fill their beds. Finally, health maintenance organizations and other alternative delivery systems, such as ambulatory surgical care centers, ‘surgicenters,” and birthing centers, are capturing more of the patient market and reducing hospital inpatient utilization.

Employers, insurers, and the government, as the third-party payers who most often pay for an individual's medical care, hope to take advantage of this new competitive environment and to moderate the increase in their health care expenditures.

There is a growing concern in our society about the proper application of life-sustaining medical treatments. This concern has been stimulated by both the explosion in medical technology and the increasing emphasis on patients’ rights and autonomy in clinical decisionmaking. Technological progress enables us to prolong or sustain life, even when its “value” or “quality” is questionable. There is also increased concern, both within and outside the medical community, about the optimal process for making decisions to withhold or withdraw treatment.

Hospital ethics committees have been suggested as a possible solution to this problem. Although few hospitals have actually adopted ethics committees, and little is known about the way that they function or their effectiveness, there have been some recent efforts to study these issues. Despite the increasing recognition of patients’ wishes to know more about and to influence their medical care, there have been no reports about patients’ attitudes toward the role of ethics committees in decisionmaking.

Guardianship has traditionally been presented by courts and in the literature as a benevolent mechanism through which those who cannot protect themselves will be assisted through surrogate management of their assets, their persons, or both. While notice has been taken of the significant deprivation of property and liberty inherent in a total guardianship, authorities recognize the sad necessity of imposing plenary external control over some of us when sufficient need is shown. The power to do so is grounded in the state's police power and the traditional role of the state as parens patriae.

Many modern work environments expose employees to the risk of injury from toxic substances. Attention to this risk may extend beyond the immediate concern for the worker's personal health, to concern that the worker's capacity to produce healthy offspring may be impaired. The conditions of employment in a particular workplace may require exposure to chemical agents that are toxic to the reproductive system of one sex and not of the other, toxic to the reproductive processes in both sexes, toxic to the developing fetus but not to the adult, or a combination of the above. Employers that exclude susceptible members of one sex from the workplace in order to prevent exposure to toxic agents, do so at the risk of violating federal employment discrimination law.

When a medical malpractice injury occurs in a hospital, the hospital is often sued under the theory that it is vicariously liable for the actions of its employees, through the doctrine of respondeat superior. Depending on the facts of the case and the laws of the state, however, the hospital may also be directly liable to the patient. Establishing the direct liability of the hospital where the facts will not support a vicarious claim may ensure for the plaintiff an adequate “deep pocket” in cases where the physician is inadequately insured. In addition, direct liability carries a longer statute of limitations.

Imposing liability on hospitals, whether vicarious or direct, encourages hospitals to oversee physicians’ competence.

In the first reported judicial interpretation of modern nursing practice acts, Sermchief v. Gonzales, the Missouri Supreme Court has decided that “new functions for nurses delivering health services” may evolve without statutory constraints.’ The notion that nurses in expanded roles are practicing medicine without a license was cast aside, as the court specifically held that nurses may render diagnosis and treatment in accordance with standing orders and protocols. While directly affecting only nurses in Missouri, the court's recognition of nursing as a profession with its own prerogatives and responsibilities has important implications for the future of nursing.

At issue was Missouri's nursing practice act which had been drafted with the assistance of members of the Missouri Nurses Association and passed by the legislature in 1975.

Surrogate motherhood, as it is practiced today, differs only in insemination technique from this biblical effort. A married couple, unable to conceive because of female infertility, or, perhaps, a single male who desires a child would, as did Sarah, seek out a woman willing to act as a surrogate mother It is likely that the couple would make the initial contact through a classified advertisement and negotiate a contract with a fertile woman through their attorneys. The contract, in its most basic terms, would provide that the surrogate be artificially inseminated with the husband's semen, carry the child to term, and relinquish her parental rights upon birth of the child. Although there have been cases where a woman becomes a surrogate mother without payment, the surrogate mother typically receives a fee for her services as a carrier.

Over the past two decades, discussion has increased among health care professionals about joint or collaborative practice. In 1971, the American Nurses” Association (ANA) and the American Medical Association (AMA) established the National Joint Practice Commission to examine and make recommendations regarding the roles of physicians and nurses in the provision of quality health care. The Commission, comprised of three nurses and three physicians appointed respectively by the ANA and the AMA, defined joint practice as “nurses and physicians collaborating together as colleagues to provide patient care”. The purpose of this broad definition was to include all collaborating registered nurses, not only nurse practitioners.

In past decades, biomedical technology has created such advances that many health care professionals and consumers are overwhelmed by the apparently unlimited choices in treatment decisions. Problems in human reproduction, preservation of life, research on human subjects, and allocation of scarce resources are just a few of the categories of concerns that we now face. These dilemmas are complex both from conceptual and ethical perspectives. Thus, it becomes more and more difficult to define such important concepts as “human life” or ‘extraordinary treatment,” and to apply these concepts to clinical situations. It has become almost impossible to objectively interpret and apply ethical principles which should guide actions of health care providers.

School health nursing in the United States began in 1902 when a school nurse named Lina Rogers was placed in four New York City schools. Her work and that of twenty-five other nurses hired a month later quickly reduced the number of children excluded from school for communicable diseases from 10,567 in September 1902 to 1101 in September 1903. The number of excluded children could be reduced so dramatically because the school nurse was available to educate parents and staff and because she was able to make home visits to known cases of disease.

Surrogate motherhood has captured the attention of both the media and the legal profession in the past several years. Courts faced with litigation on surrogate motherhood have uniformly taken the position that these arrangements are contrary to public policy, and have refused to compel the specific performance of these contracts? It is my position that these rulings have been correct, and that if surrogate motherhood is to be considered legally acceptable in this country (which I think it should not be ) then state legislatures must act to legalize the contracts drawn up for these arrangements.

The procedure for surrogate motherhood is usually initiated by either a married couple, of whom the wife is infertile, or by a single man. In either case, a contract is made with a fertile woman; the woman is to be artificially inseminated with the man's sperm. Generally, this is done in exchange for a large sum of money. At the time that the baby is born, the surrogate mother surrenders the child for adoption by the wife (in the case of a married couple) and presumably by the father to regularize his relationship with the child.