The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics
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This essay discusses the challenges faced by veterans returning to society in light of the current organization and structure of the military, veterans', and overall U. S. health care systems. ⋯ Although they perform their mandates with extraordinary commitment and demonstrably high quality, both systems need to explore improved communication, coordination, and sharing, as well as increased collaboration with the Department of Health and Human Services programs serving the same populations, far beyond current efforts. The health care-related missions and the locus of health care delivery of each agency are admittedly unique, but their distinctions must not be permitted to impede system integration and coordination of a continuum of care provided to the men and women who serve the nation, and their families.
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A resounding debate has ensued over the utility of race in biomedical research, particularly as new drugs claiming to serve particular racial populations attempt to enter the marketplace. This creates a number of challenges for the Food and Drug Administration over how best to regulate new drugs seeking race specific indications. This article suggests that it may be beneficial for the FDA to turn to an area with experience negotiating such dilemmas--Constitutional Law--and its approach--strict scrutiny--to help guide when and under what circumstances Government should give effect to racial categories in biomedicine.
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Research technologies can now produce so much information that there is significant potential for incidental findings (IFs). These are findings generated in research that are beyond the aims of the study. ⋯ We advocate a defined set of researcher duties based on law and ethics and recommend a pathway to be followed in handling IFs in research. This article traces the underlying ethical and legal theories supporting researcher duties to manage IFs, including duties to develop a plan for management in the research protocol, to discuss the possibility of and management plan for IFs in the informed consent process, and to address, evaluate, and ultimately offer to disclose IFs of potential clinical or reproductive significance to research participants when they arise.
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Empirical studies and ethical-legal analyses have demonstrated that incidental findings in the brain, most commonly vascular in origin, must be addressed in the current era of imaging research. The challenges, however, are substantial. ⋯ Risks, including a blurring of boundaries between research and clinical practice, must be weighed against the possible benefit to subjects and a moral duty to inform. Identification and examination of these challenges have been met by scientific interest and a robust, interdisciplinary response resulting in the pragmatic recommendations discussed here.
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This article provides an overview of why health insurance matters, a profile of the uninsured, and a discussion of the roles and limits of private and public health insurance as sources of coverage. It concludes with reflections on the current health insurance environment and prospects for reform.