Medicine and law
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Market forces have been introduced in the health care systems of many European countries. Fundamental to the introduction of the market was the need to distinguish between the roles of purchaser and provider. In this article the authors have analyzed the consequences of contracting and the purchaser-provider split from both a legal and organizational perspective. ⋯ Including the legal and organizational dimension into these economically oriented models, these models can also be used for analyzing recent trends and developments. A four-country analysis indicates trends towards convergence of health care systems and both decentralization and integration in the systems. The future roles of both managers and lawyers working in health care need to be further defined.
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Modern neonatal intensive care technology enhances the ability to maintain vulnerable newborns. In some circumstances survival may be insufficient justification for care. "End of life" strategies, originally applicable to adults, are being considered for newborns. Unresolved ethical issues in the care of these newborns involve multiple considerations. ⋯ The benefits to a newborn of treatment may fail to overcome the burdens of subsequent life. Under what circumstances a newborn loses the right to have life prolonged becomes a difficult ethical issue. With time and debate the proper response will become implemented.