Medicine and law
-
Women are often excluded from the process of medical decision making during pregnancy, even though medical decisions that are made by health care professionals affect them personally and affect the future well-being of the unborn. Women in general and pregnant women in particular, will feel the impact of new genetic tests and technologies, designed to predict and even treat certain genetic problems during pregnancy, through prenatal diagnosis, foetal surgery and foetal gene therapy. ⋯ This article raises, but does not answer, several important issues regarding the implications of new developments in genetic testing that will affect pregnant women's autonomy in medical decision making. The article concludes that, although there are United States constitutional protections for the right to abortion and in turn, therapeutic abortion, an unfavourable chain of precedents regarding women's autonomy during pregnancy makes it imperative that there be strong legislation providing assurances that information will be given to pregnant women about the genetic testing process; that women will be made aware of their right to refuse treatment; that the law will require health care professionals to give adequate information to pregnant women regarding possible treatment outcomes in order to make an informed choice; and that there will be adequate protection for the right to confidentiality of information regarding prenatal prognosis, in order to safeguard autonomous decision making during pregnancy.
-
Comparative Study
The influence of age on injury severity of restrained front seat occupants in head-on collisions.
This excerpt is part of a large-scale retrospective study on the interrelationship between accident severity and injury severity. A multivariate analysis of 319 cases of restrained front seat occupants involved in car-to-car head-on collisions showed the significant influence of the energy equivalent speed (EES) and age of the occupants on the number of rib fractures and sternum fractures. Three hundred occupants sustained no rib fractures, nine occupants one to 16 rib fractures, and ten occupants 17 to 32 rib fractures. ⋯ In post-mortem simulations the number of rib fractures and sternum fractures was influenced by vehicle decelerations and the age of the test subjects. The number of rib fractures increased at higher collision speeds, higher decelerations and increased age; the number of sternum fractures increased at higher deceleration and increased age of the test subjects. Seventy-two per cent of the test subjects with sternal fractures had rib fractures; 91% of the subjects with rib fractures had sternal fractures.
-
Medical science needs to regulate the transplantation of organs, including the adoption of new guidelines concerning the diagnosis of brain death in patients less than five years old. In fact in the case of anencephalic infants the specific criteria are not the same as those used in subjects with normal physical development. The authors indicate the international medical point of view on what constitutes the diagnosis of brain death in anencephalic infants and discuss medicolegal and ethical aspects.
-
Advancements in techniques of medical technology have made it possible to postpone death, which, in many situations, amounts to nothing more than a protracted process of dying rather than a prolonging of life. This, together with the fact that these techniques are prohibitively expensive has brought to the fore difficult and extremely uncomfortable problems in medical ethics, especially with regard to who should have and who should not have high technology medical treatment. ⋯ Normally it is imperative that individuals make their own autonomous decisions in respect of medical treatment but there are times when consent is of secondary importance and when autonomy must of necessity be limited. However, information concerning medical decisions in intensive care should always be freely available to patients and their surrogates.