The Medical staff counselor
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This two-part article examines the statutory framework in New York State for the issuance of DNR orders. Part I addresses the procedure for issuance of a DNR order, including determination of capacity to consent to issuance, the effect of consent to a DNR order by an adult patient or a surrogate, issuance of a DNR order for an adult who lacks capacity and for whom no surrogate is available, and consent to DNR on behalf of a minor. Part II, which will appear in the next issue of this journal, will address revocation of consent to, and cancellation of, DNR orders, the dispute mediation system, the role of the courts, and the effects of a DNR order. [Note: As this article was going to press, the New York State Legislature passed a statute (1991 N. ⋯ Laws Ch. 370) that amends New York Public Health Law Article 29-B, discussed herein. As a result of these amendments, some of the provisions discussed in Part I have been modified. A summary of these modifications will appear in Part II.]
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This article discusses the duties of hospital governing boards, medical staffs, medical staff officers, and individual medical staff members regarding the credentialing of physicians, including the potential liability of these groups for negligent medical care and wrongful denial of staff privileges. This article also proposes possible measures these groups may take to avoid or limit their exposure to such liability.
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This article describes some of the issues relevant to the different kinds of contracts that are likely to be offered to physicians entering private practice upon completion of residency programs or in the early years of practice and discusses how such issues can be resolved in the course of negotiating those contracts.
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In today's increasingly competitive medical practice environment, legal challenges to credentialing decisions abound. To minimize the risk of liability, hospitals and their medical staffs must be especially careful when adopting and applying the criteria for medical staff membership.