Office Of Counsel Research Articles

Attitudes of Entering University Freshmen toward Foreign Language Study: A Descriptive Analysis

to everything yet are prevented by a two to three year implied limit from doing very much of anything. Recently, American legislators and educational policymakers at the state and university levels have been revising ideal curricular requirements once again to include the study of FLs. The views of these public figures appear in local newspapers, in high school counseling office posters, and in credentialing requirements for many universities. Little is known, however, about the explicit perceptions of entering university students concerning this educational thrust. What, if anything, do college-bound high school students hear, remember, or believe about the curricular arguments that reverberate around them as they register for courses that will ensure that their graduation requirements will be met? Does past experience in high school FL study affect their perceptions? When given an openended opportunity to discuss the importance of FL study, what arguments and opinions do they offer? OVERVIEW

From the Office of the General Counsel. Should practice parameters be the standard of care in malpractice litigation?

From the Office of the General Counsel. Should practice parameters be the standard of care in malpractice litigation?

Should Physicians Treat Patients Who Seek Second Opinions?

To the Editor. —The recent article from the Office of the General Counsel 1 explaining the American Medical Association's position regarding the legal implications for refusing to treat patients who are referred for a second opinion is alarming. Although it rightly points to each physician's right to refuse to treat a patient who is referred for a second opinion, and although it properly identifies a possible conflict of interest in treating such a patient, the main thrust of the article is its emphasis on the prohibition against any group of physicians agreeing to not treat patients sent to them for second opinions, because such a joint decision on their parts would be anticompetitive and a violation of the Sherman Act. Not only could the physicians who entered into such an agreement be subject to civil liability of treble damages, but they could also be subject to criminal penalties, including fine

From the Office of the General Counsel. Occurrence vs claims-made medical professional liability insurance policies. Fundamental differences in the concept of coverage

From the Office of the General Counsel. Occurrence vs claims-made medical professional liability insurance policies. Fundamental differences in the concept of coverage

From the Office of the General Counsel. HIV-infected surgeons: Behringer v Medical Center

From the Office of the General Counsel. HIV-infected surgeons: Behringer v Medical Center

From the Office of the General Counsel. Should physicians treat patients who seek second opinions?

From the Office of the General Counsel. Should physicians treat patients who seek second opinions?

Some Promotions Began Before, But Extended Into, Grace Period of AMA/PMA Guidelines

ABSTRACT EARLY this year, an East Coast obstetrician-gynecologist sent documentation to the general counsel's office at the American Medical Association (AMA) of a promotion by TAP Pharmaceuticals, a joint venture of Abbott Laboratories, Abbott Park, Ill.The promotion, called The Road to ACOG 1991 Sweepstakes, was intended to send 700 physicians to the American College of Obstetricians and Gynecologists (ACOG) meeting now in progress in New Orleans, La (May 5 through May 8).The trip was to include round-trip airfare, 4 nights' lodging, and the conference registration fee, all of which appear to violate basic provisions of the AMA—Pharmaceutical Manufacturers Association (PMA) guidelines that went into effect during the course of the promotion.Winners of the trip were selected in random drawings held monthly starting August 1, 1990, and ending February 1, 1991,2 months after the guidelines went into effect. Physicians could register repeatedly for the drawings through the mail or

Medical Law, Medical Ethics

To the Editor. — As a teacher of medical ethics, I have found it increasingly difficult to find cogent ways to explain the relevant differences between law and ethics to medical students. The article by Orentlicher, 1 though generally helpful and informative, contains a most startling sentence that will serve to complicate this issue further: In the absence of state law to the contrary, physicians and family members may act in accordance with good medical practice and the ethical standards of medicine. Statements such as this can generate widespread confusion, especially when they issue from the Office of the General Counsel of the American Medical Association. I do not know what Dr Orentlicher could possibly have intended by such a claim, but the implication that ethical behavior is (or ought to be) delimited by state law is clearly false. Without an explanatory argument to support it, I can only conclude

From the Office of the General Counsel. Denying treatment to the noncompliant patient

From the Office of the General Counsel. Denying treatment to the noncompliant patient

From the Office of the General Counsel. Reports to the National Practitioner Data Bank

From the Office of the General Counsel. Reports to the National Practitioner Data Bank

Drug Testing of Physicians: The Danger of False Positives

To the Editor.— Dr Orentlicher 1 of the American Medical Association's Office of the General Counsel appropriately considers the issue of false-negative results in his discussion of drug testing of physicians. He fails, however, to mention the equally important issue of false-positive results, apparently assuming that confirmatory tests (mass spectrometry and chromatography) are incapable of error. It is true that these techniques have admirably low rates of false positivity, less than 0.01%. 2 But it is axiomatic in laboratory medicine that tests are inevitably imperfect; neither absolute sensitivity nor absolute specificity can be achieved. It should also be obvious that no amount of chain-of-custody documentation can entirely prevent the occasional contamination or exchanging of samples. I have never used illicit drugs or misused legal ones. The probability of a true-positive test of my urine is exactly zero. The probability of a false-positive test, no matter how small mathematically, is finite

From the Office of the General Counsel. The right to die after Cruzan

From the Office of the General Counsel. The right to die after Cruzan

The Right to Die After Cruzan

In June 1990, the U.S. Supreme Court decided its first right-to-die case, Cruzan v. Director, Missouri Department of Health. Writing under the auspices of the American Medical Association's Office of the General Counsel, Orentlicher sumarizes the Court's holdings in Cruzan, draws several inferences from the decision about the right to refuse medical treatment, and discusses Cruzan's implications for physicians and patients. Orentlicher concludes that while the Court "eschewed an expansive construction of the right to refuse medical treatment, its decision...enlarged the right in many respects without restricting it in other respects... In any situation in which withdrawal of treatment was permissible before the Cruzan case, withdrawal is permissible now...in some situations in which withdrawal was not permissible before the Cruzan case, withdrawal is permissible now."

From the Office of the General Counsel. Economic considerations in treatment decisions and the standard of care in medical malpractice litigation

Writing under the auspices of the American Medical Association's Office of the General Counsel, Hirshfeld discusses the possible ramifications for malpractice litigation of economic pressures on physicians to withhold unnecessary treatment from patients. Liability is determined by comparing an individual physician's actions to the prevailing standard of care, which incorporates both objective evaluations of medical science and normative societal values. Many commentators are debating whether the standard of care will become less patient-oriented in order to accommodate society's need to control costs. Hirshfeld describes the role that physicians can play in the debate by exercising their influence to preserve the tradition of providing high-quality, patient-centered care. They can best do this by clearly defining the benefits of specific medical services and articulating where medical science ends and economic considerations begin in treatment decisions.

From the Office of the General Counsel. Tobacco advertising and the first amendment

From the Office of the General Counsel. Tobacco advertising and the first amendment

From the Office of the General Counsel. Drug testing of physicians

From the Office of the General Counsel. Drug testing of physicians

From the Office of the General Counsel. Advance medical directives

The American Medical Association's Board of Trustees recently issued a report on advance medical directives, Living Wills, Durable Powers of Attorney, and Durable Powers of Attorney for Health Care (AMA; 1989). Here Orentlicher, writing under the auspices of the AMA's Office of the General Counsel, offers an expanded version of that report. Orentlicher's article discusses the advantages and drawbacks of living wills, the appointment of a proxy decision maker through a living will, a durable power of attorney, or a durable power of attorney for health care, and the physician's role in implementing treatment preferences.

From the Office of the General Counsel. When health care payers have market power

From the Office of the General Counsel. When health care payers have market power

From the Office of the General Counsel. Practice parameters and the malpractice liability of physicians

From the Office of the General Counsel. Practice parameters and the malpractice liability of physicians

Consultation between University Counseling Centers and Offices of Residence Life: An Update

Consultation between University Counseling Centers and Offices of Residence Life: An Update