Walter Wadlington

Selection of Patients for Artificial and Transplanted Organs

Abstract This study examines the critical ethical and legal dilemmas of patient selection that medical progress in artificial and transplanted organs is producing. We approach the problem by giving...

Adoption. The rights of parents versus the best interests of their children.

Abstract Adoption for the benefit of children is a relatively recent historical development which continues to be influenced by the concept of children as the property of their biological parents. Courts cannot make objective findings that a child is abandoned, is in need of an adoptive home, or is in fact already a member of a family which does not include his biological parents. The courts attention is first directed to terminating parental rights, which can be accomplished only in extremes of parental behavior. Substantial changes in current practices can occur primarily through new legislation stipulating that the interests of children are to be at least equal to the rights of their parents.

Legal responses to patient injury: a future agenda for research and reform.

Concern about liability for medical malpractice pervades our health care delivery system. A national data bank mandated by Congress now tracks all paid malpractice claims against physicians as well as information about disciplinary actions. When the Physician Payment Review Commission seeks to reform Medicare fees for physicians, an integral task is computing increments for reimbursing liability insurance premiums. Liability issues can affect medical decisions from obstetrical choice of delivery methods at the beginning of life to a determination whether to withdraw artificial life support at its end.

Consent to Medical Care for Minors

Whether minors should be accorded greater authority to make binding decisions on matters involving their personal welfare is a subject of considerable dispute today. After the 26th Amendment to the U.S. Constitution in 1971 assured that 18-year-olds could vote, many states lowered the general age of majority under their laws to conform with the voting age. Another catalyst for change was the concern that many statutes were vulnerable to constitutional challenge because they maintained differing ages for majority, or for marriage, based on sex.1 Some states lowered the general age of majority but retained (or added) higher minimum age requirements for acts such as purchasing alcoholic beverages. (Virginia, for example, permits a person to marry without consent at age 18 but not to purchase champagne—even for the wedding—until age 21.2) As a result of this somewhat haphazard process, the rules regarding majority today are a melange of legal anachronism and contemporary expediency which reflect only minimally our current understanding about the intellectual and emotional capacities and interests of young persons.