The genetics of secrecy in adoption, artificial insemination, and in vitro fertilization

In light of the significant role that heredity plays in many disease processes, statutes requiring strict secrecy with regard to medical records in cases of adoption, artificial insemination and in vitro fertilization should be reassessed. In adoption cases, attitudes concerning the adoptee's ancestry have progressed over the century, but adoptees still are unable to access their records. The problem of inaccessibility is also apparent in medical genetics clinics where valuable genetic information, necessary for an accurate diagnosis, is unavailable to the clinic, the adoptive parents, and the birth parents. A uniform law which responds to these interests and problems should be promulgated. This Note discusses the need for better access to and availability of medical records. The Note proposes a Uniform Act and suggests that, at a minimum, it include a scheme for regulating the donation of genetic material, strong record-keeping requirements with respect to family histories and pedigrees, and finally, an open access provision for certain information for both children and parents.     

Ethics and AIDS: a summary of the law and a critical analysis of the individual physician's ethical duty to treat

Persons afflicted with acquired immune deficiency syndrome (AIDS) or its preceding medical conditions face a potential problem with assured access to basic threshold medical care. Subject to certain limitations, there is no guarantee that a physician will fulfill the health care needs of any population of patients. Individuals with AIDS, thus, have a considerable interest in the development of a duty on behalf of physicians to provide treatment. This Note first highlights the limits of the legal duty to treat. It then examines the theoretical impetus propelling an ethical duty to treat. The Note concludes that the grounds for imposing an ethical duty on physicians are too weak to support that result, but the creation of an AIDS-specific legal duty is a viable alternative.     

Helping women understand their risk in situations of intimate partner violence

Only approximately one-half of the 456 women who were killed or almost killed by a husband, boyfriend, or ex-husband or ex-boyfriend in a recent national study of homicide of women accurately perceived their risk of being killed by their abusive partner. Women are unlikely to overestimate their risk; however, many will underestimate the severity of the situation. From the same study, it was found that relatively few of the victims of actual or attempted intimate partner femicide were seen by domestic violence advocates during the year before they were killed; they were far more likely to be seen in the health care system. Implications are drawn as to innovative ways that women who are abused can be identified and with skilled assessment of the danger in their relationship helped make more informed plans for their safety.     

Moving from secrecy to transparency in the offensive cyber capabilities sector: The case of dual-use technologies exports

Transparency is central to the prevention of human rights abuses. Over the past few decades, a belief in transparency has permeated multiple industries, reflected in an explosion of legislation intended to further this principle. Yet, despite this emphatic recognition of the importance of transparency, the activities of government and private sector actors involved in the development, sale, and export of Offensive Cyber Capabilities (OCC) remain cloaked in secrecy regardless of the sector’s role in facilitating human rights abuses. In this article, we tackle this broader challenge of secrecy via a case study on the export of dual-use technologies. We theorize why secrecy has been so prevalent in the OCC sector. We consider the role of different forms of secrecy—such as commercial secrecy and opportunistic secrecy by governments—in facilitating this situation. We argue that injecting greater transparency into the OCC sector is critical to deterring human rights abuses through accountability and oversight, can help counter the proliferation of offensive cyber technology proliferation, and can ensure better overall governance in regimes governing the export of dual-use technologies. Mandating transparency by governments and exporting companies in the OCC sector can pave the way for policy changes to better regulate this industry and finds support in international human rights principles related to transparency. In closing, we examine how transparency might be incorporated into export frameworks addressing dual-use technologies.     

The duty to warn/protect: issues in clinical practice

The duty of therapists to warn or protect third parties when a patient expresses a threat was established by the court in the Tarasoff decision. Confidentiality, disclosure, and prediction of violence are clinical, ethical, and legal issues that the therapist must address in the context of a therapeutic relationship. Clinical case material from the literature, as well as cases from the authors' experiences, indicate that when confidentiality is breached and a potential victim is warned, the therapeutic results may be positive, especially if the patient participated in the process. Other methods of protection, such as commitment, use of medications, police involvement, and confiscation of a weapon, may be necessary. Each case deserves individual consideration as to what appropriate and necessary steps should be taken. Through careful assessment of a patient's threats, concern for the patient and victim, adherence to ethical standards of care, and knowledge of the law, one can often protect a victim as well as engage the patient in an ongoing therapeutic relationship.