The Evanston initial decision: is there a future for patient flow analysis?

This Article analyzes the October 2005 Initial Decision of the Federal Trade Commission Administrative Law Judge ordering Evanston Northwestern Healthcare Corporation to divest Highland Park Hospital on the grounds that the January 2000 merger of the entities violated Section 7 of the Clayton Act. In particular, this Article focuses on the ALJ's discussion of the use of patient flow analysis and the Elzinga-Hogarty test in defining relevant markets in hospital merger cases. Despite the ALJ's explicit rejection of the Elzinga-Hogarty Test and patient flow analysis as irrelevant and inappropriate in defining markets in the highly differentiated Hospital market, the author concludes that the ALJ's rejection of patient flow analysis likely was a response to misplaced and over-reliance on patient flow analysis by a number of courts in past prospective government challenges to hospital mergers as evidenced by the fact that the ALJ's analysis of competition and competitive effects relied upon, and thereby implicity endorsed, the use of patient flow analysis for certain purposes. Finally, the author concludes that patient flowanalysis, when used appropriately, should continue to be used as a preliminary step in geographic market definition and competitive effects analysis.     

The external occipital protuberance: can it be used as a criterion in the determination of sex?

Sex determination of a corpse can be problematic in cases where the body is damaged. Useful criteria would assist in the identification of sex in such cases. The goal of this study is to determine the usefulness of the external occipital protuberance (EOP) in the determination of sex, especially in lateral cranium radiographs. The types and configurations of the EOP were investigated on normal lateral cranium radiographs of 1000 subjects (500 males and 500 females) and 694 dry-skull remains (371 males and 323 females) from a 16th Century Anatolian population for the purpose of sex determination. In the radiographic examination, the incidence of less prominent (Type 1) EOP is found to be 85.4% in females whereas 17.8% in males. The spine type (Type 3) EOP is found to be 63.4% in males and to be 4.2% in females. On the other hand, studies of dry-skull remains revealed the incidence of Type 1 EOP to be 67.5% in females and Type 3 EOP to be 55.2% in males. The crest type (Type 2) EOP is approximately equal in both sexes and is found to be less valuable for sex determination in both groups.     

Ethical issues in managed care: can the traditional physician-patient relationship be preserved in the era of managed care or should it be replaced by a group ethic?

Over the last decade managed care has become the dominant form of health care delivery, because it has reduced the cost of health care; however, it has also created serious conflicts of interest for physicians and has threatened the integrity of the traditional physician-patient relationship. In this Article, Dr. Grochowski argues that the efficiencies created by managed care are one time savings and will not in the long run reduce the rate of rise of health care expenditures without a concomitant plan to ration health care. He explores the traditional physician-patient relationship and concludes: a) that while rationing of health care is inevitable, physicians must not ration care at the bedside; b) that physicians must be advocates for their patients; c) that physicians must avoid conflicts of interest whenever possible; d) that physicians must put the needs of the patient before their own self-interests; and e) that physicians must act in ways to promote trust in their relationship with patients.     

Doctors in the executive suite: should the U.S. and U.K. be putting M.D. licensure at risk for shortfalls in institutional quality of care?

As our healthcare system becomes further managed, delivery organizations are reincreasingly relying upon physician executives to administer the delivery of care by other individual providers. In both the United States and the United Kingdom, this has led to instances in which physician disciplinary procedures have been invoked with respect to physicians who are perceived to be responsible for institutional defiiciencies. The author examines and analyzes the contrasting approaches taken in the two countries, and recommends an activist approach for disciplinary agencies faced with these circumstances.     

A ‘Life-Style Choice’ or a Philosophical Belief?: The Argument for Veganism and Vegetarianism to be a Protected Philosophical Belief and the Position in England and Wales

Liverpool Law Review - The recent judgment in Casamitjana Costa v The League Against Cruel Sports in England and Wales held that ethical veganism was a protected philosophical belief under...     

Does a therapeutic court context matter?: The likelihood of imprisonment for Indigenous and non-Indigenous offenders sentenced in problem-solving courts

A key aspect of the focal concerns perspective of sentencing is that time and information restrictions within the courtroom create the conditions under which perceptual shorthands may impact sentencing determinations. These shorthands are based stereotypes related to offender characteristics including minority group statuses (i.e. ethnicity, race, Indigenous status) (Steffensmeier et al., 1998). To date, sentencing scholars drawing on the focal concerns perspective have only considered the impact of minority group statuses on sentencing in the mainstream courts (Mitchell, 2005; Spohn, 2000). Utilizing multiple regression techniques the current paper explores the impact of Indigenous status on the decision to imprison in the problem solving courts of South Australia. Unlike the mainstream courts, sentencing determinations within the therapeutic problem-solving court environment involve a more extensive examination of offenders and their cases and by extension, perceptual shorthands should be less influential. Evidence supporting this argument is provided by the current research. Results show a direct relationship between Indigenous status and the likelihood of imprisonment, with leniency being extended to Indigenous offenders.     

Operationalizing The Law of Jurisdiction: Where in the World Can I Be Sued for Operating a World Wide Web Page?

The concept of personal jurisdiction-the power of a court to decide the rights of a person and issue a binding judgment-is becoming increasingly complex in cases involving the World Wide Web. The two approaches courts currently use to assert personal jurisdiction are inadequate and inconsistently employed, leaving individuals who perform services or conduct business over the Web without clear answers about where they may be haled into court. The "Zippo test" fails to consistently take an accurate account of the complete picture of the contacts generated from Internet use, and the "Calder effects test" is not applicable in all cases. This article outlines a "Web-contacts" approach as a consistent way to operationalize "purposeful availment" for personal jurisdiction based on contacts via the Web.     

The Google conundrum: Perpetrator or facilitator on the net? - Forging a fair copyright framework of rights, liability and responsibility in response to search engine 2.0 - Part II: The Google Books Search Project

Is Google in its quest for search engine optimization through the creation of new technologies, which not only improves its search algorithms but also refines its search functions for users, doing it in a manner that makes it a perpetrator of primary copyright infringement or an invaluable facilitator for Internet functionality? How should the balance of interests in the treatment of creative works be recalibrated in the face of changes in search engine technology and operations, and the disputes that have arisen within the last decade in the context of the digital age and its needs? Using Google as a case study, this paper will look at the two main areas of dispute over the operations of information locator tools and services that either threatens search engine functionality and efficiency or weakens copyright holders’ exclusive rights. It proposes a concerted set of solutions through a reassessment and amendment of copyright law to optimize the social benefits and objectives of both the copyright regime and technological innovations in the electronic model of information archiving, indexing and delivery. A fair distribution of responsibilities and allocation of rights and liabilities will be suggested. In the process, due consideration will be given to both public and private interests, with the former taking precedence; while the recommended solutions will be made within the currently outdated framework for Internet intermediary protection (i.e. safe harbor laws) and exceptions (i.e. specific statutory exemptions and the general fair use defense) under the existing copyright regime. Thus, the proposed changes will be far reaching without being too radical a departure from current law, an evolution that will likely be more acceptable and realistic a solution to the problem.This paper is published in two parts. Part One of this paper published in the previous edition of the CLSR at [2011] 27 CLSR 110-131 dealt with the challenges to the copyright regime posed by the operations and technology behind the Google Images Search Engine, while Part Two will assess the benefits of the Google Books Search Project vis-à-vis the effects it will have on the scope of copyright protection. Recommendations are made to copyright law to accommodate both functions while generally preserving the main objectives of copyright protection.     

The “process” of patenting: Why should we care about a potential U.S. Supreme Court decision in Bilski v. Doll?

In Bilski v. Doll, the U.S. Supreme Court is called to define one of the categories of patent-eligible subject matter, “process” patents. In 2008, the Court of Appeals for the Federal Circuit held that the category has a narrow meaning, and that to be eligible for a process patent under 35 U.S.C. § 101, the invention must involve a machine or apparatus or involve a transformation to a different state or thing, ultimately rejecting the patent application as unpatentable subject matter. The patent applicants have asked the U.S. Supreme Court to determine two issues: first, the meaning of “process” in 35 U.S.C. § 101 and whether the lower court properly relied on a “machine-or-transformation” test, and second, the test's potential conflict with 35 U.S.C. § 273, which provides protection for “method[s] of doing or conducting business.” The Court's decision could change the way that research and business are done, and patent protection for such investments. Parts 1 and 2 of this article address Bilski directly and what is and is not in dispute. Part 3 addresses the “machine-or-transformation” test, while Parts 4 and 5 address reasons not to adopt such a test.