The HIV-infected health care provider. Doe v. Attorney General of the United States

Doe demonstrates that once an employer enters into a relationship with an individual and thereafter determines that he or she may be disabled, the employer has the right to ask the individual questions about the possible disability when those questions are relevant to assessing his or her qualifications for continuing on the job. In fact, once a health care provider is on notice that an employee's or physician's disability may render the employee or physician no longer qualified, thereby potentially endangering patients, the provider is required to determine whether the person is qualified for the job. In these sensitive matters, employers must draw a fine line between unreasonably following up on every rumor on the one hand, and on the other hand investigating reliable information when there may indeed be a direct threat to patients.     

Urban women's informal savings and credit systems in Zambia

This article is based on findings from semi-structured interviews and discussions among "chilimba" groups in Zambia. Chilimba groups are primarily women's groups that engage in credit and savings programs. Group membership ranges from 4 to 20 members. The women agree on a fixed, regular cash contribution that is given in turn to each member in a specified order. Market groups tend to be larger and contributions of about a dollar are made daily. Smaller groups tend to make larger, but less frequent contributions. Default is rare, as the commitment is taken very seriously. New members are added at the end of the rotation. Loans can be used for domestic or business use. Chilimba groups are evidence that very poor people desire savings. Chilimba brings together people with similar financial needs and resources. Chilimba does not require formal, written procedures or formal institutional frameworks. Chilimba is not a remedy for reducing overall poverty. It is appropriate only for people with some regular source of income. It does not serve as a safety net in emergencies. Long-term loans are not possible. A limitation is its openness and lack of structure that permit potential abuse. It is a livelihood strategy for women, but benefits could be gained from including men. It is urged that groups consider whether the position of the poor is being enhanced or undermined. Different models need to be tested. Members themselves must decide on the type and phasing of activities.     

The hospice movement and its implications

Hospices, unheard of in this country a few years ago, have become a fast-growing American phenomenon. They promise effective pain relief for terminal cancer patients as well as a warm, homey atmosphere where fear and loneliness are minimized. Hospices are basically a creation of the British and it is still unclear how--or even whether--the principles they embody can be successfully incorporated into American medicine. However, hospices can make an important philosophical contribution by showing the way toward removing the stigma attached to death. Hospice principles also have implications for all of health care, in emphasizing the importance of treating the whole person rather than just the disease.