Unwarranted variations in the quality of health care: can the law help medicine provide a remedy/remedies?

This Article reviews the essential findings of studies of variations in quality of care according to three categories of care: effective care, preference-sensitive care, and supply-sensitive care. It argues that malpractice liability and informed consent laws should be based on standards of practice that are appropriate to each category of care. In the case of effective care, the legal standard should be that virtually all of those in need should receive the treatment, whether or not it is currently customary to provide it. In the case of preference-sensitive care, the law should recognize the failure of the doctrine of informed consent to assure that patient preferences are respected in choice of treatment; we suggest that the law adopt a standard of informed patient choice in which patients are invited, not merely to consent to a recommended treatment, but to choose the treatment that best advances their preferences. In the case of supply-sensitive care, we suggest that physicians who seek to adopt more conservative patterns of practice be protected under the "respectable minority" or "two schools of thought" doctrine.     

Evaluation of a national prison-based treatment program for sexual offenders in England and Wales

Treatment efficacy is described for a sample of sexual offenders who had undertaken treatment in United Kingdom prisons (N = 647) and for a retrospectively selected comparison group (N = 1,910). The outcomes under observation in this study were sexual, sexual and/or violent, and general reconviction. Treatment impact was also examined in relation to offenders' risk of reconviction. The treatment group had slightly lower 2-year sexual reconviction rates than the comparison group, but these differences were not statistically significant. Significant differences were found between the treatment and comparison group for sexual and/or violent reconviction. Further analysis suggested that treatment produced a reduction in the probability of sexual and/or violent reconviction (p <.05) when other relevant variables were controlled for. General reconviction rates were consistently lower in the treatment group, but these differences were not significant.     

Recent developments in privacy legislation

In this article, Ruth Carey takes a critical look at recent privacy-of-personal-information legislation drafted in three Canadian provinces--Ontario, Alberta, and British Columbia. The article begins with a historical overview of international legal instruments and other privacy guidelines, and the Canadian experience with privacy protection. It then critically analyzes the provincial initiatives in the context of the federal Personal Information Protection and and Electronic Documents Act and accepted privacy principles. The article goes on to highlight certain types of legislative provisions of particular interest to people with HIV/AIDS and those who advocate on their behalf. It concludes that the numerous legislative initiatives underway in Canada provide an opportunity to alter the public discourse around the virus, thereby improving the lives of people with HIV/AIDS.     

Ontario: people can now apply for forced HIV testing in certain situations

Ontario has finally issued a regulation to accompany its controversial "blood samples" legislation, passed in 2001. As a result, in certain circumstances, a person in Ontario can now seek an order to require another person to be tested for HIV, hepatitis B (HBV), and hepatitis C (HCV). However, the regulation contains a number of restrictions on the ability to apply for such an order.     

The Jewish Mother turned monster: Representations of motherhood by Hebrew women novelists 1881–1993

The paper discusses the changes in the representation of motherhood in Hebrew novels written by women within the span of a century. The outline of the changes is found to be similar to the general trend discernible in women's writing in the West, despite the anomalous history of Hebrew literature. In most general terms, the history of the mother in these novels might be outlined in terms of a move from absence to presence, from silence to voice, from passivity to activity, from asexuality to overt promiscuity, from submission to aggression. Given the culturally ingrained model of the Jewish Mother that the novelists have to cope with, this move is shattering. The mother, who was neglected or even suppressed in the earlier novels, returns, with a vengeance, in more recent ones. The vengeance, though, may prove excessive.