Book reviews

Transcaucasian Boundaries John F. Wright, Suzanne Goldenberg and Richard Schofield (editors) London: UCL Press, 1996, 248pp, £40 and £14.95

The Russian Policy Debate on Central Asia Irina Zviagelskaia London: Royal Institute of International Affairs, 1995, X, 41 pp, £12.50

CIS Integration Trends: Russia and the Former Soviet South Mark Webber London: Royal Institute of International Affairs, 1997, IX, 72 pp, £12.50 Both distributed by Plimbridge Distributors Ltd, Estover Road, Plymouth. Devon PL6 7PZ, and in North America by the Brookings Institutional Press, Washington DC.

Russia and Azerbaijan: A Borderland in Transition Tadeusz Swietochowski New York: Columbia University Press, 1995, xvi, 290 pp, $34.95

The Soviet Socialist Republic of Iran, 1920–1921 Cosroe Chaqueri Pittsburgh, Pa: University of Pittsburgh Press, 1995, xvii, 649 pp, $75.00

Bibliography of Islamic Central Asia Yuri Bregel (editor and compiler) Bloomington, Indiana: Research Institute for Inner Asian Studies, Indiana University, 1995, in three volumes: Pt. I, LXXTV+773 pp; Pt. II, XLIII+774–1512 pp; Pt. III, XXXII+1513–2276 pp, $299

Mohieddin Alempour. A Tajik Visionary Baqer Moin (editor) London: BBC Persian Service, Bush House, 1997, illus, 140 pp, £20

Tatar Costume M. Zavyalova Kazan: Zaman Publishers Fund Turan, 1996, illus, 252 pp, $50     

Arising from the dead: challenges of posthumous procreation

The medical capabilities derived from modern reproductive technology, such as in vitro fertilization and cryopreservation, have enabled physicians and scientists to intervene in the procreative process in innumerable ways. However, this intervention in the natural reproductive process raises both moral and legal concerns. In this Article, Professor Schiff explores some of the conflicts that may result when an individual or couple elects to cryopreserve gametes or embryos and subsequently, one or both of the contributors dies, or when gametes are harvested from a dead body. This Article will specifically address the moral and legal responses to circumstances where the decedent has either clearly expressed opposition to posthumous use of the reproductive material or else the decedent's intent regarding posthumous use of the material is ambiguous. By discussing philosophical and moral positions relating to personhood and the body and analyzing legal issues such as reproductive choice and organ donation, Professor Schiff creates the necessary format to examine and recommend the proper legal treatment of this controversial aspect of posthumous procreation.     

The need to know versus the right to know: privacy of patient medical data in an information-based society

"Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret."(1) "Safeguards to privacy in individual health care information are imperative to preserve the health care delivery relationship and the integrity of the patient record."(2) As early as the fourth and fifth centuries B.C., Hippocrates contemplated the importance of medical information to the care and treatment of patients. His oath suggests that privacy of a patient's medical information creates the foundation upon which a patient reposes trust in his or her physician. While defining the earliest version of the physician-patient privilege, the oath does not envision the extent of modern day access to healthcare information. A patient's relationship with the modern healthcare delivery system often includes a team of physicians, nurses, and other clinical support personnel. This relationship extends beyond direct caregivers and may include healthcare administrators, payor organizations, and persons unfamiliar with a patient's identity, such as researchers and public health officials. Accessing a patient's medical information links these participants to the patient's healthcare delivery relationship. The Hippocratic Oath does not contemplate such broad access, nor does it contemplate the emerging privacy crisis resulting from the application of computer technology to medical record storage and retrieval. The combination of broad access, individual privacy rights, and computer technology requires a rethinking of measures designed to protect the realities of the modern medical information society.     

Genetic discrimination: Huntington's disease and the Americans with Disabilities Act

This Note discusses the potential for genetic discrimination, current views as to whether genetic conditions will be covered by the Americans with Disabilities Act ("ADA"), and the specific issue of whether presymptomatic persons who test positive for Huntington's disease should be classified as persons with a "disability" within the meaning of the ADA. In considering whether presymptomatic Huntington's individuals have a disability under the ADA, an analogy is made between Huntington's disease and HIV-positive status. Inter alia, Huntington's disease and HIV-positive status are analogous in that, at the time of diagnosis, victims of both diseases may have no symptoms and may remain healthy for a number of years; but even though the exact time of onset of both diseases is unascertainable, death of both victims within a given range of years is highly likely. Further, both Huntington's disease and HIV are transmitted to offspring at a relatively high rate. Given these similarities, the author argues that Huntington's individuals should be afforded the protections of the ADA for the same reasons that HIV-positive persons are protected.     

MEDGuide and patient package inserts--again?

This article will trace the history and effects of the PPI from the time of its original concept by the FDA in the early 1970's to its current status. It will also address the response to this FDA initiative by the industry, medical community and consumer groups. Initiatives in other countries and future issues will also be discussed.