Assisted suicide under the European Convention on Human Rights: a critique

In a high profile case, a terminally ill woman, Diane Pretty, challenged the United Kingdom prohibition on assisted suicide as incompatible with certain fundamental rights which are guaranteed under the European Convention on Human Rights. Mrs Pretty's battle was ultimately unsuccessful, with a total of three courts and 15 judges ruling against her. Such unanimity of opinion might well be thought to represent the coup de grace for arguments about the right to assistance in death under European human rights law. However, in this article it is suggested that, in limited circumstances, such assistance might yet still be possible under the Constitution.     

Use of registry employees can pose legal problems

In view of the potential legal liability to which a recipient entity can be exposed when using registry employees, some care must be taken in drafting registry contract services and in modulating the recipient entity's behavior towards the registry personnel. The following steps should generally be taken by health care establishments purchasing registry services to minimize such exposure: (1) Ensure that the registry treats its personnel as employees and complies with all applicable employment law obligations, including state and federal employment tax requirements, workers' compensation laws, and any state law wage and hour requirements in the recipient's state. (2) If using an out-of-state registry, make sure that the registry also has workers' compensation insurance in the recipient's state and complies with that state workers' compensation laws. (3) Make sure that termination decisions regarding registry employees are not made for reasons that violate any federal anti-discrimination laws. (4) Provide in the registry agreement for full indemnification by the registry to the recipient. (5) Ensure that the registry is solvent and has adequate insurance to honor its indemnification obligation. (6) Obtain a warranty from the registry that it carefully screens all of its employees before hiring them. (7) Expressly state in the registry agreement that the registry has the right to discipline and supervise the personnel it refers. (8) Do not reject registry personnel for reasons that would be improper with respect to the facility's own employees, e.g., race, sex, age, religion, disability, etc.     

Validation of the use of a commercially available kit for the identification of prostate specific antigen (PSA) in semen stains

PSA is currently being used to detect and monitor quantitatively the development of prostate cancer by serum levels of PSA and has also been found to be present in high concentrations in semen. Elegantly simple, sensitive, and reproducible methods have been developed for analysis of the presence of PSA, including the Tandem-E PSA Immunoenzymetric Assay. The most common procedures for the forensic identification of semen have focused on the microscopic detection of sperm, acid phosphatase activity, and immunoelectrophoretic methods for the detection of PSA. Although these methods have been used for many years, there are problems associated with each method. The Tandem-E PSA Immunoenzymetric Assay detected PSA in 100% of the forensic casework fabric samples, 80% of the forensic casework vaginal swabs and 100% of the vasectomized individuals tested. The cut-off value was determined to be 1.77 ng/mL. These results indicate that this method can be used to identify the presence of semen in forensically significant specimens.     

Genetic testing,genetic medicine,and managed care

As modern human genetics moves from the research setting to the clinical setting, it will encounter the managed care system. Issues of cost, access, and quality of care will affect the availability and nature of genetic testing, genetic counseling, and genetic therapies. This Article will explore such issues as professional education, coverage of genetic services, privacy and confidentiality, and liability. It will conclude with a series of recommendations for the practice of genetic medicine in the age of managed care.     

Laryngeal basement membrane thickening is not a reliable postmortem marker for SIDS: results from the Chicago Infant Mortality Study.

It has been suggested that laryngeal basement membrane (LBM) thickening is a pathognomonic postmortem marker for sudden infant death syndrome (SIDS) and is not seen in other causes of explained sudden infant death. To test this hypothesis, we evaluated longitudinal sections of the right hemilarynx taken through the midpoint of the true vocal cord from 129 SIDS cases and 77 postneonatal sudden infant death controls. Using a five-point semi-quantitative scale, maximum LBM thickness (LBMT) for SIDS cases and controls was not statistically different (mean, 2.39 + 0.69 and 2.40 + 0.77, respectively). Likewise, scores based on the average thickness along the entire basement membrane (i.e., "average" score), were not found to be different between SIDS cases and controls. Average and maximum LBMT increased with age in both SIDS cases and controls and were not different between SIDS cases and controls within each age interval. Similar trends in the distribution of maximum and average LBMTs were found between black and Hispanic SIDS and controls; the number of white/non-Hispanic infants was too low for meaningful comparisons. Maximum and average LBMTs were not different in SIDS cases and controls exposed to environmental tobacco compared with unexposed infants. The LBMTs also increased significantly with body weight and length in both SIDS cases and controls. Finally, there were no differences in LBMT in infants intubated prior to death compared with those who were not intubated. From these data, we conclude that LBMT is not pathognomonic of SIDS, is present or absent with equal frequency in SIDS and controls, increases with postnatal age, and does not correlate with passive smoke exposure. Therefore, LBMT should not be used to diagnose SIDS.