“Comorbidity” of behavioral, emotional, and cognitive problems in adolescence

The purpose of this study was to examine in a sample of 11,516 secondary school students the extent to which different behavioral, emotional and cognitive problems (a) reflected one or more underlying common factors; (b) actually cooccurred; and (c) were single problems. Principal Component Analyses were performed and percentagewise techniques were used. PCA demonstrated that one or more general syndromes could not by far account for all of the variance of the variables. The results suggest the existence of adolescent subgroups with divergent comorbidity patterns: those who primarily report one single symptom; those who report concurrent symptoms either exclusively in the category of behavioral problems or exclusively in the category of emotional and cognitive problems; and those who report concurrent symptoms in both categories. This distinction between different subgroups has important theoretical, diagnostic, and treatment implications.     

Book reviews

Ash Amin and John Tomaney (eds), Behind the Myth of European Union: Prospects for Cohesion (Routledge, London, 1995), 334 pp., ISBN 0–415–13078–6 (pb)

Stephen Gundle and Simon Parker (eds), The New Italian Republic: Front the Fall of the Berlin Wall to Berlusconi (Routledge, London, 1996), 334 pp., ISBN 0–415–12161–2 (hb), 0–415–12162 (pb)

Donald Sassoon, One Hundred Years of Socialism: The West European Left in the Twentieth Century (I. B. Tauris, London, 1996), 965 pp., ISBN 1–85043–879‐X

Geoff Mulgan, Connexity: How to Live in a Connected World (Chatto & Windus, London, 1997), 280 pp., ISBN 0–7011–6396–8     

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.