Patient termination of a life-sustaining medical device: Suicide or natural death?

Medical technology has made tremendous strides in extending the lives of patients who have suffered organ failure. Machines can now replace the function of the kidneys, the heart, and other vital organs. Much has been written about a patient's right to refuse or direct the withdrawal of medical treatment, especially at the end of life, under the guise of “death with dignity.” However, little attention has been paid to the situation where a patient elects to deactivate their life-sustaining medical device without a physician's involvement. This raises the challenging question of whether the patient's manner of death should be classified as suicide or natural. Surprisingly, common law, statutes, medical ethics, and public health practice are not in alignment on the answer. This article will explore the ramifications and far-reaching impact that such divergence has on the survivors and the medical community, as well as recommend corrective actions and practical approaches for the medical and legal practitioner.     

Inquiries on intraspousal transmission of hepatitis C virus: benefits and limitations of genome sequencing and phylogenetic analysis.

During recent years, courts had to decide in some notable cases whether or not defendants infected the plaintiffs with HIV. Lawsuits on the transmission of other viral pathogens up to now have hardly become known. We report here on the use of genome sequencing and phylogenetic analysis to investigate possible intraspousal transmission of hepatitis C virus (HCV). The high degree of genetic relatedness observed in phylogenetic analysis among the HCV strains isolated from the couple demonstrates that the man and the woman are infected with the same isolate of the virus. After other plausible routes of infection have been virtually excluded by anamnestic and conventional epidemiological evaluation we could infer that the man most probably has infected his girlfriend with HCV. This conclusion was further supported by the finding that both are also infected with closely related isolates of GB virus C (GBV-C). Thus, the results from molecular biological investigations and epidemiological evaluation are complementary pieces of evidence in inquiries on possible intraspousal transmission of HCV.     

Acknowledging the Other Side in Negotiation

In a negotiation study, we investigated the efficacy of acknowledging an opponent's role in securing a concession made to that opponent. The study featured a face-to-face, one-shot bargaining session between a student favoring marijuana legalization and a confederate playing the role of a legalization opponent. When the confederate acknowledged the student's putative influence in producing a concession by the confederate, the student perceived the magnitude of the concession to be greater and was more likely to accept it. The student negotiators also reported that they liked the other party more following acknowledgement, and our mediational analysis suggested that enhanced interpersonal sentiments played a role in facilitating agreement. In this article, in addition to documenting these findings, we also discuss their implications, both for theoretical analyses of conflict and negotiation and for the practical problem of settling disputes.     

Single primer extension (SPEX) amplification to accurately genotype highly damaged DNA templates

High levels of non-authentic sequence data can be generated by traditional PCR-based methodologies when DNA is damaged, template numbers are small and/or the target amplification size too large. We therefore present an alternate methodology based on single primer extension (SPEX) amplification; that places no pre-defined size constraints on amplification and interacts with only one of the DNA strands at the target locus.