Informed consent issues in the cardiac transplantation evaluation

As consultation-liaison psychiatrists to a cardiac transplantation team, we have observed various informed consent issues that are particularly associated with evaluation for cardiac transplantation. We discuss complicating factors that relate to each component of informed consent and present the defense mechanism of denial as a barrier to making the decision to accept or refuse transplantation. Changes in the evaluation protocol could preclude existing impediments to provision of information and patient autonomy; however, certain intrapsychic issues must be recognized as ongoing clinical realities to be addressed as the doctrine of informed consent continues to evolve.     

Comparative morphine determination in parts of the brain using combined gas chromatography/mass spectrometry. A possibility for assessing survival time

Comparison of the morphine concentrations in the medulla oblongata and the cerebellum provides information on the interval between morphine administration and death. If this period is short, the ratio of CMed:CCereb is below 1. The ratio is above 1 if a number of hours have passed at least. The balance of the morphine concentrations is achieved within a few hours. Results have been achieved by gas chromatography/mass spectrometry analysis in about 100 autopsy cases.     

The distribution of health care financing in the overall population and among the elderly

This paper focuses on the distribution of health care costs among the elderly. Four revenue sources are considered: income taxes, payroll taxes, user fees, and insurance premiums. The empirical work shows that the heavy reliance on direct payments as a means of collecting revenues among the elderly makes their contribution to the health care financing structure more regressive than for the nonelderly.