Physician-Assisted Suicide: A Common Law Roadmap for State Courts

Part I examines the development of the law legalizing passively hastening death and how this development relied significantly on distinguishing passively hastening death from actively hastening death. Part II subjects the arguments used to legitimate passively hastening death to a traditional criminal law analysis and demonstrates their weaknesses which were simple to conceal when there was little enthusiasm for, and discussion of, the legalization of actively hastening death. The central role of consent in legitimating passively hastening death is analyzed in Part III. Although passively hastening death technically satisfies all of the elements of the crimes of assisted suicide and homicide, it is not illegal because it is legitimated by consent – consent of a competent patient or consent of the surrogate of an incompetent patient. Consent is the mechanism for implementing the fundamental principle. This analysis is applied to actively hastening death in Part IV. Because there is no legally significant distinction between actively and passively hastening death, consent legitimates actively hastening death just as it does passively hastening death. Nonetheless, Part V explores other reasons why actively hastening death ought to be prohibited and concludes that any arguments of any substance that can be made against actively hastening death can be equally applied to passively hastening death and should, therefore, be rejected in the latter as they are in the former. Safeguards must be established to prevent abuse of actively hastening death just as they have for passively hastening death

Pharmacists, Physician-Assisted Suicide, and Pain Control

One of the unintended consequences of the decade-old public debate about the legalization of physician-assisted suicide is an increased interest in pain control for terminally ill patients. Pain control and other aspects of palliative care are seen not only as medically desirable but as necessary to assure so as to minimize the pressure to legalize physician-assisted suicide or utilize physician-assisted suicide even if not legal. Most of the public debate has centered on the role of physicians in assisted suicide. However, there has been very little discussion about the role that health care professionals - - other than physicians -- would play if assisted suicide were legalized. One group of health care professionals -- besides physicians -- that is likely to be involved in legalized assisted suicide is pharmacists, who would dispense lethal substances prescribed by physicians. The debate about the legalization of assisted suicide has also served as an important catalyst to less drastic alternatives, most notably pain control. This, too, implicates pharmacists because an important, if not the predominant, mechanism of pain control is prescription medications. Any barriers that are placed in the way of pharmacists dispensing medications in accordance with a physician\u27s legitimate prescription for pain control undermines the rights that patients might have to receive such medication and interferes with good end-of-life care. In addition, legal barriers to terminally ill patients receiving adequate medications for pain control undermine the Supreme Court\u27s reasoning about the constitutionality of state statutes making assisted suicide a crime and could lead the Court to reconsider its decisions. Finally, legal barriers to the dispensing of medications for patients to use in physician-assisted suicide, where it is legal, interferes with this right as well. Although approximately 20 states have enacted statutes intended to make pain control medication more readily available by removing liability for patient death caused unintentionally caused by such medications, these statutes provide inadequate protection. If terminally ill patients are to receive the medications they need so that they may die peacefully, without preventable suffering, courts, legislatures, and administrative agencies will need to give pharmacists as well as physicians sufficient latitude to practice their professions in accordance with the intent of the palliative care statutes and the Supreme Court decisions

Introduction

As recently as the mid- to late-nineteenth century, it could honestly be said that there was no medical profession in the United States. Yes, there were doctors. And of course there were patients with illness and injuries. But if it is contentious today as to how best to treat various conditions, a century and a half ago it was nothing short of a circus. Although the American Medical Association had been founded in 1847, allopathic medicine could hardly be said to be the dominant school of thought. Others abounded, some of which still exist today, but none of them were capable of doing very much in the way of treating illness

The Photolysis of Phenylglycine and the Synthesis of α-Deuterated m-Anisaldehyde

Attempts were made to produce mandelic acid by irradiating phenylglycine in both acidic and basic aqueous solutions but no mandelic acid was detected

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions.Comment: 14 pages including 3 figure

A remarkable synergistic effect at the transcriptomic level in peach fruits doubly infected by Prunus necrotic ringspot virus and Peach latent mosaic viroid

[EN] Background: Microarray profiling is a powerful technique to investigate expression changes of large amounts of genes in response to specific environmental conditions. The majority of the studies investigating gene expression changes in virus-infected plants are limited to interactions between a virus and a model host plant, which usually is Arabidopsis thaliana or Nicotiana benthamiana. In the present work, we performed microarray profiling to explore changes in the expression profile of field-grown Prunus persica (peach) originating from Chile upon single and double infection with Prunus necrotic ringspot virus (PNRSV) and Peach latent mosaic viroid (PLMVd), worldwide natural pathogens of peach trees. Results: Upon single PLMVd or PNRSV infection, the number of statistically significant gene expression changes was relatively low. By contrast, doubly-infected fruits presented a high number of differentially regulated genes. Among these, down-regulated genes were prevalent. Functional categorization of the gene expression changes upon double PLMVd and PNRSV infection revealed protein modification and degradation as the functional category with the highest percentage of repressed genes whereas induced genes encoded mainly proteins related to phosphate, C-compound and carbohydrate metabolism and also protein modification. Overrepresentation analysis upon double infection with PLMVd and PNRSV revealed specific functional categories over- and underrepresented among the repressed genes indicating active counter-defense mechanisms of the pathogens during infection. Conclusions: Our results identify a novel synergistic effect of PLMVd and PNRSV on the transcriptome of peach fruits. We demonstrate that mixed infections, which occur frequently in field conditions, result in a more complex transcriptional response than that observed in single infections. Thus, our data demonstrate for the first time that the simultaneous infection of a viroid and a plant virus synergistically affect the host transcriptome in infected peach fruits. These field studies can help to fully understand plant-pathogen interactions and to develop appropriate crop protection strategies.We thank Drs M.A. Perez-Amador y J. Gadea for helping in the result analysis. This work was supported by grant BIO2011-25018 from the Spanish granting agency Direccion General de Investigacion Cientifica for the transcriptomic analyses and from the grant 2009CL0020 from the bilateral project INIA-Chile/CSIC-Spain for the phytosanitary evaluation. MC Herranz was the recipient of a contract from the Juan de la Cierva program of the Ministerio de Educacion y Ciencia of Spain.Herranz Gordo, MDC.; Niehl, A.; Rosales, M.; Fiore, N.; Zamorano, A.; Granell Richart, A.; Pallás Benet, V. (2013). 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The Expansion of Liability for Medical Accidents: From Negligence to Strict Liability by Way of Informed Consent

This article examines the various ways in which the courts have been fashioning rules of liability for medical accidents that add up to an incipient system of strict liability. The obvious judicial circumlocutions, which appear necessitated by the inability of the courts under existing rules of law to award compensation to severely injured medical-accident victims, are the main area of concern, not the routine application of well-established general principles to novel situations of fact. I. Introduction II. The War on Negligence III. The Fault System and Medical Accidents: The Gathering Storm IV. Informed Consent … A. The Law of Consent to Medical Treatment … B. The Affirmative Duty of Disclosure … 1. The Origins of the Physician\u27s Obligation to Disclose Information … 2. The Classical Elements of the Duty to Disclose … 3. Informed Consent in the 1960\u27s—A Paper Tiger … C. Expanding Liability in the Wake of Canterbury v. Spence … 1. The Standard of Disclosure … 2. Therapeutic Privilege … 3. Causation … D. Disclosure or Understanding: The Next Assault? … E. Informed Consent and Strict Liability V. The Head-On Assault of the Citadel VI. Strict Liability and the Doctor-Patient Relationship VII. Conclusio

Political Surveillance and the Fourth Amendment

The United States District Court case has left the scope of the warrant protection of the fourth amendment considerably clearer and broader. The door left ajar in Katz has been firmly fastened shut by the Court leaving only the traditional exceptions to the warrant requirement, which are based upon practical necessity, and the still unconfronted question of the power of the executive to conduct warrantless surveillances of foreign agents in national security cases. It is also clear that courts are no less competent to evaluate the appropriateness of a search and seizure in an internal security case than in a case of ordinary crime. In fact, judicial scrutiny is all the more essential because of the presence of first amendment considerations. But most significant is the fact that the government\u27s attempt to revitalize the general warrant in the guise of national security has been decisively thwarted. No more will the incantation of the mystical phrase national security shield the government from the necessity of obtaining a warrant. Political surveillance, like an orthodox search and seizure, requires the full protection of the fourth amendment, if not a fuller protection bolstered by the first amendment. The task of implementing the right to be free from government surveillance will in the long run prove to be more difficult than was the task of establishing the right. Even if the extremely difficult barrier to the implementation of remedies for illegal surveillance can be overcome-that is, discovery of the existence of the surveillance-criminal penalties and monetary awards can never truly compensate the individual for the loss of dignity suffered as a consequence of a surreptitious invasion of privacy. And as long as the detection of surveillance faces grave technological and legal obstacles, there may be little effective deterrent to the use of illegal surveillance. In the final analysis, therefore, the application of the warrant requirement to political surveillance-as in all other forms of search and seizure for which it is required \u27 - necessitates the same kind of voluntary and good faith compliance by governmental officials with constitutionally sanctioned procedures as do all other instances of the implementation of fundamental rights of the individual. Sadly, the events of recent years and months indicate the paucity of bona fides among our elected officials and their appointed assistants