The articulation by a court of a new constitutional norm serves a valuable function: the right, as elaborated by judicial opinion, provides a standard for critically evaluating current social practices. The “right to refuse treatment,” that “newly created constitutional right of personal autonomy,” draws attention to the problems of institutionalized mental patients and their desires to make their own decisions to accept or reject drug therapies, particularly where severe side effects are involved. The enunciation of the right to refuse treatment, with its hard-edged overtones, forces us to look at the tension created by the conflict between institutional attempts to treat these patients, the sometimes antithetical desire of those within the institution to control them without regard for treatment impact, and the patient's desire to retain whatever control is left to him in such settings.

The right to refuse treatment-like its common law analogue in tort, informed consent doctrine-draws its roots from concepts of personal autonomy that pervade both tort doctrine and constitutional law.

One of the central dilemmas in contemporary medical practice is determining how much information a patient needs to make an informed choice of medical care alternatives. On June 1, 1982, Texas began an experiment that requires specific information to be given to patients about to undergo selected medical procedures. The objective of this uniform disclosure is to reduce the threat of medical malpractice lawsuits based on a failure of informed consent. While this is of benefit to physicians, it is unclear whether patients’ needs for information, like the unfortunate guests of Procrustus, will be cut and stretched to fit an inflexible standard. This article reviews the antecedents of this approach to informed consent, the legal and philosophical problems involved in uniform disclosure standards, and the practical problems that uniform disclosure standards pose for health care providers.

The concept of allied health professionals practicing in hospitals arouses the opposition of many in the medical establishment. What is the nature of this conflict, and how can it be resolved? This article gives an overview of the reasons that allied health professionals are demanding hospital privileges, as well as the reasons that such privileges are opposed by physicians. In the author's opinion, the medical establishment should learn to accept practice in hospitals by non-physician providers, and can expect considerable legal opposition if it does not.

The first problem is to define what is meant by “allied health professional.” Generally, the term is applied to any health care provider who is not in the “MOD” group, which traditionally has included medicine (MD), osteopathy, and dentistry, although pursuant to certain federal regulations podiatry also falls within the MOD group. Thus, in a general sense, “allied health professionals” means everyone else who directly provides health care services.

To be a nurse involves the assumption of ethical responsibility in all areas of practice. Infection control practice is a nursing specialty which exemplifies two ethical issues: the nurse's duty or moral obligation for patient advocacy and the right of patients to safe care. Individual moral responsibility is an important issue for the nurse epidemiologist because epidemiologic fact-finding provides information that may present ethical problems as well as suggest solutions. This paper discusses ethical dilemmas arising in infection control practice, as illustrated by three actual situations.

In the course of practice, questions may arise concerning the ethical responsibilities of a nurse epidemiologist to provide facts that may be used in cases of dispute. This discussion shall be limited to institutionally acquired or nosocomial infections.

There is increasing societal concern about retention and retrieval of information about individuals; advances in technology have enlarged the means for storing and communicating personal information. Not surprisingly, some of this concern is directed toward medical records. Questions have arisen about ownership of and access to medical records, as well as their content. This column focuses solely on some basic issues pertaining to the content of medical records.

Information in a patient's medical record can be used as a basis for decisions concerning his insurance coverage or payments, employment, eligibility for educational or benefit programs, or the outcome of a lawsuit. Thus, the law generally recognizes the patient's right to control the access to his medical record by third parties.

Because of the permanence and potential importance of a patient's medical record, health professionals frequently raise questions about what to include in the record, who should write in a patient's chart, where and how to make corrections, and how to document specific problems such as patient injury or concerns about the quality of care the patient is receiving.

In an effort to broaden its scope in the area of medicolegal education, the Executive Committee of the American Society of Law & Medicine voted in Cktober 1981 to establish a Health Law Teachers Section for its members who teach health law related courses in any school of law, medicine, public health, health administration, or nursing.

Angela R. Holder, J.D., LL.M., Treasurer of the Society and Counsel for Medicolegal Affairs and Associate Professor at Yale University School of Medicine, recommended that the Society expand its efforts to assist multidisciplinary individuals who share a common interest—education. While the Society was a co-sponsor of a 1980 Health Law Teachers Workshop, chaired by George J. Annas, J.D., M.P.H., of Boston University School of Medicine, the Society had not given formal, organized attention to the specialized needs of health law teachers.