The judicial debate continues to rage over the right of a child born suffering from genetic impairments to recover on his own behalf against a physician or laboratory which failed to give his parents correct information about the defect. These “wrongful life” suits are brought by parents on behalf of their child, who in most cases is born suffering from mental or physical defects which could have been detected by genetic screening. In contrast, “wrongful birth” suits are actions brought by parents of a child born as the result of a defendant’s negligence, seeking damages for either the costs incident to the unwanted pregnancy and birth of a normal child, or the costs related to the unexpected birth and care of an impaired child.

Third party payment for health services in the United States has created an environment which offers little incentive to health care providers to be efficient. In response, health care policymakers have suggested that increased competition in the health care sector would encourage good managerial practices and improved cost efficiency. In recent years, health care providers that have the ability to provide services in a more cost-efficient manner have emerged; some, including health maintenance organizations and ambulatory surgical centers, have been encouraged by regulatory policy. In addition, a new alternative for the provision of emergency medical services has developed and has generated substantial controversy among physicians, hospitals, government officials, and the public. The entities that comprise this alternative are often collectively referred to as freestanding emergency care centers or “emergicenters.”

Much of the controversy surrounding emergicenters is caused by the lack of a definition which can be applied to the various emergicenter structures and operations.

On March 31,1981, the New York Gurt of Appeals handed down its decision in the consolidated cases of Brother Joseph Fox and John Storar. The Eichner case was generally well known, having excited considerable national publicity both before and after the Appellate Division of the Supreme Court of New York handed down its opinion on March 17,1980. The Storar case,) conversely, was not as well known and was consolidated with the Eichner case, in the words of the Court of Appeals, because future similar cases would arise. As will be discussed more fully in this article, the consolidation of these two markedly dissimilar cases not only has created confusion, but also has served to obscure the position taken by the court of Appeals relative to other similar cases both in New York and other jurisdictions.

Brother Joseph Fox was an 83 year old member of a Catholic religious order who enjoyed good health until he suffered cardiac arrest during the performance of a hernia operation. As a result of the cardiac arrest, he became anoxic, suffered permanent brain damage, and became respirator-dependent.

In a recent issue of the Hastings Center Report, Paul and Marilyn Bridge discuss the difficulties and frustrations they encountered with the physicians and hospital concerning a proposal to withhold treatment from their severely defective newborn son, Christopher. Born some three months prematurely, he had signs of viral encephalitis. His long-term outlook was quite dim: he had severe mental retardation, and would possibly suffer from uncontrollable convulsions, deafness, blindness, and quadraplegia. Brain damage was extensive, and was thought to extend to the cortex. While Christopher was not terminally ill nor in any immediate danger of dying, the pediatrician suggested that there would be situations in the future which perhaps ought not be treated, such as infection or the aspiration of food. The family rejected that option, and insisted on treatment until Christopher, on his 75th day of life, suffered cardiac arrest. After three days of ventilator support, the parents agreed to discontinue the heroic means supporting their son whom they now believed to be terminally ill and approaching brain death.

Nurses frequently wonder about the legal aspects of using siderails to prevent patient falls from bed. Questions arise as to when siderails are clinically indicated; whether a patient may refuse the use of siderails; whether, when a patient does fall from bed, the fall resulted from negligent failure to use siderails; and whether a decision to use siderails is a medical or nursing judgment. This article examines the legal issues involved in the use of siderails and provides some recommendations for the use of siderails and other restraints.

Liability for a patient's fall from bed is imposed according to the general principles of the law of negligence—when the patient-plaintiff can demonstrate that a particular act or omission on the part of the defendant (usually the hospital, through its nursing staff) did not conform to the accepted standard of care, and that this deviation resulted in harm to the patient.