{"title":"The Process of Managing Medical Malpractice Cases: The Role of Standard of Care","authors":"R. Peeples, C. Harris, Thomas B. Metzloff","doi":"10.2139/SSRN.347760","DOIUrl":"https://doi.org/10.2139/SSRN.347760","url":null,"abstract":"In medical malpractice litigation, how the standard of care is determined is of obvious importance, since failure by a defendant-physician to meet the relevant standard of care constitutes negligence. Any effort to reform how standard-of-care determinations are made should start with an understanding of the entire claims resolution process. The usual image - that of opposing experts testifying at trial - is both incomplete and misleading. Most cases are either settled by the parties or abandoned by the plaintiff, short of trial. We reviewed insurers' closed claims files, representing a sample of medical malpractice lawsuits filed in North Carolina between 1991 and 1995, as well as the matching court files. As a result, we obtained unique and highly detailed information about these cases. In this Article we report on our findings, as they relate to the insurer's assessment of the standard of care. We conclude that a shift in standard-of-care determinations to a more empirical, scientifically-based inquiry would not be likely to change the dynamics of the settlement process, where the emphasis is on bargaining and negotiation, rather than on reaching conclusions about the standard of care.","PeriodicalId":83479,"journal":{"name":"Wake Forest law review","volume":"37 1","pages":"877"},"PeriodicalIF":0.0,"publicationDate":"2002-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68597353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Down for the count? State regulation of aborted fetal tissue research.","authors":"Rachel Keener","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":83479,"journal":{"name":"Wake Forest law review","volume":"37 1","pages":"217-37"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22328551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reinventing Tax Expenditure Reform: Improving Program Oversight Under the Government Performance and Results Act","authors":"M. L. Heen","doi":"10.2139/SSRN.258973","DOIUrl":"https://doi.org/10.2139/SSRN.258973","url":null,"abstract":"This Article examines the Government Performance and Results Act framework for performance-based management and oversight of federally-funded programs, describes emerging efforts to incorporate tax expenditures into the performance review process, and places these developments into context by evaluating past experiences with tax expenditure reform. Government-wide performance-based management reforms provide a promising executive branch mechanism for achieving more coordinated review of functionally related government programs, whether funded or implemented through direct expenditures, tax expenditures, or regulatory programs. However, as past experience illustrates (including, for example, experience with employment subsidies such as the Work Opportunity Tax Credit and the Welfare-to-Work Tax Credit), significant institutional obstacles stand in the way of comprehensive reform. The Article ends with a discussion of the type of fundamental structural reforms that will be needed before meaningful legislative oversight of functionally related government programs can be achieved.","PeriodicalId":83479,"journal":{"name":"Wake Forest law review","volume":"35 1","pages":"751"},"PeriodicalIF":0.0,"publicationDate":"2001-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2139/SSRN.258973","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68213828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"DNA databanks: law enforcement's greatest surveillance tool?","authors":"M Hibbert","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>All fifty states have laws requiring the collection of DNA samples from certain classes of criminals. Genetic profiles are gleaned from these samples and entered into DNA databanks, after which they then can be accessed by law enforcement personnel and others. DNA forensic technologies can be used to identify criminal offenders, but they can also be used in ways that reveal health and other personal information about the target and even about his or her relations. Moreover, the rapid introduction of ever-changing types of DNA forensic techniques creates a potential for error. Such errors may wrongly implicate some individuals for a crime and may wrongly exculpate others. This Article examines weaknesses in state DNA databanking laws regarding the protection of genetic privacy and imposition of quality assurance mechanisms and suggests policies which state legislatures should incorporate into the state DNA databanking scheme.</p>","PeriodicalId":83479,"journal":{"name":"Wake Forest law review","volume":"34 3","pages":"767-825"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22312932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Breaking the stalemate: a prospective regulatory framework for unforseen research uses of human tissue samples and health information.","authors":"H T Greely","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The legal and ethical issues raised by new research uses of previously collected human tissues and health information are increasingly important to genetics research. This Article discusses and criticizes current positions on such uses, including the recent report of the National Bioethics Advisory Commission, Research Involving Human Biological Materials. It then proposes a new regulatory framework for tissue and information collected in the future that would better protect the interests of the people who provide them. It ends by suggesting a resolution for the problems of previously collected tissue and information.</p>","PeriodicalId":83479,"journal":{"name":"Wake Forest law review","volume":"34 3","pages":"737-66"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The impact of genetic enhancement on equality.","authors":"M H Shapiro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There apparently is a genuine possibility that genetic and non-genetic mechanisms eventually will be able to significantly enhance human capabilities and traits generally. Examining this prospect from the standpoint of equality considerations is one useful way to inquire into the effects of such enhancement technologies. Because of the nature and limitations of competing ideas of equality, we are inevitably led to investigate a very broad range of issues. This Article considers matters of distribution and withholding of scarce enhancement resources and links different versions of equality to different modes of distribution. It briefly addresses the difficulties of defining \"enhancement\" and \"trait\" and links the idea of a \"merit attribute\" to that of a \"resource attractor.\" The role of disorder-based justifications is related to equality considerations, as is the possibility of the reduction or \"objectification\" of persons arising from the use of enhancement resources. Risks of intensified and more entrenched forms of social stratification are outlined. The Article also considers whether the notion of merit can survive, and whether the stability of democratic institutions based on a one-person, one-vote standard is threatened by attitude shifts given the new technological prospects. It refers to John Stuart Mill's \"plural voting\" proposal to illustrate one challenge to equal-vote democracy.</p>","PeriodicalId":83479,"journal":{"name":"Wake Forest law review","volume":"34 3","pages":"561-637"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Herd behavior in designer genes.","authors":"P H Huang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The ability of individuals to choose their children's genes has increased over time and may ultimately culminate in a world involving free market reprogenetic technologies. Reprogenetic technologies combine advances in reproductive biology and genetics to provide humans increased control over their children's genes. This Article offers economic perspectives that are helpful in understanding the possibly unexpected ethical, legal, and social issues at stake in using reprogenetic technologies for trait enhancement selection. The Appendix analyzes two competitive games that might arise in such a biotechnological society. Specifically, the Article focuses on herd behavior, caused by either a popularity contest or positional competition, in the choice of genetic traits. The analytical game-theoretic models in the Appendix can have several equilibrium outcomes in terms of individual reprogenetic technological choices and corresponding beliefs about such choices by others. This multiplicity of potential social outcomes suggests that a society can attain efficiency if the state or some private organization transforms individual parents' beliefs over the choices of other parents regarding their children's traits and, thus, coordinates parental reprogenetic decisions by selecting, as focal, certain beliefs over parents' reprogenetic decisions.</p>","PeriodicalId":83479,"journal":{"name":"Wake Forest law review","volume":"34 3","pages":"639-69"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Genetic testing, genetic medicine, and managed care.","authors":"M A Rothstein, S Hoffman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As modern human genetics moves from the research setting to the clinical setting, it will encounter the managed care system. Issues of cost, access, and quality of care will affect the availability and nature of genetic testing, genetic counseling, and genetic therapies. This Article will explore such issues as professional education, coverage of genetic services, privacy and confidentiality, and liability. It will conclude with a series of recommendations for the practice of genetic medicine in the age of managed care.</p>","PeriodicalId":83479,"journal":{"name":"Wake Forest law review","volume":"34 3","pages":"849-88"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22312933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How will we regulate genetic enhancement?","authors":"M J Mehlman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Genetic enhancement technologies present difficult and novel regulatory issues, including the problem of measuring and comparing risks and benefits and dealing with the impact of these technologies on social values. This Article describes and evaluates the potential approaches that may be taken to regulate these technologies. The author concludes that a variety of approaches will be necessary, involving self-regulation, government restrictions on access and use, licensing, and a national lottery.</p>","PeriodicalId":83479,"journal":{"name":"Wake Forest law review","volume":"34 3","pages":"671-714"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Genetic enhancement in the twenty-first century: three problems in legal imagining.","authors":"R M Berry","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>By what method should we resolve the ethical and public policy issues surrounding genetic enhancement: a utilitarian calculus, appeal to Scripture, application of neo-Kantian principles? In this Article, the author claims that, despite the diversity of our basic methodological commitments, we can advance our shared understanding of the issues surrounding genetic enhancement and come to agree upon certain central features as essential to any adequate method for resolving those issues. The author attempts to make modest headway on both fronts by engaging in \"legal imagining.\" Legal imagining consists of examining hypothetical problems from the lawyer's perspective, the perspective of a caring, professional friend. This Article examines and discusses three problems in legal imagining.</p>","PeriodicalId":83479,"journal":{"name":"Wake Forest law review","volume":"34 3","pages":"715-35"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}