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Biomedical subjects

J E Epner

Publications and source records attributed to J E Epner.

3 recordsLinked to original sources
PubMed1998

Late-term abortion.

Recent proposed federal legislation banning certain abortion procedures, particularly intact dilatation and extraction, would modify the US Criminal Code such that physicians performing these procedures would be liable for monetary and statutory damages. Clarification of medical procedures is important because some of the procedures used to induce abortion prior to viability are identical or similar to postviability procedures. This article reviews the scientific and medical information on late-term abortion and late-term abortion techniques and includes data on the prevalence of late-term abortion, abortion-related mortality and morbidity rates, and legal issues regarding fetal viability and the balance of maternal and fetal interests. According to enacted American Medical Association (AMA) policy, the use of appropriate medical terminology is critical in defining late-term abortion procedures, particularly intact dilatation and extraction, which is a variant of but distinct from dilatation and evacuation. The AMA recommends that the intact dilatation and extraction procedure not be used unless alternative procedures pose materially greater risk to the woman and that abortions not be performed in the third trimester except in cases of serious fetal anomalies incompatible with life. Major medical societies are urged to collaborate on clinical guidelines on late-term abortion techniques and circumstances that conform to standards of good medical practice. More research on the advantages and disadvantages of specific abortion procedures would help physicians make informed choices about specific abortion procedures. Expanded ongoing data surveillance systems estimating the prevalence of abortion are also needed.

Abortion, Legal↗
PubMed1998

Primary care providers' responsiveness to health-risk behaviors reported by adolescent patients.

OBJECTIVE: To assess clinicians' responsiveness to health-risk behaviors reported by adolescent patients during a comprehensive clinical preventive services visit. DESIGN: Nonprobability sample of adolescent patients scheduled for a routine physical examination. SETTING: Seven clinical sites in the Chicago, Ill, area. PARTICIPANTS: Fifteen primary care providers and 95 adolescent patients between 11 and 18 years of age. INTERVENTION: Providers delivered comprehensive clinical preventive services to adolescent patients using the Guidelines for Adolescent Preventive Services model. This model includes screening, guidance, a physical examination, and immunizations. Prior to the visit, adolescent patients completed a screening questionnaire that included a 52-item health-risk behavior profile. Responses on the screening questionnaire were discussed during the visit. MAIN OUTCOME MEASURES: Each provider's responsiveness to reported health-risk behaviors was determined by comparing the adolescent patient's responses on the screening questionnaire with those reported during a debriefing interview with the adolescent about whether specific subjects were discussed. Responsiveness to highly sensitive behaviors was determined by comparing the screening questionnaire and the medical record. RESULTS: On average, each adolescent patient reported 10 risk behaviors, of which 7 were discussed. The severity of the reported risk behavior, the number of reported biological health concerns, and the adolescent patient's sex were significant predictors of the provider's responsiveness. The number of reported health-risk behaviors, visit duration, provider's professional role and sex, whether the adolescent was a new patient, and the adolescent patient's age were unrelated to responsiveness. CONCLUSIONS: Providers addressed most health-risk behaviors reported during a single visit, but responsiveness declined when 3 or more biological health concerns or relatively severe problems were reported. Steps can be taken to increase providers' responsiveness.

Adolescent↗