Physicians and surgeons: malpractice action for "wrongful conception"

BACKGROUND: Despite the many benefits of living donor kidney transplantation, economic consequences can result for donors. We reviewed studies which quantified the direct and indirect costs incurred by living kidney donors, in order to understand the strengths and limitations of existing literature. METHODS: We identified relevant studies in MEDLINE, EMBASE and ECONOLIT bibliographic databases, in the Science Citation Index and study reference lists. Any study which reported at least one cost relevant to donors was included. The accuracy of abstracted data was verified by two reviewers and reported in year 2004 US dollars. RESULTS: Thirty-five studies from 12 countries described costs incurred by individuals who donated between the years 1964 and 2003. No study comprehensively quantified all relevant expenses-the sum of select costs considered in one US study averaged Dollars 837 per donor and ranged from Dollars 0 to 28,906. Travel and/or accommodation costs were incurred by 9-99% of donors, and were higher in countries with a larger land mass. Post-discharge analgesics were required by 4-24% of donors, but prescription costs were not reported. Between 14 and 30% of donors incurred costs for lost income, with an average loss of Dollars 3386 in one study from the UK and Dollars 682 in another study from the Netherlands. Costs for dependent care were incurred by 9-44% of donors, while costs for domestic help were incurred by 8% of donors. CONCLUSIONS: Donors incur many types of costs attributable to kidney donation and the total costs are certainly higher than previously reported. To guide informed consent and fair reimbursement policies, further data on all relevant costs, preferably from a detailed prospective multi-centre cohort study, are required.

Compensation and Redress↗

PubMed2006

Keys to strengthening the supply of routinely recommended vaccines: view from industry.

The vaccine enterprise in the United States is a remarkable success story that has resulted in freedom from disease for millions of children. Although some persons believe that this success is in danger because of recent vaccine shortages, the reality is otherwise. The existing system fundamentally works and should be strengthened and stabilized, to improve delivery of current vaccines and to establish a firm structure into which a new generation of vaccines can be integrated. Ten practical actions to strengthen supplies of vaccine and ensure the stability of these supplies were presented to the National Vaccine Advisory Committee in February 2002. The present article has been updated to include progress made since that time. By building on what is already in place and on what we know works, we can continue to ensure success for years to come.

Compensation and Redress↗

PubMed2006

Update on vaccine liability in the United States: presentation at the National Vaccine Program Office Workshop on strengthening the supply of routinely recommended vaccines in the United States, 12 February 2002.

Two decades ago, a liability crisis brought on by concerns about the safety of diphtheria and tetanus toxoids and pertussis vaccine led to supply shortages and calls for rationing of the vaccine. Vaccine prices skyrocketed, and research on new products was threatened. In response, Congress created the National Vaccine Injury Compensation Program, which is tort reform legislation designed to compensate individuals quickly, easily, and generously. Since 1988, the Vaccine Injury Compensation Program has stabilized the marketplace, as evidenced by high immunization rates, stable pricing, and an increasing number of vaccine candidates in development. Although current vaccine shortages do not appear to be related to issues of liability, a new wave of tort litigation alleging that some vaccines cause autism has led to speculation that history could repeat itself.

Compensation and Redress↗