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This Newfoundland Act does the following, among other things: 1) equalizes the status of men and women in The Adoption of Children Act, 1972, The Child Welfare Act, 1972, The Children of Unmarried Parents Act, 1972, The Memorial University (Pensions) Act, and The Social Assistance Act, 1977; 2) removes the word illegitimate from sections of The Children of Unmarried Parents Act, 1972; and 3) deletes a provision of The Maintenance Act that authorizes a judge to rescind an order for payment of money to a wife if it is subsequently proved that she has committed adultery.
A medical malpractice insurance crisis occurred in the mid-1970s and mid-1980s evidenced by escalating malpractice insurance rates and increasing numbers of malpractice claims. Insurance companies maintained that the increase in insurance rates was necessary because of the sharp rise in the number of malpractice lawsuits, astronomical damage awards, and ineffective mechanisms to prevent and to eliminate nonmeritorious claims. Physicians responded by forming their own insurance companies, cancelling high-risk procedures, and orchestrating intensive legislative lobbying for tort reform. Insurance companies, physicians, and the legislature collaborated efforts to resolve this medical malpractice crisis. A national debate erupted regarding the proper way to address the medical malpractice insurance crisis. Insurance companies and physicians pressured state legislatures to reform liability laws that, in their opinion, permitted recovery of excessive damage awards by plaintiffs. Consumer groups and lawyers suggested tighter regulation of the insurance industry. State legislatures, in an attempt to remedy the perception that injured plaintiffs were overcompensated for their injuries, enacted "tort reform legislation," which included statutory caps on damages recoverable in medical malpractice actions. As a result of the extensive lobbying effort by physicians and insurance companies, twenty-seven states enacted statutes limiting recovery of damages in medical malpractice lawsuits. Lawyers responded by challenging state malpractice legislation on constitutional grounds, alleging violations of federal and state equal protection and due process clauses and the Seventh Amendment right to a jury trial. Opponents of the cap also asserted violations of state constitution provisions such as the "open courts" provision or the "special legislation" clause. To date, the state courts have held that statutory caps are unconstitutional. Statutory caps and other tort reform measures are extremely important in light of proposed health care legislation entitled the Health Care Liability Reform and Quality of Care Improvement Act of 1992 [the "Health Care Bill"]. This Comment critically examines the constitutionality of statutory caps on damages in medical malpractice actions. It focuses on the public policy behind the caps and the constitutional issues embodied in limiting an individual's recovery. It also analyzes the impact of the Health Care Bill on statutory caps. Part I outlines the medical malpractice insurance crisis, describes the statutory reforms and discusses the public policy behind tort reform. Part II examines the constitutionality of statutory caps and summarizes the arguments of the proponents and the opponents of these caps. Part III discusses the Health Care Bill and its impact on medical malpractice legislation with respect to statutory caps. This Comment concludes that a compromise must be reached that addresses both the growing health care insurance crisis and the protection of individual rights. The Health Care Liability Reform and Quality of Care Improvement Act of 1992 attempts to achieve this compromise.
This proposed rule sets forth procedures for the handling of complaints of employment discrimination which are filed with Federal fund granting agencies under Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972 and other provisions of Federal law which prohibit discrimination on grounds of race, color, religion, age, sex or national origin in programs or activities receiving Federal financial assistance. The regulations allow the fund granting agency to refer complaints to the Equal Employment Opportunity Commission (EEOC). For complaints covered both by Title VII of the Civil Rights Act of 1964, as amended, or other statutes within EEOC's jurisdiction and by Title VI of the Civil Rights Act or Title IX, the regulations contemplate that most complaints of individual acts of discrimination will be referred to EEOC for investigation and conciliation, while most complaints of systemic discrimination will be retained by the fund granting agency. Employment discrimination complaints which are not covered by Title VI or Title IX will be transferred to EEOC. This proposed rule is not a "major rule" as defined by Section 1(b) of Executive Order 12291.
The legal struggles waged by lesbian and gay male litigants almost invariably involve issues of freedom of expression, broadly construed. To illustrate this point, a wide array of caselaw is examined--ranging from classic "access to a forum" controversies to those concerning symbolic conduct and freedom of association (including marriage and child custody law), employment discrimination, and proscriptions against deviant sexual conduct. In each category, claims to a right of freedom of expression are manifested. Cautionary notes are offered concerning those cases in which gay litigants try to protect their rights by inhibiting the speech of others. A brief concluding section assesses the long-term and short-term efficacy of raising First Amendment arguments (as opposed to privacy or equal protection arguments) in lesbian/gay male litigation.
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OBJECTIVES: The aim of the paper is to clarify the legal rights of adolescent patients, guardians and staff in Victorian Child and adolescent Mental Health Services (CAMHS). Victorian CAMHS have now been 'gazetted' and can admit patients on an involuntary basis under the amended Mental Health Act 1986 (MHA). The MHA applies equally to young people under the age of 18 years, which has raised some confusion about who has the right to consent to treatment. METHOD: Staff of CAMHS inpatient units have recently posed questions to the Victorian chief psychiatrist. These have included clarification of when the MHA may be appropriately used for adolescents, what is the clinician's duty of care, how to assess young people's capacity to consent to treatment, how to manage some patient groups, and what is the role of the courts in treatment decisions. The author provides a view on each of these matters, based on recent literature and confirmed by legal opinion. RESULTS: Some matters of fact are presented and advice is provided. CONCLUSIONS: Services must seek the informed consent of guardians and adolescents and, for those young people with major psychiatric disorders who require treatment and are unable to consent, the amended MHA provides clearer direction for the use of involuntary treatment. Where units offer admission to provide assessment and stabilisation, a clear explanation about the treatment goals, and the role of restraint and medication in managing behaviour is essential at the outset of the admission process.
Between the mid 1960s and 1975, state legislatures, the federal courts, and the U.S. Congress spelled out strong educational rights for children with disabilities. Forty-five state legislatures passed laws mandating, encouraging, and/or funding special education programs. Federal courts, interpreting the equal protection and due process guarantees of the Fourteenth Amendment to the U.S. Constitution, ruled that schools could not discriminate on the basis of disability and that parents had due process rights related to their children's schooling. Congress, in legislation now retitled the Individuals with Disabilities Education Act (IDEA), laid out detailed procedural protections regarding eligibility for special educational services, parental rights, individualized education programs (IEPs), the requirement that children be served in the least restrictive environment, and the need to provide related (noneducational) services. Decisions on instructional matters such as curricula and the elements of the IEP remain the province of local and state authorities. Advocates for students with disabilities have continually sought separate (categorical) funding for special education services. Current movements toward block grants rather than categorical programs and toward greater inclusion of special education students in general education classrooms raise concerns in some quarters about whether students with disabilities will continue to have full access to the special services they need. While the cost of special services may be an unexpressed criterion in many decisions made by school districts, nowhere does the IDEA explicitly allow cost to be considered. Where a service is necessary for an individual child, cost considerations would not allow a school district to escape its obligations to the child. However, in instances where more than one appropriate configuration of services is available to meet a child's needs, the school district may be allowed to consider the cost of different alternatives.
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Guidelines and institutional policies regarding sexual harassment in academia have a relatively short and controversial background. Deference to Equal Employment Opportunity Commission (EEOC) guidelines in employment sexual harassment incidents guides much of the thinking in contemporary courts. Title IX of the Educational Amendments and the Civil Rights Restoration Act of 1987 are but two of the legal redresses available to students with harassment grievance complaints. Lack of definition of the term as well as research studies in nursing complicate the issue of sexual harassment. The potential impact of harassment on nursing students both in the classroom and in the practice area is significant. Nursing administrators and educators must be proactive in writing and implementing policies regarding sexual harassment.
Lasofoxifene [CP 336156] is a potent, nonsteroidal, tissue-selective estrogen receptor modulator (SERM). It has the bone-sparing and cardioprotective effects of estrogen, but lacks estrogen's uterine cancer risk. Lasofoxifene is under development with Ligand Pharmaceuticals and Pfizer (formerly Parke-Davis) for the prevention of postmenopausal osteoporosis and breast cancer. In June 2000, Parke-Davis' parent company, Warner-Lambert, merged with Pfizer. The resulting company retained the Pfizer name and Parke-Davis was integrated into Pfizer Global Research and Development. The discovery of lasofoxifene resulted from a research collaboration between Pfizer and Ligand Pharmaceuticals. There was a contract dispute between the two companies relating to their research agreement. Under a settlement of litigation, Ligand is entitled to milestone and royalty payments. If Pfizer is successful in developing the drug through to regulatory approval in the US, Ligand could receive royalty revenues from lasofoxifene as early as 2003-2004. The royalties will be equal to 6% of net sales and will be in addition to milestone payments for continuing development of the drug. However, on 6 March 2002, Ligand Pharmaceutical announced an agreement with Royalty Pharma in which the latter purchased the rights to a share of these future payments. Under the agreement, Ligand received US dollars 6 million from Royalty Pharma in exchange for a 0.25% stake in net sales of three SERM products (lasofoxifene, bazedoxifene and bazedoxifene/Premarin) for a period of 10 years. Royalty Pharma retains the option to purchase, at escalating prices, additional rights (subject to timing restrictions) to extend this stake up to 1.0%, for a total of US dollars 56 million. In April 2002, Royalty Pharma exercised its first option to purchase an additional 0.125% of potential future sales of the three SERMS in exchange for US dollars 3 million. Subsequently, in December 2002, Royalty Pharma exercised an expanded option and agreed to pay Ligand US dollars 6.775 million for 0.1875% of potential future sales of SERM products. Royalty Pharma and Ligand Pharmaceutical amended their royalty agreement in October 2003 for the three SERM products. Under the amended agreement, Royalty Pharma exercised an option to pay Ligand US dollars 12.5 million, plus cumulative milestones of up to US dollars 2.5 million upon the launches of the three SERMs (provided they are approved by 30 September 2005), in exchange for 0.7% of potential future sales of the products for 10 years. In November 2004, Ligand Pharmaceuticals and Royalty Pharma further amended their existing royalty agreement for the three SERM products. Under the terms of the revised agreement, Royalty Pharma will purchase an additional 1.625% of the SERM products' net sales for US dollars 32.5 million, which represents an acceleration of the previous option timetable and an increase in the royalty amount as well as aggregate purchase price. Consequently, Royalty Pharma increased its rights to a total of 3.0125% of net sales of each SERM product for 10 years following the first commercial sale of each product and has no further options. Ligand retains an approximately equal portion of lasofoxifene and other SERM's net sales going forward and for periods that could exceed 10 years. The royalty rates owed to Royalty Pharma for the royalties just purchased could be reduced by one-third if product sales exceed certain thresholds. Payments from the royalty purchase are non-refundable, regardless of whether the products ever become successfully launched or not. Milestone payments owed by Ligand's partners as products achieve development and regulatory targets will be paid to Ligand as earned and are not included in this amended agreement. In September 2004, Ligand Pharmaceuticals earned a milestone payment of approximately US dollars 2 million from Pfizer, payable in 181,818 shares of Ligand stock held by Pfizer. The payment was triggered by Pfizer's NDA submission for lasofoxifene in August 2004. Under the terms of the agreement between Ligand and Pfizer, Ligand is entitled to receive an additional milestone upon successful approval of lasofoxifene. On 19 August 2004, Pfizer filed an NDA with the US FDA for lasofoxifene for the prevention of osteoporosis in postmenopausal women. Product launch is forecasted to occur in 2006-2007. Ligand reported in January 2004 at the 22nd Annual JP Morgan Healthcare Conference that it anticipated the availability of phase III data and NDA filing sometime in 2004. Lasofoxifene has undergone two phase III studies with Pfizer in the US as an orally administered therapy for postmenopausal osteoporosis. In June 2003, Pfizer reported that enrolment was completed in a trial evaluating lasofoxifene in the prevention of bone loss. The trial also evaluated lasofoxifene's effect on lipid levels. The trial enrolled approximately 2000 postmenopausal women. Another trial was conducted among 8500 patients to investigate lasofoxifene in the treatment of fractures. In addition, Pfizer began a third worldwide phase III trial to evaluate whether lasofoxifene reduced the risk of vertebral fractures, breast cancer and cardiovascular disease. At the 10th Annual Meeting of the Biotechnology Industry Organization (BIO-2003), Ligand also confirmed that lasofoxifene was in phase III development for breast cancer. Lasofoxifene is under clinical evaluation as a treatment for vaginal atrophy. According to Pfizer's pipeline in November 2004, the company anticipates regulatory submission for vaginal atrophy by the end of 2004. In June 2002, Ligand estimated that lasofoxifene has the potential to reach sales of US dollars 1-2 billion, pending approval.
In the 1990s, the Supreme Court has decided several cases that have had an impact on psychiatry and psychiatric patients in the criminal justice system, on psychiatric hospitalization, and on psychotherapist-patient privilege. Of the seven cases discussed in this article, Chief Justice Rehnquist and Justice Scalia voted similarly in all seven cases. Since joining the court, Justice Thomas has voted with them. Justice Scalia interprets the Constitution, using what has been termed "textualism": avoid reference to legislative history, and interpret the Constitution according to the plain language meaning of the relevant section. Chief Justice Rehnquist and Justices Scalia and Thomas are inclined to protect states' rights from court decisions that expand US Constitutional power in cases involving civil plaintiffs and criminal defendants. They seek to protect states from being sued in federal courts, and, if there is doubt, lean toward not interfering with state prerogatives. They tend to not find unenumerated rights and prefer clear-cut rules over amorphous standards. Justices Kennedy and O'Connor, at times joined by Justice Souter in the middle of the court, provide the deciding votes in many cases. They seem to prefer a case-by-case pragmatism over a global jurisprudential philosophy. Approaching cases one at a time, they usually avoid broad philosophic pronouncements when they join with Chief Justice Rehnquist. Justice Stevens, joined by Justices Breyer and Ginsburg since they have been appointed to the court, is more likely to favor a broader reading of the 14th Amendment's Due Process and Equal Protection clauses. Of the seven cases, Kennedy and O'Connor voted with the majority in five cases, the dissent in one case (Zinermon v Burch), and split their votes in one case (Foucha v Louisiana, with O'Connor siding with the Court and Kennedy with the dissent). Commager, a noted historian, believed that political issues can be explored, explained, and debated and that the people of the new American democracy, armed with knowledge and freedom to defend, argue, and choose, will make the right decisions for their common welfare. This theory applies equally to the court: Whenever questions involving psychiatry and psychiatric patients are brought to the court, American psychiatry must make its views known in that forum. To do so requires awareness and knowledge of the cases that involve psychiatry and psychiatric patients that the court has decided, including those decided in the 1990s. To participate effectively, psychiatrists must understand the political landscape in which the cases arrive at the court's doorstep and the composition and leanings of the court and examine carefully the fact patterns (understanding that some fact patterns are more sympathetic than others). This awareness should result in amicus briefs that are scholarly, rely on empiric data, and are scrupulously honest about the limitations of our knowledge. In this way, psychiatrists may fully participate in the debate and aid the court in its exploration and analysis of the issues involving psychiatry and psychiatric patients.
A study of recent birth patterns in the Southern California Region of the Kaiser-Permanente Medical Care Program (KPMCP) suggests that individuals may have been attracted to the Program by a liberal maternity benefit. The attraction is reflected in both the type of members joining KPMCP and the birth rate of those members. Although the KPMCP birth rate has been below that of the general population, new members in their first year of coverage delivered approximatey one third of all KPMCP births in 1977, twice the number of births that would be anticipated from an equal number of members in the plan for one year or more. The maternity copayment of up to $350 did not deter women already pregnant from joining KPMCP. Termination rates for new members who gave birth, however, were no higher than expected. The Pregnancy Disability Amendment of Title VII of the Civil Rights Act of 1964, which became effective April 29, 1979, may alter the maternity benefits offered by alternative insurance carriers. The law could impact KPMCP's enrollment and utilization of obstetric services.
HELD: Oregon's Death with Dignity Act, Measure 16, which legalizes physician-assisted suicide for certain terminally ill persons, violates the equal protection clause of the fourteenth amendment to the United States Constitution. Measure 16 fails to withstand even the lowest level of judicial scrutiny because the disparate treatment afforded the class of terminally ill persons does not further any legitimate state interest.
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This Act amends the Compilation of Civil Law of Navarra to eliminate provisions that discriminate on the basis of sex, birth, or civil status. Among the changes are the following: a) the age of puberty is made the same for both sexes; b) wives are given the same rights as men to manage marital property and to exercise parental authority over children and both must agree in order to dispose of the home and household effects; c) the rights of illegitimate children are made equal to those of legitimate children; and d) obligatory dowry is eliminated.