Injury control has gained gradual acceptance as both a public policy concern and the focus of scholarly research during the last decade. Observers have noted the costs to American society of both intentional and unintentional injuries and have sought to identify preventive intervention strategies that can reduce their incidence and impact. Although many of these intervention efforts have just begun, researchers have been far more successful at identifying potential strategies for the prevention of unintentional than for intentional injury. Indeed, many observers have asked whether the majority of intentional injuries can be prevented at all. In this paper I examine the various problems associated with the prevention of intentional injuries such as homicide, assaultive violence, and suicide. Homicide among blacks is used to illustrate the variety of theoretical, ideological and practical concerns that must be confronted in efforts to successfully prevent intentionally induced injury.

Proponents of efforts to designate injury, both intentional and unintentional, as a health concern have suggested that one result of such a designation will be the development of more effective strategies for the prevention of injuries.

Nurses confront a variety of ethical and legal issues in both practice and education, and questions of rights, obligations, and duties arise which can have life and death consequences. Questions reflect the conflict between patients' rights and professional obligations, and between the use of resources for one individual at the expense of others.

The cover story of the June 12, 1978, issue of TIME magazine characterized the US. Department of Health, Education and Welfare as The Beneficent Monster. The physicians and lawyers of this nation often find themselves acting as sometime keepers and trainers of The Monster in many of its activities. While numbers of monstrous proportions may not intimidate the current generations who have witnessed the coining of the words googol (the number 1 followed by 100 zeros) or googolplex (10 raised to the 100th power), most of us are impressed when we discover that millions are affected and billions of dollars spent annually by the Social Security Administration.

That we will come into contact with The Monster is quite likely: As individuals we may become members of the beneficiary population; as practicing professionals, we may be involved in pursuing for another what may appear to be a tortuous process to guide that person to benefit status under the Social Security Administration Disability Programs.

Can new medical technologies decrease the incidence of occupational disease? Do they work to the detriment of other worker interests? Do they shift the burden of maintaining a healthy workplace from employers to employees, by keeping sensitive individuals from jobs that they are otherwise qualified to perform? These are among the central issues presented by the emerging occupational use of biological monitoring and genetic screening, as highlighted at the conference on Biological Monitoring and Genetic Screening in the Industrial Workplace, held in Washington, D.C., on May 12-13, 1983. The meeting was sponsored by the American Society of Law & Medicine and the Boston University Schools of Law, Medicine, and Public Health.

Research in progress on these issues, at the Center for Law and Health Sciences at Boston University School of Law, was one of the motivating forces for the conference. With funding from the National Science Foundation and the National Endowment for the Humanities, the study, led by Professor Michael Baram, LL.B., of Boston University School of Law, is providing a comprehensive overview and analysis of the major philosophical, ethical, and legal issues involved.

Today's practicing physicians and attorneys can be assured of increasing contact with the legal and insurance issues stemming from the adverse consequences of a patient's injuries or illnesses. Mounting litigation involving alleged medical negligence as a cause of personal injury, and expanding social legislation and insurance programs which provide benefits to injured or disabled persons, their dependents, or their beneficiaries has required an increase in the medical problem issues encountered in processing and resolving contested claims. Evaluations of such claimants by physicians are essential to the proper handling of their legal and insurance claims.

Medical evaluations performed specifically to provide information to the legal system and the expression of medical opinions formed after such evaluations constitute an area of medicine best termed Forensic Medicine. The traditional concept of “forensic medicine” was limited almost entirely to the medical investigation of the causes of death and the results of trauma, injury, and violent crimes. Forensic medicine practitioners were generally restricted to pathologists who performed medicolegal autopsies.

As general counsel to one of the largest hospitals in the United States, I want to discuss a topic which affects 15 to 20 patients in our hospital every day, those on whom physicians have written what we call “DNR” orders (Do Not Resuscitate). Any large tertiary care hospital has to deal regularly with this problem with respect to patients who are terminally ill and how to treat such patients in a wide variety of circumstances. What are the physician's and the hospital's obligations to provide Care?

On November 28,1977, the Massachusetts Supreme Judicial Court handed down its opinion in a case that has caused tremendous repercussions in hospitals throughout the country regarding the withholding or withdrawal of life-support to terminally ill patients. At the time this opinion was handed down, the decisions of physicians and hospitals on what to do with respect to withdrawing such care were based primarily on one of four models.

Physician incompetence and impairment have become one of the most controversial issues of recent years in the health care industry. Legislators, attorneys, and the general public have become actively involved in an area which had previously been within the exclusive (and oftentimes clandestine) province of hospital administrators and medical staffs. As a result of increasing public awareness, the informal and unstructured system of the past has been transformed into a more organized, results-oriented, and equitable approach to a problem which, many now realize, cannot be ignored.

Several state legislatures have enacted statutory provisions relating to the investigation and reporting of incompetent physicians. Some, like New York, have begun working closely with the state medical societies to ensure what these physicians are not only disciplined, but also treated and made to realize that their impairment can be resolved by cooperating with those who want to help. Other states, like Massachusetts, have devised regimented reporting requirements, but have overlooked the need for early investigations of, and assistance to, impaired physicians.

It has been estimated that in the United States some twenty thousand babies are born through artificial insemination by donor (AID) each year. With the startling new advances in reproductive technology, or what has been termed collaborative conception, it is now possible for a child to have up to five parents: an egg donor, a sperm donor, a surrogate mother who gestates the fetus, and the couple who actually raises the child. What we now face, then—not only in considering the New Jersey Supreme Court's decision In re Baby M but in the whole area of the new reproductive biology—is, in the words of a popular columnist, a mess.

Interestingly, the enormity of this complex, multiparent scenario—which Kerns to be on its way to becoming a reality with Baby M and its anticipated progeny—was totally lost on Mary Beth Whitchead. I just can't see how four peeple loving [Baby M], five people loving her, can hurt her, she said recently.