Several incidents involving the withdrawal of treatment and/or the ordering of supportive care for nursing home residents came to public attention in the spring and summer of 1981, raising serious concerns among advocates, attorneys, and health care professionals about the use of supportive care orders. It appeared that there was little consistency or consensus with respect to the meaning or application of the Supportive care concept.

In response to such concerns, a task force of interested individuals long term care staff and administrators, consumer advocates, medical, legal and social service professionals, and government agency officials was convened to identify and discuss issues raised by the use of supportive care. The task set by the group was to make recommendations and propose a set of guidelines for the provision of supportive care in long term care settings.

Surrogate motherhood, as it is practiced today, differs only in insemination technique from this biblical effort. A married couple, unable to conceive because of female infertility, or, perhaps, a single male who desires a child would, as did Sarah, seek out a woman willing to act as a surrogate mother It is likely that the couple would make the initial contact through a classified advertisement and negotiate a contract with a fertile woman through their attorneys. The contract, in its most basic terms, would provide that the surrogate be artificially inseminated with the husband's semen, carry the child to term, and relinquish her parental rights upon birth of the child. Although there have been cases where a woman becomes a surrogate mother without payment, the surrogate mother typically receives a fee for her services as a carrier.

Surrogate motherhood has captured the attention of both the media and the legal profession in the past several years. Courts faced with litigation on surrogate motherhood have uniformly taken the position that these arrangements are contrary to public policy, and have refused to compel the specific performance of these contracts? It is my position that these rulings have been correct, and that if surrogate motherhood is to be considered legally acceptable in this country (which I think it should not be ) then state legislatures must act to legalize the contracts drawn up for these arrangements.

The procedure for surrogate motherhood is usually initiated by either a married couple, of whom the wife is infertile, or by a single man. In either case, a contract is made with a fertile woman; the woman is to be artificially inseminated with the man's sperm. Generally, this is done in exchange for a large sum of money. At the time that the baby is born, the surrogate mother surrenders the child for adoption by the wife (in the case of a married couple) and presumably by the father to regularize his relationship with the child.

The hospital emergency department- those who receive care there and those who provide it-has changed rapidly in recent years. The number of patients going to emergency departments is steadily increasing, and the care which they seek is not confined to traditional emergency care. More and more patients utilize the hospital emergency department for routine health problems, either as substitutes for personal health care providers or as replacements when their own providers are unavailable.

Physicians, nurses, and other health care providers in the hospital emergency department have changed from generalists to emergency care specialists. The rotating, on-call staff physician serving in a department with low priority is being replaced by the emergency medicine practitioner. Since 1980, the American Board of Emergency Medicine has been certifying physicians qualified in this new specialty, and the Emergency Department Nurses’ Association has been administering an examination for certification in emergency nursing.