The standard of care with regard to any new medical technology develops slowly. Attitudes must change, and equipment must be purchased, installed and utilized. Technical problems must be resolved and protocols established. Advances are better understood and more aggressively pursued by some physicians than others, with a consequent disparity in implementation. Electronic fetal monitoring (EFM) is an example of such a technology. Little known to obstetricians 15 years ago, EFM has been accepted by practitioners widely and rapidly. Today, armed with guidelines from the American College of Obstetricians and Gynecologists (ACOG) and the recommendations of the National Institutes of Health (NIH), we monitor with EFM most obstetrical patients during labor and almost all high-risk patients before labor. While the practice or custom of a majority of obstetricians does not necessarily define the standard of care, the use of EFM for fetal surveillance during labor represents the prevailing medical and legal standard of care.

The February 1985 issue of Law, Medicine & Health Care published excerpts from the Report of the Massachusetts Task Force on Organ Transplantation, along with a report by its chairman, Professor George Annas, and commentary by a number of esteemed scholars and practitioners who were generally complimentary of both the approach and substance of the work of the Task Force. We have thoroughly reviewed the Task Force Report and feel it necessary to take strong exception to a number of points, both procedural and substantive, raised there. In general, we are concerned that the Task Force Report perpetuates and reinforces a number of serious misconceptions about the issues surrounding transplantation that, in turn, lead to conclusions that are both inaccurate and misleading. This situation is most unfortunate be cause the complexities of the issues raised by transplantation require care ful scrutiny, especially where there are empirical data that clearly call into question these often strongly held predispositions. In the following sections we point out what we feel are the major shortcomings of the Massachusetts effort.

Aesop‘s Fable, “The Dog and the Shadow,” begins with a dog walking over a bridge with a piece of meat in his mouth. Looking down into the stream, he sees his shadow. Thinking it is a bigger dog, with a piece of meat twice the size of his own, the greedy dog decides to get it. Snarling, he opens his mouth to attack. At that moment the meat falls from his mouth, into the stream. The dog realizes his mistake, and sadly says to himself, “Grasp at the shadow and lose the substance.“

Drs. Overcast and Evans have not yet realized their mistake, but this response may help them see that what they characterize as their “strong exception” to “procedural and substantive” points made by the Massachusetts Task Force on Organ Transplantation and the “major shortcomings” they purport to identify really involve insubstantial “shadows.” Their “appraisal” indicates no disagreement of substance with any of the Task Force's policy recommendations. and their tangential quibbles shrink when their content and context is understood.

The definition and regulation of nursing practice are issues of growing national interest. A variety of factors, including rising health care costs and consumer awareness, have combined to catalyze changes in health care delivery, with an increasing emphasis on disease prevention and cost-effectiveness. These goals have necessarily focused attention on the respective roles of non-physicians—most prominently, nurses—as providers of lower cost, quality health care. In a climate of professional and economic competition, state legislatures, state nursing boards, courts, and professional nursing organizations are engaged in a process of changing, adapting, or interpreting existing nursing practice laws to meet the needs of the changing health care system.

This article reviews the history and evolution of nursing practice legislation, examines the present stage in its development, and highlights some important issues affecting contemporary nursing practice acts.

Every lawyer and law teacher is familiar with the basic developments in computer-assisted legal research that have changed at least the method of legal research. Computer-assisted research has gone far beyond LEXIS and Westlaw (computerized collections of state and federal legislation and decisions, as well as other legal material) in areas that are of critical importance to effective research for the teacher of health law. The nature of health law research has special, although perhaps not unique, characteristics that are particularly benefited by computer assistance.

Research in health law, especially policy-oriented research, rarely relies entirely on case law. Rather, its reach extends to interdisciplinary or cross-disciplinary research, comparative research, and the popular, as well as the scholarly, view. While health law teachers develop the ability to keep abreast of the rapid changes in case law and federal statutes and regulations, it is more difficult to keep pace with legislative developments on a state-bystate basis.