“Pictures of Pain Pay Off,” proclaimed the title of a recent article in the legal literature. The thermographic picture, or thermogram, is raising the stakes in plaintiff back cases and gaining national attention in both the medical and legal communities. Doctors see it as a diagnostic tool; lawyers, as an objective means of documenting injuries.

Yet the diagnostic and demonstrative potentials of this modality are also arousing considerable controversy—of the kind that has attended the use in court of blood tests to determine paternity, intoxication tests, polygraphs tests, hypnosis, spectrographs, and neutron activation analysis. This article will examine the use and value of thermographic pictures as evidence of spinal conditions and nerve root compression.

Health care cost considerations exert increasing influence today over clinical decision-making. One way to help contain costs while maintaining the quality of health care may be to increase among both physicians and patients an acknowledgment of, and tolerance for, a reasonahle degree of medical uncertainty. By medical uncertainty we mean here those clinical situations in which, based on available data, absolute scientific proof regarding some aspect of a patient's heallh status cannot be obtained.

To the extent that acceptance of medical uncertainty and a corresponding restraint among physicians can he encouraged without exposing the physicians to an undue risk of legal liability, all participants in the health care system would benefit from this tolerance. To help provide this encouragement. we will explore the legal implications of medical uncertainty, focusing on diagnostic testing, and argue that our legal system does now and will continue to recognize, tolerate, and perhaps even promote some medical uncertainty in the diagnostic realm.

Diagnostic sonography, also known as ultrasound, has become an invaluable aid in the practice of obstetrics and gynecology. Rapid improvements in instrumentation have caused the sonologist and sonography to assume a primary role in the care of these patients. Patient and physician expectations have increased with the technological advances. This paper will outline the advances and capabilities of diagnostic sonography in obstetrics and gynecology, while reflecting upon the foreseeable legal implications.

The physics of ultrasound is rather complex. Briefly, ultrasound utilizes high-frequency, non-ionizing, mechanical waves, 2.25 to 10 megahertz, that require a molecular medium for propagation. The reflected energy is processed to produce an image. Because it employs non-ionizing waves, ultrasound is considered safe by most authorities when used at the intensities currently employed for diagnosis. No clinically significant adverse effects have been reported in humans to date.

Despite the current debate be tween proponents of regulation and of competition over the best way to control the inflation of medical care costs, both camps agree that health care for the uninsured poor is primarily a government obligation and cannot be left to market forces. Health care for the “medically indigent,” people unable to afford needed care due to poverty or inadequate insurance, has always been the responsibility of state or local governments. But it has often been rendered through the charity care of hospitals and other health care providers. As the willingness of private hospitals to render such care declines, policy-makers are beginning to study the uninsured and to develop new ways to finance and deliver health care to them. This interest is both timely, as the number of uninsured is increasing, and confounding, as health care costs and the pressure to reduce the federal deficit limit government's ability to expand public programs.

Less than two decades ago it was thought sufficient to say, “When a practitioner is in doubt on an ethical question, the best answer is usually No.” A more recent commentator has suggested, however, that “[s]uch platitudes have become increasingly inadequate to guide the attorney facing conflicts of interests in the private practice of law.“ Because of the general vagueness of the American Bar Association's Model Code of Professional Responsibility, and of state codes based on it, courts have begun to fashion a vast “common law” of conflicts of interest. A particularly controversial entry to this body of common law is the opinion of Justice Paul Liacos, sitting as single justice in the Massachusetts case of White v. Kaplan. This article examines the opinion and its theoretical suppon.

Less than two decades ago it was thought sufficient to say, “When a practitioner is in doubt on an ethical question, the best answer is usually No.” A more recent commentator has suggested, however, that “[s]uch platitudes have become increasingly inadequate to guide the attorney facing conflicts of interests in the private practice of law.“ Because of the general vagueness of the American Bar Association's Model Code of Professional Responsibility, and of state codes based on it, courts have begun to fashion a vast “common law” of conflicts of interest. A particularly controversial entry to this body of common law is the opinion of Justice Paul Liacos, sitting as single justice in the Massachusetts case of White v. Kaplan. This article examines the opinion and its theoretical suppon.