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This Article briefly summarizes the history of the euthanasia debate in the United States, describes the classical arguments for and against euthanasia, examines the terms of the current debate, and concludes that while society may want to recognize a competent patient's right to escape the suffering of a terminal illness, it should do so with humility—and with caution.

THE PHYSICIAN ANALOGY IN POLITICS IS NOT INHERENTLY ELITIST OR ANTITHETICAL TO CONSTITUTIONAL GOVERNMENT, AS MODERN CRITICS HAVE CLAIMED. ON THE CONTRARY, IN ITS ORIGINAL DEVELOPMENT AMONG THE ORATORS OF FOURTH-CENTURY ATHENS, IT EPITOMIZED THE AIMS OF CONSERVATIVE DEMOCRATS, OFFERING BOTH A PERSPECTIVE THAT REINFORCED THE IDEA OF A PRESCRIPTIVE CONSTITUTION GROUNDED IN TRADITIONAL AND A CONCEPTION OF LEADERSHIP COMPATIBLE WITH THE EGALITARIAN ANIMUS OF THE RESTORED DEMOCRACY. MOREOVER, THIS CONCEPTION OF THE POLITICAL PHYSICIAN ENJOYED THE FULL SANCTION OF GREEK MEDICINE. THE NORMS, CONCEPTS, AND TECHNIQUES ADDUCED IN THE HIPPOCRATIC WRITINGS CLOSELY PARALLEL THOSE OF CONSERVATIVE DEMOCRATS.

Malpractice insurance premiums for physicians have increased at an average rate of over 30 percent per year. This rate is significantly higher than health care cost inflation and the increase in physician costs. Trends indicate that malpractice related costs, both liability insurance and defensive medicine costs, will continue to increase for the near future. Pressures to limit physician costs under Medicare raise a concern about how malpractice costs can be controlled. This paper presents an overview of the problem, reviews options that are available to policymakers, and discusses State and legislative efforts to address the issue.

The physician analogy in politics is not inherently elitist or antithetical to constitutional government, as modern critics have claimed. On the contrary, in its original development among the orators of fourth-century Athens, it epitomized the aims of conservative democrats, offering both a perspective that reinforced the ideal of a prescriptive constitution grounded in tradition and a conception of leadership compatible with the egalitarian animus of the restored democracy. Moreover, this conception of the political physician enjoyed the full sanction of Greek medicine. The norms, concepts, and techniques adduced in the Hippocratic writings closely parallel those of conservative democrats.

In dem Beitrag wird die Arzt-Patient-Beziehung angesichts des gesundheitspolitischen Wandels und der zunehmenden Verstaatlichung ärztlicher Tätigkeit diskutiert. Zudem wird die ärztliche Tätigkeit im Gesundheitssystem verortet. Es wird deutlich, daß sie verfassungsrechtlich, arzt- und organisationsgesetzlich, leistungsberuflich und sozialorganisatorisch im bundesdeutschen Sozialstaat verankert ist. (ICA)

This article presents a first hand account of a pediatric physician working in an inner city clinic under a managed care environment. The frustrations, advantages, and disadvantages of the managed care implementation of services is described. The implications of managed care in this environment for the patient, the health care delivery system, and the physician are compared to a fee for service delivery system.

Medicine in the setting of the royal courts of Europe form Renaissance to the Enlightment has been recently discussed, but Italian court medicine has been so far very largely neglected. In this article central problems are the relations between court medicine and academic medicine and the social status of the court physician in fourteenth century. Both problems are investigated in two Italian courts: the Visconti court in Milan and Pavia and the Aragonese court in Sicily. The list of the Visconti physicians and astrologers attests that they had all been celebrated university professors and that their condition as personal physicians to Galezzo and Gian Galeazzo was far superior to the acdemic on in honour and salaries. Their role could also be representative and political. This was expecially the case of Ruggero de Camma, who was chosen as personal physician to the Aragonese king Martino II and appointed by him as first protomedico for political reasons. Key words: Court Medicine - Universities - Astrology - Royal doctors - Protomedicato

This purpose of this article is to provide an argument for why advanced practice nurses should be reimbursed for the full value of their services as primary care providers, and why it should result in economic parity with physicians who are primary care providers.

Physicians are increasingly expected to assume responsibility for the management of human and financial resources in health care, particularly in hospitals. Juggling their new management responsibilities with clinical care, teaching and research can lead to conflicting roles. However, their presence in management is crucial to shaping the future health care system. They bring to management positions important skills and values such as observation, problem-solving, analysis and ethical judgement. To improve their management skills physicians can benefit from management education programs such as those offered by the Physician-Manager Institute and several Canadian universities. To manage in the future environment they must increase their knowledge and skills in policy and political processes, financial strategies and management, human resources management, systems and program quality improvement and organizational design.

Purpose. This study explores two possible mechanisms through which occupational stress is linked to absenteeism. The extent to which physician-excused absenteeism and absenteeism not excused by a physician are related to employee reports of perceived stress is assessed. Design. A plantwide survey was conducted in January 1990. Employee reports of occupational stress gained from this survey were linked with 1990 absenteeism data from the employees' records. Setting. A mid-sized manufacturing plant. Sample. Complete data were available for 998 of the 1534 (65%) unionized employees in the plant. Measures. Measures of both physician-excused absences and absences not excused by a physician were created. Stressors included role ambiguity, lack of control over work pace, and being paid on a piece-rate basis. Perceived stresses included role conflict, physical environment stresses, and overall work stress. Results. For physician-excused absenteeism, role conflict (OR, 1.54, p <.01), overall work stress (OR 1.24, p <.05), and physical environment stress (OR 1.34, p <.05) had significantly elevated odds ratios, even after adjusting for demographics. For absences not excused by a physician, none of the stressors or stresses had significant odds ratios after controlling for demographic characteristics. Conclusions. Employees in this plant were not using short-term voluntary absenteeism as a way of coping with work stress. However, high levels of perceived work stress were associated with subsequent physician-excused absences.