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Dramatic scientific breakthroughs in medical technology have revolutionized the physician’s diagnostic prowess in the art of obstetrics. Scientific procedures now reveal previously undetectable secrets about the womb’s tiny inhabitants. In the last few years, perinatologists have not only demonstrated the ability to discern fetal abnormalities of an extraordinary variety, but also have become increasingly successful in correcting many of these defects in utero. This article identifies the potential medicolegal conflicts that may arise as fetal surgery becomes an accepted medical practice. It begins by surveying the legal rights of unborn persons with a particular emphasis on the role of viability in determining those rights. The article will then examine the concept of viability as developed by the Supreme Court in Roe v. Wade and later abortion decisions and concludes that the current judicial deference to the medical community in determining viability is adequate for balancing rights in the abortion context. However, conflicts among physicians and between the mother and her unborn child that may arise in the fetal surgery context suggest that viability may be an inadequate benchmark for resolving such conflicts. The article concludes with a recommendation to reform the current method of resolving the critical question of when a fetus becomes viable.
Opposition to abortion is based in part on the assumption that personhood is achieved at or shortly after fertilization of the egg. This interpretation of personhood arises from a contemporary application of the ancient doctrine of preformationism, a doctrine which holds that there is a preformed individual, in an ontological sense, within the developing entity. The assumption that the fertilized egg is unique in its capacity to develop into a human being is at least in part responsible for the opinions of those opposed to abortion. Yet, the uniqueness of the zygote in its capacity to develop into an adult organism is qualified by the discovery that development may be possible in a number of other ways. Consideration of the phenomena of cloning, parthenogenesis and chimerism can relieve moral ambiguity about abortion and may reduce opposition to that practice.
The Secretary of Health and Human Services denies Medicare reimbursement for certain indirect costs associated with health care delivery. This Note reviews arguments supporting and opposing reimbursement of costs that providers incur in three common financial transactions: the use of equity capital, acquisition of providers, and loan financing. The Note considers the Secretary’s regulations in light of the congressional mandate to encourage efficient delivery of health care and concludes that current reimbursement policy promotes inefficiency.
In Jefferson v. Griffin Spalding County Hospital Authority, the Supreme Court of Georgia affirmed a lower court order requiring a pregnant woman to submit to a cesarian section and other medical procedures necessary to save her unborn child’s life. The court found that the state’s interest in protecting the viable fetus outweighed the pregnant mother’s right to religious practice, right to refuse medical treatment, and parental autonomy. Jefferson appears to stand for the proposition that fetuses have rights that attach at viability and that mothers have a corresponding duty to ensure live births. The decision foreshadows substantial conflict between fetal and maternal rights.