Texas medicine
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Biography Historical Article
The politics of choice: roles of the medical profession under Nazi rule.
In 1933, when Adolf Hitler took power, the German medical community was faced with intense crisis and change. Because social processes become more clearly defined in times of crisis, the days of Nazi rule offer an excellent opportunity to examine health care and moral issues. ⋯ In addition, we detail four types of responses made by physicians and students: flight, conformism, individual resistance, and group resistance. We conclude that if the role of physicians is to aid and protect patients against disease or experimentation on humans, then he or she must maintain heightened political awareness in order to deal with social crises before they overwhelm any response.
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Injury is the leading cause of death in children 1 year of age and older in the United States, yet there has been little published on causes of injury deaths in Texas children. Cause-of-death information about children 0 through 19 years who were residents of Texas and died from 1980 through 1985 were examined. Injury accounted for nearly 34% of all childhood deaths from 1980 through 1985. ⋯ The leading causes of injury death varied by age group, but motor-vehicle injuries were the leading cause of injury deaths in all age groups 1 year of age and older. In addition, these data demonstrated the need for intervention in drowning deaths in every age group, choking deaths in infants, suicides in Anglos (especially teenagers), and homicides in infants, teenagers, and blacks. We must continue to support research and intervention strategies to combat this alarming public health problem.
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National attention has been directed to the problem of "dumping" of uninsured patients upon public hospitals. Federal law addresses only transfers of emergency room patients without regard to possible financial motivation. ⋯ Both the hospital and the physician responsible for the care of a patient who is transferred in violation of the law may be subject to Medicare sanctions, including termination or suspension from participation and fines up to $50,000 for each occurrence. Proposed regulations affirm that private practitioners who provide uncompensated emergency room services under an oral agreement may be subject to sanctions in the event of a violation.
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This article originally was prepared for presentation at the 1988 Texas Health Law Conference, Nov 4, 1988, in Austin. It appears this month in Texas Medicine to emphasize the importance of state and federal laws that require reporting of certain peer review actions by hospitals, medical societies, and other organizations to the Texas State Board of Medical Examiners (TSBME). ⋯ Young, is staff counsel for the TSBME. He formerly was staff attorney and director, Office of Medical Ethics, at Texas Medical Association.