[Euthanasia in the United States]

In the West, efforts to legalize active euthanasia and assisted suicide go back at least a century. Debates have emerged over the past two decades in a number of countries, however. What are the principal arguments put forward in favor of it? What development in contemporary medicine, and contemporary culture, might account for an increasingly favorable attitude toward euthanasia? What kind of efforts are being developed to stop or to impede the euthanasia movement?

Comparison of a liquid solvent extraction technique and supercritical fluid extraction for the determination of alpha- and beta-carotene in vegetables

An ethanol-pentane solvent extraction procedure and a supercritical CO2 extraction procedure are compared for the high-performance liquid chromatographic determination of alpha- and beta-carotene in vegetables. The vegetables tested included carrots, collard greens, turnips, turnip greens, kale, mustard greens, broccoli florets, zucchini, and squash. Homogenization of the sample prior to liquid or supercritical fluid extraction significantly improved recovery of the carotenoids. A combination of static and dynamic modes of extraction with ethanol modifier at 338 atm and 40 degrees C was necessary in order to achieve optimum recovery with the supercritical fluid procedure. beta-Carotene results with the supercritical CO2 procedure averaged 23% higher than results for the liquid extraction procedure. Only corn and carrots contained detectable levels of alpha-carotene, and, in both cases, liquid extraction yielded slightly higher results. Liquid extractions were performed in approximately 90 min, and supercritical fluid extractions were performed in 30 min; however, the supercritical fluid extractions procedure required less than 10 min of an analyst's time while the liquid extraction procedure was labor intensive.

Allocating health care resources. The vexing case of rehabilitation

The allocation of resources to rehabilitation is beset with many difficulties. Among them are the general crisis in the American health care system and the problem of how to make a case for the role of rehabilitation. Rehabilitation must be prepared to show how and why it is a good medical and social investment in relation to other needs. Rehabilitation has played a secondary role in the American health care system because of overemphasis on curative and life-extending medicine. Rehabilitation must work to show that money invested in caring is as well spent as money aiming at the extension of life. It must also establish a fresh new vision of health care in general as well as illustrate where rehabilitation stands in a more integrated and coherent health care system. Improved quality of life, which rehabilitation can provide, is as important as saving and extending life.

Bioethics education. Expanding the circle of participants

Bioethics education now takes place outside universities as well as within them. How should clinicians, ethics committee members, and policymakers be taught the ethics they need, and how may their progress best be evaluated?

Ethics committees and social issues: potentials and pitfalls

When the Karen Ann Quinlan case emerged in the mid-1970s and the New Jersey Supreme Court made mention of the role that ethics committees might play in such cases, no one could have predicted at the time what the consequences of that observation might be. It took a while for momentum to build, but we are now seeing the flowering of what is an important movement in the field of bioethics: the interplay of ethics committees and broader societal issues.

Evaluating the Oregon priority plan

The Oregon priority plan represents an innovative method of reforming its Medicaid program. It would replace the present system of limiting the number of people in the program with one that would, after setting priorities, limit treatment benefits. The strength of the plan is that it would provide all the poor with health care coverage; its potential drawback is that it might put expectant mothers and children at a disadvantage and possibility make some forms of needed care inaccessible to other groups as well. Despite the drawbacks and uncertainties of the priority plant, it deserves to be given a chance to prove itself.