Eliciting patient preferences in today's health care system.

The American Medical Association Council on Ethical and Judicial Affairs recommends that physicians discuss advance directives with their patients and the patients' proxies. The council could have gone further by recognizing the difficulties physicians will encounter in trying to implement its proposal in a managed health care system. There is an undeniable need for caregiver participation in end-of-life planning, but the health care system must recognize and support implementation of the council's recommendations to make that possible.

Taking a closer look at the managed care class actions: impact litigation as an assist to the market.

Professor Cerminara examines the use of class action lawsuits to empower individuals to challenge health care decision-making. The article begins by noting the benefits of class actions which provide strength in numbers and a far-ranging impact by challenging policy decisions and encouraging corporate responsiveness. Professor Cerminara concludes that class actions are but one step in the process of empowering individuals and decreasing their resentment of the lack of process currently within the health care system.