The past fifteen years have witnessed parallel advances in law and medicine which enable physicians and future parents to prevent the birth of many handicapped children. The right of reproductive freedom has been included as one facet of the constitutionally based right to privacy. Medical science has developed and refined techniques for detecting parental carriers of many handicapping conditions, as well as means to determine whether a particular fetus is afflicted. As these advances have progressed, a sort of mutual dependency has evolved: The parents' right to decide whether and when to have children cannot be fully exercised unless parents have the benefit of available medical knowledge. Nor can advances in detecting birth defects be fully implemented without legally sanctioned means of preventing or terminating pregnancy.

Along with these advances has come increased litigation over the issue of the standard of care a physician owes his or her pregnant patients. Several parents who have given birth to severely handicapped children have attempted to impose an additional duty on physicians: that is, to warn parents of the risks of having a handicapped child, and/or to diagnose the handicap in time for the parents to terminate the pregnancy.

Medical examinations and evaluations by physicians specifically undertaken to provide information for the processing of insurance and legal claims are essential to the proper functioning of our insurance and legal systems. Since such evaluations often emphasize aspects of the medical examination and employ reasoning not customarily addressed by physicians who are primarily concerned with diagnosis and treatment, the distinguishing features of these medicolegal examinations should be appreciated by physicians asked to perform this type of examination. Similarly, these features should also be understood by persons who interpret medical data and physicians' opinions in resolving claims involving such medical issues as cause-and-effect relationships and disability ratings.

The recent general disenchantment with government control has focussed attention on the concept of occupational licensing. The logical place to begin a reappraisal of occupational licensing is in the field of medicine, where such licensing originated and where it has been most fully accepted.

Our position is that no rational or moral foundation for medical licensure exists and, therefore, we recommend the total abandonment of governmental licensing and the substitution of free market protections, including private certification. Medical licensing, and occupational licensing in general, is morally wrong and ineffectual in practice.

Traditionally, hospitals have been liable for the acts of their employees or agents under the doctrine of respondeat superior, but have not been considered liable for the actions of those whom they did not employ or over whom they had no control. Accordingly, hospitals and their insurers were able to avoid legal responsibility for the acts of medical malpractice committed by physicians on their medical staffs. Although elements of a new and distinct theory of hospital corporate responsibility unrelated to respondeat superior had emerged before, the widely discussed opinion of the Illinois Supreme Court in Darling v. Charleston Community Hospital is generally considered the hallmark of a change in judicial thinking in respect to a hospital's duty to monitor the quality of care rendered within its walls. However, Darling was not a forerunner of a spate of similar holdings, and, in fact, has never been specifically relied upon even in Illinois. Only in the last several years have significant additional strides been taken in developing this theory. Two recent intermediate appellate decisions in Wisconsin and North Carolina seem to reflect the trend of the law and the affirmative duty of a hospital to monitor the quality of care rendered by its medical staff.