As recently as 1970 a legal commentator felt certain enough of his ground to say about informed consent: Good medical practice is good Iaw.' Whatever the validity of that statement then, reliance on it in 1973 is dangerous at best. Three opinions in the last year, in the District of Columbia, California and Rhode Island. have specifically repudiated this view and put the medical profession on notice that they can no longer rely on self. imposed standards to determine what constitutes informed consent.

In Canterbury v. Spence, the defendant doctor had informed both his 19 year old patient who suffered back pain and the patient's mother that a laminectomy was no more serious than any other operation. He did not mention that the procedure carried a 1% risk of paralysis. Following surgery, the patient suffered total paralysis from the waist down. Tho court decided specifically that the physician was under an affirmative obligation to disclose this risk information regardless of what was medically customary. The court held that the law, not medical custom, defines the standard of disclosure according to the patient's needs.

The letters HMO (short for Health Maintenance Organization) have very quickly become household words. In general, an HMO may be described as the organizational entity of a health care system which contracts with hospital and medical care providers on behalf of its enrolled members. More precisely, it is an organization, (usually a corporation) which accepts the responsibility to provide, directly or through contract, an agreed upon set of comprehensive health maintenance and treatment services for a volun. tariiy enrolled group of persons and is reimbursed through a premgotiated payment made by or on behalf of each person enrolled in the plan. (U. S. Department of H.E.W., Health Maintenance Organization [1971]).

HMOs can be either for profit or not for profit, although for profit HMOs are rare since establishing a for profit HMO involves the navigation of uncharted waters, containing many obstacles which most HMO organizers would prefer to avoid.

Copies of the 1973 DIRECTORY OF EXAMINING PHYSICIANS AND ROSTER OF MEMBERSHIP originally prepared and distributed by the Massachusetts Society of Law & Medicine are still available to physicians, attorneys, insurers, Social Security Administrators, Retirement Boards and others who seek physicians to perform medical examinations and evaluations for insurance, legal, Social Security Disability. workmen's compensation, disability continuation, return to work and other such medicolegal problems, Order copies with the Order Form below.

This directory contains the alphabetical and geographical listing of almost 150 physicians (primarily within the Commonweath of Massachusetts) who have indicated willingness and availability to perform medical examinations in their particular fields of specialization or interest for legal and insurance purposes, and whether and to what extent they will be avail. able for testimony in court, at the Industrial Accident Board, or for Retirement and other Panel hearings.