0
ARTICLE |

Controlling the Resurgent Tuberculosis Epidemic: Title and subTitle BreakA 50-State Survey of TB Statutes and Proposals for Reform FREE

Lawrence O. Gostin, JD
[+] Author Affiliations

Reprint requests to Office of the Executive Director, American Society of Law, Medicine, & Ethics, 765 Commonwealth Ave, 16th Floor, Boston, MA 02215 (Mr Gostin).


JAMA. 1993;269(2):255-261. doi:10.1001/jama.1993.03500020089038
Text Size: A A A
Published online

A LONG-STANDING annual decline in the number of cases of tuberculosis (TB) in the United States led the Department of Health and Human Services to establish an Advisory Council for the Elimination of Tuberculosis (ACET) in 1987.1 Yet, even before the Council was established, the decline in tuberculosis had ended, and from 1985 through 1991 there were some 39 000 more cases than would have been expected had the downward trend continued.2,3

More worrisome still is the serious increase in the rate of multidrug-resistant (MDR) tuberculosis, which is much more difficult, and more costly, to treat than nonresistant strains. The course of treatment of MDR-TB increases from approximately 6 months to 18 to 24 months or longer, and the cure rate decreases from nearly 100% to 60% or less.4,5 A 1992 survey in New York City (NY) found that 33% of patients were infected with organisms resistant

REFERENCES

Advisory Council for the Elimination of Tuberculosis (ACET).  Strategic plan for the elimination of tuberculosis in the United States. MMWR . 1989;;38( (suppl S-3) ):1-25.
National MDR-TB Task Force. National Action Plan to Combat Multidrug-Resistant Tuberculosis . Washington, DC: US Dept of Health and Human Services, Public Health Service, Centers for Disease Control; 1992;.
Centers for Disease Control. Tuberculosis Statistics in the United States 1989 . Washington, DC: Dept of Health and Human Services; 1991;.
Snider DE, Roper WL.  The new tuberculosis. N Engl J Med . 1992;;326:703-705.
Treatment of Tuberculosis and Tuberculosis Infection in Adults and Children, Official Statement of the American Thoracic Society Adopted March, 1986 . New York, NY: American Thoracic Society; 1986;.
Rieder HL, Cauthen GM, Comstock GW, Snider DE.  Epidemiology of tuberculosis in the United States. Epidemiol Rev . 1989;;11:79-98.
Braun MM, Truman BI, Maguire B, et al.  Increasing incidence of tuberculosis in a prison inmate population: association with HIV infection. JAMA . 1989;;261:393-397.
Snider DE, Hutton MD.  Tuberculosis in correctional institutions. JAMA . 1989;;261: 436-437.
Centers for Disease Control.  Tuberculosis among residents of shelters for the homeless—Ohio 1990. MMWR . 1991;;40:869-877.
Nolan CM, Elarth AM, Barr HA, et al.  An outbreak of tuberculosis in a shelter for homeless men: a description of its evolution and control. Am Rev Respir Dis . 1991;;143: 257-261.
Centers for Disease Control.  Tuberculosis outbreak among persons in a residential facility for HIV infected persons—San Francisco. MMWR . 1991;;40:649-652.
Centers for Disease Control.  Nosocomial transmission of multidrug-resistant TB to health-care workers and HIV-infected patients in an urban hospital—Florida. MMWR . 1990;;39:718-722.
Centers for Disease Control.  Nosocomial transmission of multidrug-resistant tuberculosis among HIV-infected persons—Florida and New York, 1988-1991. MMWR . 1991;;40:585-591.
Goldsmith MF.  Forgotten (almost) but not gone, tuberculosis suddenly looms large on domestic scene. JAMA . 1990;;264:165-166.
Cowley G.  A deadly return. Newsweek . (March 16) , 1992;:53-57.
Goldsmith MF.  Medical exorcism required as revitalized revenant of tuberculosis haunts and harries the land. JAMA . 1992;;268:174-175.
Small PM, Schecter GF, Goodman PC, Sande MA, Chaisson RE, Hopewell PC.  Treatment of tuberculosis in patients with advanced human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs. Am Rev Respir Dis . 1991;;144:745-749.
NIOSH Recommended Guidelines for Personal Respiratory Protection of Workers in Health-Care Facilities Potentially Exposed to Tuberculosis . Atlanta, Ga: Dept of Health and Human Services, Centers for Disease Control, National Institute for Occupational Safety and Health; 1992;.
Barnes PF, Bloch AB, Davidson PT, Snider DE.  Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med . 1991;;324:1644-1650.
Daley CL, Small PM, Schecter GF, et al.  An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus—an analysis using restriction-fragment-length polymorphisms. N Engl J Med . 1992;;326:231-235.
Brudney K, Dopkin J.  Resurgent tuberculosis in New York City: human immunodeficiency virus, homelessness, and the decline in tuberculosis control programs. Am Rev Respir Dis . 1991;;144:745-749.
Skolnick A.  Government issues guidelines to stem rising tuberculosis rates in prisons. JAMA . 1989;;262:3249-3253.
Centers for Disease Control.  Prevention and control of tuberculosis in facilities providing long-term care to the elderly: recommendations of the Advisory Committee for Elimination of Tuberculosis. MMWR . 1990;;39( (suppl RR-10) ):7-20.
Centers for Disease Control.  Tuberculosis among foreign-born persons entering the United States: recommendations of the Advisory Committee for Elimination of Tuberculosis. MMWR . 1990;;39( (suppl RR-18) ):1-21.
Centers for Disease Control.  Prevention and control of tuberculosis in migrant farm workers: recommendations of the Advisory Council for the Elimination of Tuberculosis. MMWR . 1992;;41( (suppl RR-10) ):1-15.
Centers for Disease Control.  Prevention and control of tuberculosis in U.S. communities with at-risk minority populations and prevention and control of tuberculosis among homeless persons: recommendations of the Advisory Council for the Elimination of Tuberculosis. MMWR . 1992;;41( (suppl RR-5) ):1-23.
Sherman R.  TB hysteria repeated? Natl Law J . June 29, 1992;;14( (43) ):1, 32.
Tuberculosis Control Laws in the United States: A Survey and Recommendations . Atlanta, Ga: Centers for Disease Control and Prevention; 1992;. Draft, revised.
Bayer R. Private Acts, Social Consequences: AIDS and the Politics of Public Health . New Brunswick, NJ: Rutgers University Press; 1991;.
Parmet W.  Legal rights and communicable disease: AIDS, the police power, and individual liberty. J Health Polit Policy Law . 1989;;14:741-771.
Burris S.  Fear itself: AIDS, herpes and public health decisions. Yale Law Policy Rev . 1985;;3:479-513.
Delaware, 1915
New Jersey, 1895
Rhode Island, 1896
West Virginia, 1881
Wisconsin, 1905
Wyoming, 1901.
Alabama, Alaska, Indiana, Maine, Michigan, Minnesota, Nevada, New Hampshire, Oregon, Texas.
Hawaii, Illinois, New York, North Carolina, North Dakota, Vermont, Washington.
Illinois, Kansas, Nebraska, North Dakota, South Dakota, Wisconsin.
Alabama, District of Columbia, Florida, Georgia, North Dakota, Texas.
Alaska, Indiana, Tennessee, Texas, Washington.
California, Oklahoma, Maryland.
Ballard v Woodard, 641 F2d 432 (WDNC 1986).
Byrd v Bennett, 774 F2d 498 (4th Cir 1982).
DeGidio v Pung, 920 F2d 525, 531 (8th Cir 1990).
Estelle v Gamble, 429 US 97, 104, 97 SCt285, 50 LEd2d 251 (1976).
Alabama, Indiana, Maine, Minnesota, North Dakota.
Georgia, Montana, Texas, Vermont.
Utah, Vermont.
Maine, Michigan, Minnesota.
Louisiana, Missouri, Montana, Nebraska, New Hampshire, Ohio, Vermont.
Hawaii, Indiana, Iowa, Kansas, Nevada, North Dakota, South Dakota, Virginia.
Dubler NN, Bayer R, Landesman S, White A. The Tuberculosis Revival— Individual Rights and Societal Obligation in a Time of AIDS: A Report From the Working Group on TB and HIV . New York, NY: United Hospital Fund; 1992;.
Dept of Justice, Office of the Attorney General. Nondiscrimination on the basis of disability in state and local government services; Final Rule, 28 CFR Pt 35, July 26, 1991.
Arkansas, Connecticut, District of Columbia, Massachusetts, Montana, North Carolina, North Dakota, Oregon, Texas.
Alabama, Delaware, Indiana, Louisiana, Maine, Minnesota, Tennessee, Virginia.
Florida, Georgia, Maine, Oregon.
District of Columbia, Montana, North Carolina, Texas.
Alabama, Georgia, Montana.
Eg, Arkansas.
Eg, Virginia.
Florida, Georgia.
Eg, Virginia.
Montana, Oregon, Texas.
North Dakota, Georgia.
Connecticut, Louisiana, South Dakota, Virginia, West Virginia.
Brakel SJ, Parry J, Weiner BA. The Mentally Disabled and the Law . 3rd ed. Chicago, Ill: American Bar Foundation; 1985;.
Logan v Arafeh, 346 F Supp 1265 (D Conn 1972), aff'd sub nom Briggs v Arafeh, 411 US 911 (1973).
State ex rel Fuller v Mallinax, 364 Mo 858, 269 SW 72 (1954).
Moore v Draper, 57 So2d 648 (S Ct Fla 1952).
Moore v Armstrong, 149 So 2d 36 (Fla SCt 1963).
Arizona, Iowa, Rhode Island, Nevada, Washington.
Alabama, Massachusetts, Maine.
Illinois.
Oregon.
Maryland, Massachusetts, New Hampshire, New Jersey, Ohio, Pennsylvania, South Dakota, Washington, Wisconsin.
State v Snow, 324 SW2d 532 (Ark SCt 1959).
Delaware.
Alabama, Kansas, Massachusetts, Pennsylvania, Utah.
New Jersey, Oklahoma, Washington.
New Jersey, Oklahoma, Washington.
Louisiana.
Hawaii, Virginia.
Georgia, Hawaii, Missouri, Nebraska, North Dakota.
Alabama, New Hampshire, Oregon, Vermont.
Arkansas, Hawaii, North Dakota.
Arkansas, Illinois, Kansas, Massachusetts, Michigan, Montana, New Jersey, Ohio, South Carolina, West Virginia, Wisconsin.
Florida, Georgia, Indiana, Maine, Missouri, Nebraska, South Carolina, Texas, Vermont, West Virginia.
Humphrey v Cady, 405 US 504 (1972).
Donaldson v O'Connor, 422 US 563 (1975).
Suzuki v Yen, 617 F2d 173 (9th Cir 1980).
Colyar v Third Judicial District Court for Salt Lake County, 469 F Supp 424 (D Utah 1979).
Addington v Texas, 441 US 418 (1979).
Lessard v Schmidt, 413 F Supp 1318 (ED Wis 1976).
In re Ballay, 482 F2d 648 (DC Cir 1973).
263 SE2d 661 (S Ct WVa 1980).
Indiana, Maine, Michigan, Minnesota, New Hampshire.
Shapiro v Thompson, 394 US 618 (1969).
Covington v Harris, 419 F2d 617 (DC Cir 1969).
Kentucky Ass'n of Retarded Citizens v Conn, 510 F Supp 1233 (WD Ky 1980).
Indiana, New Mexico, Oregon, Texas.
Alabama, Delaware, New Jersey.
District of Columbia, Louisiana, Oregon.
Arkansas, California, Iowa, Kansas, Wisconsin.
New Mexico, Pennsylvania, Texas.
Colorado, Delaware, Iowa, Maine, New Hampshire, Wisconsin, Wyoming.
Application of Halko, 54 Cal Rptr 661 (2d Dist 1966).
Benton v Reid, 231 F2d 780 (DC Cir 1956).
Eg, Texas.
Iowa.
New York.
South Dakota.
Texas.
Texas.
Utah.
In re Stoner, 73 SE 2d 566 (SCt NC 1952).
Gostin L.  The politics of AIDS: compulsory state powers, public health, and civil liberties. Ohio St Law J . 1989;;49:1017-1026.
Edgar H, Sandomire H.  Medical privacy issues in the age of AIDS: legislative options. Am J Law Med . 1990;;16:155-222.
Alabama, Iowa, Maine, Maryland, Nevada, North Carolina, North Dakota, Texas.
Alabama, District of Columbia, Nevada, North Dakota, Oregon, South Dakota.
District of Columbia, Maryland, Nevada.
Maryland.
Kansas, Nevada.
Alabama, Maine, New Jersey, North Carolina, South Dakota.
Alabama, Maine, Maryland.
School Board of Nassau County, Florida, v Arline, 480 US 273 (1987).
Gostin L.  The Americans With Disabilities Act and the U.S. health system. Health Aff . 1992;;11:248-257.
Gostin L.  The future of public health law. Am J Law Med . 1987;;12:461-490.
Letter from the Associate Commissioner for Health of New York City, Mark Barnes, to Paul Schwartz, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, November 16, 1992.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Advisory Council for the Elimination of Tuberculosis (ACET).  Strategic plan for the elimination of tuberculosis in the United States. MMWR . 1989;;38( (suppl S-3) ):1-25.
National MDR-TB Task Force. National Action Plan to Combat Multidrug-Resistant Tuberculosis . Washington, DC: US Dept of Health and Human Services, Public Health Service, Centers for Disease Control; 1992;.
Centers for Disease Control. Tuberculosis Statistics in the United States 1989 . Washington, DC: Dept of Health and Human Services; 1991;.
Snider DE, Roper WL.  The new tuberculosis. N Engl J Med . 1992;;326:703-705.
Treatment of Tuberculosis and Tuberculosis Infection in Adults and Children, Official Statement of the American Thoracic Society Adopted March, 1986 . New York, NY: American Thoracic Society; 1986;.
Rieder HL, Cauthen GM, Comstock GW, Snider DE.  Epidemiology of tuberculosis in the United States. Epidemiol Rev . 1989;;11:79-98.
Braun MM, Truman BI, Maguire B, et al.  Increasing incidence of tuberculosis in a prison inmate population: association with HIV infection. JAMA . 1989;;261:393-397.
Snider DE, Hutton MD.  Tuberculosis in correctional institutions. JAMA . 1989;;261: 436-437.
Centers for Disease Control.  Tuberculosis among residents of shelters for the homeless—Ohio 1990. MMWR . 1991;;40:869-877.
Nolan CM, Elarth AM, Barr HA, et al.  An outbreak of tuberculosis in a shelter for homeless men: a description of its evolution and control. Am Rev Respir Dis . 1991;;143: 257-261.
Centers for Disease Control.  Tuberculosis outbreak among persons in a residential facility for HIV infected persons—San Francisco. MMWR . 1991;;40:649-652.
Centers for Disease Control.  Nosocomial transmission of multidrug-resistant TB to health-care workers and HIV-infected patients in an urban hospital—Florida. MMWR . 1990;;39:718-722.
Centers for Disease Control.  Nosocomial transmission of multidrug-resistant tuberculosis among HIV-infected persons—Florida and New York, 1988-1991. MMWR . 1991;;40:585-591.
Goldsmith MF.  Forgotten (almost) but not gone, tuberculosis suddenly looms large on domestic scene. JAMA . 1990;;264:165-166.
Cowley G.  A deadly return. Newsweek . (March 16) , 1992;:53-57.
Goldsmith MF.  Medical exorcism required as revitalized revenant of tuberculosis haunts and harries the land. JAMA . 1992;;268:174-175.
Small PM, Schecter GF, Goodman PC, Sande MA, Chaisson RE, Hopewell PC.  Treatment of tuberculosis in patients with advanced human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs. Am Rev Respir Dis . 1991;;144:745-749.
NIOSH Recommended Guidelines for Personal Respiratory Protection of Workers in Health-Care Facilities Potentially Exposed to Tuberculosis . Atlanta, Ga: Dept of Health and Human Services, Centers for Disease Control, National Institute for Occupational Safety and Health; 1992;.
Barnes PF, Bloch AB, Davidson PT, Snider DE.  Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med . 1991;;324:1644-1650.
Daley CL, Small PM, Schecter GF, et al.  An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus—an analysis using restriction-fragment-length polymorphisms. N Engl J Med . 1992;;326:231-235.
Brudney K, Dopkin J.  Resurgent tuberculosis in New York City: human immunodeficiency virus, homelessness, and the decline in tuberculosis control programs. Am Rev Respir Dis . 1991;;144:745-749.
Skolnick A.  Government issues guidelines to stem rising tuberculosis rates in prisons. JAMA . 1989;;262:3249-3253.
Centers for Disease Control.  Prevention and control of tuberculosis in facilities providing long-term care to the elderly: recommendations of the Advisory Committee for Elimination of Tuberculosis. MMWR . 1990;;39( (suppl RR-10) ):7-20.
Centers for Disease Control.  Tuberculosis among foreign-born persons entering the United States: recommendations of the Advisory Committee for Elimination of Tuberculosis. MMWR . 1990;;39( (suppl RR-18) ):1-21.
Centers for Disease Control.  Prevention and control of tuberculosis in migrant farm workers: recommendations of the Advisory Council for the Elimination of Tuberculosis. MMWR . 1992;;41( (suppl RR-10) ):1-15.
Centers for Disease Control.  Prevention and control of tuberculosis in U.S. communities with at-risk minority populations and prevention and control of tuberculosis among homeless persons: recommendations of the Advisory Council for the Elimination of Tuberculosis. MMWR . 1992;;41( (suppl RR-5) ):1-23.
Sherman R.  TB hysteria repeated? Natl Law J . June 29, 1992;;14( (43) ):1, 32.
Tuberculosis Control Laws in the United States: A Survey and Recommendations . Atlanta, Ga: Centers for Disease Control and Prevention; 1992;. Draft, revised.
Bayer R. Private Acts, Social Consequences: AIDS and the Politics of Public Health . New Brunswick, NJ: Rutgers University Press; 1991;.
Parmet W.  Legal rights and communicable disease: AIDS, the police power, and individual liberty. J Health Polit Policy Law . 1989;;14:741-771.
Burris S.  Fear itself: AIDS, herpes and public health decisions. Yale Law Policy Rev . 1985;;3:479-513.
Delaware, 1915
New Jersey, 1895
Rhode Island, 1896
West Virginia, 1881
Wisconsin, 1905
Wyoming, 1901.
Alabama, Alaska, Indiana, Maine, Michigan, Minnesota, Nevada, New Hampshire, Oregon, Texas.
Hawaii, Illinois, New York, North Carolina, North Dakota, Vermont, Washington.
Illinois, Kansas, Nebraska, North Dakota, South Dakota, Wisconsin.
Alabama, District of Columbia, Florida, Georgia, North Dakota, Texas.
Alaska, Indiana, Tennessee, Texas, Washington.
California, Oklahoma, Maryland.
Ballard v Woodard, 641 F2d 432 (WDNC 1986).
Byrd v Bennett, 774 F2d 498 (4th Cir 1982).
DeGidio v Pung, 920 F2d 525, 531 (8th Cir 1990).
Estelle v Gamble, 429 US 97, 104, 97 SCt285, 50 LEd2d 251 (1976).
Alabama, Indiana, Maine, Minnesota, North Dakota.
Georgia, Montana, Texas, Vermont.
Utah, Vermont.
Maine, Michigan, Minnesota.
Louisiana, Missouri, Montana, Nebraska, New Hampshire, Ohio, Vermont.
Hawaii, Indiana, Iowa, Kansas, Nevada, North Dakota, South Dakota, Virginia.
Dubler NN, Bayer R, Landesman S, White A. The Tuberculosis Revival— Individual Rights and Societal Obligation in a Time of AIDS: A Report From the Working Group on TB and HIV . New York, NY: United Hospital Fund; 1992;.
Dept of Justice, Office of the Attorney General. Nondiscrimination on the basis of disability in state and local government services; Final Rule, 28 CFR Pt 35, July 26, 1991.
Arkansas, Connecticut, District of Columbia, Massachusetts, Montana, North Carolina, North Dakota, Oregon, Texas.
Alabama, Delaware, Indiana, Louisiana, Maine, Minnesota, Tennessee, Virginia.
Florida, Georgia, Maine, Oregon.
District of Columbia, Montana, North Carolina, Texas.
Alabama, Georgia, Montana.
Eg, Arkansas.
Eg, Virginia.
Florida, Georgia.
Eg, Virginia.
Montana, Oregon, Texas.
North Dakota, Georgia.
Connecticut, Louisiana, South Dakota, Virginia, West Virginia.
Brakel SJ, Parry J, Weiner BA. The Mentally Disabled and the Law . 3rd ed. Chicago, Ill: American Bar Foundation; 1985;.
Logan v Arafeh, 346 F Supp 1265 (D Conn 1972), aff'd sub nom Briggs v Arafeh, 411 US 911 (1973).
State ex rel Fuller v Mallinax, 364 Mo 858, 269 SW 72 (1954).
Moore v Draper, 57 So2d 648 (S Ct Fla 1952).
Moore v Armstrong, 149 So 2d 36 (Fla SCt 1963).
Arizona, Iowa, Rhode Island, Nevada, Washington.
Alabama, Massachusetts, Maine.
Illinois.
Oregon.
Maryland, Massachusetts, New Hampshire, New Jersey, Ohio, Pennsylvania, South Dakota, Washington, Wisconsin.
State v Snow, 324 SW2d 532 (Ark SCt 1959).
Delaware.
Alabama, Kansas, Massachusetts, Pennsylvania, Utah.
New Jersey, Oklahoma, Washington.
New Jersey, Oklahoma, Washington.
Louisiana.
Hawaii, Virginia.
Georgia, Hawaii, Missouri, Nebraska, North Dakota.
Alabama, New Hampshire, Oregon, Vermont.
Arkansas, Hawaii, North Dakota.
Arkansas, Illinois, Kansas, Massachusetts, Michigan, Montana, New Jersey, Ohio, South Carolina, West Virginia, Wisconsin.
Florida, Georgia, Indiana, Maine, Missouri, Nebraska, South Carolina, Texas, Vermont, West Virginia.
Humphrey v Cady, 405 US 504 (1972).
Donaldson v O'Connor, 422 US 563 (1975).
Suzuki v Yen, 617 F2d 173 (9th Cir 1980).
Colyar v Third Judicial District Court for Salt Lake County, 469 F Supp 424 (D Utah 1979).
Addington v Texas, 441 US 418 (1979).
Lessard v Schmidt, 413 F Supp 1318 (ED Wis 1976).
In re Ballay, 482 F2d 648 (DC Cir 1973).
263 SE2d 661 (S Ct WVa 1980).
Indiana, Maine, Michigan, Minnesota, New Hampshire.
Shapiro v Thompson, 394 US 618 (1969).
Covington v Harris, 419 F2d 617 (DC Cir 1969).
Kentucky Ass'n of Retarded Citizens v Conn, 510 F Supp 1233 (WD Ky 1980).
Indiana, New Mexico, Oregon, Texas.
Alabama, Delaware, New Jersey.
District of Columbia, Louisiana, Oregon.
Arkansas, California, Iowa, Kansas, Wisconsin.
New Mexico, Pennsylvania, Texas.
Colorado, Delaware, Iowa, Maine, New Hampshire, Wisconsin, Wyoming.
Application of Halko, 54 Cal Rptr 661 (2d Dist 1966).
Benton v Reid, 231 F2d 780 (DC Cir 1956).
Eg, Texas.
Iowa.
New York.
South Dakota.
Texas.
Texas.
Utah.
In re Stoner, 73 SE 2d 566 (SCt NC 1952).
Gostin L.  The politics of AIDS: compulsory state powers, public health, and civil liberties. Ohio St Law J . 1989;;49:1017-1026.
Edgar H, Sandomire H.  Medical privacy issues in the age of AIDS: legislative options. Am J Law Med . 1990;;16:155-222.
Alabama, Iowa, Maine, Maryland, Nevada, North Carolina, North Dakota, Texas.
Alabama, District of Columbia, Nevada, North Dakota, Oregon, South Dakota.
District of Columbia, Maryland, Nevada.
Maryland.
Kansas, Nevada.
Alabama, Maine, New Jersey, North Carolina, South Dakota.
Alabama, Maine, Maryland.
School Board of Nassau County, Florida, v Arline, 480 US 273 (1987).
Gostin L.  The Americans With Disabilities Act and the U.S. health system. Health Aff . 1992;;11:248-257.
Gostin L.  The future of public health law. Am J Law Med . 1987;;12:461-490.
Letter from the Associate Commissioner for Health of New York City, Mark Barnes, to Paul Schwartz, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, November 16, 1992.
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.