In an open letter to the physicians of New York published in the state medical journal, Robert Abrams, Attorney General of the State of New York Department of Law, urged them to sign all prescription forms over the “substitution permissible” signature line in an effort to save patients money. In its response, the Medical Society of the State of New York, while expressing its desire to eliminate unnecessary health care costs, stressed a cautious approach and noted two measures that could, in their opinion, lead to wider use of generic drugs.

First, the physicians called for controlled and scientifically valid studies to establish conclusively that generic drug substitutes are equivalent in bioavailability and therapeutic efficacy. Until such studies are performed, physicians, the Medical Society contends, are unwilling to authorize substitutes for medications with which they are familiar.

Without the use of human subjects in pediatric research, medical science would not have made many of its advances in the diagnosis and treatment of children's diseases. However, scientifically valid experimental trials require healthy subjects as controls and the use of healthy children raises many complex moral and legal questions.

The need to experiment on normal, healthy children has blocked full recognition of their legal rights. Currently, as in the past, parents are allowed to volunteer their children as research subjects by means of “proxy consent.” This doctrine is, however, the only legal justification offered for submitting children to the often potentially damaging procedures they may be subject to as unknowing and perhaps unwilling subjects. While such third party consent appears to satisfy everyone's conscience, its use in non-therapeutic experimentation is inconsistent with established legal principles.

Nosocomial infection is a serious problem in hospitals and other inpatient health care facilities. It has been receiving increasing attention in the medical literature since the first outbreaks of penicillin-resistant staphylococcal infections were recognized in the 1950s. The medical profession has been forced to acknowledge, albeit reluctantly, that infectious diseases are not going to be eradicated by the administration of antibiotics and antimicrobials alone. Microogranisms have shown amazing resilience in their ability to protect themselves against the most sophisticated drugs in our armamentarium by the formation of resistant strains. Further, organisms which were never believed to cause disease in the pre-antibiotic era are now linked with devastating infections in seriously ill hospitalized patients. Even the organisms commonly found on the skin of a healthy person can cause disease given the right set of circumstances. A carrier, however, is a person who harbors a specific pathogenic organism, yet fails to exhibit any discernible symptom of the disease. Nonetheless, the carrier is capable of spreading the organism to others.