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The Covid-19 pandemic has already stressed health care systems throughout the world, requiring rationing of medical equipment and care. The authors discuss the ethical values relevant to health care rationing and provide six recommendations to guide fair allocation of scarce medical resources during the pandemic.

Medical cannabis is widely available in the USA and legalisation is likely to expand. Despite the increased accessibility and use of medical cannabis, physicians have significant knowledge gaps regarding evidence of clinical benefits and potential harms. We argue that primary care providers have an ethical obligation to develop competency to provide cannabis to appropriate patients. Furthermore, specific ethical considerations should guide the recommendation of medical cannabis. In many cases, these ethical considerations are extensions of well-established principles of beneficence and nonmaleficence, which indicate that providers should recommend cannabis only for conditions that have the strongest evidence base. Additionally, the contested status of cannabis in American culture raises specific issues related to shared decision-making and patient education, as well as continuing clinical education.

This survey study assesses the acceptability of coronavirus disease 2019 (COVID-19) vaccine mandates among members of the US public.

As COVID-19 vaccine distribution continues, policy makers are struggling to decide which groups should be prioritized for vaccination. To assess US adults' preferences regarding COVID-19 vaccine prioritization. This survey study involved 2 independent, online surveys of US adults aged 18 years and older, 1 conducted by Gallup from September 14 to 27, 2020, and the other conducted by the COVID Collaborative from September 19 to 25, 2020. Samples were weighted to reflect sociodemographic characteristics of the US population. Respondents were asked to prioritize groups for COVID-19 vaccine and to rank their prioritization considerations. The study assessed prioritization preferences and agreement with the National Academies of Science, Engineering, and Medicine's Preliminary Framework for Equitable Allocation of COVID-19 Vaccine. A total of 4735 individuals participated, 2730 (1474 men [54.1%]; mean [SD] age, 59.2 [14.5] years) in the Gallup survey and 2005 (944 men [47.1%]; 203 participants [21.5%] aged 55-59 years) in the COVID Collaborative survey. In both the Gallup COVID-19 Panel and COVID Collaborative surveys, respondents listed health care workers (Gallup, 93.6% [95% CI, 91.2%-95.3%]; COVID Collaborative, 80.0% [95% CI, 78.0%-81.9%]) and adults of any age with serious comorbid conditions (Gallup, 78.6% [95% CI, 75.2%-81.7%]; COVID Collaborative, 72.9% [95% CI, 70.7%-74.9%]) among their 4 highest priority groups. Respondents of all political affiliations agreed with prioritizing Black, Hispanic, Native American, and other communities that have been disproportionately affected by COVID-19 (Gallup, 74.2% [95% CI, 70.6%-77.5%]; COVID Collaborative, 84.9% [95% CI, 83.1%-86.5%]), and COVID Collaborative respondents were willing to be preceded in line by teachers and childcare workers (92.5%; 95% CI, 91.2%-93.7%) and grocery workers (85.9%; 95% CI, 84.2%-87.5%). Older respondents in both surveys were significantly less likely than younger respondents to prioritize healthy adults aged 65 years and older among their 4 highest priority groups (Gallup, 23.7% vs 39.1% [χ2 = 2160.8; P < .001]; COVID Collaborative, 23.3% vs 28.8% [χ2 = 5.0198; P = .03]). COVID Collaborative respondents believed the 4 most important considerations for prioritization were preventing COVID-19 spread (78.4% [95% CI, 76.3%-80.3%]), preventing the most deaths (72.1% [95% CI, 69.9%-74.2%]), preventing long-term complications (68.9% [66.6%-71.9%]), and protecting frontline workers (63.8% [95% CI, 61.5%-66.1%]). US adults broadly agreed with the National Academies of Science, Engineering, and Medicine's prioritization framework. Respondents endorsed prioritizing racial/ethnic communities that are disproportionately affected by COVID-19, and older respondents were significantly less likely than younger respondents to endorse prioritizing healthy people older than 65 years. This provides reason for caution about COVID-19 vaccine distribution plans that prioritize healthy adults older than a cutoff age without including those younger than that age with preexisting conditions, that aim solely to prevent the most deaths, or that give no priority to frontline workers or disproportionately affected communities.

Despite potential benefits of joint ventures between dialysis companies and nephrologists, these arrangements raise legal and ethical concerns. And because of a lack of transparency, it is impossible to study whether these concerns are borne out in practice.

Hypothesis. The growth potential of an epiphyseal plate transplant is a function of the donor irrespective of the recipient site. Methodology. Immature 12 week old New Zealand White rabbits were used. There were 3 experimental groups: (1) orthotopic second metatarsal transplant (n = 22), (2) heterotopic second metatarsal transplant to the tibia (n = 22), (3) heterotopic metatarsal transplantation to the first metacarpal (n = 19). There were 3 control groups: (A) unoperated animals (n = 10), (B) animals with an anteromedial tibial osteotomy (n = 10), (C) unoperated contralateral limbs all experimental and control animals (n = 83). Growth was measured from standardized radiographs. Quantitative and qualitative histology, fluorescent microscopy and reliability studies were carried out. Results. Post-hoc analyses revealed that donor metatarsal epiphyseal plates grew similarly irrespective of whether they were transplanted to a site of higher, lower or similar growth potential. Conclusions. Experimental results supported the hypothesis that the growth potential of an epiphyseal plate transplant is a function of the donor irrespective of the recipient site. The limitations of the study include the fact that the model did not perform exceptionally well. It did, however, test the hypothesis effectively.

THE next coronavirus surge seems to be underway. Maryland, Michigan, Minnesota and Wisconsin are among the states with rising cases, hospitalizations and intensive care occupancy, and hospitalization rates among younger people are increasing nationally. The causes of this...