The motivation and inspiration for this book come directly from expe- ences with clients during the years that I practiced HIV-related law at the Legal Aid Society of San Diego, Inc. The issues discussed in this work reflect issues that arose on a recurring basis with clients participating in HIV research studies, with investigators calling for guidance on the legal implications of particular aspects of their proposed studies, and with research institutions and health care facilities struggling to make sense of legal maneuvers aimed at obtaining the records of their HIV-infected patients. It is impossible to thank each of these persons individually for their provocative questions and their insights. The discussion of ethical and legal issues relating to the design of clinical trials reflects questions raised during discussions with Donald J. Slymen, Ph.D. Don was one of the first researchers, in my realm of experience, to pay close attention to ethical concerns, and I am greatly appreciative of his contribution to both my professional growth and the development of various scenarios discussed in this text. The portions of this text dealing with confidentiality are the result of many hours of thoughtful discussion and analysis with Penn Lerblance, J.D., now deceased and still missed. Penn and I often participated together as presenters of in-service training programs for health prof- sionals. Penn addressed discrimination, and I focused on confidentiality.

Cytokines had been characterized in the early eighties as communication mole cules between immune cells, and between immunocytes and other peripheral cells, such as fibroblasts and endothelial cells. They play a key role in the regulation of the immune response and the coordination of the host response to infection. Based on these biological properties, nobody would have predicted that one decade later cytokines would burst upon neurosciences and permeate into several avenues of current research. In neurology, the connection between cytokines and inflammation, and the demonstration of a pivotal role of some of these molecules in cell death by apoptosis, prompted the investigation of their involvement in several neurological diseases involving an inflammatory component, including multiple sclerosis, brain trauma, stroke, and Alzheimer's disease. This movement started in the late eighties, and the corresponding field of research, known as neuroimmunology, is presently booming. In psychiatry, however, the relationship between cytokines and mental disorders was much less evident and took longer to materialize. The first indication that cytokines might be involved in psychopathology came from cancerology and internal medicine."

Cytokines had been characterized in the early eighties as communication mole cules between immune cells, and between immunocytes and other peripheral cells, such as fibroblasts and endothelial cells. They play a key role in the regulation of the immune response and the coordination of the host response to infection. Based on these biological properties, nobody would have predicted that one decade later cytokines would burst upon neurosciences and permeate into several avenues of current research. In neurology, the connection between cytokines and inflammation, and the demonstration of a pivotal role of some of these molecules in cell death by apoptosis, prompted the investigation of their involvement in several neurological diseases involving an inflammatory component, including multiple sclerosis, brain trauma, stroke, and Alzheimer's disease. This movement started in the late eighties, and the corresponding field of research, known as neuroimmunology, is presently booming. In psychiatry, however, the relationship between cytokines and mental disorders was much less evident and took longer to materialize. The first indication that cytokines might be involved in psychopathology came from cancerology and internal medicine."

The motivation and inspiration for this book come directly from expe- ences with clients during the years that I practiced HIV-related law at the Legal Aid Society of San Diego, Inc. The issues discussed in this work reflect issues that arose on a recurring basis with clients participating in HIV research studies, with investigators calling for guidance on the legal implications of particular aspects of their proposed studies, and with research institutions and health care facilities struggling to make sense of legal maneuvers aimed at obtaining the records of their HIV-infected patients. It is impossible to thank each of these persons individually for their provocative questions and their insights. The discussion of ethical and legal issues relating to the design of clinical trials reflects questions raised during discussions with Donald J. Slymen, Ph.D. Don was one of the first researchers, in my realm of experience, to pay close attention to ethical concerns, and I am greatly appreciative of his contribution to both my professional growth and the development of various scenarios discussed in this text. The portions of this text dealing with confidentiality are the result of many hours of thoughtful discussion and analysis with Penn Lerblance, J.D., now deceased and still missed. Penn and I often participated together as presenters of in-service training programs for health prof- sionals. Penn addressed discrimination, and I focused on confidentiality.