Interest-based mediation of medical malpractice lawsuits: a route to improved patient safety?

Mediation of medical malpractice lawsuits provides savings for the parties by shortening the litigation process. In theory, information that aids emotional healing and improves patient care can also surface through mediation. The study discussed in this article used structured interviews of participants and mediators in thirty-one mediated malpractice lawsuits involving eleven nonprofit hospitals. The study measured perceptions of the process and mediation's effects on settlement, expenses, apology, satisfaction, and information exchange. Defense lawyers were less likely than plaintiff attorneys to mediate. Both plaintiff and defense attorneys were satisfied with the process, as were plaintiffs, hospital representatives, and insurers. Changes in hospitals' practices or policies to improve patient safety were identified. This study demonstrates that major challenges stand in the way of achieving mediation's full benefits. Absence of physician participation minimizes the chances that mediated discussion of adverse events and medical errors can lead to improved quality of care. Change will require medical leaders, hospital administrators, and malpractice insurers to temper their suspicion of the tort system sufficiently to approach medical errors and adverse events as learning opportunities, and to retain lawyers who embrace mediation as an opportunity to solve problems, show compassion, and improve care.     

The Complexity of Hate Crime and Bias Activity: Variation across Contexts and Types of Bias

Are racially-motivated hate crimes, non-criminal bias incidents, and general forms of crime associated with the same structural factors? If so, then social disorganization, a powerful structural correlate of general crime, should predict rates of hate incidents. However, tests of social disorganization’s effects on racially-motivated hate crime yield inconsistent results. This study uses data from the Pennsylvania Human Relations Commission (PHRC) to explore such inconsistencies. Specifically, we assess the effects of social disorganization across contexts and types of bias motivation using bias incidents over 12 years. The results suggest that (a) social disorganization, particularly residential instability, is robustly correlated with rates of both hate crime and other prejudicial conduct, and that (b) the interactive effects of social disorganization help explain variations in incident rates by motivation type. Specifically, anti-black incidents are most frequent in unstable, homogeneous (i.e. white) and advantaged communities, while anti-white incidents are most frequent in unstable, disadvantaged communities.     

Whores, men, and other misfits: undoing ‘feminization’ in the armed forces in the DRC

The global attention focused on sexual violence in the DRC has not only contributed to an image of the Congolese army as a vestige of pre-modern barbarism, populated by rapists, and bearing no resemblance to the world of modern armies; it has also shaped gender and defence reform initiatives. These initiatives have become synonymous with combating sexual violence, reflecting an assumption that the gendered dynamics of the army are already known. Crucial questions such as the ‘feminization’ of the armed forces are consequently neglected. Based on in-depth interviews with soldiers in the Congolese armed forces, this article analyses the discursive strategies male soldiers employ in relation to the feminization of the army. In the light of the need to reform the military and military masculinities, the article discusses how globalized discourses and practices render the Congolese military a highly globalized sphere. It also highlights the particular and local ways in which military identities are produced through gender, and concludes that a simple inclusion of women in the armed forces in order to render men less violent might not have the pacifying effect intended.     

A methodology for predicting the effects of changes in civil commitment decision making

We review a three-step civil commitment model and formulas for calculating the probability of release from commitment and the relative importance of the three steps in determining the outcome. New formulas are developed which enable predictions to be made about the effects of changes on the outcome of the three steps on the release probability. With the use of data from Oregon's civil commitment process, we present an example of the application of the methodology and conclude with a discussion of its major administrative and research implications.