Medical malpractice: a study of case histories by the Forensic Medicine Section of Bari

The learning objectives of this paper are to study the actual extent of medical malpractice, the medical acts at risk, and their impact on mortality. The number of suits filed against physicians for deaths resulting from alleged malpractice and autopsies ordered by the Judicial Authority in cases of possible therapeutic misadventures are rising. A major factor pushing this trend is public mistrust of healthcare providers and public and facilities. This mistrust is partly fueled by the mass media which, often to gain larger audience shares, sensationalizes single cases of real or alleged iatrogenic injury. Further, the potential for astronomic settlements, either from the single doctor or from the healthcare institution, has increased the number of legal proceedings that start on the basis of mere suspicion. In this context, the autopsy becomes an important instrument for shedding light on the situation, and it must be carried out by highly qualified and experienced professionals capable of ascertaining the cause of death, identifying any possible misconduct, and assessing its consequences. We reviewed the data regarding autopsies performed at the Forensic Medicine Section of the Department of Internal and Public Medicine of the University of Bari over 1991 to 2000. We culled the cases alleged malpractice and, from these, identified those in which the death had truly been caused by medical error. This study also allowed us to understand the incidence of lethal therapeutic misadventures and to identify the medical and surgical branches more frequently involved.     

With friends like these: foreign policy as personal relationship

Governments are run by humans who have sympathies and moods. The study of leaders' personalities, albeit not widespread, is an important tool for foreign policy analysis. Plus, friendship is a feeling that decision-makers like to express for each other. This paper analyses the activity of Silvio Berlusconi, Italy's three times premier, who has made ‘friendship’ a central tenet of his personal foreign policy. Three cases are considered, namely, Berlusconi's relationship with George W. Bush, Tony Blair and Vladimir Putin. The paper concludes that his friendship-based foreign policy has somehow worked; but, because he decided to ignore Italy's structural constraints in the international arena, he ended up wasting opportunities and resources.     

Till Immigration do us Part? Public Opinion and the Dilemma between Immigration Control and Bilateral Agreements

As a result of the initiative against mass immigration (MEI) Switzerland faces a dilemma between control of immigration and the continuation of bilateral agreements. This contribution raises two questions: First, have Swiss citizens' perceptions regarding the incompatibility between immigration control and bilateral agreements evolved since the vote on the MEI in February 2014? Second, what would Swiss citizens decide if they had to choose between the implementation of the MEI and the continuation of the bilateral strategy? We ground our analysis on data from the VOX surveys regarding the MEI and the more recent vote of November 2014 (Ecopop initiative). While Swiss voters still seem to be uncertain about the issue of compatibility, they nevertheless show support for the continuation of the bilateral agreements. Our analyses highlight the importance of age, trust in government and left‐right orientation for individual opinions towards the bilateral way.     

Toward a political economy of post-Fordist punishment

This article suggests some new lines of research in the field of the political economy of punishment and some possible new directions for a critical approach to contemporary social control strategies. The starting point is the transition from a Fordist economy to what can be defined as a post-Fordist system of production. I outline some tendencies in the actual capitalist dynamic (concerning the labour market, the production process, the relations between the workforce and capitalist power and between work and social citizenship), suggesting that a renewed political economy of social control has to deal with them. Two tendencies are assumed to be structural. On the one hand, the tendency of the capitalist system to make the production (and extraction) of surplus-value more and more independent of the effective working time (a tendency toward the reduction of human labour in the productive process). On the other hand, the tendency towards the massive introduction of new technologies: a tendency whose main consequences seem to be the intellectualisation of human labour and the decline of the classic distinction between manual and intellectual labour. I assume that these tendencies give rise to a new productive subject (the multitude), whose characters exceed the actual organisation of work and deepen the contradictions intrinsic to post-Fordist societies. Hence, an analysis of some new social control strategies follows, where I consider actuarialism as a technology for the control of these contradictions

A Fatal Case of Anaphylactic Shock During Paragliding

Abstract: The growth in popularity of flying ultralight aircraft and paragliding has been associated with an increased involvement of Emergency Medical Services because of various types of trauma suffered from both inexperienced and skilled individuals. This case presentation reports on a paraglider pilot, who was seen spinning “unusually” rapidly toward the ground, without visible attempts to regain control of the aircraft. Besides the bilateral mydriasis and the absence of any ECG activity, there was a significant swelling of face, lips, neck, and tongue. Upon opening the mouth, a dead bee was found over the tongue, underneath the palate. A fatal anaphylactic shock was the likely cause of death of the pilot while still “in mid‐air.” This case is certainly different from the commonly reported accidents during paragliding. An updated review of the medical literature shows no reported cases of fatal anaphylactic shock during the practice of paragliding.