Prosecuting 'Gross' Medical Negligence: Manslaughter, Discretion, and the Crown Prosecution Service

This article examines prosecutions of health care professionals for gross negligence manslaughter following fatal errors committed in the course of their work. Unease has long surrounded the use of 'gross negligence' as a form of criminal liability, and particularly as it applies to health care professions operating in high-risk settings. The recent dramatic rise of such prosecutions calls for a closer understanding of the processes by which important prosecutorial decisions are made. In particular, this calls for an investigation into the exercise of discretion by prosecutors in interpreting the loosely defined and contested concept of gross negligence. This article analyses data obtained from a statistical analysis of 'medical manslaughter' cases and also from interviews with crown prosecutors. Discussion of the main findings leads to the conclusion that the offence of gross negligence manslaughter is incapable of any objective and fair measurement and ought to be abolished.     

Sodium monochloroacetate poisoning of greenfinches.

A large number of passerine birds, mainly greenfinches, were found dead or dying in a hedgerow close to a field of onions recently sprayed with sodium monochloroacetate (SMCA). An analytical method is described for isolating monochloroacetic acid from bird tissues, as its potassium salt, by ion exchange chromatography. The ion exchange eluate is evaporated to dryness, acidified, extracted with ether and the ethereal extract methylated with diazomethane. The concentration of the methyl ester of monochloroacetic acid is determined using the Mass Selective Detector in the selected ion mode. Chemical analysis confirmed the exposure of the birds to SMCA. It is calculated that 50 microliter of spray contained the lethal dose of SMCA for a greenfinch.     

Expert evidence and medical manslaughter: vagueness in action

This article examines the reliance placed on expert evidence in prosecutions of health professionals for gross negligence manslaughter, where juries must decide whether conduct goes beyond civil negligence and constitutes the crime of involuntary manslaughter. It argues that the test for liability is vague and examines some of the consequences of this. Given the vagueness of the offence, jurors are likely to place great reliance on expert medical evidence. Little is known about how experts negotiate the legal process, empirically speaking: how they approach their task, how they view their role as expert witnesses, and the attitudes, biases, and beliefs that may underpin their testimony. Drawing on the experiences and perceptions often medical experts, this article explores how experts manage the vagueness inherent in the task of interpreting and applying gross negligence. Experts appear to go beyond offering purely medical opinion and enjoy engaging with law and the legal process.     

A surprising case of endrin poisoning in dogs

A case of possible malicious poisoning of dogs by endrin was investigated. A variety of tissues were analysed. The stomach contents of one dog contained 5 g/kg endrin. The results are compared with recorded data from feeding studies pursued elsewhere to aid the diagnosis of dieldrin and endrin intoxication. A number of organochlorine compounds closely related chemically to endrin were tentatively identified.     

Designing Public Participation Processes

The purpose of this Theory to Practice article is to present a systematic, cross‐disciplinary, and accessible synthesis of relevant research and to offer explicit evidence‐based design guidelines to help practitioners design better participation processes. From the research literature, the authors glean suggestions for iteratively creating, managing, and evaluating public participation activities. The article takes an evidence‐based and design science approach, suggesting that effective public participation processes are grounded in analyzing the context closely, identifying the purposes of the participation effort, and iteratively designing and redesigning the process accordingly.     

Bayesian Spatio-Temporal Modeling for Analysing Local Patterns of Crime Over Time at the Small-Area Level

Objectives

Explore Bayesian spatio-temporal methods to analyse local patterns of crime change over time at the small-area level through an application to property crime data in the Regional Municipality of York, Ontario, Canada.

Methods

This research represents the first application of Bayesian spatio-temporal modeling to crime trend analysis at a large map scale. The Bayesian model, fitted by Markov chain Monte Carlo simulation using WinBUGS, stabilized risk estimates in small (census dissemination) areas and controlled for spatial autocorrelation (through spatial random effects modeling), deprivation, and scarce data. It estimated (1) (linear) mean trend; (2) area-specific differential trends; and (3) (posterior) probabilities of area-specific differential trends differing from zero (i.e. away from the mean trend) for revealing locations of hot and cold spots.

Results

Property crime exhibited a declining mean trend across the study region from 2006 to 2007. Variation of area-specific trends was statistically significant, which was apparent from the map of (95 % credible interval) differential trends. Hot spots in the north and south west, and cold spots in the middle and east of the region were identified.

Conclusions

Bayesian spatio-temporal analysis contributes to a detailed understanding of small-area crime trends and risks. It estimates crime trend for each area as well as an overall mean trend. The new approach of identifying hot/cold spots through analysing and mapping probabilities of area-specific crime trends differing from the mean trend highlights specific locations where crime situation is deteriorating or improving over time. Future research should analyse trends over three or more periods (allowing for non-linear time trends) and associated (changing) local risk factors.