Medicare program; peer review organization contracts: solicitation of statements of interest from in-state organizations--Alaska, Delaware, the District of Columbia, Hawaii, Idaho, Illinois, Kentucky, Maine, Nebraska, Nevada, South Carolina, Vermont, and Wyoming--HCFA. Notice

This notice, in accordance with section 1153(i) of the Social Security Act, gives at least 6 months' advance notice of the expiration dates of contracts with out-of-State Utilization and Quality Control Peer Review Organizations. It also specifies the period of time in which in-State organizations may submit a statement of interest so that they may be eligible to compete for these contracts.     

Organ weight effects of drowning and asphyxiation on the lungs,liver, brain,heart, kidneys,and spleen

An examination of the organ weights associated with victims of drowning, asphyxiation and trauma was undertaken to determine (a) the effects of asphyxiation compared to a trauma group, and in turn, (b) the effects of drowning compared to an asphyxiation group. Included in the study were 217 drowning deaths, 166 pure asphyxiation deaths and 381 trauma deaths. The effects of asphyxiation (compared to trauma) resulted in elevated mean organ weights for the lungs, liver, kidneys and spleen (with mean increases of 17.8, 10.5, 10.3 and 23.4%, respectively). Effects of drowning (compared to asphyxiation) resulted in elevated mean organ weights only with the lungs and kidneys (with mean increases of 30.0 and 4.4%, respectively). Only the mean heart and brain weight remained constant across all experimental groups. A picture of drowning is suggested in which elevated lung and kidney weights are the result of both asphyxiation and the aspiration of water that occurs with drowning, whereas elevated spleen and liver weights in drowning victims are associated with only the effects of asphyxiation. In addition, the common autopsy finding of a small, anemic spleen in drowning, rather than caused by some pathophysiological mechanism of death, is hypothesized to be a postmortem phenomenon.     

Tension, compression, and shear: directions, stresses, and outcomes of health care cost control

"Control" of health care costs is often portrayed as a struggle between external, "natural" forces pushing costs up and individuals, groups, and societies trying to resist the inevitable. This picture is false. Control includes strenuous efforts by some to raise costs, and by others to resist those increases, and/or to transfer costs to someone else. But all such forces originate in the purposes and interests of individuals and groups. Health care cost control is a struggle among conflicting interests over the priorities of a society, and claims of "inevitability" are simply part of the political rhetoric of that struggle. International experience supports certain conclusions. First, there is no basis for the claim that limits on expenditure growth must threaten the health of (some members of) a society. Second, there is a substantial variety of experience with cost control. Failure in the United States is often presented as evidence of the impossibility of control, but most other countries have succeeded. Finally, control requires the direct confrontation of interests, with substantial build-up of stress. Advocates of expansion are more successful if they can transform compressive forces into efforts to shift the burden onto someone else. Pressures from providers in every country for "privatization" and/or payment by users reflect this recognition of economic interest.     

Race,Ethnicity, Threat,and the Designation of Career Offenders

Florida statutes allow for the application of enhanced sentences to defendants designated as “Career Offenders.” The application of these laws is discretionary and as such, prosecutors seek the designation for a fraction of the defendants who qualify. Utilizing Hierarchical Generalized Linear Modeling, this paper examines whether individual attributes, such as race and ethnicity, impact an individual's likelihood of receiving the Career Offender designation for 13,704 males sentenced to prison between 2002 and 2004. The second-level analysis incorporates county characteristics into the equation and tests whether these predictors have either a direct or a cross-level effect on the relationship. The broad theoretical framework that guides the present research is grounded in the social threat and social control perspective, which argues that minorities on both the individual and aggregate levels may be perceived as threatening in ways that can mobilize or enhance social controls.     

Organ weight effects of drowning and asphyxiation on the lungs, liver, brain, heart, kidneys, and spleen

An examination of the organ weights associated with victims of drowning, asphyxiation and trauma was undertaken to determine (a) the effects of asphyxiation compared to a trauma group, and in turn, (b) the effects of drowning compared to an asphyxiation group. Included in the study were 217 drowning deaths, 166 pure asphyxiation deaths and 381 trauma deaths. The effects of asphyxiation (compared to trauma) resulted in elevated mean organ weights for the lungs, liver, kidneys and spleen (with mean increases of 17.8, 10.5, 10.3 and 23.4%, respectively). Effects of drowning (compared to asphyxiation) resulted in elevated mean organ weights only with the lungs and kidneys (with mean increases of 30.0 and 4.4%, respectively). Only the mean heart and brain weight remained constant across all experimental groups. A picture of drowning is suggested in which elevated lung and kidney weights are the result of both asphyxiation and the aspiration of water that occurs with drowning, whereas elevated spleen and liver weights in drowning victims are associated with only the effects of asphyxiation. In addition, the common autopsy finding of a small, anemic spleen in drowning, rather than caused by some pathophysiological mechanism of death, is hypothesized to be a postmortem phenomenon.     

Rights,women, and the state of Pakistan

Violence against women is a problem around the world. Addressing the issues of physical and sexual violence against women has been a complicated endeavor for criminologists. Much of the traditional criminological research on violence against women has frequently focused on rape as a crime of power between individuals. However, this framework has been expanded to incorporate the analysis of rape during times of war and rape as a state crime. In these cases, rape serves a broader purpose within the military and social structure. By focusing on the specific case of the gang rape of Mukhtar Mai, the goal of this paper was to demonstrate and analyze the role of the state in many of these crimes. Mukhtar Mai’s case should not be understood in isolation, but as a way to illuminate the role of the state in these numerous crimes.     

Fictions of Origin: Law,Abjection, Difference

This article seeks to offer a critique of what it terms ‘Law-as-Logos’ (the Western conceptualisation of ideal Law in terms of pure ‘Presence’) from a perspective that combines some of the insights of contemporary psychoanalytic, deconstructive and feminist theory with recent developments in critical legal studies. The essay seeks to offer a re-theorisation of law, not as ‘Logos’ but as ‘difference’. The law, it will be argued, exists only as that arbitrary point of demarcation between the space of the sacred and the space of the abject and, to re-orient psychoanalytic readings of abjection towards a Derridean understanding of differance, the law may be articulated as the ‘trace’ that makes ‘presence’ possible whilst at the same time threatening its total erasure. Law-as-difference thus becomes maddening in its capacity to establish and erase boundaries and the second part of the essay examines this phenomenon particularly in the context of the relation between law-as-difference and the textuality of a Law that requires to be ‘put into writing’. It argues, in conclusion, that a theorisation of law-as-difference raises inevitably the question of the relation of ‘woman’ to the law and it ends with a re-positioning of the figure of Antigone as a means of interrogating the relation of the ‘feminine’ within the Western symbolic economy to the scandalous impurity of law-as-difference.¹ P. Goodrich, Languages of Law: From Logics of Memory to Nomadic Masks (London: Weidenfield and Nicolson, 1990), 268     

The Rule of Law,Comprehensive Doctrines,Overlapping Consensus,and the Future of Europe

For more than a decade now a profound rule-of-law crisis has gripped the European Union, and while the fight for the rule of law has topped not only the academic but also the judicial and political agenda, the results have been disappointingly meagre. This article argues that the main reason for that should be sought in a political strategic move of justifying the assaults on the rule of law by resorting to an “illiberal democracy.” This premeditated political narrative shift has unleashed onto the political sphere and onto public discourse at large comprehensive doctrines which had hitherto been left dormant thanks to an overlapping consensus on the rule of law as a central building block of the political conception of justice à la Rawls. Once this overlapping consensus was broken, the rule of law itself lost its neutral character as a referee on the right among the many conceptions of the good, itself becoming part of the highly politicized power play for dominance among irreconcilable—liberal and illiberal—comprehensive doctrines. The overlapping consensus in the EU is thus broken, but there are no conceptual reasons inherent to the rule of law itself for which it could not be rebuilt in the future.     

Ironies of Crime, Control, and Criminology

Irony is a kind of communication in which shared knowledge about a particular context is formed as a counter-intuitive statement with hidden meaning. Irony is important because it branches the tree of knowledge and balances morality. This paper reviews the definition and value of irony; examines ironic works on crime and control; proposes an irony of criminology: it can be studied with science and thereby improved; draws on this idea to provide a method-based theory of theory and findings; and concludes by discussing implications for future work in reflexive criminology.     

Darwall,Habermas, and the Fluidity of Respect

What moral commitments do we manifest when we make claims upon one another? The practice of claiming is inescapable, and so any normative presuppositions of that practice are similarly inescapable (at least on pain of self‐contradiction). This inquiry thus promises an Archimedian point from which to address intractable moral disagreements in modern society. Whatever we happen to differ about, we can be shown to agree about these premises, and therefore to share commitment to whatever can be derived from these premises. The most prominent developer of this approach is Jürgen Habermas, who has sought to ground, inter alia, religious and cultural rights on this basis. I will argue that the strategy cannot resolve disagreement in the way Habermas hopes, and that this has been shown, perhaps inadvertently, by Stephen Darwall, who for very different reasons seeks to work out the premises of the practice of claiming (and who never discusses Habermas). Darwall has no apparent interest in finding a universally convincing basis for resolving moral controversies. He seeks to address, not the practical problems of a pluralistic society, but some specialized, albeit important, questions of metaethics, having to do with what kind of entity a moral claim is 1 1 These are the focus of a symposium on Darwall's book The Second Person Standpoint (Darwall 2006) in Ethics 118 (Oct. 2007). To avoid misunderstanding: I am not here attempting a comprehensive comparison of Darwall and Habermas, but only juxtaposing their views on a single important issue.
. Both Habermas and Darwall think that discourse presupposes a kind of respect among persons. Darwall, however, shows that respect is too fluid, and takes too many possible forms, to ground any but the most trivial specific moral claims.     

Risk,Precaution, Responsibility,and Equal Concern

Systemic risks are risks produced through interconnected non‐wrongful actions of individuals, in the sense that an individual's action is a negligible cause of the risk. Due to scale effects of interaction, their consequences can be serious but they are also difficult to predict and assess via a risk assessment. Since we can have good reason to engage in the interconnected activities giving rise to systemic risk, we incur a concurrent collective responsibility to ensure that the risks are fairly distributed and well regulated. James argues that fairness in this context requires taking reasonably available precautions ensuring for each risk‐bearer a favourable ratio of expected benefits over expected losses. In sections 2 and 3 we argue that such a conception of fairness applies but only on the condition that the systemic risks created are irreversible risks and that the general background conditions of justice are imperfectly fair. When risks are reversible, compensatory justice can correct for unfairness in risk imposition. Where risks are irreversible, compensatory justice necessarily fails, giving rise to a collective responsibility to regulate fairly ex ante. Additionally, where background conditions of justice are fully fair and the systemic risk is well understood, risk bearers can be said to have consented to the systemic risk. If they are not fair, we argue that the primary political obligation should lie in fixing the fairness of the backgrounds of justice. A related reason for addressing the general background conditions of fairness is that James’ account of fairness in systemic risk imposition encounters a baseline problem. If expected risks and benefits are calculated again an unfair historic background condition, systemic risk imposition would not be fully fair. Section 4 shows why differences in evidentiary uncertainty as to probability and levels of harm and effective responses require a normatively appropriate response in the form of additional precautions. We show that the evidentiary standards set for risk‐based cost‐benefit analysis have a connection with deontology because they express a postulate of equal treatment in formal terms. Systemic risks can have different possible degrees of epistemological certainty due to factors of social and natural origin, such as more available research funding or higher degrees of complexity for some systemic risks but not others. These differences have to be mitigated by taking even greater precautions in difficult‐to‐research systemic risks.     

Personhood,property rights,and the permissibility of abortion

The purpose of this paper is to argue that the tactic of granting a fetus the legal status of a person will not, contrary to the expectations of opponents of abortion, provide grounds for a general prohibition on abortions. I begin by examining two arguments, one moral (J. J. Thomson's ‘A Defense of Abortion’) and the other legal (D. Regan's ‘Rewriting Roe v. Wade’), which grant the assumption that a fetus is a person and yet argue to the conclusion that abortion is permissible. However, both Thomson and Regan rely on the so-called bad samaritan principle. This principle states that a person has a right to refuse to give aid. Their reliance on this principle creates problems, both in the moral and the legal contexts, since the bad samaritan principle is intended to apply to passive refusals to aid; abortion, however, does not look like any such passive denial of aid, and so it does not seem like the sort of action covered by the bad samaritan principle. In defense of the positions outlined by Thomson and Regan, I argue that the apparent asymmetry between abortion and the usual type of case covered by the bad samaritan principle is only apparent and not a genuine problem for their analyses. I conclude with a defense of the morality of the bad samaritan principle.     

The Ethics of Care,Dependence, and Disability*

According to the most important theories of justice, personal dignity is closely related to independence, and the care that people with disabilities receive is seen as a way for them to achieve the greatest possible autonomy. However, human beings are naturally subject to periods of dependency, and people without disabilities are only “temporarily abled.” Instead of seeing assistance as a limitation, we consider it to be a resource at the basis of a vision of society that is able to account for inevitable dependency relationships between “unequals” ensuring a fulfilling life both for the carer and the cared for. **     

An analysis of toxic deaths, 1982 to 1985, Pima County, Arizona

Toxic deaths in Pima County, Arizona, were studied over a four-year period. The deaths were analyzed according to cause and manner of death, toxic substance, and demographic data. The age group 40 to 49 years had the highest rate of suicide from toxic substances. The accident death rate was highest for ages 20 to 29 years. Carbon monoxide was most often found to be the cause of deaths in this study. The most prevalent drugs were narcotics followed by antidepressants, cocaine, and barbiturates. Comparisons are made with similar studies.     

LESBIAN, GAY, BISEXUAL, AND TRANSGENDER PARENTS

Estimates are that there are between 1.2 and 3 million people who are in same-gender partnered household relationships in the United States. Although there is less certainty about the number of parents among these couples and the number of single-parent gay and lesbian families, all research shows that a growing number of gay and lesbian as well as bisexual and transgender individuals are choosing to be parents. A sound body of empirical literature has demonstrated that the sexual orientation of a parent is irrelevant in terms of a person's ability to parent and has no lasting effect on the psychological adjustment of the person's children. Nevertheless, a majority of states in the United States place considerable legal hurdles in the face of lesbian, gay, bisexual, and transgender (LGBT) individuals who would like to be parents, as do many countries around the world, and the social context of contemporary society creates a number of special issues that the forensic evaluator or psychologist may encounter when asked to make a custody, adoption, or other fitness to parent assessment with LGBT parents. This article presents an overview of these issues and moves beyond theory to provide specific recommendations for evaluators working with LGBT parents.     

Money,Mortgages, and the Conquest of America

In colonial America, land acquired new liquidity when it became liable for debts. Though English property law maintained a firm distinction between land and chattel for centuries, in the American colonies, the boundary between the categories of real and personal property began to disintegrate. There, the novelty of easy foreclosure and consequent easy alienation of land made it possible for colonists to obtain credit, using land as a security. However, scholars have neglected the first instances in which a newly unconstrained practice of mortgage foreclosure appeared—the transactions through which colonists acquired land from indigenous people in the first place. In this article, I explore these early transactions for land, which took place across fundamental differences between colonists’ and native communities’ conceptions of money, land, and exchange itself. I describe how difference and dependence propelled the growth of the early American contact economy to make land into real estate, or the fungible commodity on the speculative market that it remains today.     

Alleged brain damage, diminished capacity, mens rea, and misuse of medical concepts.

As focus on the insanity defense diminishes, defendants may place emphasis on a lack of knowing or purposeful behavior in order to negate a criminal charge. This use of a mens rea defense in accord with Model Penal Code principles is exemplified by the current New Jersey statute. Such a defense may result in a lesser charge or a finding of not guilty. In addition to reviewing applicable law, this report presents a sex offense case in which remote brain damage was invoked as a purported basis for incapacity to formulate the required intent; the study also raises the issue of the inappropriate or questionable use of medical principles, a practice that diminishes professional credibility in the courts and in the community.     

Bones, blood, pellets, glass, and no body.

A man was found guilty of killing his wife, although her body was never found. The case centered on her car, which contained fragments of bone, glass, shotgun pellets, and dried blood. Deoxyribonucleic acid (DNA) fingerprinting techniques were used to establish the decedent's identity. Examination of the bone fragments revealed that they were from the skull. These two pieces of information, added to other evidence, proved that the defendant's wife had received a fatal injury in her car, and a guilty verdict was rendered.