Cherry-Picking Records in Independent Medical Examinations: Strategies for Intervention to Mitigate a Legal and Ethical Imbroglio

Independent medical examinations (IMEs) theoretically construe a means of “independently” assessing a claimant’s physical and psychological status, as well as to determine whether treatment that has been and will potentially be provided is reasonable and necessary. IMEs may be undertaken both for the plaintiff and defense or related adversaries. In the present case, we focus on IMEs that are requested by insurers. One can query the degree to which IMEs are actually “independent.” It has been posited that one of the ways in which claims managers contribute to potential bias against claimants is through a process of selectively providing examiners with medical records, which has been described as “cherry-picking.” Despite the existence of rules and laws that are designed to prevent cherry-picking, the practice still occurs. This analysis discusses the legal as well as ethical implications of cherry-picking and its potential to cause or exacerbate psychological injury that a claimant may experience. The authors propose that psychologists as well as attorneys can advocate for their vulnerable patients/clients in cases of cherry-picking. A recent case study from the clinical practice of the first author in which he so acted is provided. We conclude with a discussion of the ethical implications of the psychologist’s intervention.     

在知识产权领域进行跨协定报复:发展中国家可用的武器

发展中国家在第三次欧共体香蕉案和美国赌博案中向DSB申请了在知识产权领域实行跨协定报复,这是很有意义的开端.理论上,发展中国家中止知识产权义务进行报复比在货物贸易领域和服务贸易领域实施报复更具优越性.但是,要使它成为发展中国家的合法、有效、可行的报复方式,还必须权衡知识产权的地域性,权利穷竭制度以及发展中国家欠缺技术能力所带来的限制等可能产生的法律问题和经济问题.     

Medication Errors in Family Practice, in Hospitals and After Discharge from the Hospital An Ethical Analysis

Thousands of medical errors are occurring daily in physician's offices, in hospitals, and even upon discharge from the hospital, leading to unnecessary injury and death and costing billions of dollars. We have a systems approach that has been proven to be tried and true in aviation, nuclear energy and many other industrial settings. Being honest when medical mistakes occur, reporting them to national clearing house, objectively searching for root causes, avoiding the fixing of arbitrary blame, and then, where possible, implementing safeguards to minimize the occurrence of future mistakes, is the best way to enhance patient safety. But until the medical establishment takes medical errors and patient safety more seriously, and until the general public rises up in protest, it is up to the state and federal governments to take the lead in protecting the lives of innocent Americans by creating a public policy.     

生命伦理学与21世纪的法律——西方生命伦理立法概览

生命伦理学与法学交叉领域研究近几十年来受到西方国家的重视，甚至被当作21世纪法律的核心。各国围绕生命的不同阶段和状态展开的一系列立法举措与法学研究使公民在生死、器官移植、基因信息与检测等方面的权利得到了保障。介绍与分析具有代表性的生命伦理立法例，说明涉及生命伦理的法律问题应当作为一个体系加强研究，借此为我国的生命伦理立法与法学研究提供有益的借鉴与启示。     

Call for Papers: Ethical and Legal Issues in Clinical and Forensic Practice

Law and Human Behavior -     

Working for Corporate Actors: Social Change and Elite Attorneys in Chicago

Elite attorneys have been the objects of social scientific study and speculation for many years. This article contributes to that body of thought by reporting some of the results of a research project that studied 59 members of Chicago's corporate actor legal elite-the lawyers who serve the city's major business, social, civic, political, and cultural organizations.
The article briefly defines the elite studied and the design of the overall re-search project. It then focuses on the working situations of these lawyers and the professional roles they play for their respective corporate actors. A division of legal labor that is discovered to separate house counsel from law firm partners among the elite is analyzed in some depth.
Since the professional roles of these elite attorneys differ from those de-scribed by other social scientists earlier, the article concludes by offering a theory to explain this apparent social change. By tapping recent discussions of the coming of postliberal society, it suggests that corporate actors engineer this new division of legal labor for their attorneys in response to the complex new legal problems posed by institutional changes in the larger society.     

Ethical Considerations in the Development and Application of Mental and Behavioral Nosologies: Lessons from DSM-5

We are not likely to find a diagnostic system as “unethical,” per se, but rather find that it creates ethical concerns in its formulation and application. There is an increased risk of misuse and misunderstanding of the DSM-5 particularly when applied to forensic assessment because of documented problems with reliability and validity. For example, when field tested, the American Psychiatric Association reported diagnostic category kappa levels as acceptable that were far below the standard level of acceptability. The DSM-5 does not offer sensitivity and specificity levels and thus psychologists must keep this in mind when using or teaching this manual. Also, especially in light of concerns about diagnostic inflation, we recommend that psychologists exercise caution when using the DSM-5 in forensic assessments, including civil and criminal cases. Alternatives to the DSM-5, such as the International Classification of Diseases and the Psychodynamic Diagnostic Manual are reviewed.     

《政府采购协定》中发展中国家的地位和利益分析:文本的视角

<政府采购协定>作为WTO下的诸边贸易协定,只对接受或者加入的成员才具有约束力.协定成员稀少且增加缓慢一直是GPA成员非常忧虑却无奈的事实.促进更多成员尤其是发展中国家的加入成为GPA每一次修订的主要目的之一.2007年12月中国启动了加入GPA的进程.作为发展中国家,中国应该充分重视并理解GPA中关于发展中国家的条款对发展中国家利益的保障,并结合我国实践,在加人谈判中争取更为有利的条件,从而达成与我国发展中国家状态相协调的加入GPA的最终条款.     

Social and Ethical Issues in the Use of Familial Searching in Forensic Investigations: Insights from Family and Kinship Studies

This article explores the socio-ethical concerns raised by the familial searching of forensic databases in criminal investigations, from the perspective of family and kinship studies. It discusses the broader implications of this expanded understanding for wider debates about identity, privacy and genetic databases.     

The Working Alliance in Intervention for Partner Violence Perpetrators: Recent Research and Theory

The working alliance consists of therapist and client agreement on the goals and tasks of therapy, and the therapeutic bond. Measures of the working alliance, assessed during the course of therapy, have consistently predicted positive therapeutic change across various client populations and treatment approaches. This paper reviews recent research highlighting the importance of the working alliance with respect to treatment compliance and outcome in interventions for perpetrators of partner violence. The common promotion and use of confrontational intervention tactics in these interventions and the potentially negative impact of confrontational tactics on the working alliance is also discussed.     

Networking and Knowledge Transfer Between Research and Industry in Transition Countries: Empirical Evidence from the Slovenian Innovation System

Using empirical data from an innovation survey carried out in the Republic of Slovenia in 1997/1998, the paper analyses the innovation-relevant co-operation pattern between different kinds of research institutes and industry. The hypothesis is made that system transformation is not yet accomplished in Slovenia, and that the innovation system is still fragmented. While there is intense co-operation between Slovenian research institutes and companies, the level of co-operation between university institutes and industrial firms remains below the average of all Slovenian research institutes, although one focal point in the co-operation activities of university institutes is the support of firms in market introduction. Mainly larger institutes co-operate with larger firms, whereas small institutes hardly co-operate. Consequently, the challenge of innovation policy is to integrate all participants of the Slovenian innovation system in a structure of mutual knowledge and information exchange.     

Mandatory Arbitration and Civil Litigation: An Empirical Study of Medical Malpractice Litigation in the West

This article looks at the effect that pretrial, statutorilyrequired screening panels in Nevada have had on medical malpracticelitigation. I use two unique data sets on litigation in Nevadaand neighboring states from 1983–88, during which theNevada legislature enacted screening panels. Applying time-seriesand difference-in-difference analyses, I show that observeddecreases in Nevada with respect to damage awards, attorney'sfees, and duration in litigation reflected a broader seculartrend. The panels did, however, reduce the relative probabilityof claims requiring resolution by the Nevada courts.     

Damage Caps and Civil Litigation: An Empirical Study of Medical Malpractice Litigation in the South

This article looks at the effect that damage caps have on plaintiffs'recovery in medical malpractice litigation, using a unique dataset of litigation in the South, from 1987 to 1999. During thistime, Alabama underwent both the implementation and nullificationof damage-cap laws; neighboring states did not undergo any significantlegal changes. The product of a difference-in-difference approach,the results reveal that the average relative recovery by Alabamaplaintiffs decreased by roughly $20,000 after the Alabama legislatureenacted damage caps and increased by roughly double that amountafter the Alabama Supreme Court ruled them unconstitutional.     

The Base Rate Study: Developing Base Rates for Risk Factors and Indicators for Engagement in Violent Extremism

Improvements have been made in identifying the prevalence of risk factors/indicators for violent extremism. A consistent problem is the lack of base rates. How to develop base rates is of equal concern. This study has two aims: (i) compare two methods for developing base rates; the Unmatched Count Technique (UCT) and direct questioning, (ii) generate base rates in a general population sample and compare these to a sample of lone-actor terrorists (n = 125). We surveyed 2108 subjects from the general population. Participants were recruited from an online access panel and randomly assigned to one of three conditions; direct survey, control, or UCT. Survey items were based on a lone-actor terrorist codebook developed from the wider literature. Direct questioning was more suitable under our study conditions where UCT resulted in deflation effects. Comparing the base rates identified a number of significant differences: (i) lone-actor terrorists demonstrated propensity indicators related to a cognitive susceptibility, and a crime- and/or violence-supportive morality more often; the general sample demonstrated protective factors more often, (ii) lone-actor terrorists demonstrated situational indicators related to a crime- and/or violence-supportive morality more often, whereas the general sample experienced situational stressors more often, (iii) lone-actor terrorists demonstrated indicators related to exposure to extremism more often. Results suggest there are measurable differences in the prevalence of risk factors between lone-actor terrorists and the general population. However, no single factor “predicts” violent extremism. This bears implications for our understanding of the interrelation of risk and protective factors, and for the risk assessment of violent extremism.