Nursing culpability: a proposal for change in nursing regulation

Nurses make mistakes. They work in a complex environment which can sometimes be a contributory factor to a mistake being made. At present, Nurses' Boards in Australia have no mandate to investigate the circumstances in which a mistake is made. Their jurisdiction is limited to investigation of the individual nurse. This article sets out the argument for change in nursing legislation to allow for a broadening of the role of Nurses' Boards. It argues that an extension of their jurisdiction explicitly to allow them to investigate inadequacies in the health system would be a constructive development.     

Histological examination of the temporal bone in medicolegal cases of asphyxia

Histological findings of the temporal bone in 23 autopsy cases of various asphyxial fatalities were studied. The temporal bones of 12 cases who died of tumors including mammary cancer, gastric cancer, myxoma of heart and craniopharyngioma, the bones of 3 cases of heart attack and the bones of 17 cases who died of various poisoning (barbiturate, amphetamine, paraquat and alcohol) were used as controls. In drowning, the primary finding was hemorrhage in the mastoid air cells of the bilateral temporal bones. In cases of strangulation by ligature, hemorrhage and edema of the cochlear duct in the inner ear as well as hemorrhage in the mastoid air cells were demonstrated bilaterally. In contrast, congestion and edema in the mastoid air cells and inner ear were found in cases of manual strangulation but there was no hemorrhage. From these results, the histological examination of the temporal bone is useful as an adjunct procedure for diagnosing the cause of asphyxia. Differentiation between drowning, strangulation by ligature and manual strangulation may be possible by observing hemorrhages or their absence in the mastoid air cells and inner ear.     

Domestic violence: a medicolegal review

This paper reviews the recent medical and legal literature in the field of spouse abuse. Domestic violence is a national phenomenon that directly affects victims of spouse abuse and indirectly conditions the children of the victims to accept violent behavior as normative. This paper characterizes the cycle of violence battered women encounter, describes their injury patterns, explores the dynamics of the abusive relationship, and discusses the factors that compel women to remain in such violent relationships. The second section describes many of the recent legislation designed to prevent spouse abuse. Next, this paper addresses the case law utilizing the "battered woman syndrome" as a defense for spousal homicide. The third section of the paper explores the often neglected topic of the battered husband.     

Atherosclerosis: a medicolegal tool in exhumed decomposed bodies

An exhumed body of 40-year-old Hindu man was brought for repostmortem after 10 days of death with history of allegation of assault by mob. The body was in the advanced stage of decomposition with adipocere formation over chest, thigh, and arms. In the present case, atherosclerosis was present in the coronaries and aorta sufficiently enough to deduce the cause of death and to substantiate the first autopsy findings even in highly decomposed exhumed body.     

Quantitative risk-benefit analysis in regulatory decision-making: a fundamental problem and an alternative proposal

Increasingly, calls are being made for government regulatory agencies to rely on quantitative risk-benefit analysis, in a framework of cost-benefit balancing, to determine acceptable levels of public health risk arising from regulated activities. In condoning the trade-off of public health for economic benefits, this policy approach fails to correspond to moral values and legal precedents respecting individual autonomy. This paper proposes an alternative policy approach, one which requires such regulatory decisions to be justified on grounds of social necessity.     

Withholding and withdrawing of life support: a medicolegal dilemma

The developments in medicine in general and the technology of life support in particular have provided the means of maintaining organ function for prolonged periods of time. However, there are many situations where life-sustaining treatment in an intensive care unit (ICU) may lead to a death with lingering and suffering of the patient, as well as burdening their family. Although often equated, withholding and/or withdrawing life-prolonging treatments that allow the patient to die needs to be differentiated from the physician-assisted suicides and euthanasia that involve the active ending of life. There is a difference between an unintended but accepted consequence of forgoing therapy and an intended result of death from suicide or euthanasia. The present-day physicians view most patient deaths as an inevitable process secondary to disorders unresponsive to treatment and/or multiple organ dysfunction syndromes. The large majority of patients dying in ICUs today succumb not after cardiopulmonary resuscitation, but rather, after the forgoing of life-sustaining treatment. Such approach has frequently caused families, institutions, and conservators of patients to resort to judicial fiat for resolution.     

The forensic radiographer: a new member in the medicolegal team

Multidetector computed tomography is becoming more widespread in forensic medicine. In most services, autopsy assistants perform the radiological examination. We introduced professional radiographers into the legal medicine service and hypothesized they would also be able to take over duties currently reserved for other specialists. The aims of this study were to evaluate if radiographers could be trained as "forensic radiographers" by (1) integrating graduated medical radiographers into the legal medicine service, (2) investigating the advantages of this collaboration, and (3) defining the duties of the forensic radiographers.The study was performed prospectively on a group of 8 recruited radiographers who underwent a testing period with special training. They learned the basics of medicolegal case treatment, the autonomous execution of postmortem computed tomography angiography, and postprocessing of data. Seven of 8 radiographers finished the training and were integrated into our service. Although all radiographers were able to fulfill the duties demanded after the training period, some radiographers could not enter or complete the program because they were unable to work with dead bodies.Our study presents the advantages of integrating radiographers into the medicolegal team and proposes how to train the forensic radiographers. In addition, the duties and responsibilities of these new specialists are defined.     

Just compensation: a no-fault proposal for research-related injuries

Biomedical research, no matter how well designed and ethically conducted, carries uncertainties and exposes participants to risk of injury. Research injuries can range from the relatively minor to those that result in hospitalization, permanent disability, or even death. Participants might also suffer a range of economic harms related to their injuries. Unlike the vast majority of developed countries, which have implemented no-fault compensation systems, the United States continues to rely on the tort system to compensate injured research participants—an approach that is no longer morally defensible. Despite decades of US advisory panels advocating for no-fault compensation, little progress has been made. Accordingly, this article proposes a novel and necessary no-fault compensation system, grounded in the ethical notion of compensatory justice. This first-of-its-kind concrete proposal aims to treat like cases alike, offer fair compensation, and disburse compensation with maximum efficiency and minimum administrative cost. It also harmonizes national and international approaches—an increasingly important goal as research becomes more globalized, multi-site trials grow in number, and institutions and sponsors in the United States move to single-IRB review.     

Property and the human body: a proposal for posthumous conception

There is no greater error in law and bioethics than the continuing opposition to applying the concept of property to posthumous conception cases and the human body generally. The aim of this article is to challenge this error and the assumptions underpinning it. The language of property, conceived of as a "web of interests", can be used to capture and identify the social, moral and ethical concerns that arise in cases concerning the human body, a position that finds support from a correct reading of the early High Court of Australia's decision in Doodeward v Spence (1908) 6 CLR 406. However, a key issue on which the language of property is silent is how to quantify the various competing interests in the posthumous conception case: the concept is useful only insofar as it provides the device for capturing the entirety of the posthumous conception problem.     

Gangs in Nigeria: an updated examination

This paper analyzes gangs in Nigeria, providing an updated examination of their current strategies and activities. The premise of this analysis partly draws on Social Identity Theory, with respect to gang affiliation. Particularly explored are (1) gang cultism as a common phenomenon on college campuses in Nigeria (through their malicious, secret, fraternity-like activities) and (2) the role of Islam in Nigerian gangs. The case study of the ‘Yan Daba, urban gangs particularly found in the northern part of Nigeria, is used to illustrate the authors’ arguments. A brief comparison of Nigerian Muslim gangs with European Muslim gangs is also provided.     

Acid violence: a burning issue of Bangladesh--its medicolegal aspects

Throwing acid on others' face and body to cause grievous injuries is a barbaric act of vengeance. For the last few years, it has been on the rise in both urban and rural areas of Bangladesh. The perpetrators are mostly men and adolescent boys. The victims are girls and young females. The reasons for attacks are sexual advances from man, refusal of marriage proposal, and vengeance. Cheap and easy availability of acids makes it the most effective weapon for man to use against girls' or young women's faces to prove that they have no right to deny a man's proposal and is one of the extreme forms of repression and violation of women's right. The consequence of acid attacks on survivors brings dramatic change in their lifestyle. Most of them have to give up their education or work. Social isolation, fear of further attacks, and insecurity damage their self-esteem and confidence. Illiteracy, poverty, threats to further retribution, and ignorance about legal support increase their miseries. Gradual increase of acid attacks suggests that legal provisions and their enforcement are not adequate and effective. Social awareness, economic and psychologic support, rehabilitation, and strict enforcement of laws are key to combat acid violence in Bangladesh.