On the superiority of damage averaging in the case of strict liability

The literature argues that if injurers cannot anticipate the precise level of harm, courts might use expected harm as a magnitude of compensation instead of actual harm without distorting care incentives. This paper shows that the use of expected harm is in fact preferable if victims choose the value of the object placed at risk. If the court were to insist on compensating actual harm, this would result in victims choosing inefficient object values. In contrast, restricting compensation to expected harm yields the first-best outcome.     

Mothers of children removed under a care order: outcomes and experiences

ABSTRACT

Focusing on accounts by women who have children taken into care, this paper reports on a socio-legal case study in England, investigating the life experiences of nine mothers, whose children have been made subject to care orders under the Children Act 1989. In particular it considers the women’s experiences of their relationships with their own mothers and places this within the context of the mothers’ own experiences of having their children taken into care. Drawing on free association narrative interviews, the study focuses on the mothers’ accounts of long-term harm that began in their childhoods, especially their experiences of their mothers’ own difficulties and of their experiences of harm. It highlights the impact of relationship difficulties between mother and child, and questions how the legal concepts of harm and reasonable parental care are defined and deployed. In conclusion, it demonstrates a need for the legal framework to address children’s experiences of harm in a more intergenerational and intersubjective way. It highlights a new approach, suggesting consideration of harm, reasonable parental care and welfare to involve an increased concentration on the welfare of mothers and the relationship between mother and child, akin to an intersubjective and intergenerational approach to harm.     

Contact,welfare and children in care: revisiting the significance of birth family relationships after finding significant harm

The focus of this paper is the issue of continuing birth family involvement in the child’s life once the child is living in care. Drawing on a psychosocial study and free association narrative interviews with care leavers it focuses on the harm to a young woman called Frances, caused by direct contact with her birth family and the cessation of such contact. The paper addresses the tension between these two types of harm, in particular the role of contact in safeguarding and promoting the welfare of children in care. It presents an argument for the child’s care plan to emphasise the need for ongoing review of the role and impact of the child’s close relationships and contact with their birth family once the child is in care. This includes ongoing consideration of the child’s changing relationship with the birth mother and siblings with a view to reconciliation in young adulthood.     

Proportionality and Self-Defense

Proportionality is widely accepted as a necessary condition of justified self-defense. What gives rise to this particular condition and what role it plays in the justification of self-defense seldom receive focused critical attention. In this paper I address the standard of proportionality applicable to personal self-defense and the role that proportionality plays in justifying the use of harmful force in self-defense. I argue against an equivalent harm view of proportionality in self-defense, and in favor of a standard of proportionality in self-defense that requires comparable seriousness and takes into account the wrong, as opposed simply to the harm that the victim is fending off. I distinguish the standard of proportionality in self-defense from proportionality in circumstances of necessity, and I discuss whether proportionality is an internal or an external constraint on the right of self-defense.     

A revised model of unilateral accidents

This paper suggests and justifies a revised formulation of the unilateral accident model based on relaxing two assumptions of the standard model: the precaution function and the harm function. The revised model is, therefore, more general and corresponds better to various situations. A resulting trait of the generalized model is its account for the interaction between the injurer’s care and activity levels, which was implicitly assumed away so far. The revised model is examined using a few standard issues in tort and the analysis brings new results and insights for the unilateral accident case. For example, the view that, under a negligence regime, due care can be defined regardless of the optimal level of activity holds under very restrictive assumptions. In general, due care must be defined simultaneously with the optimal activity level. In addition, the common view suggests that underestimation of the level of actual damages under strict liability would induce injurers to take insufficient care and to engage excessively in a risky activity (and vice versa, for overestimation). This paper shows that underestimation of actual damages may counter-intuitively lead to insufficient activity or excessive care levels. Similarly, the results of underestimating harm under a negligence regime prove to be different than commonly thought. In addition, the revised model questions the intuitive similarity between the underestimation of harm and the judgment-proof problem, and provides some new results for the latter problem.     

Three faces of justice: Competing ethical paradigms in forensic psychiatry

Respect for justice has traditionally been an essential principle of health care ethics. However, many bioethical accounts of justice focus only on distributive justice, and how resources for health care should be allocated. In this article, I will argue that the practice of forensic mental health care requires clinicians to engage with justice in three additional and different ways: justice as liberty and fairness; retributive justice and protection of the vulnerable; and justice as the promotion of virtue. I will argue that British forensic psychiatry favours retributive and protective justice; in contrast to a libertarian approach to forensic practice in the United States. I discuss how respect for justice as support for virtue complements therapeutic work with offenders, which aims at the development of pro‐social character. I will conclude that without respect for justice as virtue, there is a danger that clinical forensic psychiatry risks doing harm to patients and bringing the profession into disrepute.     

The concept of harm reconceived: A different look at wrongful life

In wrongful life litigation a congenitally impaired child brings suit against those, usually physicians, whose negligence caused him to be born into his suffering existence. A key conceptual question is whether we can predicate “harm” in such cases. While a few courts have permitted it, many courts deny that we can, and thus have refused these children standing to sue. In this article the author examines the wrongful life cases and literature enroute to a broader consideration of harm. This literature, and philosophical discussions of harm generally, rely on a definition which ascribes harm by comparing an individual's current condition with that in which he would otherwise have been, but for the allegedly harmful event. The author shows this definition to be conceptually and morally flawed. A superior general definition is offered which, when then applied to wrongful life cases, shows that we can easily ascribe harm in these cases and can find clear potential for tort liability.     

Slim just left town: decisionmaking on an intensive care unit

The title of this paper comes from an incident that occurred while I was participating in morning rounds on the pediatric and surgical intensive care unit of a large, midwest tertiary care center. The patient under discussion was an eight-week-old girl who had been born without kidneys, and who had been cared for on the unit for seven weeks. In the previous week, the baby's condition had gone steadily downhill, as she experienced on medical catastrophe after another. One of the nurses asked the staff doctor who was leading rounds that morning, "What are the baby's chances?" The physician replied, "Her chances are slim." To which one of the young residents immediately answered, "Slim just left town."     

Mock jurors’ expectations regarding the psychological harm experienced by rape victims as a function of rape prototypicality

We examined mock jurors’ judgments in a rape case that was either prototypical (late-night assault by a stranger in a public place) or non-prototypical (daytime assault by an acquaintance in a private home). We also varied the psychological harm experienced by the victim as a result of the rape (mild anxiety or posttraumatic stress disorder (PTSD)). We hypothesized that participants’ expectations regarding the level of harm the victim is likely to experience would mediate the effect of harm level on ratings of the victim’s credibility, and this indirect effect would be contingent on the prototypicality of the case. In a pilot experiment we demonstrated that people expect prototypical rape cases to be more traumatic for victims than non-prototypical cases. In the main experiment, and as predicted, participants in the Prototypical condition expected the victim to develop PTSD more than mild anxiety, but Non-Prototypical condition participants expected the opposite. In addition, a level of harm that was consistent rather than inconsistent with their expectations led participants to rate the victim as more credible; they also rated her as less responsible for what happened, and they thought the defendant was more likely guilty and that he should be incarcerated for a longer period of time.     

Choosing to limit choice: Self-binding directives in Dutch mental health care

In certain cases of chronic mental illness (for example bipolar disorder) a self-binding directive or Ulysses contract may be a helpful intervention to prevent harm to the person him- or herself and/or others. By choosing such an arrangement, the patient can indicate when and how mental health professionals may intervene against his or her will and provide indicated care which may lead to an improvement of the patient's mental condition. In the Netherlands, since 2008 the Compulsory Admissions Act has been amended and now includes a paragraph on self-binding. Starting from the Dutch debate and statutory regulation of self-binding in mental health care, a number of issues with broader relevance are discussed, particularly as these pertain to the legal regulation and juridification of self-binding. It is argued that too many detailed rules are a threat to increasing patient empowerment.     

Sequential torts and bilateral harm

This paper analyzes care incentives of individuals in a bilateral-harm setting if care choices are sequential. We find that the efficient outcome is not guaranteed under any liability rule considered, irrespective of whether information is perfect or imperfect. Furthermore, it is no longer possible to generally rank liability rules according to their induced social costs. These findings are in strong contrast to the sequential-torts setting in which harm is unilateral.     

Causing harm: Criminal law

This paper offers two related things. First, a theory of singular causal statements attributing causal responsibility for a particular harm to a particular agent based on the conjunction of a positive condition (necessitation) and a negative condition (avoidability) which captures the notions of sufficiency and necessity in intuitive ideas about agent causation better than traditional conditio sine qua non based theories. Second, a theory of representation of causal issues in the law. The conceptual framework is that of Game Trees and Games in Extensive Form. Causal conditions are defined set-theoretically over Game Trees; causal issues and fundamental distinctions (dependent versus independent intervening causes, foreseeability or not of harm etc.) arising in legal cases are accommodated by the device of a probability distribution over the game-tree representation of cases.This theory of causing harm, or agent causation is presented in greater detail in L. Aqvist & P Mullock, Causing Harm: a logico-legal study (forthcoming, de Gruyter, Berlin) dealing primarily with causation in tort law.     

医疗事故诉讼中过失认定

医疗事故属于医疗执业侵权。医疗执业侵权中医方的过失来自于其违反了法律要求的照护义务。美国的医疗执业侵权法从“医疗常规标准”已经发展出了“群体接受的标准”,以及在此基础上的过失认定原则。在程序上,美国的原告依赖于专家证人举证证明医方过错。我国的医疗事故诉讼的过失标准是“医疗常规标准”,存在着许多法律缺陷;程序没有专家证人制度,但实行单一举证责任倒置。事实上,过失的认定上交给了医疗事故技术鉴定,成为了医疗事故诉讼的核心。“医疗常规标准”和举证责任、医疗事故鉴定存在很多法律上的冲突。医疗事故鉴定和医疗事故诉讼间的关系,现有法律存有许多待讨论的问题;鉴定人的欠缺法律责任的规范。但现有达到专家辅助人和可能有的医学专家充当陪审员,很可能有助于解决我国医疗事故诉讼中的专业问题。     

Duty to warn of genetic harm in breach of patient confidentiality

Harm caused by the failure of health professionals to warn an at-risk genetic relative of her or his risk is genetic harm. Genetic harm should be approached using the usual principles of negligence. When these principles are applied, it is shown that (a) genetic harm is foreseeable; (b) the salient features of vulnerability, the health professional's knowledge of the risk to the genetic relative and the determinancy of the affected class and individual result in a duty of care being owed to the genetic relative; (c) the standard of care required to fulfil the duty to warn should be the expectations of a reasonable person in the position of the relative; and (d) causation is satisfied as the harm is caused by the failure of intervention of the health professional. Legislation enacted subsequent to the Report of the Commonwealth of Australia, Panel of Eminent Persons (Chair D Ipp), Review of the Law of Negligence Report (2002) and relevant to a duty to warn of genetic harm is considered. The modes of regulation and penalties for breach of any future duty to warn of genetic harm are considered.     

The Principle of Full Compensation in Tort Law

According to the principle of full compensation, tort law seeks to put the victim in the position he was in before the tort. This position is generally considered to be the situation where the victim does not suffer any harm at all. We consider an alternative interpretation. If an injurer takes due care, the victim is faced with expected harm. This can be considered the victim's expected harm in the situation he was in before the tort. Thus conceived full compensation requires a negligent injurer to pay damages which bring the (potential) victim ex ante in the same position as the victim was in the case where the (potential) injurer takes due care. We investigate the consequences of this restated negligence rule. For due care levels larger than efficient care, the standard negligent rule may lead to excessive care, whereas the restated negligent rule always leads to efficient care. Furthermore, the activity level under the restated negligent rule is greater than the activity level under the standard negligent rule, which itself is greater than the efficient activity level. Social welfare under the restated negligence rule can either be higher or lower than social welfare under the standard negligence rule.     

挥发性有机溶剂的危害及滥用

本文简要介绍了挥发性有机溶剂对人体的危害及其存在的可能性,分析了几类人群对此类物质形成滥用、依赖的因素及与此相关的部分规定,提醒注意此类具有隐匿性的滥用物质。     

Agent-Relative Prerogatives to Do Harm

In this paper, I offer two arguments in support of the proposition that there are sometimes agent-relative prerogatives to impose harm on nonliable persons. The first argument begins with a famous case where most people intuitively agree it is permissible to perform an act that results in an innocent person’s death, and where there is no liability-based or consequentialist justification for acting. I show that this case is relevantly analogous to a case involving the intentional imposition of lethal defensive harm on a nonliable person. In the final part of the paper, I provide a second, independent, argument in support of the proposition that there are agent-relative permissions to foreseeably harm or kill nonliable people under certain conditions.     

The Limits of the Harm Principle

The harm principle, understood as the normative requirement that conduct should be criminalized only if it is harmful, has difficulty in dealing with those core cases of criminal wrongdoing that can occur without causing any direct harm. Advocates of the harm principle typically find it implausible to hold that these core cases should not be crimes and so usually seek out some indirect harm that can justify criminalizing the seemingly harmless conduct. But this strategy justifies criminalization of a wide range of conduct on the basis of the fear, worry, and anxiety it generates among those who are not the direct victims of the conduct, and thereby undermines the limiting role of the harm principle by permitting the very move it was meant to prevent: the criminalization of harmless conduct on the ground of others’ feelings about it. The best way to avoid this dilemma is to recognize that people have rights, operating independently of the harm principle, to be treated in certain ways just because they are persons. The existence of such rights provides a ground for both criminalizing conduct and limiting the scope of criminalization because these rights point both to conduct that people must be permitted to engage in (regardless of its harmful effects) and conduct that might well be criminalized (though it is not harmful). A complete account of criminal law will therefore require the harm principle to work together with an independent account of rights.     

Harm and Repair: Observing restorative justice in Vermont

This paper analyzes the decision-making process for negotiating reparative contracts with offenders in a restorative justice model. Based on a content analysis of videotaped Community Reparative Board meetings with probationers in Vermont, this paper defines restoration as a core concept in restorative justice; examines how boards identify harm to victims and community; discusses how boards identify strategies to repair identified harm; addresses how repair often becomes a line item in reparative contracts; and offers interpretation for situations in which harm is not identified and/or not repaired.     

A rejoinder to Vaughn and Smith's “Practicing penal harm medicine in the United States: Prisoners' voices from jail”

Correctional health care has improved tremendously over the past 25 years. This rejoinder is a response to an article published in Justice Quarterly by Michael Vaughn and Linda Smith, in which they assert that the quality of correctional health care is suspect in correctional settings, and that an examination of one jail's problems with health care delivery revealed a “penal harm medicine” movement. We call into question such an assertion, claim that the penal harm medicine hypothesis cannot be proven by the data presented by Vaughn and Smith, and state that many of their conclusions are tenuous and harmful to correctional health professionals. We offer an analysis of their claims and suggest a more balanced view of correctional health care.