"Magical thinking," suicide, and malpractice litigation

Prospective clinical assessment of suicidality differs significantly from that used retrospectively in malpractice litigation. In the latter context, the judge or jury may be susceptible to hindsight reasoning and a disproportionate emphasis on the specific method of suicide, exaggerating its foreseeability and "magically" linking the means of death to the treating clinician, especially in the case of suicide by an overdose of prescribed medication. Such magical thinking, moreover, is rooted in the clinical context of suicide: The errors of reasoning observed in the courtroom exhibit striking parallels with the mind-set of the suicidal patient. An understanding of these dynamics suggests appropriate precautions for the clinician and thus contributes to the prevention both of suicide and of malpractice litigation.     

The "New Russians," the State,and Civil Society

The problem of crime in a transition society in general, and in Russia in particular, is part of a much broader problem of "liberation from the state." The road to such liberation is not necessarily a peaceful one. The emergence of a new view on life, new ideas of what is permissible and what is not, what is morally justified and what is prohibited, may be manifested in the collective and concerted actions of society as a whole or in a significant segment of society, thereby producing a revolution. Also, the adoption of new moral practices and the rejection of older ones may take place at the individual level, and in this case we may speak of a person's "escape" from state and society.     

Reporting a fatality during tumescent liposuction

Deaths of patients during elective surgery have drawn attention to the danger of anesthesia. Tumescent local anesthesia is subcutaneous infiltration of large volumes of dilute lidocaine with epinephrine to produce vasoconstriction while delivering anesthesia over large areas without lidocaine toxicity. This report documents the case of a 38-year-old woman who attended an outpatient clinic to undergo liposuction of the abdomen and bilateral hips and thighs. According to one witness, around 30 min after anesthesia administration, the victim suffered an episode of tonic–clonic convulsion. When the emergency medical services arrived the patient was in asystole. She died in spite of attempted cardiopulmonary resuscitation. The patient had no significant past medical history including no history of allergies or any known complications with anesthesia. A complete autopsy was performed and possible causes of death such as myocardial infarction, aspiration of food or foreign body, and pulmonary embolism were discarded. Anaphylactic shock was considered a possible but unlikely explanation for the fatality. Toxicological analyses revealed the presence of lidocaine and mepivacaine in heart blood, at concentrations of 4.9 and 16.2 mg/L, respectively. All drugs involved in the case were detected using gas chromatography with nitrogen–phosphorus detector and confirmed using gas chromatography–mass spectrometry full scan mode after solid-phase extraction using Chem-Elut columns. An additional high-performance liquid chromatography coupled to diode-array detection screening also obtained the same results. Based on the autopsy findings, case history, and toxicology results, the forensic pathologists ruled that the cause of death was an overdose of local anesthetic agents. The Court of Law ruled the death as an involuntary homicide due to gross negligence.     

"King of the Mountain," or Why Postcommunist Autocracies Have Bad Institutions

The authors analyze levels of democracy and state capacity (including quality of institutions) in the postcommunist countries over the past two decades and consider the theoretical implications of the relationship between these variables. In particular, they cast serious doubt on the general validity of the J-curve hypothesis. They present their own informal "king of the mountain" model.     

政府法治化与政府职能“错位”、“越位”、“缺位”现象的治理

政府职能作为政府专有的职责和作用,体现了国家行政管理活动的实质与方向,是政府活动的综合描述。但处于转型时期的我国政府职能还带有浓厚的计划经济色彩,存在着“错位”、“越位”和“缺位”现象,阻碍着政府功能的有效发挥,影响着经济与社会的快速发展。目前,我国的行政体制改革应注重创新政府行政理念,重塑政府角色,转变不合时宜的政府职能,使我国政府早日成为务实、勤政、廉洁、高效的现代化政府。     

Nation as Partnership: Law, "Race," and Gender in Aotearoa New Zealand's Treaty Settlements

This article uses postcolonial theory to analyze the dynamic convergence of two significant international trends in Aotearoa New Zealand: the movement for reparations for historical colonial injustices, and the economic reform process known as “structural adjustment,” or Reaganomics in the United States, which was intended to produce a competitive nation of individual entrepreneurs. It argues that analysis of the interrelationships of law, “race,” gender, and nation in this convergence illuminates the reproduction and reshaping of colonial tropes, or historical racial configurations produced through colonization, in these current trends. In Aotearoa New Zealand, claims by indigenous Maori activists for self‐determination and redress of historical injustices spurred the emergence of alternative imagined communities with the potential to transform the nation. These alternative visions for the nation were shaped and limited by the economic law and policy reform of structural adjustment, producing a new official nationalism of partnership, implemented in settlements of breaches of the Treaty of Waitangi 1840. These partnerships resulted in a new individual identity of Maori men as entrepreneurs in a competitive nation. It produced a symbolic alliance of men across race that silenced and erased Maori activists' demands, and the leadership of Maori women, at the national level. The high profile partnerships, the erasure of Maori women, and relentless media attention to claims of sexism in Maori culture reproduced colonial tropes with images of the “progress” of the partnerships “saving” brown women from the sexism of brown men and “traditional” cultures. In this complex process the settlements were rational exercises of agency by the new Maori entrepreneurs with the goal of achieving economic autonomy, and worked to silence and erase the leadership of Maori women at the national level, even while women continued to be recognized as leaders at the local and regional levels. This analysis suggests that realization of the transformative potential of claims for redress of historical racial injustices requires attention to the repetition of raced and gendered dynamics of imagined communities that shape and limit that potential.     

Mapping Difficult Terrain: "Legal Culture,""Legal Consciousness," and Other Hazards for the Intrepid Explorer

By this time Gertrude Stein was in a sad state of indecision and worry. I sat next to her and she said to me early in the afternoon, what is the answer? I was silent. In that case, she said, what is the question? Then the whole afternoon was troubled, confused and very uncertain. … (Toklas, 1963: 173)     

Morality and pretextuality, psychiatry and law: of "ordinary common sense," heuristic reasoning, and cognitive dissonance

The thesis of this paper is that we will not make significant progress in understanding the tensions between the legal and mental health systems until we look carefully at a series of dissonances that affect both systems. We must consider the way that the law frequently condones pretextuality as a way of dealing with troubling or cognitively dissonant information, and the way that mental health professionals encourage a self-referential concept of morality as a way of subverting legal doctrines with which they disagree. These dissonances must be considered contextually in connection with the ways that courts generally read social science data and the ways that jurors and legislators employ such cognitive devices as "ordinary common sense" and heuristic reasoning in their judgments of cases involving mental disability questions. To ameliorate the current dilemma, we must redefine institutional and professional roles, reconsider the way we privilege expertise, recalibrate our allocation of "moral jurisdiction" over these matters, and consciously confront the way our simplifying thinking mechanisms distort the underlying social and political issues.     

The liberty of free riders: the minimum coverage provision, Mill's "harm principle," and American social morality

A direct requirement for most Americans to purchase any product or service .... certainly is an encroachment on individual liberty, but it is no more so than a command that restaurants or hotels are obliged to serve all customers regardless of race, that gravely ill individuals cannot use a substance their doctors described as the only effective palliative for excruciating pain, or that a farmer cannot grow enough wheat to support his own family. The right to be free from federal regulation is not absolute, and yields to the imperative that Congress be free to forge national solutions to national problems, no matter how local--or seemingly passive--their individual origins.