The MacArthur Treatment Competence Study. II

This article reports the development and psychometric properties of three standardized and objectively scored measures, the MacArthur Treatment Competence Research Instruments. They were designed to assess abilities related conceptually to four legal standards for competence to consent to treatment: understanding, appreciation, rational manipulation (reasoning), and expressing a choice. Scoring reliability, internal consistency, intertest correlations, and test-retest correlations were examined with data from samples of hospitalized patients with schizophrenia, major depression, and ischemic heart disease, as well as matched non-ill community samples. The results indicate very good interscorer reliability and provide guidance for the use of the instruments and interpretation of their results in future research on patients' decisional abilities in treatment contexts.     

The MacArthur Treatment Competence Study. I

This is the first of three papers reporting the results of the MacArthur Treatment Competence Study, a project designed to develop reliable and valid information with which to address clinical and policy questions regarding the abilities of persons with mental illness to make decisions about psychiatric treatment. Four commonly applied legal standards for determining decision-making competence are described: abilities to communicate a choice, understand relevant information, appreciate the nature of the situation and its likely consequences, and rationally manipulate information. Previous research related to the capacities of persons with mental illness in relation to these standards is reviewed and critiqued. The principles underlying the design of the MacArthur Treatment Competence Study are described.This work was supported by the Research Network on Mental Health and the Law, John D. and Catherine T. MacArthur Foundation. The authors, are grateful to the members of the Network for their assistance in the conceptual development of this project and for their, comments on an earlier draft of this paper: Shirley Abrahamson, Richard Bonnie, Pamela Hyde, John Monahan, Stephen Morse, Ed Mulvey, Loren Roth, Paul Slovic, Henry Steadman, and David Wexler.     

III. Assessment,Referral and Treatment

Each court must have access to a complete range of services for effective screening, identification, assessment, evaluation, treatment, and rehabilitation. Such services may be developed within the court operation or in cooperation with related agencies or through contracted service providers. Many jurisdictions will use a combination of these basic approaches for provision of services. However they are organized, the key is that they must be in place and consistently used.     

Injuries due to deliberate violence in areas of Denmark. III. Lesions. The Copenhagen Study Group

As part of a transcultural investigation of violent behavior in Denmark and South America, the lesions from accidents involving deliberate violence registered in three Danish emergency wards during a 1-year period were studied. A quantity of 2211 lesions were diagnosed in 1316 patients (953 male and 363 female patients). Sixty-five percent of the lesions were in the head/neck region, 13% in truncus, 18% in the upper extremities and 5% in the lower extremities. The most frequent diagnosis was an open wound in the head/neck region. Adding contusions and fractures in the same region this amounted to more than half of the total number of lesions. In the upper extremities 62% of the lesions were contusions or open wounds. Serious lesions of internal arteries were few, however always caused by sharp instruments (knives). Serious lesions due to firearms were not recorded/reported. Strangulation had been used against 1.1% of the victims, the male/female ratio being 1:6. The main part of the lesions were of minor severity when assessed on the basis of the scores in the Abbreviated Injury Scale (AIS). The lesions were, however, more serious compared to other recent studies, and it appeared that the female victims had fewer but more serious lesions than the male victims. The need for treatment and hospitalization was in the range of other recent studies.     

The Masculine Yardstick of Physical Competence: U.S. Police Academy Fitness Tests

State and local law enforcement training academies differ in a myriad of ways, including the content of their classes, the type of instruction received, and the tests mandated for graduation. The focus of this study is the physical fitness test and how it affects the proportion of women to men matriculating from these academies. A predictive model of academy completion rates is derived from a sample of 96 police training academies. The presence of gendered physical testing requirements was found to be positively related to the proportion of women to men graduating from training. In addition to the empirical models, data on the specific content of these tests are provided. The variability of tests suggests that gendered physical requirements are an illusionary panacea, as they do not address the fundamental assumptions of the tests themselves.     

The interpretation of refractive index measurements. III

The question of whether or not to group recovered glass fragments before comparison with a control sample is fundamental to the interpretation of refractive index measurements. A computer program has been written to perform the grouping and explore the consequences. Grouping the fragments is shown to increase the chances of finding all recovered fragments similar when they have in fact come from the same source as the control, and to give enhanced discrimination when the recovered glass has come from a different source. When the recovered fragments have come from two different sources the consequences of the grouping procedure are preferable to non-grouping.     

论精神障碍者民事行为能力评定分级

民事行为能力评定案例逐年增多，相关研究却相对匮乏。然而司法人员和司法精神病学鉴定人员对精神病人的民事行为能力研究甚少。存在着相当多的概念的混乱与分歧。本文首先介绍了民事行为能力的诸多定义。并简要分析了民事行为能力与诉讼能力的异同：然后详细介绍了当前司法精神病鉴定中民事行为能力分级分歧：最后从法律依据。实践运用及现实意义三个方面对民事行为能力三级评定进行了论证。     

Trial Advocacy Competence: The Judicial Perspective

The competence of attorneys, and more particularly the competence of trial lawyers, is currently an issue of considerable controversy both within the judiciary and within the legal profession itself. This article addresses the issue of attorneys' courtroom performance as observed by judges. Drawing on data from a survey administered to state and federal judges sitting in trial courts of general jurisdiction, this article explores the relationship of demographic and judicial characteristics to various judicial evaluations of advocacy competence. While it provides important insights into the present state of trial advocacy competence, it also constitutes a systematic examination of the judiciary's perceptions of the trial bar.     

A Study of Maltreated Children and Their Families in Juvenile Court. III. Case Plans

We reviewed publicly available court records of 88 cases referred to juvenile court for maltreatment in Hennepin County, Minnesota. The goal of the current study was to examine the content of, and extent of compliance with, case plans. There was an average of 9.5 items per child on the case plan. About half the case plans did not address at least one presenting maltreatment type. Compliance was generally high for items ordered for the children, and for cases that ended in family preservation. However, information on compliance was not included in the court records for many of the items.     

Those Who Hesitate are Lost: The Case for Setting Behavioral Health Treatment and Disability Standards, Part III

The first and second articles in this 3-part series discussed systematic issues related to multiple standardization problems and their compounding impact on the state and federal disability systems. In addition, the lack of standardization negatively influencing the behavioral health (BH) training and treatment processes may have the potential to cause harm not only to the individual receiving professional care but also to the clinician providing the treatment. In the final article of the series, I make recommendations for systemic changes for the field as well as for potentially revising previous models toward moving the Behavioral Health treatment and disability systems into more of a biopsychosocial approach. However, conclusions emphasize that successful implementation of recommendations and models require the involvement of all of the stakeholders in promoting better outcomes and in facilitating individuals; return to the workplace.     

限制与扩张:我国证人资格制度之历史嬗变

除传统之“亲不为证”外,我国古代对证人资格殊少限制,只是到了唐代,才将证人自身之作证能力纳入到了证人适格的考察范围。近代以来,受认识深化和外来文化的影响,并基于政策性、可靠性、客观性和公正性等因素的考量,关于证人资格的规定变化很大,实现了从重在证人的适格性审查到证言的真实性审查、从单向容隐到同居相隐再到特权容隐、从道德义务到法律义务再到道德义务和法律权利的结合体等几个转变。     

Urinary excretion profiles of 11-nor-9-carboxy-Delta9-tetrahydrocannabinol. Study III. A Delta9-THC-COOH to creatinine ratio study

Huestis and Cone reported in [J. Anal. Toxicol. 22 (1998) 445] that serial monitoring of Delta9-THC-COOH/creatinine ratios in paired urine specimens collected at least 24h apart could differentiate new drug use from residual Delta(9)-THC-COOH excretion following acute marijuana use in a controlled setting. The best accuracy (85.4%) for predicting new marijuana use was for a Delta(9)-THC-COOH/creatinine ratio > or = 0.5 (dividing the Delta9-THC-COOH/creatinine ratio of specimen no. 2 by the specimen no. 1 ratio). In previous studies in this laboratory [J. Anal. Toxicol. 23 (1999) 531 and Forensic Sci. Int. 133 (2003) 26], urine specimens were collected from chronic marijuana users > or = 24 h or > = 48 h apart in an uncontrolled setting. Subjects with a history of chronic marijuana use were screened for cannabinoids with the EMIT II Plus cannabinoids assay (cut-off 50 ng/ml) followed by confirmation for Delta9-THC-COOH by GC-MS (cut-off 15 ng/ml). Creatinine was analyzed as an index of dilution. The objective of the present study was to evaluate whether creatinine corrected specimens could differentiate new marijuana or hashish use from the excretion of residual Delta(9)-THC-COOH in chronic marijuana users based on the Huestis 0.5 ratio. Urine specimens (N=376) were collected from 29 individuals > or = 96 h between urine collections. The mean urinary Delta9-THC-COOH concentration was 464.4 ng/ml, mean Delta9-THC-COOH/creatinine ratio (ng/(ml Delta9-THC-COOH mmoll creatinine)) was 36.8 and the overall mean Delta9-THC-COOH/creatinine ratio of specimen 2/mean Delta9-THC-COOH/creatinine ratio of specimen 1 was 1.37. The Huestis ratio calculation indicated new drug use in 83% of all sequentially paired urine specimens. The data were sub-divided into three groups (Groups A-C) based on mean Delta9-THC-COOH/creatinine values. Interindividual mean Delta9-THC-COOH/creatinine values ranged from 4.7 to 13.4 in Group A where 80% of paired specimens indicated new drug use (N=10) and 20.4-39.6 in Group B where 83.6% of paired specimens indicated new drug use (N=7). Individual mean Delta9-THC-COOH/creatinine values ranged from 44.2 to 120.2 in Group C where 84.5% of paired urine specimens indicated new marijuana use (N=12). Correcting Delta9-THC-COOH excretion for urinary dilution and comparing Delta9-THC-COOH/creatinine concentration ratios of sequentially paired specimens (collected > or = 96 h apart) may provide an objective indicator of ongoing marijuana or hashish use in this population.     

Competence or Confidence? The Appropriate Forum to Address Multi-Purpose High Seas Protected Areas

This article addresses the question of the most suitable forum for discussions on the establishment of marine protected areas beyond national jurisdiction, and on the complementary role of other international organizations and processes related to marine biodiversity and fisheries. In light of negotiations in 2005 and 2006 within the context of the United Nations Convention on Biological Diversity (CBD) and the United Nations General Assembly, it is argued that consensus on the leading role of the General Assembly was based on political grounds – a judgement call based on the confidence in this forum to address ocean issues in an integrated manner – rather than strictly on the competence of the CBD in relation to the high seas.