Community midwifery and state measures: the new midwifery in British Columbia

The New Midwifery, a form of community midwifery rooted in home birth and intensive prenatal and postnatal care, has attracted great controversy since its appearance in British Columbia in the early 1970s. On the one hand, this form of community midwifery has endured despite legal prohibition. Midwives derive an income from their practices, obtain necessary supplies and equipment, and are active in lobbying for recognition through the State. On the other hand, community midwifery is marginalized and illegal. Out-of-hospital births comprise less than one percent of births in British Columbia (and nationwide). Community midwives are excluded from the provincal Medical Services Plan and they lack hospital privileges if their clients are transferred to hospital. Community midwives are more likely than medical personnel to be tried for criminal negligence causing death and subject to prosecution under theMedical Practitioners Act of practicing medicine without a license.Community midwifery illustrates the structural limits placed on female birth attendants working outside the norm of professionally accredited, hospital situated childbirth. It is concluded that State measures in Canada structure power relations in a dialectical fashion. This includes measures to consolidate the monopoly status of the medical profession and the nursing profession, while temporizing about demands for independent midwifery practice. State powers are however relatively autonomous of dominant economic groups such as the Medical profession. Not all prosecutions of community midwives are successful, and contradictions in State policies surrounding monopolistic powers and civil liberties, and gender relations are evident.An earlier version of this paper was presented at the Canadian Sociology and Anthropology Association Meetings, University of Manitoba, June 1986. The author is grateful for resources provided through the Social Sciences and Humanities Research Council of Canada, the Department of Anthropology and Sociology (University of British Columbia), and the School of Criminology, Simon Fraser University. Comments from Carol Bullock, Nanette Davis, Bob Ratner, Livy Visano and the Journal referees have been helpful in revising this paper.     

Chasing the Dragon: trust assets caught by the divorce courts

The recent Court of Appeal decision in Charman v Charman [2007]EWCA Civ 503 provides the latest analysis of the courts' approachin apportioning assets in ‘big money’ divorce casesand pays particular attention to the treatment of assets settledinto offshore trusts.     

CARICOM states and the WTO dispute settlement system: the case for greater engagement

This paper examines the participation of member states of the Caribbean Community (CARICOM) in the World Trade Organisation (WTO)’s dispute settlement system and its associated negotiations. In so doing, it highlights the dispute settlement system’s important contribution to the WTO and the need for CARICOM member states to engage more actively with this aspect of the WTO’s work. The paper concludes by articulating some of the lessons learnt from CARICOM member states’ experiences to date and offering some concrete suggestions on how the region can improve its current record of engagement.     

Suicidal incised wound of a fistula for hemodialysis access in an elderly woman: case report

A very rare case of suicide by stab wound of a fistula for hemodialysis access in an elderly woman is reported. The incidence of suicide attempts in people undergoing hemodialysis is well known. Nevertheless, suicide means do not usually include stab wounds of the arteriovenous access. Various pattern differences between homicidal and suicidal stab wounds, characteristics of suicide in the elderly, and approaches to the investigation of such cases are briefly discussed.     

High urine ethanol and negative blood and vitreous ethanol in a diabetic woman: a case report, retrospective case survey, and review of the literature

Several studies have shown that ethanol can be produced in urine infected with yeast or bacteria in vitro. We present the unusual case of a diabetic woman in whom ethanol was produced in her urine in vivo. The decedent was a 19-year-old woman who was noncompliant with her diabetes treatment. She presented to a local hospital in severe diabetic ketoacidosis and died shortly thereafter. Upon arrival at the hospital, a blood glucose of 553 mg/dL was detected. A urinalysis was positive for ketones (> 80 mg/dL), glucose (> 1000 mg/dL), and large budding yeast forms. A drug screen performed on the urine was positive for ethanol. At the coroner/medical examiner office, an autopsy was negative for significant anatomic findings. Toxicology analysis revealed a urine ethanol level 0.32 g/dL, although no ethanol was detected in blood or vitreous samples. A urine gram stain and culture identified Candida glabrata. A retrospective case review of all deaths related to diabetes examined at the coroner/medical examiner office from 1986 to 2003 did not reveal other cases with similar findings. This case of a noncompliant, juvenile-diabetic woman illustrates a rare finding of apparent in vivo glucose fermentation by C. glabrata to form ethanol in the urine. This case also highlights a potential difficulty in toxicologic analysis and interpretation using urine only.     

Laying the foundation for institutionalisation of democratic parliaments in the newly independent states: The case of Ukraine

This article examines the institutionalisation of the Ukrainian Parliament, the Verkhovna Rada, since the fall of the Soviet Union. The emergence of a popularly elected legislature in post‐Soviet Ukraine stands as a cornerstone in the development of a democratic regime. While the Verkhovna Rada is by no means a mature parliament, the foundation for future institutionalisation has been laid through the establishment of a representative political process, nascent political parties, a separation of powers between the executive and the legislature, and the policy‐making capacity of the Parliament.     

Partial order scalogram analysis with base coordinates (POSAC): Its application to crime patterns in all the states in the United States

In this paper, a new nonmetric method called POSAC is presented and illustrated through an analysis of the crime patterns of all the states in the United States. POSAC is a graphical technique for the display of multivariate data in a two-dimensional space. It maps the rows (e.g., states) of a matrix in a way that maximizes the preservation of theirpartial order, with similar states located in close proximity on the map. POSAC is based on the partial order among observations rather than their actual magnitude. POSAC seems to bear the same relationship to the principal-component analysis (PCA) as that borne by the median to the arithmetic mean. As a matter of fact, POSAC is a form of ordinal factor analysis. Its advantage over PCA is its robustness to the data. The technique enables observations and variables to be studied simultaneously. Seven index crime categories are analyzed. In order to demonstrate the utility of POSAC in detecting changes in crime patterns over time, we included in our analysis three selected years: 1944, 1965, and 1987. The results for the year 1987 are compared to those obtained by PCA.     

Law reform: in the Commonwealth,in small states and in the Caribbean

This paper first outlines the constitutional methods of law reform in the Commonwealth as a whole, in small states like those of the Caribbean, and in the Caribbean itself. It considers possible ways in which small states, which tend to have especially limited human and financial resources, might still be able to make greater use of independent law reform. The possibilities include the establishment of more Law Reform Agencies (LRAs), and greater regional co‐operation in law reform or even a Regional Law Reform Agency (RLRA). In this regard, it raises several issues for consideration, in its concluding paragraphs.     

Baby Doe, Congress and the states: challenging the federal treatment standard for impaired infants

In its amendments to the Child Abuse Prevention and Treatment Act, Congress set forth a strict standard for treatment of impaired infants. The statute, shaped by right-to-life groups and certain medical organizations, calls for aggressive treatment in virtually all cases, regardless of the degree of suffering imposed and the burdens and risks involved. The federal rule evidences deep distrust of parental decisionmaking, relegating most parents to a nonparticipatory bystander role. Congress did not make its rule binding on the states. Rather, it conditioned the receipt of federal funds upon incorporation of the rule into each state's law. Most states have accepted the condition, largely through rulemaking by state child abuse agencies. This article challenges the authority of state administrators to promulgate these rules, and argues that state constitutions, little mentioned in the Baby Doe debate thus far, may prohibit many states from adopting the federal standard. Ordering medical interventions that perpetuate extreme conditions of physical and mental devastation, subjecting infants to grave suffering for uncertain benefits, and depriving parents of virtually all decisionmaking power violates the norm of governments constitutionally committed to individual liberty, human dignity and family autonomy. A constitutionally sound approach to this issue would permit careful, ethical deliberation, attention to the individual circumstances of each infant Doe and a reasonable degree of parental control.     

中国配偶权立法:一个苦涩的话题--从一例重婚案件的被害女说起

重婚案件的被害女如何被保护,如何立法来规范调整公民固有的民事权利——配偶权,婚姻法却未能规定。婚姻法只将上述的内容加以原则性规定,因此对于配偶权问题就有所回避,明显滞后司法实践,法学界对配偶权有严重的理论分歧。婚姻是一个伦理范畴。它需要法律、道德各种力量来共同维系。婚姻家庭问题需要由法律来调整,但法律不可能解决婚姻家庭中的所有问题。配偶权是受双重规范调整的民事权利,谨慎对待离婚和婚姻自由。     

Medicare program; Peer Review Organizations: revised scopes of work for the District of Columbia, Puerto Rico, the Virgin Islands, and all states except Delaware, Florida, Missouri, Montana, Nebraska, Nevada, Oklahoma, Rhode Island, South Carolina, Washington, and Wyoming--HCFA. Final notice

This notice describes requirements for the review activities of Utilization and Quality Control Peer Review Organizations (PROs) under contract extensions of the Scope of Work for the District of Columbia, Puerto Rico, the Virgin Islands and all States except Delaware, Florida, Missouri, Montana, Nebraska, Nevada, Oklahoma, Rhode Island, South Carolina, Washington, and Wyoming. Section 1153(h)(1) of the Social Security Act requires us to publish any new policy or procedure adopted by the Secretary that affects substantially the performance of PRO contract obligations at least 30 days before the date the policy or procedure is to be used. Specifically, this notice describes the way in which PRO contract requirements are changed and explains significant changes in the PRO program (e.g., the way in which cases will be selected for review) and also describes continuing requirements. This notice also implements provisions of the Omnibus Budget Reconciliation Act of 1990.     

Crime,politics, and minority populations: Use of official statistics in the united states and Japan

Although the governments of the United States and Japan differ markedly in racial ideology, official crime statistics in both nations reflect political arrangements which marginalize minority populations. In both nations, official crime statistics reveal more about the attempts of majority populations to label minority populations as a criminal class than about variations in criminal behavior across racial populations. While there is no racially pure Black population in the United States, there is a “black” category within official statistics, and the statistics are used to justify crime control policies which have a disparate impact on the diverse peoples who are socially‐perceived as Black. While there are undeniably non‐Japanese populations in Japan, there are no racial categories for them in official statistics which define them out of existence; except where crime statistics are concerned, so that the police can monitor the criminality of “foreigners.” In both societies, official categorization of race in crime statistics implies that crime is a minority problem; government statistics reinforce official ideology that crimes by “foreigners” and “black violence” are the real threats to civil society.