Practical measures to reduce medical expert witness bias

To minimize bias by the testifying clinician, particularly in professional liability cases, six practical measures should be used: 1. testify for both the plaintiff and the defense in different cases; 2. assess the merits of the case separately from agreeing to testify; 3. insist on reviewing all the records thoroughly; 4. develop a solid medical posture for each case; 5. review the case in a balanced, critical manner; and, 6. articulate carefully the standard of care in his words before expressing it in deposition or at trial. The expert must stay within his role and duty as "expert witness" to remain effective.     

Policing in the Hyde Park neighborhood, St. Louis: Racial bias, political pressure, and community policing

Policing in the inner-city neighborhood of Hyde Park is evaluated against a backdrop of racial polarization within the city of St. Louis and political pressures upon the St. Louis Metropolitan Police Department (SLMPD). Data garnered from immersion into Hyde Park community life, participation in and observation of numerous police/community meetings, document analyses, a focus group session with rank-and-file police officers, interviews with a sergeant and the captain of the Police Fifth District, and numerous informal conversations with residents and police officers provide evidence of poor community/police relationships. The data also provide evidence—on the part of police—of racial bias, lack of and/or poor understanding of the underlying causes of criminal behavior, pervading adventure and excitement lures toward police work, and a less than adequate understanding of the community oriented problemsolving (COPS) policing initiative. An underlying theme of little or absent informed locus of control at various levels regarding policing practices links issues of poor police/community relationships and the influence of racial bias and political pressures.     

Racial and ethnic bias in decisions to shoot seen through a stronger lens: experimental results from high-fidelity laboratory simulations

Background

Research on racial bias in the United States includes findings that Americans tend to view blacks as more dangerous than whites. Some have argued that this bias provides a likely explanation for the disproportionate number of ethnic and racial minorities shot by police. One piece of evidence for this proposition comes from experimental work in which research participants push “shoot” or “don’t shoot” buttons when still images of people and objects that may or may not be weapons are presented in rapid succession. These studies have established that participants tend to subconsciously pair black individuals with weapons and white individuals with neutral objects. However, it is not clear from these studies that the subconscious racial bias identified by researchers affects actual decisions to shoot, perhaps because the techniques used to assess the bias-shooting link bear so little resemblance to real-world shootings.

Methods

This paper reports on the results of a novel laboratory experiment designed to overcome this critical limitation by using high-fidelity deadly force judgment and decision-making simulators to assess both subconscious and behavioral bias among 48 research participants, recruited from the general population.

Results

Study results suggest that subconscious associations between race and threat exhibited by participants are not linked to their shooting behavior.

Conclusions

The implications of this finding for understanding how race and ethnicity affect decisions to shoot, and for conducting empirical research on this important topic, are discussed.     

Undue influence in the context of medical treatment

It is argued that the application of the doctrine of undue influence to patient's decisions in the context of medical treatment is ripe for development. The doctrine is capable of providing much needed protection for vulnerable patients if developed along lines suggested by its use in other contexts. Unfortunately, the Court of Appeal has recently missed an opportunity to develop the law in this way and it may be some time before another suitable opportunity is presented to the courts.     

The judicial role in life-sustaining medical treatment decisions.

Although there has been speculation regarding the pervasiveness and nature of judicial decisions regarding life-sustaining medical treatment (LSMT), no attempt has been made to empirically assess their prevalence or the issues they address. An exploratory study utilizing a mail survey of a nationwide random sample (N = 905) of state trial court judges was conducted to provide initial information regarding this decision-making process. Twenty-two percent of the responding judges had heard at least one LSMT case, and judicial review did not appear endemic to particular states. The number of judges hearing LSMT cases dropped from 1975 to 1981 but has increased since then. Three major issues predominate: patient competency, appointment of a surrogate decisionmaker, and resolution of the ultimate issue of forgoing LSMT. Relatively few cases either contested a prior directive's validity or involved imposing sanctions for instituting or forgoing LSMT. Although subject to different interpretations, the results suggest the courts are having a significant impact on certain aspects of the LSMT decision-making process. However, the infrequency with which any one judge is called upon to make an LSMT decision causes concern about the judiciary's ability to respond in a timely and appropriate manner. With their potential for a profound effect on the actions of health care providers, greater attention to this decision-making process is warranted.     

Evidence for bias in hair testing and procedures to correct bias

A number of in vitro experiments show that different hair samples incorporate differing amounts of drugs under identical conditions. Incorporation of cocaine and morphine tends to be correlated with race, in that the hair of African American females incorporates higher concentrations of cocaine than does the hair of Caucasian males or females. Extrapolation of these data into populations has been fraught with difficulties because the dosages of drugs and their use patterns are unknown. Cosmetic treatments and hygiene alter drug binding, which must be considered in comparing populations because cosmetic treatments are often group dependent. Four reasons are proposed that account for the uptake and retention of drugs by hair and that may differ among groups: (1) permeability and other characteristics of the hair due to genetic influences, (2) cosmetic hair treatments and hair care habits (which may be culturally influenced), (3) drug removal during personal hygiene, and (4) manner and route of drug administration which can affect passive exposure to residual drugs in the environment. The data supporting bias in hair testing are reviewed and methods are proposed that use either the uptake of dyes or the incorporation of drug homologs to reduce bias.     

Examining Racial Disparities in Drug Arrests

The War on Drugs popularized a set of policies and practices that dramatically increased the number of drug arrests, particularly for low-level drug offenses. The War’s tactics have affected Americans of every race; however, minorities have been most dramatically affected. There are several explanations for the observed racial disparity in drug arrests, but relatively little research directly tests these explanations. In this study, we test three common explanations of racial disparities in drug arrest rates. We find that racial disparities in drug arrests cannot be explained by differences in drug offending, nondrug offending, or residing in the kinds of neighborhoods likely to have heavy police emphasis on drug offending. Our findings are most consistent with explanations focusing on racial bias in drug sanctions.