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

In the first article of this three-part series, an overview of systematic problems related to behavioral health (BH) treatment and disability was discussed. In this second article of the series, I discuss a number of factors that contribute to the lack of standardization regarding the work of all professionals in the area, including those in the BH field, which serve to introduce imprecision into the BH treatment and disability determination processes. From how professionals are trained and continuing to those who are providing clinical treatment, it is essential to understand how the lack of standardization impacts the treatment itself as well as treatment outcomes. This lack of standardization contributes to poorly identified mental health (MH) conditions, no identification of psychosocial issues, and an overreliance on subjective information, including professional clinical opinion, which leads to poorly defensible professional decision-making as well as poorer outcomes in treatment. In this litigious age, it is not sufficient to employ clinical opinion alone as the basis for treatment decisions. The more sophisticated professional recognizes the importance that one's assessment and treatment decisions may later be questioned in court or in a disability determination hearing. The importance of standardization and utilizing the current scientific standards has become imperative in today's professional evaluation and treatment in the area.     

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

There are multiple factors that impede the implementation of standards into the behavioral health (BH) treatment and disability processes. The combination of physical and psychological conditions as well as the influence of psychosocial issues has consistently been identified as having negative effects on treatment and treatment outcomes. Further, the wide-spread lack of standardization causes a multitude of problems throughout both BH processes. The focus of this first article in a three-part series will examine the explosion of behavioral health claims and the major factors, such as comorbid physical conditions and psychosocial issues, associated with these types of claims. In addition, the overarching theme of lack of standardization will begin to be explored in regard to the problematic definition of disability, communication difficulties between treating professionals and disability insurers and agencies as well as the introduction of bias into the BH treatment and disability processes.     

Life, Health, and Disability Insurance: Understanding the Relationships

Communitarian values are stronger in health insurance than in life or disability insurance. This correlates with increased tolerance for insurers' use of genetic information in disability insurance underwriting, which, in turn, is relevant to the scope and content of proposals to regulate such use.     

Incarcerated Battered Women: A Comparison of Battered Women Who Killed Their Abusers and Those Incarcerated for Other Offenses

The present study compared battered women incarcerated for killing/seriously assaulting their abusers with battered women incarcerated for other offenses to explore possible similarities and differences in the characteristics and experiences of the two groups as well as to determine what factors may lead some battered women to use lethal force against their partners. Comparisons were made on a number of variables including sociodemographic factors, characteristics of the battering relationship, alcohol/drug use of battered women and their abusers, perceived social support, actions taken to end the violence, prior criminal behaviors, and childhood trauma factors. Findings revealed that women in the homicide/assault group were older, in the relationship longer and experienced a longer duration of violence in this relationship. They also experienced more frequent and severe battering, including sex assaults and sustained more injuries than those in the comparison group. Further, battered women who killed/seriously assaulted their partners were more likely to believe that their lives were in danger, were less likely to use violence against their partners, and were less likely to have a prior criminal record or to have served time previously. The implications of the findings are discussed.     

Genetic Screening and Disability Insurance: What Can We Learn From The Health Insurance Experience?

Genetic information may be used by health and disability insurance companies to deny or restrict coverage. How health insurance companies use genetic information, and how public policy has limited that use, can be illustrative for genetics and disability insurance policy.     

The Costs and Benefits of Transferring Technology Infrastructures Underlying Complex Standards: The Case of IPv6

Industry stakeholders and Internet experts generally agree that networks using Internet Protocol version 6 (IPv6), an Internet communications standard which is being promoted strongly by many parties, would be technically superior to today’s networks, which are largely based on IPv4. The improvements designed for IPv6 could provide numerous benefits to Internet users, network administrators, and applications developers; among these potential benefits are cost reductions due to improved security and increased efficiency, improvements to existing products and services, and innovations leading to new products and services. However, there is wide disagreement about the characteristics and timing of benefits associated with IPv6, and the costs associated with the transition could be substantial. In this paper, we will discuss the likely costs of a transition to IPv6 for the major stakeholders and the potential benefits. Subsequently, we will introduce the cost impact of an accelerated adoption case and discuss potential ways in which the government could become involved in the process. This paper is based on a broader study funded by the National Telecommunications and Information Administration (NTIA) and National Institute of Standards and Technology (NIST). We wish to thank Greg Tassey, Fred Lee, Tim Sloan, B. Keith Fulton, John Streck, and Baran Erkel for comments and suggestions on earlier versions of this paper.     

The Kids are Alright: Making a Case for Abolition of the Juvenile Justice System

When considering abolition of the criminal justice system, there is no greater or more impactful relevance than for juveniles that find themselves inextricably linked to the juvenile justice system. From its inception, the philosophical foundation of juvenile care was to provide individualized, compassionate assistance to young men and women perceived to be in need of emotional care and/or social control. With the establishment of the Cook County Juvenile Court in 1899, the American juvenile justice system has endured a 118-year odyssey that has produced progressively rational, largely unsympathetic, and increasingly punitive practices. With happenings such as the ‘school-to-prison pipeline’, ‘juvenile life without the possibility of parole’, ‘teen courts’, and ‘deferred prosecution probation’, current juveniles that make unassuming mistakes and errors in judgment are adjoined to a system that sustains and reinforces itself through these mistakes and errors. The charge of this article is to recommend the abolition of the contemporary juvenile justice system, with safeguards for the protection from serious offenders and a return to the compassionate care that is warranted for the majority of juveniles that currently bolster the system.     

Standards for determining coal miner's total disability or death due to pneumoconiosis; claims for benefits under Part C of Title IV of the Federal Mine Safety and Health Act, as amended--Employment Standards Administration, Labor. Notice of proposed rulemaking; request for comment

On January 1, 1982, the Black Lung Benefits Revenue Act of 1981 and the Black Lung Benefits Amendments of 1981 became effective. This legislation made numerous substantive changes in the Black Lung Benefits Act, Title IV of the Federal Mine Safety and Health Act. Those changes affect both the criteria for establishing eligibility for benefits on claims filed on and after January 1, 1982, under the Black lung Benefits Act and the procedures for the payment of such benefits. These proposed rules are intended to implement those changes in the law and to make certain technical corrections in the implementing regulations previously promulgated in 1978 and 1980.     

偏好与理性选择：保守主义人士也能接受的规制——行为经济学与“非对称父爱主义”的案例

非对称父爱主义的规制目的是帮助那些有限理性的人们避免犯成本过高的错误,同时仅对理性的人们加以很小的成本甚至不加以成本。结合了认知心理学与经济学的行为经济学表明,有时候即便有健康心智的人们在某些特定的、可预见的情形下也可能不会为他们长远的自身利益行事,很多非对称父爱主义的规制就是基于这种考虑而产生的。这些规制体现在缺省规则、对信息的提供或重组、冷却期、对消费者选择的限制等方面。非对称父爱主义并不必定是严厉的,它可能会引导产生比现有政策更温和的规则。而且新技术为将这种规制作为一种新的对规制选择的成本收益评估标准提供了新的可能性,因而值得被认真对待。     

The psychiatrist's guide to right and wrong: Part III: Postpartum depression and the "appreciation" of wrongfulness

Whether or not the psychiatrist testifies on the ultimate issue in insanity defense cases, it is critically important that he familiarize himself with the applicable legal standards and interpretations in order properly to relate his clinical findings to the relevant criteria for insanity and thereby enhance the probative value of his testimony. This is the third in a series of articles which attempts to explicate judicial and statutory standards of insanity and correlate them with the psychiatrist's findings of psychopathology. This article analyzes the Model Penal Code formulation of insanity, with special emphasis on the all important distinction between "know" and "appreciate." This formulation permits the defendant possessed of mere surface knowledge or cognition to be exculpated, requiring that he have a deeper affective appreciation of the legal and moral import of the conduct involved if he is to be held criminally responsible. The Model Penal Code approach more readily lends itself to application as a standard of responsibility in cases involving affective disorders. An important disorder within this group, postpartum depression, is discussed in the context of raising the insanity defense in a case of infanticide.     

Law, Finance, and Politics: The Case of India

The liberalization of India's economy since 1991 has brought with it considerable development of its financial markets and supporting legal institutions. An influential body of economic scholarship asserts that a country's "legal origin"—as a civilian or common law jurisdiction—plays an important part in determining the development of its investor protection regulations, and consequently its financial development. An alternative theory claims that the determinants of investor protection are political, rather than legal. We use the case of India to test these theories. We find little support for the idea that India's legal heritage as a common law country has been influential in speeding the path of regulatory reforms and financial development. Rather, we suggest there are complementarities between (1) India's relative success in services and software; (2) the relative strength of its financial markets for outside equity, as opposed to outside debt; and (3) the relative success of stock market regulation, as opposed to reforms of creditor rights. We conclude that political economy explanations have more traction in explaining the case of India than do theories based on "legal origins."     

Federal Coal Mine Health and Safety Act of 1969, Title IV, as amended (The Black Lung Benefits Act); payment of benefits--withholding Part B benefits where Part C payments are made for the same period. Social Security Administration. Final rule

This regulation confirms the interim rule authorizing the Social Security Administration to withhold payment of Part B Black Lung benefits where Part C Black Lung benefits administered by the Dept. of Labor are paid for the same period. We are doing this by expanding the definition of "overpayment" in 20 CFR 410.560(a) to include these duplicate payments under Part C. This regulation provides a quick and efficient means of avoiding unjustified duplicate payments.     

疑案·存案·结案——从春阿氏案看清代疑案了结技术

清末春阿氏杀夫案在司法档案和纪实小说中有着不同版本。刑部、法部和大理院轮番审理,未能查出事实真相。大理院迫于结案的压力,以存案的方式了结了该案。判决书内容含混,而处理疑案的技艺则甚为高超。以疑案及其结案技术为切入点,重新审视并评价皇权下的司法实况,可以观察到司法现实复杂而生动的本来面目。     

This Time,it's for Real: The Health and Social Care Act 2012

This article examines the Health and Social Care Act 2012 and associated reforms to the National Health Service in England. It focuses on the Act's policy of making the NHS market more ‘real’, by both encouraging and compelling NHS bodies to act as ‘market players’. The article considers whether the reforms are compatible with the constitutional requirements of accountability for the provision of a public service such as the NHS. It argues that the reforms threaten accountability for three reasons: they make the Secretary of State for Health's relationship with the NHS more complex, they create opaque networks of non‐statutory bodies which may influence NHS decision‐making, and (especially in relation to competition) they ‘juridify’ policy choices as matters of law. Taken together, these arguments suggest that there is force in the claim that the reforms will contribute to ‘creeping’ – and thus unaccountable – privatisation of the NHS.