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.     

A unique case of congenital bilateral absence of parietal bones in a neonate

The remains of an unidentified female neonate were discovered in a field in central Missouri. Examination revealed bilateral absence of the parietal bones. A search of the literature describing similar defects suggests that the present case represents a unique condition, described here for the first time.     

SUPRANATIONAL GOVERNANCE OR NATIONAL BUSINESS‐AS‐USUAL? THE NATIONAL ADMINISTRATION OF EU STRUCTURAL FUNDS IN THE NETHERLANDS AND DENMARK

The partnership principle in EU cohesion policy was introduced in order to involve subnational authorities and interest organizations in policy formulation and implementation. In this article we examine how the member states have reacted to this call for a new way of making public policy. We argue that the multi‐level governance literature and the critics of the multi‐level governance framework have not examined implementation structures properly, but have focused on regional influence. We conduct a comparative analysis of the Dutch and Danish implementations of the European Social Fund and the European Regional Development Fund. Our findings show that when examining implementation structures it becomes clear that member states are in full control of the re‐allocation of EU funds. They show that Denmark and The Netherlands have been able to absorb EU cohesion policy within already existing national implementation structures of labour market policies and regional development. One central theoretical implication of our study is that the focus of studies of any fundamental re‐allocation of power resources in cohesion studies should comprise the entire network of implementation rather than the strategies of its individual component actors.