Off-Label Prescribing by Psychiatrists: What is the Practitioner's Liability?

In psychiatry, the molecules available and the dosages recommended when a drug receives marketing authorization are not always adequate to treat patients with major behavioral disturbances. Off-label prescribing is frequent in this context, with regard to the indications and the dosages given as well as to the drug combinations used. However, if complications or death occur, the practitioner's liability may be engaged. The authors report three deaths attributed to off-label prescribing in psychiatry and which led to charges against the physicians. They review the precautions to be taken when prescribing in such conditions (no other possible treatment, existence of sound scientific evidence, consent obtained from the patient, or their legal representatives except in cases of force majeure) and the physician's liability if adverse events occur that could be attributed to off-label prescribing.     

Perceptions of psychological well-being in UK law academics

This study provides evidence that changing and increasing expectations of university, of students, and of academics of themselves have had an impact upon the perceptions of well-being in the law teachers who responded to this survey. A total of 185 UK law teachers completed a large survey which included demographic questions (age, academic qualifications, and experience), four questionnaires and a series of open-ended questions. Although most reported depression, anxiety and stress levels within the normal range, those who reported high stress levels were significantly more likely to report lower hope scores and higher obstruction of values scores as well as significantly less environmental mastery and self-acceptance. The results reported here indicate the importance of autonomy to law teachers. It is suggested that this is an issue that requires further investigation because of the potential for levels of psychological distress to increase.     

Prescribing engagement in environmental risk assessment for gene drive technology

Gene drive technology is a nascent biotechnology with the potential to purposefully alter or eliminate a species. There have been broad calls for engagement to inform gene drive governance. Over the past seven years, the gene drive community has been developing risk assessment guidelines to determine what form future gene drive risk assessments take, including whether and how they involve engagement. To explore who is developing these guidelines and how engagement in risk assessment is being prescribed, we conduct a document analysis of gene drive risk assessment guideline documents from 2014 to 2020. We found that a narrow set of organizations have developed 10 key guideline documents and that with only one exception the documents prescribe a narrow, vague, or completely absent role for engagement in gene drive risk assessment. Without substantively prescribed engagement in guidelines, the relevance, rigor, and trustworthiness of gene drive risk assessment and governance will suffer.