Physical Restraint and Near Death of a Psychiatric Patient

Physical restraint is used as a last resort emergency measure to calm and safeguard agitated and/or aggressive psychiatric patients. This can sometimes cause injuries, and rare fatalities have occurred. One mechanism of injury and death while in physical restraint is that of severe asphyxiation. We present the case of a hospitalized man in his mid‐30s, suffering from schizophrenia. The patient was obese. He became aggressive and had to be manually restrained with a “takedown.” After having been put in the prone position on the floor with a significant weight load on his body, he lost respiration and consciousness. Subsequently, he was given CPR. He regained consciousness and respiration, while the cyanosis receded in 1–2 min. Psychiatrists and pathologists should be aware that physically restraining a patient in the prone position with a significant weight load on the torso can, in rare cases, lead to asphyxiation.     

Methadone-related deaths in Norway

IntroductionThe use of methadone in opioid maintenance treatment (OMT) is potentially associated with a number of adverse effects and the risk of fatal toxicity. Increased methadone availability may lead to an increase in methadone-related deaths. We have investigated methadone-related deaths in Norway over the period 2000–2006.Materials and methodsMethadone-positive samples over the period 2000–2006 were identified from forensic toxicological investigations, and demographic and toxicological data were retrieved. The cases were cross-linked with the Norwegian Cause of Death Registry and regional OMT registers.ResultsA total of 312 individuals had died after taking methadone over the period 2000–2006, predominantly men with a mean age of 36. In 85% of cases (n = 264), the deceased had died of a methadone-related intoxication, most often in combination with other drugs, including benzodiazepines, cannabis and other opioids. Only 22% of the deceased had been in OMT at the time of death. A larger proportion of OMT patients had died of causes other than intoxications compared to those not in OMT (30% vs. 8%, respectively), most commonly related to disease.ConclusionsOne methadone-related death occurred, on average, every week over the time period investigated. Only 22% of the deceased were registered in opioid maintenance treatment (OMT) programs. The findings underline the need to control diversion of medication from OMT programs.     

From devil’s advocate to crime fighter: confirmation bias and debiasing techniques in prosecutorial decision-making

ABSTRACT

This research examines the role of confirmation bias in prosecutorial decisions before, during and after the prosecution. It also evaluates whether confirmation bias is reduced by changing the decision maker between arrest and prosecution. In Experiment 1, Swedish prosecutors (N?=?40) assessed 8 scenarios where they either decided themselves or were informed about a colleague’s decision to arrest or not arrest a suspect. Participants then rated how trustworthy the suspect’s statement was as well as the strength of new ambiguous evidence and the total evidence. They also decided whether to prosecute and what additional investigative measures to undertake. In Experiment 2 the same method was used with Law and Psychology students (N?=?60). Overall, prosecutors’ assessments before the prosecution indicated that they were able to act as their own devil’s advocate. Also, their assessments while deciding about whether to prosecute were reasonably balanced. However, after pressing charges, they displayed a more guilt-confirming mindset, suggesting they then took on the role as crime fighters. This differed from the student sample in which higher levels of guilt confirmation was displayed in relation to arrested suspects consistently before, during and after a prosecution decision. The role of prosecutors’ working experience is discussed.     

Securitizing “spiritual-moral values” in Russia

This article examines how “spiritual-moral values” (SMV) became securitized, or defined as a matter of national security in Russia. I analyze speech acts to show how moves to securitize SMV spread from the political fringe to the center of power, and from individual sectors to the strategic level. This “moral turn” in Russian politics is not merely a superficial attempt of the elite to distract the masses and rally the conservative electorate. The securitization of SMV has wider implications: It is, in the most direct way, the regime’s way of preventing a “color revolution.” By introducing a “state of siege” to the sphere of fundamental moral values, this securitization aids the construction of a national identity that is incompatible with basic human rights. An existential threat is constructed in order to justify extraordinary measures and establish a new social contract in which modernization is sacrificed at the altar of security.     

Local Officials’ Support for PILOTs/SILOTs: Nonprofit Engagement,Economic Stress,and Politics

Nonprofit property tax exemption has become a major policy issue as the collapse of the housing market, the Great Recession, and property tax caps have threatened local tax collections. Consequently, many local governments have sought to obtain payments in lieu of taxes (PILOTs) from charities that are formally exempt from property taxes. Using a 2010 survey of local government officials in Indiana, this article examines whether support for PILOT policies is related to officials’ personal involvement with nonprofits, their views on government–nonprofit relationships, the type of position they hold, the level of economic distress in the county, local political conditions, and local nonprofit wealth. The findings support most of these hypotheses but also show that attitudes toward PILOTs appear to be shaped by somewhat different concerns than attitudes toward services in lieu of taxes (SILOTs).     

Interpreting Performance Information: Motivated Reasoning or Unbiased Comprehension

A main rationale of performance information is to empower citizens to make informed decisions by presenting them with unambiguous information about the performance of institutions. However, even objective, clear, and unambiguous performance information is subject to biased interpretation depending on whether the information is consistent with the prior beliefs held by those who receive the information. Integrating the theory of motivated reasoning with the literature on performance information, the authors hypothesize that performance information that is inconsistent with prior beliefs is less likely to be interpreted correctly than belief‐consistent information. Using randomized survey experiments in which respondents were presented with quantitative performance data, the authors show that subjects systematically interpret performance information in ways that conform with their prior beliefs. The findings question the assumption that providing performance information automatically increases knowledge about government performance, let alone improves political decisions.     

Drugged drivers in Norway with benzodiazepine detections

Norwegian drugged drivers with benzodiazepine (BZD) detections have been studied with regard to drug use pattern and rearrest rate. During 1995, 3343 drivers were apprehended by the police in Norway due to the suspicion of influence by drugs. Blood samples from all drivers were sent to the National Institute of Forensic Toxicology (NIFT). The samples were analysed using a standard program covering the most commonly abused drugs on the marked in Norway. BZDs, representing some of the most frequently detected drugs, were found in approximately 30% (n = 1051) of the cases, represented by 14% (n = 150) female and 86% (n = 901) male drivers. In 8% of the cases, one BZD only was detected, half of these cases with one BZD could reflect therapeutic use. One or more BZDs were combined with illegal drug(s) (73%), other prescribed drugs (10%), and/or alcohol (24%). 62% of the drivers with BZD detections, had earlier been arrested for the same offence, or six cases per rearrested driver. The frequency of earlier arrests were lower for female (34%) than for male (67%) drivers. Alcohol was most frequently found for those arrested for the first time before 1992, while BZD or illegal drugs were most frequently found for those with their first arrest during 1992-1995. Our study shows that apprehended drivers using BZD are mainly represented by drug abusers due to frequent multi-drug use, blood concentrations representing doses above therapeutic levels and high rearrest rate for the same offence. A treatment program or other reactions, are thus necessary in addition to fines, prison penalty and suspension of driving licence.     

Blueprint for Arab–Israeli Peace? President Carter and the Brookings Report

After the 1973 Arab–Israeli war, the American Secretary of State, Henry Kissinger, conducted a series of negotiations between Israel and its Arab adversaries, culminating in three disengagement agreements. As successful as these were, by late 1975 Kissinger’s step-by-step approach had stagnated. New approaches seemed essential to push the peace process forward. Throughout 1975, a Brookings Institution study group wrote a report on how the United States could better approach Arab–Israeli peacemaking. It recommended a comprehensive approach, aimed at solving all outstanding questions, by including all the parties within the same framework. The recommendations advocated including the Soviet Union in the peace process and that the Palestinians should represent themselves. The report was highly influential on President Jimmy Carter’s subsequent approach towards the Arab–Israeli conflict—and many of the report’s authors staffed his Administration. Carter’s perceived adaptation of the report aggrieved the Israelis, whilst for others the Brookings report served as a normative benchmark for the Carter presidency.     

Constitutional verbosity and social trust

A common argument in the trust literature is that high-trust cultures allow efficient commercial contracts to be shorter, covering fewer contingencies. We take this idea to the topic of social contracts. Specifically, we ask whether social trust affects the length and detail of constitutions. Cross-country estimates suggest that national trust levels are indeed robustly and negatively associated with the length of countries’ constitutions.