Undiagnosed progressive supranuclear palsy in a patient with neuroleptic malignant syndrome due to use of neuroleptics: the utility of autopsy in deaths due to known drug reactions

Medical examiners must decide whether or not a complete autopsy is warranted in evaluation of deaths that have been referred to their office. This decision is influenced by many factors. In most cases, the choice to perform only an external examination occurs in deaths where the decedent had previously documented potentially lethal natural disease or well-documented trauma. We report a patient who apparently died of the sequelae of a well-known complication of pharmacotherapy (neuroleptic malignant syndrome following Haldol administration). The death was referred to the medical examiner's office, where, based upon the history, an external examination was performed. Subsequently, the family requested an autopsy by the treating hospital. The autopsy established the diagnosis of progressive supranuclear palsy (PSP). The patient's presenting signs and symptoms were not typical of the disease; however, PSP most likely played a role in the neuroleptic malignant syndrome-like manifestations the patient exhibited following the Haldol administration. The results of the complete autopsy highlight its importance in identifying and enhancing our understanding of the underlying conditions in natural disease-based causes of death involving known therapeutic complications.     

“To This Day She Continues to Struggle with the Terror Imposed upon Her”: Rape Narratives in Victim Impact Statements

This study locates the victim impact statements of raped women in the sociolegal context of significant sentencing law reforms introduced in Canada to address an ascendant victim’s rights movement. We examine 38 reported sentencing decisions in sexual assault cases in Ontario, Canada (1999–2010). Our objectives are to discern (a) whether the archetype of the ideal victim continues to influence juridical discourse after conviction and (b) what narratives of harm intersect with sentencing objectives and aggravating factors. Our findings suggest women express profound fear of re-victimization and traumatic effects of sexual violence regardless of the relational context of their rape experience. Most surprisingly, our data show sentencing judges view the sexual assault of an intoxicated rape victim as an aggravating factor. Future consideration for victim impact statements in sexual assault cases is discussed.     

Communications

Abstract

President Nixon’s January 25th speech represented not the beginning but the end of negotiations. It signified that the U.S. is downgrading the Paris talks and that no further secret negotiations are taking place. Nixon’s statement of the “U.S.-South Vietnam Proposal for a Negotiated Settlement” and its rejection by the other side is the latest clarification of a truth which has underlain the Paris Peace Talks since they began, namely that the contradictions between the Nixon Administration’s vision of a peace in Indochina and that of the Provisional Revolutionary Government of South Vietnam (PRG) and the North Vietnamese are irreconcilable. Nixon has never been, and is still not, willing to make the kind of concessions necessary to make real progress in the negotiations because he has throughout been committed to the maintenance of a staunchly anti-communist government in Saigon and the continuation of dominant U.S. influence over the domestic politics of South Vietnam. As a result, the PRG has not been willing to make the kind of concessions which would allow scope for negotiation because this would mean committing political suicide by entrusting itself to the tender mercies of the Thieu government.