Teaching medical ethics and law

The teaching of medical ethics is not yet characterised by recognised, standard requirements for formal qualifications, training and experience; this is not surprising as the field is still relatively young and maturing. Under the broad issue of the requirements for teaching medical ethics are numerous more specific questions, one of which concerns whether medical ethics can be taught in isolation from considerations of the law, and vice versa. Ethics and law are cognate, though distinguishable, disciplines. In a practical, professional enterprise such as medicine, they cannot and should not be taught as separate subjects. One way of introducing students to the links and tensions between medical ethics and law is to consider the history of law via its natural and positive traditions. This encourages understanding of how medical practice is placed within the contexts of ethics and law in the pluralist societies in which most students will practise. Four examples of topics from medical ethics teaching are described to support this claim. Australasian medical ethics teachers have paid less attention to the role of law in their curricula than their United Kingdom counterparts. Questions like the one addressed here will help inform future deliberations concerning minimal requirements for teaching medical ethics.     

Community Solutions for the Community's Problem: An Evaluation of Three New Zealand Community-Based Treatment Programs for Child Sexual Offenders

The recidivism rate of 203 people mandated by the courts to attend three community-based child sexual offender treatment programs (175 treatment cases and 28 assessment-only cases) was assessed and compared with a probation comparison group. The recidivism rate was 8.1% for all participants treated in the community-based programs and 5.2% for participants who completed treatment. The recidivism rate for program attendees was approximately half that of those in the probation comparison group. The drop-out rate for treatment appears to be relatively high (45%) and noncompletion was associated with higher recidivism. These results indicate significantly better outcomes for offenders receiving specialized treatment and are consistent with, and toward the lower end of, recidivism rates reported in local and international evaluation studies.     

Psychological factors influencing religious congregation members’ reporting of alleged sexual abuse

ABSTRACT

The sexual abuse of children within religious institutions has become a topic of increasing public concern in recent decades. However, to date there has been little in the way of psychological analyses of the processes by which congregation members judge the credibility of alleged abuses, or whether they would intend to report such allegations to the police. In this study, we examined the roles of ingroup identity, moral foundations, and social dominance orientation on reporting intentions and allegation credibility assessments among Church of England congregation members (n?=?454) and non-religious controls (n?=?457). While there were few predictors of reporting intentions, we found that churchgoers were consistently more sceptical of allegations of abuse, with these trends being differentially moderated by ingroup identification, the endorsement of various moral impulses, and anti-egalitarianism. We discuss our data in light of ongoing attempts to improve reporting procedures within the Church.     

The impact of fentanyl on DUIDs and traffic fatalities: Blood and oral fluid data

Fentanyl has emerged as the most prolific drug in the ongoing opioid epidemic and has greatly impacted traffic safety in recent years. This study aimed to evaluate fentanyl prevalence and concentrations in blood and oral fluid in driving under the influence of drugs (DUID) cases in three different regions (i.e., Alabama, Orange County, CA, and Houston, TX) from 2017 to 2022. Furthermore, traffic fatalities were evaluated for Alabama and Orange County, CA. Fentanyl positivity in DUID and traffic fatalities increased for most years in this study. In Alabama, the prevalence of fentanyl DUID cases increased 4-fold in 2022 compared to 2017. Orange County's increase from 2017 to 2022 was 14-fold. In Houston, the increase was approximately 2-fold from 2019 to 2022. The greatest increase for all laboratories coincided with the start of the COVID-19 pandemic. In 2022, the median fentanyl DUID blood concentrations were 4.7, 11, and 4.7 ng/mL in Alabama, Orange County, and Houston, respectively. Most fentanyl cases were polydrug cases (≥90%). Methamphetamine, THC, and alprazolam were the most frequently detected drugs in combination with fentanyl. Alabama has collected oral fluid and blood in DUID cases since 2018. The detection of fentanyl in oral fluid was comparable to blood. However, 59% and 8.7% of fentanyl-positive cases had concentrations of >20 ng/mL in oral fluid and blood, respectively. Therefore, oral fluid as an alternative or supplemental specimen to blood is an attractive approach for fentanyl in DUID cases. This study contributes to understanding recent fentanyl trends and their impact on traffic safety.     

Predicting Serial Killers' Home Base Using a Decision Support System

The effectiveness of a geographical decision support tool (Dragnet) forlocating the base of serial offenders was compared across 570 modelscomprised of a range of negative exponential functions, buffer zonecomponents, and normalization parameters. The models were applied to thebody disposal locations within each series for 70 U.S. serial killers. Twonormalization parameters were compared for all functions. The test ofeffectiveness was a specifically defined measure of search cost. Whenapplied to the Dragnet predictions it was found that the specially developednormalization parameter (QRange) produced the optimal search costs. Theoptimal search cost was also found to be for a function that did not includeany buffer zone. The optimal, average search cost across the whole samplewas 11% of the defined search area. Fifty-one percent of the offendersresided in the first 5% of the search area, with 87% in the first 25%. Allresided in the total defined search area. These results support thepotential for operational tools using such procedures as well ascontributing to our understanding of criminal's geographicalbehavior. The applicability to other forms of serial crime is considered.     

Race,Place, and Police-Caused Homicide in U.S. Municipalities

We test structural hypotheses regarding police-caused homicides of minorities. Past research has tested minority threat and community violence hypotheses. The former maintains that relatively large minority populations are subjectively perceived as threats and experience a higher incidence of police-caused homicide than whites do, the latter that higher rates of violent crime among minorities create objective threats that explain these disparities. That research has largely ignored some important issues, including: alternative specifications of the minority threat hypothesis; the place hypothesis, which maintains highly segregated minority populations are perceived as especially threatening by police; and police-caused homicide in the Hispanic population. Using data for large U.S. cities, we conducted total-incidence and group-specific analyses to address these issues. A curvilinear minority threat hypothesis was supported by the Hispanic group-specific findings, whereas the place hypothesis found strong support in both total and group-specific analyses. These results provide new insights into patterns of police-caused homicide.     

(Close) the Door,the King (is Going): The Development of Elliptical Resolution in Bhāṭṭa Mīmāṃsā

This paper examines three commentaries on the ?abdapariccheda in Kumārila Bha??a’s ?lokavārttika, along with the the seventeenth century Bhā??a Mīmā?sā work, the Mānameyodaya. The focus is the Mīmā?sā principle that only sentences communicate qualified meanings and Kumārila’s discussion of a potential counter-example to this claim–single words which appear to communicate such content. I argue that there is some conflict among commentators over precisely what Kumārila describes with the phrase sāmarthyād anumeyetvād, although he is most likely describing ellipsis completion through arthāpatti. The paper attempts both a cogent exegesis and philosophical evaluation of the Bhā??a Mīmā?sā view of ellipsis completion, arguing that there remain internal tensions in the account of ellipsis preferred by the Bhā??a, tensions which are not entirely resolved even by the late date of the Mānameyodaya.     

国际核不扩散形势与世界安全——“第一届中英智库安全战略论坛暨国际核不扩散形势与世界安全”选辑

2010年11月10日,中国和平与发展研究中心与英国皇家三军防务研究所（RUSI）在北京共同举办＂第一届中英智库安全战略论坛暨国际核不扩散形势与世界安全研讨会＂。英方学者提交的论文可以反映西方主流智库学者在国际核裁军及核军控问题上的基本看法,现将其中两篇英文和中文翻译摘要刊出,以飨读者。     

Embracing the new professionalism: self-regulation, mandatory reporting and their discontents

In response to perceived failures in medical self-regulation in Australia, first in two States (for doctors) and now under the National Registration and Accreditation Scheme (for all health practitioners), mandatory reporting of peer status or practice that poses risks to patients has been introduced. Yet now, in response to the lobbying of State and federal health ministers by the medical profession, mainly in relation to the impairment provisions, this is to be reviewed. This column argues that claims concerning the negative consequences for practitioners of mandatory reporting are illogical and lack supporting evidence. There is, however, evidence that the medical profession does not consistently act in accordance with its professed positions in the area of physician impairment and departure from accepted clinical standards. The call for a review of mandatory reporting reflects an outdated model of regulation that does not align with increasing calls for a "new professionalism". In its own interests, but primarily in the interests of patients, the medical profession should embrace new attitudes and practices that will at first appear to threaten the privilege of self-regulation, but on proper scrutiny will be seen as necessary to retain it.