The importance of a urine sample in persons intoxicated with flunitrazepam--legal issues in a forensic psychiatric case study of a serial murderer

The sedative-hypnotic benzodiazepine flunitrazepam (FZ) is abused worldwide. The purpose of our study was to investigate violence and anterograde amnesia following intoxication with FZ, and how this was legally evaluated in forensic psychiatric investigations with the objective of drawing some conclusions about the importance of urine sample in a case of a suspected intoxication with FZ. The case was a 23-year-old male university student who, intoxicated with FZ (and possibly with other substances such as diazepam, amphetamines or cannabis), first stabbed an acquaintance and, 2 years later, two friends to death. The police investigation files, including video-typed interviews, the forensic psychiatric files, and also results from the forensic autopsy of the victims, were compared with the information obtained from the case. Only partial recovery from anterograde amnesia was shown during a period of several months. Some important new information is contained in this case report: a forensic analysis of blood sample instead of a urine sample, might lead to confusion during police investigation and forensic psychiatric assessment (FPA) of an FZ abuser, and in consequence wrong legal decisions. FZ, alone or combined with other substances, induces severe violence and is followed by anterograde amnesia. All cases of bizarre, unexpected aggression followed by anterograde amnesia should be assessed for abuse of FZ. A urine sample is needed in case of suspected FZ intoxication. The police need to be more aware of these issues, and they must recognise that they play a crucial role in an assessment procedure. Declaring FZ an illegal drug is strongly recommended.     

Glucose and lactate in vitreous humor compared with the determination of fructosamine for the postmortem diagnosis of diabetes mellitus

Diabetes mellitus is a chronic metabolic illness responsible for a great number of deaths. In postmortem diagnosis, because of the difficulty involved in interpreting blood glucose levels and relatively nonspecific pathologic features, biochemical markers in vitreous humor are useful. The aim of this study was to compare the results obtained for the combined determination of lactate and glucose with fructosamine levels recorded in the vitreous humor of two diagnostic groups (one diabetic and the other nondiabetic). The authors intended to ascertain the capacity of different markers measured in vitreous humor to diagnose diabetes mellitus. Fifty-one cadavers (mean age, 58.7 years; standard deviation, 17.09) were studied. The mean postmortem interval was 16.4 hours (standard deviation, 9.05). Cases were assigned to two diagnostic groups according to whether they were previously diagnosed as either diabetic or nondiabetic. Statistically significant differences for glucose, fructosamine, and the sum values of glucose and lactate were found between the two diagnostic groups. The highest levels were obtained in the group of cases with a previous diagnosis of diabetes mellitus. After the comparison of receiver operating characteristic curves, the sum values of glucose and lactate in vitreous humor is a better predictor of antemortem diabetes mellitus than the fructosamine.     

Contracting Out and Public Values: A Symposium

The three papers that constitute this symposium were first commissioned for a workshop entitled Citizenship and Contractualism held in October 2000. The theme of that workshop centred on the contractualisation of the relationship between service deliverers and their clients. 1 They have been published elsewhere in a special issue of Law in Context, March 2001, co‐edited by Terry Carney, Gaby Ramia and Anna Yeatman.
These three papers did not fit that theme. They are concerned more with the general use of contracting out as a tool of contemporary governance. I have used the title contracting out and public values because all three of these papers raise fundamental questions about the implications of contracting out for public values.     

The Non-Subversive Function of European Private Law: The Case of Harmonisation of Family Law

Abstract:  This article challenges the widely diffuse view of family law as peripheral to private law. It aims to the de–marginalisation of family legal issues, by showing their ties to the market realm and freedom of contract. In this theoretical framework, the article analyses the process of family law harmonisation in Europe. In particular, it focuses on three steps or aspects in respect to which the presumed peculiarity of family law is proclaimed and reveals, at the same time, its groundlessness: the status/contract dichotomy as a reflection of the family/market divide which seems to influence future developments of the harmonisation of law in Europe; the presumed political character of family law, which represents the leitmotiv in most recent harmonisation projects; and the subsequent strictly national character of family law, which makes EC institutions much more cautious in intervening in these matters than in any other field of private law.