Recent developments in medicine and law

This article addresses important developments in the field of medicine and law during the period of September 2000 through August 2001. It does not discuss every reported case or piece of legislation but surveys some of the more significant developments in the medicine and law arena.     

Antigenic differentiation of blood stains by the Lewis system in practical forensic medical expert evaluation

A modification of quantitative absorption and absorption elution tests with blood stain washing before the absorption phase is presented. Due to washing, the effect of carrier object on anti-Le(a) and anti-Le(b) sera is decreased and the sensitivity of the method is increased. Additional adsorption of the sera and elution into test erythrocytes treated with protease C is suggested for increasing the number of standard sera fit for the absorption-elution test. A new technology for preparing anti-Le(a) and anti-Le(b) immunoreagents is described.     

Effect of death from total supercooling of the body on morphofunctional state of human adrenals

The morphology of adrenals was studied in cases of death from total supercooling. The intensity and terms of response are different in different morphofunctional zones of the adrenal cortex. Presumably, the terms and intensity of responses of various portions of the adrenal cortex reflect the specific features of their function regulation.     

Federal antitrust policy and physician discontent: defining moments in the struggle for congressional relief

Organized medicine has battled the Federal Trade Commission (FTC) since the 1970s over enforcement of the antitrust laws. Physicians' discontent stems from the belief that federal policy allows managed care organizations to achieve dominance in health care markets just as it discourages physicians from taking collective action to protect their interests. This article examines two important efforts by organized medicine over a twenty-year interval to alter federal antitrust policy. In 1982, physicians and other professionals sought a special exemption from FTC jurisdiction; beginning in 1998, physicians promoted legislation that would exempt independent practitioners from the antitrust laws for collective bargaining purposes. Both initiatives passed in the House of Representatives but failed in the Senate. This article uses an advocacy coalition framework to reinterpret the events and to assess the reasons for legislative failure. The evidence suggests that in both instances, although twenty years apart, consumer groups and federal bureaucrats determined the outcome in favor of corporate medicine.     

An unusual case of driving under the influence of enflurane

An unusual case of driving under the influence of the volatile anaesthetic enflurane is reported. A markedly affected anaesthetist was sniffing at an enflurane-moistened handkerchief before he crashed into a lorry at a red traffic light. In the blood sample enflurane (2.92 mg/l) as well as diclofenac (0.28 mg/l) and 4-aminophenazone (24.4 mg/l) were found. The way of driving and the accident and the deficiency symptoms could be explained by the central suppressing effects of enflurane. The physician was considered as impaired and not suitable to drive at the time of the incidence.     

Glycated hemoglobin: a useful post-mortem reference marker in determining diabetes

Glycated hemoglobin (HbA(1c)) has been demonstrated to be a useful marker for long-term glucose control in diabetes. This parameter characterizes each non-enzymatic fixation of glucose on hemoglobin. It is a useful test in addition to periodic glycemia controls since it reflects the mean glycemia of the past 60 days. We studied the conservation of HbA(1c) at 4 degrees C as a function of time with different anti-coagulants and preservatives (3, 6 months, 1 year). A total of 106 tests were performed using the high performance liquid chromatography (HPLC) method dedicated to the semi-automatic analysis of HbA(1c) (Bio-Rad) and we applied the method in forensic cases. Conservation at 4 degrees C was good for as long as 3 months in blood samples collected with fluoride and 6 months in samples collected in a dry or in a heparinized tube. In non-diabetic subjects, HbA(1c) reference values obtained from forensic samples were identical to those of living controls (3.5-6.25% of total hemoglobin). All positive HbA(1c) results were confirmed by a medical evaluation. This method was successfully applied to five forensic cases. In cases of increased acetonemia, acetone or isopropanol are easily measured. However, in some unexplained post-mortem circumstances, increased HbA(1c) permits to differentiate alcoholic or starvation ketoacidosis from the diabetic cases. Glycated hemoglobin should, therefore, be considered the forensic marker of choice in the post-mortem diagnosis of a diabetic disorder and demonstrates its usefulness in post-mortem validation.     

NOT (QUITE) A HORSE AND CARRIAGE

This note critically interrogates the Civil Partnership Act 2004. Through an examination of the legislative background and some of the provisions of the Act, it is argued that civil partnership mirrors a marriage model with some exceptions. In creating this new legal status, the legislation also exacerbates the exclusion of some relationship forms from dominant legal norms. It should be understood as part of an agenda for social inclusion, rather than as radical social change.     

Existential Anxiety in Adolescents: Prevalence, Structure, Association with Psychological Symptoms and Identity Development

Existential anxiety is hypothesized to be a core human issue in a great deal of theoretical and philosophical writing. However, little is known about the emergence of these concerns and their relation to emotional functioning in youth. The purpose of this study was to examine the phenomenon of existential anxiety in a sample of adolescents. Data on existential concerns, identity development and psychological symptoms were collected on a sample of 139 youth in grades 9–12. Results indicated that existential anxiety concerns have a theoretically consistent factor structure, are common among adolescents, and are associated with psychological symptoms, as well as identity issues. Results are discussed with regard to the importance of existential concerns in the lives of youth and the need for additional research.Received PhD from Florida International University. Interests are identity development including associated anxiety and distress, cross-national comparisons, and the development of identity interventions.Received PhD from Florida International University. Interests focus on the developmental psychopathology of anxiety and depression.Received PhD from the University of Arizona. Interests include a range of topics in developmental psychopathology, prevention, program evaluation, and research methodology.