Palliative sedation in the Netherlands: starting-points and contents of a national guideline

In December 2005 the first national guideline for palliative sedation in the Netherlands was published. This guideline was developed by a committee of the Royal Dutch Medical Association, at the request of the Dutch government. The guideline defines palliative sedation as 'the intentional lowering of consciousness of a patient in the last phase of his or her life'. According to the guideline the objective of palliative sedation is to relieve suffering, and lowering consciousness is a means to achieve this. It is very important that palliative sedation is given for the right indication, proportionally, and adequately. It is the degree of symptom control, not the level to which consciousness is lowered, which determines the dose and combinations of the sedatives used and duration of treatment. The assessment and decision-making processes must focus on adequate relief of the patient's suffering, so that a peaceful and acceptable situation is created. Palliative sedation is given in the last phase of life, in the imminently dying patient. Palliative sedation raises several legal questions. In this article we describe the structure and contents of the guideline, with special attention for the main legal issues involved, like the distinction between palliative sedation and euthanasia and the process of informed consent.     

Joint Criminal Enterprise as a Pathway to Convicting Individuals for Genocide

This article discusses one of the most controversial yet importantmodes of liability in international criminal law: joint criminalenterprise (JCE). One such controversy is whether Third CategoryJCE can serve as a basis for genocide convictions. To answerthis question one needs to uncover the nature and origins ofJCE. It is submitted that convictions for genocide based uponthe application of Third Category JCE are justifiable. Thiscontention stems from the premise that JCE is a form of criminalparticipation to which principles of derivative liability apply.However, such an approach is only valid when JCE is strippedto its core and applied as a small-scale group crime, whichrequires proof of a direct link between co-perpetrators. Moreover,in the case of Third Category JCE, a participant should be convictedof participating in genocide, which would carry a lower sentencethan committing genocide as a participant in a First or SecondCategory JCE.     

Cross-sectional anthropometric study of the external ear

This cross-sectional anthropometric study was aimed at estimating expansion of the external ear during adult life, in order to evaluate the extent to which anatomical features appearing in earprints may vary with time. A review of the literature was provided. Data extracted from photographed ears of 1353 subjects were analyzed. The effect of age on auricle length, earlobe length, and auricle width was explored using univariate analyses of variance. The regression coefficients of age on these dimensions were, respectively, 0.178, 0.115, and 0.073 mm/yr for males, and 0.162, 0.100, and 0.073 mm/year for females (p=0.000). Regression coefficients of age corrected for stature were assumed to be less accurate. Anthelix prominence and helix width were analyzed using data of 175 subjects, and appeared unaffected by age. As lobe expansion appeared to exceed the estimated cartilage expansion, it was assumed that particularly the imprint of the lobe would be less stable with time.     

Juvenile sex-only and sex-plus offenders: an exploratory study on criminal profiles

In this study, research was done on the criminal profiles of a large group of juvenile sex-only and sex-plus (sex and other offenses) delinquents (N = 4,430) in the Netherlands. Use was made of information from police records. Results show that sex-plus offenders start their careers earlier, that more of these offenders are of non-Dutch origin, that they commit more crimes, and will partly continue their criminal career after their adolescence. Juvenile sex-only offenders rarely go on committing crimes. In sex-plus offenders, sexual crimes play only a minor role in their total crime repertory. As time goes by, their criminal career will develop into the direction of property crimes. Finally, the implications and limitations of this study will be discussed.     

Comparison of two whole genome amplification methods for STR genotyping of LCN and degraded DNA samples

The analysis of LCN or highly degraded DNA samples presents a challenge for forensic science. Improving the quantity and/or quality of samples would greatly increase the profiling success rate from LCN and degraded samples. Whole genome amplification (WGA) is one method that has such potential. Two commercially available WGA kits, GenomePlex and GenomiPhi, were investigated for use on LCN and degraded DNA samples. Both kits amplified genomic DNA, producing microgram quantities from sub-nanogram templates. Profiling success of LCN DNA samples was increased, with improvements of over 700% from 10pg template DNA compared to non-WGA-amplified control samples. The amplification success with degraded DNA was also improved by WGA. Degraded DNA was simulated using restriction enzymes to demonstrate that the application of WGA can result in the typing of STR loci that could not previously be amplified. An increase in artefacts, such as stutter alleles and amplification biases, were observed in many samples. Results show that WGA is capable of increasing both the quality and quantity of DNA, and has the potential to improve profiling success from difficult samples in forensic casework.     

The predictive validity of criminogenic needs for male and female offenders: Comparing the relative impact of needs in predicting recidivism

Most instruments used to assess offenders' risk of recidivism were developed and validated on male samples. Use of these instruments with female offenders is, however, common practice. This use with female offenders implies the assumption that the risk of recidivism can be predicted on the basis of the same risk factors for women as for men. Yet, this implied gender-neutrality of offender risk instruments has been the topic of much debate. This study compared criminogenic needs in male and female offenders and their relevance in predicting recidivism. A large sample of male and female offenders (N = 16,239) charged with a range of index offenses was studied. Results mainly support the gender neutrality of existing offender risk and needs assessment. However, results do suggest that some criminogenic needs may indeed have a different impact on recidivism for men and women. Problems with accommodation, education and work, and relationships with friends were more strongly correlated to general recidivism in men than in women. For women, difficulties with emotional well-being had a stronger correlation with recidivism than for men. In addition, relative to all other criminogenic needs, problems with emotional well-being were more important for women than for men in predicting general as well as violent recidivism. However, because the bivariate correlation for female offenders between emotional difficulties and recidivism is weak (as it is for male offenders), the question remains whether the relative importance of emotional difficulties in predicting recidivism in women actually has clinical relevance. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Dancing on coke: smuggling cocaine dispersed in polyvinyl alcohol

Recent trends suggest that cocaine smugglers have become more and more inventive to avoid seizures of large amounts of cocaine transported between countries. We report a case of a mail parcel containing a dance pad which was seized at the Customs Department of Brussels Airport, Belgium. After investigation, the inside of the dance pad was found to contain a thick polymer, which tested positive for cocaine. Analysis was performed using a routine colorimetric swipe test, gas chromatography coupled with mass spectrometry and nuclear magnetic resonance spectroscopy. The polymer was identified as polyvinyl alcohol (PVA) and contained 18% cocaine, corresponding to a street value of € 20,000. Laboratory experiments showed that cocaine could be easily extracted from the PVA matrix. This case report reveals a new smuggling technique for the transportation of large amounts of cocaine from one country to another.     

Adult-onset antisocial behavior trajectories: associations with adolescent family processes and emerging adulthood functioning

Guided by conceptual and empirical work on emerging adulthood, this study investigated the role of closeness to mother and father and behavioral autonomy during adolescence on the development of adult-onset antisocial behavior. Using data from the National Longitudinal Study of Adolescent Health (Add Health), we identified four aggressive (abstainer, adolescent-limited, adult-onset, chronic) and three nonaggressive (adolescent-limited, adult-onset, chronic) trajectories. Members of the aggressive adult-onset trajectory reported higher levels of paternal closeness during adolescence compared to the members of the aggressive chronic trajectory. Maternal closeness and behavioral autonomy did not differentially predict trajectory membership. In addition, members of the adult-onset trajectories were less likely to be employed or in a romantic relationship and reported decreased physical health during emerging adulthood compared to members of all other trajectories.     

Criminal Behavior in Opioid‐Dependent Patients Before and During Maintenance Therapy: 6‐year Follow‐Up of a Nationally Representative Cohort Sample

Lifetime prevalence of opioid dependence is about 0.4% in western countries. Opioid‐dependent patients have high morbidity and mortality and a high risk of criminal behavior. Few studies have addressed the long‐term impact of opioid maintenance therapy on convictions and criminal behavior. The PREMOS study is a prospective, longitudinal, naturalistic clinical study of a nationally representative sample of 2694 opioid‐dependent patients to investigate convictions and criminal behavior at baseline and after 6 years of maintenance treatment. At follow‐up, 2284 patients still were eligible (84.7%). A comprehensive assessment including a patient and doctor questionnaire, and the EuropASI was completed at baseline and follow‐up. Data on criminality at follow‐up had been received for 1147 (70.6%) patients. A large number (84.5%) of them had been charged or convicted at any time before baseline assessment, most frequently with drug‐related offenses (66.8%), acquisitive crime (49.1%), or acts of violence (22.0%). Reported charges and convictions had declined to 17.9% for the last 12 months before follow‐up, which was also reflected by a significant decrease in the EuropASI subscore “legal problems” from 1.52 at baseline to 0.98 after 6 years. These data indicate a significant and clinically relevant reduction in criminal behavior in opioid‐dependent patients in long‐term maintenance treatment. Maintenance therapy is effective in the reduction in both narcotics‐related and acquisition crime.     

Recent Firing Range Suicides in South Australia

Abstract: Two cases are reported from South Australia, where deaths occurred that were due to single self‐inflicted gunshot wounds to the head in individuals who were visiting indoor firearm ranges. Case 1: A 54‐year‐old man visiting an indoor firing range placed a .357 magnum handgun to his head and fired one shot. Case 2: A 23‐year‐old woman who was being instructed in firearm usage at an indoor firing range placed a 9 mm handgun to her head and fired one shot. In both cases, deaths were due to cerebral laceration with skull fracture. Firing ranges may be utilized by individuals who are seeking weapons for suicide attempts, and suicide may be successfully undertaken at such locations even while a victim is under direct supervision. In jurisdictions, where firearm ownership is strictly legislated, it may be that clubs can inadvertently provide access to firearms for this type of activity.