The judicial role in life-sustaining medical treatment decisions.

Although there has been speculation regarding the pervasiveness and nature of judicial decisions regarding life-sustaining medical treatment (LSMT), no attempt has been made to empirically assess their prevalence or the issues they address. An exploratory study utilizing a mail survey of a nationwide random sample (N = 905) of state trial court judges was conducted to provide initial information regarding this decision-making process. Twenty-two percent of the responding judges had heard at least one LSMT case, and judicial review did not appear endemic to particular states. The number of judges hearing LSMT cases dropped from 1975 to 1981 but has increased since then. Three major issues predominate: patient competency, appointment of a surrogate decisionmaker, and resolution of the ultimate issue of forgoing LSMT. Relatively few cases either contested a prior directive's validity or involved imposing sanctions for instituting or forgoing LSMT. Although subject to different interpretations, the results suggest the courts are having a significant impact on certain aspects of the LSMT decision-making process. However, the infrequency with which any one judge is called upon to make an LSMT decision causes concern about the judiciary's ability to respond in a timely and appropriate manner. With their potential for a profound effect on the actions of health care providers, greater attention to this decision-making process is warranted.     

PREDICTING WHO REOFFENDS: THE NEGLECTED ROLE OF NEIGHBORHOOD CONTEXT IN RECIDIVISM STUDIES*

Prior studies of recidivism have focused almost exclusively on individual‐level characteristics of offenders and their offenses to explore the correlates of reoffending. Notably absent from these studies are measures reflecting the neighborhood contexts in which individuals live. The current research addresses this shortcoming. Using data on a sample of ex‐offenders in Multnomah County, Oregon (Portland and surrounding area) in conjunction with 2000 census data, we answer two questions. First, which individual‐level factors influence rates of recidivism? Second, to what extent does neighborhood socioeconomic status account for variation in the reoffending behavior of ex‐prisoners that is not explained by their individual‐level characteristics? We find that those who return to disadvantaged neighborhoods recidivate at a greater rate while those who return to resource rich or affluent communities recidivate at a lesser rate, controlling for individual‐level factors.     

Ethnicity, gender, and the Level of Service Inventory-Revised

Offender assessment and classification is becoming an increasingly important part of correctional supervision and intervention. Over the last several decades, several different methods and “generations” of offender classification have emerged. Of most value appear to be third-generation, actuarial, dynamic risk/need assessments. With any new correctional strategy, however, there is a need to investigate the use of these risk/need assessments on offender subgroups in order to inform issues, such as reliability and prevalence of criminogenic risk factors. The present study utilized data that were gathered using the Level of Service Inventory-Revised (LSI-R). Results and comparisons of these assessments were investigated and presented for Native American and non-Native American offenders as well as male and female offenders. Discussion of the results, implications, and recommendations for further research are presented.     

What Do Prosecutors Maximize? Evidence from the Careers of U.S. Attorneys

This study examines the performance of chief federal prosecutors(U.S. attorneys) and their subsequent careers. In a sample of570 attorneys in office from 1969 to 2000, the length of prisonsentences is positively related to subsequent favorable careeroutcomes for U.S. attorneys. In contrast, conviction rates donot appear to affect the careers of U.S. attorneys. These resultsare consistent with longer total prison sentences’ beingpersonally beneficial to prosecutors, and prosecutors’maximizing the length of prison sentences. Overall, the resultssuggest that sentence length, as opposed to convictions rates,is the relevant performance metric.     

A modification of the microplate method for reverse ABO typing of bloodstains and additional validation studies

The results of additional validation studies of a sensitive microplate hemagglutination assay for ABO reverse grouping of bloodstains are presented. The results of the validation study demonstrate the reliability of the microplate assay for use in routine serological casework. Based on these studies, the microplate assay has now replaced the Lattes crust test for ABO reverse grouping of bloodstains in the FBI Laboratory.     

Acidic and neutral drugs screen in blood with quantitation using microbore high-performance liquid chromatography–diode array detection and capillary gas chromatography–flame ionization detection

Blood previously acidified with aqueous saturated ammonium chloride solution was extracted with ethyl acetate. The dried extract was subjected to acetonitrile–hexane partition. The acetonitrile portion was analysed for the presence of acidic and neutral drugs by HPLC–DAD (200 mm×2.1 mm I.D. microbore ODS-Hypersil column) and GC–FID (25 m narrow-bore×0.25 mm I.D. HP-5 column with 0.33 μm film thickness). The protocol was found to be suitable for both clinical toxicology (including emergency toxicology) and postmortem toxicology. At least 66 drugs of interest were unequivocally identified by RRTs (HPLC) and UV spectra (DAD) match while another 12 were unequivocally identified by double RRTs match (HPLC and GC). Quantitation was facilitated by incorporating calibration blood standards in each assay batch. The five drugs most commonly encountered in clinical blood specimens (1150 cases) were: paracetamol (47.4% of the cases); chlormezanone (6.6%), theophylline (1.74%), naproxen (1.65%) and mefenamic acid (1.56%). The following drugs were detected in toxicologically significant quantities in postmortem blood specimens (245 cases): phenobarbitone (1.22% of the cases), naproxen (0.82%), chlormezanone (0.82%), theophylline (0.82%), carbamazepine (0.41%) and paracetamol (0.41%).