Proposed changes to the hospital-medical staff relationship to improve quality of care

Medical staff attorney Snelson answers the Colloquium's charge, "What exactly has to change in the hospital-medical staff relationship for health care quality to be improved?" Her response emphasizes the logic of having clinicians vested with authority to establish policies concerning the clinical decision-making. The article discusses the cases defining the medical staff bylaws as contractual in nature, and the problem of hospital attorneys demanding unilateral amendments to bylaws. Bylaw clauses that would chill medical opinion and communication or denigrate clinical recommendations are discussed. Ms. Snelson advocates for the inclusion of the medical staff organization in exclusive contract and other clinical decision-making, and includes sample bylaw language enacting her recommendations.     

Lineup Administrators' Expectations: Their Impact on Eyewitness Confidence

This research focuses on how lineup a administrators influence eyewitnesses' postidentification confidence. What happens to witness confidence when a witness makes an identification that confirms the lineup administrator's expectations; what happens when this expectation is not confirmed? In Experiment 1, participant interviewers (n = 52) administered target-absent photo lineups to participant witnesses (n = 52). The interviewers did not view the simulated crime, but were told the thief's position in the lineup. In every instance this information was false (we used a target-absent lineup). A one-way ANOVA revealed that eyewitness identification confidence was malleable as a function of interviewers' beliefs about the thief's identity. In Experiment 2, participant jurors (n = 80) viewed 40 testimonies of Experiment 1 witnesses (2 participants viewed each testimony). Participant jurors judged all participant witnesses as equally credible despite their varying levels of postidentification confidence.

     

When is the Truth not the Truth? Truth Telling and Libel by Implication

Implied libel cases involve defamatory news stories composed entirely of factual, truthful material. Because they lack the false statements typically required for a successful libel suit, these cases present unique challenges regarding determination of falsity. This article examines how appellate judges articulate and apply conceptions of truth in libel- by-implication cases. It concludes that there exists no common understanding of truth and that judges and courts that favor the correspondence theory of truth tend to favor the media, while those that adopt the coherence theory of truth do not. This disagreement over the fundamental understanding of what constitutes truth leads to confusion and lack of clarity for journalists and judges. The article concludes that the actual malice standard apply in all implied libel cases.     

Factors Influencing the Higher Education Decisions of Criminal Justice Professionals

Criminal justice professionals are a potential source of students for many criminal justice programs, especially those in metropolitan areas. This study explored factors that influenced the higher education decisions of 480 Northwestern Ohio criminal justice employees (e.g., municipal police officers, sheriff deputies, jail staff, and prison staff). Most indicated a desire to pursue higher education. Among those indicating an interest in earning a degree, cost and convenience were the most significant factors in their choice. The availability of evening and weekend classes, availability of a part-time curriculum, availability of financial aid/tuition reimbursement, total credit hours required for the degree, the field experience of faculty, and flexibility in admission requirements were all significant factors. Location was also very significant. Most respondents indicated that they would not travel more than thirty minutes to attend classes.     

Managing incidental findings in human subjects research: analysis and recommendations.

No consensus yet exists on how to handle incidental findings (IFs) in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are findings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed.