Postmodern Professions? The Fragmentation of Legal Education and the Legal Profession

This article considers the institutional dimensions of professionalism and the legal profession's struggle with the challenges of post-modernity. An aspect of this is the Law Society's Training Framework Review (TFR) which promises changes to solicitors' education from 'cradle to grave'. The first part of the article analyses the structure and drivers of the TFR, their origins, and how they will be articulated. Secondly, the TFR is considered in the context of the political economy of higher education and its role in the new capitalism. Finally, we examine the potential effects of the TFR for the legal profession in the context of increasing practice segmentation and the threat of deprofessionalization, and also for the Law Society itself, whether it can retain a key role in the life course of the legal profession.     

How does private finance affect public health care systems? Marshaling the evidence from OECD nations

The impact of private finance on publicly funded health care systems depends on how the relationship between public and private finance is structured. This essay first reviews the experience in five nations that exemplify different ways of drawing the public/private boundary to address the particular questions raised by each model. This review is then used to interpret aggregate empirical analyses of the dynamic effects between public and private finance in OECD nations over time. Our findings suggest that while increases in the private share of health spending substitute in part for public finance (and vice versa), this is the result of a complex mix of factors having as much to do with cross-sectoral shifts as with deliberate policy decisions within sectors and that these effects are mediated by the different dynamics of distinctive national models. On balance, we argue that a resort to private finance is more likely to harm than to help publicly financed systems, although the effects will vary depending on the form of private finance.     

Postmortem urine immunoassay showing false-positive phencyclidine reactivity in a case of fatal tramadol overdose

This is a report of postmortem false-positive reactivity using an enzyme-multiplied urine phencyclidine (PCP) immunoassay (EMIT II+) due to a single-agent fatal tramadol overdose. An autopsy of a 42-year-old male who died alone at home revealed no identifiable lethal anatomic abnormalities, thus leading to toxicologic analysis. Femoral blood was obtained for drug testing by high-performance liquid chromatography (HPLC) and showed a tramadol level of 14.0 mg/L, 2 orders of magnitude greater than the therapeutic range (0.1 to 0.3 mg/L). Urine was also obtained and EMIT II+ immunoassay revealed positivity for PCP at 88 mAU/min. However, confirmatory testing by HPLC failed to identify PCP in either the urine or serum. To verify the suspicion that this was a false-positive PCP result, stock solutions of tramadol and its major metabolite (O-desmethyltramadol) at concentrations of 100 mg/L in 10% methanol/H2O were compared with a blank solution (10% methanol/H2O) for EMIT II+ PCP reactivity and demonstrated reactivities of 44 mAU/min and 27 mAU/min, respectively. While these individual results were below the cutoff reactivity for a positive EMIT II+ PCP result (ca. 85 mAU/min), they were much more reactive than the blank calibrator (set at 0 mAU/min). Therefore, we conclude that the immunoreactivity of tramadol and its metabolites in aggregate is responsible for the PCP immunoassay interference and false-positive result.     

To evaluate the utility of smaller sample sizes when assessing dental maturity curves for forensic age estimation

Dental maturation and chronological age estimation were determined from 144 healthy Western Australian individuals aged 3.6-14.5 years. The results were compared with Farah et al.'s previous study which comprised a larger heterogeneous sample of Western Australian individuals (n = 1450). Orthopantomograms were analyzed with the application of Demirjian and Goldstein's 4-tooth method based on eight stages of dental mineralization. Analysis of variance revealed no significant differences in dental maturity scores in each age group among the males in both studies; similar results were seen in the females. Paired t-tests showed no statistical significance overall between chronological and estimated ages for the males in our sample (p = 0.181), whereas the females showed significant differences (p < 0.001). Our results show that smaller samples may be used when assessing dental maturity curves for forensic age estimation.     

A comparison of Demirjian's four dental development methods for forensic age assessment

The aim of this study was to determine the comparative accuracy of Demirjian's four dental development methods for forensic age estimation in the Western Australian population. A sample comprising 143 individuals aged 4.6 to 14.5 years were assessed using Demirjian's four methods for dental development (original 7-tooth: M(2), M(1), PM(2), PM(1), C, I(2), and I(1); revised 7-tooth: M(2), M(1), PM(2), PM(1), C, I(2), and I(1); 4-tooth: M(2), M(1), PM(2), and PM(1); and an alternate 4-tooth: M(2), PM(2), PM(1), and I(1)). When comparing all four methods, the 4-tooth method overestimated age in both males and females by 0.04 and 0.25 years, respectively. The original 7-tooth was least accurate for males, while the original 7-tooth, the revised 7-tooth, and the alternate 4-tooth were unsuitable for females. Therefore, we recommend the 4-tooth method to be used for forensic age estimation in Western Australian males and females, as it has the lowest overall mean deviation and the highest accuracy.     

Population growth and foreign policy

Australian foreign policy is examined in light of the population issue and its relationships to its developing Asian neighbors. Rapid population growth has been a 20th-century phenomenon. In the ESCAP region, almost all governments are anxious to reduce growth rates and welcome international assistance for population programs. The motivation of these governments seems to be both political and economic. Asian countries do not share the view expressed at Bucharest by Latin American and African representatives that high population growth rates are not a problem. Results of national family planning programs in 16 developing Asian countries are assessed. Major fertility decline has only occurred so far in the most prosperous of these countries. Future fertility trends are hard to predict. Present inadequate knowledge of the determinants of human fertility and limited knowledge regarding fertility limitation techniques hamper progress in population reduction. Australia has aided these countries in demographic training and data collection. For both economic and humanitarian reasons, this aid should be extended to program implementation.     

Straight there,no detours: direct access to barristers

Modernity unsettles professional certainties. For centuries the Bar has enjoyed many privileges but there has been a hollowing out of its professional core as its reserved areas have come under threat. The gradual erosion of the referral aspects of barristers’ relationships with solicitors and others exposes barristers to the contingencies of the market in a raw form not usually experienced. The rising intervention of the state into the lawyer-client relationship through the control of the legal aid budget is accelerating these moves. These are moves to bureaucratic control and potential proletarianization. The Bar is losing its grip on its professional project. Or is it? One argument is that we are not observing the end of professionalism but rather various defensive manoeuvres by professionals to maintain their privileges.

Direct access by clients to barristers is one such response in a differentiated market for legal services. This has had a mixed reaction among barristers and barristers' clerks. Some see it as the route to a modern diverse profession while others see it as potentially harming these traditional relationships between barrister and solicitor that have been built up over many years. Among solicitors this has been met by their own moves to become advocates in the higher courts.

These changes are examined in the light of further changes anticipated by the Legal Services Act 2007 with the introduction of alternative business structures. These have the potential to affect traditional modes of practice with a consequent loss to barristers’ autonomy.     

A potentially catastrophic outcome from a false-positive urinary drug screen immunoassay

Background: Urinary drug screens are routinely administered for patients returning from leave from forensic psychiatric wards, and are required to be negative for patients to continue to use their allocated leave. Case: A 35-year-old woman took leave from her low-secure psychiatric unit. On return, her urine screened positively for 3,4-Methylenedioxymethamphetamine (MDMA). She strongly denied she had taken it; however, all her leave was cancelled. Her clinical state greatly deteriorated, and she attempted to hang herself the following day. After stabilisation of the patient and continued denial of taking MDMA, the urine was sent for toxicology analysis. In the weeks that followed, she started self-harming and deteriorated to the point of needing electroconvulsive therapy. The toxicological report came back as a false-positive due to recently started Mebeverine. Conclusion: Clinicians must be mindful that urinary drug screens are not diagnostic, but also that not being believed can be devastating, especially for long-stay forensic inpatients.