Gainsharing: a call for guidance

Gainsharing is a device by which hospitals and physicians share in the development, implementation, and proceeds resulting from the mechanisms to make the provision of healthcare more efficient and cost effective. The goal of gainsharing programs is to save hospitals money while maintaining the same or better quality of care--a goal that will ultimately result in both better care and lower expenses for payors and for society as a whole. Nevertheless, the OIG has ruled that gainsharing programs are per se illegal. This Article analyzes the reasons behind the OIG's determination and argues that, contrary to the OIG's conclusion, the advisory opinion process is legally and practically the best way to deal with the issues raised by gainsharing programs.     

Therapeutic misadventure. An 11-year study from a metropolitan coroner's office

"Therapeutic misadventure" and its alternative forms is a controversial, though necessary, manner of ruling deaths that result from unexpected complications of medical procedures. Such cases must be brought to the attention of the medical-legal office so that they are thoroughly investigated and documented, and so that appropriate and consistent rulings are made. While it is not generally agreed that a ruling of therapeutic misadventure implies medical negligence, a number of such cases do become the bases for litigation. During an 11-year period in a metropolitan coroner's office that examines about 2,000 cases yearly, 44 cases were ruled therapeutic misadventure, an incidence of 0.46%. A recent increase in such cases is probably the result of improved case finding and investigation. The largest category was that of surgical complications, followed, in order, by complications of anesthesia and of therapeutic and diagnostic procedures, and by drug reaction. No case occurred in ambulatory surgery. There apparently has been a low incidence of attendant lawsuits. The study of cases of therapeutic misadventure is potentially of great value in identifying outcomes and trends, and for the prevention of such cases in the future.     

How Legislation is Drafted and Enacted in Bangladesh

The creation of laws is the most direct and powerful legislativetool available to governments to fulfill their political mandate.Not surprisingly, the drafting and enactment of legislationin many Commonwealth countries often follow the same generalpattern as that established by the United Kingdom. Nevertheless,each country adds a sprinkling of local flavour and custom toits own practices. What follows is an overview of the legislativeprocess in the People’s Republic of Bangladesh, highlightingthe various distinct stages involved in the making of laws—suchas developing policy, drafting legislation, presenting proposedlaws to Parliament, final approval by the president, and publicationin the Official Gazette. Comparisons are also made with theCanadian and United Kingdom legislative drafting experiencewhere appropriate.     

Murders for profit. The case of John Donald Merrett

Forensic cases may be of historical interest because of their rarity, unique characteristics and conclusions, and potential for educating forensic scientists. The case of John Donald Merrett, who committed multiple murders for profit in Great Britain in 1926 and in 1954, is a notable example of a case in which both police and forensic scientists made serious errors, these errors leading to Merrett's acquittal when he was tried in 1927 for the shooting death of his mother. Imprisoned for forgery, Merrett was released only to resume a life of crime culminating in 1954 in the brutal murders of his wife and mother-in-law. Pursued by the police, he committed suicide. The Merrett case was of great benefit to forensic medicine in emphasizing the necessity for close teamwork among police and forensic scientists and in furthering the development of forensic ballistics.     

‘Our songs were our stones’: song and struggle in the treatment action campaign

With 3 million people receiving anti-retroviral therapies (ARV) in South Africa, it has the largest public ARV programme in the world. The implementation of this programme was made possible by the efforts of AIDS advocacy groups that lobbied the government to make ARV available. Chief among these was the Treatment Action Campaign (TAC). The group mobilised South Africans across socio-economic and racial lines against the AIDS denial of key members of the African National Congress (ANC). Through interviews with TAC members and ethnographic accounts of ©current activism, this paper examines song as a method of mobilisation against HIV/AIDS-related injustices. As instrumental components of the liberation struggle, songs have become ubiqioutus within protest action, as demonstrated by the recent hashtag student movements. By utilising similar forms of rights-based activism found in the country's liberation struggle, TAC is able to tap into reservoirs of emotional potential rooted in political struggle.     

A: Reviews: general

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“Our biggest killer”: multimodal discourse representations of dementia in the British press

A recent (2016) Office for National Statistics report stated that dementia is now “the leading cause of death” in England and Wales. Ever fixated with the syndrome (an unfailingly newsworthy topic), the British press was quick to respond to the bulletin, consistently headlining that dementia was the nation’s “biggest killer,” while (re)formulating other aspects of the report in distorting and emotive metaphorical terms. In this paper we examine how the media, through use of a recurring set of linguistic and visual semiotic tropes, portrayed dementia as an agentive entity, a “killer,” which remorselessly attacks its “victims.” Such a broadly loaded and sensationalist representation, we argue, not only construed dementia as a direful and pernicious disease, but also, crucially, obscured the personal and social contexts in which the syndrome is understood and experienced (not least by people with dementia themselves). This intensely lurid type of representation not only fails to address the ageist misinformation and common misunderstandings that all too commonly surround dementia, but is also likely to exacerbate the stress and depression frequently experienced by people with dementia and their families.