Postmortem diagnosis of meningococcemia by detection of capsular polysaccharides

Detection of specific meningococcal capsular polysaccharide (CPS) in postmortem blood permits rapid diagnosis of meningococcemia and differentiation from pneumococcemia and septicemia caused by Haemophilus influenzae Type b. We present studies validating application of latex agglutination assay for CPS on blood samples collected at autopsy, delineate the circumstances when CPS testing is indicated, and illustrate the usefulness of this procedure by several recent cases. Blood samples from victims dying of injury or disease other than infection were examined to determine whether the postmortem interval, bacterial contamination, anticoagulants, or delay in testing would result in false positive assays. Series 1 samples, collected so as to minimize bacterial contamination, were immediately submitted for assay. Series 2 evaluated the effect of adverse conditions of collection, anticoagulation, and prolonged sample storage. Despite extended postmortem intervals of up to 14 days, heavy bacterial contamination, prolonged storage at 4 degrees C, deep hemolysis, and presence of anticoagulants, false positive assays were seldom observed.     

Fatal amphetamine-associated cardiotoxicity and its medicolegal implications

Amphetamines are popular drugs of abuse, particularly among youngsters and at dance scenes. Cardiotoxicity (manifested as cardiomyopathy, acute myocardial infarction/necrosis, heart failure, or arrhythmia) after the recreational (mis)use of amphetamine and its synthetic derivatives has been documented but is rather rare. Amphetamine-related cardiac fatalities are even more rare. We present 6 cases of young persons who died unexpected after the chronic abuse of amphetamines. Death was not attributed to a lethal intoxication but to an acute myocardial necrosis, a right ventricle rupture, a cardiomyopathy, or an arrhythmia. Two of the deceased persons presented prior to their death to the emergency department, but their complaints were not considered (probably due to their young age) to be of cardiac origin. One case was a sport-related fatality where medical screening failed to identify the underlying cardiac pathology or the amphetamine abuse, and 1 case was a so-called idiopathic dilated cardiomyopathy where substance abuse was not considered by the treating physician. We think that amphetamine-associated cardiotoxicity is a rare but probably genuine entity that should be considered both in forensic and clinical/emergency medicine because of its potential medicolegal implications.     

Belief in a Just World,Causal Attributions,and Adjustment to Sexual Violence

What influence do the personal belief in a just world (i.e., the perception that one usually gets what one deserves) and different kinds of causal attributions have on adjustment to sexual violence? Using a sample of N = 62 victims of sexual aggression (mean age = 21.7) it was shown that respondents were better able to adjust to their experience of sexual violence the higher their personal belief in a just world. Moreover, the more respondents attributed their victimization to situational circumstances (external attributions) and the less they attributed their victimization to their character and personality (characterological self-attributions), the less they felt distressed by past victimization. The degree to which participants attributed their victimization to their own concrete behavior (behavioral self-attribution) was not related to their adjustment. Further analyses showed that the influence of the personal belief in a just world was mediated by the three attribution styles. Additionally, the adaptiveness of external attributions was moderated by participants’ just world belief.     

Social control of sexual assault by physicians and lawyers within the professional relationship: Criminal and disciplinary sanctions

Two penal sanctions may be imposed judicially on physicians and lawyers who are alleged to have sexually assaulted their patients and clients. Appellate opinions in each state reporting such a case were examined from 1980 through June, 1993, and generalizations from those opinions are reported here. In each profession, the administrative/disciplinary sanction imposed by the professional association may offer a stronger means of social control than does the criminal sanction. The efficacy of the disciplinary sanction, relative to the criminal, is attributable to the facts that the burden of proof is easier to meet and defenses commonly raised in sexual assault cases are not available in disciplinary proceedings. The significance of this pattern is discussed in relation to Black’s theory of the behavior of law, specifically with respect to the manner in which the style of social control is influenced by stratification, the relational distance between the parties, and organization. An earlier version of this article was presented at the National Conference on Ethics and the Professions, Gainesville, Florida, January 31, 1992. The author extends thanks to colleagues and the anonymous reviewers for their comments on an earlier draft.     

Managing Victim Confrontation: Auto Theft and Informal Sanction Threats

Objectives. This paper explores how offenders manage the prospect of victim confrontation during auto theft. Methods. Data were drawn from in-depth, semi-structured interviews with 35 active offenders recruited from the streets of a large Midwestern US city using snowball sampling methods. Results. Two contextual domains figured prominently in the offenders’ decision-making calculus: The area around the target and the target itself. The first galvanized the offenders’ attention to, and management of, informal social control. The second enjoined offenders to balance speed and stealth in breaching the target. Conclusions. Victim confrontation is an informal sanction that is distinct from both retaliation and traditional extralegal sanctions. The rarity with which it occurs in auto theft is likely due to confrontation avoidance measures offenders adopt at the front end of the offense and during the enactment process itself. The conceptual implications of victim confrontation in crime are explored in relation to the following five areas: (1) sanction celerity and present orientation; (2) sanction certainty and ambiguity aversion; (3) sanction interdependence; (4) violence avoidance; and (5) directions for future research.