Informed consent issues in the cardiac transplantation evaluation

As consultation-liaison psychiatrists to a cardiac transplantation team, we have observed various informed consent issues that are particularly associated with evaluation for cardiac transplantation. We discuss complicating factors that relate to each component of informed consent and present the defense mechanism of denial as a barrier to making the decision to accept or refuse transplantation. Changes in the evaluation protocol could preclude existing impediments to provision of information and patient autonomy; however, certain intrapsychic issues must be recognized as ongoing clinical realities to be addressed as the doctrine of informed consent continues to evolve.     

Comparative morphine determination in parts of the brain using combined gas chromatography/mass spectrometry. A possibility for assessing survival time

Comparison of the morphine concentrations in the medulla oblongata and the cerebellum provides information on the interval between morphine administration and death. If this period is short, the ratio of CMed:CCereb is below 1. The ratio is above 1 if a number of hours have passed at least. The balance of the morphine concentrations is achieved within a few hours. Results have been achieved by gas chromatography/mass spectrometry analysis in about 100 autopsy cases.     

On assessing the mood of the public toward the police: Some conceptual issues

The use of attitudinal surveys has become a widely accepted method for the incorporation of public opinion in public policy decisions. Because of the assumption that the interpretation of such surveys is straightforward and clear, little critical attention has been devoted to the methodological and theoretical problems encountered when translating these findings into public policy. A case in point involves the proliferation of surveys aimed at assessing the mood of the public toward the police. A review of the literature reveals that the research findings about the public mood are contradictory and thus lack convergent validity. The findings of this study indicate that this lack of convergent validity in the images of the public toward the police can be explained on both methodological and theoretical grounds. More specifically, the findings indicate that the mood of the public is very different depending on the level of specificity of the items used to tap that mood. Items eliciting evaluations of a general nature show the public as supportive of the police, while items of a specific nature show much less public support. This apparent paradox is explained through the use of a theoretical framework developed by Easton (1965), which emphasizes diffuse and specific support as external influences on institutions.