The right to die: state courts lead where legislatures fear to tread

The right to die may be among the most legally complex and culturally sensitive areas of civil rights to emerge in our time. The thorny issues associated with a terminally ill individual's right to self-determination, and the disposition of individuals who are incompetent to make right to die decisions for themselves, promises to keep all parties involved - health care professionals, medical ethicists, families, lawyers, judges, and state legislators -busy for some time to come. To this point, the state courts have taken the lead in the right to die debate, while the state legislatures have tended to drag their collective feet. This article lays the case law groundwork for right to die decision making, then goes on to assay the legislative responses to the issue that have been rendered in the fifty states.     

Medicaid and access to child health care in Chicago.

In this article we examine how increasing the reimbursement of physicians and expanding Medicaid eligibility affect access to care for children in Cook County, Illinois, which overlies Chicago. Using Medicaid claims and other data at the zip-code level, we compare the places where Medicaid children live with the places where all the physicians who treat children and those who accept Medicaid patients have their practices. Our findings suggest that the recent changes in legislation are unlikely to benefit extremely poor children, who are more likely to live in depressed inner-city areas, where there are few physicians. "Near-poor" children whose homes are dispersed throughout the county, who are now eligible for Medicaid as a result of the recent changes, are likely to see improvements in their access to care. Further changes in policy, aimed at enhancing the capacity of institutions providing care, could improve access for the children of the inner city.     

Policy failure and public support: The Iran-Contra affair and public assessment of President Reagan

The Iran-Contra affair is an example of the type of event that is expected to give rise to a rally of public opinion behind the president. However, the public's response to this event, uncharacteristically, was a sharp decrease in support for President Reagan. This case study constitutes an attempt to explore the sources of the public opinion response to foreign policy events. Statements of political elites, news coverage and commentary, and public opinion assessments are examined to test the patriotism, priming, and opinion leadership explanations of the rally phenomenon. The actions of opinion leaders appears to provide the best explanation of the differential public response to the Iran-Contra affair.     

Suicide by jumping from buildings

A study of 82 suicides during 1982-1986 that were committed by jumping from buildings was performed using the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, U.S.A. The analysis involved the age, race, and sex of the victim along with the results of toxicologic studies and the cause of death. Additionally, the decedent's place of residence, location of the suicide, height of the building, and the reason for the suicide were investigated. Whether or not a note was left by the decedent was also ascertained. The suicidal "jumper" most commonly was a white man who was greater than 60 years of age who died from the resultant multiple injuries. The victim commonly was sober and drug free at the time of the incident. In approximately two-thirds of the cases, the location of the suicide was the victim's residence, which frequently was an apartment or condominium-type dwelling that was seven floors or higher from the ground. The victim often had experienced depression prior to the incident and did not usually leave a suicide note. This article compares the Dade County cases with others that have been studied and discusses the reasons why jumping from a building may have been chosen as the suicidal mechanism.     

Identification of a red "fiber": chironomid larvae

During preliminary examination of the body of a homicide victim, a peculiar red "fiber" was noticed and recovered. Initially believing this to be a carpet fiber, the item was subjected to fiber analysis. It was found to be a short coiled particle not like any known natural or synthetic fabric fiber. Subsequent examinations determined this "fiber" to be the larva of a common freshwater midge (Diptera; Chironomidae). Chironomid larvae have been observed on other bodies recovered from freshwater environments. Entomological studies of this organism have led to the conclusion that the presence of chironomid larvae indicates submersion of the body.