Autonomy and the competent patient's right to refuse life-prolonging medical treatment--again

This article discusses the recent decision of the Court of Appeal of the United Kingdom in Re B (Adult: Refusal of Medical Treatment) [2002] 2 All ER 449, which confirmed the common law right of a competent patient to refuse medical treatment, even though exercise of the right would (and later did) result in the patient's own death. Re B indicates that if a competent refusal is not respected, health professionals and hospitals face the prospect of awards of damages being made against them for unlawful trespass.     

A newspaper surveillance study of homicide-suicide in the United States

The objective of this study was to identify the number and subtypes of homicide-suicides in the United States by age group and state over a 3-year period from 1997 through 1999. A total of 673 homicide-suicides, including 674 perpetrators and 779 victims, were identified from Internet searches of 191 national newspapers, and they were classified according to a modified Hanzlick-Koponen typology. One quarter of the homicide-suicides were perpetrated by persons 55 years or older, and 77% were spousal/consortial, higher than the 57% observed in the younger age group; 11% of the older homicide-suicides were familial, compared with 16% in the younger age group. Whereas only 3% of older homicide-suicides were infanticide/pedicide, 16% of the younger homicide-suicides involved parents killing their children. Forty-five states, including the District of Columbia, reported a homicide-suicide during the 3-year period, and they occurred most frequently in Florida (163), California (98), Texas (36), and New York (35). Newspaper surveillance is useful to identify where homicide-suicides are occurring most frequently, but they are underestimates of the true prevalence. However, the number of incidents detected is large enough that the cases detected may be a fairly representative sample.     

Psychosocial work environment, interpersonal violence at work and mental health among correctional officers

The main purpose of this study was to present changes occurring between 2002 and 2004 in the prevalence of psychosocial constraints and interpersonal violence at work among officers working in correctional facilities in Quebec. Results suggest that in the absence of specific organizational intervention aimed at improving a deleterious work situation, exposure to low decision latitude remained similar between 2002 and 2004, while exposure to high psychological demands improved somewhat, for both men and women. In 2000, rates of exposure of correctional officers in Quebec to high psychological demands, low decision latitude and the combination of high psychological demands and low decision latitude (job strain) were significantly higher than those obtained for the entire population of workers in Quebec in contact with the public. Exposure of correctional officers in Quebec to intimidation at work increased substantially between 2002 and 2004, among both men and women. Globally speaking, rates of exposure to intimidation by colleagues and superiors practically doubled between 2000 and 2004. Rates of exposure to intimidation among correctional officers in Quebec were particularly high in 2004 (71% among men 66% among women) compared to rates in another study conducted among federal correctional officers (48%) by Samak. The present study also showed that in 2004, correctional officers in Quebec were more likely to present signs of psychological distress linked with work when they were exposed to high psychological demands, low decision latitude, job strain and poor social support from superiors and colleagues. Psychological distress was also shown to be greater when reward at work was scarce and when there was an imbalance between effort and reward at work. Finally, in 2004, psychological distress among correctional officers was also associated with intimidation and psychological harassment at work.     

Effect of Sterilants on Amplification and Detection of Target DNA from Bacillus cereus Spores

To conceal criminal activity of a bioterrorist or agroterrorist, the site of pathogen generation is often treated with sterilants to kill the organisms and remove evidence. As dead organisms cannot be analyzed by culture, this study examined whether DNA from sterilant‐treated Bacillus cereus spores was viable for amplification. The spores were exposed to five common sterilants: bleach, Sterilox®, oxidizer foam (L‐Gel), a peroxyacid (Actril®), and formaldehyde vapor. The spores were inoculated on typical surfaces found in offices and laboratories to test for environmental effects. It was found that the surface influenced the efficiency of recovery of the organisms. The DNA isolated from the recovered spores was successfully detected using RT‐qPCR for all treatments except for formaldehyde, by amplifying the phosphatidylinositol phospholipase C and sphingomyelinase genes. The results demonstrated that evidence from sites treated with sterilants can still provide information on the uncultured organism, using DNA amplification.