Elevated morphine concentrations determined during infant death investigations: artifacts of withdrawal of care

Abstract:  Three cases are reported of elevated postmortem blood morphine concentrations (189–3036 ng/mL) that were observed during the course of death investigations involving three children ranging in age from 1 week to 2 years, all of whom underwent withdrawal of life support. In all three cases, the presence of opiates in postmortem blood was indicated by immunoassay (ELISA) and quantitative confirmatory analysis of free morphine concentrations in postmortem blood was performed by solid-phase extraction followed by gas chromatography/mass spectrometry (GC/MS) in the selected ion monitoring mode. While the practice of withdrawing life support from terminally ill patients, with the accompanying administration of narcotics/analgesics has been reported in the medical literature, it has not been adequately described in the forensic literature. The implications of this practice on the forensic toxicological interpretation of morphine findings are discussed. To our knowledge, this is the first report of postmortem morphine concentrations arising directly from administration in conjunction with withdrawal of care in pediatric patients.     

Book reviews

Ernest Gellner, Conditions of Liberty: Civil Society and its Rivals, (Hamish Hamilton, London 1994). 225pp. ISBN 0–241–00220–6 (hb).

James Petras and Morris Morley, Empire or Republic? American Global Power and Domestic Decay, (Routledge, London 1995). 172pp. ISBN 0–415–91064–1.

Keith Cowling and Roger Sugden, Beyond Capitalism: Towards a New World Order, (Pinter, London 1994), 195pp. ISBN 1 85567 301 0.

John Lewis Gaddis, The United States and the End of the Cold War. Implications, Reconsiderations, Provocations, (OUP, Oxford 1994). x. + 301 pp. ISBN 0–19–508551–5.

Alan Haworth, Anti‐Libertarianism: Markets, Philosophy and Myth, (Routledge, London 1994). 154pp. ISBN 0–415–08254–4.

Honi Fern Haber, Beyond Postmodern Politics. Selves, Community and the Politics of Difference, (Routledge, London 1995). 160pp. ISBN 0–415–90822–1.

Stjepan G. Mestrovic The Balkanization of the West: The Confluence of Postmodernism and Postcommunism (Routledge, London 1994). 226pp. ISBN 0–415–08755–4 (pbk).     

Book Reviews

Andrea C. Bianculli and Andrea Ribeiro Hoffmann, eds., Regional Organizations and Social Policy in Europe and Latin America: A Space for Social Citizenship? New York: Palgrave Macmillan, 2016. Abbreviations, figures, tables, bibliography, index, 317 pp.; hardcover $109, ebook $84.99. Barry Cannon, The Right in Latin America: Elite Power, Hegemony and the Struggle for the State. New York: Routledge, 2016. Tables, bibliography, index, 182 pp.; hardcover $127.50, paperback $44.59. Jordi Díez, The Politics of Gay Marriage in Latin America: Argentina, Chile, and Mexico. New York: Cambridge University Press, 2015. Bibliography, index, 301 pp.; hardcover $48.99, paperback $29.99, ebook $24. Julio Ríos‐Figueroa, Constitutional Courts as Mediators: Armed Conflict, Civil‐Military Relations, and the Rule of Law in Latin America. Cambridge: Cambridge University Press, 2016. Illustrations, figures, tables, bibliography, index, 256 pp.; hardcover $110, paperback $34.99, ebook $88. María Soledad Segura and Silvio Waisbord, Media Movements: Civil Society and Media Policy Reform in Latin America. London: Zed Books, 2016. Bibliography, index, 224 pp.; hardcover $95, paperback $29.95, ebook $23.96. Lee J. Alston, Marcus André Melo, Bernardo Mueller, and Carlos Pereira, Brazil in Transition: Beliefs, Leadership, and Institutional Change. Princeton: Princeton University Press, 2016. Illustrations, tables, abbreviations, bibliography, index, 280 pp.; hardcover $39.50, ebook. Sean W. Burges, Brazil in the World: The International Relations of a South American Giant. Manchester: Manchester University Press, 2017. Figures, tables, bibliography, index, 296 pp.; hardcover $115, paperback $32.95, ebook. Alejandro Velasco, Barrio Rising: Urban Popular Politics and the Making of Modern Venezuela. Berkeley: University of California Press, 2015. Maps, figures, notes, bibliography, index, 321 pp.; paperback $29.95. Tiffany D. Barnes, Gendering Legislative Behavior: Institutional Constraints and Collaboration. New York: Cambridge University Press, 2016. Map, figures, tables, bibliography, index, 274 pp.; hardcover $99.99, paperback $34.99, ebook $28. Judith Teichman, The Politics of Inclusive Development: Policy, Sate Capacity, and Coalition Building. New York: Palgrave Macmillan, 2016. Figures, bibliography, index, 261 pp.; hardcover $109, ebook $84.99.     

Basic problems in the theory of uneven and combined development. Part II: unevenness and political multiplicity

Where does ‘the international’ come from? What accounts for its existence as a dimension of the human world? This article attempts an answer, in three steps, using the idea of ‘uneven and combined development’ (U&CD). First, a depth model is constructed, comparing different ways of linking uneven development with international relations. Thus far, it turns out, these ways have all presupposed the fact of political multiplicity, rather than explaining it. In search of explanation, the article turns, secondly, to the compelling historical sociological argument of Barry Buzan and Richard Little. This locates the origins of geopolitics in the late prehistoric shift from hunter-gatherer to settled agricultural existence, together with associated processes of social differentiation and proto-state formation. Buzan and Little's explanation appears at first to pre-empt the need for the concept of U&CD. Yet closer inspection reveals that unevenness and combination play a key role in their empirical account without, however, being theorized. The third step of the argument therefore seeks to show how these are necessary parts of the process of social change which Buzan and Little describe. And in this way it emerges that the origins of ‘the international’ do indeed lie in the uneven and combined character of historical development.     

Contextualizing the Construction and Social Organization of the Commercial Male Sex Industry in London at the Beginning of the Twenty-first Century

Feminist theories are concerned to analyse how women can transform society so that they are no longer subordinated, by understanding how patriarchal relations control and constrict them.(Abbott and Wallace, 1997: 284)Feminisms start from the position that women are oppressed within a society, which is patriarchal and socially constructed within knowledge which is malestream. This traditionally defines men such that they are rendered subordinate, within a social world constructed by men. Feminisms are engaged with making transparent patriarchal constructs, and illuminating the ‘spaces’ within which women-realities can become more visible.This paper presents research undertaken by two key services working with male sex workers in central London. The insights gained from this research are discussed, as they allow comparison between the traditionally subordinate position of women and the contextual experiences of the ‘hidden’ population of male sex industry workers. It demonstrates, that like women, for male sex workers, hegenomic and heterosexist constructs ensure that they also occupy a subordinated position within society.