Medical professionals convicted of accessing child pornography--presumptive lifetime prohibition on paediatric practice? Health Care Complaints Commission v Wingate

Health Care Complaints Commission v Wingate [2007] NSWCA 326 concerns an appeal from the New South Wales Medical Tribunal regarding its findings on professional misconduct outside the practice of medicine in relation to a doctor convicted of possessing child pornography. The latest in a number of cases on this issue in Australia, it highlights the complexity of such decisions before medical tribunals and boards, as well as the diversity of approaches taken. Considering both this case and the recent Medical Practitioners Board of Victoria case of Re Stephanopoulos [2006] MPBV 12, this column argues that Australian tribunals and medical boards may not yet have achieved the right balance here in terms of protecting public safety and the reputation of the profession as a whole. It makes the case for a position statement from Australian professional bodies to create a presumption of a lifetime prohibition on paediatric practice after a medical professional has been convicted of accessing child pornography.     

A calculation of the theoretical significance of matched bullets

Abstract:  The comparison and identification of bullets from the striations that appear on their surfaces, after they have been fired from a gun, have been practiced since the 1920s. Although the significance of the correspondences of these impression marks has been empirically justified, there is a conspicuous absence of any theoretical foundation for the likelihood. What is presented here is the derivation of the formulae for calculating the probability for the correspondence of the impression marks on a subject bullet to a random distribution of a similar number of impression marks on a suspect bullet of the same type. The approach to the calculation entails subdividing the impression marks into a series of individual lines having widths equal to the separation distance at which a misalignment of striations between the two bullets cannot be distinguished. This distance depends upon the resolution limit imposed by the microscope as well as by the visual acuity of the examiner. A calculation of the probabilities for finding pairs and triplets of consecutively matching lines on nonmatching bullets, by an examiner with normal perception using a microscope at 40× magnification, produces values that agree well with the empirical probabilities determined by Biasotti in the 1950s and when determined for larger consecutive sequences suggest that they are extremely unlikely to occur. The formulae can be used to determine the probabilities for the random occurrence of any sequence of striae and provide a straightforward way to quantitatively justify the significance of a specific match between any two bullets.     

The implementation of Directive 2001/20/EC into Belgian law and the specific provisions on pediatric research

The European Clinical Trial Directive (2001/20/EC) was implemented into the Belgian legal system by the Law of 7 May 2004 concerning experiments on the human person (LEH). Apart from implementing the European Directive, this law also broadens the scope of the Directive from interventional clinical trials to all medical experiments involving human persons. This article offers an overview of the requirements for involving minors in medical experiments that are captured in the LEH, illustrates the process of protocol review by an ethics committee, and discusses the dissimilarities between the LEH and the European Directive.     

Case report: Etizolam and its major metabolites in two unnatural death cases

A simultaneous analytical method for etizolam and its main metabolites (alpha-hydroxyetizolam and 8-hydroxyetizolam) in whole blood was developed using solid-phase extraction, TMS derivatization and ion trap gas chromatography tandem mass spectrometry (GC-MS/MS). Separation of etizolam, TMS derivatives of alpha-hydroxyetizolam and 8-hydroxyetizolam and fludiazepam as internal standard was performed within about 17 min. The inter-day precision evaluated at the concentration of 50 ng/mL etizolam, alpha-hydroxyetizolam and 8-hydroxyetizolam was evaluated 8.6, 6.4 and 8.0% respectively. Linearity occurred over the range in 5-50 ng/mL. This method is satisfactory for clinical and forensic purposes. This method was applied to two unnatural death cases suspected to involve etizolam. Etizolam and its two metabolites were detected in these cases.     

Thin layer chromatography/fluorescence detection of 3,4-methylenedioxy-methamphetamine and related compounds

A rapid and sensitive method for the detection of six methylenedioxylatedphenethylamines, 3,4-methylenedioxymethamphetamine (MDMA); 3,4-methylenedioxyamphetamine; 3,4-methylenedioxyethylamphetamine; N-methyl-1-(3,4-methylenedioxyphenyl)-2-butamine; N-methyl-1-(3,4-methylenedioxyphenyl)-3-butamine; and 3,4-methylenedioxydimethylamphetamine, by thin-layer chromatography with fluorescence detection is proposed. These compounds form fluorophores on the developing plate following spraying with a reagent consisting of sodium hypochlorite, potassium hexacyanoferrate (III), and sodium hydroxide, and heating for 3 min at 100 degrees C. Blue fluorescent spots were observed under ultraviolet light in a wavelength range of 250-400 nm. The detection limits for MDMA and the above related compounds were 50 ng. The proposed method was effectively applied to the detection of MDMA in urine samples.     

Coordinated community response to family violence: the role of domestic violence service organizations

There is increasing awareness that domestic violence (DV) and child maltreatment often overlap and that there are significant negative consequences to women and children who are victims in the same families. The present study contains data from a participatory evaluation of a multisite national demonstration project on family violence (the Greenbook Initiative), funded jointly by the U.S. Departments of Health and Human Services and Justice. The goal of this initiative was to increase community capacity to assist dually victimized families. This article focuses on the DV service organizations in the demonstration with regard to collaborations with other agencies and work within the DV system to respond to dually victimized families. Findings suggest that DV agencies participated in leadership roles, cross-system collaborations, and cross-system trainings throughout the initiative. Within-agency practice changes were less apparent. Research and policy implications are discussed.     

Collaborative efforts to improve system response to families who are experiencing child maltreatment and domestic violence

The Greenbook demonstration initiative provided federal funding and other support to six communities to establish collaborations to plan and implement policy and practice changes in systems that serve families who are experiencing domestic violence and child maltreatment or child exposure to domestic violence. The demonstration sites established and organized collaborative groups in accordance with the Greenbook foundational principles and recommendations, including representation from multiple levels within the primary partner systems and other organizations, as well as the community. The sites struggled with how to engage consumers of the primary systems, however, and devoted a great deal of time to understanding and addressing organizational differences among the partners. Other salient collaborative influences included leadership, resources, trust, and commitment. The stakeholders noted that the collaborative relationships required a great deal of work but were ultimately one of the main successes of the initiative.