"Natural" death of a person under the care of a custodian

An ambulance service doctor was called to the death of a 76-year-old woman and attested cardiac arrest and psycho-organic brain syndrome as the cause of death on the death certificate. At the second external examination mandatory before cremation, extensive hematomas were detected on the right thorax and multiple haematomas in the face and on the forehead. The autopsy initially ordered by the public health officer revealed serial rib fractures and a fractured skull. After notifying the prosecutor, a forensic autopsy was ordered and death was found to have been caused by fat embolism following massive blunt force to the thorax with serial rib fractures and haematopneumothorax. After that, the adopted son, who had been appointed care custodian for the woman, and his wife were suspected, because they had given contradictory explanations for the injuries. At first, they were only suspected of failure to render assistance, but in the end they were both charged with murder. Only because of the second external examination prescribed by the law still in force could the errors of the improper first external examination be corrected.     

Notes and comments "High and dry?" The Public Readiness and Emergency Preparedness Act and liability protection for pharmaceutical manufacturers

In an era filled with fears of bioterrorism, Congress approved the Public Readiness and Emergency Preparedness Act (PREPA) to encourage development of vaccines and other countermeasures. By providing pharmaceutical manufacturers with protection from liability for potential side effects, Congress has attempted to motivate manufacturers to produce a national stockpile of countermeasures. As part of PREPA, the government established a compensatory system intended to provide compensation to persons injured by countermeasures used during a public health emergency. Although the Act provides for a compensation fund, it fails to allocate monies for that fund. Thus, in the absence of further congressional action, PREPA will not provide compensation to those injured by countermeasures. Failing to assure the American public of a compensation program constitutes bad public policy and risks inspiring potential vaccinees to refuse necessary drugs. Additionally, arguments as to the constitutionality of the Act exist should Congress fail to adequately fund the program, and the existence of those arguments undermines the purpose of the Act--namely to assure pharmaceutical manufacturers that they will not be sued into oblivion should they attempt to aid national pandemic protection. In addition to detailing both the Act and the statutory precedent for congressional attempts to spur biodefense, this Article addresses important issues of healthcare, tort, and constitutional law that will continue to manifest themselves in this new era of bioterrorism.     

Physician-assisted suicide: legal and ethical considerations

As medicine's technical limits have become increasingly clear, Americans seem more willing to address end-of-life decisionmaking. A major development during the 1990s was physician assistance in dying: physician-assisted suicide in Michigan, Oregon's Death with Dignity Act, and developments in Europe, most notably The Netherlands. This evolution toward recognizing the appropriateness of assistance in dying raises legal and ethical issues for physicians and healthcare institutions such as nursing facilities and acute care hospitals. These issues include the effects on providers' values systems, the trust between patient and provider, and the "slippery slope" that voluntary, active assistance in dying will become involuntary, active assistance. This Article addresses the policy issues that institutions must confront in a changing environment.     

The Young Turk Historical Imagination in the Pursuit of Mythical Turkishness and its Lost Grandeur (1911–1914)

Based on a comprehensive reading of the 1912–1914 issues of the journal Turkish Homeland, the highbrow intellectualist periodical of the Turkist intellectuals and the ruling Committee of Union and Progress, this article argues that sublime Turkishness envisaged by the Young Turks can be construed as a character build-up. The article also examines how history was utilized as an arsenal from where the sublime ‘Turkish character’ was extracted in a decade in which interest towards Turkic history burgeoned, arguing that valiant Turkic heroes from the glorious Turkic past were discovered or rediscovered to stand out as exemplary men and epitomes of incorruptibleness inspiring the new youth.     

The Evolution of Local Government Budgeting in Poland: From Accounting to Policy in a Leap and a Bound

The evolution of U.S. public budgeting has been described by Schick (1966) as a progression from a control orientation to a management and then a planning orientation. Lee (1992) has tracked the evolution of central budgeting staff largely from a group of accountants to a more varied set of backgrounds, dominated by public administration and general liberal arts educations. As Poland decentralizes fiscal and administrative responsibilities and powers to gminas (local self-governments), the gmina councils are beginning to view the budget as more than a financial accounting tool proscribed and prescribed by the central government. They are beginning to see the potential for using the budget as a policy and management tool. The evolutionary transformation of budgeting, which took fifty years in the United States, may take only five years in Poland. The evidence for this metamorphosis is based on interviews with several gmina city budgeters, with special attention devoted to the city of Lublin.     

Decentralization and accountability in the health sector from an international perspective: What are the choices?

This article reviews alternative decentralization policies for the health sector. It discusses the forms that decentralization can take, illustrating these with country examples. It then considers the choice of levels in a decentralization policy and the desirability of the creation of health boards or authorities. Decentralized authorities can be given differing levels of responsibility for different tasks: those considered here are revenue raising, policy-making and planning, resource allocation, funding of service provision and interagency and intersec-toral coordination. The article concludes by considering some criteria for evaluating decentralization approaches.     

Literatur

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