The conversion of coroner systems to medical examiner systems in the United States: a lull in the action

Coroner and medical examiner systems in the United States conduct death investigations for most deaths that are sudden and unexplained, or which involve external causes such as injury and poisoning. They play a very important role in the criminal justice, public health, public safety, and medical communities, and they also contribute a substantial portion of autopsy-based mortality data to the state and federal mortality statistics systems. Death investigations often involve complex medical issues and necessarily require the involvement of appropriately trained physicians. Over the years, there has been a trend to replace the elected lay coroner systems with systems run by appointed, physician medical examiners. Presently, about 31% of counties in the United States are served by a medical examiners at the county, district, or state level. Between 1960 and 1989, there was considerable conversion to medical examiner systems, but this trend slowed in the 1990s. Since 2000, only 6 counties in the United States have converted to a medical examiner system, no states have converted since 1996, and 1 county has reverted to a sheriff-coroner system. Possible reasons for this decline are discussed, including legislative, political, geographical, financial, population-based, and physician manpower distribution factors. It is important to ensure that all death investigation systems have appropriate access to medically educated and trained physicians such as forensic pathologists.     

Violent Behavior Preceding Hospitalization Among Persons with Severe Mental Illness

The need to better understand and manage risk of violent behavior among persons with severe mental illness (SMI) in community care is increasingly being recognized. Of particular concern is a subset of the SMI population characterized by a revolving door pattern of institutional recidivism and poor adherence to outpatient treatment. Little empirical research exists which examines the specific dimensions of violent incidents and their surrounding context in this population. The present paper describes characteristics of violent behavioral events in a sample of 331 people with psychotic or major mood disorders who were placed on involuntary outpatient commitment in North Carolina. By pooling baseline data from respondents' self-report, collateral informant interviews, and hospital records, the study found violent behavior to be a problem affecting over half the sample in a 4-month period preceding hospitalization. The study also found considerable variability in the frequency of violent events, severity, weapon use, subjective state when incidents occurred, initiation of fights, settings, relationship to others involved, and associated threat of victimization. Multivariable analyses showed that cooccurring substance abuse problems, history of criminal victimization, and age (being younger) were significantly associated with violent behavior when all sources of data were taken into account. Clinical diagnosis and symptom variables were not related to violence in this sample. Implications of these findings for service delivery priorities and future research are discussed.     

Identification of the unidentified deceased: turnaround times, methods, and demographics in Fulton County, Georgia

CONTEXT: Multiple methods may be employed in an attempt to identify deceased individuals who are unidentified when reported to the medical examiner or coroner. The success and turnaround times of various methods differ. OBJECTIVE: To determine the number of deaths initially involving unidentified individuals, their demographics, the methods used and turnaround times for cases in which identification was successful and the portion of cases that remain unidentified for significant periods of time. DESIGN, SETTING, AND PARTICIPANTS: Retrospective case review of all decedents who were initially unidentified when death was reported to the Fulton County Medical Examiner in Atlanta, Georgia, during a 1-year period between May 2003 and May 2004. MAIN OUTCOME MEASURES: Rate per 1000 deaths which involved an unidentified decedent, tabulation of methods used to make identifications, and rate of cases remaining unidentified. RESULTS: Of 2279 deaths reported to the office, 100 were originally unidentified, resulting in a rate of 44 unidentified decedents per 1000 deaths reported. Those who remained unidentified involved 6 cases, resulting in a "cold case" rate of 2.6 per 1000 deaths. Seventy-eight percent were identified within 2 days, and the most common successful methods were visual identification (52%) and fingerprints (31%). Dental (10%), x-ray (4%), and other methods (6%) were least commonly used. Of the 94 persons identified, all identifications occurred within 29 days. DNA procedures were not needed in most cases, and in the few cases where such tests were needed, results were either unavailable or failed to show a match with known samples. CONCLUSIONS: The majority of unidentified deceased individuals were identified within 2 days, with visual verification or fingerprints accounting for about 83% of methods successfully employed. The medical examiner noted a rate of 44 unidentified deceased persons per 1000 death reports, with an ultimate "cold case" (long-term unidentified) rate of about 2.6 cases per 1000 death reports. These data may be useful in developing office policy and procedure regarding the procedural and temporal aspects of investigations centered on achieving identification and making dispositions of unidentified deceased bodies.     

Context and the Economic Vote: A Multilevel Analysis

Randy Stevenson Department of Political Science, Rice University, P.O. Box 1892, Houston, Texas 77251–1892 e-mail: rduch{at}uh.edu (corresponding author) e-mail: stevenso{at}ruf.rice.edu Voters use observed economic performance to infer the competenceof incumbent politicians. These economic perceptions enter thevoter's utility calculations modified by a weight that is minimizedwhen the variance in exogenous shocks to the economy is verylarge relative to the variance in economic outcomes associatedwith the competence of politicians. Cross-national variationsin the political and economic context systematically increaseor undermine the voter's ability to ascertain the competencyof incumbents. We test one hypothesis: As policy-making responsibilityis shared more equally among parties, economic evaluations willbe more important in the vote decision. We employ two multilevelmodeling procedures for estimating the contextual variationsin micro-level economic voting effects: a conventional pooledapproach and a two-stage procedure. We compare the multivariateresults of a pooled method with our two-stage estimation procedureand conclude that they are similar. Our empirical efforts usedata from 163 national surveys from 18 countries over a 22-yearperiod.     

Reviews

Herbert J. Ellison, (ed.), Soviet Policy Toward Western Europe, Seattle and London: University of Washington Press. 1983. xvii + 322 pp. £25.00.

Edwina Moreton and Gerald Segal, (eds.), Soviet Strategy Toward Western Europe, London: George Allen & Unwin. 1984. 296 pp. £17.50.

Lawrence L. Whetten (ed.), The Present State of Communist Internationalism, Lexington & Toronto: Lexington Books, 1983, xi + 254 pp. £25.00.

Neil Harding (ed.), The State in Socialist Society, London: MacMillan, 1984, 316 pp. h/b £20.00. p/b £7.95.

Stephen White, John Gardner and George Schopflin, Communist Political Systems: an Introduction, Macmillan, 1982, viii + 293 pp. £15.00.

John Erickson, The Road to Berlin. Volume 2 of Stalin's War with Germany, London: Weidenfeld and Nicolson, 1983. xiii + 877 pp. £20.00.

John B. Dunlop, The Faces of Contemporary Russian Nationalism, Princeton, N.J.: Princeton University Press, 1983, 363 pp. £28.20.

Aryeh L. Unger, Constitutional Development in the USSR. A Guide to the Soviet Constitutions, London: Methuen, 1981. viii + 310 pp. £12.50.

Stefan Hedlund, Crisis in Soviet Agriculture, London and Sydney: Croom Helm and New York: St. Martin's Press, 1984, 228 pp. £17.95.

Vladimir Sobell, The Red Market: Industrial Co‐operation and Specialisation in Comecon, Gower Publishing Company, 1984, 265 pp. £16.50.

Raymond Hutchings, The Structural Origins of Soviet Industrial Expansion, London and Basingstoke, Macmillan: 1984, x + 242 pp. Index, £25.00.

Peter Blandon, Soviet Forest Industries, Boulder, Colorado: Westview Press. Distributed by Bowker Publishing Co., Erasmus House, Epping, Essex, UK 290 pp. £19.75.

Ronald Grigor Suny, Transcaucasia: Nationalism and Social Change. Essays in the history of Armenia, Azerbaijan, and Georgia, University of Michigan: Ann Arbor, 1983, 349 pp. + xiv.

Sidney Bloch and Peter Reddaway, Soviet Psychiatric Abuse: The Shadow over World Psychiatry, London: Victor Gollancz Ltd. 1984, 288 pp. £10.95.

Thomas T. Hammond, Red Flag Over Afghanistan. The Communist Coup, the Soviet Invasion, and the Consequences, Boulder, Colorado; Westview Press, 1984, xvii + 261 pp. £9.75 pb., £23.00 hb.

Martin Crouch and Robert Porter (eds.), Understanding Soviet Politics through Literature. A book of readings, London: George Allen and Unwin, 1984, xi + 211 pp. h/b £15.00. p/b £6.95.

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S. Brucan, The post‐Brezhnev era, New York: Praeger, 1983 126 pp. xiii + $21.95.     

The Rise of Linguistic Philosophy and Pragmatic Turn in Jurisprudence Research on Hart’s Jurisprudence Under Language Game

Linguistic turn from epistemology to linguistic philosophy constitutes the most important philosophy thinking foundation in 20th century western Jurisprudence. Under the background of this kind of theory current of thought H.L.A. Hart, the master of western Jurisprudence, succeeded in applying the theory of language game advocated by Wittgenstein into the research of Jurisprudence and caused the pragmatic turn of 20th century western Jurisprudence. Hart’s methodology is one of the most precious resources in Chinese Jurisprudence research, so our Jurisprudence research should learn and benefit from it.