Legislative and educational alternatives to a judicial remedy for the transfer trauma dilemma

Transfer trauma is alleged to be an increase in morbidity and mortality in institutionally relocated chronically ill elderly. Efforts by the legal profession to persuade courts that transfer trauma should be a legally recognized phenomenon invoking judicial protections against transfer (the "transfer trauma argument") have been unproductive. In O'Bannon v. Town Court Nursing Center, Inc., the United States Supreme Court denied standing to elderly persons claiming a property interest in remaining in alleged substandard facilities. The Court rejected the argument that the possibility of transfer trauma constituted a deprivation of life or liberty that would have required due process protections of notice and hearing. Despite the Court's preclusion of transfer trauma litigation in a constitutional context and the general unwillingness of lower courts to recognize the phenomenon, attorneys continue to burden the judicial system with frivolous transfer trauma arguments. The unfruitful pursuit of a judicial remedy for the ethical and social problems that arise with relocation of the elderly continues, in part, because of a misguided belief that this distressing social phenomenon is best remedied by the courts. Judicial unwillingness to recognize the transfer trauma argument, however, does not preclude legislative consideration of the humanitarian issues concerning the institutional relocation of elderly persons. This Article examines gerontological research in order to understand the judicial rejection of the transfer trauma argument and argues in support of legislative and educational solutions for the ethical and social problems attending transfer.     

Characteristics of adolescent incest sexual perpetrators: Preliminary findings

Adolescent incest sexual perpetrators seen at an out-patient clinic were interviewed regarding demographic characteristics and occurrence of deviant and nondeviant sexual behaviors. Results indicate that subjects (1) committed more sexual crimes than they had been arrested for, (2) reported a very early onset of sexual behavior, (3) had additional DSM-III psychiatric disorders, and (4) reported previous sexual victimization. Recommendations for future research are made.     

Therapists' obligations to report their patients' criminal acts

The law governing the obligation of therapists to report their patients' previous criminal acts was reviewed. Most often, discussions of this subject fall under the general category of "misprison of a felony," that is, the presumed general obligation of all citizens to report felonies that come to their attention. Review of federal law revealed that the courts have consistently interpreted the federal misprision statute as requiring active concealment of a crime, not a mere failure to report, in order to convict for the offense. State law is more diverse. Only one state has a general misprison statute labeled as such, and several states have recently repealed such statutes. The strong trend in states without statutes is to reject misprison as a common law crime, because of its incompatibility with modern notions of justice. Most states, however, have limited reporting statutes, such as for child abuse or gunshot wounds, that impose similar obligations. Therapists' reporting of past crimes may be affected by clinical and ethical concerns, as well as by obligations to protect future victims. In almost all jurisdictions, however, the fear of prosecution for failure to report a past crime should not be a factor in deciding on a course of action.     

An unusual shotgun injury pattern produced by an intermediate target

Discharge of a shotgun with a shotgun casing in its muzzle as a "dust cover" produced a pattern of injuries suggestive of combined intermediate- and distant-range wounds.     

The "empty heart" sign

Approximately 15% of victims of instantly lethal central nervous system trauma have an empty or nearly empty heart at autopsy. This article defines and discusses the "empty heart" sign.     

The writings of Sir Bernard Spilsbury: Part I

This is a two-part historical feature, highlighting the rare writings of Sir Bernard Spilsbury, the recognized leader of British forensic medicine in the first half of the 20th century. Parts I and II were compiled from the publications of the Medicolegal Society of Great Britain, where Sir Bernard Spilsbury served as President in 1933. Although his profile was presented previously in this Journal (vol. 2, no. 2, 179-182, 1981), it is felt that much of Sir Bernard Spilsbury's personality comes out in his writings and recordings of his speeches in the Medicolegal Society publications. Part I includes his lecture on "The Medico-Legal Significance of Bruises," presented before the Medicolegal Society in 1938; and a short case report read before the Medicolegal Society in 1924. The subject of the case report was sudden death from inhibition. Part II will contain two papers from the Medicolegal Society publications.