Contributory and Incidental Blood Concentrations in Deaths Involving Citalopram

All cases presenting to the New South Wales Department of Forensic Medicine between January 1, 2001 and December 31, 2010 in which citalopram was detected were retrieved. A total of 348 cases were identified. Citalopram contributed to death in 21.0%, and was incidental in 79.0%. Cases in which citalopram was contributory to death had significantly higher blood citalopram concentrations than incidental cases (0.50 mg/L vs. 0.30 mg/L). Citalopram concentrations varied significantly by contributory status: sole citalopram toxicity (median = 1.30 mg/L), citalopram/other drug toxicity (0.50 mg/L), and incidental cases (0.30 mg/L). Citalopram concentrations also varied by suicide status, with the highest concentration found in suicides where citalopram contributed to death (0.70 mg/L) compared with 0.50 mg/L for nonsuicide cases where citalopram contributed to death. In almost all contributory cases (69/73), other psychoactive substances were also detected, most commonly benzodiazepines (47.9%), alcohol (45.2%), and opioids (40.1%).     

Sudden or Unnatural Deaths Involving Anabolic‐androgenic Steroids

Anabolic‐androgenic steroids (AASs) are frequently misused. To determine causes of death, characteristics, toxicology, and pathology of AAS positive cases, all cases (n = 24) presenting to the New South Wales Department of Forensic Medicine (1995–2012) were retrieved. All were male, and the mean age was 31.7 years. Deaths were mainly due to accidental drug toxicity (62.5%), then suicide (16.7%) and homicide (12.5%). Abnormal testosterone/epitestosterone ratios were reported in 62.5%, followed by metabolites of nandrolone (58.3%), stanozolol (33.3%), and methandienone (20.8%). In 23 of 24 cases, substances other than steroids were detected, most commonly psychostimulants (66.7%). In nearly half, testicular atrophy was noted, as was testicular fibrosis and arrested spermatogenesis. Left ventricular hypertrophy was noted in 30.4%, and moderate to severe narrowing of the coronary arteries in 26.1%. To summarize, the typical case was a male polydrug user aged in their thirties, with death due to drug toxicity. Extensive cardiovascular disease was particularly notable.     

Psychological Assessment of Symptom and Performance Validity,Response Bias,and Malingering: Official Position of the Association for Scientific Advancement in Psychological Injury and Law

Evidence-based forensic psychological opinions require thorough and accurate information about examinees. Psychometric instruments can facilitate diagnostic decision making, but they rely on examinees to respond honestly to questions and put forth good effort on cognitive tests. Given the strong incentives for examinees in psychological injury cases to minimize prior problems and emphasize postaccident or posttrauma problems, the assessment of validity as part of forensic psychological evaluations is essential. Best practices in forensic psychology have their foundation in ethical principles. The purpose of this position statement is to promote ethical psychological practice in legal contexts by reviewing validity assessment issues and their ethical foundations. Because no previously published document focused specifically on symptom and performance validity assessment in psychological injury evaluations performed in forensic contexts, such a position statement provided by a professional organization devoted to the interface of psychological injury and law was needed to inform and guide practitioners and to educate other interested parties. The position statement emphasizes (a) the need for ethical practice in assessing validity, (b) consideration of factors such as culture and functional limitations, and (c) the importance of adopting a comprehensive, impartial, and scientific approach to validity assessment. The position statement acknowledges areas of differing opinions and the need for further research.     

The Politics of Inclusive Agreements: towards a Critical Discourse Theory of Democracy

This article offers a critical assessment of Jürgen Habermas's discourse theory of democracy. It suggests that the main thrust of a discursive account of legitimacy is the attempt to show how the demands of maximal democratic inclusion might be reconciled with a politics of reasoned agreements. While this aim is endorsed, the thrust of the argument is that a critical theory of democracy requires that normative frameworks that bring certain substantive features of democratic life into focus should supplement Habermas's procedural approach. First, the account of maximal inclusion has to be developed in a way that clarifies the egalitarian demands of distributive justice. Secondly, the account of a politics of reasoned agreements has to be connected to a theoretical analysis of the bonds of solidarity that could underpin such a form of political engagement. These developments contribute to a critical theory that gives a more adequate account of the motivational basis of discursive democracy.