The most plausible pro-coercion view: requiring informed agreement while penalizing non-participation in research

In ‘(Why) should we require consent to research?’ Alan Wertheimer probes whether it is legitimate for the government to ‘coerce’ people into participating in biomedical research, including interventional biomedical research. In debating the rules that ought to govern participation in interventional biomedical research, we should distinguish two separate moral claims. First, interventional research should proceed only when the subject has given her informed agreement. Second, it is legitimate for the state to set a requirement that people participate in interventional biomedical research, and to penalize or punish those who refuse to participate. The most plausible ‘pro-coercion’ view accepts both of these claims. Though I stop short of endorsing this view, it captures important ‘pro-coercion’ and ‘anti-coercion’ intuitions.     

Can epidemiological studies assist in the evaluation of community treatment orders? — The experience of Western Australia and Nova Scotia

Epidemiological studies using administrative databases have several advantages over other methodologies in studying the effectiveness of compulsory community treatment such as community treatment orders (CTOs). We compared patients placed on CTOs in Western Australia with controls drawn from both within the jurisdiction and from another without this measure (Nova Scotia). Although in different countries, the mental health services in both jurisdictions share common characteristics. Notably, we were able to control for forensic history in our comparison within Western Australia. We analysed predictors of admission and number of bed-days using multiple, logistic or Cox regression as appropriate. Of the 274 subjects placed on a CTO, we were able to find controls for up to 96% (n = 265). CTO placement was not associated with reduced admissions or mean bed-days, although there was a threshold effect with a reduced risk of inpatient stays exceeding 100 days. Outpatient contacts were significantly greater for the CTO group. However, we do not know whether the intensity of treatment, or its compulsory nature, effected outcome.     

The Treatment Engagement Rating scale (TER) for forensic outpatient treatment: Description,psychometric properties,and norms

Abstract

The Treatment Engagement Rating scale (TER) is a Dutch therapist rating instrument for treatment engagement (TE) of forensic outpatients. It yields scores for nine components of TE, which are aggregated in a total score. Following an analysis of the concept of TE, the TER is described, and various psychometric analyses of data from a forensic outpatient sample are reported. The nine component scores were found to constitute a homogeneous scale with good internal consistency (α=0.93, n=328) and adequate inter-rater reliability (intraclass correlation coefficient (ICC)=0.76, n=99). The validity of the TER is supported by correlations of 0.47, 0.66, and 0.91 (n=328) with measures for the motivation to engage in treatment. Applications for the TER in clinical practice and research are suggested.     

The Psychopathological Profile of Cannibalism: A Review of Five Cases

In today's society, human cannibalism is extremely rare and represents an unthinkable act of violence. Scientific literature on the topic is sparse due to significant methodological problems, such as collecting enough data and generating unbiased analyses. The purpose of this article is to illustrate some psychodynamic aspects of cannibalism. After a review of the literature, we will present and compare five cannibalistic patients hospitalized in the Henri Colin secure unit (Villejuif, France). The patients described fall into two subgroups, suffering either from severe schizophrenia or from a mixed personality disorder with sadistic and psychopathic features associated with paraphilia. For the schizophrenia group, cannibalism is a self‐defense reaction to a perceived threat of destruction: survival depends on the annihilation or assimilation of the other. For the mixed personality disorder group, ego and narcissism are the central issue with a desire to overcome deep‐rooted frustrations by means of an extraordinary act.     

Unpredictable Behavior Under the Influence of “Magic Mushrooms”: A Case Report and Review of the Literature

Fatalities implicating psychedelic mushrooms are not a common clinical situation in everyday forensic medicine. Despite classification as an illegal drug in many countries, psilocybin mushrooms have the reputation of being safe. We report the case of a young man who jumped from a second story balcony under the influence of psilocybin mushrooms. The psilocin assay was performed by gas chromatography coupled to an electron‐impact ionization time‐of‐flight detector (GC‐EI‐TOF) after solid‐phase extraction. Total psilocin was quantified in peripheral and cardiac blood as 60 and 67 ng/mL, respectively, and in urine (2230 ng/mL), bile (3102 ng/mL), and vitreous humor (57 ng/mL). This case report and review of literature highlights the danger of psilocybin mushrooms. Isolated use of psilocybin mushrooms by a regular consumer without psychiatric history, even under “safe” circumstances, can lead to a fatal outcome.     

A method for calculating the strength of evidence associated with an earwitness's claimed recognition of a familiar speaker

The present paper proposes and demonstrates a method for assessing strength of evidence when an earwitness claims to recognize the voice of a speaker who is familiar to them. The method calculates a Bayes factor that answers the question: What is the probability that the earwitness would claim to recognize the offender as the suspect if the offender was the suspect versus what is the probability that the earwitness would claim to recognize the offender as the suspect if the offender was not the suspect but some other speaker from the relevant population? By “claim” we mean a claim made by a cooperative earwitness not a claim made by an earwitness who is intentionally deceptive. Relevant data are derived from naïve listeners' responses to recordings of familiar speakers presented in a speaker lineup. The method is demonstrated under recording conditions that broadly reflect those of a real case.     

Influence of acculturation strategies on the judgement and punishment of an offender of North African descent

Very few studies have examined the influence of the acculturation strategies of an offender of foreign descent on the way a third party judges the personality and action of that offender. The aim of our study was thus to measure the effect of three variables (Seriousness of the harm suffered by the victim; Type of acculturation strategy of the offender; Level of Social Dominance Orientation [SDO]) of the person making the judgement) on the judgements and decisions made by a sample of students faced with a situation of physical aggression committed by a man of North African descent living in France. After reading a scenario describing a criminal act committed by a man of North African descent, who had or had not adopted French culture, 168 French students completed a judgement scale concerning the criminal act and the offender and an SDO scale. The results show that the crime was perceived as less serious when the perpetrator had adopted French culture than when he had not. The perpetrator was also judged less severely. Participants with higher levels of SDO advocated harsher punishment and attributed the crime to the offender’s personality. We discuss these results and identify new avenues for research.     

Rapid screening for the detection and differentiation of γ-hydroxybutyrate using ion chromatography

The analysis of gamma-hydroxybutyric acid (GHB) is problematic because it is hygroscopic, it lacks a good UV chromophore, and it undergoes heat-induced cyclization. This paper presents a new method utilizing ion-exchange chromatography (IC) with conductivity detection. The simple sample preparation, rapid analysis time, and inorganic anion detection capabilities are all advantages over the current methods. The detection of inorganic salts (formed during GHB synthesis) gives insight into the synthetic route utilized and can aid in drug seizure comparison. The developed method has a detection limit for GHB anions of 0.57 mg/L and chloride of 0.22 mg/L. A comparison of this technique with a current gas chromatography-mass spectrometry technique is presented, and a t-test found that the two methods' results are not statistically different at the 99.9% confidence level demonstrating the merits of this fast, simple, and informative IC method as a routine screening tool.     

Cost Effectiveness and Target Group Influence in Norwegian Climate Policy

Cost effectiveness is a key principle of climate policies in industrialised countries, yet there are significant political barriers against its implementation. The Norwegian case demonstrates that differences in the climate policy instruments targeting different sectors cannot be explained by the sectors' relative significance in the national economy. Whereas the economically insignificant energy‐intensive industries (EIIs) successfully resisted mandatory greenhouse gas (GHG) regulations until 2008, the offshore petroleum industry (the most important sector for Norway's gross domestic product) has paid NOK 300 per tonne of CO₂ since 1991. What explains why some sectors successfully resist GHG regulations while others do not? This analysis indicates that a key determinant is interdependence between target groups and decision makers in winning coalitions. EIIs were capable of issuing relevant and credible threats to shut down and relocate if costly GHG policies were imposed. In contrast, decision makers did not perceive as credible the offshore petroleum industry's claim that a CO₂ tax would undermine its competitiveness. Moreover, when target groups can issue effective threats, private information becomes more relevant and reinforces decision makers' dependence on target group cooperation.     

Advising Ministers – The Special Problem of Defence

Successive Australian Defence Ministers have been frustrated and occasionally embarrassed by the quality of advice and information provided to them by the Defence organisation. Decades of reviews and reorganisations have failed to find solutions to the special difficulties that Defence faces in providing accurate, timely information and advice to ministers across the broad spectrum of their responsibilities. This article argues that there are multiple explanations for the concerns that are frequently expressed about its policy advisory capacity – most of which are inherent to Defence organisations around the world. While the Defence culture of secrecy is partly responsible, other factors such as the scale of Defence's operations, the multiple cultures that exist within it (military, civilian, and intelligence) that make coherence harder than in more homogenous departments, the long‐time horizons of defence planning as well as the high costs of procurement, must also be considered. The erosion of trust between the organisation and minister has been exacerbated by the intense scrutiny of the media that overburdens ministers and adds another layer of complexity to their role. As history shows, there are push and pull factors that continue to embroil ministers in the minutiae of defence difficulties, while the complexity and scale of operations will undoubtedly continue to impact on the timeliness of advice.