The judicial role in life-sustaining medical treatment decisions.

Although there has been speculation regarding the pervasiveness and nature of judicial decisions regarding life-sustaining medical treatment (LSMT), no attempt has been made to empirically assess their prevalence or the issues they address. An exploratory study utilizing a mail survey of a nationwide random sample (N = 905) of state trial court judges was conducted to provide initial information regarding this decision-making process. Twenty-two percent of the responding judges had heard at least one LSMT case, and judicial review did not appear endemic to particular states. The number of judges hearing LSMT cases dropped from 1975 to 1981 but has increased since then. Three major issues predominate: patient competency, appointment of a surrogate decisionmaker, and resolution of the ultimate issue of forgoing LSMT. Relatively few cases either contested a prior directive's validity or involved imposing sanctions for instituting or forgoing LSMT. Although subject to different interpretations, the results suggest the courts are having a significant impact on certain aspects of the LSMT decision-making process. However, the infrequency with which any one judge is called upon to make an LSMT decision causes concern about the judiciary's ability to respond in a timely and appropriate manner. With their potential for a profound effect on the actions of health care providers, greater attention to this decision-making process is warranted.     

The Australian Welfare State: Has Federalism Made a Difference?

This paper examines the historical development of the Australian welfare state with a view to identifying the role that Australia's federal constitutional arrangements have played in shaping that development. Theoretical paradigms have been unanimous in their prognoses: that federal states are likely to be slow in developing welfare state programmes and typically spend less on them than unitary states. But recently it has been argued that federal institutions may have a “ratchet effect” of slowing down the pace of change, irrespective of its direction. The purpose of this chronological account of significant stages in the development of the Australian welfare state is to use the unfolding of historical events — far too rich in nuance and detail to be captured in quantitative modelling — as a test‐bed for establishing whether, and, if so, to what extent, federalism has impacted on the trajectory of Australian welfare state development.     

Ethnicity, gender, and the Level of Service Inventory-Revised

Offender assessment and classification is becoming an increasingly important part of correctional supervision and intervention. Over the last several decades, several different methods and “generations” of offender classification have emerged. Of most value appear to be third-generation, actuarial, dynamic risk/need assessments. With any new correctional strategy, however, there is a need to investigate the use of these risk/need assessments on offender subgroups in order to inform issues, such as reliability and prevalence of criminogenic risk factors. The present study utilized data that were gathered using the Level of Service Inventory-Revised (LSI-R). Results and comparisons of these assessments were investigated and presented for Native American and non-Native American offenders as well as male and female offenders. Discussion of the results, implications, and recommendations for further research are presented.     

What Do Prosecutors Maximize? Evidence from the Careers of U.S. Attorneys

This study examines the performance of chief federal prosecutors(U.S. attorneys) and their subsequent careers. In a sample of570 attorneys in office from 1969 to 2000, the length of prisonsentences is positively related to subsequent favorable careeroutcomes for U.S. attorneys. In contrast, conviction rates donot appear to affect the careers of U.S. attorneys. These resultsare consistent with longer total prison sentences’ beingpersonally beneficial to prosecutors, and prosecutors’maximizing the length of prison sentences. Overall, the resultssuggest that sentence length, as opposed to convictions rates,is the relevant performance metric.     

Economic Interdependence and the Balance of Power

To account for variance in great powers responses to threats and the implications for the peacefulness of the international system since the late nineteenth century, this article elucidates a theory which refines and synthesizes economic liberal perspectives and realist balance of power theory. I argue that different patterns and levels of economic interdependence in the great power system generate societal-based economic constraints on, or incentives for, state leaders of status quo powers hoping to mobilize economic resources and political support to oppose perceived threats. This mobilization process influences strongly the preferences of status quo powers, other states beliefs about those preferences, and the interpretation of signals in balance of power politics. In this way, economic ties influence the strategies great powers pursue. Firm balancing policies conducive to peace in the international system are most likely, I then hypothesize, when there are extensive economic ties among status quo powers and few or no such links between them and perceived threatening powers. When economic interdependence is not significant between status quo powers or if status quo powers have strong economic links with threatening powers, weaker balancing postures and conciliatory policies by status quo powers, and aggression by aspiring revisionist powers, are more likely. I then illustrate how these hypotheses explain the development of the Franco-Russian alliance of the 1890s and its effectiveness as a deterrent of Germany up to 1905, British ambivalence toward Germany from 1906 to the First World War, the weakness of British, French, Soviet, and American behavior toward Germany in the 1930s and World War II, and the American and European responses to the Soviet threat, including the NATO alliance, and the "long peace" of the post-1945 era.     

Acidic and neutral drugs screen in blood with quantitation using microbore high-performance liquid chromatography–diode array detection and capillary gas chromatography–flame ionization detection

Blood previously acidified with aqueous saturated ammonium chloride solution was extracted with ethyl acetate. The dried extract was subjected to acetonitrile–hexane partition. The acetonitrile portion was analysed for the presence of acidic and neutral drugs by HPLC–DAD (200 mm×2.1 mm I.D. microbore ODS-Hypersil column) and GC–FID (25 m narrow-bore×0.25 mm I.D. HP-5 column with 0.33 μm film thickness). The protocol was found to be suitable for both clinical toxicology (including emergency toxicology) and postmortem toxicology. At least 66 drugs of interest were unequivocally identified by RRTs (HPLC) and UV spectra (DAD) match while another 12 were unequivocally identified by double RRTs match (HPLC and GC). Quantitation was facilitated by incorporating calibration blood standards in each assay batch. The five drugs most commonly encountered in clinical blood specimens (1150 cases) were: paracetamol (47.4% of the cases); chlormezanone (6.6%), theophylline (1.74%), naproxen (1.65%) and mefenamic acid (1.56%). The following drugs were detected in toxicologically significant quantities in postmortem blood specimens (245 cases): phenobarbitone (1.22% of the cases), naproxen (0.82%), chlormezanone (0.82%), theophylline (0.82%), carbamazepine (0.41%) and paracetamol (0.41%).