The Effects of Medical Accidents and Litigation on Doctors and Patients*

Medical accidents and litigation can have a profound and long lasting effect on both doctors and patients. Research has shown that for doctors, working in a profession which is intrinsically stressful, the added stress of litigation and accidents is leading to considerable strain and sometimes to maladaptive and inappropriate behaviors on the part of some doctors. For many it is leading to the practice of defensive medicine. For patients the picture is not better. Some are left with no clear idea of what has happened or why they have been injured by their medical treatment. Many are left needing further remedial treatment and for some the psychological effects are akin to those suffered by victims of major disasters. In this paper we have looked at these issues and have put forward proposals to suggest how things can be improved for both doctors and patients.     

THE SOCIAL DETERMINANTS OF GUN OWNERSHIP: SELF-PROTECTION IN AN URBAN ENVIRONMENT*

Based on a survey of 539 residents of Cincinnati, this study assesses various explanations of gun ownership. The analysis reveals that gender and childhood socialization into a gun culture are significantly related to protective and general (or “sport”) firearm possession. In contrast, only protective gun ownership appears to be linked to crime-related factors. Conservative crime ideology and concern about the relative level of crime in one's neighborhood increase armament for defensive purposes, while informal collective security—the belief that neighbors will provide assistance against criminal victimization—reduces protective gun ownership.     

PARENTAL EFFICACY AND DELINQUENT BEHAVIOR: DO CONTROL AND SUPPORT MATTER?

Recently, the concept of "collective efficacy" has been advanced to understand how communities exert control and provide support to reduce crime. In a similar way, we use the concept of "parental efficacy" to highlight the crime reducing effects associated with parents who support and control their youth. Using data from the National Longitudinal Survey of Youth (NLSY), we examine the inter-relationship between parental controls and supports and their joint influence on youthful misbehavior. The results show that (1) support and control are intertwined, and (2) that parental efficacy exerts substantive effects on adolescent delinquency for the sample as a whole and across varying age groups.