Antemortem chemical hypothyroxinemia

Based on reports of hypothyroidism in intensive care unit patients, a preliminary study was instituted in which 40 patients coming to autopsy, with no history of thyroid disease, were studied to include gross and microscopic study of the thyroid gland and the performance of thyroid function tests on all serum specimens submitted within seven days of death. Initial studies show that with the exception of sudden cardiac death, all of the autopsy patients showed evidence of chemical hypothyroxinemia within three days preceding death without any histologic abnormalities of the thyroid gland. Thyroid function tests were subsequently studied of decedents and survivor controls matched for age, sex, disease, and stage of disease if applicable. The findings were similar.     

When complex facts threaten court reviews: Litigation over navigation projects

The capacity of the U.S. courts to provide effective review of cases involving complex scientific and economic analysis is declining. Rational action in such cases requires three things: a general rule by which to judge the appropriateness of actual or proposed actions; a set of facts sufficient for determining the consistency of the action with the general rule; and an independent review institution with power to enforce actions under the rule. Where the issues are complex, however, government agencies increasingly have tended to cloak their decisions in needlessly technical formulations and to buttress their presentations in masses of impenetrable data. Courts tend to avoid involvement in the complexities, resting instead on a presumption that government reports are accurate and government actions appropriate; this is a tendency we label “judicial math block.” Two cases taken from the complex area of public navigation investment illustrate the problem.     

The bird in hand: A feasible strategy for gun control

Policy analysis has failed to guide gun control policy away from its current impasse because analysts have avoided facing several crucially important features of the current reality: the existence of some widely held values in the United States public that favor the possession of guns; the limitations on the ability of public agencies in the United States to enforce restraints on the possession of handguns; and the implications of the fact that so many guns are already in the hands of the public. These factors greatly reduce the possibility that effective measures will be introduced to reduce the existing supply of guns. Some effective measures of gun control may be possible nonetheless, mainly through the mobilization of large metropolitan police forces.