Euthanasia: a challenge for the forensic toxicologist

People die daily in the hospital. Mostly, they die because their illnesses were no longer treatable (natural death). Unfortunately, some people die an unnatural death, in particular, as the result of euthanasia. In contrast to the situation in most countries, in the Netherlands euthanasia is accepted by the courts under strict conditions. It can be very difficult for the legal authorities to establish whether a person has died from natural causes or from suicide, euthanasia, or murder. In addition to the pathologist and the lawyer, the toxicologist also has a number of problems in showing whether euthanasia has been carried out. These can consist of the following analytical problems: (a) interactions--the patients involved have frequently been receiving a large number of toxic and nontoxic drugs simultaneously; (b) identification--not all drugs administered are included in general screening procedures; (c) metabolites--a large number of metabolites may have accumulated toward the end of a long therapeutic regimen; and (d) determination--determination of quaternary muscle relaxants and their various metabolites, as well as other drugs, can be problematic. There are also toxicokinetic problems; because of poor kidney and liver function, low serum albumen, general malaise, and interactions between these factors and other drugs, the kinetics of a given drug can differ from normal. This makes it all the more difficult to determine whether the patient died from an accumulation of medication or from a so-called "euthanetic" drug mixture.(ABSTRACT TRUNCATED AT 250 WORDS)     

How medicine mistreats the elderly

Hamstrung by biases and limited facts, doctors routinely deliver shoddy care to old people. This guide shows how to reject that medical mindset and stay healthy longer.     

From fiddle factors to networks of collusion: Charting the waters of small business crime

Small business crime has been largely ignored in American criminology; studies of nontraditional crime have focused mainly on corporate crime or on the misdeeds of employees pursuing personal gain. This paper calls for criminologists to redirect their efforts toward the systematic study of small business crime. In particular, it advocates in-depth qualitative studies that explore small business culture and opportunity structures, and that examine the networks of collusion that subvert the legitimate economy. The paper concludes with illustrations from an own story currently being shared with the author by a small businessman who participated for five years in an urban crime network that infiltrated the redistributive economy.     

Doctors under the knife

With Bill Clinton's new reforms only a month away, the health-care system is on the operating table--and the doctors are under the knife. Americans have a love-hate relationship with physicians: they like the care that doctors provide but hold them to blame for the nation's health-care mess. NEWSWEEK looks at how the culture of medicine may change, assesses doctors' fears--and examines the brave new world of HMOs.     

Reviews

Orlando Figes, A People's Tragedy: The Russian Revolution 1891–1924. London: Jonathan Cape, 1996, xx + 923 pp., £25.00

Hafeez Malik (ed.), The Roles of the United States, Russia and China in the New World Order. Basingstoke: Macmillan, 1997, xvi + 333 pp., £47.50.

Leszek Buszynski, Russian Foreign Policy after the Cold War. Westport and London: Praeger, 1996, xiv + 243 pp., £46.95.

Mette Skak, From Empire to Anarchy: Postcommunist Foreign Policy and International Relations. London: C. Hurst & Company, 1996, x + 340 pp., £35.00 h/b, £14.95 p/b.

Hans von Zon, The Future of Industry in Central and Eastern Europe. Aldershot: Avebury, 1996, x + 164 pp., £35.00.

Bartlomiej Kaminski (ed.), Economic Transition in Russia and the New States of Eurasia. Armonk, New York: M.E. Sharpe, 1996, xviii + 430 pp.

Ben Fowkes, The Disintegration of the Soviet Union: A Study in the Rise and Triumph of Nationalism. Basingstoke: Macmillan, 1997, xii + 273 pp., £40.00

Juan J. Linz & Alfred Stepan, Problems of Democratic Transition and Consolidation. Southern Europe, South America, and Post‐Communist Europe. London: The Johns Hopkins University Press, 1996, xx + 479 pp., £15.50.

David Lane, The Rise and Fall of State Socialism. Cambridge: Polity Press, 1996, 233 pp., £12.95.

Reneo Lukic & Allen Lynch, Europe from the Balkans to the Urals: The Disintegration of Yugoslavia and the Soviet Union. Oxford: Oxford University Press, 1996, xvii + 436 pp.

Thomas Cushman & Stjepan G. Mestrovic (eds), This Time We Knew: Western Responses to Genocide in Bosnia. New York: New York University Press, 1996, ix + 412 pp., $50.00 h/b, $18.95 p/b.

Derek Hall & Darrick Danta (eds), Reconstructing the Balkans. A Geography of the New Southeast Europe. Chichester: John Wiley & Sons, 1996, xx + 260 pp., £45.00.

Ajay Patnaik. Central Asia. Between Modernity and Tradition. New Delhi: Konark Publishers, 1996, viii + 238 pp.

Rudolf L. Tokes, Hungary's Negotiated Revolution: Economic Reform, Social Change and Political Succession, 1957–1990. Cambridge: Cambridge University Press, 1996, xxiii + 544 pp., £19.95.

John D. H. Downing, Internationalizing Media Theory, Transition, Power, Culture, Reflections on Media in Russia, Poland and Hungary 1980–95. London: Sage, 1996, xviii + 269 pp., £45.00 h/b, £13.95 p/b.

Rogers Brubaker, Nationalism Reframed: Nationhood and the National Question in the New Europe. Cambridge: Cambridge University Press, 1996, xi + 202 pp., £35.00 h/b, £12.95 p/b.

Donald P. Steury (ed.), Intentions and Capabilities: Estimates on Soviet Strategic Forces, 1950–1983. Washington DC: Center for the Study of Intelligence, 1996, xxii + 504 pp.

R. W. Davies, Crisis and Progress in the Soviet Economy, 1931–1933. Basingstoke: Macmillan, 1996, xviii + 612 pp., £65.00.

William Chase, Jeffrey Burds, S. V. Praslova, A. K. Sokolov & E. A. Tiurina (eds), Russian Stale Archive of the Economy: A Research Guide: I. Guide to Collections. Moscow: Blagovest, 1994, xx + 679 pp.

V. P. Butt, A. B. Murphy, N. A. Myshov & G. R. Swain (eds), The Russian Civil War. Documents from the Soviet Archives. London: Macmillan, 1996, xvii + 217 pp., £15.99.

Ilya Somin, Stillborn Crusade: The Tragic Failure of Western Intervention in the Russian Civil War, 1918–1920. New Brunswick, NJ: Transaction Publishers, 1996, ix + 236 pp., £21.95, $32.99.

David R. Shearer, Industry, State, and Society in Stalin's Russia, 1926–1934. Ithaca: Cornell University Press, 1996, xiv + 263 pp., £33.50 h/b, £14.95 p/b.

Peter H. Solomon Jr., Soviet Criminal Justice under Stalin. Cambridge: Cambridge University Press, 1997, xvii + 494 pp., £55.00 h/b, £19.95 p/b.

Richard G. Hovannisian, The Republic of Armenia, Volume III, From London to Sèvres, February‐August 1920, xx + 534 pp., and Volume IV, Between Crescent and Sickle: Partition and Sovietization, xii + 496 pp. Berkeley, University of California Press, 1996. £35.00 each volume.

Ian D. Thatcher & James D. White (eds), Journal of Trotsky Studies. Glasgow: Institute of Russian & East European Studies, 1993–1996, Nos. 1–4, £10.00 (Institutions), £5.00 (Individuals).

Mikhail Baitalsky, Notebooks for the Grandchildren. Recollections of a Trotskyist Who Survived the Stalin Terror, Edited and translated by Marilyn Vogt‐Downey. Atlantic Highlands, New Jersey, 1996, xviii + 447 pp.

Leopoldina Plut‐Pregelj & Carole Rogel, Historical Dictionary of Slovenia. London: The Scarecrow Press, Inc, 1996, xxvii + 345 pp., £63.65.