Forensic psychiatry and malpractice

This paper concerning the last 87 malpractice cases referred to the Department of Psychiatry and Law, Menninger Clinic, includes 57 suits against mental health practitioners and/or institutions, and 30 nonpsychiatric suits against general hospitals, surgeons, obstetricians, etc. A patient was available for interview in only 12 percent of the psychiatric cases; in 88 percent we reviewed medical records and consulted with attorneys. In the psychiatric cases the crucial question was whether a generally accepted standard of care was breached. The inherent problems of applying appropriate criteria to standards of care by practitioners and institutions are discussed. In half the psychiatric cases we found no significant deviation from acceptable clinical performance; in half we concluded that negligent practice had occurred. We did see a litigant for evaluation in 90 percent of the nonpsychiatric cases. The main issue involving them concerned harm or disability related to presumed negligence by medical personnel. How we evaluate such cases and apply disability criteria is discussed.     

胸外按摩致肋骨骨折法医病理学分析

目的　探讨胸外按摩致肋骨骨折特点。　方法　对 1990～ 2 0 0 0年间华西医科大学法医学院所做 30例胸外按摩致肋骨骨折的尸检进行法医病理统计分析。　结果　肋骨骨折男性 2 8,女性 2例 ,年龄为 18～ 6 8岁 ,胸外按摩骨折主要发生在疾病、电击伤、溺死及中毒病例 ,以第 6～ 9肋骨的腋前、中线骨折常见 ,多为左侧。　结论　胸外按摩与外伤所致肋骨骨折具有明显的区别。     

Effects of positional restraint on oxygen saturation and heart rate following exercise

This report assesses the effects on peripheral oxygen saturation and heart rate that positional restraint induces when a person is prone, handcuffed, and "hog-tied." Peripheral oxygen saturation and heart rate were monitored at rest, during exercise, and during recovery from exercise for 10 adult subjects. The effects of positional restraint produced a mean recovery time that was significantly prolonged. Consequently, the physiological effects produced by positional restraint should be recognized in deaths where such measures are used.     

Garcia and the Political Safeguards of Federalism: Is There a Better Solution to the Conundrum of the Tenth Amendment?

In Garcia v. San Antonio Metropolitan Transit Authority (1985),Justice Harry Blackmun held that the Tenth Amendment does notprevent the Congress from subjecting state and local governmentsto the provisions of the Fair Labor Standards Act, concludingthat the "political safeguards offederalism" are generally adequateto protect state interests on the national scene. This articleexamines the intellectual foundations of the "political safeguardsof federalism" and finds them inadequate. It then surveys thepost-Garcia scholarship to ascertain whether an alternativetheory of the Tenth Amendment has emerged. Concluding that ithas not, the author suggests the need for afresh approach inview of the hints contained in Justice Sandra Day O'Connor'sopinion in Gregory v. Ashcroft (1991) that five justices maybe ready to reexamine the central thesis of Garcia.     

Impersonal influence: Effects of representations of public opinion on political attitudes

Many phenomena of interest to political scientists involve what may be termed impersonal influence; that is, influence that derives from individuals' perceptions of others' attitudes, beliefs, or experiences. Others in this case refers not to the close friends and acquaintances that concerned the authors of classics such asThe People's Choice andPersonal Influence, but rather to the anonymous others outside an individual's realm of personal contacts. Modern mass media facilitate the influence of anonymous others by devoting considerable time and attention to portraying trends in mass opinion. This study explores the rationale for theories of impersonal influence, synthesizing existing research findings falling under this general theoretical framework, and investigating its psychological underpinnings using experiments embedded in representative surveys.