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.     

DEVELOPMENTS IN THE PURCHASING PROCESS IN THE NHS: TOWARDS AN EXPLICIT POLITICS OF RATIONING?

The introduction of the internal market to the National Health Service in Britain marks a major change in the form of provision of health care interventions. This article reports the findings of independent research into the development of the purchasing process in eight purchasing authorities (which collectively purchase health care for 5 per cent of the population of Britain), and considers the extent to which this has led to an explicit politics of rationing in British health care. The structure and organization of purchasing organizations is described, along with their relationship with providers of health care. The ability of purchasing organizations to assess the health needs of the populations for which they purchase health care services, and their ability to influence change in the nature of the services provided, is also examined.     

Public Service Reform in Malta, 1988-95: Lessons to be Learned

Malta's latest round of administrative reform has produced mixed results. While it has achieved more than any previous initiative, vital elements of the reform program have not been carried out and results have fallen short of initial expectations.
The reform initiative yields a number of lessons, some of which have already been brought to light—the need to keep the reform agenda small, the need for sustained political backing—and others which are less well known, such as the difficulty of creating an effective authority to direct reform, and the drawbacks to giving reform agencies lavish funding and a high profile.     

STRUCTURAL AND SOCIAL PSYCHOLOGICAL CORRELATES OF PRlSONlZATlON

This study. based on an analysis of data obtained from a randomly selected sample of 239 inmates of a maximum security federal penetentiary, assesses the explanotory power and relative importance of variables related to prisonization in the previous literature. While support for hypotheses derived from the importation and deprivation models was found, our analysis. consistent with earlier research, reveals that the proportion of variance in prisonization which can be accounted for is not high. Still, our findings underline the necessity of moving toward an integration of existing theories of prisonization rother than attempting to view them as contradictory perspectives.     

JUDGING WITHOUT CONSENSUS: The Diplock Courts in Northern Ireland

This article examines nonjury trials for political/terrorist offenses in Northern Ireland. It traces the origins of the current troubles; the breakdown of the jury system; the work of the royal commission, chaired by Lord Justice Diplock; and the establishment of courts, known as Diplock Courts, in which a single judge tries cases using modified rules of evidence and lowered standards for the admission of confessions. Finally, the article evaluates the work of the Diplock Courts, and suggests their wider relevance to future policy-making. In doing so, it touches upon a fundamental role of governing through courts—the maintenance of the ability to govern, particularly in a society that has neither political nor judicial consensus.     

Newspaper Representation of the Debates in the 2007 Jamaican General Election Campaign

This article deconstructs the newspaper representations of three debates held in 2007 during the Jamaican General Election campaign. The theory of social representation is used in this article to explain political behaviour and outcomes. Representations are the images, words, symbols or phrases that are generated from people's dialogic interaction that signify meanings. Content analysis of relevant articles covering the electoral campaign in the main print media in Jamaica forms the empirical basis for study. The majority of representations of the three main debates were negative, revealing that political manifestos were largely ignored and policy funding was not addressed. Significant issues such as crime, education, health, garrison politics, corruption and unemployment were inadequately addressed, and the wider global context of these matters was ignored. The consensus was that the Jamaica Labour Party (JLP) won two of the three debates, notably the leadership debate in which the Leader of the Opposition, Bruce Golding MP, performed more effectively than the then current Prime Minister, Portia Simpson‐Miller of the People's National Party (PNP). Social representation theory is used to assess the types of political meanings generated by media coverage during the General Election. It is suggested that the perceived success of the JLP candidates in the main debates was an important contribution to the party's overall electoral victory.     

DRIVING WHILE BLACK: BIAS PROCESSES AND RACIAL DISPARITY IN POLICE STOPS*

We estimate the degree of racial disparity in police vehicular stops separately for local and state police in North Carolina in the year 2000. We introduce four mechanisms that might produce racial disparities in police stops—racial profiling, race sensitive police deployment, cognitive bias and stereotyping, and prejudice. We then model the relative odds of police vehicle stops as a function of race, driving behavior, and other demographic statuses separately by police organization type, with controls for omitted variable bias at both the driver and spatial level. We find only weak evidence of racial disparity in stops by officers of the state highway patrol but stronger evidence in those made by local police officers.