The judicial role in life-sustaining medical treatment decisions.

Although there has been speculation regarding the pervasiveness and nature of judicial decisions regarding life-sustaining medical treatment (LSMT), no attempt has been made to empirically assess their prevalence or the issues they address. An exploratory study utilizing a mail survey of a nationwide random sample (N = 905) of state trial court judges was conducted to provide initial information regarding this decision-making process. Twenty-two percent of the responding judges had heard at least one LSMT case, and judicial review did not appear endemic to particular states. The number of judges hearing LSMT cases dropped from 1975 to 1981 but has increased since then. Three major issues predominate: patient competency, appointment of a surrogate decisionmaker, and resolution of the ultimate issue of forgoing LSMT. Relatively few cases either contested a prior directive's validity or involved imposing sanctions for instituting or forgoing LSMT. Although subject to different interpretations, the results suggest the courts are having a significant impact on certain aspects of the LSMT decision-making process. However, the infrequency with which any one judge is called upon to make an LSMT decision causes concern about the judiciary's ability to respond in a timely and appropriate manner. With their potential for a profound effect on the actions of health care providers, greater attention to this decision-making process is warranted.     

Entry barriers and evolution of banking systems: Lessons from the 1980s Canadian western bank failures

Abstract: As federal policy‐makers revise and update the Bank Act, any change should be seen in the context of public policy towards financial institutions in Canada. Rather than being condemned to repeat history, both policy‐makers and potential bank entrepreneurs would be well advised to re‐examine the Report of the Inquiry into the Collapse of the ccb and Northland Bank (August 1986), chaired by the Honourable Willard Z. Estey. Public policy for financial institutions faces the challenge of reconciling competing interests. Since 1867, Canada has experienced a nationally controlled banking system that is highly stable (i.e., few bankruptcies) and that has enabled in‐flows of capital needed for national economic development. The Canadian Commercial Bank failure raised a fundamental challenge to the government's policy agenda. When asked what the government's position should be, the three officials recommended the rescue package. All three participants from the political side advised against it. Future policy must learn the lessons from this important and atypical moment in Canadian financial history. Sommaire: Alors que les decisionnaires federaux revoient et mettent à jour la Loi sur les banques, toute modification devrait être envisagée dans le contexte de la politique gouvernementale visant les institutions financières au Canada. Plutôt que d'être condamnés à répéter les mêmes erreurs, les décisionnaires et les banquiers potentiels feraient bien mieux de réexaminer le Rapport de la commission d'enquête sur la faillite de la Banque commerciale du Canada et la Norbanque (août 1986), présidée par l'honorable Willard Z. Estey. La politique gouvernementale concernant les institutions financières a la tâche difficile de réconcilier des intérêts opposés. Depuis 1867, le Canada connaît un système bancaire contrôléà l'échelle nationale qui est très stable, ayant enregistré peu de faillites, et qui a permis des rentrées de fonds nécessaires au développement économique national. La faillite de la BCC a lancé un défi fonda mental au programme de politique gouvernementale. Lorsqu'on leur a demandé quelle devrait être la position du gouvernement, les trois responsables ont recommandé le programme de renflouement. Les trois participants du secteur politique ont conseillé le contraire. Les futurs décisionnaires doivent tirer des leçons de cet évènement important et exceptionnel dans l'histoire financière canadienne.     

Determination of cocaine and benzoylecgonine in human amniotic fluid using high flow solid-phase extraction columns and HPLC.

A new solid-phase extraction procedure for the determination of cocaine and benzoylecgonine in amniotic fluid, using high flow co-polymeric sorbents is reported. The recoveries of cocaine and benzoylecgonine within the range 0.1-1 mg/l were 95.7% and 50.3%, respectively. The use of high-flow sorbents allowed the easy extraction of amniotic fluid regardless of sample viscosity or physical nature. The use of these solid-phase columns provided many advantages over the more commonly used solvent extraction, including an increase in extraction speed and efficiency, reduced operator time, reduced solvent use and disposal volumes and exceptional extract quality. Further, the determination of amniotic fluid obtained from pregnant cocaine users may provide important information about handling of cocaine by the fetus at various gestational ages. The procedure was successfully applied to amniotic fluid from suspected cocaine abusers.     

An improved method for complement subcomponent C1R typing

An improved method has been developed for the reliable classification of different C1R genetic variant forms from human serum or plasma. The method combines the use of neuraminidase-digested samples followed by monodimensional isoelectric focusing in the pH range 5 to 8 followed by immunoblotting. The method yields a simple pattern, with one major band in homozygote and two major bands in heterozygote cases.     

Civil procedure: Can the Scots learn from Woolf?

Conclusion So can the Scots learn from Woolf? The answer must be in the affirmative, for his review points up similar problems to those we encounter here. There is no room for complacency in the civil justice system in Scotland, particularly in the field of Information Technology, where court systems and expertise are sadly lacking. It is clear that there is a need for a system of case management in all civil courts, targeted in particular areas or on particular cases, but only after a rigorous reappraisal of court timetabling; and that the public will lose confidence in a civil justice system which does not meet their needs for speedy and affordable decisions, perhaps by turning their backs on it and seeking means of Alternative Dispute Resolution. As for written pleadings, perhaps the most that can be said is that the case for their complete abolition is “not proven”, but that thestatus quo should not be maintained is beyond reasonable doubt. Sheriff of Lothian and Borders at Edinburgh; Member, Sheriff Court Rules Council.     

A Test of Generalizability of the Social Development Model Across Gender and Income Groups with Longitudinal Data from the Elementary School Developmental Period

The social development model (SDM) is a theory of behavior that has proven useful in explaining the etiology of delinquency, violence, and substance use among adolescents as well as early antisocial behavior among pre-adolescents. A further test of the model is its generalizability across population groups. A section of the SDM representing prosocial influences in the etiology of problem behavior was compared for boys and girls and for children from low- and non low-income families using three waves of child, parent and teacher survey data on a sample of 851 elementary school students. Multiple group structural equation modeling was used to assess differences across groups in both measurement of model constructs and hypothesized structural paths between constructs. The results indicate overall similarity in the reliability of measurement models and validity of structural models.     

Inmates: Who occupies our jails?

The purpose of this investigation was to identify inmate personal and demographic data that may be used to further define or profile persons with a greater likelihood of being at risk for serving a jail sentence. This study was explorative. The survey administration was similar in format to that conducted by the U.S. Department of Justice. Chaplains were used as survey proctors. Pilot studies were conducted to determine the suitability of survey content. Surveys consisted of 172 items. Subjects included four hundred inmates: males comprised 88.75 percent of the sample, Caucasians 58.25 percent, Blacks 37 percent, Hispanics 3.25 percent and other 1.5 percent of the sample. Respondents ranged in age from 15 to 64 years with an average age of 30.3 years. Less than two percent of the contacted inmates refused participation in the survey. Results are presented for demographic data, select legal/criminal data, select drug and alcohol use data, employment data, health, parent/family data, education data, social data, and “other”.     

School crime policy changes: The impact of recent highly-publicized school crimes

Highly-publicized school shootings have heightened concern over school safety. This study examines the impact of school crimes on campus policy. The administrators of 336 Texas middle and high schools were surveyed. Policy changes were related to parental complaints about school crime policies and administrator perceptions that students felt less safe. School administrators should base safety policies on strategies that have been evaluated for their effectiveness in reducing school crime and fear. The authors wish to thank the anonymous reviewers for their helpful comments.