Ethical, professional and legal regulation of medical practice

Moral or ethical codes of practice represent one of the oldest forms of medical regulation. Legislation such as the Medical Practice Act 1992 (NSW) enables regulatory bodies to create codes of practice for medical practitioners. Such codes can become an important aspect of disciplinary proceedings by providing the yardstick against which practitioners' conduct is evaluated. An important aspect of the New South Wales Board's Code of Professional Conduct 2005 is the obligation for doctors to report adverse events which reflect on the performance or conduct of colleagues. This is part of an increasing impetus to report adverse events in the interest of public safety. In the long- term this is a constructive development as it is likely to lead to improvements in identification of risks and hazards and thereby to result in better service provision and community health.     

The Introduction of Voter Registration and Its Effect on Turnout

David M. Konisky Department of Political Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Room E53-386, Cambridge, MA 02139 e-mail: sda{at}mit.edu e-mail: konisky{at}mit.edu (corresponding author) Studies of voter turnout across states find that those withmore facilitative registration laws have higher turnout rates.Eliminating registration barriers altogether is estimated toraise voter participation rates by up to 10%. This article presentspanel estimates of the effects of introducing registration thatexploits changes in registration laws and turnout within states.New York and Ohio imposed registration requirements on all oftheir counties in 1965 and 1977, respectively. We find thatthe introduction of registration to counties that did not previouslyrequire registration decreased participation over the long termby three to five percentage points. Though significant, thisis lower than estimates of the effects of registration fromcross-sectional studies and suggests that expectations aboutthe effects of registration reforms on turnout may be overstated.     

Fatal dog maulings associated with infant swings

We present three cases of fatal dog maulings of infants placed in mobile infant swings, a phenomenon not previously described in the literature. In each case, the victim was left in a mobile swing, unsupervised by an adult, and the attacking dog was a family pet. Case 1 involved an 18-day-old male infant attacked by a pit bull; Case 2 involved a 3-month-old male infant attacked by a Chow Chow and/or a Dachshund, and Case 3 involved an 18-day-old female infant attacked by a Labrador-pit bull mix. These cases not only underscore the importance of not leaving young children unattended in the presence of pet dogs, but also raise the possibility that mobile swings may trigger a predatory response in dogs and thus may represent an additional risk factor for dog attack.     

Fatal bromethalin poisoning

Bromethalin is a neurotoxin found in some rodenticides. A delusional 21-year-old male presented to a hospital with altered mental status the day after ingesting a bromethalin-based rodenticide. He died 7 days after his self-reported exposure to c. 17 mg bromethalin (equivalent to 0.33 mg bromethalin/kg). His clinicopathologic course was characterized by altered mental status, obtundation, increased cerebrospinal fluid pressure, cerebral edema, death, and diffuse histologic vacuolization of the white matter in the central nervous system seen on microscopic examination at autopsy. The presence of a demethylated form of bromethalin in the patient's liver and brain was confirmed by gas chromatography with mass spectrometry. Clinical signs and lesions observed in this patient are similar to those seen in animals poisoned with bromethalin. This case illustrates the potential for bromethalin ingestion to result in fatal human poisoning.     

A qualitative analysis of the use of community treatment orders in Saskatchewan

This study examined the opinions of patients who have been placed on a community treatment order (CTO), their relatives, mental health clinicians and representatives of community agencies about the use of CTOs in Saskatchewan. Patients were assessed using indepth interviews, while their relatives, mental health professionals and representatives of community agencies took part in facilitated focus groups. Patients had contradictory feelings about CTOs. Most experienced some degree of coercion while on the orders but many believed that CTOs provided necessary structure in their lives. Clinicians were more consistently positive but recognized the difficult choices in balancing the subject's right to self-determination with the benefits of a treatment order. Family members viewed CTOs as necessary to control a chaotic situation caused by the subject's limited insight.     

Prisoners’ Positive Illusions of Their Post-Release Success

Prisoners' forecasts of post-release success may have implications for how they respond to imprisonment, release, and parole decisions. We examined sentenced US and UK prisoners' forecasts of recidivism, and how well UK prisoners believed they would fare compared to the average other prisoner. In both samples, forecasts of recidivism were unrealistically optimistic when compared to official statistics on recidivism. UK prisoners also demonstrated a self-enhancement bias by forecasting that they were less likely to re-offend than other prisoners. Prisoners' forecasts of recidivism were predicted by only a few of the pre-prison, in-prison, and post-prison factors that have been shown to be associated with actual recidivism. We discuss the implications of these findings and propose avenues for future research.