Analysis of cocaine-positive fatalities

A review of all autopsy and toxicology reports for persons dying in New York City in an 11-month period found 935 persons dying with cocaine in their bodies. Cocaine-positive fatalities were more likely in the young black and Hispanic and male population. In addition to cocaine and its metabolites, heroin and other opiates were found in 39% of persons and ethanol in 33% and barbiturates and minor tranquilizers in only 2% of the deceased. Cocaine overdose was responsible for 4% of the deaths and overdose with heroin and cocaine for 12% of the deaths. Violence was often the cause of death. Thirty-eight percent died of homicide, seven percent of suicide, and eight percent from accidents. Of particular interest were 6 persons who died of acute cardiac events directly related to cocaine as well as 4 cases of ruptured dissections of the ascending aorta, and 9 cases of cerebral hemorrhage. Autopsy findings for these individuals are described, and possible mechanisms of death are discussed.     

A proposed exception to the AIDS confidentiality laws for psychiatric patients

The authors offer psychotherapists a proposed exception to strict acquired immune deficiency syndrome (AIDS)-related confidentiality laws. The proposal is based on previously established exceptions to the psychotherapist-patient privilege. The recommended breach of confidentiality applies only to cases that meet all of the following criteria: (1) A patient knows that he or she has a human immunodeficiency virus (HIV) positive blood test and has been informed of AIDS-related safety precautions, (2) the HIV-positive patient has a mental disorder, and (3) it is reasonable to believe that the mental disorder has significantly impaired or may significantly impair the patient's ability and behavior to follow AIDS-related safety precautions.     

Moral Reasoning in the Context of Reform: A Study of Russian Officials

This article reports on an exploratory study of ethical reasoning among public administrators in Russia. Survey interviews and focus group follow-ups with civil servants participating in graduate training programs at the Russian Academy of Public Service provide information about their preferred mode of ethical reasoning; the demographic, attitudinal, organizational, and professional factors associated with that reasoning; and the behavioral choices implied. Using a sample of 113 public officials who represent a broad spectrum of regions in Russia, this study assesses moral reasoning, examines variables associated with alternative models, and compares these responses with findings from studies conducted in Poland and the United States. Based on this exploratory study, we suggest implications for theory, research, and practice.     

Quantitative determinations of Hp, Pi, Tf and GC in stored blood stains

Quantitative analysis of serum proteins in blood stains by rocket immunoelectrophoresis showed the following results: Long elution times in processing blood stains do not produce a significantly higher yield of serum proteins in stains, and they increase the risk of structural alteration of protein molecules. The amount of proteins detected decreases with increasing age of blood stains. Some proteins are already altered in stains after a short storage time and are no longer useful for phenotyping. Our results confirm that blood stain material should be processed as soon as possible.     

1998 NATIONWIDE SURVEY OF THE LEGAL STATUS OF PARENT EDUCATION

This article reports the findings of a legislative survey conducted to determine the legal status of parent education in the United States. Specifically, this survey reveals that since 1994. the number of states that enacted legislation authorizing or mandating attendance at parent education programs has more than quadrupled. The article features a state-by-state analysis of the various legal models currently in effect, including the source of authority, attendence model, and legal circumstances giving rise to participation. A capsule summary describing specific characteristics of the governing law of each state is also provided for reference.     

Evolution of the Psychological Autopsy: Fifty Years of Experience at the Los Angeles County Chief Medical Examiner‐Coroner's Office

The origin of the psychological autopsy was in the late 1950s and the result of a collaboration between the Los Angeles County Chief Medical Examiner‐Coroner's Office and the Los Angeles Suicide Prevention Center. It was conceptualized as a thorough retrospective analysis of the decedent's state of mind and intention at the time of death. It was used initially in “equivocal” deaths where the manner of death was possibly either suicide or accident. Later, it was used in cases where a party (primarily family members) protested the Medical Examiner‐Coroner's suicide determination. Over the past 25 years, the University of Southern California Institute of Psychiatry, Law, and Behavioral Science has served as the psychiatric/psychological consultants to the Coroner's Department. Research findings, the use of this approach in high‐profile cases, and the most recent manner in which the psychological autopsy is conducted are discussed.