Practice guidelines and malpractice litigation: collision or cohesion?

Practice guidelines are standardized specifications for managing particular clinical problems and are intended to improve the outcomes of medical care by increasing adherence to standards of care. They are also meant to make medicine more cost-effective by eliminating unnecessary procedures. A relatively recent phenomenon, the practice guidelines now emerging will have implications for malpractice, which also intends to bring about better care. They will probably not revolutionize the procedures that courts use to determine negligence, but judges will integrate guidelines into their decision-making process. This development should be welcomed. Guidelines should prove to be useful as either inculpatory or exculpatory evidence of negligence. They are unlikely to generate much new litigation, although there is some potential for suits against those who issue guidelines, especially if guidelines are not revised as the technology of medical care changes.     

Estimation of postmortem interval (PMI) as revealed through the analysis of annual growth in woody tissue

The discovery of human remains lying across a black spruce (Picea mariana) leader (branch) that subsequently grew up around the remains provided an opportunity to use the growth ring pattern to estimate the postmortem interval (PMI). As these remains were discovered in an advanced state of decomposition in October of 2000, and it was clear that relevant insect evidence was not forthcoming, this novel approach to estimating PMI was proposed. The asymmetrical growth of the leader resulted in a correspondingly asymmetrical pattern of its growth riings. As the date of cutting the leader was known, it was possible to evaluate the asymmetrical growth pattern to provide an estimation of PMI. Fine polishing of the cross section and computerized quantification of ring widths enabled an estimation of the displacement of the leader, and hence the time the decedent's body was so positioned. By charting the ring-width differential for the leader, it was concluded that the displacement occurred sometime between July of 1993 and May of 1994. The actual date of disappearance was confirmed to be August 24, 1993.     

The jury is still in: Florida's Birth-Related Neurological Injury Compensation Plan after a decade

Florida's Birth-Related Neurological Injury Compensation Plan (NICA) is the most significant experiment with compensation for medical injury yet undertaken in the United States. As NICA enters its second decade of operation, maintaining the scheme's jurisdictional integrity has emerged as a key challenge for policy makers in Florida. We explore the relationship that has emerged between NICA and the tort system as competing avenues for families to obtain compensation for severe birth-related neurological injury. By linking NICA claims data with data on malpractice claims filed in Florida, we found a lively persistence of "bad baby" litigation despite NICA's implementation. Many families pursued claims in both fora. An explanation for these results can be traced to key features of the plan's design--primarily, the way in which "exclusive" jurisdiction over injuries is determined and the restrictive nature of the compensation criteria used. Our findings may help efforts to consolidate NICA's role in injury compensation and inform future design of alternative compensation systems.     

Expressive voting and electoral equilibrium

There are two rival accounts of rational voting in the public choice tradition: the mainstream instrumental account, that sees the vote as a revelation of preference over possible electoral outcomes, essentially analogous to a market choice; and the expressive account, that sees the vote as expressing support for one or other electoral options, rather like cheering at a football match. This paper attempts to lay out some of the implications of the expressive account of voting for the issue of who votes as well as for the nature of political equilibrium, and to compare these implications with those derived from the instrumental account. We also identify and discuss the alternative views of the domain of electoral politics associated with the instrumental and expressive accounts of voting, and sketch a route towards the integration of expressive and instrumental ideas in the analysis of rational electoral politics.     

An Investigation of Biographical Information as a Predictor of Employment Termination among Law Enforcement Officers

An important service that police psychology can offer law enforcement administrators is assistance in the selection of future officers. Police psychologists have traditionally focused on the identification of psychopathology and exclusion of applicants who were found to be mentally ill. The introduction of the Americans with Disabilities Act (1990) has changed what had been considered appropriate exclusion criteria because of the introduction of increased civil rights protections for persons with disabilities. At the same time, increasing civil liability for law enforcement departments in regard to officer misconduct has compelled police psychologist to evaluate potential for future misconduct by non-clinical means. The scientific examination of biographical data may be one method of establishing the relationship between officer candidate variables and future misconduct. This paper examined the predictive validity of biographical information for a sample of 2965 police officer candidates. Results indicated that several biographical variables were significantly correlated with later termination. However, results of regression analyses indicated that biographical variables alone accounted for limited variance in the prediction of police officer termination. The use of biographical information as a sole determinant of police candidate suitability was not supported and the use of additional sources of data would be required for effectual forecasting purposes.     

Can Changes in Transformational-Oriented and Transactional-Oriented Leadership Impact Turnover over Time?

This article empirically examines the impact that leadership styles have on turnover. The results reveal that transformational-oriented leadership was found to lower voluntary turnover—that is, the aggregate of quits and transfers. Transactional-oriented leadership, on the other hand, was found to increase quits in agencies. The theoretical and practical implications of these findings are discussed in the article.