Overriding Psychiatric Advance Directives: Factors Associated with Psychiatrists' Decisions to Preempt Patients' Advance Refusal of Hospitalization and Medication

Psychiatric advance directives (PADs) are intended to support patients' treatment decisions during a crisis. However, PAD statutes give clinicians broad discretion over whether to carry out patients' advance instructions. This study uses data from a survey of psychiatrists (N=164) to examine reasons for overriding PADs. In response to a hypothetical vignette, 47% of psychiatrists indicated that they would override a valid, competently-executed PAD that refused hospitalization and medication. PAD override was more likely among psychiatrists who worked in hospital emergency departments; those who were concerned about patients' violence risk and lack of insight; and those who were legally defensive. PAD override was less likely among participants who believed that involuntary treatment is largely unnecessary in a high-quality mental health system.     

The Iron Fist in the Latex Glove: The Intersection of Public Health and Criminal Justice

The intersection of public health and criminal justice involves reducing negative human outcomes, disease and crime, respectively. In this article, we examine the public health approach in detail and how it relates to criminal justice research and practice and how each discipline achieves legitimacy. We demonstrate the public duties of the criminal justice system and how it already performs some public health duties and how we can better integrate public health approaches at the academic, bureaucratic, and street levels.     

Visions of Reality

John Clare: A Biography , by Jonathan Bate
W. B. Yeats: A Life, Volume 2: The Arch Poet , by R. F. Foster     

Michael H. v. Gerald D.

The author attempts to apply semiotic analysis to a question of family law. By examining the language used by the Supreme Court in the title case, Michael H. v. Gerald D., along with the case briefs, lower court opinions, other Supreme Court cases and prior legal scholarship, the author attempts to determine the requisite relationships between father–child and father–mother in order for a legal tie to exist between a father and his biological child. The author tries to not only determine the necessary circumstances but also the political ideology that distinguishes these familial ties. The author further attempts to analyze the goals of these underlying political ideologies.     

Psychopathy, treatment change, and recidivism in high-risk, high-need sexual offenders

The present study investigated 154 consecutive admissions to the Regional Treatment Center (Ontario) Sex Offender Treatment Program with reference to psychopathy and outcome. Ratings of treatment behavior, as well as clinical judgments as to whether risk was reduced, were coded based on treatment reports. With reference to Psychopathy Checklist-revised (PCL-R) scores, survival analyses indicated that high scorers recidivated at significantly higher rates than low scorers. However, offenders who received high PCL-R scores and lower scores on measures of treatment behavior recidivated at the same rate as low scorers on the PCL-R. Furthermore, among high PCL-R offenders, those rated as lower risk at post treatment in fact reoffended at a lower rate than those whose risk was rated as unchanged, although this difference failed to reach significance. Findings are discussed in light of the clinical and research literature.     

What Would Mary Douglas Do? A Commentary on Kahan et al., “Cultural Cognition and Public Policy: The Case of Outpatient Commitment Laws”

Involuntary outpatient commitment is a highly controversial issue in mental health law. Strong supporters of outpatient commitment see it as a form of access to community-based mental health care and a less restrictive alternative to hospitalization for people with severe mental illness; vocal opponents see it as an instrument of social control and an unwarranted deprivation of individual liberty. Kahan and colleagues apply the theory of “cultural cognition” in an empirical study of how cultural worldviews influence support for outpatient commitment laws among the general public and shape perceptions of evidence for these laws’ effectiveness. This article critiques Kahan et al. and offers an alternative perspective on the controversy, emphasizing particular social facts underlying stakeholders’ positions on outpatient commitment laws.     

Development of STR profiles from firearms and fired cartridge cases

Fired cartridge cases are a common type of evidence found at crime scenes. However, due to the high chamber temperatures and touch nature of this evidence, DNA testing is not commonly sought because it is believed DNA is only present in low levels, whether it is due to initial low levels of DNA and/or DNA degradation from the heat or inhibition of the PCR reaction. Moreover, very few laboratories report STR typing success with fired cases. This study focused on obtaining STR profiles from fired cartridge cases using the AmpFℓSTR^® MiniFiler™ kit, which is designed to amplify DNA from low level, inhibited, and degraded samples. Comparisons to other STR amplification kits were also conducted. In attempt to simulate casework, random individuals loaded cartridges into a firearm. DNA was recovered from the fired cartridge cases using the double swab technique and extracted using an automated large volume DNA IQ™ method. Initially, testing focused on known shedders handling cartridges for 30 s prior to firing. A significantly greater number of alleles was obtained following amplification with the MiniFiler™ kit versus the PowerPlex^® 16 BIO kit. No alleles were observed using the Identifiler^® kit. In an attempt to better simulate casework, a random selection of laboratory personnel handled shotshells for as long as needed to load and fire the weapon. In this mock sample study, the MiniFiler™ kit successfully amplified an average of 22% of expected alleles from DNA recovered from shotshell cases versus the PowerPlex^® 16 BIO kit where an average of 7% of alleles were observed. However, the total number of alleles obtained from the two kits was not significantly different. The quality of the DNA obtained from fired cases was studied with evidence of inhibition in at least 11% of shotshell case samples. After swabbing the head and the hull of three shotshell cases separately, a significantly greater number of alleles was obtained from the hull as opposed to the head of the fired shotshell case. In addition, after firing, various internal firearm surfaces were swabbed, including the chamber of barrel, ejection port, and breechface, in an attempt to obtain amplifiable DNA. DNA was obtained from the chamber of the barrel and was amplifiable using the MiniFiler™ kit, although mixtures were obtained with extensive drop-in and drop-out making this analysis unlikely to aid an investigation.     

The role of the Asia Pacific Partnership in discursive contestation of the international climate regime

After withdrawing from the Kyoto Protocol, the US Bush Administration and the Australian Howard Government pursued an international climate change policy focussed on voluntary international agreements outside the UN climate negotiations. This strategy included the formation of several climate agreements directed at technology development, including the 2005 Asia Pacific Partnership on Clean Development and Climate (APP). The APP provides a model for international climate change policy directed at voluntary national greenhouse gas intensity targets, technology development through sectoral public–private partnerships and technology diffusion through trade. This article situates the APP within these US and Australian inspired climate agreements formed outside the UN negotiations. Bäckstrand and Lövbrand’s (in M. Pettenger (ed.) The social construction of climate change: power knowledge norms discourses, 2007) discourse analysis in relation to the international climate negotiations is used to explore differences between the APP and UN climate treaties. We find the APP embodies a discourse of what we call ‘deregulatory ecological modernisation’ that promotes limited public funding to ease informational failures in markets for cleaner technologies and management practices. The deregulatory ecological modernisation discourse is a deeply intensive market liberal approach to international climate change policy, which contests binding emission reduction targets and the development of a global carbon market. The USA, Australia, Japan and Canada represented a core group of countries that used the APP to promote the deregulatory ecological modernisation discourse and thereby contest any deepening of developed nations' emission reduction targets for the post-2012 period. However, with changes of leadership and new parties in power in the USA and Australia, it appears that the deregulatory ecological modernisation discourse has lost ground compared to a reengagement with discourses supportive of developed country emission reduction targets and equity-based adaptation and technology transfer assistance for developing nations.     

A decade of child-initiated family violence: comparative analysis of child--parent violence and parricide examining offender, victim, and event characteristics in a national sample of reported incidents, 1995-2005

This article examines 11 years (1995-2005) of National Incident Based Reporting System data comparing victim, offender, and incident characteristics for two types of child-initiated family violence: child-parent violence (CPV) and parricide. The objective is to better understand the victim-offender relationship for CPV and parricide and to highlight distinguishing features between the two offenses. This work extends the research and addresses shortcomings in the extant literature. Data analysis consists of chi-square tests and logistic regression. Findings suggest that CPV and parricide are distinct and unique crimes. In short, parricide offenders and victims are both older than CPV offenders and victims, with CPV offenders more likely to be female, more likely to be African American, and less likely to use a weapon than parricide offenders. The study calls for future research and exploration of preliminary support for a family violence escalation hypothesis.