Clarifying the Status of Policy

This essay examines ‘What is a policy?’ from the viewpoint of a public servant trying to make sense of the maze of official statements, procedures, guidelines and various other expressions of intra‐governmental opinion that might bear upon a discretionary decision. It seeks to clarify the meaning and status of policy, to explain how to determine cases which are not covered by explicit statements of policy, and to decide how much relative weight to accord to various policy documents and circumstances. Although it does not set out to rehash the old debate about the distinction between politics and administration (often misunderstood as a distinction between policy and administration), it finds Woodrow Wilson's 1886 aphorism on this subject a good place to start.     

Analyzing and Interpreting Lime Burials from the Spanish Civil War (1936–1939): A Case Study from La Carcavilla Cemetery

Over 500 victims of the Spanish Civil War (1936–1939) were buried in the cemetery of La Carcavilla (Palencia, Spain). White material, observed in several burials, was analyzed with Raman spectroscopy and powder XRD, and confirmed to be lime. Archaeological findings at La Carcavilla's cemetery show that the application of lime was used in an organized way, mostly associated with coffinless interments of victims of Francoist repression. In burials with a lime cast, observations made it possible to draw conclusions regarding the presence of soft tissue at the moment of deposition, the sequence of events, and the presence of clothing and other evidence. This study illustrates the importance of analyzing a burial within the depositional environment and taphonomic context.     

Fatality involving complications of bupivacaine toxicity and hypersensitivity reaction

This case represents unusual findings of elevated bupivacaine and tryptase concentrations following local anesthetic, bupivacaine, administered as a scalene nerve block for elective rotator cuff repair surgery. Following bupivacaine injection, the patient exhibited almost immediate seizure activity, bradycardia, and cardiac arrest. Resuscitative efforts including cardiopulmonary bypass restored a cardiac rhythm. However, the clinical medical status of the patient progressively declined and he died 7 h following administration of the local anesthetic. Autopsy revealed several abnormalities of the heart including cardiomegaly, myocardial bridging, and lipomatous hypertrophy of the intraatrial septum, which may have contributed to bradycardia and arrhythmia. Postmortem toxicology results revealed elevated bupivacaine and tryptase concentrations. Elevated postmortem bupivacaine concentrations 7 h following administration and abrupt onset of seizures indicate unintentional intravascular injection instead of nerve and tissue infiltration. An elevated postmortem tryptase concentration points to the possibility of a hypersensitivity reaction to bupivacaine.     

Suicide by asphyxiation due to helium inhalation

Suicide by asphyxiation using helium is the most widely-promoted method of "self-deliverance" by right-to-die advocates. However, little is known about persons committing such suicides or the circumstances and manner in which they are completed. Prior reports of suicides by asphyxiation involving helium were reviewed and deaths determined by the North Carolina Office of the Chief Medical Examiner to be helium-associated asphyxial suicides occurring between January 1, 2000 and December 31, 2008 were included in a new case series examined in this article. The 10 asphyxial suicides involving helium identified in North Carolina tended to occur almost exclusively in non-Hispanic, white men who were relatively young (M age = 41.1 T 11.6). In 6 of 10 cases, decedents suffered from significant psychiatric dysfunction; in 3 of these 6 cases, psychiatric disorders were present comorbidly with substance abuse. In none of these cases were decedents suffering from terminal illness. Most persons committing suicide with helium were free of terminal illness but suffered from psychiatric and/or substance use disorders.