Duty of care in immunisation against biological warfare agents

In peacetime, the Crown owes a duty of care to members of the Armed Forces to provide adequate medical support. This includes the provision of safe and effective vaccines. A Serviceman who considers himself harmed by immunisation against biological warfare (BW) agents would have access to legal action in the tort of negligence. However, the outcome would be uncertain because of the absence of clear precedent in respect of the Crown's duty of care in the period of transition between peace and war and the statutory right of the Government to bar proceedings against the Crown for alleged negligence during time of war. Moreover, no claimant has yet succeeded in any common law action in the United Kingdom for vaccine damage because of the difficulty of proving causation. The Serviceman would not be covered by the Criminal Injuries Compensation (Overseas) Scheme. Likewise, he would not be eligible for payment under the Vaccine Damage Payments Act 1979 unless the Act was amended. The Serviceman would therefore have to rely on the current pension system that is accessible, relatively generous and, until recently, independent of the Ministry of Defence.     

The ‘Hybrid Order’: origins and usage

The hospital direction (Hybrid Order) was inserted into the Mental Health Act (MHA) in 1997 (Crime (Sentences) Act, 1997). It enables higher courts to direct hospital admission for offenders, whilst still imposing a prison sentence. The origins of the ‘Hybrid Order’ and its patterns of usage are examined. Comparisons are made with its Scottish equivalent, Section 59A of the Criminal Procedure (Scotland) Act 1995. Both the ‘Hybrid Order’ and Section 59A have been used infrequently. This may reflect the fact that they were strongly resisted on ethical grounds at their point of inception and that they force the psychiatrist into the position of ‘punisher’, rather than ‘treater’. Since the 2007 Amendment of the MHA in England and Wales which expanded the remit of the ‘Hybrid Order’ to include all legal categories of mental disorder, not solely psychopathy, its use has unsurprisingly increased – this article delineates the considerations that need to be given in its recommendation.     

Medium‐Chain Acyl‐CoA Dehydrogenase Deficiency in Adulthood: A Potential Diagnosis in a Patient with Mental Status Changes Suspected of Drug Toxicity

Medium‐chain acyl‐CoA dehydrogenase (MCAD) deficiency is a rare but important component of the differential diagnosis for adults with a history of premortem mental status changes and the postmortem finding of hepatic steatosis. This case report describes a 30‐year‐old white man who, following a period of nausea and vomiting, was admitted to the hospital with sudden mental status deterioration followed rapidly by clinical deterioration and death. Treating physicians in this case suspected acute illicit drug toxicity with synthetic cathinones based on social history. Clinicians and medical examiners should be aware that the presentation, signs, and symptoms described may indicate an underlying inborn error of metabolism such as MCAD deficiency and take action accordingly.     

Does Intolerance Dampen Dissent? Macro-Tolerance and Protest in American Metropolitan Areas

Political Behavior - Political tolerance has long been regarded as one of the most important democratic values because intolerant political cultures are believed to foster conformity and inhibit...     

Sexual orientation,political trust,and same-sex relationship recognition policies: evidence from Europe

Public Choice - This study uses data from the European Social Survey to analyze the impact of same-sex relationship recognition policies on the political trust of sexual minorities. We exploit...