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Little is known about the amendment of death certificates (DCs) issued by medical examiners and coroners. This retrospective study examined why, how, and with what frequency cause and manner of death were amended on DCs issued by forensic pathologists over a 6-year period at the New Mexico Office of the Medical Investigator. Approximately 1% of DCs had either cause or manner of death amendments, with arteriosclerotic cardiovascular disease and intoxicants the most commonly amended and resulting causes of death, respectively. There was a significant association between manner of death and number of DCs amended (p<0.001). By percent, natural and suicide DCs were the most frequently amended. The way in which manner of death changed was significantly associated with the amount of time elapsed between DCs (p=0.04). Toxicology was the most common reason for DC amendment. 相似文献
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This study presents the rapid screening of various high grade explosives by high performance liquid chromatography (HPLC) with monolithic stationary phases. Two gradient methods were developed, the first for quantitative analysis of eleven explosives: HMX; RDX; Tetryl; TNT; 2,3-DNT; 2,6-DNT; 3,4-DNT; 2-NT; 3-NT; 4-NT; and PETN in under 14 min. The second method separated seven explosives in under two min and is suitable for rapid screening to determine the presence of specific and/or class of explosive. The rapid screening methods were successfully applied to soils spiked with known amounts of target explosives. This technology showed excellent potential for forensic explosives detection and analysis. 相似文献
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This Article reviews the essential findings of studies of variations in quality of care according to three categories of care: effective care, preference-sensitive care, and supply-sensitive care. It argues that malpractice liability and informed consent laws should be based on standards of practice that are appropriate to each category of care. In the case of effective care, the legal standard should be that virtually all of those in need should receive the treatment, whether or not it is currently customary to provide it. In the case of preference-sensitive care, the law should recognize the failure of the doctrine of informed consent to assure that patient preferences are respected in choice of treatment; we suggest that the law adopt a standard of informed patient choice in which patients are invited, not merely to consent to a recommended treatment, but to choose the treatment that best advances their preferences. In the case of supply-sensitive care, we suggest that physicians who seek to adopt more conservative patterns of practice be protected under the "respectable minority" or "two schools of thought" doctrine. 相似文献
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