The judicial role in life-sustaining medical treatment decisions.

Although there has been speculation regarding the pervasiveness and nature of judicial decisions regarding life-sustaining medical treatment (LSMT), no attempt has been made to empirically assess their prevalence or the issues they address. An exploratory study utilizing a mail survey of a nationwide random sample (N = 905) of state trial court judges was conducted to provide initial information regarding this decision-making process. Twenty-two percent of the responding judges had heard at least one LSMT case, and judicial review did not appear endemic to particular states. The number of judges hearing LSMT cases dropped from 1975 to 1981 but has increased since then. Three major issues predominate: patient competency, appointment of a surrogate decisionmaker, and resolution of the ultimate issue of forgoing LSMT. Relatively few cases either contested a prior directive's validity or involved imposing sanctions for instituting or forgoing LSMT. Although subject to different interpretations, the results suggest the courts are having a significant impact on certain aspects of the LSMT decision-making process. However, the infrequency with which any one judge is called upon to make an LSMT decision causes concern about the judiciary's ability to respond in a timely and appropriate manner. With their potential for a profound effect on the actions of health care providers, greater attention to this decision-making process is warranted.     

A unique case of congenital bilateral absence of parietal bones in a neonate

The remains of an unidentified female neonate were discovered in a field in central Missouri. Examination revealed bilateral absence of the parietal bones. A search of the literature describing similar defects suggests that the present case represents a unique condition, described here for the first time.     

Ethnicity, gender, and the Level of Service Inventory-Revised

Offender assessment and classification is becoming an increasingly important part of correctional supervision and intervention. Over the last several decades, several different methods and “generations” of offender classification have emerged. Of most value appear to be third-generation, actuarial, dynamic risk/need assessments. With any new correctional strategy, however, there is a need to investigate the use of these risk/need assessments on offender subgroups in order to inform issues, such as reliability and prevalence of criminogenic risk factors. The present study utilized data that were gathered using the Level of Service Inventory-Revised (LSI-R). Results and comparisons of these assessments were investigated and presented for Native American and non-Native American offenders as well as male and female offenders. Discussion of the results, implications, and recommendations for further research are presented.     

What Do Prosecutors Maximize? Evidence from the Careers of U.S. Attorneys

This study examines the performance of chief federal prosecutors(U.S. attorneys) and their subsequent careers. In a sample of570 attorneys in office from 1969 to 2000, the length of prisonsentences is positively related to subsequent favorable careeroutcomes for U.S. attorneys. In contrast, conviction rates donot appear to affect the careers of U.S. attorneys. These resultsare consistent with longer total prison sentences’ beingpersonally beneficial to prosecutors, and prosecutors’maximizing the length of prison sentences. Overall, the resultssuggest that sentence length, as opposed to convictions rates,is the relevant performance metric.