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.     

Juvenile Criminality And Semi-Criminality: Learning From Victorian Perceptions And Responses

This article focuses on media reportage of offensive juveniles, past and present, to elicit lessons that the twenty-first century can learn from the Victorian past in terms of diversionary responses. How to prevent vulnerable juveniles sliding into dangerous criminality is a continuing preoccupation: the issue explored in this article relates to the creation of the identity of the criminal juvenile. In utilising the concept of semi-criminality to label certain types of juvenile anti-social behaviour the Victorians avoided actual criminalisation of socially offensive but, in legal terms, minor behaviours. The reasons for and negative consequences of the abandonment of this concept by the modern age are explored, including the reconceptualisation of where responsibility for juvenile offending lies in the modern era.