The Effects of Medical Accidents and Litigation on Doctors and Patients*

Medical accidents and litigation can have a profound and long lasting effect on both doctors and patients. Research has shown that for doctors, working in a profession which is intrinsically stressful, the added stress of litigation and accidents is leading to considerable strain and sometimes to maladaptive and inappropriate behaviors on the part of some doctors. For many it is leading to the practice of defensive medicine. For patients the picture is not better. Some are left with no clear idea of what has happened or why they have been injured by their medical treatment. Many are left needing further remedial treatment and for some the psychological effects are akin to those suffered by victims of major disasters. In this paper we have looked at these issues and have put forward proposals to suggest how things can be improved for both doctors and patients.     

DO PARENTS MATTER IN CREATING SELF‐CONTROL IN THEIR CHILDREN? A GENETICALLY INFORMED TEST OF GOTTFREDSON AND HIRSCHI'S THEORY OF LOW SELF‐CONTROL*

Gottfredson and Hirschi's general theory of crime (1990) has generated an abundance of research testing the proposition that low self‐control is the main cause of crime and analogous behaviors. Less empirical work, however, has examined the factors that give rise to low self‐control. Gottfredson and Hirschi suggest that parents are the sole contributors for either fostering or thwarting low self‐control in their children, explicitly discounting the possibility that genetics may play a key role. Yet genetic research has shown that ADHD and other deficits in the frontostriatal system are highly heritable. Our research thus tests whether “parents matter” in creating low self‐control once genetic influences are taken into account. Using a sample of twin children we find that parenting measures have a weak and inconsistent effect. We address the conceptual and methodological issues associated with the failure to address genetic influences in parenting studies.     

STICK-UP,STREET CULTURE,AND OFFENDER MOTIVATION*

Motivation is the central, yet arguably the most assumed, causal variable in the etiology of criminal behavior. Criminology's incomplete and imprecise understanding of this construct can be traced to the discipline's strong emphasis on background risk factors, open to the exclusion of subjective foreground conditions. In this article, we attempt to remedy this by exploring the decision-making processes of active armed robbers in real-life settings and circumstances. Our aim is to understand how and why these offenders move from an unmotivated state to one in which they are determined to commit robbery. Drawing from semistructured interviews with 86 active armed robbers, we argue that while the decision to commit robbery stems most directly from a perceived need for fast cash, this decision is activated, mediated, and shaped by participation in street culture. Street culture, and its constituent conduct norms, represents an essential intervening variable linking criminal motivation to background risk factors and subjective foreground conditions.     

PARENTAL EFFICACY AND DELINQUENT BEHAVIOR: DO CONTROL AND SUPPORT MATTER?

Recently, the concept of "collective efficacy" has been advanced to understand how communities exert control and provide support to reduce crime. In a similar way, we use the concept of "parental efficacy" to highlight the crime reducing effects associated with parents who support and control their youth. Using data from the National Longitudinal Survey of Youth (NLSY), we examine the inter-relationship between parental controls and supports and their joint influence on youthful misbehavior. The results show that (1) support and control are intertwined, and (2) that parental efficacy exerts substantive effects on adolescent delinquency for the sample as a whole and across varying age groups.