Is there an acceptable answer to rising medical malpractice premiums?

This article explores the key issues involved in the attempts at reform of the present medical malpractice system. Investigating the effects that federal tort reform legislation would have on physicians, patients, lawyers, and the medical malpractice insurers, Dr. Gunnar succinctly outlines the issues surrounding the present "crisis in healthcare" and explores the separate interests involved. The article examines the economic forces influencing the medical malpractice insurance industry, reviews previous tort reform, and predicts the future of federal tort reform legislation. Dr. Gunnar concludes by proposing alternatives for malpractice reform.     

"Medical necessity" determinations--a continuing healthcare policy problem

To promote an understanding of the implications of current structures and processes for medical necessity determinations that affect everyone, directly or indirectly, the American Health Lawyers Association will devote its biannual Public Interest Colloquium (to be held in February 2005) to the topic. In preparation for the colloquium, the author summarizes the history and current importance of the topic, identifies stakeholders in the system and their interests, and sets forth a preliminary list of issues to be considered by the colloquium participants, focusing on potential elements of an ideal system for making medical necessity determinations.     

The International Criminal Court and the Control of State Crime: Prospects and Problems

Over the past two decades, crimes committed by nation states has received strong theoretical and empirical attention from critical criminologists. Much of this work has highlighted the lack of internal and external mechanisms to control such injurious behavior. Potentially, this has now changed. In the summer of 1998, delegates from nearly 140 countries created the Rome Statute establishing the International Criminal Court (ICC). Entering into force in the summer of 2002, the ICC has unprecedented international jurisdiction over the crimes of genocide, war, aggression, and those against humanity. This paper provides a brief history of international law and attempts to develop an ICC. It then examines the functioning and structure of the ICC as established in the Rome Statute. We then proceed to analyze the potential which the ICC posses to control state criminality. Our analysis concludes with discussions of how the ICC might be modified to better act as a deterrent to such offending.     

"Just say no!": the right to refuse psychotropic medication in long-term care facilities

This article examines the rights of patients, particularly incompetent patients, in long-term care facilities to refuse psychotropic medication. In exploring this topic, the author focuses on the provisions of the Omnibus Budget Reconciliation Act of 1987 which was part of a Congressional solution to afford greater protection to residents of long-term care facilities. Because the legislation has not lived up to expectations, the author advocates for further legislative action to protect the dwindling bundle of rights of the elderly.     

„Spielarten des Kapitalismus“ und institutionelle Komplementaritäten in der Makroökonomie — Eine empirische Analyse

Der Beitrag geht der Frage nach, wie national unterschiedliche politökonomische Institutionen die Leistungskraft entwickelter Marktwirtschaften beeinflussen und ob institutionelle Komplementaritäten in der Makroökonomie existieren. Der Ansatz der ?Spielarten des Kapitalismus“ behauptet, dass es diese Komplementaritäten gibt und sich die Länder entsprechend dem in den ökonomischen Sphären vorherrschenden Modus der Koordination in klare Gruppen unterscheiden lassen. In dem Artikel werden die Kernaussagen des Ansatzes einer Reihe von empirischen Tests unterzogen, die auf einer zusammenfassenden Analyse einer Reihe von Fallbeispielen beruht, Die empirischen Ergebnisse bestätigen die Annahmen in überzeugender Weise. Dieliberalen undkoordinierten Marktwirtschaften variieren systematisch entsprechend dem relativen Verhältnis zwischen marktförmiger und strategischer Koordination. Institutionelle Komplementaritäten finden sich in beiden Typen, und sie bringen gesamtwirtschaftliche Leistungszuwächse hervor. Abschließend werden die Muster des institutionellen Wandels in den entwickelten politischen Ökonomien analysiert und einige politische Implikationen der Befunde diskutiert.     

Relationships between the deinstitutionalization of healthcare for patients with mental disorder, substance abuse, and isolated death

Isolated death (ID) (i.e., dying alone without anyone noticing for several days) has been suggested to be related to social isolation, mental disorder, and alcohol and/or drug abuse. A major transfer of patients with a mental disorder and/or alcohol and/or drug abuse from institutionalized care to treatment as outpatients has been enacted in Sweden during the past decade. On the basis of the assumption that such deinstitutionalization is likely to result in increased social isolation, our working hypothesis was that the incidence of ID among patients belonging to these categories has increased in Sweden. The present study involved all deaths subjected to a medicolegal examination in Stockholm County (with a population of approximately 1.9 million people) during the period 1992-2000. The pattern of ID (defined as cases involving a postmortem delay between death and discovery of at least 1 week), as well as the incidence of fatalities subjected to medicolegal examination with a record of mental disorder and/or alcohol and/or drug abuse was evaluated. Throughout this period, the proportion of the deceased with a record of a mental disorder was high among all the cases examined and higher still among the cases of ID, especially among those younger than 65 years of age. There was a rather limited increase in the incidence of ID and a much more pronounced increase in the number of former psychiatric patients whose deaths were subjected to medicolegal examination, but did not satisfy the criteria for ID. A record of alcohol and/or drug abuse was more common than a diagnosis of mental disorder among both the males and females who died at an age of less than 65, with a clear difference between the cases of ID and non-ID in the case of men. There was no significant increase in incidence over the course of this study. Thus, this study reveals a slight increase in the number of IDs and a more pronounced increase in the number of medicolegal examination of non-IDs of individuals with a record of a mental disorder.     

Development of a finger printing device for use on a mobile robot

In this paper, we describe the development of a device for fuming fingerprints with cyanoacrylate (Super Glue) to enable police tactical units to obtain fingerprint evidence from suspicious packages using a remote-controlled robot. Through a series of initial experiments and preliminary designs, we show that effective cyanoacylate fuming requires sufficient heat, humidity, and airflow. This work led to the development of a final working prototype, called robot accessory for fuming fingerprint evidence (RAFFE), which is currently being field tested by the Calgary Police Service.