Metric forensic anthropology decisions: Reliability and biasability of sectioning-point-based sex estimates

Subjective decisions make human cognitive processes more susceptible to bias and error. Specifically, research indicates that additional context biases forensic anthropologists’ morphological analyses. To address whether metric analyses are also subject to bias, we conducted a pilot study in which 52 experienced osteologists measured a difficult-to-classify human femur, with or without additional contextual information. Using a metric sectioning-point sex-estimation method, participants provided a sex estimate for individual skeletal element(s) and, when given multiple elements, the combined skeletal assemblage. Control group participants (n = 24) measured only the femur. In addition to the femur, bias group participants (n = 28) either measured a female humerus and viewed a female-biasing photograph (n = 14) or measured a male humerus and viewed a male-biasing photograph (n = 14). We explored whether the experts in the different groups would differ in: (1) femoral measurements; (2) femoral sex-estimation conclusions; and (3) final sex-estimation conclusions for the skeletal assemblage. Although the femoral measurements and femoral sex estimates were comparable across groups, the overall sex estimates in the female-biased group were impacted by contextual information—differing from both the control and male-biased groups (p < 0.001). Our results demonstrate that cognitive bias can occur even in metric sex-estimation conclusions. Specifically, this occurred when the metric data and single-element sex estimates were synthesized into an overall estimate. Thus, our results suggest that metric methods are most vulnerable to bias when data are synthesized into an overall conclusion, highlighting the need for bias countermeasures and comprehensive statistical frameworks for synthesizing metric data to mitigate the effects of cognitive bias.     

论医疗事故罪的主体

医疗事故罪是新刑法增加的一种犯罪,自规定后争议一直颇大,特别是医疗事故罪的主体范围问题。医疗事故罪主体除了医务人员外,实习人员、医疗单位中从事行政管理、后勤服务等非医疗工作的人员在特定情况下也能成为本罪主体,但是单位不能成为本罪的主体。     

医疗事故罪客观要件探析

认定医疗事故罪,在客观上首先必须存在合法的医疗行为。其次必须在合法的医疗过程中出现严重不负责任的行为。认定严重不负责任,应当主要结合医务人员的注意义务,把违反常规性、常识性的注意义务,以及常发性的过失行为认定为严重不负责任。再次,严重损害就诊人身体健康应当根据《刑法》所规定的重伤标准去判断。最后,严重不负责任是就诊人死亡或严重损害就诊人身体健康的后果的主要原因力。     

医疗责任保险的思考

大力发展医疗责任保险,对医疗执业过失给患者造成的损害进行充分赔偿,在保障患者和医疗机构及其医务人员的合法权益,优化医疗环境和医疗公共秩序方面有重要的促进作用。由于我国医院主体是公立医院,侵权法人身损害赔偿相对于综合医院尚未到重大程度,并且综合性医院每年发生的医疗过失案件基本确定,选择满足面临危险的医院财务安全需要的医疗责任保险模式,如医疗责任保险信托等,才能促进医疗责任保险的发展。实践表明,商业性医疗责任保险不宜成为我国医疗责任保险的主体。建立独立的医疗过失纠纷调解鉴定机构,才能保证医疗责任保险顺利开展。     

SPECIAL NEEDS CHILDREN IN FAMILY COURT CASES

This article presents a conceptual framework for describing cases involving children with special needs that are increasingly being seen in family court. Three categories that represent the most common of such cases include (1) acute, life-threatening medical conditions; (2) chronic developmental disorders; and (3) psychological and behavioral syndromes. After detailing the nature of the disabilities in each category, perspectives from the bench are offered with specific recommendations and general strategies for effective case management. This is followed by a proposal of an innovative conceptual model—the Individualized Parenting Plan (IPP)—that organizes and integrates nine domains essential for a comprehensive parenting plan for special needs children. The article concludes with a list of sixteen strategic guidelines for servicing the families of these special needs children, in their best interests.     

人道功利主义——当今医学道德的价值取向

医学道德规范体系的核心是医学道德的价值取向。在当代的医疗实践中 ,传统的医学道德价值取向不能够适应实践的需要。根据新的实践要求 ,重构医学道德的价值取向———人道功利主义 ,这是当今医疗卫生事业的性质及发展所决定的。因此 ,人道功利主义应是构建当今医德规范体系的基石。     

医疗事故罪认定之我见

医疗事故罪的认定,需要从犯罪的主体、主观方面、客观方面综合评定,并正确区分责任事故和技术事故。医疗事故鉴定结论在医疗事故罪的认定中有着重要的作用,但是医疗事故鉴定的程序、规则、组成人员等方面亟待改革。     

关于文登市新型农村合作医疗的调查报告

通过封文登市新型农村合作医疗的调查发现,现在参加新型农村合作医疗的农村居民参与度低、个人缴费少,80％的资金来源于各级政府,待遇支付管“小”不管“大”,客观上造成“帮富不帮贫”,政府成为新型农村合作医疗的主角,制度的建立不能解决参加新型农村合作医疗的农村居民因病致贫和因病返贫问题。针对上述问题,本文建议加强宣传,增强农农村居民的保险意识,提高参加新型农村合作医疗的农村居民本人的缴费比例及数额,政府加大封农村居民中弱势群体的补助,取消新型农村合作医疗家庭账户,调整新型农村合作医疗支付结构,变保“小”为保“大”,加快医药卫生体制改革,有效地防止参加新型农村合作医疗的农民因病致贫和因病返贫。     

“多次违法行为”入罪之思考——以多次非法行医为视角

我国法律规定未取得医生执业资格的人非法行医,被卫生行政部门行政处罚两次以后,再次非法行医的,应当以非法行医罪追究其刑事责任。此种将多次行政处罚后再实施违法的行为纳入刑事犯罪构成要件或者说作为罪量要素的定罪模式是合理的,不违反禁止重复评价原则和刑法谦抑性原则。但为了防止刑事制裁范围的肆意扩大,应从违法主体、违法程序及违法次数上对"非法行医被二次行政处罚后再次非法行医"入罪进行一定的限制,以实现人权保障和惩罚犯罪的有机统一。