Recent developments in medicine and law

This article addresses important developments in the field of medicine and law during the period of September 2000 through August 2001. It does not discuss every reported case or piece of legislation but surveys some of the more significant developments in the medicine and law arena.     

What's Love Got To Do With It?: Perceptions of Marital Positivity in H-to-W Aggressive, Distressed, and Happy Marriages

Husbands' and wives' perceptions of positive relationship behaviors and interactions (e.g., caring gestures, reasons for staying married, frequency of positive communication) were assessed in a sample of maritally happy (H), maritally distressed but non-aggressive (D/NA), and maritally distressed and husband-to-wife physically aggressive (D/H-to-W) couples. As expected, the relationship positivity reports of the two groups of maritally distressed couples differed from the happily married couples. In addition, D/H-to-W spouses gave different reasons for staying married than did D/NA spouses (i.e., love versus family roles and commitments). Spouses in D/H-to-W aggressive marriages were also less likely to report using intimate language with their partner than were spouses in either of the other two groups. Few gender differences were found. Results underscore the importance of considering the role of love and intimacy in husband-to-wife aggressive and distressed marriages.     

Severity of Partner and Child Maltreatment: Reliability of Scales Used in America's Largest Child and Family Protection Agency

This paper describes two studies investigating the interrater agreement of severity scales for family maltreatment used in America's largest child and family maltreatment agency: the U.S. military's Family Advocacy Program (FAP). The USAF-FAP Severity Index is a multidimensional rating system for clinicians' evaluations of the severity of seven forms of family maltreatment: partner physical, emotional, and sexual abuse; child physical, emotional, and sexual abuse; and child neglect. The first study evaluated the reliability of the scale as it is used in the field. The second study compared a generalizable sample of clinicians' ratings to an established gold standard of what the ratings should have been. The Severity Index demonstrated fair-to-good levels of reliability, suggesting that with minimal cost, investigating caseworkers can routinely assess, and make fairly reliable ratings of, the severity of seven forms of family maltreatment for each case they investigate.     

Health IT and Solo Practice: A Love-Hate Relationship

A small town solo gynecologist describes the process of starting a practice based on health information technology, how catastrophic it can be to lose data, how difficult it can be to try to exchange information, and yet how rewarding it can be to accomplish a "paperless" experience.     

Be Careful How You Frame the Issues

Immigration is related to widening inequality and insecurity in the United States, but it is not the main cause of such changes and to focus on the host/immigrant conflict diverts attention from many different elite projects that have widened inequality. Moral arguments about immigration cannot just address outsiders who only want to get into nations, but must address the moral situation of people in the process of entry and especially of insider/outsiders, people already in. Over the long run, civic nationalism is a healthier model than exclusionary biological or cultural fundamentalist definitions of the national community.

Domestic Violence and Asylum: Toward a Working Model of Affirmative State Obligations

While the 1951 Convention is no longer limited geographicallyand its definition of a refugee is not linked to any particularcrisis or place, the source of persecution and the role of thestate with respect thereto has proved problematic. Domesticviolence claims have suffered particularly because of theseshortcomings, as these cases have been uneasy fits within doctrine.Though the Convention definition ordinarily envisions the stateas persecutor, domestic violence follows a different course.Almost inevitably, its victims are persecuted by their husbands.As ‘non-state actors’, they have frequently andwrongly eluded the Convention norms, revealing a tragic protectiongap in the Convention. An asylum seeker must prove that shehas a well-founded fear of persecution based on race, religion,nationality, membership of a particular social group or politicalopinion. Despite the seriousness of the claim, if the reasonfor the threat does not lie in one of those five sources, aproper asylum claim has not been made. Worse, however, the sourceof the persecution, a non-state actor, often blocks Conventionprotection. This paper will analyze these stumbling blocks toasylum seekers. It will posit the notion that legitimate asylumseekers have been marginalized by their home countries, renderedvirtual non-citizens. Whether through complicity, neglect orsheer indifference or incompetence, these home countries are‘failed states’, failures in not having providedfull rights of citizenship throughout their populations. Inconjunction with that, it will examine the standards for determiningwhen the non-state actor is a persecutor within the Conventionsense. Finally, it will set out factors to be used to test thefailed state for litigation purposes.