Distribution of ethyl glucuronide in rib bone marrow, other tissues and body liquids as proof of alcohol consumption before death

Postmortem ethyl glucuronide (EtG) concentrations in rib bone marrow, liver, muscle, fat tissue, urine, blood and bile have been determined by LC-MS/MS. Samples have been taken from twelve corpses during autopsies. In nine corpses EtG could be detected, corresponding blood ethanol concentrations (BAC) were 0.04-0.37 g%. In three cases, no EtG was found; two of these cases showed postmortem BACs - possibly due to putrefaction - of 0.01 and 0.1g%. In rib bone marrow, which is easily accessible during autopsy, EtG concentrations (0.77-9.36 microg/g) have been lower than in blood (2.24-20.46 microg/mL) in eight of nine cases and comparable or higher than in muscle tissue. Therefore, rib bone marrow has been found suitable as matrix for EtG determination. The highest EtG concentrations have been found in urine in all but one case, where the resorption of ethanol had been incomplete. Second highest EtG concentrations have been detected in liver samples. In two cases with putrefaction, EtG could not be detected. In these cases, the detectable ethanol might have been produced partially or in total by postmortem fermentation. However, instability of EtG during putrefaction cannot be totally excluded which might result in a total loss of EtG.     

What you don't know can hurt you: why managed care organizations have a legal duty to disclose the use of financial incentives to limit medical care

This article, winner of the 2000-2001 American Health Lawyers' Student Writing Competition, examines the conflicting policy goals at the heart of managed care--particularly in the use of financial incentives for physicians who limit their use of referrals and expensive diagnostic tests. While conceding the legality of such incentives, the author contends that Managed Care Organizations (MCOs) have a legal duty to disclose their existence to beneficiaries. After analyzing the basis for imposing a duty to disclose, the author proceeds to examine such issues as the proper timing, level, and extent of disclosure.     

Human Rights Violations,Weak States,and Civil War

This study examines the role of human rights violations as a harbinger of civil wars to come, as well as the links between repression, state weakness, and conflict. Human rights violations are both part of the escalating process that may end in civil war and can contribute to an escalation of conflict to civil war, particularly in weak states. The role of government repression and state weakness in leading to civil war is tested empirically. The results show that both closely correlate with civil war onset, especially if they are observed in combination. A two-stage model shows that, while low-level conflict leads to human rights violations, they increase the risk of an escalation to civil war in turn. Human rights violations are identified as an important aspect of understanding civil war onset as the result of an escalation over time and a clear early warning sign of wars to come.