Search PubMed⌕ Search

Biomedical subjects

A Brodsky

Publications and source records attributed to A Brodsky.

At least 55 records · Page 3Linked to original sources

"Magical thinking," suicide, and malpractice litigation.

Prospective clinical assessment of suicidality differs significantly from that used retrospectively in malpractice litigation. In the latter context, the judge or jury may be susceptible to hindsight reasoning and a disproportionate emphasis on the specific method of suicide, exaggerating its foreseeability and "magically" linking the means of death to the treating clinician, especially in the case of suicide by an overdose of prescribed medication. Such magical thinking, moreover, is rooted in the clinical context of suicide: The errors of reasoning observed in the courtroom exhibit striking parallels with the mind-set of the suicidal patient. An understanding of these dynamics suggests appropriate precautions for the clinician and thus contributes to the prevention both of suicide and of malpractice litigation.

Humans↗

Depression, self-love, time, and the "right" to suicide.

Elizabeth Bouvia, whose legal struggle to compel a psychiatric hospital to assist her in committing suicide ended with a decision that she could be force fed by the hospital, presented the psychiatric community with a host of ethical questions concerning the rights of a patient to choose death, and the obligations of the medical profession to promote life. What the courts did not decide is when a patient is incompetent to decide her own fate, and what is the duty of the hospital to intervene with a suicidal patient. The authors suggest that there is an ambiguity present whenever a patient presents herself to a hospital or therapist as suicidal, and that a time limited period, or cooling-off period, should exist that would allow an alliance to form between patient and care-giver, if possible, and then permit them to explore underlying issues of depression. The authors believe that there is a need to acknowledge the patient's ultimate right to choose death, but that autonomy should not be confused with impulsivity when anyone is faced with the irrevocability of the decision to die.

Adult↗

Process analysis of judges' commitment decisions: a preliminary empirical study.

The current debate over the "police powers" versus parens patriae rationales for involuntary hospitalization of the mentally ill underscores the need for empirical study of the process of judicial decision making in civil commitment and determinations of competence. The authors report the ratings on 26 descriptive variables made by five Massachusetts district court judges for 35 patients in civil commitment hearings. Nearly all of the hearings resulted in commitments. These findings suggest that psychiatrists may be setting too high a threshold for petitioning for commitment. Experienced judges appeared to be sensitive to the kinds of clinical issues that earlier studies have shown to contribute significantly to the psychiatrist's decision to petition for commitment.

Attitude↗

[Subacute and chronic joint involvement occurring during the course of familial Mediterranean fever (author's transl)].

Subacute and chronic joint involvement occur in less than 5 p. cent of patients with familial mediterranean fever, whereas acute joint lesions are observed in approximately 3 out of 4 cases. The various aspects of these atypical forms are discussed in relation to 10 such cases. In most of these patients the lesions were merely due to the prolongation of the acute process, presenting as a subacute mono-arthrites lasting for several months before regression. X Rays show only regional demineralisation, sometimes predominating in the subchondral zone. Symptoms totally regress without sequelae. A time destructive arthropathy may however develop, especially in the hip. The presentation associates limitation of joint motion with, on X Rays, joint space narrowing and osteophytes. In 2 of our cases and one case reported in the literature, there was a progressive development of a chronic caxopathy without any previous acute involvement of this joint. At last, in some cases, familial mediterranean fever may be associated with a known arthritidis, usually ankylosing spondylitis.

Adolescent↗