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PubMed2002

Case studies of pre- and midtrial prejudice in criminal and civil litigation.

This paper presents a number of case studies involving pre- and midtrial prejudice in criminal and civil litigation. The cases reveal deficiencies in the way that prejudicial publicity has been conceptualized and operationalized in many simulation experiments. The studies reveal that potential juror prejudices that concern lawyers and judges involve more than just main effects of mass media. Pre- and midtrial prejudice also involves more general prejudices, gossip and rumor, the assertion of community normative values about justice, and conformity pressures. Four categories of prejudice recognized in American law are described and labeled: interest, specific, generic, and conformity prejudice. The case studies also reveal interesting dynamics involving "minimization" and inconsistency in jurors' self-reports of attitudes which contradict a commonly held judicial view that superficial questioning is sufficient to uncover prejudice. Despite identifying deficiencies in the simulation literature, the paper concludes that experimental research is necessary to provide answers to causal questions that case studies and field research cannot ordinarily provide.

Civil Rights↗
PubMed2003

Sexual harassment stories: testing a story-mediated model of juror decision-making in civil litigation.

The story model of juror decision-making proposes that jurors use personal experience and information presented at trial to create stories that guide their verdicts. This model has received strong empirical support in studies using criminal cases. The research presented here extends the story model to civil litigation and tests a story-mediated model against an unmediated model of jury decision-making. In Phase 1, content analysis of mock juror responses to 4 realistic sexual harassment cases revealed prototypic plaintiff and defense stories. In Phase 2, these prototypic stories were included as mediators in a model predicting verdicts in 4 additional sexual harassment cases. Mock juror attitudes, experiences, and demographics were assessed, then attorneys presented abbreviated versions of 4 actual sexual harassment cases. Path analyses provided support for the story-mediated model, which added significantly to the amount of variance accounted for in the outcome measures of verdict, commitment to verdict, and confidence times verdict. Implications for sexual harassment and other types of civil cases are discussed.

Adult↗
PubMed2000

The triumph of the segregationists? A historiographical inquiry into psychology and the Brown litigation.

Psychologists testified at the trials of Brown v. Board of Education and helped write briefs that were submitted to the Supreme Court on appeal. Psychologists were once proud of what they did in Brown but are now seen as liberal reformers who masked their political wishes in the guise of social science. The argument that psychologists involved with Brown were social reformers rather than objective scientists dates to the segregationist critique of Brown. The author traces the history of the critique of the Brown psychologists from its segregationist origins to its acceptance by mainstream social scientific and historical scholars. The author concludes that the critique is based on a misreading of what the Brown psychologists did during the litigation.

Black or African American↗
PubMed2003

Atypical squamous cells of undetermined significance: audit and the impact of potential litigation. Retrospective review of 682 cases.

For quality assurance purposes, the frequency of 'abnormal' cytological diagnoses of the non-systematic National Cervical Cancer Screening Programme (NCCSP) was evaluated. In 1999, an unexpected high number of Class (Cl) III cases (i.e. atypical squamous cells of undetermined significance) was reported. The cytological and histological results were reviewed in order to detect a possible cause for this threefold increase. The abnormal Papanicolaou (PAP) smears examined by conventional methods from 1 January 1990 to 31 December 2002 were analysed. The smears of 682 cases diagnosed in 1999 with a Cl III category were reviewed in 2000 and correlated with the available histological diagnoses provided by the Central Department of Pathology. Of the 682 Cl III cases, 176 cases (26.1%) had no follow-up, 314 cases (46.0%) had repeat cytology and 192 cases (28.2%) an histological correlate corresponding to 90 (46.9%) benign lesions, 78 (40.6%) squamous intraepithelial lesions, two (1%) invasive cervical cancers (one squamous and one glandular). Twenty-two Cl III cases (11.5%) were histologically within normal limits. Retrospective smear review confirmed 330 Cl III diagnoses (48.3%), 127 cases (18.6%) were recategorized as Cl IIIG (i.e. atypical glandular cells of undetermined significance), 22 cases (3.2%) as Cl IIID (i.e. mild to moderate dysplasia) and six cases (0.9%) as Cl IVa (i.e. severe dysplasia and/or carcinoma in situ). A total of 197 original Cl III cases had to be reclassified in the Cl II category (28.9%), only two cases showing mild and moderate dysplasia on histology. Thus, 195 cases (28.6%) comprised cytological overdiagnoses. The Cl III category being, by definition, a delicate and often subjective diagnosis, all external influences such as pressure of litigation should be avoided to reduce cytological overdiagnoses as a result of an unnecessary 'fear-factor'.

Diagnosis, Differential↗
PubMed2000

Litigation and changes in professional behaviour: a qualitative appraisal.

OBJECTIVE: Concerns about an apparent rise in defensive clinical practice have centred on an alleged rise in intervention rates, particularly in maternity care. This, the second of two articles, explores the views of a number of clinical and other practitioners concerning defensive practices. DESIGN: Qualitative using semi-structured interviews. PARTICIPANTS: (a) midwives and obstetricians who had responded to an earlier postal survey, and (b) a purposive sample of others with experience in this area. FINDINGS: Differing views about the extent of defensive practices, and about what constitutes defensiveness, were expressed. A discussion of these, and of the findings of the survey reported in the first article, casts doubt on the view that defensive practices are necessarily detrimental. While an increase in caesarean sections was claimed, and justification of this option made, other more positive responses were also noted. KEY CONCLUSIONS: The definition and extent of defensive practice are difficult to determine. While some responses indicate that the fear of litigation leads to restrictions on client choice through interventions which are difficult to justify clinically, others claim that the same fear has improved standards of communication and documentation.

Female↗
PubMed2000

Evaluation of a WMS-R malingering index in a non-litigating clinical sample.

The purpose of this study was to examine the prevalence of a Wechsler Memory Scale-Revised "malingering index" in a large sample of non-litigating individuals from an inpatient substance abuse program. Past research has demonstrated that experimental-malingerers often obtain substantially lower scores on the Attention/Concentration Index than on the General Memory Index. In the present study, only a small percentage of patients showed large General Memory - Attention/Concentration difference scores. These results provide further support for the validity of this difference score as a marker for non-optimal effort.

Adult↗
PubMed2001

Validation of the computerized assessment of response bias in litigating patients with head injuries.

The detection of malingering in neuropsychological assessment requires valid measures of incomplete effort. The Computerized Assessment of Response Bias (CARB) is a digit-recognition procedure designed to detect poor effort during a neuropsychological evaluation. We examined the CARB performance of a consecutive series of litigating patients (N = 119) with a full range of head-injury severity, from trivial to severe. Patients with trivial or mild head injuries performed more poorly than did patients with frank brain injuries. Specifically, patients with moderate to severe traumatic brain injuries obtained higher total scores and demonstrated briefer response latencies than did patients with trivial or mild head injuries.

Adult↗
PubMed2003

Wechsler Adult Intelligence Scale-Third Edition findings in relation to severity of brain injury in litigants.

WAIS-III findings were reported for 150 litigants, classified into three groups according to severity of traumatic brain injury (TBI), and a general population control group. There was a significant "dose response" relationship between TBI severity and all Index/IQ scores. Effect size was greatest for the Processing Speed Index (PSI). Between group differences were significant on all subtests except Information and Digit Span. Effect sizes were greatest for Digit Symbol, Symbol Search, Similarities, and Picture Arrangement. Relative to the control group, there was a significant difference for the Severe and Extremely Severe TBI groups on all IQ/Index scores and most subtests. The Moderate TBI group differed significantly on one Index (the PSI) and none of the subtests. Clinical implications of the findings are discussed in relation to the utility of the WAIS-III in assessing the cognitive sequelae of TBI, the use of current WAIS-III IQ scores to assess intelligence-memory discrepancies, WAIS-III short forms, and estimation of premorbid intelligence.

Adolescent↗
PubMed2003

Exaggerated pain report in litigants with malingered neurocognitive dysfunction.

Twenty-nine litigants who met criteria for either definite or probable malingered neurocognitive dysfunction and reported chronic pain produced scores on the McGill Pain Questionnaire (MPQ), Pain Disability Index (PDI), and Modified Somatic Perception Questionnaire (MSPQ) that were significantly higher than scores produced by large samples of clinical pain patients. At 0.90 specificity, the MPQ, PDI, and MSPQ yielded sensitivities of 0.21, 0.59, and 0.90, respectively. The MSPQ alone, correlated significantly with the Lees-Haley Fake Bad Scale (FBS). Overall, the MSPQ is superior to the MPQ and PDI for detection of exaggerated pain symptoms.

Adult↗
PubMed1994

Why healthcare reform may unleash a litigation explosion.

One aspect of healthcare reform that has been largely overlooked is the expansion of antidiscrimination laws far beyond the traditional grounds of race, sex, age, and religion. Added to this is a provision giving individuals the broad right to sue over "government-guaranteed" medical treatment. What are the implications of such sweeping reforms? According to law professor Bradley A. Smith, a new wave of litigation is a real possibility.

Civil Rights↗
PubMed1999

Detecting malingering in head injury litigation with the Word Memory Test.

The Word Memory Test (WMT) is a relatively new computer-based test that is designed to measure both verbal memory and biased responding (i.e. malingering). The purpose of this study was to examine the performance of a large sample of patients involved in head injury litigation on the WMT measures of biased responding. The patients were divided into two groups, those with relatively mild head injuries (n = 234) and those with moderate or severe brain injuries (n = 64). The patients with less severe injuries performed significantly poorer on the WMT measures of biased responding.

Adult↗
PubMedDate not supplied

Clinical trials litigation: practical realities as seen from the trenches.

Litigation involving human clinical research trials has escalated rapidly in the past few years. Whereas these suits raise many important theoretical questions, they also have important practical and human dimensions of which many people are unlikely to be aware until, by some unfortunate turn, they must live the reality. From the vantage of a fairly close view on one recent lawsuit, this article offers some ground-level observations and reflections that, it is hoped, may be of use to people in clinical research who might one day find themselves in a similar position.

Clinical Trials as Topic↗
PubMed2005

WMS-III findings in litigants following moderate to extremely severe brain trauma.

Published information pertaining to the clinical utility of the WMS-III in assessing memory impairment in traumatic brain injury (TBI) remains inadequate. WMS-III findings are reported for 180 litigants with post-acute moderate to extremely severe TBI, classified into three groups according to injury severity, and a healthy control group. A significant "dose-response" relationship was found between memory impairment and TBI severity for most of the WMS-III indexes and subtests. Effect sizes were large for the Immediate and General Memory Indexes and medium for the Working Memory Index. In general, TBI had a greater effect on the Visual than Auditory Indexes. Effect sizes were greatest for Family Pictures and least for the auditory recognition and working memory tasks. Group findings indicate the immediate memory tasks to be clinically useful in relation to a severe or extremely severe TBI, but not for less severe trauma. Delayed memory tasks do not provide information additional to that obtained from immediate memory measures. The revised Tulsky indexes are no more sensitive to the effects of TBI than the original ones. Differences between WMS-III memory indexes are unlikely to be of diagnostic utility although memory-intelligence discrepancies may be.

Adolescent↗
PubMed1999

Establishing the right of the terminally ill to adequate palliative care: the litigation alternative.

The Bazelon Center For Mental Health Law in Washington, D.C., has undertaken a palliative care project to examine how litigation might be used to secure the rights of terminally ill patients to receive adequate palliative care, including the medications necessary to relieve the pain that often accompanies a final illness. One area of inquiry is the Medicare Hospice Benefit and the requirement that, to qualify for the benefit, a patient must have a prognosis of 6 months or less to live. A second major area of inquiry is regulatory restrictions on the prescription of opioids for pain relief of terminally ill patients and whether those restrictions improperly impede the physicians in their ability to engage in effective and appropriate pain management.

Journal Article↗
PubMed2001

Litigation on behalf of victims of exposure to environmental tobacco smoke. The experience from the USA.

BACKGROUND: For a quarter of a century, lawsuits have been filed on behalf of individuals who have been harmed by exposure to environmental tobacco smoke (ETS). METHODS: A review of hundreds of legal cases where exposure to ETS was the basis for the lawsuit was undertaken. The history of ETS-based lawsuits was categorised and analysed. RESULTS: While ETS-based lawsuits have arisen in a variety of divergent settings, there have been an increasing number of instances in which individuals have achieved relief from exposure to ETS and/or monetary compensation for having been so exposed. Such successful outcomes make it easier for others to achieve similar results through litigation. CONCLUSION: Lawsuits will probably continue to be a viable remedy in assisting those being harmed by exposure to ETS, both-inside and outside the USA.

Adult↗
PubMed1989

Cost, correlates and effects of malpractice litigation in family practice residency programmes in the United States.

A survey of family practice residency programme directors in the United States was undertaken to look at the impact of malpractice and malpractice insurance on residency education. Of 385 programmes 276 (71.7%) responded to the 20 question survey. The results indicated a mean rate of 0.043 claims per resident or faculty member in the previous year. One-fifth of the respondents did not report the type of malpractice insurance retained for residents and over half did not report the cost of insurance for residents. Current problems with liability were most often related to the region of the country, number of visits to the family practice centre, the number of residents, the number of faculty, the type of faculty employer and the type of resident employer. Programmes which anticipated future problems with liability were most likely to be those with current problems. The areas identified as most concerning to residents included: obstetrics, cost of malpractice insurance, difficulty obtaining coverage, and the general anxiety created by malpractice litigation.

Education, Medical, Graduate↗
PubMed2002

Enacting litigious environments: litigation and Florida's nursing homes.

This article examines how different for-profit nursing home facilities with varying levels of lawsuit risk responded to the litigious environment existing in Florida during 1999. Specifically, this article considers the question: How do nursing home staffs differ in their views of litigation risks and their reactions to those perceived risks? To answer this question, this study examined selected Florida facilities from a large, multinational, for-profit long-term-care chain.

Attitude of Health Personnel↗
PubMed2001

Pre-litigation strategies--gathering and preserving documentary evidence.

Radiation injury claims may arise under various legal theories. In addition, plaintiffs may advance such claims within different jurisdictional venues, such as federal and state courts and workers' compensation boards. Irrespective of the jurisdiction or the legal theory underlying the claim, one element remains common to these claims--the quality and quantity of the evidence. While many different pieces of evidence may be needed to litigate a radiation injury claim, the most important evidence for the investigating health physicist is that which establishes the nature and extent of radiation exposure. Most radiation injury claims are associated with late radiation injury, often an allegation of radiation-induced cancer. Because radiation-induced cancers have a long latency period, claims may not arise for years, or even decades, after exposure. Therefore, the immediate challenge to the health physicist, who investigates an exposure, is to avoid the temptation of a "wait and see" approach to gathering evidence. Not only may evidence be short-lived in nature, but with the passage of time memories grow dim and witnesses may become unavailable. Prompt and thorough gathering of pertinent evidence likely will be a determining factor in the outcome of any radiation injury claim. Although ensuring the availability of all pertinent evidence is the key role of the investigating health physicist, he or she also can help to ensure that the evidence does not inadvertently become inadmissible in a court of law, for example, under the hearsay rule. To ensure that the necessary evidence is available in admissible form, the task of gathering evidence should be systematically approached using a pre-established process that reflects a basic understanding of the rules of evidence. Such a process is discussed here.

Documentation↗