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PubMed1995

Tuberculosis, public health, and civil liberties.

The resurgence of tuberculosis confronts policy-makers with difficult legal and ethical questions about the proper use of state power and resources to protect public health. This chapter examines the implications of expanded use of invasive or coercive measures-including directly observed therapy, involuntary detention of noncompliant patients, and forced administration of medications--designed to reduce the risk of tuberculosis transmission and to ensure that those with TB are fully treated. These measures focus attention on the limitations of government power and obligation and on the delicate balance between the demands of civil liberty and the demands of public health.

Civil Rights↗
PubMed1984

Ten years of "civilization": fitness of Canadian Inuit.

Data on the cardiorespiratory fitness of the Canadian Inuit has been obtained before and after 10 yr exposure to "white civilization." The population tested comprises 201 males (aged 9-76 yr) and 143 females (aged 10-69 yr), about 70% of the eligible population of Igloolik (69 degrees 40'N). During direct maximum tests to exhaustion, a higher maximum heart rate was attained in 1980-81 (194.4 beats X min-1) than in 1970-71 (184.5 beats X min-1); this probably reflects a closer approach to a centrally limited maximum as the Inuit have become familiar with white investigators. The Astrand nomogram currently underestimates the directly measured maximum O2 intake (VO2max) by some 3% in subjects making a good maximum effort. Comparing the 1980-81 data with results for 1970-71, there has been a 15% decrease of predicted VO2max, accompanied by a 2- to 4-kg increase of body mass, accumulation of subcutaneous fat, and a decrease of leg extension strength, these changes affecting all subjects except boys aged 9-15 yr. It is suggested that the loss of personal fitness is related to adoption of a more sedentary lifestyle, particularly the use of tracked vehicles in place of walking through deep snow.

Adolescent↗
PubMed1975

Civil liberties versus involuntary hospitalization.

The authors examine the issue of involuntary hospitalization for mental illness with particular reference to legal rights and civil liberties. Follow-up data of patients treated on a closed ward, as well as other available evidence, indicate that society is not ready for the abolition of involuntary hospitalization. The authors believe that the most fundamental right of the patient is that of adequate treatment, and therefore this should take precedence over an absolute right to liberty.

Attitude↗
PubMed1985

Miranda comes to the hospital: the right to remain silent in civil commitment.

One procedural protection that has not generally made the transition from the criminal justice system to involuntary civil commitment is the Fifth Amendment protection against self-incrimination. The authors present the results of a study of the implementation of the right to remain silent, which demonstrate that warning patients that anything they say may be used against them in the commitment hearing has little impact on their willingness to talk to staff or to cooperate with treatment. The authors discuss the possible reasons for their findings.

Adult↗
PubMed1989

An empirical comparison of the stone and dangerousness criteria for civil commitment.

Massachusetts civil commitment criteria were compared in an emergency setting with a set of criteria developed by Dr. Alan Stone. Contrary to expectations, the Stone criteria proved to be more restrictive in a sample of 503 patients. Few patients would be newly committable under the Stone criteria; of the 35 patients committable under the Stone standard, 32 also met the current Massachusetts criteria for commitment. The clinical and policy implications of the adoption of the Stone criteria are discussed.

Adult↗
PubMed1977

Criminal justice procedures in civil commitment.

The actions of federal district courts and state legislatures in recent years have resulted in the growing application of procedures of the criminal justice system to the civil commitment process. Increasingly patients can be confined only if they are dangerous to others, and increasingly due-process procedures of the criminal law are required, to the detriment of the patient's treatment and his survival in the community. The author says that allegations of patients' being railroaded into hospitals are, with few exceptions, fictitious. Abuses thet do exist should be handled through writs of habeas corpus and malpractice suits, remedies much more available now than in the past. The principal abuse in commitment occurs not when patients are admitted, the author believes, but at discharge, when so many patients are turned out into communities that lack proper services for them.

Child Advocacy↗
PubMed1988

Post-traumatic stress disorder and civil violence in Northern Ireland.

The case records of 499 victims of civil and terrorist violence were examined, and the presence or absence of post-traumatic stress disorder (PTSD) and associated features recorded. The results support the face, and predictive, validities of PTSD. 'Acting as if the event were reoccurring' and 'survivor guilt' seemed not to be characteristic symptoms, and the homogeneity of the emotional state in PTSD was questionable. Only marital disharmony and suicidal behaviour were associated complications. PTSD seemed to be found in a wide range of stressors, but the danger in over-reliance on results from combat veterans is emphasised.

Adult↗
PubMed1998

Genetic and non-genetic basis of essential hypertension: maladaptation of human civilization to high salt intake.

The relation between salt intake and hypertension has long been controversial. Available evidence provides conflicting results. However, biological and evolutionary insights into the structure and principle function of the kidney and the blood pressure sustaining machinery, with the extracellular fluid volume and the renin-angiotensin system acting as a central player, clearly indicate that salt has been a precious commodity in the terrestrial animal kingdom and that essential hypertension may be a consequence of the kidney's maladaptation to excess salt intake, which is specific to recent human civilization. This review provides a hypothesis to explain how and why hypertension develops and attempts to define the roles of genetic, non-genetic, and environmental factors in its pathogenesis.

Adaptation, Physiological↗
PubMed1979

The collection and analysis of documents for the Civil Liberties and Sexual Orientation Project.

This article shows how documents are collected and analyzed as part of a complex methodology to supplement and verify data gathered for the Civil Liberties and Sexual Orientation Project. During interviews, respondents are shown a checklist and asked if they have documents that may support their belief that they have experienced discrimination. Interviews are considered fully documented if materials are obtained which demonstrate that action was taken against a respondent and that the action was based on sexual orientation or on departures from social sex-role stereotypes. Documents are also collected to see if other attributes of a respondent were involved in the action. In addition, supplemental information is obtained that augments interview data.

Civil Rights↗
PubMed1986

Lesbianism, homosexuality, and the American Civil Liberties Union.

One of the turning points in changing the legal status of homosexuals in the United States was the change in policy of the American Civil Liberties Union. The author of this paper was instrumental in bringing about change in the Southern California ACLU, the first affiliate to modify the policy and carry on the legal battle for gay rights. This article details the background of and some of the insights gained from that experience.

Civil Rights↗
PubMed1994

A moral justification for gay and lesbian civil rights legislation.

This essay explores, in two parts, the problems of justifying civil rights legislation for gays, lesbians, and bisexuals. Part I shows that discrimination against gays and lesbians at least in respect to employment, housing, and public accommodations is an evil unsupported by ethical traditions in utilitarianism, rights theory, and communitarianism. It also shows that two theories, Kantian theory and natural law theory, which do support such discrimination on the claim that homoerotic behavior is universally or objectively immoral only do so because of a failure to make precise the concept of "natural" which underlies those theories. Part II argues that anti-discrimination legislation is both an appropriate and effective means to promote the idea that discrimination against lesbians and gays in respect to most employment, housing, and public accommodations is sufficiently injurious to both individuals and society that it should not be tolerated. The section also explains how such legislation might succeed practically in eliminating discrimination in these areas.

Bisexuality↗
PubMed2003

The San Francisco bathhouse battles of 1984: civil liberties, AIDS risk, and shifts in health policy.

In the mid-1980s, controversy emerged in a number of American cities over the roles gay bathhouses and sex clubs might play in the spread of AIDS, and in raising safe-sex awareness. In 1984, San Francisco became the first city where political debates broke out over AIDS-related policies for bathhouses and sex clubs. These debates were dominated by questions of public health and gay civil liberties. A variety of proposals were put forward during 1984 to try to reconcile these two concerns, or to give one a higher priority than the other. Certain officials in San Francisco's government, and members of its gay/lesbian/bisexual community, strongly disagreed over whether the businesses should be closed, should make their own AIDS-prevention efforts, or should continue operating under new regulations. Policies implemented for the city's baths were disconnected from the known AIDS risk of different sexual behaviors, and from research findings on AIDS and the local baths. Political and judicial decisions concerning San Francisco's bathhouses and sex clubs that were made in 1984 had continuing influences on these businesses through the later 1980s and the 1990s.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Psychoanalytic peregrination VI: "the effect on countertransference of the collapse of civilization".

There is an aspect to countertransference that has not been discussed very much in the literature of psychoanalysis, one that is becoming increasingly important. This centers around the effect on the analyst's countertransference of the deterioration of the culture in which he or she is immersed. I discuss the decline of Western civilization as it is described by a number of contemporary authors in order to show how changes in the value system of the psychoanalyst or his or her turning a blind eye to the injustices and barbarism of the cultural surround both affect the capacity to immerse in the creative process of psychoanalysis, and send a tacit message to the patient about the permissability of hiding certain material. All this contradicts the "fundamental rule" of psychoanalysis, and disturbs the analyst's listening process. The impact of the dumbing down and deterioration of the educational, cultural, and home upbringing milieu of the new generation of psychoanalysts will be profound in influencing the future practice of psychoanalysis.

Civilization↗
PubMed2004

[Psychological factors and effects of reaching settlements in civil actions].

The purpose of this research was to examine disputant's cognitive processes in a civil suit empirically. We analyzed the data which was gathered by The Judicial Reform Council. We assumed that a disputant who wishes to reduce costs for suit often chooses settlement procedure in the judicial process and who thinks highly of the judge is more likely to accept judge's proposition. Although we could not confirm the effect of cost anxiety, the results suggested that a good impression forward the judge promotes reaching settlement. It was also suggested that corporations are apt to compound more than natural persons. In addition, analysis of effect of settlement indicated that reaching settlement promotes acceptance, agreement and satisfaction about unfavorable outcomes.

Anxiety↗
PubMed2005

Surgical pathology in the era of the Civil War: the remarkable life and accomplishments of Joseph Janvier Woodward, MD.

Joseph Janvier Woodward was an assistant surgeon in the US Army during the Civil War, coauthored the definitive works on the mortality and morbidity of that war, attended at the autopsy of President Lincoln, and attended President Garfield after he was shot. He revolutionized the field of photomicroscopy and was one of the first pathologists to use aniline dyes as tissue stains. Yet despite the occasional biographical sketch every few decades, he is largely unknown today. Herein, we review his contributions to surgical pathology and medicine and present modern-day photomicrographs of 140-year-old slides from Woodward's original collection.

American Civil War↗
PubMedDate not supplied

[About the necessity of neuropsychological assessment in the civil law].

Giving expert opinions within legal psychiatry in civil cases requires more and more strict co-operation of expert psychiatrists with psychologists. Assessment of the cognitive functions with the help of neuropsychological methods is an important diagnostic element that leads to giving the right opinion. The most frequent reasons for appointing experts in psychiatry and psychology are disorders of cognitive functions as a result of various brain injuries. Dementia syndromes are particularly often subjects of doubts in preparing expert opinions as they must be distinguished from other organic dysfunctions and from the age--associated memory impairment. Considering the evidence value the most important thing is to assess all the objective data included in the medical records and subsequently to assess the testimony of the witnesses Usually people from legal circles and families of the people who make declarations of will overvalue the importance of additional examinations. Those examinations are important but they do not settle the patient's psychic state because the decisive factor is not the kind of somatic disease but the influence of that disease on the psychic state. The neuropsychologist's role in giving medical statements is going to increase together with the tendency to objectivization and qualitative assessment of intensification of respective disorders of cognitive functions when examining patients in order to give expert opinions.

Brain↗
PubMed1975

The classification of trauma. Lessons leaned in classifying injuries of 1,797 patients from civil disturbances in Northern Ireland, 1969-1971.

The difficulties of applying the rules of the International Classification of Diseases to trauma cases are discussed on the basis of coding the injuries of 1,797 injured patients from civil disorders in Northern Ireland, 1969-1971. Certain inadequacies of the code are indicated and suggestions made about ways to modify it and make its applications more informative.

Civil Disorders↗
PubMed2002

DOTS-based tuberculosis treatment and control during civil conflict and an HIV epidemic, Churachandpur District, India.

OBJECTIVE: To pilot the WHO guidelines on DOTS for tuberculosis (TB) among displaced people affected by conflict in Churachandpur District, Manipur State, north-east India, which has endured an HIV epidemic, injecting drug use, civil unrest, high levels of TB, and poor TB treatment and prevention services for many years. METHODS: Prerequisites for TB control programmes were established. WHO guidelines and protocols were adapted for local use. Outreach workers were appointed from each ethnic group involved in the conflict, and training was conducted. Quality control and evaluation processes were introduced. FINDINGS: TB was diagnosed in 178 people between June and December 1998. Of the 170 with pulmonary disease, 85 were smear-positive. Successful outcomes were recorded in 91% of all patients and in 86% of smear-positive cases of pulmonary TB. The default rate and the mortality rate were low at 3% each. HIV positive serostatus was the only factor associated with a poor treatment outcome. CONCLUSION: TB treatment and control were possible in a conflict setting and WHO targets for cure were attainable. The factors associated with the success of the programme were strong local community support, the selection of outreach workers from each ethnic group to allow access to all areas and patients, the use of directly observed therapy three times a week instead of daily in the interest of increased safety, and the limiting of distances travelled by both outreach workers and patients.

Blood-Borne Pathogens↗