Results for “EXPERT TESTIMONY” — Page 74

PubMedDate not supplied

Memory for murder. A psychological perspective on dissociative amnesia in legal contexts.

There is currently a complex and inconsistent state in the law relating to dissociation and dissociative amnesia (McSherry, 1998). Although dissociative amnesia in defendants is relevant to both competency to stand trial and criminal responsibility in principle, courts have typically assumed a skeptical stance toward such claims in practice. However, there is considerable evidence from both nonoffender and offender populations to support the validity of dissociative amnesia in defendants. Further, there is information available to aid in the evaluation of amnesia, such as the quality of the report itself and characteristics of the person reporting the amnesia (e.g., psychopathy). When consideration is given to the legal response to reports of dissociative amnesia by complainants, the situation becomes even more complex. While some courts have rejected recovered memory evidence, others have convicted defendants of historical offenses based on such evidence. In some cases, judges have argued that jurors should be left to decide on the validity of recovered memories based on their common sense and experience. The uncritical acceptance of the validity of repressed memories in complainants by many courts stands in stark contrast to the response to claims of amnesia from defendants. It seems apparent that the courts need better guidelines around the issue of dissociative amnesia in both populations. We think that the increasing scientific understanding of memory in the past decade (see Schacter, 1999) can meaningfully contribute to the development of such guidelines. Responsible, nonpartisan expert testimony from mental health professionals would be one step in the direction of rectifying the current state of law in regards to dissociation.

Amnesia↗

PubMed1990

Legal aspects of orthodontic practice: risk management concepts. The uncooperative patient: terminating orthodontic care.

In this and succeeding issues of the American Journal of Orthodontics and Dentofacial Orthopedics, factual risk management scenarios will be presented. These scenarios are based on composites of actual court cases that have been tried to verdict or decision. Valuable risk management lessons may be learned from careful analysis of the course of the events described. Please be advised that the standard of care determined in any case is specific for that jurisdiction and that set of facts as established by expert testimony for the prevailing party.

Continuity of Patient Care↗

PubMed1990

Legal aspects of orthodontic practice: risk management concepts. The need for a structured dismissal program.

In this and succeeding issues of the American Journal of Orthodontics and Dentofacial Orthopedics, factual risk management scenarios will be presented. These scenarios are based on composites of actual court cases that have been tried to verdict or decision. Valuable risk management lessons may be learned from careful analysis of the course of the events described. Please be advised that the standard of care determined in any case is specific for that jurisdiction and that set of facts as established by expert testimony for the prevailing party.

Defensive Medicine↗

PubMed1990

Legal aspects of orthodontic practice: risk management concepts. Excellent diagnostic informed consent practice and record keeping make a difference.

In this and succeeding issues of the American Journal of Orthodontics and Dentofacial Orthopedics, factual risk management scenarios will be presented. These scenarios are based on composites of actual court cases that have been tried to verdict or decision. Valuable risk management lessons may be learned from careful analysis of the course of the events described. Please be advised that the standard of care determined in any case is specific for that jurisdiction and that set of facts as established by expert testimony for the prevailing party. Readers' comments may be addressed to Dr. Donald E. Machen, 5801 Beacon St., Pittsburgh, PA 15217.

Adult↗

PubMed1991

Legal aspects of orthodontic practice: risk management concepts. Disposing of your orthodontic practice: be careful.

In this and succeeding issues of the American Journal of Orthodontics and Dentofacial Orthopedics, factual risk management scenarios will be presented. These scenarios are based on composites of actual court cases that have been tried to verdict or decision. Valuable risk management lessons may be learned from careful analysis of the course of the events described. Please be advised that the standard of care determined in any case is specific for that jurisdiction and that set of facts as established by expert testimony for the prevailing party. Readers' comments may be addressed to Dr. Donald E. Machen, 5801 Beacon St., Pittsburgh, PA 15217.

Humans↗

PubMed1991

Legal aspects of orthodontic practice: risk management concepts. TMJ update: the adult patient.

In this and succeeding issues of the American Journal of Orthodontics and Dentofacial Orthopedics, factual risk management scenarios will be presented. These scenarios are based on composites of actual court cases that have been tried to verdict or decision. Valuable risk management lessons may be learned from careful analysis of the course of the events described. Please be advised that the standard of care determined in any case is specific for that jurisdiction and that set of facts as established by expert testimony for the prevailing party. Readers' comments may be addressed to Dr. Donald E. Machen, 5801 Beacon St., Pittsburgh, PA 15217.

Adult↗

PubMed2005

The current crisis in obstetrics.

Of the issues leading to legal actions in obstetrics, the most important are events occurring before delivery that are deemed to account for the birth of a physically or mentally challenged child. In determining causation in the clinical setting, the diagnosis of fetal asphyxia can be made using blood gas and acid-base assessment. However, there are many subsidiary questions that in most cases cannot be answered, including when the asphyxia began, the severity and nature of the asphyxia during the exposure, the quality of the cardiovascular compensation, and when the brain damage occurred. When scientific proof is not available, the dilemma for the court is the requirement to reach a conclusion about the timing of brain damage on the balance of probabilities. Although it is of value, clinical risk scoring using fetal heart rate (FHR) monitoring may result in false positive predictions of fetal asphyxia. The problem in FHR monitoring is the lack of a detailed algorithm for the interpretation of FHR patterns with appropriate recommendations for management. Until such an algorithm is developed, health care workers cannot be expected to respond to fetal heart rate patterns consistently. Responsibility for the crisis in obstetrics must rest with the members of the health care disciplines who provide expert testimony. Progress made in research encourages us to assume that more is known about the causes of brain damage in the clinical setting than in fact is known. Similarly, health care professionals, parents, and lawyers often assume current methods of prediction and diagnosis to be more effective than they actually are.

Blood Gas Analysis↗

PubMed2005

[Learning from the experiences of an arbitration unit for medical liability questions].

While other countries', e.g. the United States', experience with alternative dispute resolution (ADR) in medical malpractice has been disappointing, German physicians have instituted extrajudicial claims resolution as an alternative to civil litigation: Established by the Arztekammern (corporate bodies of professional self-governance) in the mid-1970s, the Schlichtungsstellen (SchlSt--claims resolution panels) offer patients and doctors, on a voluntary basis, proceedings directed toward achieving a settlement. The number of cases submitted to these panels has been constantly growing since. In 90% of cases decided upon by the panel, civil litigation was avoided. Doctors can, as exemplified by the operation of the SchlSt, tackle difficult and complex problems and solve them--without being funded or directed by outside agencies. What can be learnt from being, as a physician member, associated with a SchlSt for several years? (1) Physicians--as Eddy has pointed out--must make decisions about complex problems under difficult conditions on the basis of inadequate information. Expert testimony suffers from similar uncertainties. Decisions on individual cases cannot be improved by external and necessarily generalized ruling (disease management programs, other directives). (2) Errors and adverse events in medical care have to be accepted as principally unavoidable. Most claims heard by the panel have to do with operations and--in the non-surgical specialties--with invasive procedures. Medical tasks of high complexity, as many operative and invasive procedures indeed are, seem to have an inherent accident-proneness. Therefore decisions as to operations and invasive procedures should be weighed with utmost care. More is not always better (3) 25% of the patients filing claims with the SchlSt complain of deficient doctor-patient-communication. Failure of doctors and staff to communicate adequately with the patients and with their professional contacts plays an important role as risk factor for negligence and injury and even as cause of disputes and claims. (4) The GP, the generalist in a profession characterized by specialization, has to treat a wide spectrum of diseases, wider than any specialist. As far as can be seen, he does his job well. He needs adequate--if possible personal--contact with and support by his colleagues involved in the treatment of the same patient.

Germany↗

PubMed1983

Testimonial compulsion. The involuntary medical expert witness.

Explore the source record for details and available documents.

Expert Testimony↗

PubMedDate not supplied

Gait analysis in rehabilitation medicine: a brief report.

Gait analysis can be a powerful tool for rehabilitation research and clinical practice. However, there has been little coordinated effort to set goals for the application of gait analysis in rehabilitation. Therefore, a priority setting process was engaged to obtain the opinions of a diverse pool of experts related to human motion analysis. The primary goal of this process was to develop priorities for future research, development, and standardization in gait analysis. A multistep approach was used that included expert testimony, group discussions, individually developed priorities, and a ranking process. Several important priorities emerged from this activity. The highest priority was assigned to research on the efficacy, outcomes, and cost-effectiveness of gait analysis.

Cost-Benefit Analysis↗

PubMed1986

Screening and monitoring data as evidence in legal proceedings.

The greatest legal impact of medical screening and biological monitoring may be in proceedings to compensate workers for occupational disease. In workers' compensation, failure to demonstrate a disease's work-relatedness has often barred compensation. Screening and monitoring data can add a new causal link by demonstrating longitudinally a worker's reaction to a toxic exposure. Employers may also use the data to rebut claims. In tort suits, the data can help establish causation and aid the admissibility of expert testimony. Of most significance, it may create a higher legal standard of care for employers based on increased knowledge of their workers' health status, which may open up new grounds for suits. These legal implications of greater liability may make employers reluctant to collect medical test data. On the other hand, testing programs may aid them in legal proceedings by demonstrating good faith efforts to reduce disease risks.

Humans↗

PubMed1990

A fluoridation campaign: the Phoenix experience.

On January 31, 1989, the city council of Phoenix, Arizona, voted to approve water fluoridation. Despite a small number of campaign participants and a limited budget, profluoridationists launched a successful 16-month effort that included novel marketing techniques, intensive collaboration with media representatives, and an aggressive challenge of the antifluoridation movement. Public support was garnered through an advisory petition effort and positive media coverage; political support resulted from a carefully orchestrated educational strategy that included expert testimony and comprehensive reference materials. With a population of approximately 1 million people, Phoenix is the ninth largest city in the country and, until the measure was implemented, the third largest nonfluoridated city.

Arizona↗

PubMed2006

Thrombolysis (tissue plasminogen activator) in stroke: a medicolegal quagmire.

BACKGROUND AND PURPOSE: Despite the success of the 1995 National Institutes of Neurological Disorders and Stroke (NINDS) study using IV recombinant tissue plasminogen activator (tPA) within 3 hours in acute stroke and its subsequent FDA approval, there has been a reluctance to use tPA because of safety and efficacy issues with high incidence of intracerebral hemorrhage, and protocol violations. SUMMARY OF REVIEW: The following cases will illustrate the increased number of malpractice lawsuits generated by the controversy of "standard of care" and illustrate and educate clinicians regarding specific issues and how to avoid: (A) Failure to use tPA (loss of chance) or to transfer, Reed versus Granbury Hospital (Texas): acute stroke victim taken to local hospital with tPA available only for cardiology. Wife subsequently transferred patient to nearby stroke center but no tPA given. Defendant verdict; (B) Stroke misdiagnosis (failure to diagnose, loss of chance), Mei versus Kaiser Permanente South (San Francisco, CA): acute stroke while driving with ambulance taking to local hospital. Symptoms were misdiagnosed and neurologist did not see her for 6 hours. Plaintiff verdict; (C) Bleeding complications of therapy/failure of informed consent, Harris versus Oak Valley Hospital (California): acute stroke and hypertension treated with tPA with subsequent development of intracerebral hemorrhage. Patient alleged that tPA should not have been given. Defense verdict; (D) Expert witness testimony, Wojcicki versus Caragher (Massachusetts): a prominent neurologist gave "false and misleading testimony" and the Court found that the neurologist perpetrated a "fraud on the Court" intentionally and deliberately misleading the Court and jury. Court sanctioned the neurologist 88,685 dollars; Ensink versus Mecosta County General Hospital (Michigan): neurological testimony (plaintiff expert) regarding potential benefit of using tPA during last available 1 hour of window was felt to be "speculative". Defendant verdict. CONCLUSIONS: Neurologists, emergency room physicians and hospitals are at increased liability risk if they use or do not use tPA. Detailed documentation, informed consent or timely transfer should reduce threat of legal action.

Aged↗

PubMedDate not supplied

Legal responsibilities of the pathologist.

Pharmaceutical companies exist today in a hostile legal and regulatory environment. The threat of product liability in the pharmaceutical industry has risen to the point where it stifles research and development, especially for contraceptive and psychotropic drugs. Regulatory sanctions against the industry are more likely now than in the past since the Food and Drug Administration (FDA) has placed significant emphasis on regulatory inspection and enforcement. Industrial pathologists play a critical role in defending their company in product liability litigation and from regulatory sanctions. In-house and contract pathologists should be prepared to give expert testimony in court and ensure that an effective document retention policy is implemented. Pathologists should know the limits of the FDA's inspection authority and be aware of the "pitfalls" of the FDA's new Fraud Policy. In addition to keeping abreast of science, industrial pathologists today can best serve the pharmaceutical industry if they maintain an awareness of legal issues that pose a threat to the future success of the industry.

Drug Industry↗

PubMed2005

The effectiveness of sexual assault nurse examiner (SANE) programs: a review of psychological, medical, legal, and community outcomes.

In sexual assault nurse examiner (SANE) programs, specially trained forensic nurses provide 24-hour-a-day, first-response medical care and crisis intervention to rape survivors in either hospitals or clinic settings. This article reviews the empirical literature regarding the effectiveness of SANE programs in five domains:(a) promoting the psychological recovery of survivors, (b) providing comprehensive and consistent post-rape medical care (e.g., emergency contraception, sexually transmitted disease [STD] prophylaxis), (c) documenting the forensic evidence of the crime completely and accurately, (d) improving the prosecution of sexual assault cases by providing better forensics and expert testimony, and (e) creating community change by bringing multiple service providers together to provide comprehensive care to rape survivors. Preliminary evidence suggests that SANE programs are effective in all domains, but such conclusions are tentative because most published studies have not included adequate methodological controls to rigorously test the effectiveness of SANE programs. Implications for practice and future research are discussed.

Counseling↗

PubMed2003

The health educator's role in advocacy and policy: principles, processes, programs, and partnerships.

Advocacy skills are essential for the public health practitioner. Recognizing this need, two statewide public health organizations partnered for a series of advocacy trainings. Outcomes included an increased competence for such advocacy as providing expert testimony, writing position papers, forging stronger relationships with policy makers, and committing to ongoing advocacy. An increase in statewide initiatives also included a legislative scorecard, development of a model advocacy network by voting districts, advocacy policy for associations, fact sheets for legislators on pending public health issues, a new university advocacy course, and advocacy action by two associations' members to reach common goals. The trainings and subsequent initiatives provide a template for organizations and individuals to build advocacy skills and increase the role of public health professionals in setting state public health policy.

Consumer Advocacy↗

PubMed2005

Medical errors.

Following the 2000 report of the Institute of Medicine, To Err Is Human, which documented that as many as 98,000 people in this country die of medical errors every year, medical, hospital, and governmental agencies began to consider changes in hospital systems. The report had found that errors were much more likely to result from systemic problems than from inept health care providers. Progress in reinventing hospital systems has been very slow, although some institutions have made great gains."Medical errors" may be of several types. Some lead to malpractice claims, many do not. Many people who have been severely injured by errors never file claims. Making a medical mistake is not necessarily "malpractice." There are six elements a patient must prove in order to win a malpractice case: a physician-patient relationship must exist, the care provider must owe the patient a duty of care, evidence (usually expert testimony) must be presented that there was a failure in some part of the duty of care, there must proof that the lack of care was the proximate cause of harm, and proof of evidence that harm occurred. The patient must also prove his or her assessment of damages. Solutions to the problem of patient injuries are suggested.

Delivery of Health Care↗

PubMed2006

Demons, nature, or God? Witchcraft accusations and the French disease in early modern Venice.

In early modern Venice, establishing the cause of a disease was critical to determining the appropriate cure: natural remedies for natural illnesses, spiritual solutions for supernatural or demonic ones. One common ailment was the French disease (syphilis), widely distributed throughout Venice's neighborhoods and social hierarchy, and evenly distributed between men and women. The disease was widely regarded as curable by the mid-sixteenth century, and cases that did not respond to natural remedies presented problems of interpretation to physicians and laypeople. Witchcraft was one possible explanation; using expert testimony from physicians, however, the Holy Office ruled out witchcraft as a cause of incurable cases and reinforced perceptions that the disease was of natural origin. Incurable cases were explained as the result of immoral behavior, thereby reinforcing the associated stigma. This article uses archival material from Venice's Inquisition records from 1580 to 1650, as well as mortality data.

Catholicism↗