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PubMed1998

Relations among mock jurors' attitudes, trial evidence, and their selections of an insanity defense verdict: a path analytic approach.

This study examined an important question relevant to the domain of the insanity defense: What are the interrelationships among important evidential and attitudinal factors which influence how jurors decide their final verdicts? To answer this question, a mock trial in which the insanity defense was argued was presented to 224 college undergraduates by means of an audiotape and slide show. Following the presentation, participants were asked to answer a series of questions regarding the trial. A path model was specified with four evidential factors as endogenous variables, i.e., evaluation of the defendant's mental status, belief that the defendant could be rehabilitated, beliefs regarding the accuracy of the expert witnesses, and mock-jurors' predeliberation verdicts. In addition, three attitudinal factors were specified as exogenous variables, i.e., attitudes toward the insanity defense, attitudes towards due process vs crime control, and attitudes towards the death penalty. The path model was consistent with previous literature, suggesting that jurors' attitudes toward the death penalty and the insanity defense had a direct effect on how they evaluated the accuracy of the expert testimony and their evaluation of the defendant's over-all mental status. In turn, mock jurors' evaluations of the defendant's mental status had a direct effect on their selections of verdict. Importantly, mock jurors' evaluations of the evidential factors, particularly the mental status of the defendant, were a stronger predictor of their selections of verdict than were their initial attitudes.

Attitude↗
PubMed1997

Clinical pathways can help you prevent, win malpractice lawsuits.

By adopting critical pathways and closely adhering to nationally accepted guidelines, you can substantially reduce your risk of facing a malpractice lawsuit and increase your chances of winning if you are sued, experts say. Pathways introduced as evidence in your defense can serve as "expert testimony," establishing that you worked in accordance with an appropriate standard of care. To avoid any appearance that you breached the standard of care, make sure you document and justify any deviations from the clinical paths in place at your institution.

Critical Pathways↗
PubMed1978

How courts measure standards of care.

Malpractice liability exists only when a patient proves a provider failed to meet the standard of care that the law regards as his duty. Setting the standard against which the physician is measured is a complex and individualized judicial process. Such key benchmarks as similar geographic locality, community of providers, accreditation standards, expert testimony, and res ipsa loquitur are explained.

Hospitals↗
PubMed1986

Legal doctrines associated with medical malpractice.

Malpractice is the legal charge against a professional accused of a private wrong. Claims must be filed under tort (or civil) law; specific statutes can vary from state to state. Legal doctrines associated with malpractice include respondeat superior, which places ultimate liability with a superior or employer; proximate cause, which states that the professional's negligence resulted in injury; and res ipsa loquitur, which allows malpractice to be proved without expert testimony. Traditionally, PAs have been protected by respondeat superior; however, while some legal precedents have assigned liability to the physician entirely, others have distributed it proportionately between the supervised nonphysician provider and the physician. Consequently, no clear guidelines exist for PAs regarding malpractice, since the degree of liability has not yet been definitely decided by the courts. However, in the current legal climate, more and more PAs assume malpractice liability, and are providing for personal coverage.

Malpractice↗
PubMed2000

Abortion, breast cancer, and informed consent.

The purpose of this article is to show that the current level of scientific evidence linking induced abortion with increased breast cancer risk is sufficient to support an ethical and legal duty to disclose fully the risk to women who are considering induced abortion. The article examines the relationship between this evidence and the elements of a medical malpractice claim alleging failure to obtain informed consent. The first part focuses on the elements of informed consent, which require the plaintiff to establish that the physician had a duty to disclose information, which he failed to disclose, that this failure to disclose was a legal cause of the plaintiff's decision to undergo the procedure, and the procedure was a legal cause of the plaintiff's injury. The second part compares two prevalent standards for determining which risks a physician has a duty to disclose. Part three reviews the scientific evidence of the abortion/breast cancer (ABC) link and explains why it survives both the Frye and the Daubert tests for admissibility of expert testimony. The fourth part assesses the materiality of the risk posed by the ABC link. Parts five and six discuss evidentiary issues and the possibility of punitive damage awards.

Abortion, Legal↗
PubMed2001

[Fighting dogs--dangerous dogs: legal situation in Bavaria].

A report is given on eight years of experience with the Bavarian legal regulation for the protection against dangerous dogs of 10.7.1992. The implementation of the regulation was a success. Since then only two cases of biting accidents are reported. In one case the dogs were euthanatized, in the other case they were taken away and given to other owners. The advantages of the regulation are seen in the increased responsibility of the dog owner who has to give proof of the peaceful character of his dog in form of an expert testimony. This lowers the administration costs and has revealed a preventive effect, the dog owners are looking more carefully after their animals to avoid any security problems.

Aggression↗
PubMedDate not supplied

[Forensic neuropsychology: principal issues and applications].

INTRODUCTION: The term Forensic Neuropsychology refers to the application of the knowledge of the field of Neuropsychology to the legal matters. The field of Clinical Neuropsychology has experienced a great development, thanks to the investigations and publications that have been made both in the basic and applied fields. Nevertheless, only in the last years, clinical neuropsychologists have participated actively in the courts. DEVELOPMENT: The testimony as experts of neuropsychologists is more and more common. They inform to the judge on the behavioral, emotional and cognitive sequels following lesions to the human brain, as well as the importance of psychosocial variables in modulating brain function and dysfunction. The relationship between Neuropsychology and Law has been influenced by the confluence of a series of related factors that have contributed to the professionalization of this discipline. Among these, we can emphasize the study of brain-behavior relationships by means of quantitative methods, the interpretative strategies to infer the presence, location and type of neuropathology; the decision making on legal subjects like the determination of disability; the description of the characteristic cognitive-behavioral profiles of neurological disorders; the implication of the psychosocial variables and the decision on the most appropriate interventions. Some of the most important objectives of this new discipline are: the identification of the sequels of mild traumatic brain injury as the posconmocional syndrome , the determination of premorbid intellectual functioning and the valoration of cognitive loss. There is no doubt that in the next years this field of application of Clinical Neuropsychology is going to experience an important growth in our country, thanks partly, to the norms that are followed to establish the degree of disability and the compensations of the insurance agencies, that consider these neuropsychological sequelae.

Brain Damage, Chronic↗
PubMed2002

Individuality of handwriting.

Motivated by several rulings in United States courts concerning expert testimony in general, and handwriting testimony in particular, we undertook a study to objectively validate the hypothesis that handwriting is individual. Handwriting samples of 1,500 individuals, representative of the U.S. population with respect to gender, age, ethnic groups, etc., were obtained. Analyzing differences in handwriting was done by using computer algorithms for extracting features from scanned images of handwriting. Attributes characteristic of the handwriting were obtained, e.g., line separation, slant, character shapes, etc. These attributes, which are a subset of attributes used by forensic document examiners (FDEs), were used to quantitatively establish individuality by using machine learning approaches. Using global attributes of handwriting and very few characters in the writing, the ability to determine the writer with a high degree of confidence was established. The work is a step towards providing scientific support for admitting handwriting evidence in court. The mathematical approach and the resulting software also have the promise of aiding the FDE.

Adolescent↗
PubMed1975

Malignant hyperthermia during general anesthesia: medicolegal considerations.

Malignant hyperthermia is a pathophysiologic process, the occurrence of which is nearly impossible to predict, the diagnosis difficult to discover rapidly, and the treatment unsuccessful in the majority of cases as is borne by the high mortality rate. It is in almost all instances, a fortuitous event, and liability will most probably not be imposed unless the plaintiff can establish by way of expert testimony that defendant-anesthesiologist departed from acceptable methods of care. Definite departures from the present standard of care could be: (1) administering a potent general anesthetic utilizing halogenated inhalation agents and depolarizing muscle relaxants to an individual who has undergone a previous malignant hyperthermia episode, and possibly to a member of his immediate family; (2) failing to have available appropriate resuscitative equipment; and of course, (3) lack of diligence and due care in attempting to treat a case of malignant hyperthermia. It seems, at this point, that serum CPK levels and constant temperature monitoring are additional safeguards, but are not part of the standard of care imposed upon the anesthesiologist.

Anesthesia, General↗
PubMed2002

The civil commitment of sexually violent predators: a unique Texas approach.

Numerous states have enacted statutes focusing on the civil commitment of sexually violent predators. The Texas statute, like many others, calls for the involuntary commitment of those with a mental abnormality--specifically in Texas, a behavioral abnormality--who are likely to engage in predatory acts of sexual violence. All of these states, except Texas, have passed legislation creating inpatient treatment for those persons committed. Texas, instead, has focused exclusively on the use of outpatient treatment and supervision as an alternative to the route of inpatient commitment This article is focused on the development and implementation of the Texas statute with an emphasis on forensic assessment, expert testimony, and risk assessment.

Commitment of Persons with Psychiatric Disorders↗
PubMed1992

Insanity: making law in the absence of evidence.

The Insanity Defense Reform Act (IDRA) of 1984, passed by the United States Congress after two years of hearings, illustrates the dangers of making law in the absence of evidence. In attempting to produce fewer not guilty by reason of insanity (NGRI) verdicts, the lawmakers changed the test definition of insanity, banned ultimate opinion testimony by experts and altered the burden and standard of proof. Yet, when each of these changes was empirically tested, it failed to produce fewer NGRI verdicts. From an empirical vantage point, research now is exploring the common sense constructs of sane and insane that mock jurors consistently appear to use, and these turn out to be complex, relevant and powerfully determinative of verdict. Evidence for partial responsibility judgments, along with two types of culpability judgments--at the moment of the act for the act, and for earlier actions that may bring about the mental disability--have been found. Finally, a sequential schema for insanity, which assesses both types of culpability and their degree has been tested, and the results show the least variance and the greatest coherence with other judgments and ratings of responsibility.

Expert Testimony↗
PubMed2003

Researcher liability for negligence in human subject research: informed consent and researcher malpractice actions.

Two sets of federal regulations, the "Common Rule" and Food and Drug Administration (FDA) regulations, govern human subject research that is either federally-funded or involves FDA regulated products. These regulations require, inter alia, that: (1) researchers obtain informed consent from human subjects, and (2) that an Institutional Review Board (IRB) independently review and approve the research protocol. Although the federal regulations do not provide an express cause of action against researchers, research subjects should be able to bring informed consent and malpractice actions against researchers by establishing a duty of care and standard of care. Researchers owe human subjects a duty of care analogous to the special relationship between physicians and patients. The federal regulations should provide the minimum standard of care for informed consent in human subject research, and complying with them should be a partial defense. In contrast, expert testimony should establish the standard of care for researcher malpractice, and IRB approval should be a partial defense.

Ethics Committees, Research↗
PubMed1992

American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.

OBJECTIVE: To define the terms "sepsis" and "organ failure" in a precise manner. DATA SOURCES: Review of the medical literature and the use of expert testimony at a consensus conference. SETTING: American College of Chest Physicians (ACCP) headquarters in Northbrook, IL. PARTICIPANTS: Leadership members of ACCP/Society of Critical Care Medicine (SCCM). RESULTS: An ACCP/SCCM Consensus Conference was held in August of 1991 with the goal of agreeing on a set of definitions that could be applied to patients with sepsis and its sequelae. New definitions were offered for some terms, while others were discarded. Broad definitions of sepsis and the systemic inflammatory response syndrome were proposed, along with detailed physiologic variables by which a patient could be categorized. Definitions for severe sepsis, septic shock, hypotension, and multiple organ dysfunction syndrome were also offered. The use of severity scoring methods were recommended when dealing with septic patients as an adjunctive tool to assess mortality. Appropriate methods and applications for the use and testing of new therapies were recommended. CONCLUSION: The use of these terms and techniques should assist clinicians and researchers who deal with sepsis and its sequelae.

Critical Care↗
PubMed1990

Legal aspects of orthodontic practice: risk management concepts. Performing a risk management audit of your practice.

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.

Costs and Cost Analysis↗
PubMed1989

[Physicians and the death penalty. Physicians' participation in the death penalty and executions].

Doctorss' participation in the death penalty and in executions is described from the literature on the subject. Expert testimonies from psychiatrists during death penalty trials, concerning the mental condition and the possibility of future violent behaviour of the person charged, are of decisive importance for whether the death penalty is imposed or not. By treating prisoners on death row for mental illness the doctor can precipitate the execution. Psychiatrists make fit-for-execution certificates stating whether the condemned is healthy enough to be executed. The doctor monitors the execution and gives advice to the executioner; at an intravenous execution the doctor and medical technique are further involved. It is concluded that doctors should not participate in the death penalty and executions, and that they should discuss ways of achieving such a situation.

Capital Punishment↗
PubMed1989

[An arsonist with a sexual motivation].

In the period 1963-1983 expert opinion was given 147 times on the criminal accountability of premeditated arsonists. In 12% of the cases the crime was sexually motivated. We exemplify the transition of the motive from heightened SELBSTWERTERLEBEN through FREUDE UND ALLGEMEINE LUST in fire to (pre)sexual motivation. The individual features of these 18 cases are noted and distinguished, and the conclusions reached in the expert testimony set out.

Adult↗
PubMed1988

Legal issues related to drug testing in the clinical laboratory.

As has been reported many times by the lay press, urine drug testing may pose some unique challenges. The clinical laboratory interested in industrial drug testing (typically known as employee drug testing) should be aware of the many challenges that may be brought on by the fact that the result may be contested in an adversarial proceeding. This is what makes the urine drug test a forensic test. It may be one piece of evidence or the only piece of evidence used in an adversarial proceeding that may decide on punitive or rehabilitative action against an employee. As a result, unique standards for governmental contract laboratories have been proposed from the National Institute on Drug Abuse, and special proficiency testing and accreditation procedures have been promoted by professional societies. These standards illustrate the sensitive nature of the results. Because the results are subject to adversarial proceedings, all parties concerned in the testing process should be aware of the legal issues surrounding urine drug testing. There are constitutional and statutory issues as well as tort issues such as negligence, defamation, invasion of privacy, battery, infliction of emotional distress, and others. Laboratories should be especially aware of these issues, since they may be brought in as a third-party defendant to a suit or brought in as a participant in gathering the evidence. The laboratory should also be aware of other legal ramifications such as chain of custody, expert testimony, and the acceptability of scientific evidence.

Civil Rights↗