Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Louisiana v. Perry”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

13 recordsLinked to original sources
PubMed1991

Perry v. Louisiana: medical ethics on death row--is judicial intervention warranted?

The following note considers the complex case of Perry v. Louisiana, in which the Louisiana Supreme Court ordered an insane defendant on death row to be medicated against his will in order to render him sane, and therefore capable of being executed. In so doing the court pit judicial interests in effecting punishment of certain murderers against the physician's Hippocratic Oath, "first do no harm." In considering this conflict, the note identifies "first do no harm" as a guiding principle, explores the societal values underlying this basic principle, and concludes the judiciary must provide legal support for this medical ethical imperative. Similarly the legal profession must identify its organizing principles, its "first do no harm" proscriptions, and consider the application of those principles in the context of representing the insane. Some of the conflicts confronting the physician in the Perry situation have parallels for the attorney representing an insane client. Should the client be medicated in order to proceed to trial? Is it in the best interests of the client to remain a prisoner of her mental illness rather than to risk the possibility of conviction? How should the attorney address the paradoxical reality that a heavily medicated client may indeed become more lucid without becoming more competent? By publishing this note, the Journal hopes to engender discussion and clarification of the vague and sometimes incoherent guidance offered by the Medical Rules of Professional Responsibility, the Model Code of Professional Conduct, and the Criminal Justice Mental Health Standards for legal work with mentally disturbed clients.

Beneficence↗
PubMed2002

[Role of psychiatrists in capital punishment cases : a review].

Many medical organizations have passed resolutions banning participation of psychiatrists in legal executions, such as the Madrid Declaration of World Psychiatric Association. The Criminal Procedure Act of Japan prohibits the execution of the insane. Although the USA and Japan are both among the few so-called developed countries that have a system of capital punishment, many disputes about psychiatrists' participation in death penalty cases have occurred in the US, but few in Japan. This author has reviewed papers addressing this issue. The U.S. Supreme Court decided in Ford v. Wainwright that the execution of an "insane" inmate was not constitutional. The rationale for excluding the mentally incompetent from execution, however, is not completely clear. The most compelling reason is that execution does not satisfy the requirement for "effective retribution," since the insane criminal is not capable of understanding the implications of the death penalty. Nonetheless, there are those who dispute this interpretation and offer other explanations. Psychiatrists may be called upon to assess a criminal's competency for execution. Some find no problem with this practice, while others object to it stating that it conflicts with the ethical tenet to "first do no harm." Those who argue from a middle position insist on assessing competency while recognizing the existence of problems in making such an assessment. Furthermore, there is controversy over which factors exactly constitutes "competency to be executed." Usually, it is thought to be one's capacity to understand the nature of the death penalty and the reasons why the penalty is to be inflicted, but other arguments exist, including the capacity to assist legal counsel in last minute appeals. The question of whether to offer treatment to death row inmates who have been found incompetent to be executed is also under debate. The first position argues that they should "never be treated", because such prisoners would be executed when treatment restores competency. The second, always-treat-position, asserts that psychiatrists are responsible for treating severe mental illness whenever possible. The third, intermediate position, insists upon treatment with several conditions, which entail, for example, respecting the prisoner's autonomy and/or selecting forms of treatment that are unlikely to restore competency. When treatment is given, assessment as to whether competency has been restored is then required. This is still a troublesome issue. The decision in Perry v. Louisiana dealt with the question of whether the state may forcibly treat prisoners incompetent for execution. There were reports about ambivalence and anger among the staff of a psychiatric hospital where an inmate found incompetent for execution was treated. More than a few disputes insist that the ethical dilemma can only be resolved by commuting the sentences of incompetent death row prisoners to life imprisonment. This author further asserts that the secretiveness with which the Ministry of Justice of Japan handles these types of cases should be abolished as soon as possible.

Capital Punishment↗
PubMed1999

Informed consent and the refusal of medical treatment in the correctional setting.

Authors note that the legal framework courts use for analyzing patients' decisions to refuse treatment does not accommodate the ethical issues arising when such decisions are made by patients in correctional settings. In lieu of the traditional model, they propose a more cautious approach when inmates refuse life-sustaining medical treatment.

Ethics, Medical↗
PubMed1995

Denouement of an execution competency case: is Perry pyrrhic?

In October 1992, the Louisiana Supreme Court ruled that that state could not forcibly medicate condemned, mentally ill prisoners to make them competent to be executed. State v. Perry has been seen as a victory for psychiatrists, but the decision contains bad news as well as good: although the Court extricated psychiatrists from having to medicate convicts involuntarily in preparation for their execution, the Court justified its decision by invoking a distortion-filled, highly critical interpretation of standard psychiatric treatment for psychoses. This article summarizes the Perry case and the Court's opinion, describes the perceptions of antipsychotic medication that animated the majority's legal conclusions, and reviews subsequent decisions in which Perry has been influential. The article suggests that Perry's description of pharmacotherapy may not have been motivated by a reasoned view of neuroleptic therapy so much as the Court's desire to uphold the institution of capital punishment. By studying the Perry majority's opinion, psychiatrists can appreciate how certain characterizations or descriptions of psychotic symptoms and antipsychotic therapy lend themselves to distortion and misunderstanding by legal decisionmakers. Recently developed conceptions of schizophrenic symptoms and pharmacological therapy may provide psychiatrists with sophisticated modes of explanation that courts will find more difficult to misconstrue or misrepresent.

Adult↗
PubMed1995

Cardiovascular risk factors among third grade children in four regions of the United States. The CATCH Study. Child and Adolescent Trial for Cardiovascular Health.

Data on cardiovascular risk factors (body mass index, triceps and subscapular skinfolds, blood pressure, serum total cholesterol, high density lipoprotein (HDL) cholesterol, and apolipoprotein B) were collected as part of the baseline examination (fall 1991) of the Child and Adolescent Trial for Cardiovascular Health, a multicenter school-based intervention study for promoting healthful behaviors. A total of 5,106 third grade children (mean age, 8.76 years) in four states (California, Louisiana, Minnesota, and Texas) were examined. After excluding 194 children of other or unknown origin, the study population consisted of 3,530 Anglo-American children, 674 African-American children, and 708 Latino children. African-American children were the tallest by 1-3 cm (p < 0.0001), while Latino children had the largest body mass index (p < 0.05). Blood pressure levels were similar for boys and girls and among the three races, but systolic levels were 2 mmHg higher in Texas than at the other sites. Serum total cholesterol levels were 5 mg/dl higher in girls than in boys (p < 0.05), while HDL cholesterol levels were 2 mg/dl higher in boys (p < 0.05). HDL cholesterol levels were highest in African-Americans (55.5 mg/dl) compared with Anglo-Americans (50.7 mg/dl) and Latinos (51.3 mg/dl) (p < 0.0001).

Analysis of Variance↗
PubMed1999

Three-year maintenance of improved diet and physical activity: the CATCH cohort. Child and Adolescent Trial for Cardiovascular Health.

OBJECTIVE: To assess differences through grade 8 in diet, physical activity, and related health indicators of students who participated in the Child and Adolescent Trial for Cardiovascular Health (CATCH) school and family intervention from grades 3 through 5. DESIGN: Follow-up of the 4-center, randomized, controlled field trial with 56 intervention and 40 control elementary schools. PARTICIPANTS: We studied 3714 (73%) of the initial CATCH cohort of 5106 students from ethnically diverse backgrounds in California, Louisiana, Minnesota, and Texas at grades 6, 7, and 8. RESULTS: Self-reported daily energy intake from fat at baseline was virtually identical in the control (32.7%) and intervention (32.6%) groups. At grade 5, the intake for controls remained at 32.2%, while the intake for the intervention group declined to 30.3% (P<.001). At grade 8, the between-group differential was maintained (31.6% vs 30.6%, P = .01). Intervention students maintained significantly higher self-reported daily vigorous activity than control students (P = .001), although the difference declined from 13.6 minutes in grade 5 to 11.2, 10.8, and 8.8 minutes in grades 6, 7, and 8, respectively. Significant differences in favor of the intervention students also persisted at grade 8 for dietary knowledge and dietary intentions, but not for social support for physical activity. No impact on smoking behavior or stages of contemplating smoking was detected at grade 8. No significant differences were noted among physiologic indicators of body mass index, blood pressure, or serum lipid and cholesterol levels. CONCLUSION: The original CATCH results demonstrated that school-level interventions could modify school lunch and school physical education programs as well as influence student behaviors. This 3-year follow-up without further intervention suggests that the behavioral changes initiated during the elementary school years persisted to early adolescence for self-reported dietary and physical activity behaviors.

Adolescent↗
PubMed1996

Outcomes of a field trial to improve children's dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health. CATCH collaborative group.

OBJECTIVE: To assess the outcomes of health behavior interventions, focusing on the elementary school environment, classroom curricula, and home programs, for the primary prevention of cardiovascular disease. DESIGN: A randomized, controlled field trial at four sites with 56 intervention and 40 control elementary schools. Outcomes were assessed using prerandomization measures (fall 1991) and follow-up measures (spring 1994). PARTICIPANTS: A total of 5106 initially third-grade students from ethnically diverse backgrounds in public schools located in California, Louisiana, Minnesota, and Texas. INTERVENTION: Twenty-eight schools participated in a third-grade through fifth-grade intervention including school food service modifications, enhanced physical education (PE), and classroom health curricula. Twenty-eight additional schools received these components plus family education. MAIN OUTCOME MEASURES: At the school level, two primary end points were changes in the fat content of food service lunch offerings and the amount of moderate-to-vigorous physical activity in the PE programs. At the level of the individual student, serum cholesterol change was the primary end point and was used for power calculations for the study. Individual level secondary end points included psychological factors, recall measures of eating and physical activity patterns, and other physiologic measures. RESULTS: In intervention school lunches, the percentage of energy intake from fat fell significantly more (from 38.7% to 31.9%) than in control lunches (from 38.9% to 36.2%)(P<.001). The intensity of physical activity in PE classes during the Child and Adolescent Trial for Cardiovascular Health (CATCH) intervention increased significantly in the intervention schools compared with the control schools (P<.02). Self-reported daily energy intake from fat among students in the intervention schools was significantly reduced (from 32.7% to 30.3%) compared with that among students in the control schools (from 32.6% to 32.2%)(P<.001). Intervention students reported significantly more daily vigorous activity than controls (58.6 minutes vs 46.5 minutes; P<.003). Blood pressure, body size, and cholesterol measures did not differ significantly between treatment groups. No evidence of deleterious effects of this intervention on growth or development was observed. CONCLUSION: The CATCH intervention was able to modify the fat content of school lunches, increase moderate-to-vigorous physical activity in PE, and improve eating and physical activity behaviors in children during 3 school years.

Analysis of Variance↗