Help or Hindrance? The Support Person in the Psychiatric Medico-legal Examination

The option of having a support person available in industrial disputes and disciplinary hearings has become a well-accepted practice. However, the implications of having a third party present and the potential for inhibition of disclosure in the forensic psychiatric/psychological assessment has not been examined in more than a limited fashion. Expectations of claimants and lawyers that the presence of a support person is a right and assumptions that altering the usual one-to-one dynamic has no influence are challenged in this experience-based commentary. Instances in which the support person may be a “help” or a “hindrance” are outlined, as are recommendations for managing some of the common pitfalls in conducting the evaluation in the presence of another party. An argument is also made for heightened awareness on the part of solicitors about choosing an appropriate support person.     

Getting the C-bit between your teeth

In this article, it is suggested that an important cultural image of intoxication in some Western societies appears to be ‘intoxication as ecstasy’, intoxication as escape from the everyday into a ‘wild’ and ‘natural’ state. The purpose of this article is to discuss this cultural image and its link to gendered ideas about sexuality and, on the basis of this discussion, to develop a hypothesis for further testing. The hypothesis developed proposes that women–via the cultural linking of their sexuality to biological processes of reproduction–are placed closer to nature than men. This makes women's drinking and intoxication seem more dangerous than men's, because drinking and intoxication would seem to make women come even closer to nature. It is suggested that women's ‘dual licentiousness’ threatens the distinction between nature and culture.     

略论人性与医德教育

社会科学的所有理论都直接或间接地包含着对人们行为的假定,医德教育自然也更应以人性为基础,只有在全面把握人性的基础上才能更好地开展医德教育,才能进一步缓和医患矛盾。     

Drugs on the Internet,Part V: Absinthe,Return of the Emerald Mask

Absinthe, a famous liquor of the 19th century, has become immensely popular with its return to legality and mass marketing and drug culture enhancement of its purported unique effects. The electronic world of the Internet has greatly expedited the extent and depth of societal knowledge about the allure of the green fairy, absinthe. An extensive number of websites exists, representing 22 categories of topics about or using the word absinthe. Recent research has dispelled many myths about absinthe and its effects, yet beliefs about its magical powers persist, thus maintaining its reputation as an extraordinary experience within a bohemian lifestyle.     

试论思想道德修养与法律基础课程教学中德与法融合的实现路径

在思想道德修养与法律基础课程教学中实现法律与道德的融合,面临一些现实的制约因素.对教材中的道德与法律的双重解读不能面面俱到,要抓住重点章节,同时注重典型案例的选取,以案例教学为中心,架起德与法融合的桥梁.小悦悦和药家鑫两则案例的双重分析,为德与法的融合路径提供了良好的范本.道德的追求并非空洞的说教,更是一种理性的思考.只有结合实例的双重分析,才能不断增进理性和成熟心智,这才是德与法融合的精神实质和内涵所在.     

药品缺陷侵权法律问题与对策研究——以权利救济为视角

目的 解决药品缺陷侵权的权利救济问题，保障用药患者的合法权利。方法 梳理药品缺陷侵权的立法现状与权利救济现状，分析中国药品缺陷侵权权利救济存在的问题，并针对问题提出相应的解决措施。结果 药品缺陷侵权的相关立法不完善，权利救济案件数量少且成功率低，权利救济现实情况堪忧。药品缺陷概念缺失与认定标准不明确、侵权归责原则不明、举证责任分配不合理、救济途径单一以及药品缺陷认定困难是药品缺陷侵权在权利救济方面存在的现实问题。结论 药品缺陷侵权的权利救济问题不容忽视，必须通过明确药品缺陷概念与认定标准、完善药品缺陷的归责原则立法、拓宽救济途径、完善药品鉴定制度以及建立、健全多元救济体系等措施，对药品缺陷侵权问题加以规制，从而提高药品服务的质量，保证用药安全。     

Valeur juridique des recommandations de bonne pratique : cas de l’hormonothérapie des cancers du sein

On April 27th 2011, the French Supreme Administrative Court (Conseil d’État) granted the Recommendations for Good Practice set out by the French National Authority for Health (Haute Autorité de santé - [HAS]) a legal status, considering that they “must be regarded as (…) decisions which may be subject to an action for annulment”. The judge came to this conclusion through a quasi-syllogistic reasoning. Firstly, the French Code of Medical Ethics requires physicians to care for their patients in accordance with established scientific knowledge. Secondly, the HAS recommendations recall in particular this established scientific knowledge. Treating patients according to established scientific knowledge requires then that physicians follow the HAS recommendations. While the case at bar does not directly involve liability for medical malpractice – since the applicant only sought to have an HAS recommendation declared void – it is nonetheless necessary to examine the impact of this ruling for health professionals. Indeed, this decision raises a number of concerns for everyday medical practice. Guidelines concerning the endocrine treatment of hormonodependant breast cancers are plentiful. In January 2010, the HAS and the French National Institute for Cancer (Institut national du cancer) issued a “Guide for long-term illnesses – Breast cancer” (Guide ALD - Cancer du sein). In addition to these nation-wide guidelines, the Regional Networks for Cancer (réseaux régionaux de cancérologie) issued their own recommendations. Other guidelines are also set out in the framework of consensus conferences, such as the Nice Saint-Paul-de-Vence (France) and St. Gallen (Switzerland) conferences. In the United States, the National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO), and in Europe, the European Society of Medical Oncology (ESMO) make recommendations as well. Therefore, the HAS recommendations are hardly the sole source of information for physicians and these documents sometimes contradict each other. Besides, these can quickly become obsolete, what still limits their relevance. Nevertheless, in the judge's mind, there is no place for conflicting interpretations; scientific knowledge must be consistent, homogeneous and objective. However, the reality is quite the opposite. This simplistic vision shared by judges does not seem to grasp the complexity of everyday medical practice. After a critical reading of the Conseil d’État judgment, we shall consider the potential issues and concerns raised by this ruling in medical practice using the example of hormone therapy for breast cancer patients.     

Checking and Balancing New Zealand's Mental Health Review Tribunal: Perspectives of Forensic Patients

The aim of the study was to examine perspectives of forensic patients who applied for Mental Health Review Tribunal (MHRT) hearings regarding their compulsory detention in New Zealand. Ten participants were identified; semistructured interviews were completed; and a thematic analysis was performed. The participants described variable understanding of the process and scope of the MHRT. They explained why they applied for hearings, including to resolve disputes with clinicians regarding aspects of their care and the desire to expedite examination of their compulsory status. In some instances, the participants described feelings of distress and powerlessness regarding the process and outcome of the hearings. They also discussed the impact of the process upon the therapeutic relationships with their treatment teams. It emerged as important for patients to understand the limited functions of the MHRT. Written and other accessible forms of information may be helpful in this regard. For participants, the application process and hearing had variable value and utility, although some participants reported that the MHRT afforded them dignity because they had the right to challenge their compulsory detention.