The Utility of the Random Controlled Trial for Evaluating Sexual Offender Treatment: The Gold Standard or an Inappropriate Strategy?

This paper examines the scientific, practical, and ethical issues surrounding the employment of the Random Controlled Trial (RCT) in the evaluation of sexual offender treatment. Consideration of these issues leads us to conclude that the RCT design is not suitable for determining the effectiveness of sexual offender treatment. We also examine the RCT study by Marques et al. (Sexual Abuse: A Journal of Research and Treatment and Evaluation 17:79–107, 2005) that is often held up as the model for the evaluation of sexual offender treatment. We found several problems with this study that, in our opinion, reduce its relevance for deciding whether treatment is effective with these clients. Finally, we examine two alternative strategies for evaluating treatment that may allow treatment providers to more readily examine, and report, the results of their programs.     

Written advance directives: Theuth’s blessing ... or ... curse?

Advance directives are discussed from a philosophical standpoint and with reference to their relationship to informed consent. The necessity of an advance directive being truly informed is stressed. The author suggests that the validity of these instruments is made quite difficult when the particular context in which they find themselves is one which neither patient nor physician anticipated.     

Herbal or complementary medicine: fact or fiction?

Although herbal medications have been used in medical therapy since the dawn of civilization, they have not undergone careful scientific assessment. Some herbal derivations are exceptional and have become standard therapy in cardiovascular disease; eg, digitalis, reserpine, and aspirin. The high prevalence of herbal use around the world and in the United States today may have a negative impact on patient care when herbal preparations are used in combination with medications ordered by healthcare providers who are not advised of the patient's use of herbs. Healthcare providers need to be familiar with all herbal medications in order to prevent potentially serious reactions between conventional and herbal medications. They should be asking patients about herbal use when first obtaining a medical history. Patients who use alternative therapies do not tell their healthcare providers about such use.     

Partnerships: panacea or pretence?

This article seeks to explore the centrality and reality of partnerships or partnership working in current British social policy. The article will investigate the rhetoric and reality of partnerships using research based on the Early Years Development and Childcare Partnerships (EYDCPs) as an exemplar to critically question whether partnerships have become more pretence than panacea? In so doing the article will suggest that partnerships are deserving of greater critical analysis and research as their rhetorical force potentially represents another metaphor for social control.