How case characteristics differ across four types of elder maltreatment: implications for tailoring interventions to increase victim safety.

Purpose: The purpose of this study was to determine whether case characteristics are differentially associated with four forms of elder maltreatment.

Method: Triangulated interviews were conducted with 71 APS caseworkers, 55 victims of substantiated abuse whose cases they managed, and 35 third party persons.

Results: Pure financial exploitation (PFE) was characterized by victim unawareness of financial exploitation and living alone.

Using research evidence to reframe the policy debate around mental illness and guns: process and recommendations.

Recent mass shootings have prompted a national dialogue around mental illness and gun policy. To advance an evidence-informed policy agenda on this controversial issue, we formed a consortium of national gun violence prevention and mental health experts. The consortium agreed on a guiding principle for future policy recommendations: restricting firearm access on the basis of certain dangerous behaviors is supported by the evidence; restricting access on the basis of mental illness diagnoses is not.

[Information technology in medicine - some legal observations].

Information Technology (IT) and computing capabilities are revolutionizing the practice of medicine in an unprecedented way. Some current legal and ethical concerns evolving from this revolution are addressed, pointing to the emerging concepts in Israeli jurisprudence, which regards medical IT as an important contribution to patient empowerment, to medical risk management and in managing the resources of a national health system.

Personalized disclosure by information-on-demand: attending to patients' needs in the informed consent process.

Obtaining informed consent has typically become a stylized ritual of presenting and signing a form, in which physicians are acting defensively and patients lack control over the content and flow of information. This leaves patients at risk both for being under-informed relative to their decisional needs and of receiving more information than they need or desire. By personalizing the process of seeking and receiving information and allowing patients to specify their desire for information in a prospective manner, we aim to shift genuine control over the informational process to patients.

Telemedicine: licensing and other legal issues.

The growth of information technology and telecommunications has created promising opportunities for better, faster, more accessible, barrier-free health care; telemedicine (TM). The feasibility of many TM projects depends on resolving legal issues. Mastering technical issues or providing training remain important benchmarks for implementation of TM, but legal issues constrain progress.

The Health Care Reform Act of 2010 and Medical Malpractice Liability: Worlds in Collision or Ships Passing in the Night.

The Patient Protection and Affordable Care Act of 2010 tackles many health care-related issues, but medical malpractice liability reform is not one of them. Despite being a perennial target of health care reform-with accompanying assertions that a medical malpractice liability crisis is corrupting the delivery of health care in the United States-only three short sections that made little substantive change to existing law were devoted to it in a bill that eventually totaled over 900 pages in length. This Article describes what the bill did, what it failed to do, and its likely and perhaps unanticipated consequences for the ongoing medical malpractice liability reform debate.

FDA's regulation of tanning beds: how much heat?

This paper considers the problem of indoor tanning bed use by teenagers. The paper explores FDA's current authority to regulate tanning lamps as Class I medical devices, concluding that FDA's authority is poorly tailored to affect teenagers' repeated use of these products. An outright ban is unlikely; therefore, the best available options are to regulate access by minors and to amend the warning label requirements to reflect the current state of knowledge about the risks of tanning bed use.

Howard Zonana and the transformation of forensic psychiatry.

In recognition of Howard Zonana's contributions, I take stock of the progress of the field of forensic psychiatry over three decades. As forensic psychiatrists, you are the voice of psychiatry in the law and the interpreter of law to your colleagues in psychiatry. I offer provisional impressions of your collective accomplishments under three themes: expertise, influence, and integrity.

Post-mortem pregnancy: a proposed methodology for the resolution of conflicts over whether a brain dead pregnant woman should be maintained on life-sustaining treatment.

In this article, the author examines conflicts over whether to maintain a brain dead pregnant woman on life-sustaining treatment. The author cautions that on the rare occasions when courts are confronted with such a conflict, they should employ a consistent methodology for resolution of the conflict and attempt to honor the wishes of the post-mortem mother and her family. The author draws on relevant areas of law to demonstrate the existence of a legal fiction that protects the interests of post-mortem pregnant women in refusing medical treatment.

Why Precedent in Law (and Elsewhere) is Not Totally (or Even Substantially) About Analogy.

Cognitive scientists who conduct research on analogical reasoning often claim that precedent in law is an application of reasoning by analogy. In fact, however, law's principle of precedent, as well as the use of precedent in ordinary argument, is quite different. The typical use of analogy in law, including analogies to earlier decisions, involves retrieval of a source analog (or exemplar) from multiple candidates in order to help make the best decision now.

Patenting medical devices: the economic implications of ethically motivated reform.

This article explores whether the current patent system strikes the optimal balance between providing incentives to inventors to bring new medical devices to the marketplace and promoting public health by ensuring that these medical devices are widely available at a reasonable price. After providing an overview of the relationship of patent law to medical devices, the author explains how ethical and economic considerations suggest the need for an alternative patent system for medical devices and notes the difficulties with this proposal. The author concludes that a combination of alternatives to the current system most equitably account for the interests and needs of both healthcare device consumers and producers.

Beyond overpopulation: a comment on Zawistowski et al. and Salman et al.

The intentional production and destruction each year of millions of companion animals is a sobering fact. The need for meaningful statistical data on this phenomenon is urgent. No less pressing, however, is the need for a conceptual framework to make sense of the empirical findings.

From coercion to contract: reframing the debate on mandated community treatment for people with mental disorders.

Approximately half the people receiving treatment in the public sector for mental disorder have experienced some form of "leverage" in which deprivations such as jail or hospitalization have been avoided, or rewards such as money or housing have been obtained, contingent on treatment adherence. We argue in this essay that framing the legal debate on mandated community treatment primarily in terms of "coercion" has become counterproductive and that the debate should be re-framed in terms of "contract." Language derived from the law of contract often yields a more accurate account of the current state of the law governing mandated community treatment, is more likely to be translated into a useful descriptive vocabulary for empirical research, and is more likely to clarify the policy issues at stake than the currently stalemated form of argumentation based on putative rights.

An actuarial model of violence risk assessment for persons with mental disorders.

Objectives: An actuarial model was developed in the MacArthur Violence Risk Assessment Study to predict violence in the community among patients who have recently been discharged from psychiatric facilities. This model, called the multiple iterative classification tree (ICT) model, showed considerable accuracy in predicting violence in the construction sample. The purpose of the study reported here was to determine the validity of the multiple ICT model in distinguishing between patients with high and low risk of violence in the community when applied to a new sample of individuals.

Understanding prohibitions against genetic discrimination in insurance.

The justification for laws prohibiting genetic discrimination in health insurance is not at all clear. Neither privacy protection, the distinctive features of health insurance, nor the distinction between presymptomatic genetic tendencies and actually manifested disease provide a justification, although certain practical considerations may justify these laws.

Use of leverage to improve adherence to psychiatric treatment in the community.

Objectives: A variety of tools are being used as leverage to improve adherence to psychiatric treatment in the community. This study is the first to obtain data on the frequency with which these tools are used in the public mental health system. Patients' lifetime experience of four specific forms of leverage-money (representative payee or money handler), housing, criminal justice, and outpatient commitment-was assessed.