Prevention as the Primary Goal of Sentencing: The Modern Case for Indeterminate Dispositions in Criminal Cases

Among modern-day legal academics determinate sentencing and limiting retributivism tend to be preferred over indeterminate sentencing, at least in part because the latter option is viewed as immoral. This Article contends to the contrary that, properly constituted, indeterminate sentencing is both a morally defensible method of preventing crime and the optimal regime for doing so. More specifically, the position defended in this Article is that, once a person is convicted of such an offense, the duration and nature of sentence should be based on a back-end decision made by experts in recidivism reduction, within very broad ranges set by the legislature. The territory covered in this Article, particularly as it addresses the debate between deontological retributivists and utilitarians, is well-trodden. But this Article seeks to provide new perspectives on the morality, legality, and practicality of indeterminate sentencing. It starts with an outline of what a properly constituted indeterminate sentencing regime would look like. It then defends this regime against numerous objections

“Dueling” Experts and the False Claims Act: Weaponizing Legal Falsity to Combat Hospice Fraud

In 2020, in United States ex rel. Druding v. Care Alternatives, the United States Court of Appeals for the Third Circuit advanced a broad interpretation of “falsity” under the federal False Claims Act (FCA) to allow conflicting medical opinions on a patient’s medical prognosis as evidence of false certification for hospice eligibility. In doing so, the court rejected a blanket rule that clinical judgments are immune from legal challenge and dismissed an “objective falsehood” requirement because it inappropriately conflated elements of the statute. The holding has important implications in industries with high risk for fraud, particularly the for-profit hospice industry that contracts with Medicare. This Comment argues that the Third Circuit’s liberalization of the falsity element aligns with congressional intent to create broad FCA liability for any attempt to defraud the government. Moreover, the Third Circuit’s approach incentivizes entities that receive federal funding to strengthen internal oversight and compliance programs

Prevention as the Primary Goal of Sentencing: The Modern Case for Indeterminate Dispositions in Criminal Cases

This Article contends that properly constituted, indeterminate sentencing is both a morally defensible method of preventing crime and the optimal regime for doing so, at least for crimes against person and most other street crimes. More specifically, the position defended in this Article is that, once a person is convicted of an offense, the duration and nature of sentence should be based on a back-end decision made by experts in recidivism reduction, within broad ranges set by the legislature. Compared to determinate sentencing, the sentencing regime advanced in this Article relies on wider sentence ranges and explicit assessments of risk, cabined only very loosely by desert. Compared to limiting retributivism, the key difference is that risk assessments are periodic rather than made at the front end, thus producing sentences that are much more individualized and flexible. Finally, post-sentence commitment based on risk would not make sense in an indeterminate sentencing regime that is already focused on that criterion. The territory covered in this Article, particularly as it addresses the debate between deontological retributivists and utilitarians, is well trodden. But this Article seeks to provide new perspectives on the morality, legality, and practicality of indeterminate sentencing. It starts with an outline of what a properly constituted indeterminate sentencing regime would look like. It then defends this regime against numerous objections

Sanctionable Behavior in a Felony Level Drug Court: Categorizing Noncompliant Behavior Through a Criminal-Thinking Lens

Drug courts use sanctions as a form of behavior management and modification, and they are an important structural tool in the treatment of drug offenders by the criminal justice system. This research examined noncompliant behavior being sanctioned in a felony level drug court. The sample consisted of 66 high risk/high needs individuals who were enrolled in a drug court over a two-year period. Sanctionable behaviors were analyzed through a criminal-thinking framework in order to better understand noncompliant behavior in drug court. This study finds support for applying a criminal-thinking framework to noncompliant behavior sanctioned in drug court. The findings from this study illustrate the nuances of noncompliant behavior of a drug court population

Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program

Objective: To compare levels of persistency between cholinesterase inhibitors (ChEIs) among a Medicaid patient population of older adults. Methods: Survival analysis was used to assess differences in discontinuation between ChEIs (donepezil versus rivastigmine and galantamine), and for difference in patient gender, age, race, and care setting. Results: Rates of discontinuation increased from 42.7% (95% CI = 39.9-45.5) at 12 months to 84.8% (95% CI = 82.3-87.3) at 24 months. In multivariate models, no significant difference in discontinuation existed prior to 365 days. However, patients dispensed donepezil were less likely to discontinue as compared with users of the other two ChEIs after the first year (RR = 0.70; CI = 0.499-0.983; p \u3c 0.04). Patients of white race were less likely to discontinue (RR = 0.549; 95% CI = 0.43-0.82; p = 0.0015), while gender, care setting, and age were not associated with discontinuation. Conclusions: One-year persistence rates were similar between different ChEIs. Among patients persisting with ChEI medication for at least 12 months, users of donepezil were slightly more likely to continue to persist at 24 months. Nearly half of patients failed to persist with ChEI therapy for at least 12 months. Our findings underscore the limitations of the ChEI medications and the urgent need for effective and tolerable therapeutic options for patients having dementia. © 2008 Abughosh and Kogut, publisher and licensee Dove Medical Press Ltd

Continuing professional development: Medico-legal aspects of epilepsy

AbstractGenerally protection against possible litigation and good clinical practice go hand in hand. Situations in which the law has special relevance for people with epilepsy, those who work with them, and their clinicians are reviewed with special reference to the topics of driving, employment, duties of social carers, the clinician’s everyday role, the responsibilities of researchers and epilepsy and the criminal law. What constitutes professional negligence is discussed, with special reference to the United Kingdom. Clinicians are advised to think clearly, write clearly, communicate clearly and have a good relationship with their patients

Improving Compliance: Listening to the Patient\u27s Perspective

A large number of patients do not follow medical advice for reasons generally unclear to the health care provider. Significant morbidity and mortality can be outcomes of noncompliance. The purpose of this naturalistic inquiry was to study and clarify from the patient\u27s perspective, issues identified as influencing the ability to comply with provider recommendations. Data collection and analysis occurred simultaneously as a fluid process of organizing and synthesizing qualitative material into categories or themes that emerged to illuminate a phenomenon. Seventy-six percent of participants described themselves as 100% compliant though they did not take medications as prescribed or failed to follow through with other recommendations, such as lifestyle changes. Participants listed positive perceptions when the provider: related to them, listened, addressed concerns, and included them in the plan of care. The provider behavior of listening was important to patients but was not the only aspect identified with a potential influence on compliance levels. Unexpected study findings included connections between symptomatology and medications, control issues between patient and provider, and the patient\u27s perceptions of office personnel attitudes

Paracetamol for Acute Low Back Pain

The aim of this thesis was 1) to describe the similarities and differences between recommendations for pharmacotherapy of low back pain (LBP) from recent clinical practice guidelines; 2) to investigate if the results and inferences from the Paracetamol for Acute Low Back Pain (PACE) trial could be reproduced; 3) to assess the efficacy of paracetamol for acute non-specific LBP in participants of the PACE trial who complied with the treatment regimen; and 4) to investigate if there is an association between reporting adverse events (AEs) and the outcomes of acute LBP