Judges as Medical Decision Makers: Is the Cure Worse than the Disease

I shall examine and criticize three of the many judicial decisions in the area of law and medicine. These cases are Doe v. Bolton, Superintendent of Belchertown State School v. Saikewicz, and Rogers v. Commissioner of the Department of Mental Health. Those of you who like to think of the law as reason and justice tempered by mercy will be offended by what I have to say; but I shall be evenhanded. Those of you who think of medicine as science and art tempered by compassion will also be offended. My justification for the critical and polemical thesis I shall present is my deep and growing conviction that in law, as often as in medicine, the cure can be worse than the disease. There is a word in medicine for cures that create diseases-the word is iatrogenic. Law needs a similar word; let me suggest juridicogenic

The Tree of Life (2011)

This is a film review of The Tree of Life (2011)

Judges as Medical Decision Makers: Is the Cure Worse than the Disease

I shall examine and criticize three of the many judicial decisions in the area of law and medicine. These cases are Doe v. Bolton, Superintendent of Belchertown State School v. Saikewicz, and Rogers v. Commissioner of the Department of Mental Health. Those of you who like to think of the law as reason and justice tempered by mercy will be offended by what I have to say; but I shall be evenhanded. Those of you who think of medicine as science and art tempered by compassion will also be offended. My justification for the critical and polemical thesis I shall present is my deep and growing conviction that in law, as often as in medicine, the cure can be worse than the disease. There is a word in medicine for cures that create diseases-the word is iatrogenic. Law needs a similar word; let me suggest juridicogenic

National Time Accounting: The Currency of Life

This monograph proposes a new approach for measuring features of society’s subjective well-being, based on time allocation and affective experience. We call this approach National Time Accounting (NTA). National Time Accounting is a set of methods for measuring, comparing and analyzing how people spend and experience their time -- across countries, over historical time, or between groups of people within a country at a given time. The approach is based on evaluated time use, or the flow of emotional experience during daily activities. After reviewing evidence on the validity of subjective well-being measures, we present and evaluate diary-based survey techniques designed to measure individuals’ emotional experiences and time use. We illustrate NTA with: (1) a new cross-sectional survey on time use and emotional experience for a representative sample of 4,000 Americans; (2) historical data on the amount of time devoted to various activities in the United States since 1965; and (3) a comparison of time use and wellbeing in the United States and France. In our applications, we focus mainly on the Uindex, a measure of the percentage of time that people spend in an unpleasant state, defined as an instance in which the most intense emotion is a negative one. The U-index helps to overcome some of the limitations of interpersonal comparisons of subjective well-being. National Time Accounting strikes us as a fertile area for future research because of advances in subjective measurement and because time use data are now regularly collected in many countries.

Effective One-Dimensional Coupling in the Highly-Frustrated Square-Lattice Itinerant Magnet CaCo2−y_{\mathrm{2}-y}As2_{2}

Inelastic neutron scattering measurements on the itinerant antiferromagnet (AFM) CaCo$_{\mathrm{2}-y}$As$_{2}$ at a temperature of 8 K reveal two orthogonal planes of scattering perpendicular to the Co square lattice in reciprocal space, demonstrating the presence of effective one-dimensional spin interactions. These results are shown to arise from near-perfect bond frustration within the $J_1$-$J_2$ Heisenberg model on a square lattice with ferromagnetic $J_1$, and hence indicate that the extensive previous experimental and theoretical study of the $J_1$-$J_2$ Heisenberg model on local-moment square spin lattices should be expanded to include itinerant spin systems

Model-based Bayesian inference of brain oxygenation using quantitative BOLD

© 2019 The Authors Streamlined Quantitative BOLD (sqBOLD) is an MR technique that can non-invasively measure physiological parameters including Oxygen Extraction Fraction (OEF) and deoxygenated blood volume (DBV) in the brain. Current sqBOLD methodology rely on fitting a linear model to log-transformed data acquired using an Asymmetric Spin Echo (ASE) pulse sequence. In this paper, a non-linear model implemented in a Bayesian framework was used to fit physiological parameters to ASE data. This model makes use of the full range of available ASE data, and incorporates the signal contribution from venous blood, which was ignored in previous analyses. Simulated data are used to demonstrate the intrinsic difficulty in estimating OEF and DBV simultaneously, and the benefits of the proposed non-linear model are shown. In vivo data are used to show that this model improves parameter estimation when compared with literature values. The model and analysis framework can be extended in a number of ways, and can incorporate prior information from external sources, so it has the potential to further improve OEF estimation using sqBOLD

The prognosis of functional limb weakness, a 14-year case-control study

Reliable data on the prognosis of functional motor disorder are scarce, as existing studies of the prognosis of functional motor disorder are nearly all retrospective, small and uncontrolled. In this study we used a prospectively recruited, controlled cohort design to assess misdiagnosis, mortality and symptomatic and health outcome in patients with functional limb weakness compared to neurological disease and healthy control subjects. We also carried out an exploratory analysis for baseline factors predicting outcome. One hundred and seven patients with functional limb weakness, 46 neurological and 38 healthy control subjects from our previously studied prospective cohort were traced for follow-up after an average of 14 years. Misdiagnosis was determined in a consensus meeting using information from records, patients and their GPs. Numbers and causes of death were collected via death certificates. Outcome of limb weakness, physical and psychiatric symptoms, disability/quality of life and illness perception were recorded with self-rated questionnaires. Outcome measures were compared within and between groups. Seventy-six patients (71%) with functional limb weakness, 31 (67%) neurological and 23 (61%) healthy controls were included in follow-up. Misdiagnosis was found in one patient in the functional limb weakness group (1%) and in one neurological control (2%). Eleven patients with functional limb weakness, eight neurological control subjects and one healthy control subject had died. Weakness had completely remitted in 20% of patients in the functional limb weakness group and in 18% of the neurological controls (P = 0.785) and improved in a larger proportion of functional limb weakness patients (P = 0.011). Outcomes were comparable between patient groups, and worse than the healthy control group. No baseline factors were independent predictors of outcome, although somatization disorder, general health, pain and total symptoms at baseline were univariably correlated to outcome. This study is the largest and longest follow-up study of functional limb weakness. Misdiagnosis in functional limb weakness is rare after long-term follow-up. The disorder is associated with a higher mortality rate than expected, and symptoms are persistent and disabling. It appears difficult to predict outcome based on common baseline variables. These data should help inform clinicians to provide a more realistic outlook of the outcome and emphasize the importance of active and targeted therapy