Law and the Unconscious: A Psychoanalytic Perspective

The following essays reflect on Professor Anne Dailey’s challenge to the presumptions of rationality in law in light of all we now know today about the unconscious. The authors draw from a wide array of perspectives ranging from the classroom to poetry

The New Parental Rights

This Article sets forth a new model of parental rights designed to free children and families from the ideals of parent–child unity and family privacy that underlie the law’s expansive protection for parental rights. The law currently presumes that parents’ interests coincide with those of their children, creating an illusion of parent–child union that suppresses the very real ways in which children’s interests and identities, even at a young age, may depart from those of their parents. Expansive protection for parental rights also confines children to the private family, ignoring children’s broad range of interests beyond the family and thwarting calls for more robust state support of children subordinated by race and class. The new model of parental rights presented here brings children out from under parental control and into public view. The model conceives of parental rights in relational terms, offering greater state support for the parent–child relationship, addressing the race and class biases underlying expansive parental rights, and highlighting children’s independent interests and agency. This new approach calls for the highest scrutiny of governmental action that threatens to separate parents and children, but a less strict level of scrutiny for governmental action that intrudes upon parental authority in ways that support children’s independent interests and agency. The model also strengthens the parent–child relationship by urging a radical increase in affirmative support for all children, but especially for low-income children and children of color who suffer the most under a legal regime that privatizes the costs of children’s upbringing. This reenvisioning of parental rights has the potential to transform a broad range of laws affecting the lives of children and parents. The Article analyzes several issues of critical importance to children’s welfare: homeschooling; transgender youth medical decisionmaking; foster care; children’s peer relationships; and the forced separation of parents and children through immigration detention, child welfare removal, and parental incarceration. By calling for greater state support of both children and families, the “new parental rights” challenges the privatization of dependency; fosters diversity of family life; and respects the independent capacities, values, beliefs, and identities of all children

Success Factors of European Syndromic Surveillance Systems: A Worked Example of Applying Qualitative Comparative Analysis

Introduction: Syndromic surveillance aims at augmenting traditional public health surveillance with timely information. To gain a head start, it mainly analyses existing data such as from web searches or patient records. Despite the setup of many syndromic surveillance systems, there is still much doubt about the benefit of the approach. There are diverse interactions between performance indicators such as timeliness and various system characteristics. This makes the performance assessment of syndromic surveillance systems a complex endeavour. We assessed if the comparison of several syndromic surveillance systems through Qualitative Comparative Analysis helps to evaluate performance and identify key success factors. Materials and Methods: We compiled case-based, mixed data on performance and characteristics of 19 syndromic surveillance systems in Europe from scientific and grey literature and from site visits. We identified success factors by applying crisp-set Qualitative Comparative Analysis. We focused on two main areas of syndromic surveillance application: seasonal influenza surveillance and situational awareness during different types of potentially health threatening events. Results: We found that syndromic surveillance systems might detect the onset or peak of seasonal influenza earlier if they analyse non-clinical data sources. Timely situational awareness during different types of events is supported by an automated syndromic surveillance system capable of analysing multiple syndromes. To our surprise, the analysis of multiple data sources was no key success factor for situational awareness. Conclusions: We suggest to consider these key success factors when designing or further developing syndromic surveillance systems. Qualitative Comparative Analysis helped interpreting complex, mixed data on small-N cases and resulted in concrete and practically relevant findings

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Comparative Treatment Outcomes for Patients With Idiopathic Subglottic Stenosis.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadImportance: Surgical treatment comparisons in rare diseases are difficult secondary to the geographic distribution of patients. Fortunately, emerging technologies offer promise to reduce these barriers for research. Objective: To prospectively compare the outcomes of the 3 most common surgical approaches for idiopathic subglottic stenosis (iSGS), a rare airway disease. Design, setting, and participants: In this international, prospective, 3-year multicenter cohort study, 810 patients with untreated, newly diagnosed, or previously treated iSGS were enrolled after undergoing a surgical procedure (endoscopic dilation [ED], endoscopic resection with adjuvant medical therapy [ERMT], or cricotracheal resection [CTR]). Patients were recruited from clinician practices in the North American Airway Collaborative and an online iSGS community on Facebook. Main outcomes and measures: The primary end point was days from initial surgical procedure to recurrent surgical procedure. Secondary end points included quality of life using the Clinical COPD (chronic obstructive pulmonary disease) Questionnaire (CCQ), Voice Handicap Index-10 (VHI-10), Eating Assessment Test-10 (EAT-10), the 12-Item Short-Form Version 2 (SF-12v2), and postoperative complications. Results: Of 810 patients in this cohort, 798 (98.5%) were female and 787 (97.2%) were white, with a median age of 50 years (interquartile range, 43-58 years). Index surgical procedures were ED (n = 603; 74.4%), ERMT (n = 121; 14.9%), and CTR (n = 86; 10.6%). Overall, 185 patients (22.8%) had a recurrent surgical procedure during the 3-year study, but recurrence differed by modality (CTR, 1 patient [1.2%]; ERMT, 15 [12.4%]; and ED, 169 [28.0%]). Weighted, propensity score-matched, Cox proportional hazards regression models showed ED was inferior to ERMT (hazard ratio [HR], 3.16; 95% CI, 1.8-5.5). Among successfully treated patients without recurrence, those treated with CTR had the best CCQ (0.75 points) and SF-12v2 (54 points) scores and worst VHI-10 score (13 points) 360 days after enrollment as well as the greatest perioperative risk. Conclusions and relevance: In this cohort study of 810 patients with iSGS, endoscopic dilation, the most popular surgical approach for iSGS, was associated with a higher recurrence rate compared with other procedures. Cricotracheal resection offered the most durable results but showed the greatest perioperative risk and the worst long-term voice outcomes. Endoscopic resection with medical therapy was associated with better disease control compared with ED and had minimal association with vocal function. These results may be used to inform individual patient treatment decision-making.Patient-Centered Outcomes Research Institute - PCOR

A developmental perspective on the ideal of reason in American constitutional law

The ideal of reason is central to contemporary accounts of citizenship in American constitutional law. The individual capacity for reasoned choice lies closely aligned with the constitutional values of personal liberty and democratic self-government as they have evolved in Supreme Court decisions over the past century. Yet as presently conceived, the ideal of reason in constitutional law overlooks the process by which individuals actually acquire the capacity to choose their own values and commitments or to engage in reasoned thinking about collective ends. This paper argues that we cannot hope to sustain and foster a constitutional polity committed to the principles of individual liberty and democratic self-government without knowing something about how individual citizens come to possess this requisite skill of mind. A developmental perspective on reason in constitutional law provides a framework for examining the source and contours of the psychological skills that make it possible to lead an autonomous, self directed life and to participate meaningfully in the processes of democratic self-government. Developmental psychology, together with research in related fields, provides empirical support for the proposition that the psychological capacity for reasoned thinking has its roots in the early caregiving relationship. Thus, a comprehensive and integrated constitutional family law must recognize the role of early caregiving in the political socialization of children. This developmental approach offers a substantial reworking of constitutional doctrine in the areas of family privacy, parental rights, congressional power, and affirmative welfare rights

Holmes and the Romantic Mind

Oliver Wendell Holmes, Jr. is perhaps best known for his tough-minded jurisprudence based on objective standards of reasonableness. Scholars have traditionally understood Holmes\u27s jurisprudential outlook as fundamentally behavioristic. Professor Dailey challenges that understanding, revealing the importance of Romantic psychology in Holmes\u27s major writings. His outlook, she argues, was shaped by his belief in unconscious motivations, imagination, irrationality and instinctual drives. Rather than simply characterize Holmes as a Romantic, Professor Dailey draws out the conflict in his thought, illuminating his struggle to develop an empirical approach to law that could also account for the depth and complexity of human nature