Questioning Miranda

This Article argues that the Supreme Court should go further and reexamine the basic principles underlying Miranda. Although its impact has been tamed by interpretation and practice, and although the hour is late, a case can be made for overruling Miranda. Miranda was not a wise or necessary decision, nor has Miranda proved to be, as is generally contended, a harmless one. It sent our jurisprudence on a hazardous detour by introducing novel conceptions of the proper relationship between the suspect and authority. It accentuated just those features of our system that manifest the least regard for truth seeking, that imagine the criminal trial as a game of chance in which the offender should always have some prospect of victory, and that ultimately reflect doubt on the rectitude of our laws and institutions. Beyond this, it was decided at a time when effective alternatives for restraining unlawful police conduct were ripe for implementation. This Article is divided into six parts. Part II discusses historical perspectives toward interrogation and confession and explore show Miranda may have influenced these perspectives. Part III traces the Supreme Court\u27s attempt to fashion a means of controlling police misconduct without substantially impairing the effectiveness of criminal investigation. The focus of this section is on the due process clause of the fourteenth amendment. Part IV illustrates through two cases--Gallegos v. Colorado and Escobedo v.Illinois --the erosion of the fourteenth amendment voluntariness test. Part V critiques Miranda. Part VI examines how police have received and adapted to Miranda and attempts to assess the consequences. The final section makes the argument for overruling the decision and suggests alternative ways to limit police misconduct

Anesthesia advanced circulatory life support

The constellation of advanced cardiac life support (ACLS) events, such as gas embolism, local anesthetic overdose, and spinal bradycardia, in the perioperative setting differs from events in the pre-hospital arena. As a result, modification of traditional ACLS protocols allows for more specific etiology-based resuscitation. Perioperative arrests are both uncommon and heterogeneous and have not been described or studied to the same extent as cardiac arrest in the community. These crises are usually witnessed, frequently anticipated, and involve a rescuer physician with knowledge of the patient's comorbidities and coexisting anesthetic or surgically related pathophysiology. When the health care provider identifies the probable cause of arrest, the practitioner has the ability to initiate medical management rapidly. Recommendations for management must be predicated on expert opinion and physiological understanding rather than on the standards currently being used in the generation of ACLS protocols in the community. Adapting ACLS algorithms and considering the differential diagnoses of these perioperative events may prevent cardiac arrest