Could Depression and Loss of Dignity Correlate with Requesting Euthanasia and Physician-Assisted Suicide? A Look at the Research from the United States, Canada, and the Netherlands

Euthanasia and physician-assisted suicide are legal in the Netherlands, Belgium, Luxembourg, Colombia, and Canada. Physician-assisted suicide alone is legal in Switzerland and within the U.S. in Oregon, Washington, Montana, California, and Vermont. Public support in the United States and the Netherlands for the “right to die” has steadily increased since 1950. This research seeks to uncover the underlying reasons that patients request euthanasia and physician-assisted suicide. Signs of psychological depression and loss of dignity appear to be the main reasons for considering euthanasia and physician-assisted suicide. In the United States, requests for euthanasia and physician-assisted suicide correlated most strongly with loss of autonomy, not being able to enjoy everyday life activities, and loss of dignity. In the Netherlands, more than half of euthanasia/physician-assisted suicide cases contained loss of dignity as one of the reasons. In Canada, the desire for death in the terminally ill was higher for people who had higher ratings of pain, lower family support, and depressive symptoms. Of these, depression is the best predictor of the desire to die. Palliative care that respects individual differences and psychological treatment that emphasizes the therapeutic alliance would provide people with more years of meaningful living

Medical Malpractice of Vestibular Schwannoma: A 40-Year Review of the United States Legal Databases.

OBJECTIVES:To analyze medical malpractice lawsuit trends pertaining to cases of vestibular schwannomas (VS). METHODS:Two major computerized legal databases (LexisNexis and WestLaw) were queried and reviewed for evaluation of all the US state and federal court records from civil trials alleging malpractice between 1976 and 2016. RESULTS:A total of 32 VS cases were identified. Allegations were divided into four categories: misdiagnosis/delayed diagnosis (47%), postoperative complications (44%), failure of informed consent or information sharing (16%), and other (3%). Postoperative complications included facial nerve paralysis, myocardial infarction, meningitis, and intracranial hemorrhage. Judgment amounts ranged from $300,000 to$2,000,000. The specialist type was specified for 24 of the 32 cases (75%): neurosurgeons (n = 9; 37%), neurotologists (n = 6; 25%), general otolaryngologists (n = 5; 21%), primary care physicians (n = 4; 17%), neurologists (n = 3; 12%), radiologists (n = 3; 12%), anesthesiologists (n = 2; 8%), radiation oncologists (n = 1; 4%), and general surgeon (n = 1; 4%). Of these 24 cases, (n = 9; 37%) two or more physicians were named as defendants in the lawsuit. CONCLUSIONS:Enhanced physician-patient communication, ensuring proper and adequate patient consent procedures, and proper documentation are good practices that may decrease the likelihood of lawsuits

Muzzling the Press:When Does the Law Justify Reporting Restrictions? Contempt Cases Against Journalists at the ICTY and Beyond

Chapter 16 deals with contempt cases against journalists. Restrictions on freedom of the press have been striking at international criminal tribunals, where violations of protective measures granted to, for example, witnesses have led to several landmark yet controversial prosecutions of journalists for contempt of court. This chapter examines these practices from a human rights law perspective, as part of the recognized exceptions to the principle of public trials. In doing so, it reviews the law and jurisprudence of international and hybrid tribunals, including the International Criminal Tribunal for the former Yugoslavia (ICTY), the Special Tribunal for Lebanon (STL), and the International Criminal Court (ICC). In addition, it surveys contempt of court, offences against the administration of justice, and the law on reporting restrictions in a number of common law and civil law domestic jurisdictions. It concludes that the right to freedom of the press in the context of international criminal trials is not absolute, and that limits ordered by international tribunals, despite the polemics they may cause, are actually fully in line with both human rights law and domestic legal trends

The determinants of Bank Profitability: Does Liquidity Creation matter?

Using a panel data set of 4995 banks across 11 developed and emerging countries during the period (2011-2015), this report analyses the amount of liquidity created by banks, how liquidity creation, bank-specific and the macroeconomic factors affecting bank profitability. The results show evidence of increased creation of liquidity over the period. By applying the panel data fixed effect technique, banks that create more liquidity, are set up to have lower profitability. As well as, Asset management, bank size and capital ratio are positively correlated with bank profitability. While, credit quality and operating efficiency affect bank’s profits negatively. Additionally, macroeconomic factors have different impact on profitability indicators in each market. Our findings may help decision makers inside and outside bank to determine important factors affecting bank profitability

The determinants of Bank Profitability: Does Liquidity Creation matter?

Using a panel data set of 4995 banks across 11 developed and emerging countries during the period (2011-2015), this report analyses the amount of liquidity created by banks, how liquidity creation, bank-specific and the macroeconomic factors affecting bank profitability. The results show evidence of increased creation of liquidity over the period. By applying the panel data fixed effect technique, banks that create more liquidity, are set up to have lower profitability. As well as, Asset management, bank size and capital ratio are positively correlated with bank profitability. While, credit quality and operating efficiency affect bank’s profits negatively. Additionally, macroeconomic factors have different impact on profitability indicators in each market. Our findings may help decision makers inside and outside bank to determine important factors affecting bank profitability

Patient Decision Making in Vestibular Schwannoma: A Survey of the Acoustic Neuroma Association.

Objective To assess the decision-making process of patients with vestibular schwannoma (VS). Study Design Patients with VS completed a voluntary survey over a 3-month period. Setting Surveys were distributed online through email, Facebook, and member website. Subjects and Methods All patients had a diagnosis of VS and were members of the Acoustic Neuroma Association (ANA). A total of 789 patients completed the online survey. Results Of the 789 participants, 474 (60%) cited physician recommendation as a significant influential factor in deciding treatment. In our sample, 629 (80%) saw multiple VS specialists and 410 (52%) sought second opinions within the same specialty. Of those who received multiple consults, 242 (59%) of patients reported receiving different opinions regarding treatment. Those undergoing observation spent significantly less time with the physician (41 minutes) compared to surgery (68 minutes) and radiation (60 minutes) patients ( P < .001). A total of 32 (4%) patients stated the physician alone made the decision for treatment, and 29 (4%) felt they did not understand all possible treatment options before final decision was made. Of the 414 patients who underwent surgery, 66 (16%) felt they were pressured by the surgeon to choose surgical treatment. Conclusion Deciding on a proper VS treatment for patients can be complicated and dependent on numerous clinical and individual factors. It is clear that many patients find it important to seek second opinions from other specialties. Moreover, second opinions within the same specialty are common, and the number of neurotologists consulted correlated with higher decision satisfaction

The Political Crisis and Bank Financial Performance: Evidence from the Middle East

The political crisis happened in the Middle East and still continues in some countries affected its economicindicators. Due to the importance of banks in every economy, this study examines the impact of political crisisand bank internal factors on financial performance of 61 banks in Bahrain, Egypt, Syria and Yemen during theperiod 2004 – 2014 using financial ratio analysis technique. The effect of political crisis on bank performance isnegative. The findings also state that financial performance of selected countries’ banks is affected positively bycapital adequacy, bank size, asset management and operating efficiency. On the other hand, the factors of creditrisk, asset quality and overheads have a negative impact on this performance. However, the ratios ofmanagement quality, capital ratio, cost to income ratio, deposits and liquidity have no significant impact onROAA.Keywords: Financial Performance, Political Crisis, Middle East, Return on Assets

Who I Am: A Mixed-Methods Analysis of Guatemalan Adolescents\u27 Identity Development

Identity development is the paramount task of adolescent development and globalization seems to shape identity. Recent research with the world’s adolescents suggests that adolescents hold culturally traditional view of self while adopting some self-identifications of other cultures. Remote acculturation contributes to formation of a remixed identity, and it occurs when an individual internalizes cultural values and identities from a region in which they have never lived. Indirect exposure to other cultures, especially through the media, facilitates the adoption of a remixed identity and the process of remote accultural. Remote acculturation and adolescent identity formation was examined in 129 sixth through twelfth grade students (47.3% male, 52.7% female), at a bilingual school on the south coast of Guatemala. Adolescents completed an open-ended 20 item “I am” test and a remote acculturation measure in English. “I am” responses were coded using an adaptation of Cheek & Cheek’s (2018) identity typology; the codes included personal identity orientation, relational identity orientation, public identity orientation, collective identity orientation, and personal hobbies/activities. For each participant, the number of responses per category was recorded. Across all participants, personal identity was the most commonly endorsed orientation (M = 9.91, SD = 3.71) followed by public identity (M = 3.41, SD = 2.43), then hobbies/activities (M =3.08, SD = 2.93) and collective identity (M =2.16, SD =1.96), and finally, relational identity (M = 2.06, SD =1.57). A series of Analyses of Variance (ANOVAs) were used to compare gender and age differences across the identity domains and revealed a main effect of gender in the hobbies/activities domain; boys were more likely to identify with hobbies/activities than girls. The higher prevalence of responses from the personal identity domain over relational or collective domains suggests potential acculturation among the Guatemalan adolescent sample

The changing landscape of vestibular schwannoma diagnosis and management: A cross-sectional study.

ObjectivesTo assess the current state of the diagnosis and management of vestibular schwannoma (VS) as well as treatment trends, and to evaluate the role of treatment setting and various specialists in treatment plan.MethodsPatients diagnosed with VS completed a voluntary and anonymous survey. The questionnaires were distributed through Acoustic Neuroma Association website, Facebook page, and e-mail newsletters from January to March 2017.ResultsIn total, 789 VS patients completed the survey. Of those, 414 (52%) underwent surgery; 224 (28%) underwent radiotherapy; and 121 (15%) were observed. General otolaryngologists diagnosed 62% of responders, followed by primary care (11%) and neurotologists (10%). Patients who underwent surgery were significantly younger and had larger tumors compared to those treated with radiation or observation. The ratio of patients having nonsurgical versus surgical resection changed from 1:2 to 1:1 for the periods of 1979 through 2006 versus 2007 through 2017, respectively. Neurosurgeons (40%) and neurotologists (38%) were the most influential in treatment discussion. Neurotologists (P < 0.001) and general otolaryngologists (P = 0.04) were more influential than neurosurgeons for the decision process in patients with smaller tumors. Patients treated at academic versus nonacademic private institutions reported similar tumor sizes (P = 0.27), treatment decisions (P = 0.09), and decision satisfaction (P = 0.78).ConclusionThere is a continuing trend toward nonsurgical management, with approximately half of the patients opting for nonsurgical management. In this cohort, the patients commonly presented with otologic symptoms and otolaryngologists made the most diagnoses. Neurotologists and neurosurgeons were the most influential in treatment discussion.Level of evidenceNA Laryngoscope, 130:482-486, 2020