Family violence experts in the criminal court: the need to fill the void.

This paper describes the role of family violence expert evidence and argues for the need for adequately trained and experienced specialists to provide that evidence within the criminal jurisdiction of the District Court and High Court in Aotearoa New Zealand. Court processes for the criminal jurisdiction were reviewed to consider the roles and the requirements of expert witnesses in cases of family violence. Given the lack of expert witness training in Aotearoa New Zealand, components of best practice in other jurisdictions, including examples of international expert witness skills and knowledge were sought. Unique skills and experience are necessary for an accurate description of a history of family violence. Experience working with survivors and offenders provides an understanding of the nature and dynamics of violence experienced within a relationship and allows experts to address myths and misconceptions, particularly in relation to the effective nature of the current family violence safety system. Without a contemporary, comprehensive understanding of family violence across police prosecution, judges and lawyers, expert evidence from trained and experienced specialists is required. To enhance the educative role of family violence expert evidence, such evidence should be called by the Court.

Suicide prevention in mental health services: A qualitative analysis of coroners' reports.

Suicide is a major concern for mental health nurses because of its clear correlation with mental illness. In New Zealand, coroners investigate all deaths that appear to be a result of suicide, and provide reports to mental health services (MHS). The aim of the present study was to investigate coronial recommendations to MHS in relation to suicide prevention and to examine clinical and family responses to these. The present study was a three-phase design: (i) analysis of coroners' recommendations related to suicide in MHS; (ii) interviews with clinicians for their response to the recommendations; and (iii) interviews with individuals working with families of consumers of MHS for their responses in relation to family-related recommendations. A qualitative content analysis was conducted on the recommendations from coroners, the interviews with clinical leaders, and the focus group for family workers. Coroners recommended that MHS should implement suicide-prevention strategies that would facilitate improved communication, risk containment, service delivery, and family involvement. Clinicians agreed with most recommendations, apart from those related to risk containment. Family workers endorsed the coronial perspective that family inclusion in MHS was suboptimal. Coroners, MHS, and mental health nurses need to consider the latest clinical evidence for suicide prevention. However, given the complexity of factors that influence suicide, it is important to be realistic about MHS role in preventing suicide, but ensure that MHS provide interventions for which there is evidence, including facilitating family participation and providing access to psychotherapies.

Ethical, legal, and social issues in the translation of genomics into health care.

PURPOSE: The rapid continuous feed of new information from scientific discoveries related to the human genome makes translation and incorporation of information into the clinical setting difficult and creates ethical, legal, and social challenges for providers. This article overviews some of the legal and ethical foundations that guide our response to current complex issues in health care associated with the impact of scientific discoveries related to the human genome. ORGANIZING CONSTRUCT: Overlapping ethical, legal, and social implications impact nurses and other healthcare professionals as they seek to identify and translate into practice important information related to new genomic scientific knowledge. METHODS: Ethical and legal foundations such as professional codes, human dignity, and human rights provide the framework for understanding highly complex genomic issues. Ethical, legal, and social concerns of the health provider in the translation of genomic knowledge into practice including minimizing harms, maximizing benefits, transparency, confidentiality, and informed consent are described. Additionally, nursing professional competencies related to ethical, legal, and social issues in the translation of genomics into health care are discussed. CONCLUSIONS: Ethical, legal, and social considerations in new genomic discovery necessitate that healthcare professionals have knowledge and competence to respond to complex genomic issues and provide appropriate information and care to patients, families, and communities. CLINICAL RELEVANCE: Understanding the ethical, legal, and social issues in the translation of genomic information into practice is essential to provide patients, families, and communities with competent, safe, effective health care.