Swimming Together Upstream: How to Align MLP Services with U.S. Healthcare Delivery.

Medical-legal partnership (MLP) embeds attorneys and paralegals into care delivery to help clinicians address root causes of health inequities. Notwithstanding decades of favorable outcomes, MLP is not as well-known as might be expected. In this essay, the authors explore ways in which strategic alignment of legal services with healthcare services in terms of professionalism, information collection and sharing, and financing might help the MLP movement become a more widespread, sustainable model for holistic care delivery.

Integrating legal services to improve behavioral health, a challenge met from a different angle.

The United States' current healthcare delivery system is not prepared to address the expanding behavioral health (BH) crisis without treatment of upstream social determinants that contribute to downstream BH exacerbations. Medical Legal Partnerships (MLP) utilize lessons from integrated BH to create efficiencies, augment the reach of the current BH workforce, network community resources, and likely provide BH prevention at the family unit. Payment policy changes are needed, however, to provide sustainable access to these services. The current surge of federal and state funding for BH care needs may provide the policy window necessary to sustainably fund MLP lawyers as a novel, high-impact, professional on the integrated healthcare team. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Mindful Lawyer: Investigating the Effects of Two Online Mindfulness Programs on Self-Reported Well-Being in the Legal Profession.

OBJECTIVES: Two studies were conducted to determine whether mindfulness meditation could be an effective tool for improving well-being among legal professionals-a population plagued by high rates of depression, anxiety, and stress. METHODS: Study 1. Legal professionals completed questionnaires before and after an 8-week mindfulness program. Study 2. Lawyers were randomly assigned to either an experimental or waitlist condition. Questionnaires were administered at the beginning of the study and after experimental participants had completed a 30-day intervention. RESULTS: Study 1. Participants reported significant improvements in mood, resilience, trait mindfulness, stress, anxiety, and depression over time. Study 2. Post-intervention, experimental participants reported better mood, lower levels of stress, and higher levels of non-reactivity and observing than waitlist participants. CONCLUSIONS: Mindfulness and meditation may effectively improve well-being among legal professionals.

The caul and its relation to drowning, lawyers and sorcerers.

The caul is a fragment of amniotic membrane that is occasionally observed adherent to the head and face of a newborn child. A dried caul has been in The University of Adelaide Pathology Archive for a number of years. Beliefs in the supernatural powers of these detached membranes are found in the historical traditions of a wide variety of cultures, resulting in cauls being regularly dried out and sold as talismans. It was thought that lawyers could sway opinions in court more readily if they possessed a caul, and that such a token could either be used to facilitate black magic rituals or alternatively to thwart the machinations of sorcerers and witches. A pervasive belief was that a caul would guarantee that the owner would never drown resulting in cauls being sold for between £10 to £30 in the seventeenth century at a time when considerable naval warfare and maritime exploration were occurring. Thus, rather than illuminating pathophysiological processes occasional specimens in pathology archives may remind us of folk traditions and superstitions that have long since been forgotten in modern times.

'There's more to life than money and health': Family caregivers' views on the role of Power of Attorney in proxy decisions about research participation for people living with dementia.

People living with dementia may experience difficulties when making decisions for themselves in the later stages of the condition. While there are mechanisms in England and Wales for appointing an attorney to make decisions about welfare and finances on their behalf, there are no provisions for appointing an attorney to make future decisions about research participation. This is despite a growing focus on Advanced Care Planning and other processes that provide opportunities to discuss future preferences and ensure that decisions are made in line with those preferences. This qualitative study with 15 family caregivers who had acted as research proxies explored the role of Power of Attorney in their decisions about research, and their views about extending current legal arrangements to include research. Five themes were identified: the holistic nature of decision-making; the 'power' of attorney; making decisions by putting yourself in their shoes; support for bringing research under the umbrella of attorney arrangements and a unifying theme of trusting relationships. Legal provisions for prospectively appointing a research proxy may encourage discussion about future wishes and so enable decisions about research to be made that are in accordance with the person's preferences and wishes. However, further consultation with the public including people living with dementia and their families, and a range of stakeholders is needed. Providing guidance to families, people living with dementia and the wider research community may provide greater clarity and improve decision-making in the meantime.

How do international lawyers handle facts? The role of folk sociological theories at the International Criminal Court.

The International Criminal Court (ICC) investigates international crimes committed in different parts of the world. Earlier scholarly analysis of the work performed by the ICC judges has pointed out that judges often lack cultural and national understanding of the local norms and customs of regions where defendants come from. This article treats this lack of contextual knowledge displayed by the court as a case of structural ignorance rather than an aberration to be 'exposed' or censured. International lawyers indeed must ground their legal narratives with plausible sociological explanations of contextual elements to overcome their lack of familiarity with the field and the scarcity of their investigative resources. By uncovering the role of 'folk sociological theories' (FSTs) in the establishment of facts in a court context, this article addresses the debate over the efficiency of international criminal justice by highlighting the need to bring historical truth back in. The empirical evidence is based on several years of participant observation in the ICC during the trials against Mathieu Ngudjolo and Germain Katanga, two militiamen from the Democratic Republic of Congo (DRC).

Defining Social Work within Holistic Public Defense: Challenges and Implications for Practice.

Social work has a history of forensic practice, but social work as an integral component of the holistic model of public defense is new and is creating a demand for better definition of roles and services. The intent of this article is to contribute to and encourage dialogue surrounding social work practice within the holistic public defense model. A brief overview of the indigent criminal defense system and its emerging models of defense practice is provided. Models of practice established by the Knox County Public Defender's Community Law Office are offered. Challenges, implications, and future directions are discussed.

No fault compensation in perinatal medicine in Japan-from results for 8 years

No fault compensation in perinatal medicine has been established to provide aid to patients in the event of disability due to a medical accident during delivery and to strive to resolve disputes quickly that contributes to reduce medical malpractice suit in the field of perinatal medicine. Furthermore, this system is aimed to establish a mechanism that achieves higher quality of obstetric care by analyzing the causes of accidents. This system is operated by Japan Council for Quality Health Care and 99.9% of childbirth facilities in Japan registered with this compensation system. Compensation system has two major functions including compensation and cause analysis and recurrence prevention based on cases. Compensation eligibility is reviewed in the Review Committee at the organization in Japan Council for Quality Health Care and currently 1,717 cases are judged as eligible cases out of 2,250 since 2009. The cause of each eligible case is analyzed in the Cause Analysis Committee one by one. The Cause Analysis Committee has 7 independent subcommittee and each subcommittee members are consistent of obstetricians, neonatologists, pediatricians, midwives and lawyers. Original cause analysis report is sent to childbirth facility and patient's family. Questionnaire survey demonstrated that 73% of childbirth facilities and 65% of patient family were satisfied with the cause analysis report. The number of medical lawsuit in obstetrics and gynecology is significantly decreased compared to those in all medical departments since the compensation system was introduced suggesting that these cause analysis reports may contribute the decrease in medical lawsuits. The major purpose of the Recurrence Prevention Committee is striving to prevent future cases of cerebral palsy and to improve the quality of obstetric care. To accomplish the purpose, the committee routinely collect information from individual cases and analyze quantitatively and epidemiologically. Furthermore the committee choose subject from cases to discuss for future prevention and provide wide public disclosure of the information with recommendation. The committee issued 6 reports until now and these reports have been distributed to childbirth facilities, perinatal medicine-related scientific society and administrative agencies.

Can access to a medical-legal partnership benefit patients with asthma who live in an urban community?

Approximately one in 10 children in the U.S. has a diagnosis of asthma. African American and low-income children are more likely to be diagnosed with asthma. They are more likely to suffer the worse outcomes because of low socioeconomic status and environmental exposures. A medical-legal partnership is an interdisciplinary collaboration between a medical entity such as a hospital or clinic and a legal entity such as a lawyer, law school, or legal aid society created to address barriers to health care access and limitations to well-being. Addressing the legal concerns of these patients can improve access to medical services, reduce family stress, and address legal concerns that contribute to poor health. The Health Law Partnership (HeLP) is one such medical-legal partnership that provides a holistic, interdisciplinary approach to health care. During the seven-year study period we found both financial ($501,209) and non-financial benefits attributable to interventions by the attorneys at HeLP.

The health law partnership: adding a lawyer to the health care team reduces system costs and improves provider satisfaction.

Addressing the legal issues of patients of low socioeconomic status can be useful in increasing organizational reimbursements, reducing costs and improving access to care. Medical-legal partnership is an addition to the health care armamentarium that directly addresses this goal. A medical-legal partnership is an interdisciplinary collaboration between a medical entity such as a hospital or clinic and a legal entity such as a law school or legal aid society that addresses barriers to access to care and limitations to well-being experienced by patients of low socioeconomic status. The Health Law Partnership is one such medical legal partnership that provides a holistic, interdisciplinary approach to health care. An evaluation of the legal and educational services provided by Health Law Partnership showed that Health Law Partnership secured otherwise unreimbursed Medicaid payments for services over a 4-year period from 2006 to 2010, increased physician satisfaction, and saved hospital employers approximately $10 000 in continuing education costs annually.

A "glyconutrient sham".

The discipline of glycobiology contributes to our understanding of human health and disease through research, most of which is published in peer-reviewed scientific journals. Recently, legitimate discoveries in glycobiology have been used as marketing tools to help sell plant extracts termed "glyconutrients." The glyconutrient industry has a worldwide sales force of over half a million people and sells nearly half a billion dollars (USD) of products annually. Here we address the relationship between glyconutrients and glycobiology, and how glyconutrient claims may impact the public and our discipline.

[Medical opinions in court--a challenge for communication between physicians and lawyers]. / Das medizinische Gutachten im Prozess--Kommunikationsprobleme zwischen Arzten und Juristen.

Medical opinions in court constitute a great challenge in regard to communication between physicians and lawyers. Considerable differences in their professional training and requirements frequently result in misunderstandings. Therefore physicians and lawyers need to learn more about each other and interact when evaluating opinions. A synergistic rather than a conflicting approach would help judges to find the happy medium between accepting medical reports unreservedly and coming to their own conclusions in more or less total disregard of the medical opinion presented in court. The expert, on the other hand, must ensure that the judge will understand the opinion as it was meant. Neither of them can call upon a translator.

The history of euthanasia debates in the United States and Britain.

Debates about the ethics of euthanasia and physician-assisted suicide date from ancient Greece and Rome. After the development of ether, physicians began advocating the use of anesthetics to relieve the pains of death. In 1870, Samuel Williams first proposed using anesthetics and morphine to intentionally end a patient's life. Over the next 35 years, debates about the ethics of euthanasia raged in the United States and Britain, culminating in 1906 in an Ohio bill to legalize euthanasia, a bill that was ultimately defeated. The arguments propounded for and against euthanasia in the 19th century are identical to contemporary arguments. Such similarities suggest four conclusions: Public interest in euthanasia 1) is not linked with advances in biomedical technology; 2) it flourishes in times of economic recession, in which individualism and social Darwinism are invoked to justify public policy; 3) it arises when physician authority over medical decision making is challenged; and 4) it occurs when terminating life-sustaining medical interventions become standard medical practice and interest develops in extending such practices to include euthanasia.