In Vitro Fertilization, State Wrongful Death Statutes and State Fetal Homicide Statutes: The Reaction to LePage v. Center for Reproductive Medicine.

The Alabama Supreme Court recently held, in LePage v. Center for Reproductive Medicine, that the parents of human embryos that were negligently destroyed at a fertility clinic could bring an action for damages under the State's wrongful death statute. Although the Alabama legislature promptly enacted a law essentially overturning the state supreme court's decision, concerns have been raised that the court's decision might influence courts in other States to interpret their wrongful death statutes, or possibly even their fetal homicide statutes, to apply in similar circumstances, thereby threatening the availability of in vitro fertilization (IVF) technology. This article addresses those concerns.With respect to wrongful death statutes, only fourteen States (excluding Alabama) have interpreted their statutes to apply to unborn children without regard to their stage of gestation or development. The majority of States impose a gestational requirement (typically, viability) which would preclude their application to the destruction of human embryos. Even with respect to the minority of States that impose no limitation on the cause of action, those statutes, either by their express language or by fair interpretation, would not apply to unimplanted human embryos.With respect to the fetal homicide statutes in thirty-one States that do not have any gestational or developmental limitation, the statutes in twenty-six of those States apply only to acts causing the death of an unborn child in utero. As to the statutes in the other five States, the structure of the statute, considered in light of the applicable case law, strongly suggests that there would be no liability for causing the death of an unborn child before implantation. In sum, the Alabama Supreme Court's decision in LePage is not likely to be followed as a precedent in interpreting either the wrongful death statutes or the fetal homicide statutes of any other State.

[The prohibitions against murder and incest: transgressions and consequences]. / Interdits du meurtre et de l'inceste : transgressions et conséquences.

The link between incest and domestic violence is explored. Violence is an inherent characteristic of humanity, but its expression is supposed to be channeled by family and societal norms, notably the fundamental prohibitions of murder and incest. The aggressor's act lies outside these common norms, while the victims are often made vulnerable by a family past marked by violence.

What is suicide? Classifying self-killings.

Although the most common understanding of suicide is intentional self-killing, this conception either rules out someone who lacks mental capacity being classed as a suicide or, if acting intentionally is meant to include this sort of case, then what it means to act intentionally is so weak that intention is not a necessary condition of suicide. This has implications in health care, and has a further bearing on issues such as assisted suicide and health insurance. In this paper, I argue that intention is not a necessary condition of suicide at all. Rather, I develop a novel approach that deploys the structure of a homicide taxonomy to classify and characterise suicides to arrive at a conceptually robust understanding of suicide. According to my analysis of suicide, an agent is the proximate cause of his death. Suicide is 'self-killing,' rather than 'intentional self-killing.' Adopting this understanding of suicide performs several functions: (1) We acquire an external standard to assess diverging analyses on specific cases by appealing to homologous homicides. (2) Following such a taxonomy differentiates types of suicides. (3) This approach has application in addressing negative connotations about suicide. (4) As a robust view, adding intention is an unnecessary complication. (5) It is more consistent with psychological and sociological assessments of suicide than 'intentional self-killing.' (6) It has useful applications in informing public policy. This paper's focus is on classifying types of suicides, rather than on the moral permissibility or on underlying causes of suicidal ideation and behaviour.

Bawa-Garba ruling is not good news for doctors.

Although some doctors celebrated when the Court of Appeal overturned Hadiza Bawa-Garba's erasure from the medical register, it is argued here that in many ways the ruling is by no means good news for the medical profession. Doctors' interests are served by transparent professional tribunals but the Court of Appeal's approach to the GMC Sanctions Guidance risks increasing opacity in decision-making. Close attention to systemic factors in the criminal trial protects doctors yet the Court of Appeal states that the structural circumstances surrounding Bawa-Garba's failings were only of peripheral relevance to her conviction. Public confidence in the profession is undermined when convicted doctors return to work because the public de facto do not understand the nuance of gross negligence manslaughter law. Rather than changing the law to make the regulator more lenient towards doctors, it would be better to ensure that doctors are only convicted of gross negligence manslaughter when their conduct is so serious that they ought to be struck off.

Gross negligence manslaughter and doctors: ethical concerns following the case of Dr Bawa-Garba.

Dr Bawa-Garba, a senior paediatric trainee who had been involved in the care of a child who died shortly after admission to hospital, was convicted of gross negligence manslaughter and subsequently erased from the medical register. We argue that criminalisation of doctors in this way is fraught with ethical tensions at levels of individual blameworthiness, systemic failures, professionalism, patient safety and at the interface of the regulator and doctor. The current response to alleged manslaughter during clinical care is not fit for purpose because of its narrow focus on criminalisation and punishment of individual doctors. The justice system fails to take into account systemic issues in a sufficiently proper and informed way particularly in respect of human factors involved in decision-making. It is easier to convict individual doctors for gross negligence manslaughter than it is to effect legal accountability upon organisations. If educational reflections are used to apportion blame, then this could impact detrimentally on honesty and the duty of candour, with negative implications for patient safety. Regulatory processes should not be deployed without consideration of context. There is an urgent need for a fresh and open evaluation of professional and societal expectations from the regulator that should include positive action as well as those that are proportionately punitive. Justice and patient safety would be served better by more sophisticated contextualisation through an approach that balances accountability in healthcare with failures that can occur within complex systems, and by working to a radical shift towards a just culture.

Gender differences in legal outcomes of filicide in Austria and Finland.

Female offenders of filicide have been found to receive more lenient legal handling than male offenders. We aimed to discover these possible gender differences in the legal outcome of filicide cases. This was a binational register-based study covering all filicide offenders in Austria and Finland 1995-2005. We examined the legal outcomes of the crimes of all living offenders (64 mothers and 26 fathers). Mothers received a conviction of murder and life imprisonment less often than fathers. Within psychotic and personality-disordered offenders, infanticides, and offenders convicted for life, gender differences were less evident. Even though there seems to be some gender differences within the legal outcomes of filicide, ruling seemed more consistent than expected within distinct subgroups of offenders. Gender-based assumptions should not hinder equal and just handling of filicide cases.

Juvenile homicide offenders: A 35-year-follow-up study.

Murders committed by juveniles have been a major concern in the USA for more than 40 years. Due to decisions in the 21st century by the United States Supreme Court, the likelihood of juvenile homicide offenders being sentenced to life without parole (LWOP) is less than in past decades. In addition, hundreds of individuals in prison who were sentenced to LWOP under mandatory sentencing statutes or their equivalent as juveniles for murder are now eligible for resentencing and may be released. Given these changes in sentencing policies and practices, follow-up research on juveniles involved in murder is needed. This study is a 35-year follow-up study of 59 boys who were convicted of murder and sentenced to adult prisons in a southeastern state, and initially interviewed in the early 1980s. Twenty-two of these men agreed to participate in clinical interviews about their experiences in prison and upon return to the community if released. The experiences in prison are highlighted for all men. Thereafter, attention focuses on the 19 juvenile homicide offenders who have been released. Of these 19 men, 11 were classified as failures given that they were sent back to prison at least once. Length of time served and completion of GED were the best predictors of post-release success. Clinical observations, implications of the findings, limitations of the study, and directions for future research are discussed.

Florida's Red Flag Gun Law and Firearm and Nonfirearm Homicide and Suicide Rates.

This study estimates the association between Florida's red flag law enactment and firearm and nonfirearm homicide and suicide rates.

Doctor's Criminal Liability and Medically Assisted Death - The Portuguese Case.

Recently, the Portuguese Parliament discussed four proposals aimed at allowing some forms of medically assisted death. However, all of them were rejected by the majority. Therefore, doctors who in some way accelerate a patient's death risk being convicted of the crime of homicide. Portuguese law provides some legal mechanisms that can exempt a doctor from criminal liability, such as causes excluding the conduct's wrongfulness, and causes excluding the doctor's culpability. Other elements to take into consideration are a proper interpretation of homicide crimes, thereby excluding conducts without the intent to kill; the relevance of patient consent; and the rejection of medical futility. This article explains how a doctor may not be held criminally accountable for medically assisted death, even in restrictive jurisdictions such as the Portuguese one.

Who Should We Blame for Healthcare Failings? Lessons from the French Tainted Blood Scandal.

Many well-known cases of 'medical manslaughter' have shown that systemic issues play a significant role in contributing to fatal errors in healthcare institutions. The most prominent NHS scandal, Mid Staffordshire, demonstrated that wrongful prioritization of resources and staff shortages had contributed to the deaths of between 400 and 1200 patients due to appalling care by nursing staff and doctors between 2005 and 2009. Following the scandal, the Trust was prosecuted and convicted of a criminal offence under the Health and Safety at Work Act 1974 in 2014 and 2015. In contrast, in a scandal of comparable scale across the Channel, 'the HIV-contaminated blood scandal', individual decision-makers were subject to criminal convictions. Learning from features of the French criminal process, and the aftermath of the 1980s French tainted blood scandal, this article argues that the criminal process can only be a useful response to healthcare systemic failings if higher-level decision-makers are also included in the scope of criminal liability when they have recklessly endangered patients. When no individual reckless fault is found on the part of decision-makers, corporate criminal liability is a suitable alternative to individual criminal liability, if it is focused on ensuring safety and offering justice to patients who have been harmed as a result of healthcare systemic failings.

Association between Firearm Laws and Homicide in Urban Counties.

Laws related to the sale, use, and carrying of firearms have been associated with differences in firearm homicide rates at the state level. Right-to-carry (RTC) and stand your ground (SYG) laws are associated with increases in firearm homicide; permit-to-purchase (PTP) laws and those prohibiting individuals convicted of violent misdemeanors (VM) have been associated with decreases in firearm homicide. Evidence for the effect of comprehensive background checks (CBC) not tied to PTP is inconclusive. Because firearm homicide tends to concentrate in urban areas, this study was designed to test the effects of firearm laws on homicide in large, urban U.S. counties. We conducted a longitudinal study using an interrupted time series design to evaluate the effect of firearm laws on homicide in large, urban U.S. counties from 1984 to 2015 (N = 136). We used mixed effects Poisson regression models with random intercepts for counties and year fixed effects to account for national trends. Models also included county and state characteristics associated with violence. Homicide was stratified by firearm versus all other methods to test for specificity of the laws' effects. PTP laws were associated with a 14% reduction in firearm homicide in large, urban counties (IRR = 0.86, 95% CI 0.82-0.90). CBC-only, SYG, RTC, and VM laws were all associated with increases in firearm homicide. None of the laws were associated with differences in non-firearm homicide rates. These findings are consistent with prior research at the state level showing PTP laws are associated with decreased firearm homicide. Testing the effects of PTP laws specifically in large, urban counties strengthens available evidence by isolating the effects in the geographic locations in which firearm homicides concentrate.

Medical manslaughter in Hong Kong-how, why, and why not.

The increasing number of medical manslaughter cases in recent years raises concerns about the concept of criminal liability in medical negligence. Contemporary cases in Hong Kong have also generated debate on whether criminal law intervention is justified and effective at dealing with substandard medical practices. This paper examines the legal principles underlying the applicable legal offence of gross negligence manslaughter and the implications that recent events may have on patient care and the medical profession. The author argues that the criminalisation of medical mistakes can have a detrimental effect on clinical practice and patient welfare. At stake is the potential for a loss of mutual trust between the medical profession and the rest of society. Gross negligence manslaughter is an unstable legal concept, and criminal sanctions should at most be applied to conscious violations of established rules and standards but not unintentional errors. As we await the outcomes of ongoing cases in Hong Kong, there is an urgent need to uphold standards of practice and to nurture a robust culture of ethical awareness, compassionate care, and professionalism.

The utility of plastinates in court: a case of firearm homicide.

Plastination is a technique renowned for its use in the preservation of human tissues or organs, and is mainly employed in anatomical training and in research regarding various scientific fields. The advantages of this method are related to the natural appearance, absence of odor, and easy-handling of the plastinated products. The use of plastinates in forensic sciences, their potential role in personal identification, and their usefulness in interpretation of post-mortem findings has been described, although literature on this topic is poor. The present paper is the first report of a firearm homicide where the brain of the victim was plastinated and presented in court as documentary evidence. Three dimensional examination of the brain during the trial allowed the judge to directly evaluate the pathway of the projectile and to compare it with the information that was presented based on depositions, post mortem data and police investigations, in a more straightforward manner. The important role played by plastination in the reported case in assisting with the final verdict could be a catalyst to extend the use of this technique to other criminal cases.