'We did everything we could': An account of toxic leadership.

BACKGROUND: The UK government's reckless and incompetent response to Covid-19 has produced an outcome which is amongst the worst in the world, and arguably the worst in terms of deaths per 100,000 population of major countries (especially when one measures mortality from Covid in terms of cause of death on the death certificate, rather than the UK government's own measure-death of a tested individual within 28 days of testing). This article updates my initial analysis in this journal over a year ago, and traces the negligent and shambolic policy-making, and supine official scientific advice, which has led to such a dismal outcome. METHODS: It does so by examining the policies and approach of the UK government from the begining of the pandemic (in UK terms, January 2020) up to June 2021. All relevant declarations, speeches, decisions, public interviews and policies were noted on a daily basis, examined and critically assessed-along with daily data and information over the whole period on Covid's threat to, and spread across, the UK. CONCLUSIONS: On three successive occasions, Boris Johnson and his compliant Ministers acted too late and too weakly to prevent avoidable death and illness. At the time of writing the vaccination programme in the UK has been destabilised by the government-yet again-having failed to secure its borders, this time against the Delta variant (Indian mutation) of the virus. Overall, in terms of border control, quarantine, testing, tracing, isolation and timely and enforced lockdown, the government put short-term, superficial considerations above coherent strategy. It dressed up its incompetence as a superficial libertarianism and defence of the economy, but thereby managed to achieve the worst of all worlds in terms of three egregious failures-appalling health outcomes; (ironically) worse economic damage than countries which took draconian action; and (also ironically) continually recurring restrictions as a result of earlier failure to take strong action to suppress Covid and keep it at bay. Public reaction in England (unlike in Scotland and Wales) to the Johnson government's shenanigans has not been commensurate with that government's level of failure, which sadly reflects a debasement of the political culture in England.

The Doctrine of Double Effect and Potential Criminal Liability of Medical Practitioners in Australia.

Recent parliamentary inquiries into end-of-life choices identify the need to provide legal certainty for health practitioners working in end-of-life care. A concern identified is the lack of clarity surrounding the operation, status and application of the doctrine of double effect. This discussion clarifies these concerns. Although the doctrine is judicially recognised in several overseas jurisdictions, in Australia the doctrine of precedent means that it does not form part of the common law. In most jurisdictions, the fault element for murder includes recklessness, and application of the doctrine does not avoid criminal liability being established against orthodox criminal law principles. Although the prosecution of a medical practitioner who incidentally causes death in the proper course of medical treatment is a rare event, it remains a live issue. Legislative protection of medical practitioners, as has occurred in Queensland, South Australia and Western Australia, is the means to achieve the certainty sought.

Predicting the knowledge-recklessness distinction in the human brain.

Criminal convictions require proof that a prohibited act was performed in a statutorily specified mental state. Different legal consequences, including greater punishments, are mandated for those who act in a state of knowledge, compared with a state of recklessness. Existing research, however, suggests people have trouble classifying defendants as knowing, rather than reckless, even when instructed on the relevant legal criteria. We used a machine-learning technique on brain imaging data to predict, with high accuracy, which mental state our participants were in. This predictive ability depended on both the magnitude of the risks and the amount of information about those risks possessed by the participants. Our results provide neural evidence of a detectable difference in the mental state of knowledge in contrast to recklessness and suggest, as a proof of principle, the possibility of inferring from brain data in which legally relevant category a person belongs. Some potential legal implications of this result are discussed.

Defining "recklessness" in research misconduct proceedings.

To find research misconduct in research that has been supported by federal funds, an institution must determine that the misconduct was committed intentionally, knowingly, or recklessly. "Intentional" and "knowing" are straightforward standards. Yet "reckless" often mystifies institutions, which struggle to assess whether a respondent's conduct should be deemed "reckless," or merely negligent. This difficulty is most pronounced when allegations are lodged against the author under whose supervision the primary research was conducted - most often, the senior and/or corresponding author of a published paper who may not have been directly involved in performing the experiments or preparing the data under scrutiny. In these situations, investigation committees and the institutional "deciding official" must assess whether the supervising scientist is guilty of research misconduct - based on the theory that their supervision of the research and development of the publication containing falsified, fabricated, or plagiarized information was reckless - even if that person did not perform the experiment or assemble the research records in question. This paper seeks to provide a framework for evaluating the circumstances in which past supervisory conduct should be deemed "reckless" and thus a basis on which a finding of research misconduct may be made.

COVID-19 in the Courtroom: The Role of Mask Mandates and Source of Exposure on Negligence and Recklessness Decisions.

The current study examined whether business owners would be found liable for an employee's illness from COVID-19 contracted at work. We varied whether there was a mask mandate at the time of the employee's exposure (Yes or No), how the employee was exposed (an unmasked customer, an unmasked owner who forgot her mask, or an unmasked owner who did not require masks in her store) and measured participants' political orientation. Participants (N = 257) read and listened to a trial transcript about an employee that contracted COVID-19 at her workplace and was suing her employer for compensation to cover hospital bills. Participants were more likely to find the defendant negligent, reckless, and responsible when a mask mandate was present and when an unmasked owner led to the employee's COVID-19 exposure compared to an unmasked customer. Furthermore, the more conservative the participant, the less likely they were to find the defendant negligent, reckless, and responsible. In sum, presence of a mask mandate, owner exposure, and juror political orientation play an important role in civil litigation involving COVID-19.

Quantitative and qualitative analysis of lawsuits against veterinarians and correlation of potential risk factors with court decisions.

The increase in lawsuits against veterinarians based on recklessness, negligence and malpractice is a current trend since pets are increasingly viewed as part of the family, and legal action is sought if the owner is frustrated with the services rendered by the veterinarian. However, since scarce data exists on this issue, this study aims to quantify and qualify lawsuits filed against veterinarians in the state of São Paulo, Brazil to identify and correlate potential risk factors that may lead to conviction or acquittal of defendants. For this purpose, the methodology employed a search for lawsuits on the website of the São Paulo State Court of Justice, sorted by year; proceedings (summary or special civil court); plaintiff's claim (non-economic damages, economic damages, malpractice, negligence or recklessness); court decision (case granted or denied); reason for judgment (sufficient or insufficient evidence); reverse burden of proof (present or absent); type of evidence (deposition, documentary and expert testimony); value of damages claimed and awarded; location (greater São Paulo or inner state), and whether the lawsuit was filed against a veterinary clinic or hospital. These categories shed light, through bivariate and Poisson regression analyses, on the potential risk factors relative to court decisions. Results demonstrate that reverse burden of proof and insufficient evidence as the basis for judgment were, respectively, risk factors for conviction and acquittal of veterinary practitioners, and the number of lawsuits increased by 533 % over eight years.

The Italian Supreme Court Joint Sections set forth the interpretative underpinnings of the "Gelli-Bianco" law: varying degrees of guilt aimed at limiting medical liability, article 2236 c.c. makes a comeback.

The article's author has sought to summarize the regulatory and legal evolution of accidental criminal liability of doctors starting from earliest positions up until the enactment of the Gelli-Bianco law. An in-depth analysis is laid out based on the Italian Supreme Court Joint Sections ruling n. 8770/2018 (so-called Mariotti decision). The author has also elaborated upon the notion of varying degrees of guilt, which was taken out of the law's wording, to be later reintroduced as a concept by judicial interpretation.  It is worth noting that Article 3 of the Balduzzi decree, article 590 sexies of the Italian Criminal Code and the reference to article 2236 of the Civil Code reflect an awareness on the part of legislators that medical liability needs to be limited. Clearly, the approach based on lawfulness alone, which protects from liability physicians that have adhered to guidelines, has been dismissed, superseded by the notion of minor fault. Nonetheless, the new legislation, in the author's estimation, constitutes a standard particularly ill-suited to modern medical practice, which has a high degree of complexity. The author concludes that it might be worth considering a more balanced alternative: getting back to the notion of fault, considering minor fault relevant, rather than major fault.

Infracción del deber de cuidado y responsabilidad penal del profesional de la salud

Introducción: A pesar de su antigüedad la cuestión de la responsabilidad jurídico-penal del profesional de la salud adquiere cada vez mayor importancia en el orden teórico y práctico, en cuyo escenario se pone de manifiesto una excesiva judicialización de la actividad médica como mecanismo de tutela de los derechos del paciente. Objetivo: Sistematizar las diferentes posturas teóricas que en la actualidad se aprecian en torno a la judicialización de la actividad médica y las causas que la estimulan. Método: Se llevó a cabo un estudio de carácter documental a través de una revisión bibliográfica exhaustiva en buscadores bibliográficos como Scopus, SciELO, Google Académico y PubMed. La indagación de carácter argumentativa y exploratoria se realizó el 16 de marzo de 2023 y de los 30 artículos encontrados que abordaron la problemática de la mala praxis médica, solo 11 fueron elegidos para el estudio según criterios de selección. Desarrollo: Se sistematizaron las posturas teóricas sobre la judicialización de la actividad médica y las causas que la estimulan; además se determina la correcta interpretación de la lex artis como mecanismo de heterointegración normativa del deber de cuidado del ejecutor de actos médicos, en aras de evitar excesos en la aplicación de la ley penal en este ámbito de actuación profesional. Consideraciones finales: Una mayor intervención del Derecho Penal en el ejercicio de la Medicina no es el paradigma político criminal más eficiente en aras de proteger la vida e integridad del paciente frente a hechos de mala praxis médica.

Introduction: Legal and criminal liability of the health professionals, regardless its antiquity, at present has becoming more and more theoretical and practical relevance in which an excessive judicialization of medical activity is revealed as a mechanism for the protection of patient rights. Objective: Systematization of the different theoretical positions that are currently identified around the judicialization process of medical activity and the likely causes that stimulate it. Method: A documentary study was carried out through an exhaustive bibliographic review in bibliographic search engines such as Scopus, SciELO, Google Scholar and PubMed. The argumentative and exploratory research was conducted on March 16, 2023 and of the 30 articles found concerning medical malpractice, only 11 were chosen for the study with strict selection criteria. Development: The theoretical positions on the judicialization of medical activity and the causes that stimulate it were systematized; in addition, the correct interpretation of the lex artis was presented as a mechanism of normative heterointegration of the duty of care by the medical personnel, in order to avoid excesses in the application of the criminal law in this area of professional activity. Final considerations: A much greater intervention of criminal law in the practice of medicine is not the most efficient policy to protect the life and integrity of the patient in the face up to the medical malpractice.

Introdução: Apesar de sua idade, a questão da responsabilidade jurídico-penal do profissional de saúde adquire cada vez maior importância na ordem teórica e prática, cenário em que se revela uma excessiva judicialização da atividade médica como mecanismo de proteção dos direitos. do paciente. Objetivo: Sistematizar as diferentes posições teóricas que se apreciam atualmente em torno da judicialização da atividade médica e as causas que a estimulam. Método: Foi realizado um estudo documental por meio de revisão bibliográfica exaustiva em buscadores bibliográficos como Scopus, SciELO, Google Acadêmico e PubMed. A investigação argumentativa e exploratória foi realizada no dia 16 de março de 2023 e dos 30 artigos encontrados que abordavam o problema da impericía médica, apenas 11 foram escolhidos para o estudo de acordo com os critérios de seleção. Desenvolvimiento: Foram sistematizados os posicionamentos teóricos sobre a judicialização da atividade médica e as causas que a estimulam; Além disso, determina-se a correta interpretação da lex artis como mecanismo de heterointegração normativa do dever de cuidado do executor de atos médicos, a fim de evitar excessos na aplicação do direito penal neste campo de atuação profissional. Considerações finais: Uma maior intervenção do Direito Penal no exercício da Medicina não é o paradigma político criminal mais eficiente a fim de proteger a vida e a integridade do paciente contra atos de imperícia médica.