The Risk of Revictimization and the Ethics of Covering School Shootings: What Journalists Can Learn from IRBs

By Michelle Meyer

Updated below

Like most parents, after learning about the latest mass school shooting this morning, my thoughts immediately went to my own kindergartener. And of course, like most reading this blog, I thought about how poorly we handle guns and mental illness. Before too long, though, I couldn’t help but make a less direct connection between today’s events and my scholarly interests. I’m thinking of the way journalists cover school shootings as compared to how we regulate human subjects research.

As I write in The Heterogeneity Problem, 65 Admin. L. Rev. __ at 14-16 (forth. June 2013):

Studies on sexual abuse and assault, grief, war, terrorism, natural disasters and various other traumatic experiences are critical to better understanding and addressing these phenomena. But exposure to trauma — whether as a survivor or as a first rescuer or other third party — often causes substantial psychological morbidity. . . . Given their potentially fragile state, IRBs understandably worry that “questioning [or otherwise studying] individuals who have experienced distressing events or who have been victimized in any number of ways . . . . might rekindle disturbing memories, producing a form of re-victimization.”

IRBs — local licensing committees who operate according to federal statute and regulation and must approve most studies involving humans before researchers can even approach anyone about possibly participating — sometimes impose burdensome requirements on the way trauma research is conducted in order to protect adult subjects from the risk of revictimization. And they do so in addition to applying regulations that require that researchers disclose that risk (and others) to subjects.

Contrast this with the way journalists cover trauma. Read More

An International Meeting of Public Health and Law Enforcement

By Scott Burris

We know, and now most people acknowledge, that police activity has some clear, and in some instances intentional, effects on health.  To start with the obvious, police are instrumental in reducing the number of people who are murdered, assaulted, raped, or otherwise terrorized. Policing – like any form of social intervention – can also have unintended consequences. There is, for example, considerable evidence that criminal law and legal practices can increase risks of HIV and other harms among drug users.

These facts are well-established and pretty well recognized. So now the question is not whether policing has health consequences, but rather whether social and health work is to be seen as an integral element of law enforcement in the 21st century.  In much of their day to day work, police are engaged in far more than the prevention of crime or the maintenance of social order.  This is something we all know, something that has probably always been true of police work, something that is shaping a lot of programs around the world, and yet something we need to talk more openly about.

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Art Caplan: MA Should Legalize Physician-Assisted Suicide

Weighing in on Question 2, Massachusetts’ ballot initiative on physician-assisted suicide, Art Caplan says we should vote “yes”:

Mass. should legalize physician-assisted suicide

Of the numerous ballot initiatives that will be decided at the state level on Tuesday, none is more hotly contested than the Massachusetts bill to decide whether to legalize physician-assisted suicide. The citizens of Massachusetts, my home state, should vote to legalize.

The proposed measure allows terminally ill patients to be given access to lethal drugs. A terminally ill patient is defined as someone with six months or less to live. The patient’s terminal diagnosis and mental competency must be attested to by two doctors. Patients would have to make a request to their doctor twice orally and once in writing. The written request would have to be witnessed.

Yet even with such restrictive conditions, opponents of the proposal say doctors should never, as a matter of professional ethics, intentionally hasten the death of one of their patients, even one who is terminally ill. The codes of medicine and nursing ethics reject helping patients die.

Keep reading…

Taking Allegations of Child Abuse Seriously: Former Penn State President Spanier Charged

By Michele Goodwin

Penn State’s former president, Graham Spanier, is the latest person to be charged in the fallout involving Jerry Sandusky’s sexual abuse of boys on the Penn State campus.  A year ago, I blogged about Spanier’s curiously timed defense of his former staff members following the horrific allegations involving the former, popular football coach.

Jerry Sandusky’s crimes are deplorable. He was convicted of molesting boys from a charity he helped to found (Second Mile) and will serve 30-60 years in prison; he will likely die there.  Yet no less problematic were Spanier’s statements immediately following the release of the grand jury’s presentment.  Last year, the statement released by Spanier could only be described as cavalier and irresponsible.  Spanier claimed that the perjury charges against his former athletic director, Timothy Curley, and Gary Schultz, his senior vice president for finance and business, were “groundless,” and that he has “complete confidence in how they… handled the allegations” against Sandusky.  Stunning.

Remember the grand jury report?  Schultz said that the allegations were “not that serious” and that he and his colleague “had no indication that a crime had occurred.”  What we know now from the Freeh Report is that there were emails between Spanier, Curley, and Schultz about allegations of Sandusky’s showers with boys in the Penn State football locker room. Spanier claims that there may have been emails that he received, but he can’t remember them.  He told Jeffrey Toobin in a New Yorker article: “I was apparently copied on two emails…I didn’t reply to them.”  A few years later, Michael McQuery (a former graduate student) reported witnessing Sandusky sexually abusing a child in the shower; he also testified before the grand jury.

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Good news and bad news about gun laws, mental illness and violence — Part 3

This is Part 3 in a three-part series on gun laws, mental illness and violence in the United States. Read Part 1 and Part 2.

By Jeffrey Swanson, PhD

So what can the law do about gun violence?  The US Supreme Court’s decisions in District of Columbia v. Heller, 554 U.S. 570 (2008) and McDonald v. Chicago, 561 U.S. 3025 (2010) made it pretty clear that legal solutions to our nation’s firearm violence problem do not include “getting rid of the guns,” but do include preventing dangerous people from getting their hands on them.

So, the difficult question of whether our nation’s gun laws are capturing the right “dangerous people” remains crucial, and it invites a prior question: Whose criteria are we talking about?

Variations in law and policy among the states and between federal and state statutes mean that the same person with a severe mental illness might be disqualified from buying a gun in one state but not in another. Functional incapacity stemming from a psychiatric disorder may or may not lead to firearm disqualification, depending on how various applicable laws and policies define it in different contexts.

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Good news and bad news about gun laws, mental illness and violence — Part 2

This is Part 2 in a three-part series on gun laws, mental illness and violence in the United States. Read Part 1.

By Jeffrey Swanson, PhD

It is hard to find good news in our nation’s gun violence statistics, but here’s this: If somebody shoots you today, your chances of survival are about 83 percent — up from 78 percent just ten years ago.  The improving survival rate for gunshot victims has helped nudge the national homicide rate down by about half a percentage point since 2001. Of course, the cloud behind that silver lining is that more people are actually getting shot. The CDC recorded almost 600,000 injuries caused by assault with a firearm in the past decade, as the combined rate of fatal and nonfatal gun assault injuries rose from about 18 to about 21 per hundred thousand.

Now for the bad news: When the shooter and the victim happen to be the same person, the odds of survival and death are reversed: 8 out of 10 die. Suicide attempts with a gun almost always succeed, because they are almost always aimed at the brain at close range, and there is seldom anyone around to call 911.

For those who “get lucky,” surviving a gunshot to the head can be a pyrrhic victory.  We all cheered Gabrielle Giffords’ courageous walk across the stage at the Democratic National Convention, but let’s face it: Her physical appearance was as much a reminder of what she has lost as it was a testimony to the miracles that timely neurosurgery can perform. Most survivors of gunshot injuries — whether self- or other-inflicted — don’t look like much like Gabby Giffords and they tend to have fewer supportive friends. They are often disadvantaged young people who struggle to recover in places where hope runs thin. Could better gun laws, better enforced, prevent their plight?  Perhaps they could, but only as a small piece of complex sociological puzzle.

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Good News and Bad News About Gun Laws, Mental Illness and Violence — Part 1

This is Part 1 in a three-part series on gun laws, mental illness and violence in the United States.

by Jeffrey Swanson, PhD

Federal and state efforts to restrict firearms access to potentially dangerous people with mental illness have focused in recent years on extending the reach of states’ reporting to the National Instant Criminal Background Check System (NICS). In August, in response to the Colorado movie theater shooting, Mayors Against Illegal Guns released a report tallying the number of mental health records each state has submitted to the NICS and ranking each state’s reporting performance. Nearly five years after Congress enacted the NICS Improvement Act, only about half the states have submitted more than a negligible proportion of their mental health records.

The Mayors’ report mentions the “mentally unstable man” who shot President Reagan and his press secretary, Jim Brady, for whom the Brady Handgun Violence Prevention Act was named. It recalls the deadly rampages at Virginia Tech in 2007 and in Tucson in 2011. It includes an interactive map titled Fatal Gaps: Can dangerous people buy guns in your state?  The not-so-implicit message here is that states’ spotty reporting of mental health records to the background check database is partly to blame for the senseless deaths in mass shootings.

It is easy to say there’s a problem with our gun laws or their enforcement by pointing to isolated cases where mentally disturbed mass shooters were able legally to buy guns. That is probably true. Unfortunately, there is no evidence yet available to suggest that filling the NICS with more records of people with gun-disqualifying mental health histories would have any measurable impact in reducing firearm violence in the population.

A study underway at Duke University, funded by the National Science Foundation and the Robert Wood Johnson Foundation’s Public Health Law Research Program, may soon provide some answers to that question. Whatever the study finds, though, the results will hinge on whether two assumptions underlying our gun prohibitions turn out to be true:  that there is a strong causal relationship between serious mental illness and gun violence; and that our extant gun-disqualifying legal criteria can accurately identify the subgroup of mentally ill individuals at risk.

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