Alfred Allan

Patients’ and family members’ views on how clinicians enact and how they should enact incident disclosure: the “100 patient stories” qualitative study

Objectives To investigate patients’ and family members’ perceptions and experiences of disclosure of healthcare incidents and to derive principles of effective disclosure. Design Retrospective qualitative study based on 100 semi-structured, in depth interviews with patients and family members. Setting Nationwide multisite survey across Australia. Participants 39 patients and 80 family members who were involved in high severity healthcare incidents (leading to death, permanent disability, or long term harm) and incident disclosure. Recruitment was via national newspapers (43%), health services where the incidents occurred (28%), two internet marketing companies (27%), and consumer organisations (2%). Main outcome measures Participants’ recurrent experiences and concerns expressed in interviews. Results Most patients and family members felt that the health service incident disclosure rarely met their needs and expectations. They expected better preparation for incident disclosure, more shared dialogue about what went wrong, more follow-up support, input into when the time was ripe for closure, and more information about subsequent improvement in process. This analysis provided the basis for the formulation of a set of principles of effective incident disclosure. Conclusions Despite growing prominence of open disclosure, discussion about healthcare incidents still falls short of patient and family member expectations. Healthcare organisations and providers should strengthen their efforts to meet patients’ (and family members’) needs and expectations.

The South African truth and reconciliation commission as a therapeutic tool

A Truth Commission is one of the institutions used in international law to investigate gross human rights violations within a specific country. In this article we examine claims that the South African Truth and Reconciliation Commission (TRC) was therapeutic. In the absence of empirical evidence, this examination will be guided by a theoretical framework that will reflect ways by which we believe international legal institutions can contribute tot he healing of the people of a country in which human rights abuses have taken place. We developed this framework with reference to the literature. Our conclusion is that the legislators emphasis on truth, reconciliation, stability, and restorative justice enhanced the TRCs potential to promote healing, but that some features of this procedure and the enabling Act, the Promotion of National Unity and Reconciliation Act (1995), restricted its ability to be therapeutic. We conclude by looking at the role culture may have played in the success of the TRC.

Prediction of the risk of male sexual reoffending in Australia

Abstract This paper reports the findings of a retrospective study designed, primarily, to investigate the predictive accuracy of the Rapid Risk Assessment for Sexual Offence Recidivism (RRASOR); the Static 99 and two models developed in Western Australia, namely the Violent Offender Treatment Program Risk Assessment Scale (VOTPRAS) and the 3-Predictor model on a Western Australian sample of violent and nonviolent sexual offenders. A secondary aim was to establish whether the instruments are equally valid for Indigenous and non-Indigenous, and violent and nonviolent sexual offenders. The data of 538 convicted sexual offenders, who were assessed by the Sex Offender Treatment Program of the Western Australian Department of Justice from 1987 to 2002, were used. The predictor variables were the total scores obtained for each instrument and the outcome variable a conviction in a court for a further sexual offence and, in the case of the VOTPRAS, also a further violent offence. In general the predictive accuracy...

Recidivism Among Male Juvenile Sexual Offenders in Western Australia

Juvenile sexual offenders form a substantial part of the sexual offender population and a subset of them will continue offending against the person in general, and sexually in particular, into adulthood. Part of a strategy to reduce offending against the person, and sexual offending specifically, should therefore be to identify and treat high-risk juvenile sexual offenders. To identify the characteristics of such offenders, recidivism studies are traditionally used. After reviewing 11 recidivism studies we briefly discuss the difficulty of comparing the recidivism rates found by them. We then report the findings of a study that examined the official records of 326 male juvenile sexual offenders convicted in Western Australia from January 1990 to June 1998. During the follow-up period almost 7 in 10 of the offenders reoffended. Most were convicted of non-sexual offences, with only 1 in 10 convicted of new sexual offences. Offenders who reoffended against the person (sexual and non-sexual), constituted more than one-third of the total sample. Stepwise logistic regression analyses failed to identify variables that are useful to predict sexual reoffending, but identified variables that predict further offending against the person. Western Australian juvenile sexual offenders who consistently offend against the person appear to start offending at a younger age and have a general offending history that, among other offences, includes a violent sexual offence.

The Use of Psychological Tests by Australian Psychologists Who do Assessments for the Courts

Abstract Psychological tests form a central part of most forensic assessments. However, the tests used, and the manner in which they are used, have been criticised, especially in the United States. In a survey of 79 Australian psychologists who do evaluations for the courts, we tried to determine which psychological tests they use, how frequently they use them, and their reasons for using particular tests. Our survey reveals that the Wechsler Intelligence Scales, Rey Complex Figure Test, and Minnesota Multiphasic Personality Inventory (MMPI) are used most frequently. Notably, 7 of the 10 most frequently used instruments were neuropsychological tests. Respondents most frequently take into account the “suitability to the situation” and the “psychometric properties of the test” when selecting a test. The study demonstrates that the tests used by forensic psychologists are generally well established in the clinical field, and that psychologists doing assessments for the courts must be competent users of neuro...

Exploratory study to examine the impact of television reports of prison escapes on fear of crime, operationalised as state anxiety

Using an experimental design that is unique in the study of fear of crime, this study compared the impact of different television report formats (standard, reassuring and remote) of a prison escape on fear of crime (operationalised as state anxiety) experienced by a middle-aged (35 - 45 years) and an older group (65 - 75 years) and male and female subjects. The format of television reporting influenced fear of crime, and the effect was the same for men and women, but older people who viewed the standard format, experienced significantly higher levels of fear than middle-aged people. Furthermore, women experienced higher levels of state anxiety than men after viewing the crime reports.

Functional Apologies in Law

Apology has recently emerged from being a relatively obscure construct in law to one that is prominent in various areas of law through actual or proposed law reforms. Whilst law reform is welcome, it is important that changes should be grounded in scientifically accepted theories and supported by research data and, furthermore, that the effectiveness of such endeavours should be evaluated before they are further expanded. This cannot be said of the growth of the use of apology in law. In this article I use a model of apology developed by Slocum, Allan and Allan (2006) to examine why apologies may be functional in law. I also examine what form an apology may have to take to be functional in criminal, civil, and constitutional law respectively.

Assessments for the courts: A survey of Australian psychologists

Forensic psychology is established in Australia. However, unlike in some countries, no survey of forensic psychologists and their activities has been published locally. This paper reports the findings of a survey of 79 Australian psychologists who do assessments for the courts. The results reveal that most of the respondents had post‐graduate qualifications in psychology and were experienced psychologists, but were less experienced in doing assessments for the courts and lacked formal forensic training. The study identifies areas in forensic training that respondents believe were not adequate, including key areas such as childcare and custody evaluations. It highlights the importance of reports in the forensic field because, relative to the number of reports they prepare, it is rare for respondents to testify. Finally the study discloses that while respondents are generally satisfied with the treatment they receive, and the court atmosphere, they believe that their answers and testimony are sometimes distorted.

An Observational Study of Bail Decision-Making

Pre-trial detention of defendants has important legal, human rights and practical implications for defendants, their families, and society and therefore the area justifies research scrutiny. However, there is a dearth of empirical studies of bail decision-making and most of them have been retrospective studies. Prior studies have nevertheless identified a number of purported shortcomings in bail legislation and decision-making. The rarely used observational methodology employed in this study provided data that are not normally available from official records. The first appearances of 648 defendants were observed in the lower courts in metropolitan Perth (Western Australia) to identify factors that play a significant role in bail decision-making and to collect baseline data for a longitudinal study. Legal factors made a significant contribution to the bail decision, while extra-legal factors did not.

Apology in Civil Law: A Psycho-legal Perspective

Apology in law, particularly in civil law has become very prominent in Australia with every state and territory introducing legislation that promotes the making of apologetic statement by wrongdoers in civil proceedings. In this article I briefly review some of the arguments that are offered in support of these provisions and then examine some of the questions that arise from them. In this regard I consider the meaning that the construct of apology has in civil justice and the assumption that an apology may avert lawsuits. I conclude by examining the conflicting arguments about the morality of protecting apologies from being admitted as evidence against defendants in civil proceedings.