Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal

PURPOSE: It was to analyse the most critical areas in Obstetrics and to suggest measures to reduce or avoid the situations most often involved in these disputes. METHODS: Obstetrics cases submitted to the Medico-legal Council since the creation of the National Institute of Legal Medicine and Forensic Sciences in 2001 until 2011 were evaluated. A comprehensive characterization, determination of absolute/relative frequencies, hypothesis of a linear trend over the years and the association between each parameter was done. RESULTS: The analysis has shown no significantly linear trend. The most common reasons for disputes were perinatal asphyxia (50%), traumatic injuries of the newborn (24%), maternal sequelae (19%) and issues related to prenatal diagnosis and/or obstetric ultrasound (5.4%). Perinatal asphyxia showed no significantly linear trend (p=0.58) and was usually related to perinatal deaths or permanent neurologic sequelae in newborn children. Traumatic injuries of the newborn, mostly related to instrumented deliveries, shoulder dystocia or vaginal delivery in breech presentation, has shown a significantly increased linear trend (p<0.001), especially related to instrumented deliveries. The delay/absence of cesarean section was the clinical procedure questioned in a significantly higher number of cases of perinatal asphyxia (68.7%) and of traumatic lesions of the newborn due to instrumented deliveries (20.5%). CONCLUSION: It is important to improve and correct theoretical/practical daily clinical performance in these highlighted areas, in order to reduce or even avoid situations that could end up in medico-legal litigations.

Export subsidies, countervailing duties, and welfare

Using a simple Cournot duopoly model, this paper provides an important policy implication for trade disputes involving export subsidies. In this paper, the possibility that a foreign export subsidy could benefit the domestic country as well as the foreign country by appropriately using countervailing duties is identified.

Assessing development and the idea of development in the 1950s in Brazil

The decade of 1950s was a crucial period of the industrialization of the Brazilian economy. The dominant school of thought was the national-developmentalism, which was not restricted to the sphere of economic production but also encompassed political and socio-cultural processes of change. Combining repression, persuasion and paternalism, the national state took a significantly political and economic responsibility in the social, material and symbolic modernization during the Vargas and Kubitschek administrations. However, internal disputes, foreign demands and a long legacy of socio-spatial inequalities prevented the achievement of more socially inclusive goals, leading a legacy of unanswered questions that still have currency today.

Estado, bloco no poder e acumulação capitalista: uma abordagem teórica

State, power block and capitalist accumulation: a theoretical approach. This article aims to elaborate a theory, based on Poulantzas, about the role of the State in a capitalist economy through a relational perspective that perceives the State as a field and a strategic process for the disputes of class fractions within the power bloc. In order to do so, it exposes the relation between State and accumulation at an abstract-formal level, emphasising the limitations of studies that use only this dimension. Next, it analyzes the role of the power bloc in mediating between the abstract and concrete levels of the State, observing that public policies are elaborated as a result of the clashes within the power bloc. Finally, it promotes a discussion on the external constraints (international system) that are affected and affect the State and, consequently, the dynamics of the power bloc.