Sleep and the Law
Considering sleep and law, only somnambulism, REM Behaviour Disorder (RBD) and sleepiness with/without sleep apnoea (OSA) will be discussed.
Somnambulism involves purposeful behaviour during slow wave sleep, possibly causing criminal behaviour. Parks, drove > 20 km, attached his in-laws, killing one and injuring the other, then drove to police and was exonerated. RBC involves acting out violent dreams with potential criminal behaviour. Sleepiness and OSA, while driving, may establish ‘mens rea’ if the driver continues, knowing (s)he is excessively tired, risking sleep. While the High Court overturned Jiminez, non-compliance with OSA treatment or driving excessively tired suggests ‘mens rea’.
Drug Driving in the UK
The UK have recently, March 2nd 2015, introduced limits for drig driving with a statutory ‘medical defence’. Drugwipes have been introduced for use at the roadside for cocaine and cannabis. Following a positive test the individual is taken to the police station for a confirmatory blood sample. All practitioners will have a duty to warn patients of the side effects of commonly prescribed benzodiazepines and opiates, among other potentially impairing drugs, in relation to driving. The offence of impairment will remain. So there will be a need for appropriately qualified experts (forensic physicians/scientists) to interpret the findings in cases where levels fall outside therapeutic range and tolerance has developed.
Forensic Physiotherapy – A Proposed Model
Traditionally physiotherapists have been reluctant to make themselves available to perform Independent Clinical Assessments, write medico-legal reports and give evidence as expert witnesses at court.
With an increasing focus on evidence based practice within the profession, physiotherapists are critically reviewing their knowledge and experience in areas such as physical and functional capacity for work and the performance of activities of daily living and diagnosis.
In musculoskeletal disorders misdiagnosis in work related injury is not uncommon. This is likely to result in inappropriate treatment and poor outcome of treatment and return to work processes.
This presentation proposes a model, based on the principles of evidence based practice for physiotherapists interested in rigorous forensic exploration of factors involved in work injury to assist in efficient return to pre-injury job, differential diagnosis and effective recovery from work related injury.
Current Issues with Contractors in Health Practice: Contractors or Employees and Restraint
With the preponderance of Health practitioners’ engagement presently as independent contractors as opposed to employees in the private sector, there is great uncertainty about the characterisation of these engagements. Secondly the issue of restraints for employees as opposed to vendors continues to cause problems particularly for junior practitioners. The present law and the practicalities will be reviewed.