Sexual offences committed by members of the armed forces: Is the service justice system fit for purpose?
Abstract: Recent policy reviews, academic research and high-profile media critiques have repeatedly emphasised the UK military as a hypermasculine culture, seemingly permissive of sexual violence, marked by high prevalence of sexual offences and inadequate justice response. The service justice system has been characterised by low conviction rates and poor treatment of victim-survivors of sexual offences, prompting recommendations that rape should be tried in the civilian criminal justice system rather than the service justice system. Despite notable debate on this matter, the Ministry of Defence (MOD) ultimately rejected this recommendation in December 2021 and instead committed to implementing clear and meaningful change within the service justice system response to sexual offences. In light of this decision, this article interrogates available data about the current service justice system response to sexual offending, and lessons that may be learnt from the civilian criminal justice system, to highlight current obstacles to justice and outline areas in which further research and scrutiny is necessary.
Abstract: Context: In response to the opioid crisis, federal guidelines were implemented, including the Veterans Health Administration's (VA) Opioid Safety Initiative in 2013. The impact of policies on patients near the end of life is unknown. Objective: Examine temporal trends in opioid prescribing, pain, and opioid overdoses among Veterans near the end of life. Methods: Retrospective, time series analysis of VA decedents between October 2009 and September 2018 whose next-of-kin participated in VA's Bereaved Family Survey (BFS). Using multivariate regression to adjust for sociodemographic and clinical covariates, we examined temporal trends in outpatient opioid prescribing, uncontrolled pain based on BFS report, and opioid overdose-related hospitalizations, in the last month of life, overall and by clinical diagnosis (cancer versus non-cancer). Results: Among 79,409 decedents, mean daily outpatient opioid dose in morphine milligram equivalents in the last month of life decreased from 4.6 mg in 2010 to 2.1 mg in 2018 (adjusted change -0.20 mg/year; P