Journal of Scholastic Inquiry: Behavioral Sciences, Volume 3, Issue 1, Fall 2014

Emotional Intelligence in Martial Arts

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Journal of Scholastic Inquiry:

Behavioral Sciences

Behavioral Sciences Edition, Volume 3, Issue 1

Fall 2014

Published by: Center for Scholastic Inquiry, LLC ISSN: 2330-2330-6750 (online)

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Journal of Scholastic Inquiry: Behavioral Sciences

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Journal of Scholastic Inquiry: Behavioral Sciences The Center for Scholastic Inquiry (CSI) publishes the Journal of Scholastic Inquiry: Behavioral Sciences (JOSI: BS) to recognize, celebrate, and highlight scholarly research, discovery, and evidence-based practice in the behavioral sciences field.

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JOURNAL OF SCHOLASTIC INQUIRY: BEHAVIORAL SCIENCES Fall 2014, Volume 3, Issue 1 Managing Editor Dr. Tanya McCoss-Yerigan Editor-in-Chief Dr. Jamal Cooks General and APA Editor Jay Meiners Editorial Advisory Board Shirley Barnes, Alabama State University Joan Berry, University of Mary Hardin-Baylor Brooke Burks, Auburn University at Montgomery Timothy Harrington, Chicago State University Mark Wesolowski, Practitioner-Chicago Public Schools Lucinda Woodward, Indiana University Southeast

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Please note that all reviewers were not fully active for this particular journal issue.

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TABLE OF CONTENTS

Publication Agreement and Assurance of Integrity Ethical Standards in Publishing Disclaimer of Liability

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Research Manuscripts 8-41

Psychosocial Needs of Men with Breast Cancer: A Case Study James T. Decker, California State University, Northridge Jodi L. Constantine Brown, California State University, Northridge

A Neo-Weberian Review of the Criminal Courts: How the Bureaucratic State Creates Injustice Sven Smith, Stetson University Lonn Lanza-Kaduce, University of Florida Carley Fockler, Stetson University

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PUBLICATION AGREEMENT AND ASSURANCE OF INTEGRITY By submitting a manuscript for publication, authors confirm that the research and writing is their exclusive, original, and unpublished work. Upon acceptance of the manuscript for publication, authors grant the Center for Scholastic Inquiry, LLC (CSI) the sole and permanent right to publish the manuscript, at its option, in one of its academic research journals, on the CSI's website, in other germane, academic publications; and/or on an alternate hosting site or database.

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Psychosocial Needs of Men with Breast Cancer: A Case Study James T. Decker California State University, Northridge Jodi L. Constantine Brown California State University, Northridge

Abstract Cancer and its treatment have more than a physical impact. There are emotional, social, psychological, functional, spiritual, financial, and practical consequences as well. Life is never exactly the same once a cancer diagnosis has been made regardless of age, gender, or diagnosis.

A cancer diagnosis can be particularly challenging if it is unusual or unfamiliar, such as men’s breast cancer. Men are alienated by the breast cancer treatment and recovery process, including assumptions and myths, which further complicate their difficulty in expressing pain associated with a breast cancer diagnosis. This single-subject case study details the diagnosis, treatment, and recovery experience of Ben, a 64 year old Caucasian man who had one of the warning signs related to breast cancer: a change in his nipple. Research suggests the importance of including men with breast cancer into treatment through a psychosocial educational process. Despite being physically treated in much the same way, results suggest that breast cancer is emotionally different for men and women. Including men in the “breast cancer sisterhood” in a masculine way could reduce mortality rates in men with breast cancer.

Keywords: male breast cancer, cancer treatment, cancer recovery, cancer psychosocial need, case study An estimated 2,200 men will be diagnosed with breast cancer and approximately 410 (20%) will die each year (American Cancer Society, 2013). Lacking awareness of breast cancer signs and symptoms can result in a greater likelihood of fatality, as cancer found at later stages may be less likely to be effectively treated (Borgen et al., 1992). Survival rates and clinical outcomes for men are about the same as for women with the same stage of cancer at the time of diagnosis (Cutuli et al., 1995; Howlader et al., 2013; Weber-Chappuis, Bieri-Burger, & Hurlimann, 1996). However, men are usually diagnosed at a later stage because they are less likely to identify or report symptoms. Men with breast cancer often mistake visible lumps for other problems or ignore them until it is too late. Lack of awareness, embarrassment, and social

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stigma can contribute to later cancer diagnosis (Stage III or IV) resulting in fewer positive outcomes for men than women (Adami, Holmberg, Malker, & Ries, 1985).

Breast Cancer in Men Although breast cancer in men is rare, it does happen since men have breast tissue. Boys and girls begin life with similar breast tissue, but men do not have the same complex breast growth and development as women. At puberty, high testosterone and low estrogen levels stop breast development in men. While some milk ducts exist, they remain underdeveloped, and lobules are most often absent (“Breast Cancer in Men,” n.d.). As with female breast cancers, most male cancers begin in the milk ducts of the breast as invasive ductal carcinomas. Less often, male breast cancers begin in the lobules of the breast as invasive lobular carcinomas. In rare cases, men can be diagnosed with inflammatory breast cancer, ductal carcinoma in situ (a non-invasive breast cancer) or Paget’s disease of the nipple (American Society of Clinical Oncology, 2010; National Cancer Institute, 2010; Wisinski & Gradishar, 2010). Paget’s disease of the nipple is a cancer that begins in the milk ducts of the breast tissue, but spreads to the skin of the nipple; it can cause a scaly rash on the skin of the nipple. Although Paget’s disease is rare, it occurs more often in men than in women (American Society of Clinical Oncology, 2010).

Occurrence Both men and women may develop benign (not cancerous) breast conditions. However, the benign breast conditions that are most common in women (such as cysts and fibroadenomas) are very rare in men. The most common benign condition in men is gynecomastia or enlargement of the breast tissue (Niewoehner & Schorer, 2008). Certain diseases, hormone use, obesity or other bodily changes can cause hormonal imbalances leading to gynecomastia (Niewoehner & Schorer, 2008), but it is unclear whether gynecomastia is related to male breast cancer. Although some data suggest it may increase the risk of male breast cancer, most studies have found no link between gynecomastia and breast cancer (Brinton, Carreon, Gierach, McGlynn, & Gridley, 2010; Fentiman, Fourquet, & Hortobagyi, 2006; Wisinski, & Gradishar, 2010). The aging process increases the risk of male breast cancer. Most breast cancer in men occurs between ages 65 and 67 (Wisinski & Gradishar, 2010). The strongest risk for male breast cancer is Klinefelter’s syndrome, a condition related to high levels of estrogen in the body (Fentiman et al., 2006; Niewoehner & Schorer, 2008; Wisinski & Gradishar, 2010). This rare condition occurs when men are born with two X chromosomes instead of one (XXY instead of XY). Men with Klinefelter’s syndrome are 20 to 50 times more likely to develop breast cancer than men without the condition (Wisinski & Gradishar, 2010).

Similar to women, men with an inherited mutation in the BRCA2 gene have an increased risk of breast cancer (Fentiman et al., 2006; Niewoehner & Schorer, 2008; Wisinski, & Gradishar, 2010). Men who carry a BRCA2 mutation have about a 7% chance of developing

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breast cancer by age 70 (Tai, Domchek, Parmigiani, & Chen, 2007). BRCA2 mutation carriers are also at an increased risk for other types of cancer, such as prostate cancer. Men can inherit a BRCA2 mutation from either parent. Further, a man who carries the BRCA2 mutation can pass the mutation on to both his male and female children. Whether or not a man carries a BRCA2 mutation, having a family member with breast cancer increases the chances of developing male breast cancer (American Society of Clinical Oncology, 2010; Mayo Clinic Staff, 2010). Heavy alcohol use, chronic alcoholism, chronic liver disease, and obesity may also increase the risk of male breast cancer (Fentiman et al., 2006; Niewoehner & Schorer, 2008; Wisinski & Gradishar, 2010). These conditions can increase estrogen levels in the body and these higher estrogen levels, in turn, may increase breast cancer risk. Some hormone drugs used to treat prostate cancer also may increase the risk of male breast cancer (American Society of Clinical Oncology, 2010; Wisinski & Gradishar, 2010).

Case Study While the loss of a breast may not be as devastating for men as women from an “appearance” perspective, receiving a cancer diagnosis is still life changing. In addition to the shock, the fear, and the upheaval of a breast cancer diagnosis, men may feel there is a stigma to having what is considered a ‘woman’s disease.’ This is no small thing for men. Literature discussing the warning signs of male breast cancer exist (American Cancer Society, n.d.), but are not easily accessible or something men are familiar or bombarded with in the same way as women. Even though literature states the warning signs of male breast cancer, most men are in denial of those symptoms.

Ben Davidson A case study design is used to illustrate the diagnosis, treatment, and recovery experience of Ben Davidson (pseudonym), a 64 year old, Caucasian man who had one of the warning signs related to breast cancer: a change in his nipple. Before his diagnosis, Ben had a history of being overweight, drank three glasses of wine a night, and had high blood pressure. Ben participated in regular in-depth interviews throughout his treatment and recovery process, and allowed the authors access to his treatment and follow-up appointments over a three-year period. The California State University Institutional Review Board approved this study. The case study is presented in timeline form, beginning in October 2010 and ending in October 2013. Quotations, comments, and circumstances pertaining to Ben’s diagnosis, treatment, and recovery are used to illustrate the challenges men face when diagnosed with breast cancer and the importance of including men in the treatment and recovery process.

October 2010. Ben’s left nipple was discolored, turning almost black. He saw this, but was not concerned, nor did he realize that it was one of the warning signs related to breast

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cancer. “None of my doctors ever discussed signs and symptoms of breast cancer with me.

They poked me every year for prostate cancer, but we don’t talk about breast cancer.”

January 2011. Three months later, after first discovering a change in his nipple, Ben went to the doctor for his yearly physical examination. His doctor did not notice the change in his nipple, so Ben asked his doctor about the change in his nipple and was informed that he should have it looked at and possibly biopsied. His male internist did not offer him a referral to a pathologist or oncologist, but suggested he have his dermatologist look at it. Ben is like most men, who do not like going to doctors, and he had already scheduled his annual visit to his dermatologist for June. Since his primary care doctor did not seem to think the nipple change was serious, Ben waited until June to talk to his dermatologist during his annual appointment.

June 15, 2011. Ben’s dermatologist biopsied his nipple and sent the tissue to a pathologist. The results came back inconclusive, but with the suggestion that Ben see a breast specialist. Although Ben’s girlfriend had not questioned him about the change in his nipple, she works in a hospital and knows doctors and their reputations. She recommended that Ben see an international breast cancer surgeon at a medical center in Los Angeles, California, since he is one of the leading experts on breast cancer. Ben scheduled an appointment with the internationally renowned oncology surgeon.

July 11, 2011. Upon arrival at Los Angeles Medical Center Comprehensive Cancer Institute, the parking attendant opened the door for Ben’s girlfriend and stated, “Be careful getting out.” The attendant looked at Ben and said, “You take care of her.” After going upstairs and registering, they sat down and a volunteer approached the couple. “She asked my girlfriend if she would like to take a survey on breast cancer. My girlfriend declined since she wasn’t the one with breast cancer. It bothered me that the volunteer assumed my girlfriend was the patient, but I figured it was a common mistake. But then a staff member approached her about coffee and magazines and ignored me. Pink was everywhere! Everywhere I looked there were pictures of women, women’s anatomy, and pink.”

After registering, a nurse requested additional information from Ben and two oncology surgeons examined him. Ben presented as asymptomatic for breast cancer, based on a breast tissue exam looking for a lump in the chest area and a lack of skin dimpling or puckering.

Although he did have a nipple change, which explained the lack of skin dimpling and/or puckering, the biopsy was inconclusive. The oncology surgeons asked Ben if he would pick up the biopsy slides from his dermatologist along with the pathologist’s report.

July 12, 2011. Ben called his dermatologist and requested his biopsy slides and the pathologist’s report. He picked up the slides and documents, and delivered the information to the oncology surgeons the same day. Unbeknownst to Ben, the pathologist did not send the full

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report to his dermatologist. Since the report was not the full report, Ben’s oncology surgeons requested the report themselves. They received it on Monday, a week later.

July 19, 2011. Both oncology surgeons called Ben immediately and requested that he come in that day. “I knew that when they ask you to come in on short notice that it’s not good news.”

July 22, 2011. Ben met with his oncology surgeons and was told that the pathology report came back positive for Stage II breast cancer. Ben needed surgery and it was scheduled for Thursday July 28, 2011.

July 25, 2011. Ben was scheduled for a chest x-ray, EKG, MRI, PET scan, CT/CAT scan, bone scan, MRI, ultrasound, and a mammogram. None of these tests were explained to him. “It was apparent that the technicians who administered the mammogram had never had a male patient since there was no discussion about what they were going to do.” Since Ben has a son, he was instructed by the oncology nurse to have a comprehensive BRAC analysis to see if his son would be at risk from a genetic family history. Another oncology nurse came in and provided Ben with a pink notebook and information related to his upcoming surgery. “It had information for women facing breast cancer and was called ‘A Women’s Guide to Breast Cancer Treatment.’ There was nothing there for men facing breast cancer surgery.”

Ben admitted that the pink notebook contained helpful information as it explained the PET scan, CT/CAT scan, bone scan and the mammogram, about which he knew nothing.

Unfortunately, Ben received the pink notebook after he completed all of the aforementioned tests. However, the pink notebook also contained information about the Los Angeles Medical Center Comprehensive Cancer Institute for Breast Center with a statement on the second page reading “We provide emotional support for women with breast cancer.” Ben was disappointed that nothing was in the resource guide for supporting men emotionally, and no support groups for men with breast cancer were listed.

July 27, 2011. Ben’s doctors asked him to come in on Wednesday, the day before he was scheduled for surgery, and he was provided with more information related to the surgery and recovery. “They still didn’t tell me anything specifically about men. I asked about breast reconstruction and was informed that I would not need it since I did not have large breast tissue.”

At this meeting, the day before his breast cancer surgery, Ben was informed that the oncology surgeons had contacted his urologist. At that point, his oncology surgeons informed Ben that he had prostate cancer as well as breast cancer; his PSA was 9.8 and the pathology report was positive for cancer. Ben was told that his urologist said the breast cancer was the number one priority and that he would work with Ben once all of the treatment for breast cancer was completed.

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Treatment The overall ratio of female to male breast cancer in the United States is 100 to 1, but knowledge about specific adjuvant therapies for men with breast cancer is limited because of the rarity of the diagnosis (American Cancer Society, 2010). The main treatment for male breast cancer is a mastectomy. Lumpectomy (also called breast conserving surgery) is rarely used because of the size of the male breast. After the mastectomy, some men may have radiation therapy following surgery. Treatment for male breast cancer is similar to treatment for female breast cancer. Since most male breast cancers are hormone receptor-positive, Tamoxifen is usually the first drug therapy used. Tamoxifen is taken in pill form every day for five years. If the tumor does not respond to the first hormone therapy (usually Tamoxifen), gonadotropin inhibitors may be used to lower hormone levels in the body. Depending on the cancer stage, chemotherapy may be given before Tamoxifen therapy. For men with hormone receptornegative breast cancer, chemotherapy is usually the first drug therapy used. Men with HER2/neu-positive breast cancer may be treated with trastuzumab (Herceptin) plus chemotherapy that contains a taxane (“Breast Cancer in Men”, n.d.).

July 31, 2011. Following successful breast cancer surgery, Ben was referred to a medical oncologist who would follow him for the next five years. Ben was prescribed Tamoxifen to be taken for five years. Tamoxifen slows or stops the growth of cancer cells that are already present in the body. It helps keep the original breast cancer from coming back and helps prevent new cancer in the opposite breast. When Ben asked his oncologist about the research findings related to men and this drug, he was informed that none existed. When he asked about the side effects from this drug, Ben was given a long list of potential negative side effects including hot flashes, vaginal dryness, discharge, or irritation, and reduced interest in sex.

Ben was informed that there are many studies on women and Tamoxifen, and it is assumed that side effects are the same for men as for women. Ben asked how men could experience vaginal dryness, discharge, or irritation, but did not receive a satisfactory answer to his question.

Because of the lack of research specific to men, Ben did not begin taking Tamoxifen until the end of October 2011. Curious about what was being prescribed, Ben looked for research specific to men. He did not find any at the time.

At the meeting with his medical oncologist, Ben was also referred for radiation therapy.

Radiation therapy was scheduled for eight weeks, five days a week. At no point did anyone talk to Ben about the potential effects of the breast cancer treatment on his prostate cancer. Nor did anyone at the radiation therapy center explain the risks of having a higher rate of cardiac issues since it was Ben’s left breast that had the mastectomy.

August 10, 2011. On his first day of radiation treatment, Ben saw a copy of the Cancer Support Community calendar of programs for September/October 2011. Listed in the calendar were drop-in-groups for Brain Cancer, Stage 1 & 2 Breast Cancer, Prostrate Cancer, and 10 other

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groups, but none for men specifically with breast cancer. Ben could attend the Stage 1 & 2 Breast Cancer group and tried it one time, but he felt out of place since the group focused on women and he was the only man there.

Also in the waiting room for radiation treatment was the “Perspectives” magazine published by the Cancer Institute. There was an article on ‘Triple-Negative Breast Cancer for Women’ and another article on a pink background titled ‘Supporting Breast Cancer Research Eighth Avon Walk Benefits the Cancer Institute.’ Once again, Ben found nothing in the magazine specifically related to men.

Breast Cancer in the Media Ben’s experience not being able to find available information on breast cancer in men was not unusual. WebMD magazine has an article on 10 cancer symptoms women (italics added) should never ignore. The winter 2010 Caring for Cancer magazine has wonderful suggestions on cancer questions to ask and the roles that each professional plays, but offers nothing specifically for men with breast cancer. The Caring for Cancer website states: Breast cancer is the most common form of cancer in women. It will account for an estimated 26 percent of all cancer diagnosed in women in 2010, according to the American Cancer Society. Over the course of a woman's life, she has a 1 in 8 chance of getting breast cancer (para. 1).

The article goes on to state “It is also possible for men to develop breast cancer, although this is rare” (Caring for Cancer, n.d., para.1). Unlike many websites, the Caring for Cancer website does have a link for men and breast cancer. When a man clicks on that link, he is led to a Reuters Health article titled “Male breast cancer rare, but can be aggressive” (Lies & Nishikawa, 2011). There can be little that is more frightening than having recently received a breast cancer diagnosis and reading an article that talks about how aggressive the disease can be for you without offering additional psychosocial support, resources, or information.

Cancer Support Groups for Men The Caring for Cancer magazine lists cancer support groups in the community. The Cancer Support Community-Benjamin Center has a group for Stage 1& 2 Breast Cancer, but the flyer only has pictures of women on it. Seeing pictures of women on a pink background does nothing to make men feel welcome, despite men being able to benefit from a support group (Decker, 2008).

An Internet search of the term “breast cancer support groups for men” revealed numerous links to webpages for nationally known organizations. The Susan G. Komen for the Cure webpage has pink headings, a pink banner, and a small listing at the bottom of the ‘Support Group’ page saying “In-person support groups for men with breast cancer can be hard to find” (“Support Groups”, n.d., para. 12). They go on to suggest that there are support groups for men

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with any cancer, which does not take into account the stigma and embarrassment men might feel having a ‘women’s disease’ in the midst of other men.

The Men Against Breast Cancer (MABC) webpage is light purple with a pink banner and proudly states their heritage as the “first and only national 501 (c)(3) nonprofit organization designed to provide targeted support services that educate and empower men to be effective caregivers when cancer strikes” (Men Against Breast Cancer, n.d., para. 1). While laudable that an organization exists to help partners cope with disease, the assumption driving the MABC’s mission perpetuates the myth that breast cancer happens only to women in heterosexual relationships; further ignoring the fact that men get breast cancer, too.

Ben was unable to find a breast cancer support group for men in his community. He tried going to a general cancer support group, but once there he discovered he did not want to share his diagnosis with the group members. He did not go back. Ben continued his treatment and recovery largely on his own. His girlfriend remained a source of support, but Ben’s work colleagues were aware only that he was receiving treatment for cancer. Ben tried to keep his personal and professional life separate.

July 2012. Ben successfully completed cancer treatment and radiation therapy and went for his first yearly check-up with his surgeon. After registering, a nurse came out to the waiting room of eight women and one man (Ben) and asked for Mrs. D. No one moved. The nurse called again, at which point Ben looked up and said “Are you looking for Mr. D?” The record and registration sheet clearly stated “Mr.”, but the nurse’s jaw dropped when Ben informed her it was Mr. D. not Mrs. D. It was still painful for Ben knowing he had a ‘women’s disease,’ and not being acknowledged as a man with breast cancer by the nurse who was going to examine him made the follow-up visit unnecessarily painful and difficult. Ben felt embarrassed, emasculated, and ashamed by the nurse’s assumption that only women get breast cancer.

October 2013. Ben found research on Tamoxifen which was presented at the 2013 American Society of Clinical Oncology (ASCO) meeting. This study, called a TTom trial, included 6,953 women with early breast cancer who had been taking Tamoxifen for five years and who had not had a recurrence. These women were randomized to either continue taking Tamoxifen for an additional 5 years (10 years total) or stop after five years (American Society of Clinical Oncology (ASCO) Annual Meeting, 2013). The group has now been followed for longer than 10 years, and outcomes suggest that results are better for women over a 10 year period. Disappointed he did not find research specific to men, Ben decided to talk to his doctor about increasing the length of time he would be taking Tamoxifen.

Discussion Ben’s case study clearly identifies the need for additional research and psychosocial support for men with breast cancer. From a medical perspective, research should include men in

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drug treatment studies for breast cancer. Assuming that drugs used to treat breast cancer will work similarly for men and women (and that side effects will be the same), without testing those drugs on men, is akin to assuming medication will work equally well on women as men without testing. Although pharmaceutical companies would benefit by including men in their research on Tamoxifen and other chemotherapies by potentially enhancing cure rates for breast cancer, the cost of including men in studies, and the rarity of the condition, often makes research prohibitive (Giordano, 2005). However, laws exist requiring the inclusion of women and minorities in drug trials in order to receive federal funding to correct a history of medical trials using only men as subjects. Correcting that wrong is important and benefits society as a whole.

However, it should not mean that the same wrong now occurs with men as the silent victims instead of women.

Research should also be conducted from a psychosocial perspective. Researchers should study risk factors that may help determine if and when a man should start having breast screenings. One suggestion would be to develop a research project using the Health Belief Model (HBM) which is a psychosocial framework developed in the 1950s and revised in latter decades to explain and predict the adoption of health promotion behaviors which could be modified for men with breast cancer or at risk for breast cancer (Becker, 1974; Rosenstock, 1974; Rosenstock, Strecher, & Becker, 1988). According to the HBM, the adoption of health promotion behaviors depends on an individual’s (1) perceived susceptibility to a disease (men and breast cancer), (2) perceived severity of the disease (knowledge of men and breast cancer), (3) perceived benefits of adopting a new health behavior (addressing risk factors like heavy alcohol use, chronic alcoholism, chronic liver disease, and obesity may decrease the risk of male breast cancer), (4) perceived barriers to adopting the behavior (the myth that real men do not cry, ask for help, or get breast cancer), (5) personal or environmental motivators or cues to promote the behavior (asking for insight into breast cancer screenings from their primary care doctors), and (6) self-efficacy or confidence to carry out the behavior (Austin, Ahmad, McNally, & Stewart, 2002). Outcomes of this research should address what motivates men to undergo cancer screening; more importantly, do men believe that they have a chance of developing breast cancer? It would be useful to know how men utilize existing resources, or whether they see these existing recourses as biased toward women. What do men see as the barriers to breast cancer screening and what would be the benefits of breast cancer screening for men?

Raising Awareness While research may take years, the number of men with breast cancer is too small to be able to perform studies that include only men (Giordano, Buzdar, & Hortobagyi, 2002).

Researchers would have to find a method by which every man with breast cancer was included in a study in order to have sufficient numbers to achieve the necessary statistical power, but simple steps can – and should – be immediately taken to raise awareness about male breast cancer, and improve the treatment experience for men with breast cancer. Raising awareness about male

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breast cancer needs to occur on two fronts: a) from the primary care physician, and b) in the media.

Primary Care Physicians’ Office - Primary care doctors should integrate information about breast cancer and breast cancer screening exams for early detection for men when they are seen for their annual physical. Men without symptoms should be made aware of the possibility of breast cancer by their physician, and told what signs and symptoms to look for. Specifically, discussions and explanations should begin with men starting at age 20, and at age 40 men with risk factors for breast cancer should follow the guidelines for breast cancer screening, including having an annual breast examination by their physician, conducting monthly breast selfexaminations, and having a mammogram if warranted.

Media - In addition to the doctor’s office, raising awareness about male breast cancer needs to occur in the media. Breast cancer resources and organizations, such as Susan G. Komen for the Cure, acknowledge the fact that men can, and do, get breast cancer. However, the perception generated by pink ribbons, Avon 3-Day Walks, events like the Revlon Run/Walk for Women, and organizations such as Save the Ta-Tas is that breast cancer is a women’s disease.

Breast cancer is discussed, but men are relegated to the supportive caregiver role instead of the one in need of treatment or services. If men believe the myth that “men don’t get breast cancer” or that men’s breasts are somehow less important than women’s, they are less likely to seek treatment if they see changes in their breast tissue or nipple, and more likely to be diagnosed at a later stage with a worse prognosis for recovery. The media can help demystify the myth of male breast cancer, encourage screening, and increase knowledge of early signs and symptoms. Social media sites (e.g. Facebook pages) could be easily developed and devoted to men and male breast cancer. A blog that men can go to and talk about their issues related to having breast cancer as a male, might offer men the social support they deserve and include the privacy they seek when dealing with health issues.

Clinical Implications Improving the treatment and recovery process for men with breast cancer begins at the doctor’s office with the patient. Providing a leather informational notebook for men, instead of a pink notebook, may make important information more palatable and easier for men to digest.

The Man’s Guide to Breast Cancer Treatment should include information specific to men, such as why some men are more likely to have breast cancer, the importance of men getting prompt attention, and using mammograms to find hidden breast cancer. Screening and diagnostic tests, such as biopsies and mammograms, should be clearly defined and detail exactly what will occur for men who may be unfamiliar with the processes. Information should include the causes of breast cancer, how common the disease is in men, types and stages of breast cancer, and

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additional tests that may be conducted for men that are different from those performed for women.

Like women, men want to know about their treatment options. While many options are similar on their face, the needs of men differ from those of women. As seen in Ben’s case, men are typically not offered a lumpectomy as there is not enough tissue in the male breast.

Hormonal therapy is likely to be different, with different side effects. Previous research has shown that men are less likely to use complementary alternative medicine therapies (Cherniack, Senzel, & Pan, 2001; Fouladbakhsh & Stommel, 2008; Fouladbakhsh & Stommel, 2010; Lengacher et al., 2002; Sparber et al., 2000; Spiegel et al., 2003), and clinical trials may not be as available to men. Breast cancer prognosis and treatment is typically identified by Stage (I - IV), but men will likely have different ideas and options around reconstruction than women.

Also in the doctor’s office, after receiving the leather bound Man’s Guide to Breast Cancer Treatment informational notebook, it should be made clear to male patients that breast cancer is treated using a team approach. Men share different information than women (Klemm, Hurst, Dearholt, & Trone, 1999), and may not naturally gravitate toward having a team of specialists and clinicians. A man needs to understand that he is the most important member of the team, and carefully needs to choose doctors and specialists who work well together and can give him the best care possible. The patient (male or female) typically ends up as the care coordinator, responsible for navigating treatment through a complicated health care system. For example, Ben was asked to retrieve the pathologist’s report from his dermatologist to bring to the oncology surgeons. This coordinator role may not come easily to men, who tend to be private about their health care needs (O’Brien, Hunt, & Hart, 2005). Communication between all team members is required for treatment to be as hassle-free as possible, and traditionally men are not as open about talking to their doctors as women (Noone & Stephens, 2008; Pombal, 2013).

Supportive Care Processes - Improving the recovery process for men with breast cancer includes improving follow-up and supportive care processes. Psycho-oncology, social work, nutrition, pain and symptom management services, and physical therapy are vital to improving the wellbeing of patients with cancer; and not only should men be aware that these services exist, these professionals need to be aware of the quirks, challenges, and rewards of working with men with breast cancer. A relatively easy strategy for improving the comfort level of men with breast cancer would be to have a trained male social worker on call to explain the mental health side effects of the treatment process to men who have been diagnosed with breast cancer.

Improving the recovery process for men with breast cancer starts in the doctor’s office and continues with support groups in the community. Calendars of Events published by cancer support organizations such as the Cancer Support Community should include a group for men with breast cancer that is led by men and for men only. These groups should meet weekly.

There should be a support group for partners of men with breast cancer that is led by a male breast cancer survivor, meeting weekly, and focused on supporting the partners of men with breast cancer.

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Cancer survivorship and rehabilitation services such as exercise recovery (tai chi, yoga), mindful meditation, and art therapy abound and these services should be made available to men as well as women. For example, Team Survivor California was founded in 1999 to provide free exercise opportunities for women with cancer (Team Survivor, n.d.). In 2009, Team Survivor California welcomed its first male breast cancer survivor into a yoga class and in 2010 changed its mission to include all cancer survivors. Despite welcoming men into the organization, the majority of participants in the Team Survivor classes are women.

It may not be enough just to open doors to male breast cancer survivors. In order to participate in social support groups, men need to feel as if it is their own support group (Sabo, Brown, & Smith, 1986). For example, “men only” recovery groups, like Alcoholics Anonymous, are successful where men talk to other men, and men are comfortable in those meetings since the common theme is recovery.

In addition to providing social support to others with a similar challenge or condition, support groups provide valuable information. Cancer survivors talk about “chemo brain,” the haziness of thought and memory loss that can occur during and after chemotherapy. Support groups and their members discuss attention and memory strategies, sleep, exercise, and nutrition for optimum brain functioning, and relaxation and meditation techniques to assist mood monitoring. Hearing coping strategies from others who have “been there”, or are currently “there”, helps alleviate feelings of isolation, loss, and confusion. Making these resources available to men in a comfortable manner would improve their breast cancer treatment and recovery process.

Conclusion Clearly, there are unique differences in health beliefs and behaviors between men and women with breast cancer. Men appear to differ from women in terms of screening behaviors, for example, and may therefore experience different barriers and facilitators to breast cancer screening. Little is known, however, about men’s breast cancer screening behavior, although this group has disproportionally suffered from breast cancer mortality. Further complicating the already challenging task of raising awareness and improving treatment for men with breast cancer are differences within the broad male category. There is an urgent need not merely to consider men as an aggregate, but to examine the unique subgroup differences within that broad designation. Research reveals racial disparities exist for treatment outcomes for men with breast cancer: “black men were more likely to die from their breast cancer compared with white men” (Crew et al., 2007, p. 1096).

In social work, cultural competency with diverse populations is paramount and interventions targeting men are urgently needed to raise confidence in the importance and utility of screening, dismantle perceived barriers to screening, and improve the treatment experience for men diagnosed with breast cancer. The lack of psychosocial support for men with breast cancer, coupled with the myth that “men do not get breast cancer”, likely makes a man diagnosed with

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breast cancer feel marginalized, emasculated, and alone. As with treatment outcome differences, this may be more so for men of color who feel they have to live up to masculine cultural expectations (e.g. ‘machismo’ expected of Latino men).

Women are not the only ones who care about their appearance. Assumptions about body image and fears of disfigurement exist for men, although men typically do not talk about their emotional or physical pain and trauma, and loathe talking about being diagnosed with breast cancer. Having a woman’s disease is embarrassing to a man since men see having a women’s disease as being emasculating (Decker, 2008). Media, culture, and stereotypical beliefs perpetuate the myth that “real men do not get breast cancer” leaving men with breast cancer isolated in a sea of pink. Breast cancer is different for men and women, and men need to be included in the “breast cancer sisterhood” in a masculine way to reduce mortality rates in men with breast cancer.

Author Biographies Jim Decker, Professor, is a Licensed Clinical Social Worker and former Chair of the Department of Social Work at California State University, Northridge. He teaches research and practice classes to MSW students and has published and presented in the areas of trauma, rehabilitation, men’s health, and international social work.

Jodi L. Constantine Brown, Assistant Professor, joined the California State University, Northridge faculty in the fall of 2011 after five years as the Program Director of a non-profit organization that provides free exercise for individuals with cancer. Her teaching and research interests include mental health, organizations, program evaluation, capacity for and access to health services, and health outcomes. She has presented locally, nationally, and internationally, and recently published a case study of an organizational program evaluation.

References Adami, H.O., Holmberg, L., Malker, B. & Ries, L. (1985). Long-term survival in 406 males with breast cancer. British Journal of Cancer, 52(1), 99-103.

American Cancer Society. (n.d.). Breast cancer in men. Retrieved from http://www.cancer.org/cancer/breastcancerinmen/index American Cancer Society. (2010). Cancer Facts & Figures 2010. Retrieved from http://www.cancer.org/research/cancerfactsstatistics/cancerfactsfigures2010/index American Cancer Society. (2013). Cancer Facts & Figures 2013. Retrieved from http://www.cancer.org/research/cancerfactsstatistics/cancerfactsfigures2013/index American Society of Clinical Oncology. (2010). Breast cancer - male. Retrieved from http://www.cancer.net/cancer-types/breast-cancer-male American Society of Clinical Oncology. (2013). Extending adjuvant Tomoxifen reduces breast cancer recurrence, mortality. Retrieved from http://chicago2013.asco.org/extendingadjuvant-tamoxifen-reduces-breast-cancer-recurrence-mortality

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Austin, L. T., Ahmad, F., McNally, M. J., & Stewart, D. E. (2002). Breast and cervical cancer screening in Hispanic women: A literature review using the Health Belief Model.

Women’s Health Issues, 12(3), 122-128.

Becker, M. H. (1974). The Health belief model and personal health behavior. Health Education Monographs, 2, 324-473.

Borgen, P. I., Wong, G. Y., Vlamis, V., Potter, C. Hoffmann, B., Kinne, D. W., … McKinnon, W.M. (1992). Current management of male breast cancer. A review of 104 cases.

Annals of Surgery, 215(5), 451-459.

Breast Cancer in Men. (n.d.). Susan G. Komen for the Cure. Retrieved from http://ww5.komen.org/breastCancer/maleBreastCancer.html Brinton, L. A., Carreon, J. D., Gierach, G. L., McGlynn, K. A., & Gridley, G. (2010). Etiologic factors for male breast cancer in the U.S. Veterans Affairs medical care systems database.

Breast Cancer Research and Treatment, 119(1), 185-92.

Caring for Cancer. (n.d.). Retrieved from https://www.caring4cancer.com/go/breast Cherniack, E. P., Senzel, P. S., & Pan, C. X. (2001). Correlates of use of alternative medicine by the elderly in an urban population. Journal of Alternative and Complementary Medicine, 7, 277-280. doi:10.1089/107555301300328160 Crew, K. D., Neugut, A. I., Wang, X., Jacobson, J. S., Grann, V. R., Raptis, G., & Hershman, D. L. (2007). Racial disparities in treatment and survival of male breast cancer. Journal of Clinical Oncology, 25(9), 1089-1098. doi:10.1200/JCO.2006.09.1710 Cutuli, B., Lacroze, M., Dilhuydy, J. M., Veiten, M., DeLafontan, B., Marchal, C… Berlie, J. (1995). Male breast cancer: Results of the treatments and prognostic factors in 397 cases.

European Journal of Cancer, 31(12), 1960-1964. doi: http://dx.doi.org/10.1016/09598049(95)00366-5 Decker, J. T., (2008). Males and psychological pain & trauma: Real men don’t cry, but they drink. Island Park, NY: Whittier Publications, Inc. Fentiman, I. S., Fourquet, A., & Hortobagyi, G. N., (2006). Male breast cancer. Lancet 367(9510), 595-604.

Fouladbakhsh, J., & Stommel, M. (2010). Gender, symptom experience, and use of complementary and alternative medicine practices among cancer survivors in the U.S. cancer population. Oncology Nursing Forum, 37(1), E7-E15. doi:10.1188/10.ONF.E7E15 Fouladbakhsh, J. M., & Stommel, M. (2008). Comparative analysis of CAM use in the U.S. cancer and noncancer populations. Journal of Complementary and Integrative Medicine, 5, Article 19. doi:10.2202/1553-3840.1140 Giordano, S. H., Buzdar, A. U., & Hortobagyi, G. N. (2002). Breast cancer in men. Annals of Internal Medicine, 137(8), 678-687. doi:10.7326/0003-4819-137-8-200210150-00013 Giordano, S. H. (2005). A review of the diagnosis and management of male breast cancer. The Oncologist, 10, 471-479. doi: 10.1634/theoncologist.10-7-471

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Howlader, N., Noone, A. M., Krapcho, M., Garshell, J., Neyman, N., Altekruse, S. F., … Cronin, K.A. (Eds). SEER cancer statistics review, 1975-2010, National Cancer Institute.

Retrieved from http://seer.cancer.gov/csr/1975_2010/ Klemm, P., Hurst, M., Dearholt, S. L., & Trone, S. R. (1999). Gender differences on Internet cancer support groups. Computers in Nursing, 17(2), 65-72.

Lengacher, C. A., Bennett, M. P., Kip, K. E., Keller, R., LaVance, M. S., Smith, L.S. & Cox, C. E. (2002). Frequency of use of complementary and alternative medicine in women with breast cancer. Oncology Nursing Forum, 29(10), 1445–1452. doi:10.1188/02.ONF Lies, E., & Nishikawa, Y. (2011, October 18). Male breast cancer rare, but can be aggressive – study. Reuters.com. Retrieved from http://www.reuters.com/article/2011/10/19/healthcancer-idUSL3E7LJ01Z20111019 Mayo Clinic Staff. (2010). BRCA gene test for breast cancer. Retrieved from http://www.mayoclinic.org/tests-procedures/brca-gene-test/basics/why-its-done/prc20020361 Men Against Breast Cancer. (n.d.). Retrieved from http://www.menagainstbreastcancer.org/about-us/ National Cancer Institute. (2010). General information about male breast cancer. Retrieved from http://www.cancer.gov/cancertopics/pdq/treatment/malebreast Niewoehner, C. B., & Schorer, A. E. (2008). Gynaecomastia and breast cancer in men. British Medical Journal, 336(7646), 709-13.

Noone, J. H., & Stephens, C. (2008). Men, masculine identities and health care utilisation.

Sociology of Health and Illness 30(5), 711–725.

O’Brien, R., Hunt, K., & Hart, G. (2005). It’s caveman stuff, but that is to a certain extent how guys still operate: Men’s accounts of masculinity and help seeking. Social Science and Medicine 61(3): 503–516.

Pombal, N. (2013). Depressed older adults linger under the radar. (Unpublished MSW capstone paper). California State University, Northridge, Northridge, CA. Rosenstock, I. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328-335.

Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the health belief model. Health Education Quarterly, 15(2), 175-183.

Sabo, D., Brown, J., & Smith, C. (1986). The male role and mastectomy: Support groups and men’s adjustment. Journal of Psychosocial Oncology, 4(1-2), 19-31.

DOI:10.1300/J077v04n01_02 Sparber, A., Bauer, L., Curt, G., Eisenberg, D., Levin, T., & Parks, S. (2000). Use of complementary medicine by adult patients participating in clinical trials. Oncology Nursing Forum, 27, 623–630.

Spiegel, W., Zidek, T., Vutuc, C., Maier, M., Isak, K., & Micksche, M. (2003). Complementary therapies in cancer patients: Prevalence and patients’ motives. Middle European Journal of Medicine, 115(19–20), 705–709.

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Support Groups. (n.d.). Susan G. Komen for the Cure. Retrieved from http://ww5.komen.org/Content.aspx?id=5692 Tai, Y. C., Domchek, S., Parmigiani, G., & Chen, S. (2007). Breast cancer risk among male BRCA1 and BRCA2 mutation carriers. Journal National Cancer Institute, 99(23), 18111814.

Team Survivor (n.d.). Retrieved from http://www.teamsurvivor-la.org/ Weber-Chappuis, K., Bieri-Burger, S., & Hurlimann, J. (1996). Comparison of prognostic markers detected by immunohistochemistry in male and female breast carcinomas.

European Journal of Cancer, 32(10), 1686-1692: doi: http://dx.doi.org/10.1016/09598049(96)00154-2 Wisinski, K. B., & Gradishar, W. J. (2010). Male breast cancer. In J. R. Harris, M. E. Lippman, M. Morrow, & C. K. Osborne (Eds.), Diseases of the breast (4th ed., pp. 63-65).

Philadelphia, PA: Lippincott, Williams and Wilkins.

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A Neo-Weberian Review of the Criminal Courts: How the Bureaucratic State Creates Injustice Sven Smith Stetson University Lonn Lanza-Kaduce University of Florida Carley Fockler Stetson University

Abstract The Neo-Weberian approach of Ritzer (2004) is combined with Jurisprudence authorship to prepare a description of the different elements explaining how bureaucracy and its formal rationality is implemented in the law. The pathologies that this approach creates (i.e. ritualism, limiting the rationality of the bureaucratic actor, dehumanization) within the bureaucratic actors are discussed. The expected results of the discussed effects of bureaucracy are tested with performance check-sheets (n=420) reviewing judge professional behavior across six different courthouses varying in size from smallest to largest. The data is analyzed using linear regression; the results parallel the proposition that performance is affected by bureaucratic size.

A discussion and suggestions for further research follow.

Keywords: Neo-weberian, injustice, criminal court

The Problem: Ineffective Courts The Courts of the Criminal Justice System (CCJS) are not achieving the goals that they were designed to achieve. Although the crime rate has reportedly decreased since the 1980s, "public fear of crime" is estimated by historians and criminologists to be quite possibly the highest it has ever been (Walker, 1998, p. 240). This discontent is for good reason as the United States’ violent crime rate still towers over that of any other industrialized nation. For example, the murder rate is eight to ten times higher than any other nation in Western Europe and the average age of our violent offenders has decreased. In the United States, 53% of arrested males and 39% of arrested females are re-incarcerated (recidivists) (Visher, 2003). The CCJS's response to the public outcry to "crack down on crime" has been little more than to direct the war

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on drugs primarily at African Americans. The US has poured millions into the CCJS but has fallen short of solving any of these problems. As a result, the general principles of the CCJS such as reducing crime, insuring justice, and assuring the public of its security are not being reached. This failure of the CCJS is not simply due to lack of rehabilitation and faulty court personnel. This paper suggests that the process of the CCJS itself creates obstacles that block the path toward an answer when it asks the question, “To what extent does the actual process of the CCJS keep itself from producing the above mentioned goals”.

There is a multi-step process to answer this question. First, Weber’s theory of bureaucracy and Ritzer’s modern interpretations are explained. Then the process by which organizations like the CCJS become bureaucracies is described. Next, the CCJS is discussed in terms of the Ritzer’s four characteristics of bureaucracy (1996) and how an overemphasis on each of these characteristics can lead to an ineffective CCJS. Then the method by which practical indicators of the effects of the CCJS on the performance of its officers is discussed.

The results are then compared with underlying theory and future research is suggested.

Bureaucracy Although there is a common belief that bureaucracy developed gradually, incidentally and solely in response to an exploding population, some such as Max Weber (1904-1905) and those modern theorists who agree with him (Ritzer, 1996), do not completely agree with this contention. Weber believed that although the multiplying population plays a role in increasing the networking and expansion of a bureaucracy, the Western tendency to rationalize (bureaucratize) was cut into the minds of people by "charismatic" breakthroughs of tradition (Weber, 1958). Such a breakthrough occurred with the ideas associated with the Reformation and its effects on people's religious interests. Weber theorized that the ideas embodied within the Reformation,(at 111) predestination and the Protestant work ethic, (at 117) led people to value the use of rational, formal, efficient, and methodical ways to attain individual and social goals(105-109).

Weber found that these concepts helped develop a bureaucracy (such as the CCJS) to become a highly formal and prescribed bureaucracy relying heavily upon process to diminish irrationality as much as possible. Such an approach is particularly evident in the criminal courts (117). Rules of procedure (federal and state) are clearly laid out in order that substantive goals can be achieved (criminal statutes and the common law) and that the general principles of society (constitution) may be upheld. This system is believed by Western thinking to be the best means to an end. Weber believed that it has merit but also professed that if faced with high numbers (and then overemphasized to compensate), it can lead to strong conflicts between substantive goals and the formal procedure used to achieve them (Id.). Such a situation is evident in the CCJS of the US. The caseload of the CCJS has been at colossal proportions since the 1980s. The war on drugs and the unceasing creation of new criminal statutes have increased the court's workload

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tremendously (Glendon, 1994, p. 143). Legal Sociologist Mary Ann Glendon has commented on one example of this expansion: The evolution of the federal judiciary from an elite judging corps into a layered bureaucracy was complete in less than two decades. Between 1961 and 1980, the number of federal trial judges, after remaining stable (relative to the US population) from 1900 to 1961, expanded from 227 to 483, and by 1993 was approaching 600, while the total number of federal judges was 846(authorized). The growth in the staff of the federal courts was even more dramatic-from 6,887employees in 1970 to 14,261 in1981 and 22,399 in 1991. Ironically, the expansion of court staffs to deal with the growing workload turned judges into supervisors, saddling them with distracting new duties.

Even with more judges, staff attorneys, and clerks, the courts have not been able to keep up. (1994, p. 143) In response to this, the same values of the US that stimulated the creation of bureaucracy have encouraged expanding the bureaucracy of the CCJS in order to "compensate" (Ritzer, 1996, p. 146). Such an overemphasis on bureaucratic expansion has led to other problems such as judicial neglect. Judges, because they are often responsible for keeping the courtroom machine going procedurally, often have less time for the substantive aspects of their job. This can mean administering such important tasks to their staff. One popular judge (who also clerked for William Brennan) notes, "Today, a judge-written opinion, at any level of the American judiciary is rare” (Posner, 1993, p. 69). Thus, the CCJS has grown so intricate and compartmentalized that the substantive reasons for each bureaucratic procedure can become lost in trying to fulfill its bureaucratic requirements.

The characteristics of this system, and their tendency to create more problems for the CCJS than they solve, are discussed in the next section. Bureaucracy and how the CCJS is overbureaucratized is modernized and simplified through an application of George Ritzer's model of bureaucracy to the CCJS. Ritzer’s Model In his model, Ritzer divides the goals of bureaucracy into four dimensions and explains how each of these dimensions can become overdone until the fulcrum balancing the good characteristics with the bad is upset in favor of the latter. Ritzer’s explanation borrows significantly from Weber’s theory but contains its own conceptual organization: the four characteristics of bureaucracy. The first of these is efficiency. Efficiency is the “optimum method for getting from one point to another” (Ritzer, 1996, p. 12). The next is calculability.

Calculability is “an emphasis on the quantitative aspects” of that which is produced by the bureaucracy (Ritzer, 1996, p. 12). The third is predictability, an assurance that the product/service delivered by a piece or the entire part of the bureaucracy will be consistent no matter where produced (Ritzer, 1996, p. 13). The final element is dehumanization, or control to be “exerted over those who enter the world” of the bureaucracy (Ritzer, 1996, p.13). Ritzer

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(1996) then explains that “rational systems inevitably spawn irrational consequences” (p. 16).

The more rationalized a system becomes the more it can serve to deny human reason and defeat its very purposes.

Over Bureaucratization Bureaucracy is the modicum of modernism in the Western World. It is a large-scale organization composed of a hierarchy of offices where its actors have certain responsibilities and must act in accord with rules, written regulations, and means of compulsion exercised by those who occupy higher-level positions (Ritzer, 1996, p. 17). This formalism is a sharp contrast to the structure of traditional societies, where tasks were performed as loyalty to a leader and subject to personal whim rather than formal procedure. Throughout the US, bureaucracies thrive, and the formalism of the courts of the Criminal Justice System naturally fit it to this mold. The CCJS is an archetype of bureaucracy, possessing pristine examples of the four characteristics of bureaucracy: efficiency, calculability, predictability, and control (Ritzer, 1996, p. 11). Analyzing each of these properties' presence in the CCJS reveals how an overemphasis of the bureaucratic method creates more problems than it solves.

Emphasis on efficiency. Efficiency is the quickest possible means to a desired end (Ritzer, 1996, p. 35). It is often the most identifiable character of a bureaucracy as it is the substantive reason why the organizational structure bureaucracy is used. In the CCJS striving for efficiency is seen as important because it allows for its participants to "obtain what they need more quickly and with less effort”, while its “caretakers perform their tasks more rapidly and easily as work gets done" (Ritzer, 1996, p. 35). However, when the goal of efficiency becomes focused too intensely the process becomes inefficient.

An overall goal of the CCJS is justice. Often, this goal is not met as the main concern in the courtroom is moving cases and clearing the docket. In many courtrooms, such basics as a defendant's awareness of his constitutional rights and protections are seen and treated as nothing more than obstacles to efficiency (Luskin, 1987). This phenomenon is particularly visible in municipal courts (Time Magazine, 1974). Such an overemphasis on efficiency seems to be especially apparent in the early stages of a proceeding. Observations of first appearances, arraignments, and plea-bargaining reveal how efficiency is overemphasized to the detriment of the defendant as well as the general principles of the CCJS. Many states require that any defendant still in custody 24 hours after arrest must appear before a judge in order that the judge can advise the defendant of the charges, maintain his rights, and set bail. New defendants are often brought into the courtroom by the busload where they are often shackled at the ankles and deposited into cages to await their first appearance before the judge. A former assistant state attorney notes that "these first appearances have become an increasingly perfunctory proceeding in the last few years; this is evident by the fact that many

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prosecutors and public defender's offices don't send a rep to them (S. Newsome, personal communication, May 15, 2006).

Also many jurisdictions will hold first appearances at the jail rather than a courthouse to save money and time (S. Newsome, personal communication, May 15, 2006). At this step, the function is to insure that the defendant understands his rights (such as his right to counsel) and of what exactly he's been accused (this is the main substantive goal that must be attained in order to stay on the path toward the general principle of justice). [In Argersinger v. Hamlin, 407 U.S. 25 26, (1972) the Court found that "absent a knowing and intelligent waiver, no person may be imprisoned for any offense, whether classified as petty, misdemeanor, or felony unless he was represented by counsel"]. However, the very brief time before the judge, the absence of counsel (this in particular suggesting an overemphasis on efficiency), and the defendant's unfamiliarity with the legal process all serve to counter achieving this goal.

In the arraignment, the sacrifice of substance in the name of more efficient procedure continues (L. Krieger, Interview, Jan 17, 1998). Although the goals of this proceeding mirror those of the first appearance with the addition of receiving a well-informed plea from the defendant, the paths to achievement of these are clouded by court officials anxious to clear their docket. In many jurisdictions, the judge simply reads defendant’s rights to the defendants in groups, if he speaks to them at all (Mileski, 1971). These defendants will most likely hear that pleading innocent means that the next hearing will not be for two or three weeks, in which the defendant may have to spend in jail -a strong incentive to plead guilty when they are charged with a minor offense (Wice, 1974). A defendant's initial appearance or arraignment is very often his final one (Mileski, 1971).

Another procedure that conflicts with substantive goals is plea-bargaining. Pleabargaining is another excellent example of the focus on efficiency bringing about inefficient results. When faced with the option to plea to a lesser charge or proceed to trial, defendants choose the former because they fear a harsher penalty may occur if they proceed and then lose.

On the surface, this process may appear efficient in the short term in that they have quickly disposed of a case on the docket. The general principles of the CCJS have not been met in two situations. One of these occurs when the defendant commits the crime and so receives a lighter sentence. For example, most would agree that more than one third of felony defendants that enter the CCJS are guilty but statistics show that less than a fourth ever proceeds to a trial (Mather, 1974). Both victims and police become quite disillusioned with the CCJS when this occurs (Neubauer, 1974). This hinders the credibility of the common belief in the CCJS, damaging the community's sense of security and support for the CCJS. The other situation occurs when a defendant's lawyer (often a public defender trying to remain efficient) accepts a plea offer from the prosecution despite his client's adamant declaration of innocence. One metropolitan public defender explained: "If you've got an exceptional case-one which is weak and there's a good chance that the defendant may be innocent-then you don't want to take it before a jury" (Mather, 1974). Neither of these scenarios results in the proper sentence or the statute requirements (the substantive goals) being met.

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"Today's guilty-plea system leads even able, conscientious, and highly motivated attorneys to make decisions that are not really in their clients' interests and subjects defense attorneys to serious temptations to disregard their clients' interests; the plea bargaining system is an inherently irrational method of administering justice” (Alshuler, 1968). Even though, such situations are viewed by court officials as a success partly because they are concerned with the sheer number of cases on the docket and quickly completing their individual tasks within the bureaucracy. This leads to another trait of the bureaucratic CCJS, calculability, discussed in the next section.

Emphasis on calculability. Another characteristic of the CCJS that can lead to irrational results is calculability. This occurs when the focus of its participants shifts from achieving overall substantive goals to speeding up processes for the single purpose of increasing the quantity of final dispositions. In other words, "quantity becomes the surrogate for quality” (Ritzer, 1996, p. 59). An example of the mentality that restructures the CCJS's goals is the US's obsession with “more”. More is always better. Money, possessions, and end results all get better simply by increasing. The process of the CCJS and success, as perceived by its caretakers, is also reduced to numbers (size and speed). This is evident in the standards by which its officers measure themselves as well as the demand for larger sentencing.

The process of the CCJS and success, as perceived by its caretakers, is also reduced to numbers. Getting as many people in and out in as short a time as possible becomes the new objective. However, just as with efficiency, an overemphasis on this goal can lead the CCJS to lose sight of the general principle of insuring justice. For example, many state attorneys measure themselves by their conviction rate alone. This is without consideration of what percentage of those convicted were guilty or what percentage of those convicted received lighter sentences than deserved. This paradigm continues to every player within the CCJS. A New York State trial judge bragging about handling a caseload containing over 800 cases in 1992 demonstrates the awesome emphasis the CCJS places on numbers (Baer, 1992). To these court officials, the bigger it is the more impressive. Besides the obvious example that a caseload too large is not good, there are other examples that show how bigger is not necessarily better.

One example of how the obsession with sheer numbers prevails despite showings that quantity increases but quality does not, is the continuing call for larger penalties as an answer to crime. Many people in the US believe prison sentences to be too small in response to crime (Krisberg, 1988). Therefore, legislators attempt to solve larger crime problems with larger sentences (Thomson & Ragona, 1987). However, past research has shown that bigger sentences do not result in lower crime rates (Zimring & Hawkins, 1973).

Increasing the size of the penalty (overemphasis on procedure: calculability) not only falls short of deterring crime (conflict with substantive goals) but can also create additional obstacles procedurally (conflict with procedural goals). It does this by placing those applying the law on notice that their own decision has a greater impact. Often, this results in removing discretion from the judge's or jury's position to other places in the criminal justice system

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(McCoy, 1984). For example, when the state of Connecticut wanted to reduce the level of speeding within their community, they raised the penalty. However, police made fewer arrests as soon as the larger penalties were announced (Campbell & Ross, 1978). By the same token, prosecutors decide not to prosecute "borderline" cases with larger penalties because their own conscience does not allow it and the prosecutors fear that juries will not convict if the sentence is too harsh.

This overemphasis on calculability can lead to further problems. Although a proposed reason for supporting bigger penalties is deterrence of crime, and ultimately a decrease in the court backlog, the opposite is often the result. Confronted by larger sanctions, more suspects opt for more trials. An example of this phenomenon occurred in New York. As a result of a strong political campaign for harsher penalties for drug related offenses, the New York legislature created stiff, mandatory sentences for drug related offenses (Association of the Bar of the City of New York Drug Abuse Council, 1976). This more than doubled the number of drug cases that went to trial. It also increased the backlog of cases, increasing delays while decreasing the certainty and thoroughness required for conviction (L. Krieger, interview, Jan 17, 1998).

Therefore, when the emphasis is only on quantity of sentence, not only is the path toward justice impeded substantively but procedurally as well.

Emphasis on predictability. Predictability is inherent in the procedure and substantive goals of the CCJS. Like all bureaucracies, the CCJS requires predictability in order to function.

As an example, predictability in process is achieved through strict compliance with statutes and judicial precedent. These tools of predictability give shape to the process of the CCJS as well as give suggestion to the outcome of a particular case. Predictability is also the result once the substantive goals (like fairness and certainty of treatment of defendants) of the CCJS are achieved. However, if overemphasized, it can leave the CCJS too rigid and without the flexibility to handle diverse problems in a manner consistent with the US's perception of justice.

An example of how deeply predictability is infused within the CCJS (and the nation's values) can be seen in the CCJS's response to the public outcry for more unity in the sentencing of the convicted. Lobbying for stricter sentencing guidelines, Senator Edward Kennedy presented this public opinion in total clarity. Sociological research has shown that factors such as geography of the court (Austin, 1981), judicial background (Gibson, 1980) and the defendant's background (Radelet & Pierce, 1985) can lead to significant discrepancies in sentencing. These discrepancies can weaken the credibility of the CCJS not only in the eyes of the public but court officials as well (Black, 1984, p. 93). Thus, the state and federal legislatures, as well as the US Supreme Court, have enforced various sentencing guidelines in order to make sentencing outcomes more predictable.

These attempts at making sentencing more predictable have been strongly questioned as not achieving this goal as well as creating additional problems for the CCJS. The main reason why these attempts have fallen short is that they are often very narrow in scope. Only a small range of offenders committing limited kinds of crimes are affected, leaving the majority of

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offenders alone. Also, such laws have been proven to not strictly determine the amount of time one of these affected defendants spends in prison, given the relief received for "good time" in prison and other programs that still affect such defendants (Kress, 1980).

These guidelines not only fall short of the goals they are designed to achieve but they demonstrate the dangers of overemphasizing predictability by introducing additional problems to the CCJS as well. The Twentieth Century Fund Task Force on Sentencing (Twentieth Century Fund task Force on Sentencing, 1976) states that such guidelines result in a rigid and mechanical overreaction to problems of judicial discretion. Condemning every defendant found guilty under a general statute to the same exact sentence constrains the judicial flexibility needed to insure the fair treatment of all defendants. Thus, the general principle of justice can be lost when the need for predictability infringes upon substantive goals like fairness of treatment.

Emphasis on control. The fourth characteristic prevalent in the CCJS is control. More specifically, it is the tendency to increase the control over participants in the CCJS as well as limiting the human side of their participation as much as possible. In other words a "great source of uncertainty, unpredictability, and inefficiency in any bureaucracy (namely, the CCJS) is people- those who work in it and are served by it (are also detriments to it)" (Ritzer, 1996, p.

101). Thus, the way to improve the bureaucracy is to limit the human element through the creation of new mechanical and procedural technologies.

The CCJS is a controlling agent of the general population. The CCJS is filled with examples of this characteristic that are obvious and helpful. Video conferencing, videotaping of testimony, home detention transmitters, etc., are all examples of needed mechanical technology that improves the efficiency of the CCJS. However, this technology can also be used to control and shape the inputs of human actors. The examples of first appearances and sentencing guidelines vividly portray how overemphasis on controlling the bureaucracy (and so its participants) can result in removing too much of the human element from the CCJS (Block & Rhodes, 1987).

Sentencing guidelines. Modern sentencing guidelines such as flat time or mandatory minimums are considered by many to have the effect of removing the judge at the sentencing hearing and replacing her with a machine (Kress, 1980). With such guidelines in place, judges are no longer deciding what sentences each defendant should receive (once adjudicated guilty) but are merely performing a role clearly delineated much like a mechanistic arm on a car assembly line. These critics also argue that removing her discretion and forcing her to comply with Congressional predetermination of a proper sentence upsets the balance of powers between the branches of government (Kress, 1980). However, this is not the only example of technology designed to rest too much control away from participants in the CCJS. First appearances and arraignments. Examples of the overemphasis on technology and control are abundant during arraignment and first appearances as well. For example, hurriedly Â

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advising the day's defendants as a group without insuring their understanding keeps them disoriented, confused, and therefore controlled into doing what they are told. Threatening extra jail time to those who plead not guilty (either by threat in final sentence or in waiting for their next hearing) can control defendants into following the trends of plea bargaining (Maynard, 1988). In some jurisdictions, the practice is often that the defendant will never set foot into a traditional courthouse as they are "advised" by the judge in a cornered part of the detainment center; or they are "advised" by way of video conferencing where the judge will spend around two precipitous minutes with each defendant. This abrupt interruption into the defendant's time is often very disorienting to the defendant (Mileski, 1971), for they often have no understanding of the procedure they have just taken part. Such tactics also encourage defendants to plea as they are only concentrating on the quickest way out of jail (L. Krieger, interview, Jan 17, 1998).

While they clear the docket, these are clear examples of how overemphasis on improving bureaucratic procedure can lead to controlling defendants as well as preventing the substantive goal of fair treatment of defendants. Control (of the human element) affects every participant in the CCJS; other sources of this characteristic will be discussed further in the upcoming sections of this paper.

Effects of Bureaucracy on the Officers of the CCJS Various discords between substance and procedure have been discussed as stemming from an overemphasis on a particular characteristic of the bureaucratic CCJS. These problems have one overall result, the failure to achieve the general principles of the CCJS. This next section takes a more personal investigation in exploring why people overemphasize these procedures when they do not produce the results for which they were designed.

The bureaucratic nature of the CCJS actually limits finding a solution to the problems it creates. As discussed earlier, the US people come from a background of thinking that parallels the basic notions of modernism. In other words, the bureaucracy is the answer to their need to have a rational, impersonal, and diversified method to solving problems. However, also inherent in such a system is removal of the human element such as free choice and morality (Weber, 1978). (The rules of a bureaucracy set out clearly the only accepted ways to achieve one of its substantive goals.) As only part of a whole, a person working within such a system has her individual responsibility and personal accountability minimized. Also, case-by-case thinking, aka “external thought” (Litowitz, 1998), or the ability to solve problems outside the "mode of thinking" (approved procedure) of the bureaucracy, is removed. Thus, the bureaucratic nature of the CCJS results not only in a formal restraint on finding creative solutions for problems but in an unknowing acquiescence to this by its officers. The inability to think externally leads to other problems as well. All of these contribute to the CCJS's inadequate attainment of its general principles. This process is more closely explained below.

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Limiting the Internal Actor The bureaucratic nature of the CCJS encourages people to think only within the confines of its procedure. Rational methods for achieving goals are very often the best way to solve a problem. However, this type of method comes with certain drawbacks as well. One of these is the formal "depersonalization" of its participants (Weber, 1978, p. 600). The most obvious example of this is the common view of professionalism. Each officer of the court is praised when they follow the formal rules of the CCJS. For example, judges' performances are praised highly when they comply with the formal procedure of the CCJS and use clear law as support for their decisions. However, when their opinion is not clearly supported by preexisting law and appears to be the result of their personal opinion (perhaps a posthoc rationalization), the result is disapproval and ridicule for such admonishable practices. It is obvious how this can encourage people to think only within the confines of the CCJS. There are, however, more indirect ways in which such limits on thinking is promoted.

The bureaucracy grows as the people or the number of problems it serves grows. It will often expand physically in response to this (Glendon, 1994, p. 143) but will also grow more intricate and diversified (Black, 1976). For example, in small towns,(where the bureaucracy is small) judges do not specialize; but as the population increases judges will become more diversified, each one handling the same type or stage of a case (Einstein & Jacob, 1977). This increases the number of procedural exchanges that have to be accomplished before a general principle is achieved. It also minimizes the kinds of tasks that each must perform. In the same frame of mind as an assembly line, each person becomes assigned to performing the same individual and monotonous task. The collective reason (justice) for each person completing their task grows more distant as the tasks become more specialized and minute. As a result, the persons assigned to carrying out these tasks grow more removed from the concept of the "overall product" (justice) and become concerned mainly with following the procedures assigned to their individual task. A judge's tendencies to "cut corners" during arraignments and doing only enough to fulfill the requirements of the statute is an example of this mentality (Mileski, 1998).

The Problems of the CCJS Paradigm Once informal depersonalization and indirect pressures encourage officers of the CCJS to adopt this internal thinking, the ability to think externally becomes very difficult (Litowitz, 1998). A lack of external thinking is problematic for several reasons. First, it allows officers of the CCJS to "assume the legitimacy of the existing legal framework without...critique” (Litowitz, 1998). Secondly it prevents a sociological analysis of the various participants that enter the CCJS (L. Krieger, interview, Jan 17, 1998) . These two ultimately prevent the officers of the CCJS from possessing the flexibility needed to make counter-procedural decisions parallel with the general principles of the CCJS.

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Examples of the problems that stem from a lack of external thinking are prevalent in every aspect of the system. An illustration of how deep (and possibly damaging) acceptance of the CCJS without critique is, can be found in the justifications behind neutral partisanship.

Neutral partisans believe that the CCJS requires each lawyer to represent every client, guilty or not, to the fullest of their ability, employing every means within the letter of the law (Herold, 1985). This is quite often not the case. This causes the general public to view(s) these duties of defense counsel with understandable suspicion and probable contempt (Herold, 1985). Neutral partisans maintain that truth and overall justice are found in the conflict of two such lawyers.

Therefore, countless defendants escape justice at the hands of "legal tricks of the trade" possessed by knowledgeable counsel (Grady, 1990, p. 87). Such blind faith in the procedure of the adversary system prevents the realization that the general principles of the CCJS (like justice) are not being met.

Another problem that stems from a lack of external thinking in the CCJS is a failure to consider the sociological data that has affected the defendant (Litowitz, 1998). The laws of substance and procedure, for the most part do not mention social structure, and also speak specifically about equality of treatment of all people (constitution). Our laws treat defendants "in a social vacuum” (Black, 1984, p. 17). Therefore, the internal actor places an assumption of equality on every defendant that appears in the court. This assumption is as incorrect as it is problematic.

From before they enter the court, to their sentencing, defendants are never equals in the eyes of the CCJS. "More blacks than whites are poor, unemployed, and uneducated, and fewer blacks than whites own their own home, live in a two-parent family, or enjoy social resources of any kind. Blacks therefore suffer legal disadvantages...inhabiting the bottom of society” (Black, 1984, p.18). Outside of color, defendants are even discriminated through such basic characteristics as speech. This information is just a drop of the tremendous amount of sociological data that refutes the assumption of equality. However, because internal thinking (a lack of case-by-case thinking) does not allow the consideration of such external sources, it never enters the determination of justice. Internal thinkers do not recognize such sociological problems within the realm of the CCJS, and so they can never correct the problem. Both (1) blind acceptance of legal procedure and (2) a failure to legally recognize the sociological factors of a case, constrain the officers of the CCJS to the bureaucratic procedure. They will follow this procedure even to the point that of denying the overall goal of justice.

Propositions and Design Based upon the sociology and jurisprudence literature, a conceptual model could be developed specifically to use as a skeletal framework to guide further research. The model would be based upon two basic propositions.

Proposition 1: Bureaucratic size will be positively related to mechanistic performance of the internal actors.

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Proposition 2: Bureaucratic size will be negatively related to case-by-case thinking by its internal actors.

As the courthouses’ bureaucracies grow more numerous, the more mechanistic the judges will become. Their mechanical performance will improve but their creative performance will decline.

“Bigness” has several implications. First, “bigness” requires more people and more specialists. The number of bureaucrats increases with size. Second, “bigness” encourages formalization and procedures to handle the volume of cases efficiently. In bureaucratic fashion, it pressures toward more rules. This formalization also requires conformity to procedural rules and consistent application of the rule, creating an environment wherein personalized (considering/thinking beyond the rigid rule framework) justice is less likely and cookie cutter justice is more likely.

The essence of a bureaucracy has always been the improvement of efficiency; to produce/process more quickly. The literature describes bureaucracies as based on control in order to reduce uncertainty. The value added of mechanical focus is found in uniformity, speed, quantity, and the ability to quantify results rather than adaptability or innovation. Mechanical focus will decontextualize cases and control internal actors, turning their actions more and more generic. This leads to a decrease in qualitative and creative response. As a result, there is less external thinking and internal actors failing to contextualize their work product. Such a decrease creates mechanistic-like responses and stronger adherence to standards that thus simultaneously increase performance of only formalized standards.

Such propositions were tested through comparative analysis using performance checksheets of county judges. Different courthouses (ordered from smaller to larger) and their personnel could be compared cross-courthouse to determine if the personnel in courthouses indeed perform more mechanically than smaller courthouses. Courthouses are a perfect hunting ground for operationalizing these propositions. The uniformity across circuits, as enforced by rules of procedure, statutes, etc. control for many variables that would inflate concerns over spuriousness. The checksheet recorded indicators of mechanistic performance and case-by-case thinking. For measurement of mechanistic performance, the checksheet recorded answers to questions such as are judges more likely to start on time in larger courthouses than smaller ones?

Are judges in larger courthouses more likely to spend less time with each individual defendant or case than judges in smaller courthouses? Are judges in bigger courthouses more likely to engage defendants in greater dialogue than judges in smaller courthouses? If these are answered in the positive, such supports the notion that there is a correlation, and possibly a causal connection, between size and behavior within a bureaucracy. Likewise, as the mechanistic performance increases, the case-by-case thinking must decrease. This was measured by measuring the judges’ performance on Fla. R Crim. Pro. 3.111. This specific rule provides a strategic research site in that it explicitly requires judges to make creative and human case-by-case inquiries of defendants. 3.111 requires judges to go beyond the kind of mechanistic bureaucratic application of the law and really have a quality conversation with the defendant to ensure that they

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understand how valuable their right to an attorney is, the significance of its waiver, and also whether the defendant is intelligent enough to proceed. (Faretta v California 422 U.S. 806 (1974), State v. Young, 626 So. 2d 655; (Fla. 1993).

Methods To explore how size related to judicial performance involved direct observations of arraignments at selected courthouses in six judicial circuits; the chosen circuits that varied in size, from few (six judges) to many (40 judges) and were all within the same state, thereby containing the same procedural and substantive rules and statutes. Each district was chosen in order that each judge would have roughly the same number of defendants per arraignment (means for the six courthouses varied by only 7%), and that each judge tested would have roughly the same job expectations (same organizational structure). Specifically, each observed judge was required to perform the same type of tasks. Also, each judge was graded performing only the tasks involved with taking guilty or no contest pleas from pro se defendants. Each judge performed this task relatively the same number of times per arraignment, between 7-8 with 3 and 12 as the range.

Observational Checklists were used to record the behaviors of judges to capture some of the indicators of performance thought to be linked to patterns of case-by-case thinking that could vary depending on the size of the judiciary. One set of those behavioral indicators concerned some mechanical performance features of the judicial role at arraignments. Another set of indicators focused on the manner in which Florida Rule of Criminal Procedure 3.111 was implemented.

The advantage of this two-part instrument design is one of triangulation. Different research methodologies are used to see if patterns that emerge from each instrument will eventually converge. If the conceptualization is correct, indicators of case-by-case thinking should decrease as mechanistic performance increases. This is exploratory research; appropriate convergence will indicate whether the theoretical development is pointed in the right direction, or whether it should be refined in the future. The disadvantage of this method is the degree of complication the two methodological approaches adds. The two-pronged instrument design makes it more difficult to keep the abstract theoretical constructs sorted out as they are woven through different methodological adjustments of each of the approaches. To manage the complexity, the design components are referenced in terms of case-by-case thinking and mechanistic performance.

The basic independent variable will be the size of the judiciary in each district. The basic dependent variables will be three performance indicators of the abstract construct of case-by-case thinking (3.111 performance) and indicators of mechanistic performance (formal rule following such as offering the public defender, apprising the defendant of the charges, starting on time, ensuring that a plea is voluntary and not coerced or misunderstood, etc.). Â

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Sample and Units of Analysis The observational checklists were conducted between 2012-2014 on a sample of 420 county court (misdemeanor) arraignments in the six courthouses. The arraignment was the unit of analysis. The selection of arraignments was made so that each judge was observed during arraignments no less than five times. At this time, there were a total of 100 judges working the criminal docket in these counties. The number of arraignments and the number of judges observed in comparison to the number of judges working the criminal bench (presented in parentheses) in each courthouse were: Least 26 (3 out of 5 judges); Lesser 36 (5 out of 8 judges); Less 42 (6 out of 10 judges); More B 61 (8 out of 17 judges); More A 70 (10 out of 17 judges); and Most 185 (37 out of 43 judges). It is important to note that all county judges, not just those who worked the criminal docket, were used to calculate the county’s size of the judiciary (size) for subsequent analyses. So the corresponding county’s number of judges was assigned as a variable to each of the checklists done in its courts.

Reliability Eleven research assistants were trained by the author. They were instructed concerning the relevant courtroom procedure and arraignments, including the legal requirements placed upon a judge by Florida Statutes, Florida Rules of Criminal Procedure, and applicable case law.

At least one observer went to the 420 arraignments. Lead author was present for the initial observations. Each member’s recordings were checked by the author to ensure 80% consistency/reliability with this author in reporting before being sent out alone, or with another assistant.

Each trained observer recorded the performance of the judge at the sampled arraignment.

The judges were not made aware of the presence of an observer in the arraignment courtroom.

Observers were trained to keep their presence and the presence of the checklist undetected by the judge or any staff in the courtroom to minimize the chance that the procedure may affect the arraignments. Each judge was observed at no fewer than five separate arraignments.

These checklist observations were used to construct two important indicators of case-bycase thinking: Mechanistic Performance and Rule 3.111 Performance. Items designed to indicate Mechanistic Performance were included on the checklist. A count index [Mechanistic Performance] was created from the items that produced variation regarding mechanistic approach to formal procedure. A reliability analysis of these items produced a Cronbach’s alpha of 0.74. Higher scores on the index indicate more mechanistic performance.

Items tapping Rule 3.111 Performance (non-mechanistic) were contained on the checklists as well. A reliability analysis was performed on those items. Four of them did not scale well and they were discarded. The remaining eight items of the index [called Rule 3.111 Performance] yielded a Cronbach’s alpha of .93. Higher scores on this scale mean more caseby-case analysis (i.e., less mechanistic performance).

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Analytic Strategy The statistical strategy proceeded through bivariate analyses. OLS regression was used to examine the bivariate relationships between and among the variables of theoretical interest: size, the judicial performance indicators of Mechanistic Performance, and Rule 3.111 Performance. OLS was also used in a series of multiple regression analysis examining each of the judicial performance indicators. In these series, the bivariate analysis between the judicial performance indicator and size was followed by a multiple regression analysis (using simultaneous entry of variables) where that judicial performance variable was regressed on size, while controlling for demographic variables regarding each judge and defendant.

Size and the indexes constructed to measure Mechanistic Performance and Rule 3.111 Performance were measured at the interval level. The Mechanistic Performance and respective judicial adjustment scales were ordinal in nature with enough ordinal categories so that their use should be robust with OLS techniques. Un-standardized coefficients, standard errors, and standardized (beta) coefficients were reported along with measures of explained variance (R square) and levels of significance. An alpha of .05 was used as the cut-off for significance tests.

The thrust of this research is exploratory. The aim is to assess the viability of a conceptual scheme that seeks to explain how rational-legal actors (judges) in a rational legal system (courtrooms) operate. More specifically, it proposes that a structural variable (differences in the size of the judiciary) will affect judicial performance, which in the tradition of Weber occurs because of its relationship to different patterns of thinking. One complication is that different data are collected in different ways from methods that have different levels of analysis and different numbers of cases. The central independent variable is size, measured by the size of the county judiciary in six counties. Measures obtained from observational checklists of arraignments in those counties (n=420) have to be joined with the size variable to conduct the analysis. In some ways, the checklist data is nested in the six counties, but not enough counties exist to support hierarchical linear modeling.

Preliminary analyses were conducted to see the depths of inter-related relationship of the performance indicators of case-by-case thinking. The two performance indicators from the checklists, Mechanistic Performance and Rule 3.111 Performance, were related (r= -.286; p <.001). The measure of more mechanistic performance was inversely related to the less mechanistic case-by-case implantation of Rule 3.111. The relationship between the mechanistic performance that was based on the average for the judges in that county and the Rule 3.111 performance was negatively related. The inverse relationship (r= -.427; p<.001) was expected.

Findings Size was related to case-by-case thinking as indicated by two judicial performance measures (mechanistic performance (Checklist), and Rule 3.111 Performance) as well as the size of the judiciary in the respective counties related to each of the three performance measures. The Â

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bivariate relationships were moderate to strong (-.487 to .647). Size of the judiciary was inversely related to case-by-case thinking in regard to Rule 3.111 (as proposed). Size was positively related to the bureaucratic, mechanistic performance features of the arraignments, as observed on the checklists (as proposed). The results suggest that size matters. Recall that the design eliminated differences in functions (task specialization) for arraignments and controlled for the individual workloads of the judges.

Conclusions and Future Research Over bureaucratization is a major source of the CCJS’s lack of effectiveness. It becomes so intricate and compartmentalized that its caretakers lose sight of the very reasons for which the procedure was created. The rules of criminal procedure themselves become the ends for which they are the means. The CCJS, as well as its officers, is so rigid and one dimensional that any diversity encountered becomes unmanageable. As a result, substantive and procedural rules, although intended to harmonize to achieve the general principles the CCJS is designed for, often conflict-deterring the courts from achieving these goals.

Irrational results occur in the CCJS as a result of its nature. Such irrationality appears when the processes designed to produce the substantive goals that ensure the existence of general principles of society (and the CCJS) actually hinder this goal. This most often occurs when an element of the procedure of the CCJS, either efficiency, calculability, predictability, or control becomes overemphasized. This over bureaucratization can also cause such results when it influences the people within it to problem solve in a manner prescribed. The resultant lack of external analysis also results in encouraging these problematic procedures to remain unchecked.

At the end of it all, the research may demonstrate how abstract notions of law and the sociology of law play out in the more mundane practice of law. Those abstract notions harp that structural variables are important. In this work, it is proposed that size will affect judicial performance and court performance indicators. A fairly clean look into this relationship can be retrieved because the formality within which courts must operate could control for many other variables (spuriousness) and afford opportunities to assess the degree of mechanistic performance in contradistinction to creative problem solving. This feature helps draw the implications of the research into sharp relief and give this research a policy thrust that legal practitioners may want to consider. To be sure, the pattern of relationships between size and judicial performance emerged using other measures and data collection techniques. Yet its import may be dismissed when dealing with mundane features.

Judges are called on to be creative and to utilize case-specific inquiries to fulfill the requirements of justice. Yet, size affects and matters. The literature and experience suggest that the rules of procedure may be implemented differently in the small courts than in large courts.

Small courts are more likely to make the kind of non-bureaucratic case-by-case inquiries embodied in the rule are their counterparts in the large courts. Scientifically conducted observations are needed to show that the difference in performance does not stem from

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differential caseloads but from size itself. Such needs to be more empirically tested, for if this pattern is confirmed in research of other features of law work and across jurisdictions, to what extent is a rule of law model compromised by a seemingly simple structural feature like size?

And if judges are indeed affected, despite the problem solving and creative aspects of their professional role, what of the more menial tasked internal actors?

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Glendon, M. A. (1994). A nation under lawyers: How the crisis in the legal profession is transforming American society. Cambridge, MA: Harvard University Press.

Grady, B. (1990, July 8). Lawyer uses bag of tricks to do job. New Orleans Times-Picayune, p. 1b.

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Luskin, M. L. (1987). Social loafing on the bench: The case of calendars and caseloads. Justice System Journal, 12, 2, 177-195.

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Institutional Affiliation o Education affiliation – if no institutional affiliation, list city and state of author’s residence o This educational affiliation should be on the line directly under the author’s name. o If there are multiple authors, please place a space between them each set of information (name and affiliation).

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Abstract o The abstract (150-word maximum) should effectively summarize your completed research and findings. o The word “abstract” should be bold.

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Keywords o This line should be indented. The word “Keywords” should be italicized and followed by a colon.and two spaces.

Journal of Scholastic Inquiry: Behavioral Sciences

Volume 3, Page 43

o

Following the two spaces, list 3 or 4 keywords or key phrases that you would use if you were searching for your article online.

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Body of Paper (sections) ALL of the following sections MUST be present or your manuscript WILL be rejected. o Introduction o Review of Literature o Methods o Results o Discussion

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Author Biography o If there are multiple authors, please label this section Author Biographies o Please be sure to indent the paragraph before the biography begins. If there are multiple authors, please begin a new paragraph for each author.

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References –this heading is NOT bolded within the manuscript o Manuscripts should be thoroughly cited and referenced using valid sources. o References should be arranged alphabetically and strictly follow American Psychological Association (APA) sixth edition formatting rules. o Only references cited in the manuscript are to be included.

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Tables and Figures o If tables and figures are deemed necessary for inclusion, they should be properly placed at the end of the text following the reference section. o All tables and figures should be numbered sequentially using Arabic numerals, titled, acknowledged, and cited according to APA guidelines. o If graphs or tables are too wide for portrait orientation, they must be resized or reoriented to be included.

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Appendices (if applicable) o Must be labeled alphabetically as they appear in the manuscript. o Title centered at the top.

GENERAL INSTRUCTIONS: 

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Headings o Strictly follow APA sixth edition guidelines to format headings. Five levels of headings are allowed, per APA guidelines.

Abbreviations and/or Acronyms o Abbreviations and/or acronyms should be defined at first mention and used consistently thereafter.

Footnotes/Endnotes o Do not use footnotes or endnotes.

English Language Support o If your native language is not English, you may want to make use of CSI’s in-house editing service to increase the quality of your paper. o The use of these services is elective and in no way guarantees acceptance for publication.

Journal of Scholastic Inquiry: Behavioral Sciences

Volume 3, Page 44

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Journal of Scholastic Inquiry: Behavioral Sciences

Volume 3, Page 45

Volume 3, Page 46

Journal of Scholastic Inquiry: Behavioral Sciences

Psychosocial Needs of Men with Breast Cancer: A Case Study James T. Decker, California State University, Northridge Jodi L. Constantine Brown, California State University, Northridge

A Neo-Weberian Review of the Criminal Courts: How the Bureaucratic State Creates Injustice Sven Smith, Stetson University Lonn Lanza-Kaduce, University of Florida Carley Fockler, Stetson University

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