Baby Doe, Congress and the states: challenging the federal treatment standard for impaired infants

In its amendments to the Child Abuse Prevention and Treatment Act, Congress set forth a strict standard for treatment of impaired infants. The statute, shaped by right-to-life groups and certain medical organizations, calls for aggressive treatment in virtually all cases, regardless of the degree of suffering imposed and the burdens and risks involved. The federal rule evidences deep distrust of parental decisionmaking, relegating most parents to a nonparticipatory bystander role. Congress did not make its rule binding on the states. Rather, it conditioned the receipt of federal funds upon incorporation of the rule into each state's law. Most states have accepted the condition, largely through rulemaking by state child abuse agencies. This article challenges the authority of state administrators to promulgate these rules, and argues that state constitutions, little mentioned in the Baby Doe debate thus far, may prohibit many states from adopting the federal standard. Ordering medical interventions that perpetuate extreme conditions of physical and mental devastation, subjecting infants to grave suffering for uncertain benefits, and depriving parents of virtually all decisionmaking power violates the norm of governments constitutionally committed to individual liberty, human dignity and family autonomy. A constitutionally sound approach to this issue would permit careful, ethical deliberation, attention to the individual circumstances of each infant Doe and a reasonable degree of parental control.     

Book reviews

DANIELE CONVERSI, The Basques, The Catalans and Spain: Alternative Routes to Nationalist Mobilization (Hurst, London, 1997), 312 pp., ISBN 1–85065–268–6 (pb)

LEO PANITCH and COLIN LEYS, The End of Parliamentary Socialism: From New Left to New Labour (Verso, London, 1997), 341 pp., ISBN 1–85984–109–0 (pb)

MARK MATTERN, Acting in Concert: Music, Community, and Political Action (Rutgers University Press, New Brunswick, 1998), 185 pp., ISBN 0–8135–2484–9 (pb)

RICHARD J. GOLSAN (ed), Fascism's Return: Scandal, Revision and Ideology since 1980 (University of Nebraska Press, Lincoln and London, 1998), 330 pp., ISBN 0–8032–7071–2

KATHERINE FIERLBECK, Globalizing Democracy. Power, Legitimacy and the Interpretation of Democratic Ideas (Manchester University Press, Manchester, 1998), 216 pp., ISBN 0–7190–4995–4 (hb)     

Malaria control and population growth∗

This paper investigates the effects of malaria control programmes on mortality and fertility rates, and hence on population growth, with special reference to Ceylon. The crude death rate (C.D.R.) by district in Ceylon fell sharply from pre‐1945 to post‐1945 on the average, and the variance between district C.D.R.s almost disappeared; it is shown that the near‐eradication of malaria can account wholly for the latter phenomenon but not completely for the former, more than half of which was due to causes other than changes in malaria prevalence.

Crude birth rates (C.B.R.s) by district rose moderately on the average from pre‐1945 to post‐1945, and substantially increased their variance. It is shown that the near‐eradication of malaria is consistent with the latter phenomenon, but that even in the absence of malaria control the national C.B.R. would have fallen slightly, as it has done in recent years.

A technique is devised by means of which it is possible to establish that these shifts in district C.D.R.S and C.B.R.s, in the decade or so following the war, were due mainly to changes in district age‐specific vital rates rather than to changes in age distributions brought about by past fertility rates or by internal migration.

The paper closes with a brief discussion of other studies of this set of problems.     

Central-Local Relations in an Era of Multi-Level Governance: The Case of Public Participation Policy in England, 1997-2001

The election of a 'New Labour' UK government in 1997 promised a new era of central-local relations facilitated by a programme of local government reform which recognised local government's 'community leadership' role. Other aspects of the agenda supported the development of multi-level governance, for example, the establishment of sub-national institutions such as the Scottish Parliament and the promotion of neighbourhoods as key sites for action. Despite these actions this paper will argue that in England the central state retains considerable influence over the key agents of local governance. Using the example of public participation policy, and drawing on the findings of a recent study in two English cities, the paper will explore how national policy aspirations were reflected locally. It concludes that while local action generally complemented national priorities, there were important points of contrast, and that localities' capacity to act in their own interests is supported by the opportunities presented in a multi-level governance environment.     

Last in line: Housing assistance for households with children

Abstract

This article examines the relationship between receipt of different types of rental housing assistance and housing outcomes for households with children. We rely on the 1989 American Housing Survey (AHS) and a special data supplement that attempted to accurately categorize every assisted renter‐occupied address in the AHS sample as either public housing; privately owned, federally assisted housing; or certificates and vouchers. Housing outcomes examined are physical condition of the unit, crowding, affordability, perceived neighborhood quality, and crime. We analyze three research questions: (1) Do the characteristics of households enrolled in housing programs differ by program type? (2) Do housing outcomes differ with the type of assistance received? (3) Do differences in household characteristics account for observed differences in program outcomes?

The analysis suggests that the housing assistance system channels different types of households with children into different housing programs. The least disadvantaged households are most likely to end up in privately owned assisted stock, while the most disadvantaged end up in public housing. The most notable interprogram difference in housing outcomes relates to neighborhood quality. In contrast to other forms of rental assistance, residence in public housing is associated with a decline in neighborhood quality. This result holds even after controlling for household characteristics and geographic location of the unit.     

External Barriers to Help Seeking for Older Women Who Experience Intimate Partner Violence

There has been relatively little research published to guide the field in identifying and addressing barriers to seeking help for older women who experience domestic violence (DV). The current article focuses on findings related to external behaviors to help-seeking in the Domestic Violence Against Older Women (DVAOW) study. Data were collected in 21 focus groups with 134 women, 45 to 85 years of age. External barriers, described by DVAOW respondents as contributing to the reluctance of some older women to seek help for domestic abuse, include response of family, response of clergy, response of the justice system, and responsiveness of community resources. These findings are discussed with implications for community outreach and future research.