Citizens’ Perceptions of Governance in Rural and Urban China

This article presents three main findings from a purposive stratified survey of urban and rural residents. First, Chinese citizens “disaggregate” the state with high levels of satisfaction for Central government that fall dramatically as government gets closer to the people. Satisfaction levels are noticeably lower for those in rural China. Second, attitudes about the way policy is implemented by local governments raise concerns. Irrespective of place of residence, respondents feel that when implementing policy local officials and governments are mainly concerned with their own interests, are more receptive to the views of their superiors rather than those of ordinary people, favor those with money, and are formalistic in implementing policy rather than dealing with actual problems. Third, the areas of work that citizens would really like government to concentrate on are job creation and providing basic guarantees to protect against the shocks of the transition to a market economy. Tony Saich is the Daewoo Professor of International Affairs, Kennedy School of Government, Harvard University and Director of the Harvard University Asia Center. His recent research focuses on the development of social policy in China, particularly on the provision of public goods by local governments. His publications include Governance and Politics of China by Palgrave and edited volumes on Financial Sector Reform in China (with Yasheng Huang and Edward Steinfeld) and AIDS and Social Policy in China (with Joan Kaufman and Arthur Kleinman both by Harvard University Asia Center. He would like to thank Edward Cunningham for his great help in preparing this article. He also wants to thank Victor Yuan (Horizon Market Research Company) for his tremendous help in designing the survey and implementing it. In addition, I would like to thank Anita Chan, Martin King Whyte and two anonymous reviewers for their extremely helpful comments on an earlier draft.     

Autonomy, guardianship and mental disorder: one problem, two solutions

The law in England and Wales governing both the provision of medical care in the case of adults with incapacity and the provision of care and treatment for mental disorder presents serious problems for the principle of patient autonomy. The adult with incapacity has no competence either to consent to or refuse medical treatment but the law provides no statutory structure for substitute decision making on that adult's behalf. On the other hand the law does allow a person with mental disorder to be treated for that disorder despite his or her competent refusal. The nature of these inconsistencies is considered and the implications which flow from the singling out of mental disorder are examined with reference to experience in two Australian jurisdictions. The current proposals for reform of the Mental Health Act are then considered in the light of the conclusions drawn.