Symbols, rationality, and justice: rationing health care.

Proposals to ration health care in the United States meet a number of objections, symbolic and literal. Nonetheless, an acceptance of the idea of rationing is a necessary first step toward universal health insurance. It must be understood that universal health care requires an acceptance of rationing, and that such an acceptance must precede enactment of a program, if it is to be economically sound and politically feasible. Commentators have argued that reform of the health care system should come before any effort to ration. On the contrary, rationing and reform cannot be separated. The former is the key to the latter, just as rationing is the key to universal health insurance.     

WINNING COALITIONS AND ETHNO-REGIONAL POLITICS: THE FAILURE OF THE OPPOSITION IN THE 1990 AND 1995 ELECTIONS IN COTE D'IVOIRE

Why is that former dominant or single party regimes, especiallythose in Africa, have generally survived and even emerged strengthenedafter the introduction of multi-party competitive elections?In Côte d'lvoire since 1990 the ruling party has beenable to win elections by using incumbency to present itselfas the organization most likely to be capable of putting togethera winning coalition. In a society segmented by a multiplicityof cultural and religious divisions and where political poweris a zero-sum game, the logic of democratic representation meansthat no group can afford to be excluded. Yet in the 1990 and1995 Ivorian elections .the opposition attacked die ethnic characterof the government and deliberately mobilized ethnic minorities,regional and religious (Islamic) sentiments. They thereforefailed to escape, in electoral terms, from their extremely localizedstrongholds. Their attempt to mobilize around an anti-foreignerplatform in 1990 rebounded in 1995 when the government itselftook over their ‘ultra-nationalist’ stance by excludingnon-Ivorians from the elections. The consequent exclusion ofthe opposition's favoured Presidential candidate and the failureof the opposition alliance to agree on a non-northern, non-Islamicalternative candidate led to a violent boycott and the eventualcollapse of the opposition alliance.     

Examining the empirical relationship between prison crowding and inmate misconduct: A meta-analysis of conflicting research results

Incarceration rates in the United States dramatically increased over the past several decades. This trend has drawn significant academic attention to prison overcrowding and its potential effect on inmate misconduct. The empirical relationship between inmate misconduct and overcrowding, however, is less than clear. To be sure, studies indicating positive, negative, and null relationships can all be found in the literature. The current research subjects this body of literature to a meta-analysis in an effort to: (1) clarify the direction and strength of the relationship between overcrowding and rates of prison misconduct across all studies, and (2) to uncover the degree to which variation in research outcomes can be attributed to methodological differences across studies. Results indicate that prison crowding has little substantive impact on inmate misconduct. Implications of the findings are discussed in detail.     

Observations of high velocity bloodspatter on adjacent objects

In a recent homicide investigation, high velocity backspatter was observed on the sleeve cuff of the accused. These minute droplets were discovered only after microscopic examination and were limited in number. A study was initiated to determine if these were truly backspatter droplets or transferred blood produced from light contact with a bloody item. It was observed that the backspattered blood was primarily limited to contact or near contact shots. An exception was a shot into an already bloody surface. It was found that backspattered blood would deposit on the shooter's shirt sleeve irrespective of the weave pattern. Transferred blood was observed only on the fiber tops. This information was found to be useful in reconstruction of events in suicides as well as possible homicides.     

Ethics and the Physician-Patient Relationship

Book Reviews in This Article:
Getting Rid of Patients: Contradictions in the Socialization of Physicians . By Terry Mizrahi
Physicians and Social Change . By John Colombotos and Corinne Kirchner
Changing Values in Medicine . Edited by Eric J. Cassell and Mark Siegler
Professional Ethics and Primary Care Medicine: Beyond Dilemmas and Decorum . By Harmon L. Smith and Larry R. Churchill
Physician—Patient Decision-Making: A Study in Medical Ethics . By Douglas N. Walton
With Dignity: The Search for Medicare and Medicaid . By Sheri I. David
The Dismissal of Students with Mental Disorders. Legal Issues, Policy Considerations, and Alternative Responses .
Courtroom Toxicology . By Marshall Houts, Randall C. Baselt, and Robert H. Cravey     

Corporate Governance in Spain (with an Application of the Power Indices Approach)

This paper describes the governance system of Spanish listed firms in the early 1990's. Although the institutional setting of the Spanish Stock Exchanges differs little from other European national markets, we found important differences in several aspects of corporate governance. In particular, some of the standard mechanisms of control (e.g. boards and institutional shareholders) do not play an active role, whereas ownership is relatively concentrated. Moreover, power indices suggest that controlling blocs of large shareholders are very likely to form. We thus conclude that the ownership of shares is a pivotal mechanism in the governance of Spanish corporations.     

ASSESSING NEIGHBORHOOD AND SOCIAL PSYCHOLOGICAL INFLUENCES ON CHILDHOOD VIOLENCE IN AN AFRICAN‐AMERICAN SAMPLE*

The present study examines the extent to which neighborhood and social psychological influences predict childhood violence among 867 African‐American youth. The results showed that neighborhood affluence was the only neighborhood‐level variable to exert a significant influence on childhood violence. Furthermore, childhood violence was significantly related to social psychological influences, such as adopting a street code, associating with violent peers, parental use of violence, and quality parenting. Overall, the findings suggested that simply living in a violent neighborhood does not produce violent children, but that family, peer, and individual characteristics play a large role in predicting violence in childhood.