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.     

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     

The Influence of Advisers and Decision Strategies on Foreign Policy Choices: President Clinton's Decision to Use Force in Kosovo

In the following paper, I analyze the influence of advisers and domestic political factors on President Clinton's decision to use force against Slobodan Milosevic and the Serbs in Kosovo in March 1999. I present an analysis and examination of President Clinton's decision-making process, using press reports, personal speeches, etc. In other words, I attempt to trace the process by which Clinton came to the decision to use force in Yugoslavia. Specifically, using the poliheuristic theory, I argue that President Clinton's decision was influenced by noncompensatory domestic political calculations and the strong influence of his Secretary of State, Madeleine K. Albright. Examining how advisers interact with one another, their status in the advisory group, and the manner in which presidents solicit information from advisers will further our understanding of how, when, and under what conditions national security-level decision makers make decisions.     

A Test of Generalizability of the Social Development Model Across Gender and Income Groups with Longitudinal Data from the Elementary School Developmental Period

The social development model (SDM) is a theory of behavior that has proven useful in explaining the etiology of delinquency, violence, and substance use among adolescents as well as early antisocial behavior among pre-adolescents. A further test of the model is its generalizability across population groups. A section of the SDM representing prosocial influences in the etiology of problem behavior was compared for boys and girls and for children from low- and non low-income families using three waves of child, parent and teacher survey data on a sample of 851 elementary school students. Multiple group structural equation modeling was used to assess differences across groups in both measurement of model constructs and hypothesized structural paths between constructs. The results indicate overall similarity in the reliability of measurement models and validity of structural models.     

The European community software directive: The United Kingdom implementation

Conclusion The Regulations appear to have reinforced the protection available to software producers under United Kingdom law. The provisions of the Software Directive and the Regulations are complex and not without significant inconsistencies which are likely to prove to be a source of litigation. The drafters of the Regulations chose, unlike many of its European partners, not to adopt the wording of the Software Directive but to write their own interpretation, adding an element of uncertainty to the law in this area, which is perhaps inevitable bearing in mind the linguistic problems of translating and interpreting any directive coupled with the ambiguity and omission of definitions of several key terms. More important, however, than any academic argument will be the practical impact of the new law and its effectiveness in achieving its aim.     

Threatening and otherwise inappropriate letters to members of the United States Congress

The authors examine the characteristics of threatening and otherwise inappropriate communications sent to members of the U.S. Congress by a sample of 86 subjects, 20 of whom threatened assassination. We quote excerpts from these letters and provide quantitative data on such variables as the volume, duration, form, and appearance of such communications; the enclosures; the subjects' perceived relationships to the recipients; the thematic content of the communications; and the messages and threats communicated. Comparisons between 43 subjects who pursued encounters with members of Congress and 43 who did not revealed 17 factors associated with such pursuit. In this population, threateners were significantly less likely to pursue an encounter than inappropriate letter writers who did not threaten, regardless of the type of threat or the harm threatened. Inappropriate letters to members of Congress are compared with those directed to Hollywood celebrities. Mentally disordered persons writing to public figures often mention and sometimes threaten public figures other than those to whom the letters are addressed, which raises important issues regarding notification of endangered third parties and the sharing of information among protective agencies.     

Microbial Sampling and Data Interpretation for Problematic Buildings: Considerations for Construction Related Environmental Claims

Bioaerosol data is often used in cases of building mold infestation alleging damage or adverse health effects upon occupants, despite the lack of consistent sampling and analytical protocols and numerical health-based standards. The most fundamental problem in these scenarios is defining a “significant” difference between a suspect indoor environment and the reference environment, regardless of the type of sampling and analysis utilized. Data interpretation focused upon differences in absolute numerical concentrations of fungi is subject to wide differences in expert opinion. On the other hand, an objective quantification of differences can be expressed in terms of probability and better meets criteria established in evidentiary rules.     

Der Begriff der „Landeskultur“ im deutschen Recht

Der Begriff der Landeskultur umfasst alle Maßnahmen zur Verbesserung der land- und forstwirtschaftlichen Nutzung des Bodens einschließlich der Erhaltung der Kulturlandschaft. Landeskultur ist somit alles Planen und Handeln mit dem Ziel, die Umwelt als gegebenes Naturraumpotential, insbesondere Wasser, Boden, Luft und die dazugehörigen Natur-, Kultur- und Sachgüter optimal zu erhalten, gestalten und rationell zu nutzen sowie dieses Potential mit bestmöglicher Qualität als natürliche und kulturelle Lebensgrundlage für die Allgemeinheit nachhaltig zu sichern. Landeskultur dient somit auch der Belebung und Werterhöhung der gebauten und gepflanzten Umwelt. Dies schließt auch und gerade die kulturelle Seite einschließlich Kulturlandschaften mit ein. Dabei ist es bis zur Überprüfung durch das BVerfG noch hinnehmbar, dass der Begriff „Landeskultur“ in Art. 89 Abs. 3 GG wegen der Mischkompetenz von Bund und Land vom BVerwG enger ausgelegt wird als in anderen Rechtsvorschriften.