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.     

Short versus Long Coalitions: Electoral Accountability and the Size of the Public Sector

This article examines the policy consequences of the number of parties in government. We argue that parties externalize costs not borne by their support groups. Larger parties thus internalize more costs than small parties because they represent more groups. This argument implies that the public sector should be larger the more parties there are in the government coalition. We test this prediction using yearly time-series cross-sectional data from 1970 to 1998 in 17 European countries. We find that increasing the number of parties in government increases the fraction of GDP accounted for by government spending by close to half a percentage point, or more than one billion current dollars in the typical year. We find little support for the alternative claim that the number of legislative parties affects the size of the public sector, except via the number of parties in government .     

Mass screening in low-income populations: the challenges of securing diagnostic and treatment services in a national cancer screening program

Funding for many mass screening programs for low-income and uninsured populations provides resources for screening tests, yet only rarely does it provide coverage for necessary follow-up diagnostic and treatment services. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP), a federally funded initiative that provides cancer screening to low-income uninsured and underinsured women, covers some diagnostic follow-up tests and no treatment services. We conducted in-depth case studies of seven state programs participating in the NBCCEDP to investigate the strategies and approaches being used to secure diagnostic and treatment services. The results suggest that the program relies on a patchwork of resources--at state and local levels--to provide diagnostic and treatment services. This includes a number of components of local safety nets, all of which are unstable and have uncertain futures. Public health disease-screening initiatives need to reconsider the feasibility of continued reliance on case-by-case appeals to the local safety net for diagnostic follow-up and treatment services.     

‘Politics’ and Academic Feminist Theorising: Reflections on Women's Studies in Asia

When invited by the organisers of the Asia-Pacific Non-governmental Organisation (NGO) Beijing+10 Forum to make a brief presentation on the question of academic feminists and the de-politicisation of feminist theorising, I asked myself: What politics? What feminist theorising? Then I remembered how close the links were between the history of feminism in academe—particularly in the form of Women's Studies—and the women's movement.2 Vina Mazumdar, ‘Whose Past, Whose History, Whose Tradition? Indigenising Women's Studies in India’, paper prepared for the International Conference on Women's Studies in Asia, Seoul, 18–21 October 2000 published in Asian Journal of Women's Studies, vol. 7, no. 1, 2001, pp. 133–53; Carol Sobritchea, ‘Imaging the Future of Asian Women's Studies and Feminist Scholarship’, paper prepared for the International Conference on Women's Studies in Asia, Seoul, 18–21 October 2000; and Tita Marlita and E. Kristi Poerwandari, ‘Indonesian Women's Movement throughout History: 1928–1965’, paper prepared for the International Conference on Women's Studies in Asia, Seoul, 18–21 October 2000, are recent narratives of the development of Women's Studies and its ties to the women's movement in India, the Philippines, and Indonesia, respectively. View all notes Ah, that politics!     

泰国北部各民族中的儒教传统

生活在泰国北部山地的泰族及其他少数民族 ,深受中国汉族的儒家信仰及传统观念的影响 ,特别是在“礼仪”、“尊卑”、“举止”上 ,都严格遵循儒家的规矩。同时 ,也用儒家的伦理道德来处理民族之间的关系。     

Managing incidental findings in human subjects research: analysis and recommendations.

No consensus yet exists on how to handle incidental findings (IFs) in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are findings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed.