The right to refuse treatment: An application of the economic principles of decision-making under uncertainty

When courts do not defer to professional judgment, alternative ways must be used to make treatment decisions for persons who are deemed incompetent. Rather than impose the preferences of society on the mentally ill individual, courts have favored alternative procedures. The two most common approaches are substituted judgment and best interests. In using both the substituted judgment standard and the best interest standard the guardian of a patient who is judged incompetent to make a treatment decision tries to make the decision the patient would have made, had he been competent. The guardian must consider the individual's attitude toward risk in making this assessment. Substituted judgment can be used when clear and convincing evidence of the patient's preferences exists. The evidence would come from a study of the patient's expressed attitudes towards medical treatment and behavior before he or she became incompetent. This approach is effective only if the patient has revealed his or her preferences toward relevant medical treatment in the past. The best interest standard is used when no clear and convincing evidence of the patient's treatment preferences exists. The treatment decisions of competent patients whose characteristics are similar to the incompetent patient's, and who have faced a similar situation, can be used as a proxy for the decision the incompetent patient would have made. Using the choice function of similar people may make it possible to develop a reasonably objective basis for determining what course of action is in the patient's best interest.     

Budgeting for Our Times: Target Base Budgeting

Target base budgeting sets limits on how much a department may request in its budget. Departments must submit two budget requests—one within the target base and another for additional funds. Some supplemental requests may be funded from a reserve pool. Target base budgeting has been used in parts of the federal government over the last forty years. Its use continues to slowly expand. This article examines the experiences in three cities: Rochester, Tampa, and Phoenix.     

Biological monitoring: the employer's dilemma

The industrial workplace contains many potential health hazards that not only can cause great harm to workers, but also can destroy the employers' economic stability. Often these hazards are documented and dealth with, but frequently they are unknown. When health-conscious employers monitor the physical well-being of their employees in an effort to avoid the terrible personal and economic costs these hazards can produce, they may be supplying their employees with the documentation necessary to recover financially for their industrial illnesses. This Article analyzes this dilemma confronting employers. It describes the many factors employers must consider when deciding whether to institute a monitoring process that takes full advantage of technological developments in medical care. The Article suggests an approach employers may take until some of the disincentives surrounding the implementation of monitoring are removed.     

Electoral-system change in Latvia and the elections of 2010

Latvia’s highly distinctive proportional electoral system owes its origins to Latvia’s 1922 Constitution and the new democracy’s electoral legislation of 1919 and 1922. Latvia’s unique feature lies in its preference system, offering the voters the opportunity to judge each candidate on their party’s list. Although the system appears to maximise responsiveness to voters’ preferences, in practice this promise remained unfulfilled and the representative quality of parliament was questionable. This was in large measure because of the capacity of candidates to stand in multiple constituencies. In 2009 amendments to the electoral law altered this key provision. This change clearly made a difference, but it could not resolve fundamental problems of Latvia’s political process in general and its political parties in particular.     

Can Turkey's state–religion relationship serve as a role model for emerging Arab regimes? A critical assessment

One of the most pressing issues facing Arab societies, in view of the large-scale political transitions taking place in the Middle East, is the status of religion in the state. In this regard, Turkey, a Muslim democratic state, is often offered as a model to follow. The current piece demonstrates that despite the seeming appeal of the Turkish model, it is inadequate for Middle Eastern societies, in which religion plays a significant social role and is a core ingredient of individual and collective identity. This is because the foundations of the Turkish model were artificially imported from the Western experience, and forced from above onto the Turkish populace without much-needed contextual adjustment. This assertion is true not only for the original state-religion model in Turkey, but also for its modified present-day version, which bears to a large extent the burdens of the past. The article concludes by outlining some points that might serve emergent Arab democracies aiming to design a constructive and authentic model of religion and the state.