The MacArthur Treatment Competence Study. II

This article reports the development and psychometric properties of three standardized and objectively scored measures, the MacArthur Treatment Competence Research Instruments. They were designed to assess abilities related conceptually to four legal standards for competence to consent to treatment: understanding, appreciation, rational manipulation (reasoning), and expressing a choice. Scoring reliability, internal consistency, intertest correlations, and test-retest correlations were examined with data from samples of hospitalized patients with schizophrenia, major depression, and ischemic heart disease, as well as matched non-ill community samples. The results indicate very good interscorer reliability and provide guidance for the use of the instruments and interpretation of their results in future research on patients' decisional abilities in treatment contexts.     

A. reviews: general

WARFARE IN THE LATIN EAST, 1192–1291. By CHRISTOPHER MARSHALL. (Cambridge Studies in Medieval Life and Thought, fourth series, 17.) Cambridge, Cambridge University Press, 1992. xiv, 290pp. 7 figures, 9 plates.

MINORITES RELIGIEUSES DANS L'ESPAGNE MEDIEVALE [ = Revue du Monde Musulman et de la Méditerranée, 63–4]. Aix‐en‐Provence, Edisud, 1992. 292 pp. 150FF.

THE TRANSMISSION OF KNOWLEDGE IN MEDIEVAL CAIRO. By JONATHAN BERKEY. Princeton, Princeton University Press, 1992. x, 238pp. $39.50.

PRAGMATISM IN THE AGE OF JIHAD: THE PRECOLONIAL STATE OF BUNDU. By MICHAEL A. GOMEZ. Cambridge, Cambridge University Press, 1992. xiii, 252 pp. £35.00.

THE CHURCH OF THE EAST AND THE CHURCH OF ENGLAND. A HISTORY OF THE ARCHBISHOP OF CANTERBURY'S ASSYRIAN MISSION. By J.F. COAKLEY. Oxford, Clarendon Press, 1992. £45.00.

WOMEN, ISLAM AND THE STATE. By DENIZ KANDIYOTI. London, Macmillan, 1991. 271pp. + index.

MARRIAGE ON TRIAL: A STUDY OF ISLAMIC FAMILY LAW. By ZIBA MIRHOSSEINI. (Society and Culture in Modern Middle East Series.) London, I.B. Tauris, 1993. 200 pp. + notes and index.

WOMEN IN THE MIDDLE EAST: PERCEPTIONS, REALITIES AND STRUGGLES FOR LIBERATION. Edited by HALEH AFSHAR and MARY MAYNARD. Basingstoke, Macmillan, 1993. xiv, 250pp.

WRITING WOMEN'S WORLDS: BEDOUIN STORIES. By LILA ABU‐LUGHOD. Berkeley, Los Angeles and Oxford, University of California Press, 1993. xxiii, 266 pp., bibliography. $30.00 (hb), $12.00 (pb).

NASSER'S BLESSED MOVEMENT: EGYPT'S FREE OFFICERS AND THE JULY REVOLUTION. By JOEL GORDON. Oxford, Oxford University Press, 1992. vii, 254 pp.

WAR AND PEACE IN ISRAELI POLITICS: LABOR PARTY POSITIONS ON NATIONAL SECURITY. By EFRAIM INBAR. Boulder and London, Lynne Rien‐ner, 1991. 184pp., appendices. £21.95.

TURKEY AND THE WEST: CHANGING POLITICAL AND CULTURAL IDENTITIES. Edited by METIN HEPER, AYSE ÖNCÜ and HEINZ KRAMER. London/New York, Tauris, 1993. xiv, 289 pp.

TURKEY'S NEW GEOPOLITICS: FROM THE BALKANS TO WESTERN CHINA. By GRAHAM E. FULLER and IAN O. LESSER, with PAUL B. HENZE and J.F. BROWN. Boulder and Oxford, Westview Press, 1993. xv, 197pp.

THE SOCIALIST MOVEMENT IN TURKEY, 1960–1980. By IGOR P. LIPOVSKY. Leiden, Brill, 1992. ix, 190pp. $48.75.

ISLAM IN MODERN TURKEY: RELIGION, POLITICS AND LITERATURE IN A SECULAR STATE. Edited by RICHARD TAPPER. London/New York: Tauris, 1991. v, 314 pp.

SIBAWAYH THE PHONOLOGIST: A CRITICAL STUDY OF THE PHONETIC AND PHONOLOGICAL THEORY OF SIBAWAYH AS PRESENTED IN HIS TREATISE AL‐KITAB. By A.A. AL‐NASSIR. London and New York, Kegan Paul International, 1993. xx, 130 pp.

AL‐MADKHAL ILā TAQWīM AL‐LISāN WA‐TA'LīM AL‐BAYāN. By IBN HISHāM AL‐LAKHMī. Edited by JOSÉ PÉREZ LÁZARO. (Fuentes Arábico‐Hispanas, no. 6.) Madrid, Consejo Superior de Investigaciones Científicas & Insti‐tuto de Cooperatión con el Mundo Árabe, 1990. 2 vols. 219; 599pp.     

Testing the limits of freedom of contract: the commercialization of reproductive materials and services

This article examines the cases for and against commercializing, or "commodifying," reproductive materials and services. Using a supply/demand third-party framework, three basic scenarios in which commercial-exchange relationships may be possible--exchange of gametes and zygotes, exchange of gestational services, and exchange of fetal material--and the major parties of interest, or stakeholders, are identified. The study sketches the liberal, essentialist, and radical contingency theories that shape the debate over the commercialization of reproductive materials and services. The article then attempts to derive some basic governing principles that reflect as much common ground as possible amongst these various normative perspectives, while recognizing that complete reconciliation is impossible. Taken together, these principles are designed to reflect a strategy of "constrained commodification," where commercialization or commodification, that is, financial remuneration, plays a relatively neutral role in the utilization of reproductive materials and services. In light of these principles, the article concludes by sketching legal and regulatory regimes with respect to the exchange of gametes and zygotes, gestational services, and fetal tissue.