The emergence of maternal-fetal conflict policies

George Washington University Medical Center's Policy on decisionmaking by pregnant patients is being widely circulated by the ACLU; copies of the Policy can be obtained by calling the American Civil Liberties Union Reproductive Freedom Project. There is, of course, much disagreement over the details of the Policy; not everyone will agree with its underlying philosophy favoring maternal rights. Nevertheless, there does seem to be a consensus that wherever possible these conflicts should be resolved in accordance with previously adopted policies rather than by the courts on an ad hoc basis. Had the Policy been in place in 1987, the Carder case would probably not have been submitted to a judge in the first place, nor would Angela Carder have been forced to undergo a Caesarean section. All hospitals should consider adopting a maternal-fetal conflict policy, and those that do so should be aware of the George Washington University Medical Center Policy, whether or not they agree with its provisions. Whatever policy each hospital ultimately develops should be integrated with decisionmaking and informed consent policies already in place. The formulation and implementation of such a policy, reflecting the hospital's legal and ethical obligations to its pregnant patients, will go a long way towards preventing unnecessary resort to the courts.     

Circumventing formal structure through commitment: Presidential influence and agenda control

Although the formal institutional structure that defines the temporal order of play in a policy game between the Congress and President ought to provide Congress with agenda power, the President is traditionally treated as the dominant player in this relationship. We show that if the President can make clear-cut commitments, presidential commitment can counter the dominance hierarchy and the complexion of equilibrium outcomes. Thus, the details of political interactions (in particular, the possibilities for commitment) may be as important as the formal specification of institutional structure.We thank Peter Aranson, David Austen-Smith, Ed Campos, Gerry Faulhaber, Art Frank, Ken Koford, William Riker, Janet Pack, the anonymous referees, and seminar participants at the University of Delaware, the University of Pennsylvania, and the University of Rochester for helpful comments, subject to the usual caveat. We also thank Joel Friedlander and Harold Dichter for research assistance.     

Competition in political and economic markets

Prepared as a response to Frey and Eichenberger's Anomalies in Political Economy. We thank Gordon Tullock for helpful discussions. This work was partially supported by the Taylor Experimental Laboratory at Washington University.     

Elections and government spending

It is widely believed that electoral pressures cause legislators to favor government spending programs. This electoral theory of spending is shown to encompass two core hypotheses: (1) the electoral consequences hypothesis, which states that support for spending programs improves the representative's electoral showing; and (2) the legislator insecurity hypothesis, which states that greater electoral insecurity leads representatives to be more in favor of spending programs. A test of these ideas using spending scores for U.S. representatives in 1986 finds that neither hypothesis is supported by the data.     

Attitudes of Canadians toward affirmative action: Opposition,value pluralism,and nonattitudes

Set against a backdrop of current public policy and case law, this study investigates Canadian attitudes toward affirmative action among both citizens and decision makers. We find low levels of support for such programs across a variety of contexts and intended beneficiaries, but we also discover that opinion on both sides of the issue is rather soft, for large portions of those taking positions on the matter are willing to reconsider their views when prompted. We interpret this finding as an indication of what Philip Converse has called nonattitudes. Thus, a substantial portion of Canadians appear to hold no genuine attitudes on the question of affirmative action and are relatively open to persuasion. In contrast, the preferences of those with stable attitudes are rooted in the tradeoff between values of equality and merit. Implications for policy activists in this issue area are discussed.The research reported here is part of a large project supported by the Social Sciences and Humanities Research Council (Grant No. 411-85-001). The Centre of Criminology at the University of Toronto has provided a home, and indispensable support, for the Charter Project. This research was also facilitated by a contribution from the Solicitor General of Canada to the Centre of Criminology, University of Toronto. Our thanks also go to Robert Vipond for his help in clarifying our concepts.     

Last rights. In sickness and in health, more people are taking life's biggest decision away from doctors and into their own hands

When dying is all that awaits them, more and more people are choosing certain death now rather than uncertain life on medical support systems. But the decision seldom comes easy, as a Newsweek reporter discovers during three weeks with the doctors, nurses, patients and families in an intensive-care ward. A best-selling guide to suicide fires debate over when it is right to let life go--and who should make that choice when the patient no longer can.     

Money madness. Are private psychiatric hospitals resorting to kidnapping in their quest for paying patients?

In their zeal for lucrative insurance reimbursement, some private psychiatric hospitals seem to have gone over the edge themselves. A number of these institutions, critics charge, use outright coercion to commit and retain patients. Now some formerly abducted "recruits" are fighting back with lawsuits.