Parliamentary decision making and foreign policy: Sweden's participation in international armed missions and the crucial role of the Riksdag

SUMMARY

The last 20 years have witnessed a marked increase in Swedish participation in major international UN-, EU- and/or NATO-led armed missions mandated according to Chapter VII of the UN Charter. This development reflects the new foreign and security priorities of Sweden in the wake of the end of the Cold War. Decisions on Swedish participation in such missions, however, cannot be taken without parliamentary approval. The Riksdag's role in Sweden's new foreign and security policy is thus crucial. Since the first bill on an international mission was submitted in 1993, the Parliament has gradually elaborated an informal internal working order for handling bills of this type, as well as the establishment of a system of signification for communicating approval or discontent with certain aspects of the bills, in conjunction with the Cabinet. This article is aimed at investigating the nature and content of the Parliament's contribution to the wider process of decision making on Swedish participation in international armed missions.     

Evaluating quality or lowest price: consequences for small and medium-sized enterprises in public procurement

This study investigates the effect of evaluating the most economically advantageous tender (MEAT) in public procurement rather than lowest price. According to the European Union (EU), evaluations based on MEAT, rather than lowest price, give an advantage to small and medium-sized enterprises (SMEs) in winning public procurement contracts because such firms are viewed as sources of innovation. Thus, MEAT as an evaluation criterion is recommended throughout the EU. Using procurement data from Sweden, I find no significant effect on SME participation in procurement calls for tender as a result of the use of MEAT in firm evaluations. However, large firms significantly increase their participation when MEAT is evaluated. Even more importantly, micro, small and medium-sized firms’ probability of winning procurement contracts significantly decreases when MEAT rather than lowest price is used as an evaluative criterion. Thus, evaluation in terms of MEAT increases large firms’ bids and success rates; hence, this policy is counterproductive. The reasons SMEs are disadvantaged as a result of evaluations based on MEAT are, however, not examined in this paper and require further research.     

Fatal unintentional intoxications with tramadol during 1995-2005

Tramadol is an extensively used centrally acting analgesic and is considered a safe drug devoid of many serious adverse effects of traditional opioids. However, recently, toxicity and an abuse potential of tramadol have been reported. This study examined fatal unintentional tramadol intoxications among Swedish forensic autopsy cases between 1995 and 2005. All fatal intoxications were selected, in which toxic concentrations of tramadol (>1 microg/g femoral blood) had been detected, and where the forensic pathologist considered the intoxication unintentional and the fatal outcome at least partly explained by tramadol. Toxicology analyses, police reports, autopsy protocols and medical records were scrutinized. A total of 17 cases (eleven men and six women) of fatal unintentional tramadol intoxications were identified. For these cases the median age was 44 years (range 18-78 years) and the median tramadol concentration was 2.0 microg/g (range 1.1-12.0 microg/g). Other pharmaceutical substances, illicit drugs or ethanol were detected in addition to tramadol in all of these cases. In fact, intoxication with multiple drugs was considered the cause of death in 10 (59%) cases. However, in seven cases tramadol was the only substance present in toxic concentrations. A history of substance abuse was identified in 14 (82%) subjects and a present tramadol abuse in 8 (47%). These results suggest that fatal intoxications with tramadol may occur unintentionally and that subjects with a history of substance abuse may be at certain risk. Precaution is therefore warranted when prescribing tramadol in such patients.     

Measures to enhance the success of global climate treaties

We analyze important forces that hamper the formation of successful self-enforcing agreements to mitigate global warming from an economic point of view. The analysis combines two modules: (a) an integrated assessment model that captures the feedback between the economy, environmental damages and the climate system and (b) a game theoretic model that determines stable coalitions in the presence of free-riding incentives. We consider two types of measures to enhance the success of international environmental treaty-making: (a) transfers, aiming at balancing asymmetric gains from cooperation; (b) institutional changes, aiming at making it more difficult to upset stability of a treaty. We find that institutional changes may be as important as transfers and should therefore receive more attention in future international negotiations.

Comparative Toxicology of Intentional and Accidental Heroin Overdose*

Abstract: The demographic and toxicological characteristics of deliberate (SUI, n = 50) and accidental (ACC, n = 927) fatal heroin overdose cases were examined. SUI cases were more likely to be female, had lower body mass indices, were more likely to be enrolled in treatment and less likely to have hepatic pathology. The median blood morphine concentration of SUI cases was significantly higher than that of ACC cases (0.70 vs. 0.40 mg/L, p < 0.001). Blood morphine concentrations of >1 mg/L were seen among 38.0% of SUI cases compared to 13.9% of ACC cases. Being a member of the SUI group remained a significant independent predictor of higher morphine concentrations after controlling for the effects of potential confounders (p < 0.001), other significant predictors being the absence of alcohol (p < 0.001), the presence of methadone (p < 0.05), and the presence of cocaine (p < 0.05). The current data are consistent with the view that suicide forms a small, but distinct, category of heroin overdose cases, rather than overdose being a parasuicidal phenomenon per se.     

Clinical and Autopsy Characteristics of Fatal Methamphetamine Toxicity in Australia

Characteristics of death attributed solely to methamphetamine toxicity (MT, n = 93) by forensic pathologists were examined and compared to cases of multiple drug toxicity (MDT, n = 634). The mean age of MT cases was 36.7 years, and 86.0% were male. Strenuous activity was reported in 12.9%. The most common witness observations were: collapse (60.3%), difficulty in breathing (36.2%), and hyperthermia (27.6%). MT cases had higher blood methamphetamine (0.54 vs. 0.11 mg/L) and amphetamine (0.04 vs. 0.02 mg/L) concentrations and lower likelihoods for opioids (12.5% vs. 80.9%), hypnosedatives (27.3 vs. 60.7%), antidepressants (14.8 vs. 29.8%), and antipsychotics (9.1 vs. 19.7%). MT cases had significantly heavier hearts than MDT cases (423.4 vs. 385.8 g) and were more likely to have cardiomegaly (37.1 vs. 20.4%) and replacement fibrosis (25.7 vs. 14.5%). The clinical picture was of a sudden cardiac event in a middle‐aged man with a high methamphetamine concentration. Cardiovascular signs of heavy methamphetamine use are frequently seen.     

Morphine Concentrations in Stomach Contents of Intravenous Opioid Overdose Deaths

Abstract:  Death caused by heroin overdose is almost always the result of intravenous injection of the drug in Australia. We briefly describe a case where a heroin overdose was initially thought to be the result of oral ingestion of the drug, primarily as a result of higher concentrations of morphine in stomach contents than in blood. During the subsequent criminal trial and investigation, however, the issue of the entero-hepatic circulation of morphine was raised as a possible reason for the presence of morphine in the stomach contents. In this study, we report on the distribution of opioids in blood, stomach contents, urine, liver, and bile in 29 deaths caused by intravenous heroin overdose. The mean total and free blood morphine concentrations were 0.60 and 0.32 mg/L , respectively, and the mean stomach contents total morphine concentration was 1.16 mg/kg. All cases had detectable morphine in the stomach contents, and 24 of 29 cases (83%) had higher concentrations of total morphine in stomach contents than in blood. The mean total morphine concentration in bile was c. 100 times that in blood, and the liver total morphine concentration averaged twice that of blood levels. We conclude that the entero-hepatic circulation of morphine and subsequent reflux of duodenal contents back into the stomach can result in the deposition of morphine in gastric contents. Consequently, the relative levels of opioids in blood and stomach contents cannot be used to determine the site of administration of the drug.     

Democratic accountability and the changing European political order

This article is about democratic accountability and a Europe struggling to find viable answers to the questions of who and what shall constitute “Europe” and how to develop legitimate political institutions for governing it. The article is, nevertheless, first and foremost about political order and change, rules for living together, the role of democratic politics in society and the relations between political organization and civilized coexistence, and the study of the political. Modern democracies live with unresolved conflict, and accountability regimes are part of an institutional arrangement for preserving order and continuity and also for creating dynamics and change. Accountability processes take place within settled and unsettled orders, and they affect and are affected by existing orders. Without denying the importance of contending interests, power struggles, strategic behaviour, non‐cooperative games, and (re)distributional battles, attention is directed towards the search for unity, political cohesion and solidarity based upon the informed voluntary consent of the people through reflection and reasoned deliberation among individuals with different values, interests, understandings and resources.