Ethics and the Physician-Patient Relationship

Book Reviews in This Article:
Getting Rid of Patients: Contradictions in the Socialization of Physicians . By Terry Mizrahi
Physicians and Social Change . By John Colombotos and Corinne Kirchner
Changing Values in Medicine . Edited by Eric J. Cassell and Mark Siegler
Professional Ethics and Primary Care Medicine: Beyond Dilemmas and Decorum . By Harmon L. Smith and Larry R. Churchill
Physician—Patient Decision-Making: A Study in Medical Ethics . By Douglas N. Walton
With Dignity: The Search for Medicare and Medicaid . By Sheri I. David
The Dismissal of Students with Mental Disorders. Legal Issues, Policy Considerations, and Alternative Responses .
Courtroom Toxicology . By Marshall Houts, Randall C. Baselt, and Robert H. Cravey     

Does Federalism Weaken Democratic Representation in the United States?

The framers of the U.S. Constitution explicitly designed federalismto enhance representation. Because powers are divided amongmultiple governments, citizens are able to exert pressure onthe elected officials of various governments in an effort toachieve desired outcomes. If one government is not doing whatcitizens prefer, they can seek it from a different government.This assumes that individuals form opinions about the functionsperformed by different governments. Given the complexity offederalism, this may be an unrealistic assumption for many citizens.Original survey data uniquely suited to explore this questionsuggest that citizens do behave in a fashion consistent withthe federalist framework. Moreover, the actual change in theassignment of functional responsibilities across governmentsbehaves as if it responds to public opinion.     

General systems theory and criminal justice

Criminal justice agencies are organized sequentially — “output” from one agency is “input” to the next — but most scholars argue that criminal justice is not a system in a theoretical sense. In this article, it is argued that general systems theory (GST) reveals important insights into criminal justice structures and functions. Specifically, it is argued that the criminal justice system processes “cases” rather than people, and that the common goal of criminal justice processing is to “close cases so that they stay closed.” It also is argued that processing capacity progressively declines, in that at each system point the subsequent agency cannot input as many cases as the previous agency can output. Each agency therefore experiences “backward pressure” to close cases in order to reduce input to the next agency. Overall, this article highlights that criminal justice agents and agencies are best understood as operating in the context of the larger whole, thus it is concluded that criminal justice is a system in the sense of general systems theory.