Reviews

Susan Gross Solomon (ed.), Beyond Sovietology: Essays in Politics and History. New York and London: M.E. Sharpe, 1993, 254 pp., £38.00.

Alice H. Amsden, Jacek Kochanowicz & Lance Taylor, The Market Meets Its Match. Restructuring the Economics of Eastern Europe. Cambridge, MA: Harvard University Press, 1994, 250 pp.

Robert E. Ebel, Energy Choices in Russia. Washington, DC: Center for Strategic and International Studies, 1994, xii + 152 pp., $16.95.

Michael Waller, The End of the Communist Power Monopoly. Manchester: Manchester University Press, 1993, viii + 287 pp., £35.00 h/b., £9.99 p/b.

Minxin Pei, From Reform to Revolution: The Demise of Communism in China and the Soviet Union. Cambridge, MA: Harvard University Press, 1994, 253 pp., £29.95.

William G. Rosenberg & Lewis H. Siegelbaum (eds), Social Dimensions of Soviet Industrialisation. Bloomington and Indianapolis, IN: Indiana University Press, 1993, xix + 296 pp., £12.99 p/b.

Taras Kuzio & Andrew Wilson, Ukraine: Perestroika to Independence. Basingstoke: Macmil‐lan Press, 1994, xiv + 260 pp., £40.00.

Russell F. Farnen (ed.), Nationalism, Ethnicity, and Identity. Cross National and Comparative Perspectives. New Brunswick, NJ, and London: Transaction, 1994, xiv + 538 pp., £49.95.

Edwin Thomas Bacon, The Gulag at War: Stalin's Forced Labour System in the Light of Archives. Basingstoke: Macmillan, 1994, xii + 190 pp.

Robert S. Ross, China, the United States and the Soviet Union: Tripolarity and Policy Making in the Cold War. Armonk, NY: M. E. Sharpe, 1993, x + 204 pp., £42.00.     

Book reviews

Stephen Chan and Andrew J. Williams (eds), Renegade states: The Evolution of Revolutionary Foreign Policy (Manchester: Manchester University Press, 1994).

Adam Roberts and Benedict Kingsbury (eds), United Nations, Divided World. The UN's Role in International Relations 2nd edition (Oxford: Clarendon Press, 1993)

G. Hastedt and K. Knickrehm, (eds), Toward the Twenty‐first Century. A Reader in World Politics (New Jersey: Prentice Hall, 1994).

A. J.R. Groom and Margot Light (eds), Contemporary International Relations: A Guide to Theory (London: Pinter Publishers, 1994).     

Evaluating adolescent decision making in legal contexts

Challenges the use by policy researchers of a model for comparing adolescent and adult decision making that is based on informed consent standards. An expanded decision-making framework designed to evaluate judgment in adults and adolescents can better test the empirical basis of paternalistic legal policies. The theoretical and empirical literature on the informed consent framework is critiqued and an alternative framework incorporating judgment factors is proposed. Three judgment factors—temporal perspective, attitude toward risk, and peer and parental influence—and their effects on decision making are explored. Finally, implications for future research are analyzed in several decision-making contexts.Several of the ideas in this article were originally presented by the first author and were published as part of a symposium on competence (see Scott, 1992). The current article expands and refines these ideas, provides a more substantial research base, and suggests several future research directions. We thank Joseph Allen, Richard Bonnie, Baruch Fischhoff, William Gardner, John Monahan, Edward Mulvey, Richard Redding, Paul Slovic, and three anonymous reviewers for their helpful comments. Special thanks to Thomas Grisso for providing much constructive criticism and to Wendy Shang for outstanding research assistance. Finally, we would like to acknowledge the MacArthur Foundation, which supported this work in its early stages.     

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.     

State Medicaid reform under Section 1115 demonstration authority

Given the complexity of federal Medicaid law and the limitations it imposes on state flexibility, it is likely that states will continue to ask the Secretary to grant waivers under Section 1115 to allow them to pursue new approaches to health care reform. The results of currently operational Section 1115 projects involving statewide managed care systems will be useful in evaluating the Medicaid reform measures currently under discussion in other states and at the federal level. In particular, the ability of the states to control Medicaid and indigent care costs and to utilize federal dollars more efficiently should prove important in evaluating a block grant approach to federal Medicaid funding. Moreover, Section 1115 project results that bear on the sufficiency of various Medicaid capitation rate methodologies will also be of value as more states expand the use of managed care arrangements for their Medicaid populations.     

The Department of Health and Human Services issues proposed regulations on physician incentive payments by hospitals

Hospitals tempted to operate their own physician incentive plans are reminded that, under OBRA 1986, they are precluded from paying physician incentives of any kind to reduce or limit Medicare or Medicaid covered services. In light of the proposed regulations and the guidance of the preamble, hospitals should review their incentive plans to determine whether physicians providing direct patient care are receiving prohibited payments. Further, supervising physicians who are receiving incentives for certain hospital departments may not influence direct care over patients served by those departments, even through other physicians. Some risk may also exist if incentives are based on a formula that considers patients of the supervising physician's medical group. Finally, it may be useful to develop a utilization and quality of care review program specifically designed to assure that patient undertreatment does not occur as a result of any supervising physician incentive program.