Genomic research and incidental findings.

The Human Genome Project showed that there is significant genetic variation within the population. Current research is accumulating large databases that may reveal genetic variations associated with disease or health risks, even if not intended as part of the study design. These incidental findings create legal, ethical, and financial challenges for researchers. Current federal and international guidelines are not adequate. Plans for dealing with incidental findings need to be established in the study design and reviewed and approved by the Institutional Review Board.     

PLESSY V.FERGUSON IN LIBERTARIAN PERSPECTIVE

Law and Philosophy -     

An economic theory of governability: Choosing policy and optimizing performance

When collective violence occurs, a management and decision-making crisis exists for governmental authorities. We examine this situation with an economic model of governability within states. Political decision-makers wish to minimize two goals that enter as components of the government's performance function: political violence and revolutionary change of regime. We further assume that authorities have only a scarce supply of two policy instruments available with which to respond to violence: the accommodation and repression of the demands of their oppositions. Moreover, these elites confront a number of structural determinants of violence and revolution. After laying out these basic components of the model, we propose several theorems about the causes of political performance and about the regime's decision-calculus. These are then proven through a comparative static analysis of the model and by optimizing the performance function. The deductions indicate that the regime's policy instruments produce contradictory effects on the targetted levels of violence and revolution. In general, both accommodation and repression of opponents will, up to some point, reduce violence (an intended consequence) but increase revolution (an unintended consequence). Thus, upon close examination the goals of political decision-makers, to simultaneously minimize both violence and revolution, turn out to be inconsistent. Authorities therefore select an optimal level of performance by balancing the costs and benefits that come from accommodating and repressing their opponents.     

The impact of the right to refuse treatment in a forensic patient population: six-month review

In December of 1987, the Wisconsin supreme court held that all involuntarily committed mental patients in the state had the right to refuse psychotropic medication unless a court held that they were incompetent to make treatment decisions. The authors studied the effects of this decision in a 165-bed forensic hospital over the first six months after implementation of the decision. They found that 29 percent of patients already on psychotropic medication initially refused further treatment as opposed to 75 percent of newly admitted patients. Of refusers, 32 percent eventually resumed taking medication voluntarily; courts overturned the refusals of all the 51 percent who maintained their refusals, after an average delay of over a month. The length of procedural delays actually increased over the six months of the study as the courts learned of the decision. The authors compare their findings with other reported studies of implementation of right to refuse treatment decisions and discuss differences between the right to refuse treatment for civilly and criminally committed patients.     

The first decade of the Congressional Budget Act: Legislative imitation and adaptation in budgeting

The influence of institutions on budgetary behavior at the federal level is the subject of this article, which examines the Congressional Budget Act of 1974. While its impact on budgetary priorities and growth seems modest at best, the Act has had a substantial impact on the process of budgetary decisionmaking, the nature of budgetary debate, and the budgetary strategies employed within Congress. These new and generally dysfunctional forms of congessional budgetary behavior are consequences of a budgetary reform that attempted to transfer many of the resource allocation procedures of the Executive branch to a legislative context. The transfer of many Executive branch budgetary procedures has led to the appearance within Congress of budgetary behavior previously confined largely to the Executive branch. The article also discusses attempts to render the congressional budget process more compatible with the legislative environment, analyzing the modifications in the original budget process that have been effected and proposed in recent years.Earlier versions of this article were delivered at the Workshop on Budgetary Control in the Public Sector, Brussels, Belgium, October 13–14, 1983, the meetings of the Association for Public Policy Analysis and Management, October, 1983, and the meetings of the American Political Science Association, September, 1983. Allen Schick, Robert X. Browning, Alex Hicks, Robert Strauss, John R. Hibbings, Evelyn Brodkin, and Rod Kiewiet provided helpful comments, and Pamela Reyner provided secretarial assistance. All remaining deficiencies are the responsibilities of the authors.     

The Japanese legal system: Why many Americans fail

In the United States, a businessperson can operate within the familiar framework of American law, relying on a legal expert only for the relevant specifics. However, because the historical background, modern usage, and basic logical structure of the Japanese legal system differs so completely from American expected norms, this simple acquaintance with the law is insufficient in Japan. The failure of the American trans-Pacific business community to acquaint itself adequately with the unique Japanese legal system has contributed to America’s inability to penetrate Japanese markets, the default of many business ventures, and ultimately to the decline of America’s economic status relative to Japan.