The future of public health law

Developments in medicine and constitutional law dictate modification of public health legislation in the United States. Traditionally overlooked by legislators, present public health laws provide inadequate decision-making criteria and inappropriate procedures for dealing with issues. Revised legislation should provide health care officials and agencies with the tools to balance individual rights against public health necessities. This Article makes four recommendations for legislative reform: (1) remove artificial legislative distinction between venereal and other communicable diseases; (2) provide criteria defining "public health necessity" to limit discretionary exercise of police power by health officials; (3) provide strong confidentiality protections in the collection and storage of public health information; (4) empower public health officials to select from a graded series of less restrictive alternatives in dealing with public health problems.     

"False confessions" and identification with the aggressor: another forensic misuse of a psychiatric concept

Some psychiatrists misuse theoretical concepts beyond their generally accepted dimensions in an attempt to support a conclusion favorable to a litigant or defendant. In the case presented, the concept of identification with the aggressor was used in an attempt to eliminate or minimize the effect of a confession and to buttress the claim that the confession itself was false. Quotations from the actual reports and testimony are used to reflect both this tactic and the context in which these issues were pursued, including a rather startling admission by the psychiatrist dealing with the thoroughness of his professional effort. A brief history of "identification with the aggressor" is presented, a history which contrasts with its application to rather routine police questioning. Similarly, skepticism is clearly merited when a psychitrist testifies as to truthfulness or falsity of a statement.     

Work,fertility, and the status of women in Mexico

Among the major transformations affecting Mexican women in recent decades were their growing participation in the labor market and the fertility decline that began in the 1970s with widespread access to contraception. Data from 3 major Mexican fertility surveys, employment surveys, and censuses are used to analyze changes in female employment and their determinants during the years of economic recession in the 1980s. The main characteristics of the Mexican fertility decline are described, and the relationship between fertility and female employment before and during the economic recession is scrutinized for different social sectors. Suggestions for research on the affects of these changes on the social condition of Mexican women are then presented. The proportions of Mexican women over 12 years old who declared themselves economically active increased from 16% in 1970 to 21% in 1979 and 32% in 1987. Until the 1970s the majority of employed women were young and single or childless. But a clear increase occurred between 1976-87 in the economic participation of older women in union. Economic participation of low income and less educated women increased as they sought work or created their own in response to deteriorating living conditions during the recession. Young women with intermediate or higher educational levels did not increase their relative presence in the labor market in the same period. The marked increase in economic participation of less educated women in union with small children was accompanied by a significant increase in manual occupations. Between 1982-87, the proportion of women aged 20-49 in nonsalaried manual occupations rose from 7.6% to 18.5%. Mexico's fertility decline has been well documented. The total fertility rate declined from 6.3 in 1973 to 3.8 in 1986, while the percentage of women in union using a contraceptive method increased from 30.2 in 1976 to 52.7 in 1987. Fertility differentials have been declining but are still considerable. The inhibitory influence of children on female labor force participation in Mexico is clear, but in the years of economic recession the most notable increase in female workers was in women with 3 or more children of whom the youngest was under 3. It appears that the influence of children on women's employment depends on the socioeconomic status of the woman as well as on the dynamism or sluggishness of the labor market. Research is needed on the significance of changes in fertility and female employment for women's status in Mexico. Several recent works have presented results of microsocial analyses of the ways in which women experience changes in their lives resulting from fertility and employment decisions. A methodological strategy for studying these changes and their influence on women's status should focus on comparisons between different generations and birth cohorts, different types of employment, and different socioeconomic statuses. Both macrosocial and microsocial forms of analysis are needed to provide a full picture.