Reviews

Gordon B. Smith, Soviet Politics: Continuity and Contradiction. Basingstoke and London: Macmillan Education, 1988. xi + 388 pp. £30.00 h/b, £8.95 p/b.

Daniel Thorniley, The Rise and Fall of the Soviet Rural Communist Party. 1927 39. London: Macmillan Press, 1988, xiii + 246 pp., £29.50.

Zenovia A. Sochor, Revolution and Culture: The Bogdanov‐Lenin Controversy, Cornell University Press, 1988, $32.95 ($29.95 USA and Canada.

Robert Edelman, Proletarian Peasants. The Revolution of 1905 in Russia's Southwest. Ithaca: Cornell University Press, 1987, xv + 195 pp., no price.

Robert W. Thurston, Liberal City, Conservative State: Moscow and Russia's Urban Crisis, 1906 1914. New York and Oxford: Oxford University Press, 1987, viii + 266 pp., £27.50.

Douglas R. Weiner, Models of Nature: Ecology, Conservation, and Cultural Revolution in Soviet Russia. Bloomington and Indianapolis, Indiana University Press, 1988, xiv + 312 pp., $35.00.

Werner G. Hahn, Democracy in a Communist Party: Poland's experience since 1980. New York: Columbia University Press, 1987, xxv + 368 pp., $42.00.

Jaroslav Bilocerkowycz, Soviet Ukrainian Dissent: a Study of Political Alienation. Boulder: Westview Press, 1988, xii + 242 pp., $27.50 p/b.

Petro R. Sodol, UPA: They fought Hitler and Stalin, New York: Committee for the World Convention and Reunion of Soldiers in the Ukrainian Insurgent Army, 1987, 128 pp., $12.00.

Bruce McFarlane, Yugoslavia: Politics, Economics and Society. London and New York: Pinter Publishers, 1988, xxii + 240 pp., £25.00 h/b., £8.95 p/b.     

Reviews

Archie Brown and Michael Kaser, (eds.) Soviet Policy for the 1980s, London: Macmillan/ St Antony's, 1982. 282 pp. £20.00 (hardback) £7–95 (paperback).

David Holloway and Jane M. O. Sharp, (eds.) The Warsaw Pact: Alliance in Transition? London: Macmillan, 1984, 290 pp. £25.00.

Daniel N. Nelson, (ed.) Soviet Allies: the Warsaw Pact and the Issue of Reliability. Boulder, Colorado: Westview Press, 1984—UK suppliers, Bowker Publishing Company, xiii + 273 pp. £22.50.

Bohdan Harasymiw, Political Elite Recruitment in the Soviet Union. London: Macmillan, 1984, xviii + 277 pp. £25.00.

Rex A. Wade, Red Guards and Workers’ Militias in the Russian Revolution. Stanford: Stanford University Press, 1984, ix + 391 pp. $32.50.

Joachim Hoffmann, Die Geschichte der Wlassow‐Armee. Einzelschriften zur militärischen Geschichte des Zweiten Weltkrieges. Band 27. Verlag Rombach, Freiburg im Breisgau, 1984, xviii + 468 pp. DM. 32.00 (paperback).

Michal Mirski, The mixed economy: NEP and its lot. Translated from Polish by Roger A. Clarke. Copenhagen: Rosenkilde and Bagger, 1984, 295 pp. DKr. 125.

Jean‐Charles Asselain, Planning and Profits in Socialist Economies. London: Routledge and Kegan Paul, 1984, xii + 269 pp. £12.50.

Roger Skurski, Soviet Marketing and Economic Development. London: Macmillan, 1983, 190 pp. £20.00.

Borys Lewytzkyj, Politics and Society in Soviet Ukraine 1953–80. Edmonton: Alberta: Canadian Institute of Ukrainian Studies, 1984, 219 pp.

Timothy Garton Ash, The Polish Revolution: Solidarity 1980–82. London: 1983, George Sanford, Polish Communism in Crisis. London‐New York: 1983.

Jack Bielasiak and Maurice D. Simon, (eds.) Polish Politics: Edge of the Abyss. New York: Praeger, 1984, xv + 366 pp.

Kari Möttölä, O. N. Bykov and I. S. Korolev, (eds.) Finnish‐Soviet Economic Relations, London: Macmillan (in association with the Finnish Institute of International Affairs), 1983, xxi + 358 pp. £30.00

John Dunn, The Politics of Socialism, An Essay in Political Theory Cambridge University Press. 1984, xviii + 107pp. £15 (hardback) £4.95 (paperback).     

Crisis of conscience: reconciling religious health care providers' beliefs and patients' rights

In this note, Katherine A. White explores the conflict between religious health care providers who provide care in accordance with their religious beliefs and the patients who want access to medical care that these religious providers find objectionable. Specifically, she examines Roman Catholic health care institutions and HMOs that follow the Ethical and Religious Directives for Catholic Health Care Services and considers other religious providers with similar beliefs. In accordance with the Directives, these institutions maintain policies that restrict access to "sensitive" services like abortion, family planning, HIV counseling, infertility treatment, and termination of life-support. White explains how most state laws protecting providers' right to refuse treatments in conflict with religious principles do not cover this wide range of services. Furthermore, many state and federal laws and some court decisions guarantee patients the right to receive this care. The constitutional complication inherent in this provider-patient conflict emerges in White's analysis of the interaction of the Free Exercise and Establishment Clauses of the First Amendment and patients' right to privacy. White concludes her note by exploring the success of both provider-initiated and legislatively mandated compromise strategies. She first describes the strategies adopted by four different religious HMOs which vary in how they increase or restrict access to sensitive services. She then turns her focus to state and federal "bypass" legislation, ultimately concluding that increased state supervision might help these laws become more viable solutions to provider-patient conflicts.     

Big is different from little: on taking size seriously in the analysis of Canadian governmental institutions

Abstract: An institution's size is one of its most obvious and important features. This paper suggests that although analysts and practitioners are certainly aware that scale does matter, the consequences of size for comparative analysis of Canadian governmental institutions have been seriously under-appreciated. To be sure, size is only one of a host of factors shaping our political institutions, but this should not discount its importance, which is both pronounced and widespread. The paper also raises the question of whether the great variations in size evident in Canada's governmental institutions — legislatures, cabinets, and bureaucracies — may not amount to differences in kind rather than degree. In short, the size of our governmental institutions matters, and it matters more than we usually imagine. Size may be relative or absolute. In this paper both dimensions are important. Both the ratio of the cabinet to the legislature and the number of elected members relative to the population have significant implications. So too, the absolute size of the cabinet and the number of bureaucrats are of substantial consequence. Sommaire: Les effets de la taille sur les institutions gouvernementales du Canada (parlements, cabinets et bureaucraties) sont reconnus sans être véritablement étudiés. Cet article analyse les structures des gouvernements fédéral et provinciaux pour identifier et explorer ces effets. On y affirme que les variations dans la taille des institutions gouvernementales du Canada revdent souvent une différence de nature plutôt que de degré. En ce qui concerne les Parlements, la taille affecte les procédures, la formation des comités, les rapports entre les députés et ceux avec I'exécutif. Dans les cabinets, elle influence le processus décisionnel, le rôle du premier ministre et les rernanie-ments ministériels. Quant aux bureaucraties, la taille y exerce un effet sur les rapports entre les ministres et les fonctionnaires, sur la capacité de gérer avec souplesse et sur I'efficacité d'ensemble. Cet article ne constitue pas un plaidoyer favorable ou défavorable des institutions gouvernementales de taille plus petite; il rnontre qu'elles sont différentes, souvent fondamentalement. Entre autres, cela jette le doute sur I'idée que I'on se fait souvent des structures gouvernernentales des provinces, qui ne seraient que des versions réduites de celles du fédéral.     

Why is regulation introduced in the health sector? A look at occupational licensure

Economic theories suggest that the introduction of regulation can be analyzed in terms of the magnitude and distribution of its economic impact. This article uses this approach to consider the introduction of licensure in the health sector for clinical laboratory personnel. At the micro level, there is no evidence of active consumer support for licensure and it seems to have been introduced mainly at the behest of members of the occupation and bureaucrats involved in the regulation of laboratories. Bureaucrats appear to have acted largely on their own initiative and are the single most important group involved in the introduction of licensure. The large role of the occupation supports a "producer protection" model of licensure over a "consumer protection" model. But the independent role of bureaucrats suggests that actors in the public sector are also a major interest group who need to be included in any model of regulation. Their motives are complex, but in the past one of the attractions of licensure seems to have been low direct administrative costs, despite large indirect costs to consumers. At the macro level, recent changes in social policy, which may reflect broad class interests, have shifted these indirect costs increasingly to the public sector through programs like Medicare. These changes in the distribution of costs may explain a growing concern by bureaucrats about the efficiency of licensure and a shift away from this type of regulation.     

Stigma and discrimination in mentally disordered offender patients – a comparison with a non-forensic population

High levels of stigma and discrimination are reported by individuals with mental health problems. Aim: To assess self-reported levels of stigma and discrimination in forensic psychiatric patients, with psychotic illness, compared with general adult psychiatric patients with psychosis. Hypothesis: Individuals with a history of violent offending, as well as severe mental illness, report more stigma and discrimination, than non offender patients, as a result of them being perceived as dangerous and unpredictable. Method: Experiences of stigma and discrimination were compared in 32 forensic and 32 non-forensic general psychiatric patients, with schizophrenia or schizoaffective disorder, using the Stigma and Discrimination Scale (DISC). Results: Stigma and discrimination were widely reported by all patients, particularly affecting relationships with family, intimate relationships and friendships. No significant difference emerged between the forensic and non-forensic patients, in experienced or anticipated stigma. Conclusions: We suggest that the lower level of psycho pathology, longer inpatient stays and intensive rehabilitation for forensic patients may reduce the extent to which these patients experience stigma and discrimination.     

The Outbreak of Fentanyl‐Related Deaths in Cook County,Illinois, Between October 2015 and December 2017: A Retrospective Study and a Comparison with Previous Data

The National Institute on Drug Abuse has observed an increase in fentanyl deaths in the United States. One epidemic related to the abuse of fentanyl happened in Cook County in 2005–2007 (350 deaths). Another outbreak of fentanyl deaths occurred in 2015–2017 in the same area. The database of the Cook County Medical Examiner's Office was searched for cases of fentanyl deaths between 2015 and 2017: 1244 deaths were found. A comparison was performed with the previous data: an increase in the number of females was observed in 2015–2017. Also, in 2005–2007, the majority of deaths occurred among African American, while in 2015–2017, Caucasians were more involved. Within our population, some drug combinations were more common in specific demographic subgroups (male/females; Caucasian/African American; and certain age groups). The epidemiology and the most significant drug associations found at the toxicology are discussed, highlighting the usefulness of the knowledge about this outbreak for public health.     

Moving from the Mainstream to the Margins: Lessons in Culture and Power

This article highlights the ways in which power is conceptualized, activated, and institutionalized in American culture. Drawing from research and the author’s experience within mainstream and culturally-specific organizations in the violence against women field, this article exposes the subtle, yet pervasive mechanisms that lead to the marginalization of culturally specific communities and smaller, typically culturally specific, community-based organizations. By design and unconsciously, researchers, mainstream organization, and leaders often perpetuate a system designed to localize research, evaluation, services and resources for white people, organizations and institutions. This occurs for example, when researchers center and elevate a “gold-standard” of evidence-based practices, research, and evaluation that share no frame of reference to those being “studied” and most effected. It also happens when organizations marginalize culturally specific community members and organizations by seeking their participation at the final stages rather than at the conception of projects. The author provides concrete recommendations that researchers, providers, and leaders can adopt to counteract institutional oppression and help move culturally-specific communities and organizations from the margins to the center.