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.     

Second Thoughts on Europe's "Third Level": The European Union's Committee of the Regions

The Maastricht Treaty provided for a consultative Committeeof the Regions to bring the European Union's "third level" intothe deliberation of legislation. It began to operate in early1994. This article assesses its creation and recent activityagainst the expectations and demands that were expressed atthe outset, looking in turn at the representative, advisory,and symbolic functions the new body can perform. What emergesis a largely symbolic body that suffers from entrenched internaldivisions and functional overreach in the absence of any realinfluence on the Union's policymaking process. The danger isa downward spiral of progressive obscurity and the frustrationof its members' aspirations.     

The Impact of Electoral Reform: "Open Elections" and the Louisiana Party System

This article examines effects of the "open-elections" law passedby the Louisiana legislature in 1975. The law eliminated traditionalclosed party primaries, creating instead, an open-electionssystem that requires all candidates, regardless of party affiliation,to appear on the same ballot. By and large, the new system hasnot had a significant effect on party competition, party success,or voter turnout in Louisiana.