Dosage of treatment to sexual offenders: are we overprescribing?

A sample of 337 offenders who received treatment in a variety of sex offender treatment programs in the Ontario region of Correctional Service Canada between 1993 and 1998 were divided based on the highest intensity sex offender programming that they received (low, moderate, and high). The three groups were compared with reference to a variety of actuarial risk assessment measures, criminogenic factors, and the number and type of treatment programs completed. It was hypothesized that the high-intensity group would have more criminogenic risk factors, higher actuarial scores, and participate in more treatment programs than both the moderate- and low-intensity groups. The results indicate that in general, the hypotheses were supported. Nonetheless, the results suggest that the low-intensity group may be receiving too much sex offender-specific treatment.     

Dr. Jekyll's waiver of Mr. Hyde's right to refuse medical treatment: Washington's new law authorizing mental health care advance directives needs additional protection

Mental health care advance directives are gaining popularity nationwide. Following a growing trend, the Washington State Legislature has recently passed a law allowing patients to draft mental health care advance directives that could be irrevocable. Patients who sign an irrevocable directive essentially waive their fundamental right to refuse treatment in the future. The United States Supreme Court has held that waivers of fundamental rights must be made knowingly, voluntarily, and intelligently. However, as passed, Washington's new law contains insufficient safeguards to guarantee such a waiver. This Comment proposes that the Washington State Legislature amend this law the require two additional protections: a "rights advocate" to explain the potential waiver of rights, and a written warning in the advance directive form. These safeguards will help ensure that patients make knowing and intelligent waivers of their fundamental right to refuse treatment.     

Human bites and the risk of human immunodeficiency virus transmission.

The risk of human immunodeficiency virus (HIV) transmission following a bite injury is important to many groups of people. The first are those who are likely to be bitten as an occupational risk, such as police officers and institutional staff. Another group are represented by the victims and perpetrators of crimes involving biting, both in attack and defense situations. The possibility of these bites transmitting a potentially fatal disease is of interest to the physicians who treat such patients and the legal system which may have to deal with the repercussions of such a transmission. Bite injuries represent 1% of all emergency department admissions in the United States, and human bites are the third most common following those of dogs and cats. The worldwide epidemic of HIV and acquired immunodeficiency syndrome (AIDS) continues, with >5 million new cases last year and affecting 1 in 100 sexually active adults. A review of the literature concerning human bites, HIV and AIDS, HIV in saliva, and case examples was performed to examine the current opinion regarding the transmission of HIV via this route. A bite from an HIV-seropositive individual that breaks the skin or is associated with a previous injury carries a risk of infection for the bitten individual.     

Worldwide experience in sales taxation: Lessons for North America

Worldwide fiscal experience over the past twenty-five years indicates steady expansion in the political and academic constituency for expenditure taxation, including indirect taxes on consumption. Retail levies have emerged as the preferred method of indirect taxation of consumption, as older, pre-retail sales taxes have proven unsuited to modern economic structures. Increasingly, reform of sales taxation has involved a shift to one particular form of tax, the European Community type of value-added tax (VAT). This consumption tax option is again a topic of policy debate in North America, particularly in Canada where a VAT was under active consideration in 1985.This paper sifts through worldwide experience with broad-based sales taxes to identify lessons for tax policy in North America both in the short and longer-run. It indicates that the reputation of such taxes as regressive instruments may have been much exaggerated, and that in any case methods are available, particularly in Canada, for resolving equity issues in sales taxation. The VAT is shown to have marginal economic and administrative advantages over single-stage federal retail taxes in both Canada and the US. However, these advantages are not nearly so significant as in European countries where the VAT was adopted there. Further, sensible debate over the merits and limitations of the VAT in North America will call for much closer scrutiny of the problems unique to this form of tax. Finally, three political issues that were not significant in Europe will likely have an important bearing on any future choices of sales tax instruments, both in the U.S. and in Canada.     

Reviews

Sidney Bloch and Peter Reddaway, Russia's Political Hospitals: The Abuse of Psychiatry in the Soviet Union. London: Victor Gollancz, 1977. 510 pp.

Richard B. Remnek (ed.), Social Scientists and Policy Making in the USSR. New York: Praeger Publishers, and London: Martin Robertson, 1977. xi+144 pp. £10.90.

Boris Shragin, Protivostoyanie dukka. London: Overseas Publications Interchange, 1977. 316 pp.

Murray Yanowitch, Social and Economic Inequality in the Soviet Union. London: Martin Robertson, 1977. xv+197 pp. £8.85.

Ulrich Hewer, Zentrale Planung und technischer Fortschritt. Probleme seiner Organisation und Durchsetzung am Beispiel der sowjetischen Industrie. Berlin: Duncker & Humblot, 1977. Vol. 84, Series I of Giessen Monographs in Agricultural and Economic Research on Eastern Europe. 225 pp.

Donald W. Green and Christopher I. Higgins, SOVMOD I. A Macro‐econometric Model of the Soviet Union. New York and London: Academic Press, 1977. xxii+312 pp. $22.50. £15.95.

Harry G. Shaffer (ed.), Soviet Agriculture: An Assessment of Its Contributions to Economic Development. New York: Praeger Publishers and London: Martin Robertson, 1977. 167 pp. £11.70.

Connie M. Friesen, The Political Economy of East‐West Trade. New York: Praeger, 1976 and London: Martin Robertson, 1977. ix + 203 pp. £13.75.

Gunnar Adler‐Karlsson, Studien über Wirtschafts‐ und Systemvergleiche. Band 7: The Political Economy of East‐West‐South Cooperation. Vienna and New York: Springer Verlag, 1976. 208 pp. DM 48.—. S330.—.

Jozef M. van Brabant, East European Cooperation. The Role of Money and Finance. New York: Praeger Publishers, 1977. xxv+395 pp.

Martin McCauley (ed.), Communist Power in Europe 1944–1949. London: Macmillan Press, 1977. xxiii+242 pp. £10.00.

Lilly Marcou, Le Kominform. Le Communisme de guerre froide. Paris: Presses de la Fondation Nationale des Sciences Politiques, 1977. 360 pp. 120 F.

William S. Heiliger, Bibliography of the Soviet Social Sciences, Troy, New York: Whitston Publishing Co., 1978. 2 vols. v+966 pp. $65.00.