Rational Choice,Agency and Thoughtfully Reflective Decision Making: The Short and Long-Term Consequences of Making Good Choices

Notions of human agency are a prominent part of some but not all criminological theories. For example, McCarthy (Annu Rev Sociol 28:417–442, 2002) argues that rational choice theory, which allows persons great involvement in decision making, is more congenial with notions of human agency than others. It would appear from his argument that rational choice theory offers fertile ground to develop a clearly defined role for human agency in criminal behavior. In this paper we have taken up McCarthy’s view and argue that an important part of what is human agency consists of thoughtfully reflective decision making. We outline four elements of thoughtfully reflective decision making, and claim that it is a characteristic that varies both across persons and within persons over time. It is in short the process by which good decisions are made because by using this process one increases the likelihood that choices made will be consistent with preferences. We develop a clear operational definition of thoughtfully reflective decision making and link it to the concept of human agency. We also articulate testable hypotheses about the short-term and longer-term implications of thoughtfully reflective decision making. We conclude with a discussion of what we think lies ahead for future conceptual and empirical work.

浅论毒品犯罪所侵害的法益

毒品犯罪法益研究对毒品犯罪的罪与非罪、此罪与彼罪的认定以及其他诸多问题的解决具有很大的意义。现有的关于毒品犯罪法益的诸多论述是错误的,会让我们在司法实践中产生混乱,也没有办法在理论上自圆其说。文章认为,毒品犯罪的法益是社会有机体的公共健康,我们的司法解释和司法实践应当在这样一个基本的认识之上进行。同时,毒品犯罪的法益又是随时间和空间而变化的,不能进行僵化的理解。     

Therapeutic jurisprudence and mental health tribunals: changing patterns of demand and its impact

For decades the mental health system has been ‘in crisis,’ with too little funding, too much demand and fragmented services. In England and Wales, decisions made concerning the care and treatment of those suffering from a mental disorder is governed by the Mental Health Act 1983 (as amended) (MHA 1983). Detention under the legislation is fraught with conflict; patient and clinical views are often at odds. Mental health tribunals enable patients to seek a review of their case and the legality of their detention. This paper argues that with the increased use of formal detention under the MHA 1983, the caseloads of mental health tribunals have similarly risen. Whether it is possible to advance therapeutic benefit to psychiatric patients attending tribunals is open to question. While mental health tribunals have a role to play in generating a positive psychological impact on an applicant, there is a risk that time and resource pressures may inhibit the adoption of a therapeutic approach. This paper considers the key drivers that are currently pushing detention rates up, the impact this is having on mental health tribunal caseloads and whether it is possible to bring therapeutic jurisprudence to the patient.     

Forty-five revolutions per minute: a qualitative study of Hybrid Order use in forensic psychiatric practice

Psychiatrists who recommend a Hybrid Order (Section 45A) as a disposal option at the point of sentencing accept that the convicted individual, as well as being mentally disordered and in need of treatment, is also culpable and deserving of criminal punishment. Ethical and clinical concerns have typically limited its clinical use. However, in 2015 the Court of Appeal specified in R v Vowles and others that the Hybrid Order disposal should be considered first in terms of potential mental health disposals. This judgement sets a high threshold for the use of the hospital order which has been the bedrock of inpatient forensic psychiatric practice since 1983. This study sought to explore the attitudes of consultant forensic psychiatrists towards the use of the Hybrid Order in the wake of the Vowles judgement. We interviewed 12 consultant forensic psychiatrists with longstanding experience of psychiatric sentencing recommendations. We found that the majority of consultants considered the Hybrid Order to be a valuable disposal option when used under specific circumstances. However, significant concerns were raised about its use in those with an enduring psychotic illness. Community aftercare arrangements for Hybrid Order disposals were viewed as inferior to community aftercare arrangements for Section 37/41 patients.     

Pledges not kept: JICA's project challenges in Ghana

Japan's project aid initiatives for capacity development still occupy a large part of the aid discourse of the country's development cooperation programme. Over the years, Japan's development rhetoric has been significantly adapted to the wider policy shifts of Western donor countries and has introduced in its programme and project documents such terms as ‘ownership’, ‘needs-based approach’, and ‘participatory’ initiatives in order to achieve more ‘sustainable’ results. Furthermore, the importance of ‘institutional memory’ has been repeatedly highlighted by Japan as an important element for greater project effectiveness. This article investigates how this development rhetoric translates in Japan International Cooperation Agency's (JICA) project practice in a three-year community-based initiative in rural Ghana. The results illustrate that despite the short-term benefits the project has brought to the targeted communities, the development practice of JICA falls short of its discursive representation and more effort is needed by JICA toward a more committed and inclusive project practice.     

The ‘Hybrid Order’: origins and usage

The hospital direction (Hybrid Order) was inserted into the Mental Health Act (MHA) in 1997 (Crime (Sentences) Act, 1997). It enables higher courts to direct hospital admission for offenders, whilst still imposing a prison sentence. The origins of the ‘Hybrid Order’ and its patterns of usage are examined. Comparisons are made with its Scottish equivalent, Section 59A of the Criminal Procedure (Scotland) Act 1995. Both the ‘Hybrid Order’ and Section 59A have been used infrequently. This may reflect the fact that they were strongly resisted on ethical grounds at their point of inception and that they force the psychiatrist into the position of ‘punisher’, rather than ‘treater’. Since the 2007 Amendment of the MHA in England and Wales which expanded the remit of the ‘Hybrid Order’ to include all legal categories of mental disorder, not solely psychopathy, its use has unsurprisingly increased – this article delineates the considerations that need to be given in its recommendation.     

Planning,Budgeting, and Health Care Performance in Ukraine

Abstract

The Government of Ukraine has not pursued health care reforms now commonplace in the rest of Europe and Central/Eastern Europe that rely less upon centralized, state delivery of services and more on decentralized operational responsibilities and competition for services that increase patient choice. The Ukrainian health sector suffers from personnel overspecialization and facility overcapacity, resulting in high-cost, low productivity services. Budget funds are unavailable for operations and maintenance resulting in poor quality services. The state provides health care as a constitutionally-protected monopoly, relying on the traditional command and control model which ignores cost/quality competition options and responsibilities to patients. Overall, the system which produces these results is over-centralized, requiring achievement of physical service norms without providing sufficient funds. The centralized system does not monitor or evaluate services beyond narrow financial accountability and control requirements. The health care system is paradoxically over-centralized but unable to regulate or control local health care official decisions to ensure compliance with national standards. Needed are reforms in the health care policy and operational areas to produce the supply of services needed for national economic recovery. In the short-term, the budgetary framework can be improved as an operational/management guide through development of comparative information on results. Most of this information can be based on the economic classification consistent with the chart of accounts. Funding stability can be increased to improve expenditure control by implementing a new fiscal transfer formula that provides discretion (i.e., block grants) and performance criteria (i.e., outcome measures). In the medium-term, building on the technical foundation of physical norms and statistical reporting, the health care budgeting and financial management system should shift emphasis to: program planning, policy and management analysis, and public communications. The results of these reforms should lead to decentralized health care operations, service analysis, and delivery responsibilities. At the same time, the reforms should lead to proper centralization of responsibilities for strategic policy decisions, safety regulation, national standards, and program evaluation.     

Short notices

Eastern Asia: An Introductory History, edited by Colin Mackerras. Longman Cheshire Pty Ltd., Melbourne, 1992. xiv + 639 pp., illus., tables, maps. Aus $18.99. ISBN 0–582–87005–4.

Asia Pacific: A view of its role in the New World Order, by M.S. Dobbs‐Higginson. Longman Asia Ltd., Hong Kong, 1993. xxviii + 422 pp., maps. £25.00. ISBN 962–000105–2

Korea Briefing 1993: Festival of Korea, edited by Donald N. Clark. Westview Press, Boulder CO, San Francisco and Oxford, in cooperation with The Asia Society, 1993. x + 249 pp. £9.95 paperback. ISBN 0–8133–8770–1.

Southeast Asian Affairs 1992, edited by Daljit Singh. Institute of Southeast Asian Studies, Singapore, 1992. x + 364 pp. S$ 26.00. ISSN 0377–5437.     

Are healthier people happier? Evidence from Chile and Uruguay

Based on data from the Latinobarómetro, this study analyses data on happiness to establish the probability that an individual is happy. The focus is put on self-reported health status as a key aspect in increasing levels of happiness. The probability of being happy is econometrically estimated by probit models for each country. Results show that the main relationship is between happiness and health status. Whether this is a causal effect or only a correlation, is not clear. This issue is explored by using propensity score matching methods. These show that good health status increases the probability of being satisfied with life by between 13 and 17 percentage points. In line with the literature, we find that the relationship between age and happiness is U-shaped, with happiness at its lowest point at the age of 48.2.

Les personnes en bonne santé sont-elles plus heureuses ? Données concrètes en provenance du Chili et de l'Uruguay

Sur la base de données tirées du Latinobarómetro, cette étude analyse des données sur le bonheur afin d'établir la probabilité du bonheur de personnes données. L'accent est mis sur l'état de santé présenté par la personne elle-même comme aspect clé du niveau croissant de bonheur. La probabilité de bonheur est estimée économétriquement au moyen de modèles probit pour chaque pays. Les résultats indiquent que le principal rapport est celui qui relie le bonheur et l'état de santé. Quant à savoir si c'est là une relation de cause à effet ou seulement une corrélation, ce n'est pas évident. Cette question est traitée au moyen de méthodes d'appariement par score de propension, qui montrent qu'un bon état de santé accroît la probabilité de se sentir satisfait de sa vie de 13 à 17 pour cent. Conformément aux documents écrits sur ce thème, nous constatons que le rapport entre l'âge et le bonheur est en forme de U, le bonheur atteignant son niveau le plus bas à l'âge de 48,2 ans.

¿Son más felices las personas sanas? Hallazgos en Chile y Uruguay

A través del Latinobarómetro para Chile y Uruguay 2007, se estima a través de modelos probit la probabilidad de que un individuo sea feliz. La principal correlación positiva se da entre la felicidad y el buen estado de salud. A efectos de controlar la potencial heterogeneidad observable de esta variable, se utilizan técnicas de correspondencia encontrando que tener buena salud aumenta entre 13 y 17 puntos porcentuales la probabilidad de ser feliz para los datos agrupados regionales. Consecuentemente con la literatura, se encuentra una forma convexa con respecto a la edad, siendo los 48.2 años la edad de mínima felicidad.

As pessoas mais saudáveis são mais felizes? Evidências do Chile e Uruguai

Baseado em dados do Latinobarómetro, este estudo analisa dados sobre felicidade para estabelecer a probabilidade de um indivíduo ser feliz. O enfoque é dado na condição de saúde auto-relatada como aspecto-chave para aumentar os níveis de felicidade. A probabilidade de ser feliz é econometricamente estimada por modelos probit para cada país. Resultados mostram que a principal relação é entre felicidade e condição de saúde. Se isto é um efeito causal ou apenas uma correlação, não está claro. Esta questão é explorada utilizando-se métodos PSM (Propensity Score Matching). Estes métodos mostram que boas condições de saúde aumentam a probabilidade de satisfação com a vida em cerca de 13 a 17 pontos percentuais. Em sintonia com a literatura, constatamos que a relação entre idade e alegria tem a forma de U, com a alegria em seu ponto mais baixo na idade de 48.2.     

试论卫生应急“机制”建设中不容忽视的几个问题

卫生应急工作要迈上科学发展轨道,应多关注从"机制"建设上找寻亟待解决的问题。本文拟从突发公共卫生事件特点及应急机制建设重要性入手,探究卫生应急机制建设过程中尚存的"拦路虎",找寻卫生应急机制建设应对之策,即:关口前移,建立应急预案动态更新机制;瞄准实战,建立突发疫情应对处置机制;筑牢"后墙",建立突发事件储备保障机制;紧盯"重心",建立医院危机攻关应急机制。