Citizenship, Consumerism and Local Government in Sweden

Recent developments in Swedish local government and central-local government relations have been characterized by re-regulation and cut-back strategies on the one hand and decentralization and deregulation on the other. In this article these developments are analysed as a dynamic process with contradictory features. Swedish society is becoming more and more differentiated and specialized with fewer mechanisms of collective socialization, but with more economic and strategic calculations on the part of central and local authorities, interest organizations and individuals. New formal rules are developed in order to handle conflicts and enhance public sector legitimacy. In the communes we can identify an ideological shift from viewing the commune as a political institution to regarding it as a service-producing company. In addition, citizens are increasingly looked upon as individual consumers rather than political citizens. Corresponding organizational solutions such as depoliticization, privatization and freedom of choice have been developed. However, as a reaction to communal consumerism there is also a growing interest in communitarian values. There is an increasing number of examples of people participating in matters of common nature and expressing their belonging to a community. An interesting question for future research is whether the observed contradictory tendencies will increase or decrease the legitimacy of the traditional democratic institutions at the communal level.     

Relationships between the deinstitutionalization of healthcare for patients with mental disorder, substance abuse, and isolated death

Isolated death (ID) (i.e., dying alone without anyone noticing for several days) has been suggested to be related to social isolation, mental disorder, and alcohol and/or drug abuse. A major transfer of patients with a mental disorder and/or alcohol and/or drug abuse from institutionalized care to treatment as outpatients has been enacted in Sweden during the past decade. On the basis of the assumption that such deinstitutionalization is likely to result in increased social isolation, our working hypothesis was that the incidence of ID among patients belonging to these categories has increased in Sweden. The present study involved all deaths subjected to a medicolegal examination in Stockholm County (with a population of approximately 1.9 million people) during the period 1992-2000. The pattern of ID (defined as cases involving a postmortem delay between death and discovery of at least 1 week), as well as the incidence of fatalities subjected to medicolegal examination with a record of mental disorder and/or alcohol and/or drug abuse was evaluated. Throughout this period, the proportion of the deceased with a record of a mental disorder was high among all the cases examined and higher still among the cases of ID, especially among those younger than 65 years of age. There was a rather limited increase in the incidence of ID and a much more pronounced increase in the number of former psychiatric patients whose deaths were subjected to medicolegal examination, but did not satisfy the criteria for ID. A record of alcohol and/or drug abuse was more common than a diagnosis of mental disorder among both the males and females who died at an age of less than 65, with a clear difference between the cases of ID and non-ID in the case of men. There was no significant increase in incidence over the course of this study. Thus, this study reveals a slight increase in the number of IDs and a more pronounced increase in the number of medicolegal examination of non-IDs of individuals with a record of a mental disorder.     

Voting competitions with interested politicians: Platforms do not converge to the preferences of the median voter

We examine equilibrium voting strategies for elections with interested politicians facing uncertainty about voter pReferences. If politicians' utilities are defined over the set of strategies that voters select (instead of being dependent only on the probability of winning an election), equilibrium strategies will diverge (instead of converging to the median voter's pReferences) as long as politicians have different pReferences. We present conditions (i) for political compromise, and (ii) for politicians with different utility functions to merge into parties with complete strategic agreement.     

Acute Influence of Alcohol,THC or Central Stimulants on Violent Suicide: A Swedish Population Study

Alcohol and substance abuse in general is a risk factor for suicide, but very little is known about the acute effect in relation to suicide method. Based on information from 18,894 medico‐legal death investigations, including toxicological findings and manner of death, did the present study investigate whether acute influence of alcohol, tetrahydrocannabinol (THC), or central stimulants (amphetamine and cocaine) was related to the use of a violent suicide method, in comparison with the nonviolent method self‐poisoning and alcohol‐/illicit drug‐negative suicide decedents. Multivariate analysis was conducted, and the results revealed that acute influence of THC was related to using the violent suicide method–– jumping from a height (RR 1.62; 95% CI 1.01–2.41). Alcohol intoxication was not related to any violent method, while the central stimulant‐positive suicide decedent had a higher, albeit not significant, risk of several violent methods. The study contributes with elucidating suicide methods in relation to acute intoxication.     

Representation,Participation or Deliberation? Democratic Responses to the Environmental Challenge

The environmental question poses four challenges to democracy: global justice, intergenerational justice, the value of non-human species and technocratic decision-making. This article discusses these challenges in the light of three values or dimensions of democratic theory: representativity, participation and deliberation. It is found that even, if participation and deliberation by a broad set of actors are crucial to integrate democratic decision-making and environmental concern, there is also a need for representative institutions at all levels of society. The democracy–environment relation is not just about values and ideas. It also requires global, international, regional, national and local institutions armed with power resources.