book annotations - new york university journal of...

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BOOK ANNOTATIONS

DROBAK, JOHN N., NORMS AND THE LAW (New York, New York:Cambridge University Press, 2006).

ELLISON, HERBERT J., BORIS YELTSIN AND RUSSIA’S DEMOCRATIC

TRANSFORMATION (Seattle, Washington: University ofWashington Press, 2006).

INGEBRITSEN, CHRISTINE, IVER NEUMANN, SIEGLINDE GSTOHL,AND JESSICA BEYER, EDS., SMALL STATES IN INTERNATIONAL

RELATIONS (Seattle, Washington: University of Washing-ton Press, 2006).

KELLMAN, BARRY, BIOVIOLENCE: PREVENTING BIOLOGICAL TER-

ROR AND CRIME (Cambridge, United Kingdom: Cam-bridge University Press, 2007).

MURPHY, RAY, UN PEACEKEEPING IN LEBANON, SOMALIA, AND

KOSOVO (Cambridge, United Kingdom: Cambridge Uni-versity Press, 2007).

NORDSTROM, CAROLYN, GLOBAL OUTLAWS: CRIME, MONEY, AND

POWER IN THE CONTEMPORARY WORLD (Los Angeles, Cali-fornia: University of California Press, 2007).

SAXON, DAN, TO SAVE HER LIFE: DISAPPEARANCE, DELIVERANCE,AND THE UNITED STATES IN GUATEMALA (Berkeley, Califor-nia: University of California Press, 2007).

VAN HARTEN, GUS, INVESTMENT TREATY ARBITRATION AND PUB-

LIC LAW (Oxford, United Kingdom: Oxford UniversityPress, 2007).

WICKS, ELIZABETH, HUMAN RIGHTS AND HEALTHCARE (Portland,Oregon: Hart Publishing, 2007).

615


616 INTERNATIONAL LAW AND POLITICS [Vol. 40:615

Norms and the Law. Edited by John N. Drobak. New York, NewYork: Cambridge University Press, 2006. Pp. ix, 298.$75.00 (hardcover), $29.99 (paperback).

REVIEWED BY CLAY H. KAMINSKY

Although norms, extralegal rules that govern human be-havior, have long played a prominent role in sociologicalscholarship, only recently have they attained a degree of im-portance in legal analyses. In this burgeoning area of legalinquiry, Norms and the Law may prove a valuable catalyst and aroadmap for future research. A collection of essays firstpresented at the inaugural conference of the Center for Inter-disciplinary Studies at the Washington University School ofLaw, this slim volume brings together theoretical and empiri-cal research by leading scholars in the fields of law, economics,and political science. Although anyone interested in the rela-tionship between law and society will enjoy Norms and the Law,those wishing to conduct their own research will find it espe-cially useful, since the essays do more to frame thoughtfulquestions than to provide complete answers.

The book is divided into four thematic parts. Part oneinvestigates how norms influence the law within the frame-work of behavioral economics and cognitive science. Part twoexamines cooperative norms of the commons. Part three isdevoted to judicial norms, both institutional and individual.Part four discusses the role of the law in shaping extralegalnorms.

In part one, “Rationality and Norms,” three essays con-sider the interplay between individual rationality and societalnorms in the context of group decisionmaking. Cass R. Sun-stein confronts the problem directly in his essay, “Damages,Norms, and Punishment,” which presents evidence from hissurvey of jury decisionmaking in personal injury cases. Profes-sor Sunstein relates that although individuals rate the cases insubstantially similar ways on a numbered scale, there is noagreement on how their assessments should be converted intomonetary damages. Professor Sunstein finds that the effect ofgroup discussion is to drive juries to the extremes, decreasingaverage lower awards and raising higher ones. Analyzing thesefindings in the context of social norms, Professor Sunstein ten-tatively suggests that institutional redesign may be needed to


2008] BOOK ANNOTATIONS 617

bring a degree of rationalization and standardization to juryawards.

The other two essays in part one challenge the dominantrational-choice model of economics. In his essay, “CognitiveScience and the Study of the ‘Rules of the Game’ in a World ofUncertainty,” Douglass C. North moves beyond the assump-tion of rationality to examine the problem of uncertainty.Drawing on cognitive science for the proposition that humans’understanding of external reality is internally constructed,Professor North catalogues the problems of constructing the-ory and policy in a nonergodic world—that is, a world thatlacks a fundamental underlying unity that would allow extra-polation to new circumstances. Professor North illustrates hispoint with the example of the collapse of the Soviet Union andpredicts that cognitive science will play an increasingly impor-tant role in social and economic theory.

Lynn A. Stout attacks the other assumption of the ra-tional-choice model: that economic actors are motivatedpurely by self-interest. In her essay, “Social Norms and Other-Regarding Preferences,” Professor Stout finds empirical sup-port for what she calls “other-regarding preferences” in threetypes of experimental games: social-dilemma games, ultima-tum games, and dictator games. People will sometimes foregomaximizing their own payoff in order to help or harm others,and they behave as though they expect others to exhibit simi-lar other-regarding preferences. Professor Stout suggests thatan awareness of other-regarding norms will lead to a deeperunderstanding of social phenomena.

In part two, “Norms of the Commons,” Robert C. Ellick-son and Lawrence Lessig use their essays to explore the normsof the commons by focusing, respectively, on a microcosmiccommons, the household, and perhaps the largest commonsthe world has ever known, the internet. Confining his discus-sion to “liberal households,” in which there exists a freedom ofexit, Professor Ellickson considers the production and alloca-tion of household surpluses in his essay, “Norms of the House-hold.” Professor Ellickson describes how, since much of theincreased utility of cohabitation comes from the low transac-tion costs associated with trust, informal household norms andconsensus govern the household as long as residents expect tocontinue living together, but external norms and the law gainimportance once exit is anticipated. Drawing analogies to cor-



porations, Professor Ellickson demonstrates how residual con-trol rights generally accompany the contribution of at-risk cap-ital in a liberal household.

In his essay, “.commons,” Professor Lessig describes cyber-space as a commons. Although its physical infrastructure isprivately owned and much of its content is also privatelyowned, the internet’s logical level, with its nondiscriminatoryend-to-end structure, makes it a commons based on the under-lying norm of open source code. Extolling the creativity theinternet has enabled, Professor Lessig concludes his essay bycataloguing different types of cyber-enclosure threats.

In the third and final essay of part two, Juan Camilo Car-denas and Elinor Ostrom bring the lab to the field in order tocontrol for such factors as culture, group identity, and socialcontext. Conducting social experiments in three Columbianvillages, the authors elaborate a four-level framework to ap-proach collective-action phenomena in their essay, “HowNorms Help Reduce the Tragedy of the Commons: A Multi-Layer Framework for Analyzing Field Experiments.” Theirdata and analysis shed particular light on the social norm ofreciprocity and its influencing factors.

Part three, “Judicial Norms,” consists of three essays and aresponse, “Judicial Norms: A Judge’s Perspective,” by JudgeHarry T. Edwards of the D.C. Circuit Court of Appeals. BothLawrence M. Friedman and Kathryn Abrams consider the pos-sible effects of social influence on judicial rulings. ProfessorFriedman addresses the question broadly in his essay, “Judgingthe Judges: Some Remarks on the Way Judges Think and theWay Judges Act,” concluding that although judges are by andlarge independent, they are neither truly autonomous nor im-partial and that research should focus on the social forces thatshape judicial behavior. Judge Edwards disagrees with Profes-sor Friedman’s conclusions and criticizes his logic and assump-tions. Although Judge Edwards shares Professor Friedman’sobjective that judges remain committed to principled decision-making, he believes that judges remain significantly con-strained by discernible legal principles.

In her essay, “Black Judges and Ascriptive Group Identifi-cation,” Kathryn Abrams investigates judicial interdependencein light of one powerful social force: racial affinity. Focusingher research on African-American judges, Professor Abrams



considers both empirical studies on the degree to which judi-cial decisionmaking covaries with the race of the judge andalso extended narratives by African-American judges on howrace affects their judicial lives. Finding that race is not a relia-ble determinant of the judicial decisions of African-Americanjudges, with the slight exception of criminal sentencing wherea degree of covariance likely indicates not bias but a freedomfrom bias, Professor Abrams shows that the principal effect ofa judge’s race is his or her sense of civic responsibility towardan ascriptive community. Judge Edwards, himself an African-American judge, commends Professor Abrams’s research andconsiders the question, “if ascriptive group membership islargely irrelevant in the judicial process, then why worry aboutracial or sexual diversity on the federal bench?” In response,he suggests that a diversity of personal perspectives enrichesjudicial deliberations and enhances decisionmaking.

If Professors Friedman and Abrams are concerned prima-rily with judicial autonomy and impartiality, John Ferejohnand Larry D. Kramer focus instead on judicial independencein their essay, “Judicial Independence in a Democracy: Institu-tionalizing Judicial Restraint.” The authors begin with theproposition that judges are individually insulated from the po-litical process, but the judiciary as an institution is vulnerableto the degree that the political branches could refuse to exe-cute judicial decisions, cut the judiciary’s budget, or strip judi-cial jurisdiction. From this proposition, Professors Ferejohnand Kramer trace out judicial doctrines embodying restraint,including the rules of justiciability, federal-question jurisdic-tion, and constitutional interpretation. Judge Edwards agreeswith the authors’ doctrinal conclusions but suggests that po-tential non-enforcement is the sole threat that truly encour-ages judicial restraint. Judge Edwards also develops the ideathat collegiality is an important component of judicial re-straint.

Finally, part four, “The Influence of Law on Norms,” iscomprised of a sole essay in which Amartya Sen examines theproblematic propensity of law to shape social norms. Accord-ing to Professor Sen in his essay “Normative Evaluation andLegal Analogues,” human rights norms have suffered from theanalogy between morality and law in at least two distinct ways.First, the analogy may suggest that normative rights not codi-fied into positive law are not as legitimate as legal rights. Sec-



ond, the dominant political analogy of societal organization toa hypothetical legal contract forecloses many other ap-proaches that may be especially valuable in the area of globaljustice.

Professor Sen recognizes that laws and norms cannot andshould not be coextensive, and he does not suggest that draw-ing analogies between the two is always harmful. On the con-trary, Professor Sen suggests that such analogies may be gener-ally helpful. It is simply critical that more scholarly attentionbe directed at the nature of the analogies drawn. Norms andthe Law marks a commendable step in this direction, and itsauthors do much to suggest where further steps should follow.

Boris Yeltsin and Russia’s Democratic Transformation. By HerbertJ. Ellison. Seattle, Washington: University of WashingtonPress, 2006. Pp. xii, 263. $30.00 (hardcover).

REVIEWED BY NANCY HULL

More theoretical than a biography and less descriptivethan a reference book, Boris Yeltsin and Russia’s DemocraticTransformation provides in-depth insight into the Russian tran-sition of the early 1990s. With both new and old problems inRussia making the news every day, the historical developmentsdriving one of the most influential political transformations inthe modern world are increasingly relevant. Herbert J. Ellisonprovides this history through a detailed analysis of the transi-tion’s prominent leader: Boris Yeltsin. The book’s main ob-jective is to present Yeltsin—who is, in the author’s opinion,under-analyzed and under-appreciated in current politicalliterature—as the force behind Russia’s democratization. Elli-son achieves this goal convincingly.

The book begins with an overview of Yeltsin’s political ca-reer. The author praises Yeltsin as a career politician who rosequickly through the ranks of the Communist Party only to beexpelled from the Politburo for uncensored criticism of hisshort-sighted colleagues. Yeltsin then built up his own powerbase within Russia, survived a coup attempt, and led the firstindependent, non-communist Russian state through a criticalphase in history.

Ellison next reviews the tumultuous years preceding Yelt-sin’s presidency. The book portrays Yeltsin as a major factor in



the growing democratic transformation that provoked acounter-revolutionary coup attempt in August 1991. Yeltsinbegan as a reformer trying to change the system from within.As an impressive local leader in Sverdlovsk, one of the SovietUnion’s most important industrial regions, Yeltsin was quicklypromoted within the Communist Party and moved to Moscow.Once in the capital, however, Yeltsin’s relations withGorbachev and other Communist leaders deteriorated. WhileGorbachev’s mission was reform, Yeltsin eventually became anoutspoken critic of Gorbachev’s policies as well as the socialiststate in general. Finally, Yeltsin lost faith in the possibility ofreforming the Party from within and ultimately resigned hispost by making a spontaneous speech during a plenary sessionof the Central Committee that attacked many prestigiousmembers of Soviet government and virtually all of Gorbachev’sreform policies. While simultaneously dealing with gravehealth problems, Yeltsin was then forced to apologize to theParty. Gorbachev responded by naming Yeltsin a USSR minis-ter, thus removing him from all policymaking aspects of gov-ernment.

Undeterred by these setbacks, Yeltsin entered politics in-side the Russian Federation and worked against the Party tooverwhelmingly win election to the Congress of People’s Dep-uties and the Supreme Soviet as a representative of the RussianRepublic. Yeltsin worked tirelessly for reform in the RussianRepublic, stressing economic reform, democracy, and sover-eignty. Eventually, Yeltsin completely parted ways with theCommunist Party, resigning his membership and focusingsolely on democratization in Russia. Once outside of the partysystem, Yeltsin was able to build up support within the quicklychanging Russian Republic and to begin implementing re-forms. Yeltsin’s first major change was to oversee passage oflegislation creating a popularly elected president for Russia.As a popular leader, Yeltsin easily won election to the presi-dency after the Russian Congress of People’s Deputies passedhis new legislation. These actions provoked an attemptedcounter-revolutionary coup that provided Yeltsin the perfectopportunity to rally opposition against conservative politiciansand to become the primary nationalist leader in Russia afterthe coup’s failure. As the Russian president, Yeltsin was a cru-cial figure in the breakdown of the Communist Party as well asthe entire Soviet Union.



The second section of the book covers Yeltsin’s turbulentpresidency in the newly independent Russian state. The firstchapter in this section depicts Yeltsin’s determined fight forconstitutional reform against an increasingly resistant Duma.Despite many challenges, Yeltsin succeeded in implementing ademocratic constitution by dissolving the Supreme Soviet andholding elections, as well as a popular referendum on thedraft constitution in 1993. This constitution included provi-sions for a new parliament, the Federal Assembly, consisting ofthe State Duma and the Council of the Federation. It also pro-vided for extensive restructuring of local and regional govern-ment. These successes were, however, hard-won for Yeltsin,who faced vigorous opposition to his every move. Yeltsin strug-gled throughout his eight years in office against persistenthealth problems as well as an increasingly uncooperative legis-lature and endured repeated impeachment attempts. As such,Boris Yeltsin and Russia’s Democratic Transformation attributesYeltsin’s success in implementing a democratic constitution tohis political skill and steadfast commitment to democracy inRussia. Near the end of Yeltsin’s presidency, strong politicalopposition created an impasse that prevented Yeltsin from ad-equately responding to the escalating economic and social cri-sis in Russia.

The following chapter focuses on the economic reformthat took place during the Russian transition. WhileGorbachev was committed to maintaining the Soviet Union’ssocialist economy, Yeltsin espoused the need for a marketeconomy and reform in private enterprise, land, and agricul-ture from the beginning of his political tenure. In October1991, Yeltsin presented his economic plan for Russia to theRussian Supreme Soviet. This plan called for price liberaliza-tion, enterprise privatization, and conversion of collectivefarms to private landownership, but it was rejected as “too lib-eral” by Gorbachev. Gorbachev’s long delays in implementingreal economic and agricultural reforms left Yeltsin with agreatly complicated situation when he eventually took controlof the Russian state as President. Yeltsin spent his two presi-dential terms working to remedy these problems with only lim-ited results. Despite the unfinished nature of his reforms, Yelt-sin left office having achieved irreversible privatization in bothurban and rural economies. Key to this chapter is Ellison’sportrayal of Yeltsin’s political opposition. The book contends



that the powerful opposition challenging Yeltsin at every cor-ner stalled Yeltsin’s reforms and resulted in great hardshipand poverty for Russian citizens.

The final section connects Russia’s transformation to therest of the world by looking at Yeltsin’s foreign policy with re-spect to the West, East Asia, and former Soviet Republics. Bol-stered by the end of the Cold War under Gorbachev, Yeltsinwas left with the task of cultivating new international relation-ships around the globe. Ellison divides Russia’s relationshipwith foreign states into three phases. The first was the initialmove towards partnership with democratic states. The secondphase consists of Russia’s disappointment with the West’s lackof support for its transitional economy and refusal to includeRussia in global security systems such as NATO. Finally, Russiabegan to view the United States as the sole hegemonic super-power rather than as a potential partner. As a result, Russiapursued “strategic partnerships” with China and other states tocounteract the U.S. influence in the world.

The book concludes with a brief look at the state of Russiaupon Yeltsin’s exit from politics. Yeltsin choose his successor,Vladimir Putin, by appointing him prime minister in August1999. He felt Putin shared his commitment to democracy, amarket economy, and peaceful foreign policy with a focus onintegration into the world economy. Like Yeltsin, Putin wouldface many challenges, including strong political opposition.Yeltsin had created a key tool through which Putin could re-solve these conflicts, however: democratic parliamentary andpresidential elections under the new constitution. Addition-ally, Yeltsin created a strong institutional legacy of checks andbalances in the governmental system that would help Putincontinue executing the broad reforms that Yeltsin had workedso hard to install in the newly independent Russia.

As an in-depth study for someone interested in the detailsof the political restructuring that took place during the firstdecade of post-Soviet Russia, this book is an invaluable re-source. Ellison presents Yeltsin as the primary figure in thistransition, an interesting and unique theory in a field thatoften attributes the beginning of Russia’s democratization toGorbachev. In doing so, however, it often seems that thebook’s objective tone is lost in favor of a strong pro-Yeltsinbias. The author’s high opinion of Yeltsin is overwhelminglyapparent throughout the book and leads one to wonder



whether the limited criticism presented of Yeltsin is lacking inthoroughness. A further weak point for a non-expert reader isthe assumption that one is familiar with Russian governmentalinstitutions and political characters. The political backgroundof many government officials and institutions involved in im-plementing reforms is brushed over in the all-encompassingfocus on Yeltsin. Nevertheless, Boris Yeltsin and Russia’s Demo-cratic Transformation presents a well-informed examination ofone of modern history’s most important figures as well as adetailed explanation of the processes and events that defineRussia’s condition today. As such, this book is valuable for un-derstanding the current political context in Russia, and istherefore a worthwhile contribution to current political litera-ture.

Small States in International Relations. Edited by Christine In-gebritsen, Iver Neumann, Sieglinde Gstohl, and JessicaBeyer. Seattle, Washington: University of WashingtonPress, 2006. Pp. 352. $30.00 (paperback).

REVIEWED BY RYAN SHANOVICH

Imagine a tiny polity with a population well under 50,000people—the U.S. Census Bureau’s cut-off for “urbanized ar-eas”—that is also an original member of the World Trade Or-ganization, has been admitted as a party to the Statute of theInternational Court of Justice, and is an active member in theUnited Nations. What’s more, this polity’s population consistsof well over one-third foreigners. The international accept-ance of Liechtenstein’s statehood reflects the laudable adapta-bility and adroitness of small states, as well as our need to studythem closely. Small States in International Relations is a compila-tion of essays that challenge the prevailing pedagogical ap-proach to international relations—that of merely studying thesuperpowers or large states.

In the text’s introduction, Iver B. Neumann and SieglindeGstohl, two of the book’s four editors, explain the value ofstudying small states as opposed to focusing on giant powers.Following the Napoleonic War, ideas of state puissance dividedthose states privy to the Congress of Vienna from others thatwould merely be consulted. Later, “middle powers” would be-come a classification, as would “small powers,” a group later to



be known as “small states.” It is not surprising, the editors tellus, that small states are confused with weak states; however, weare reminded that “the former is a distinction of quantity, thelatter of quality.” And though the disparate ways to define“smallness” manifest themselves throughout this collection,the ultimate message is not one of classification but of appro-priate analysis. The essays included provide such analysisalong definitional, economic, and political lines.

The book begins with an excerpt from Annette BakerFox’s text, The Power of Small States: Diplomacy in World War II,in which Fox compares the wartime experiences of five Euro-pean states with a shared purpose: non-participation in hostili-ties and resistance of belligerents. Fox’s chronology empha-sizes that small states—in this instance, Turkey, Finland, Nor-way, Sweden, and Spain—could put the entirety of theirwartime efforts into avoiding hostilities and, through a shiftingset of maneuvers, convince the great powers that respectingthis neutrality was in their best interest. In so doing, Fox high-lights how different circumstances increased the neutrals’ abil-ity to resist pressures. Additionally, small states could play thepowers’ interests off of each other. Though the reader is leftdesirous of concrete examples, the message is clear: smallstates need not wither to great power demands in even themost exigent circumstances, though many things will be out oftheir control.

Robert O. Keohane’s chapter, “Lilliputians’ Dilemmas:Small States in International Politics,” navigates the bounda-ries of defining small states by questioning whether we shouldprefer David Vital’s arbitrary yet clear definition of small statesbased on population and economy or search for a definitionamenable to manipulative analysis. Keohane posits that weshould determine “smallness” by gauging the systemic role ofstates. This definition balances the systemic power that a statewields with its own perceived role. Keohane’s review ends bycontrasting the positions on nuclear proliferation of two schol-ars, Robert Rothstein and Robert Osgood. Though Keohanedoes not endorse either position—Rothstein suggests theUnited States may even give nuclear weapons to threatenedstates to inhibit proliferation (an idea replete with contradic-tion) and Osgood weighs in on the inefficacy of guarantees—he does find that “restraint-withdrawal-containment should beseriously considered.”



Keohane’s piece is followed by the introduction to Vital’s1967 book, The Inequality of States: A Study of the Small Power inInternational Relations, which explains the need to study smallstates in nonalignment as the only point at which such statesare fully dependent upon their own resources and ability. Theshellshock of the Cuban missile crisis and the Cold War imbueVital and Keohane’s theoretical underpinnings, but there ismuch value in comparing today’s world with their prognostica-tions.

Highlighting the ineffableness of “statehood,” Jorri Duur-sma’s chapter, entitled “Micro-States: The Principality ofLiechtenstein,” challenges the traditional characteristics of na-tions through a brief yet comprehensive history of Liechten-stein’s unlikely rise to statehood. The background Duursmaprovides is exhaustive, leading us from the incipient statehoodthat Napoleon granted the Prince of Liechtenstein in a displayof camaraderie to the State’s growing twentieth century in-volvement in international relations. Duursma effectively de-lineates Liechtenstein’s route to statehood, highlighting itsbreak with Austria and subsequent delegation of sovereignpowers to Switzerland. The facts surrounding Liechtenstein’screation serve to destroy traditional notions of state creation,as this state is of infinitesimal size, has arguably no autochtho-nous culture or language, and is composed of large numbersof foreigners. Nevertheless, the international status of Liech-tenstein’s statehood is indisputable today, a contingency un-doubtedly unforeseen by Prince Johann von Liechtenstein,who purchased this part of the ancient Roman province ofRhaetia in a political maneuver three hundred years ago.Though lacking in theory or critical application, this chapter isfar and away the most enthralling section of the book. As thereader traces the toddler steps of a micro-state’s formation, theingenuity and vulnerability of Liechtenstein reminds us that instate power it is not the size that counts (62 square miles), northe population (34,000 and counting), nor the military (whatmilitary?), but the state’s capacity to create an internationalpersona. Indeed, Duurma’s analysis results in state personifi-cation, and one cannot help but imagine the nervous care andsubsequent anxiety of Liechtenstein during its application tothe League of Nations. The application, which it had to handin through the Swiss Minister in London (the official in chargeof Liechtenstein’s diplomatic communication), was denied.



With the enormous economic success of oil-rich MiddleEastern states in the closing decades of the Cold War, theworld witnessed a paradigm shift in defining smallness. Withthe prodigious proceeds of the oil trade, a new breed of eco-nomically strong but militarily weak states emerged. Thesenew states were capable of what Michael Handel, in an excerptfrom his book, Weak States in the International System, calls “re-verse imperialism.” The apprehension regarding these statesis palpable throughout the text. Handel outlines commodity-driven states and suggests that state size has much to do witheconomic independence and strength. In noting that one-di-mensional economies often lead to political dependence,Handel claims there is much to be gained from taking the riskof diversification, as Serbia did in route to bucking its eco-nomic subordination to Austria. However, Handel rightfullycontrasts Serbia’s success with Cuba’s continued struggle withpolitical independence. The essay ends with quite an apoca-lyptic tone—not uncommon for a piece written in the ColdWar era—as Handel posits that the economic pressure on theWestern powers “could lead to an economic disaster or even tothe extinction of the industrial civilization.” The point is clear:do not push the West too far, lest you suffer its military might.Handel is clearly referring to “the Arabs,” whose tactics hecompares to Germany’s prior to WWII. Overall, Handel fallsinto the characteristic paranoia of Western states’ dealingswith developing countries and the East and overestimates thepower of developing countries with commodity-driven econo-mies and no oil.

The subsequent two excerpts must be read in conjunc-tion, as the first, by Peter J. Katzenstein, is followed by a cri-tique by Baldur Thorhallson modifying Katzenstein’s theoryon the role of “corporatism” in small states in the EuropeanUnion. Democratic corporatism becomes the savior of thesestates, as they slowly lose their comparative advantage in pro-duction with the opening of the world market. Democraticcorporatism, Katzenstein states, copes with change by using apolitical mechanism rather than an institutional solution. Farfrom transmitting perfect social harmony, democratic corpo-ratism offers a procedural mechanism for arriving at a politi-cally agreeable solution to economic hardship in a manner im-possible in larger states. In the United States, corporatismleads to political exclusion and protectionism—as manifested



by the growing number of voluntary restraint agreements be-tween large market economies—while small states hop alonglike resilient amphibians. Thorhallson adds to the discussionby focusing on the maneuverability of small states outside oftheir domestic contexts. Unconstrained by the rigidities oflarge hierarchies and preordained policy, the roving adminis-trators of small-state international relations can rely on astronger political consensus and the manipulation of the Euro-pean Commission to achieve their principal goals. Thus,Thorhallson aggregates the size and characteristics of small-state administrations to demonstrate their capacity to make ec-onomic gains in an increasingly competitive world economy.

The final part of the book, “Small State Capacity in Inter-national Relations,” consists of works by Dan Reiter and Chris-tine Ingebritsen. This section shifts the book’s tone fromlargely a military- and economic-centric discussion to one oflearning theory and communitarian undertones. The shiftfrom theory to empiricism underlines Reiter’s study, “Learn-ing, Realism, and Alliances.” Unfortunately, Reiter takes enor-mous leaps of faith when applying organizational and learningtheory to small state alliance decisions from WWI throughWWII. Moreover, Reiter even suggests that his findings mayapply to great power behavior, since “organization theory andsocial psychology principles ought to apply to great power de-cision processes, too.” By using “learning experiences,” Reitermyopically deconstructs state decisionmaking, trumpeting thevalidity of his hypothesis even as he recognizes its limits. Thestudy compares winners’ decisions to maintain the status quoand losers’ decisions to change their game plan, producing avery unsurprising autocorrelation, as institutional inertia andalliances are hard to crack. This just proves, however, thatstates behave according to learning theory. Reiter’s conclu-sions are as hard to swallow as his experiment is falsifiable.

The book does not end on any more satisfying a note. In-gebritsen provides a quick discussion—so quick, in fact, that itseems more fitting for a newspaper article—of Scandinavianstates’ “lead” in international norm-creation. Ingebritsen’swork borders on braggadocio, providing an impressive but notoverwhelming list of Scandinavian contributions, such as theidea of sustainable development established by the BrundtlandCommission. She asserts that the United States has had to re-peatedly confront Scandinavian norms but gives no examples,



highlighting the lack of utility the article supplies to the seri-ous international relations scholar.

Overall, Small States in International Relations may providemuch to the critical reader willing to parse disparate theoriesthrough a historical lens. For the reader not vitally connectedto European small-states theory, however, this book is certainlynot a must-have.

Bioviolence: Preventing Biological Terror and Crime. By Barry Kell-man. Cambridge, United Kingdom: Cambridge Univer-sity Press, 2007. Pp. xxviii, 362. $28.99 (paperback).

REVIEWED BY KATE RHODES

In the hands of humans, the theory of natural selectionstands to become one of the world’s most dangerous weapons.Biological pathogens, naturally occurring poisons, and infec-tious diseases are manipulated by science for waging biologicalwarfare—a battle for which, expert Barry Kellman argues, theUnited States and the global community are not prepared.While some deem it a limited threat because of the seemingcomplexity behind the weaponization of pathogens and thesmall likelihood of wide-reaching effects, Kellman’s message isthat biological warfare is a serious threat. Written in almostencyclopedic style, Bioviolence: Preventing Biological Terror andCrime not only educates the reader on the scientific reality ofbiological weapons but also offers preventative policy strategiesto reduce this threat on a global scale.

Given the near-universal vulnerability of the human spe-cies to harmful pathogens, it is not surprising that Kellmanstructures his policy solutions in global terms. Like natural se-lection itself, the manipulation of natural influences of diseaseon the evolution of the human race employs forces over whichpeople are not meant to exert control. Kellman frames hisefforts as combating this most dangerous game, finding its par-ticipants guilty of “species treason.” The first part of the book,“The Bioviolence Condition and How it Came to Be,” outlinesthe threat posed by biological weapons, analyzes the variousagents and diseases capable of weaponization, and summarizesthe history of past biological warfare participants, includingtheories regarding which actors are most likely to make use ofbiological weapons in the future. The second part of the



book, “The Global Strategy for Preventing Bioviolence,” is di-vided into two parts. The first four chapters address generalideas that Kellman believes both states and the internationalcommunity should adopt, including the criminalization of bi-oviolence. This section also discusses obstacles surroundingthe enforcement of these proposed laws, the regulation of sci-entific research, and the preparedness of public health author-ities. The second part consists of a chapter outlining a planfor international nonproliferation of biological weapons and achapter detailing Kellman’s own vision of the end of the threatof bioviolence: a “Global Covenant” designed under the aus-pices of the United Nations (UN) to oversee and effectivelyexecute the mission for bioviolence prevention.

While first addressing the tools and delivery of biologicalwarfare, Kellman coins the term “bioviolence” to describe “theinfliction of harm by the intentional manipulation of livingmicro-organisms.” To him, this constitutes a criminal offense.He urges the reader to worry about bioviolence, which he de-scribes as the employment of a new kind of weapon targetedonly at other living things. Biological weapons are largelyanonymous and conceivably devastating, both in the delay be-tween the actual attack and their effects and in the widespreadpanic that can result.

Evaluating the potential harmfulness of several biologicalagents in turn, Kellman argues that anthrax is among the mosteffective, as it is easily made and weaponized. As with mostpathogens, the obstacle for the would-be user of anthrax is dis-semination: it is neither contagious nor easily inhaled in largeopen areas. There is also a stockpiled vaccine. The book of-fers a detailed discussion of the most effective means of creat-ing and disseminating anthrax, as well as sixteen other harm-ful pathogens including small pox, ricin, and mad cow disease.These discussions are detailed and the pathogens compared incomprehensive chart form.

Kellman addresses his publicizing of this potentially dan-gerous information with the disclaimer that the section is writ-ten to be intentionally vague and contains purposeful omis-sions and that “information about how to conduct bioviolenceis widely available.” As he notes, “unlikely as it might be thatthis book would be a reference for a bio-offender, I am hesi-tant to put such information in print.” The neophyte reader,however, is still given a wealth of hypothetical situations to



consider. These methods of bioviolence include both histori-cally-used agents such as the plague, tularemia, q fever, andricin as well as influenza and hemorrhagic fevers, botulinumin food, and “agroviolence,” the use of diseases that effect live-stock and crops. Advancements in technology through themicro-sciences also provide new modifications of old threats,as pathogens can be altered to resist vaccines or an agent’scharacter can be changed to survive in different environments.Synthetic genomics, the science of creating genomes from syn-thetic DNA, has produced synthetic viruses, RNA inhibitors,and bioregulators as well as recreated diseases such as polio inlabs.

After being immersed in this arsenal, the reader’s atten-tion is then turned to actors who have used biological weaponsin the past and those who would likely make use of them giventhe opportunity. Kellman is critical of those who believe thatthe use of biological weapons is too “repulsive” a threat to berealized: “To ignore th[e] extensive history [of the use of bio-logical weapons] and presume that today’s villains are not fer-vent about weaponizing disease is very dangerous.” He can-vasses the history of biological warfare, beginning with the an-cient world and moving on to the colonization of NorthAmerica, World War II, the Cold War, the apartheid era, andfinally the development of the Iraqi biological weapons pro-gram over the last 40 years. The historical overview is not fullycomplete, however, as Kellman did not have access to classifiedinformation on biological weapons development in Egypt orIsrael or on current activities in North Korea, Iran, and Syria.Therefore, the section on “current” or “alleged” state pro-grams analyzes the information publicly available on weaponsprograms in these countries, but the author speculates thatthere are more programs than those we might name. Suchstate programs are worrisome not only because of allegationsthat some states are sympathetic to terrorist organizations, butalso because Kellman’s plan of bioviolence prevention re-quires consensus-based global policies that cannot be realizedif some states have biological weapons programs. He antici-pates that modern-day state bioviolence is most likely to bedeployed against poor, segregated populations.

Finally, the last section analyzes the use of bioviolence byterrorist organizations, giving an overview of Al Qaeda’s activi-ties as well as a chart of attempted acts of bio-terrorism or



hoaxes. While this section is also notably affected by the un-availability of classified materials, Kellman believes the na-tion’s current perception of the threat from terrorist organiza-tions to be skewed: In his opinion, terrorist groups do not lackthe intention to use such weapons and “asserting they lack ca-pacity might be well-founded for the moment but offers abso-lutely no security for tomorrow.”

The second part of the book offers “The Global Strategyfor Preventing Bioviolence.” The first chapter of this sectionoutlines a four point overview of Kellman’s prevention strat-egy: “Prevention = Complication + Resistance + Preparedness+ Nonproliferation.” Each of the next four chapters addressesa separate factor in this formula, illustrating how states and theglobal community must adapt to prevent biological warfare.In considering these strategies, Kellman argues that the princi-ples of comprehensive security, distributive justice, and fairparticipation in the legal process must be at the core of imple-mentation. The final chapter of the book provides variousmeans of adopting the formula on a global scale through theUN.

The first element in Kellman’s prevention strategy, com-plication, simply makes it more difficult for would-be bio-of-fenders to access the materials necessary to create weapons.This chapter is divided into initiatives: denial tactics and thecriminalization of the development of biological weapons.Most significantly, only the actual commission of an attack iscriminal, and police lack the authority and ability to track thedevelopment and sale of pathogens. This reality calls for newmethods of tracking criminal bioscience and increased com-munication between law enforcement and bioscientists. Kell-man believes that complication policies should focus on know-ing where sensitive items are located and where they travel andpreventing wrongful access and theft while avoiding “monitor-ing individual bioscientists’ activities.” Access to harmfulpathogens should be controlled by creating census and track-ing systems like bar-coding as well as improving security at bio-laboratories to deny access to equipment and materials. In ad-dition, “[t]o effectively interdict [bioviolence]: 1) national lawmust authorize police to act and 2) law enforcers must haveenhanced capabilities for identifying covert bioviolence prepa-rations.” For example, the Weapons of Mass Destruction Com-mission has created comprehensive guidelines for the trans-



port of “biological materials” that should, according to the au-thor, be adopted by every country.

Second, resistance measures pose a “double-edgedsword,” as they concern the scientific advancement of vaccinesand medication—discoveries whose pursuit may result in polit-ical scenarios that are even more dangerous than the alterna-tive. Kellman believes that a large part of preventing biovi-olence must come from within the bioscience community it-self, by providing better training and whistleblower protectionto scientists as well as by creating a “professional certification”program. Of most prominent concern are issues concerningthe regulation of bioscience itself and the hindering of scien-tific discovery. Kellman, however, believes that self-regulationand ethical codes will not be effective without universal stan-dards and participation. With this in mind, he suggests “trans-lucency” as a guide to detection and deterrence policies. Afterregulation of the community itself, the second side of resis-tance is the creation of vaccines and medications.

The first element in Kellman’s prevention strategy,preparedness, supports both complication and resistancemethods and focuses on an effort to prevent bioviolence andrespond when it occurs. With quick response protocols, thecomplication of perpetuating such an attack is increased as theeffects are reduced and resistance is improved in the dissemi-nation of medicines in the aftermath. In terms of preventionstrategies, Kellman looks at practical measures to inhibit thespread of disease by guarding likely targets, namely “buildings,airplanes, subways, or sports arenas” with special attentionpaid to air and water supplies. Once an attack has been de-tected, various methods of containment can be introduced,such as vaccines for emergency workers and special locationsfor victim treatment. Quarantines, however, are politicallycomplex, effective only under certain short-lived conditions,and strictly regulated by the World Health Organization.

The fourth element, nonproliferation, stresses that bio-logical weapons must be observed and regulated carefully, asstates have both greater access to biological agents and moremeans with which to execute biowarfare than individual ac-tors. Kellman argues that the Biological Weapons Convention(BWC), signed over thirty-five years ago as the first treaty onbiological weapons, is abused and in need of reform. Kellmanprovides four recommendations on how to improve the Con-



vention, including revising the definition of biological weap-ons to include nonlethal pathogens, introducing criteria bywhich states can identify one another’s legal biological defenseactivities to increase trust, dismantling existing stockpiles of bi-ological weapons from the former USSR, and, finally, limitingof the scope of the BWC to address effective biological non-proliferation only and not other political ends. Most contro-versially, Kellman supports an expansion of biological weaponsclassification to include nonlethal pathogens, though he antic-ipates that critics of his proposal will respond by noting thatstates will have no incentive to create less harmful weapons.

Kellman would put all these strategies to use in the formof a global covenant regulated by the UN. Aware of the eco-nomic burden that adopting these strategies would pose formany states, Kellman does not separate the prevention of bi-oviolence from the general international fight against disease.Instead, he proposes the creation of three new bodies withinthe UN system: “1) a Commission on Bioscience and Security;2) a Bioviolence Prevention Office within the United NationsSecretariat; and 3) a Bioviolence Committee of the SecurityCouncil.” While the Commission would serve as the corner-stone, with the mission of increasing bioscience and defining“its standards of conduct,” the Office would assist individualstates to develop infrastructure and the Security Council Com-mittee would investigate questionable state activities. Accord-ing to Kellman, this would effectively bring the problem of bi-oviolence to the center of the world stage.

Throughout the book, Kellman is surrounded by ene-mies—terrorists, microbes, unresponsive governments, andnegligent scientists—a fact that sets the tone for the entirework. Despite this, his book is well structured, first demon-strating the significant threat of bioviolence and then offeringan extraordinarily comprehensive plan featuring numerousstrategic approaches for the prevention of biological attacks.Kellman’s expertise and research are wide-reaching, and Biovi-olence reads as a convincing and thoughtful authority on thethreat and prevention of biological violence. Kellman’s em-phasis on the urgent need for the world to acknowledge biovi-olence as its most significant and immediate threat, however, isonly briefly addressed in light of other global concerns. Un-fortunately, the official designation of bioviolence as our most



pressing threat is in the hands of the very governments thatKellman hopes to persuade.

UN Peacekeeping in Lebanon, Somalia, and Kosovo: Operationaland Legal Issues in Practice. By Ray Murphy. Cambridge,United Kingdom: Cambridge University Press, 2007. Pp.275. $112.00 (hardcover).

REVIEWED BY BINISH HASAN

United Nations peacekeeping has increased considerablysince 1985. Though set against diverse political, historical,and geographic backgrounds and with mandates that vary inbreadth, peacekeeping operations often face the same struc-tural, political, and legal issues. In UN Peacekeeping in Lebanon,Somalia, and Kosovo, Ray Murphy evaluates challenges posed tothese United Nations (UN) operations through three differentpeacekeeping operations: the United Nations Interim Forcein Lebanon (UNIFIL), the United Nations Operation inSomalia (UNSOM), and the United Nations Mission in Kosovo(UNMIK). Murphy tackles three broad problems with respectto peacekeeping: the unity of command and control, indeci-sion and restraint regarding the use of force, and violations ofinternational humanitarian law.

After touching on some basic issues surroundingpeacekeeping in the book’s introductory chapter, the authorspends chapter two exploring the failures and successes ofeach case study. He first looks at the UNIFIL operation inLebanon in 1978, a response to Israel’s invasion of southernLebanon during the Lebanese civil war. The operation wasplagued by a lack of clear consensus surrounding the mandateand thus was very conservative in terms of combat and enforce-ment actions. There was also a lack of strong support from theSecurity Council, as the Soviet Union abstained from every res-olution regarding UNIFIL. On the other hand, the UN’s op-eration in Somalia was a three-tiered mission beginning withUNSOM I, followed by the U.S.-led United Task Force(UNITAF), and ending with UNSOM II. Security Council Res-olution 814 authorized a multifunctional operation in UN-SOM II as it “demand(ed)” disarmament and “requested” na-tional reconciliation. However, Murphy uses UNSOM to illus-trate that a robust mandate is not enough to guarantee the



success of a mission. A robust mandate can also lead to theescalation of tensions, in direct conflict with a peacekeepingmandate. Finally, peacekeeping operations in Kosovo cameon the heels of the NATO intervention in the region andworked in conjunction with NATO’s Kosovo Force (KFOR).UNMIK’s operation was even broader than UNSOM’s, com-prising civilian administration, facilitation of a political pro-cess, and relief and reconstruction. The main problem of themission was that the Security Council did not give legal sanc-tion to statehood for the Kosovars, leading to tensions with thevery group the UN had intervened to aid. UNMIK was success-ful in aiding demilitarization of the Kosovo Liberation Army(KLA) and in preventing a civil war, but it failed to preventnumerous attacks on Serbian minorities.

Murphy argues in this chapter that legal confusionplagues the command and control structures of peacekeepingoperations. Part of the problem derives from the domesticcommand and control structures of member nations. As a so-lution to this problem, Murphy advocates a diffusion of com-mand within domestic governments as well as reforms withinUN operations. For example, Canada divides command andcontrol of armed forces between different branches of govern-ment. In Canada, military forces are also under Parliamentarycontrol, which has flexible authority to place Canadian forcesunder the control of a UN Force Commander. States withmore streamlined command structures that keep forces underexecutive authority, however, are more problematic. The au-thor uses the example of Ireland, which places military com-mand under the Minister of Defense, which itself has no flexi-bility to place Irish forces under UN control.

Murphy highlights the need for valid command and con-trol structures and for responsible member nations as well asthe UN Secretariat to reach workable solutions to these issues.He cites Canada as a model example. Aside from legal issues,the tendency of peacekeepers to maintain communicationwith their own countries regarding procedure and action is an-other widespread problem. This problem was particularlyacute in Somalia, where the United States retained full com-mand and control of its forces to the point where there was aparallel U.S. chain of command. This led to a lack of cohesionin the mission overall.



Chapter three is devoted to issues surrounding the ques-tion of the use of force. In peacekeeping operations, the useof force is authorized by the UN Security Council to achievethe relevant military mission or mandate and to protect per-sons or property within the operation. Murphy argues thatself-defense is the only justification for peacekeeping opera-tions and that peacekeeping should therefore be distinguishedfrom enforcement operations. He reasons that there is a dan-ger that lack of clarity in the designation of a mission will leadto disputes over legitimate uses of force and could lead to theUN becoming another party to the conflict it hoped to end.

UNIFIL is cited as an example of an operation hinderedsomewhat by restraint but nonetheless showing sound judg-ment. UNIFIL was dependent in its deployment on the con-sent and cooperation of a multitude of forces in Lebanon, in-cluding the Lebanese government and the Israeli occupiers.In order to prevent escalation, those in charge took a strictinterpretation of the rules of engagement and used force onlyfor self-defense purposes. Thus, while UNIFIL was con-strained in its movement and was somewhat ineffective, it re-mained in Lebanon. In contrast, UNSOM II had a ChapterVII mandate and a position on the use of force that allowed itto act beyond mere self-defense. Resolution 837 authorizedforce to disarm militia, leading to many UNSOM-sponsored at-tacks and eventual withdrawal of the authorization after nu-merous casualties were suffered on both sides. Murphy usesthe UNSOM II example to support his argument that robustpeacekeeping can cause escalation of tensions.

The two cases above seem to highlight the argument thatthe UN should refrain from forceful action, because what isnecessary to enforce an operation’s mandate may be unclear.The situation of Kosovo, however, is an example where forcewas needed but a consistent policy lacking. UNMIK andNATO forces often capitulated to intimidation and threats ofviolence and each unit had a different interpretation of whenit was appropriate to act. Overall, the forces were ineffectiveand ill-equipped to handle civil unrest and prevent widespreadattacks on minorities. On this basis, Murphy argues that inorder for the UN to engage in enforcement action, a “doctri-nal basis for robust peacekeeping actions is needed.”

Chapter four explores the applicability of internationalhumanitarian and international human rights law to



peacekeeping. The UN is not a state, and thus does not have aclear source of responsibility under these two bodies of law.However, Murphy maintains that this does not mean that UNpeacekeeping operations are free from their constraints.States that are home to peacekeeping operations must be re-lied upon to discipline peacekeepers. In addition, while theUN has expressed a commitment to international legal princi-ples, it is not clear that it is bound by them. It can be confus-ing which principles apply. For instance, international treatiesdid not seem to apply to UNSOM forces, as they were not in-volved in a conflict of an international nature and it was diffi-cult to determine if the label of armed conflict was appropri-ate. Any legal analysis placing the Somali situation within theparameters of the Geneva Convention seemed to come upshort. Likewise, Murphy raises the issue of whetherpeacekeeping troops are bound to intervene to prevent viola-tions of humanitarian law. For example, UNIFIL essentiallybecame a bystander to humanitarian violations, as their man-date did not allow them to stop Lebanese resistance or Israelicounter-measures against resistance forces. Finally, Murphyevaluates the role of human rights law in peacekeeping situa-tions where there is no effective rule of law through UNMIKand KFOR’s experience. In Kosovo, there was no enforcementmechanism that could prosecute egregious violations ofhuman rights on the part of the UN or internal forces. Whenforces like UNMIK cannot be a party to these instruments, it isunsurprising that international human rights law has not beenestablished as a standard for peacekeeping action.

Murphy cites the urgent need to codify international lawin this respect. Such a codification would lead to acknowl-edgement that UN peacekeepers are bound by these rules andnot solely by the criminal jurisdictions of their home states.Murphy also points to the possible solution of incorporatinghuman rights and humanitarian norms into status of forceagreements in order to create a legal source of humanitarianlaw for such operations. He finally reaches the conclusionthat, while there is no set of firm guidelines that operationscan follow in order to ensure success, there are certainproblems endemic to peacekeeping that must be rememberedwhen instituting such operations. The case studies are wellchosen, as they represent a broad range of UN actions andshed light on the problems in both narrow and broad man-



dates. The diverse mandates of the relevant operations, how-ever, makes it difficult to use them as a baseline to evaluatesuccessful policies in the general context of peacekeeping.

The work is a good introduction to the myriad differentissues associated with peacekeeping operations. The tensionsbetween legality and reality are well presented. The discussionwould benefit, however, from a further examination of debatewithin the Security Council over each operation’s mandate.Murphy often cites political constraints and lack of clear man-dates as an overarching problem for all missions. An exposi-tion of the discussions between Security Council members andwithin the Secretary-General’s office would aid understandingof this argument.

Finally, while the book is aimed at tackling the three ma-jor issues mentioned earlier, it is obvious that many other is-sues, from the political agendas of major powers to the struc-tures of status of force agreements, play a role in UNpeacekeeping. An attempt to give these more discreet issuesmore attention in their own sections would benefit a reader’soverall breadth of understanding of the complex issues associ-ated with peacekeeping.

Global Outlaws: Crime, Money, and Power in the ContemporaryWorld. By Carolyn Nordstrom. Los Angeles, California:University of California Press, 2007. Pp xiii, 234. $21.95(paperback).

REVIEWED BY GUNJAN SHARMA

The subways of New York have recently given rise to a newmerchant: the counterfeit DVD-seller, who moves from car tocar offering the latest movies for a dollar or two. Obviouslydestitute, these sellers present an ethical dilemma: What gooddoes it do to arrest a person driven by poverty to sell illicitgoods? Yet, these shady traders are also the last link in a net-work of organized and dedicated counterfeiting that reapsgreat profits for those willing to take the risks of entering intoorganized crime and that may extend as far away as China.Crime, it seems, has its own international economy.

For those interested in the complex economics and ethicsunderlying international organized crime, Carolyn Nord-strom’s Global Outlaws is a compelling read. An anthropologi-



cal-cum-political science text, the book is a description ofglobalized crime drawn from Nordstrom’s extensive research,travels, and interviews. The book concentrates not on themore obvious—and, according to Nordstrom, smaller inscale—crime of narcotics trafficking, but rather on the devel-opment of “extra state” economies, namely chains of supplyand sale designed to subvert and avoid national laws.

The organization of the work’s twenty chapters traces theinternational criminal economy from the street-vendors sellingsmuggled cigarettes in Africa through to the citizens of devel-oped nations that encourage or ignore criminal activity. Eachchapter features a different subject related to international or-ganized crime, including particular goods (such as fish,diamonds, and pharmaceuticals), individuals (such as shop-keepers, truckers, and women’s cooperatives), and moreamorphous concepts (such as the culture of criminals and ofpolice officers). While this disjointed approach damages thebook’s continuity, readers are nevertheless educated on arange of subjects many of them have probably never even con-sidered.

The first chapter introduces the reader to a street childNordstrom has named Okidi (the book is obsessed with ano-nymity). An Angolan war orphan about nine years old, Okidi,like the counterfeit DVD-seller in New York, is a petty streetsoldier in a larger criminal network: He spends his day sellingpre-colonial coins to UN peacekeepers and smuggled ciga-rettes to anyone who will buy them. Okidi and his friends arepresented in two lights: first, as businessmen who havelearned market skills in order to survive; and second, as inno-cent children who can still be naıve. In one moment, the chil-dren show Nordstrom—a complete stranger—the stash of pre-colonial coins that constitutes their livelihood. Apparently, ac-cording to Nordstrom, the children still have that naıve inno-cence that allows them to trust total strangers. Years after theirmeeting, Nordstrom attempts to find Okidi again. She is un-successful, leaving her readers with a pit in the bottom of theirstomachs.

The next few chapters trace a possible route that suppliesOkidi with the smuggled cigarettes he sells: from a broken-down store (chapter two) through to the Angolan military(chapter five) and the “robber barons” who control them(chapter seven). Along the way, the reader is also introduced



to the courageous story of a cooperative of women who havebeen injured by landmines. Among the various ingenious de-vices the women use is a form of banking. Each woman gives aset amount to the collective every month, and the total moneycollected is then given to each woman in turn to be used asseed money for a small business venture. We are also intro-duced to the most blood-boiling story throughout the book: awarlord named Gov’nor who uses the military to force villagersfrom their homes “for their own safety.” The villagers aregiven new land, which they work hard to develop. As soon asthe land is developed, however, the villagers are forced offagain, and Gov’nor seizes the now-developed property for him-self. According to Nordstrom, men like the Gov’nor are re-sponsible for most of Africa’s resource wars. With war, thesemen can title property and assets to themselves, and thenwhen they end the war, those property and assets make themen extremely rich.

Nordstrom continues her journey through internationalorganized crime by investigating the supply routes that areused to supply Angolans with illicit food, drugs, clothes, andalcohol. We are introduced to both a booming border townand its truckers (chapter eight) and the individuals who defythe export laws of neighboring countries by operating thebusinesses that run the trucks (chapter nine and ten). In thissection, Nordstrom introduces the process of cognitive disso-nance that envelops the criminal underworld: Neither Okidi,nor the businessmen, nor the truckers, nor even the heartlessmilitary warlords actually believe they are doing wrong. Mostbelieve that they are developing their country.

Having explored the dynamics of organized crime withinAfrica, Nordstrom next turns her attention to issues on a moreglobal scale. She begins by identifying the major smuggledgoods in the international criminal world, none of which, sur-prisingly, are narcotics. Instead, the reader discovers the valueof smuggled fish (chapter eleven) and learns that counterfeitand substandard pharmaceuticals are as profitable as the nar-cotics trade and take many more lives (chapter twelve). And,also surprisingly, counterfeit pharmaceuticals are not the onlysource of dangerous or substandard medicine. Lethal substan-dard pharmaceuticals, which are secretly disbursed across theThird World, are often made by licensed manufacturers. Yet,according to Nordstrom, political pressure from pharmaceuti-



cal companies and the industrialized world means that theWorld Health Organization does little to address or study theissue.

From the goods that define international smuggling andcrime, Nordstrom moves into the culture of its participants,both criminal (chapter fourteen) and law enforcement (chap-ter fifteen). Using her background in anthropology, Nord-strom identifies a series of trust-based norms that govern thebehavior of criminals. At the same time, she demonstrates thefrustration felt by law enforcement officials who are told tofight the narcotics trade while they know other trades are justas devastating. She then goes on to discuss in-depth themoney-laundering schemes that constitute $5 trillion, or 10%of the global economy—apparently, it is relatively simple tobuy a foreign bank, make deposits into it, and then have thebank loan you money (chapter seventeen). Nordstrom thentakes a moment to consider the issue of human trafficking(chapter eighteen) and describes how she herself boarded acargo vessel to be trafficked into Europe. Throughout this sec-tion, there is a strong emphasis on the role of global shippingand how its concern for speed and correspondingly inferiorsecurity procedures allow organized crime to flourish.

The conclusion of the book is two-fold. First, there is achapter on the sloppiness of American port security (chapternineteen). Nordstrom then proceeds to interject some theory(chapter twenty), arguing that the development of significantlevels of international organized crime indicates the formationof new power structures in international relations beyond thestate-based system created by the Enlightenment. Given theconcurrent rise of transnational military actors like Al Qaeda,her argument has a certain resonance. However, as with mostpost-statist arguments, one wonders whether the state will actu-ally be displaced by new power structures, as Nordstrom ar-gues, or rather will simply be the most powerful entity in aworld where it will not have a monopoly on human behavior.

Nordstrom is an accomplished scholar, but those lookingfor a thorough academic analysis of the subject matter will bedisappointed. Instead, this book is a powerful introduction toan often-ignored part of the global economy. It describes aworld most do not even consider—a world of war orphans,land mine amputees, warlords, and multinational corpora-tions. Nordstrom’s book does not create a framework to ad-



dress the study of international organized crime, but it is apowerful call for the creation of such a framework. Nord-strom’s experience in anthropological fieldwork is by far hergreatest strength as a writer: The stories she tells remain withthe reader well after the last chapter has been read. Nord-strom’s work is also a stunning indictment of the politicalelites of the West, who, because they profit from smuggling orillicit trade, either ignore its existence or actively partake in it.In one instance, a customs agent complains that whenever hecatches a large American company under-declaring goods atthe border, a Congressman calls to end the investigation.

In the end, global organized crime is, according to Nord-strom, driven by the Western consumer: The middle-class con-sumer who, believing it really does no harm, pays for smuggledcigarettes or accepts the dubious provenance of diamonds,thereby driving the demand for global organized crime. Afterreading this book, I would not buy a counterfeit DVD on thesubway.

To Save Her Life: Disappearance, Deliverance, and the United Statesin Guatemala. By Dan Saxon. Berkeley, California: Uni-versity of California Press, 2007. Pp. 306. $19.95 (paper-back).

REVIEWED BY ANDREA GITTLEMAN

International politics is nuanced in a way that often doesnot provide the best protection to populations and individualssuffering at the hands of violent groups or governments.From Darfur to Burma, international responses to grosshuman rights abuses are limited by actors’ political interests.Objectives such as securing natural resources or curtailingdrug trafficking hamper a nation’s ability to effectively re-spond to human rights violations. In his recent work, To SaveHer Life, Dan Saxon uses this frustrating context to frame hisanalysis of the international community’s response to disap-pearances in Guatemala. The goal of the book, according toSaxon, is to encourage governments and international organi-zations to provide more support to victims of human rightsviolations. He shows that the international community’s va-ried responses to violence may be a reflection of the humaninability to unequivocally fight for human rights. Using the



experience of a previously “disappeared” woman now his wife,Saxon asks for more effective intervention on behalf of torturevictims.

Saxon begins the book by providing introductory infor-mation for readers interested in Guatemalan politics and thelarger field of humanitarian responses to political violence.He recounts the ordeal of Maritza Urrutia, a woman kid-napped by anti-Communist military officials, and the politicaldealings surrounding her eventual release and immigration tothe United States. The book carefully details the events sur-rounding Maritza’s two weeks in captivity; at the same time,however, it sheds light on a wide breadth of the conflict inGuatemala and the ensuing international response. Saxon be-gins by describing Maritza’s family’s experience during theGuatemalan revolution in 1944 and quickly moves to July 23,1992, the day members of the Guatemalan army kidnappedMaritza as she was dropping her son off at school. In thisbook, part mystery novel and part historical analysis, Saxondoes a good job of intertwining stories with explanation of therelevant political context. For instance, passages on Maritza’sabduction and torture are followed by chapters detailing thehistory of the involvement of the Catholic Church in politicalaffairs and the intricate process of obtaining a United Statesvisa.

Saxon explains in the preface that he has learned that hu-manitarianism is politics. He details the “quiet negotiations”between the Guatemalan and U.S. governments concerninghow humanitarian responses would alter their respective rolesin narcotics trafficking in the region. When Carlos Castillo Ar-mas took power in Guatelama, the Central Intelligence Agency(CIA) drafted a list of “top flight Communists” who were con-sidered dangerous threats and who could be arrested and de-tained indefinitely without trial. The murky history of U.S. in-volvement in Guatemalan politics explains its hesitation tocome to Maritza’s assistance several decades after the fall ofthe Communist leadership.

One of the author’s main points is that international re-sponses to human rights violations are rife with political ma-neuvers and indecision that do injustice to the victims them-selves. Although the author recognizes the moral ambiguity inresponses to human rights violations, he paints Guatemala’spolitical history as a world of binary opposites—the differences



between the Communist supporters of Jacobo Arbenz and theCIA and its sympathizers become models of peace against vio-lence and good against evil. Contrary to this depiction, inter-national relations are not founded on clear-cut associations,and external assistance is based on carefully negotiated andtenuous relationships. Saxon tends to assume that there is aclear distinction between peaceful and violent actors, therebyoversimplifying the nature of international politics and hu-manitarianism. The author rightly implicates the UnitedStates in bringing about the fall of Arbenz and installing a sym-pathetic figure in his place, yet he also criticizes its failure totake a more active role in countering the government that sup-ported the kidnapping of Maritza. Using Saxon’s argumentthat international dealings are highly complex, it is hard tothen argue that observers can easily decide when and what va-riety of international action is required. Although the authorstays true to his intention of demonstrating the moral ambigu-ity of politics and humanitarian aid on the international level,he does not thoroughly analyze that same ambiguity in Guate-mala’s national history.

Readers should not approach this book expecting a calcu-lated and precise recapitulation of the recent history of Guate-mala but rather a personal narrative of a torture victim entan-gled in a network of uncoordinated individuals, states, and or-ganizations. The attention the author calls to disappearancesand human rights violations in Guatemala serves a greater pur-pose than that of a balanced portrayal of political events—thebook draws upon Maritza’s experience in order to highlightthe frustrations of the politics of humanitarianism. Saxon’sview of the relatedness of aid and politics is not groundbreak-ing, but the book still makes a valuable contribution throughits intersection of the personal and the political. The text al-ternates between the perspectives of the “disappeared,” inter-national organizations, religious groups, guerrilla units, mem-bers of the military, and government officials. This techniqueworks well to show the intricate nature of responses to humanrights violations, though it also creates a disjointed narrativeperhaps analogous to the emotions of those personally af-fected by these violations.

One of the international organizations Saxon highlights isAmnesty International, a group that, like Saxon, highlights in-dividual victims of human rights abuses in order to bring



about political action. Focusing on one individual with a gen-eral political analysis can be an effective advocacy tool, but ithas its drawbacks. Although readers may rally behind Maritzaand her experience, they may also see the Guatemalan conflictin a more limited manner if they equate a general strugglewith that of a single person. Focusing on the trauma of onevictim can limit the audience’s perception of the extent of po-litical violence. Even though Maritza was granted asylum inthe United States, the recent violence surrounding the elec-tions in Guatemala shows that the more general political con-flict has not yet subsided.

Although Saxon’s running theme is that politics deter-mine a given state’s involvement in conflict areas, he fails toput forth solutions about how to overcome this problem andprovide more effective assistance to those affected by humanrights abuses. Saxon describes the lack of communication be-tween government officials and the myriad organizations inGuatemala and the United States that were working to saveMaritza, but does not provide workable solutions to this lack ofcoordination. The reader is left with frustration regarding theslow-moving reactions of governments and international orga-nizations but without ways to encourage prompt and dedi-cated responses.

Readers should use To Save Her Life not as a resource forinternational lawmakers, but as a tool to increase awareness ofgovernment-sponsored torture and of the complexities sur-rounding foreign intervention in general. Saxon may not pro-vide solutions to humanitarian responses, but his treatment ofdisappearance and torture resonates in current U.S. endeavorsin its “war on terror.” He argues that the outrage that followedthe publicity about United States-sanctioned torture shouldalso extend to the torture used by other governments. It is hishope that an increased awareness of state-sanctioned torturewill allow the international community to more effectively pro-tect the rights of those suffering from human rights violations.



Investment Treaty Arbitration and Public Law. By Gus Van Har-ten. Oxford, United Kingdom: Oxford University Press,2007. Pp. xxxii, 214. $110.00 (hardcover).

REVIEWED BY PAMILA GUDKOV

International arbitration is not a new legal phenomenon.Rather, it has been utilized for settling contract disputes anddisputes between states for decades. Until the mid 1990s, how-ever, investment treaty arbitration—claims made by investorsagainst sovereign states—remained a relatively small segmentof arbitration not well known to those outside the field. In thepast decade, claims brought under NAFTA and bilateral invest-ment treaties have hit the mainstream media. Gus Van Har-ten’s recent book, Investment Treaty Arbitration and Public Law,the latest addition to the Oxford Monographs in InternationalLaw series, presents an introduction to this growing field. VanHarten provides a background on the history of investmenttreaty arbitration and explains what distinguishes investmenttreaty arbitration from other forms of international arbitrationas well as critiquing the current system and making sugges-tions for reform.

Van Harten introduces his critique of the current systemwith the case of Argentina, a timely and particularly dramaticexample of how powerful—and possibly misguided—invest-ment treaty arbitration decisions can be. Following Argen-tina’s severe economic decline in 2001, foreign investorsbrought dozens of legal claims against the floundering nationamounting to more than $17 billion in claimed compensation,nearly the entire annual budget of the national government.The suits potentially ask arbitrators to decide whether invest-ing companies or regulating governments should bear the riskand responsibility for government actions. While many ofthese claims remain undecided, an important standard was setin 2005, when a panel of arbitrators put the responsibility onthe government and ordered Argentina to pay $133 million toa U.S.-based investor in CMS v. Argentina. The panel’s decisionraises many policy questions: Should private arbitrators havecomprehensive jurisdiction to rule sovereign regulatory acts il-legal? Can these decisions be delegated away from publiccourts? Should investors be able to recover for taking whatamounts to an economic risk? Van Harten touches on these



issues but focuses less on the policy ramifications of specificarbitration decisions and more on fleshing out the system as awhole and discussing why it is a revolutionary development ininternational adjudication.

Chapter one presents an overview to Van Harten’s argu-ment that investment treaty arbitration is a revolutionary de-velopment in international adjudication. Unlike any otherform of international arbitration, investment treaty arbitrationis a method of public law adjudication, meaning that it is usedto resolve regulatory disputes between private parties (usuallycorporations) and states. This is as opposed to the traditionalinternational law model, which only looked at disputes be-tween states. The system’s unique use of private arbitration inthe regulatory sphere conflicts with the cherished principles ofgovernmental accountability and judicial independence indemocratic societies; in effect, it taints the integrity of the legalsystem by contracting out of the judicial function in public lawand holding governments fiscally hostage for what may be nec-essary measures.

Chapter two examines the historical and political back-ground leading up to international arbitration’s current prom-inent status. The system has its roots as a less costly (and morepeaceful) alternative to the use of force to settle economic dis-putes. Van Harten asserts that the growth in cross-border capi-tal flow since the 1980s and the mobile nature of foreign in-vestment have led to the conclusion of many bilateral invest-ment treaties, as capital-exporting countries attempt to protectnationals making foreign investments and capital-importingcountries scramble to keep investors from moving capital else-where. Van Harten also begins bringing out negative implica-tions of the system. Since the bilateral investment treaties aretypically concluded between exclusively capital-importing andexclusively capital-exporting countries, the capital-importingstate takes on major liabilities to multi-national forums withoutsecuring any real advantage under the treaty for its own na-tionals.

Chapter three presents Van Harten’s central argument:Investment treaty arbitration should be seen as a form of pub-lic law adjudication, because the system is established by a sov-ereign act of state (the signing of an investment treaty) and ispredominantly used to resolve disputes arising from state regu-lation. Van Harten distinguishes investment treaty arbitration



from other forms of arbitration because unlike conventionalinternational disputes (which occurred only between states) orcommercial disputes (between private parties), the two partiesin investment arbitration are not equally capable of possessinglegal rights and obligations. There is no reciprocity betweenthe investors who make claims and the states that give generalconsent to pay remedies if the claim is successful, making thesystem more closely resemble the public domestic law modelof a an individual making a claim against a state than that of aprivate party suing another private party for breach of con-tract. If, as Van Harten argues, investment treaty arbitration ismore akin to constitutional or administrative law than to pri-vate law, there is a serious question of whether privately con-tracted arbitrators using private law rules should be resolvingthese issues.

Chapter four deals with the scope and standards of reviewin investment treaty arbitration. Van Harten first draws outthe range of activity that is subject to control by private adjudi-cators and is therefore removed from the domain of domesticcourts. He argues that broad interpretations of key terms like“investment” and “goods” allow arbitration to encompass anextremely broad range of economic activity, well beyond themore narrowly tailored definitions of those same terms foundin customary international law. This makes a host state’s mon-etary policy reviewable by arbitrators and potentially subject toan order to compensate affected foreign capital. The scope ofarbitral review typically guarantees investors national treat-ment, fair and equitable treatment according to internationallegal minimums, and compensation for expropriation. VanHarten examines and criticizes each of these in turn, arguingthat because investors have no need to protect a future inter-est in defending against a similar claim, and because they arenot burdened by the state’s general welfare, they are free tomake arguments to broaden the scope of review solely in theirown interest. Though arbitrators may not always accept thesearguments, they are steadily moving toward a broader view ofinvestors’ rights that leaves states unable to reliably estimatethe cost of government measures.

Chapter five presents the argument that the emergence ofinvestment treaty arbitration is a revolutionary transformationin international adjudication. The system, in Van Harten’sview, “uniquely combines various innovative features of inter-



national adjudication to form a singularly far-reaching and po-tent system that uses arbitration to review and control states.”Van Harten identifies these “innovative features” as the abilityof investors to make claims in the context of regulatory dis-putes; the prospective consent of states to be subject to a claim(unlike claims tribunals, where foreign nationals can bringclaims only after retrospective consent); the main remedy ofstate liability in public law; the liberal approach to forum shop-ping and removal of the requirement to exhaust local reme-dies; and the broad enforcement of awards with minimal possi-bility for judicial review.

In chapter six, Van Harten classifies approaches and inter-pretations of arbitration jurisprudence into four categories.He criticizes the first two—the analogy to either commercialarbitration or public international law—because each of theserepresent a reciprocal framework, which, as he argues in chap-ter three, investment treaty arbitration lacks. The third ap-proach described by Van Harten is an analogy to human rightslaw. Some scholars have taken the view that investment trea-ties, like human rights instruments, create fundamental rightsfor investors. Although Van Harten gives this approachcredence, he views it as wrong-headed because, taken to its log-ical conclusion, it prioritizes the norm of investor protectionabove the overall welfare of the state in governmental deci-sionmaking. The final approach, and the one which Van Har-ten looks on most favorably, is the public law framework. Thisapproach, he believes, will promote predictability for govern-ments and investors and balance the rights of investors againstthe regulatory interest of the state.

The final chapter takes on two tasks, first identifying flawsin investment treaty arbitration and then offering suggestionsfor reforming the system. Van Harten suggests that to have aneffective system of public law adjudication (which, as he arguesin chapter six, is the only appropriate approach to investmenttreaty arbitration), there must be accountability, openness, co-herence, and independence—four criteria the current systemlacks. In order to better incorporate these characteristics, VanHarten suggests allowing domestic courts some oversight of ar-bitral tribunals as well as creating of an international invest-ment court. His suggestions for reform are sweeping: Theflaws identified above can only be remedied, he argues, by astructural overhaul moving arbitration closer to a public court



model and allowing greater domestic review that can overruleerrors of law made by arbitral tribunals. Van Harten is opti-mistic that this sort of reform might come to pass. He pointsout that many capital-exporting states have called for an inter-national court on previous occasions, and that it can only be tothe benefit of capital-importing states to move to a system inwhich their interests will be better represented.

While this book might have little to offer to those alreadyintimately familiar with international investment arbitration, itis a clear and comprehensive introduction for those who arenew to the field. Though it suffers from some overlap and re-dundancy, the work is remarkably clear, concise, and compre-hensive while covering an expansive and complex area of in-ternational law.

Human Rights and Healthcare. By Elizabeth Wicks. Portland,Oregon: Hart Publishing, 2007. Pp. xxi, 291. $56.00 (pa-perback).

REVIEWED BY DANIELLE POLEBAUM

In her recent work, Human Rights and Healthcare, Eliza-beth Wicks presents a survey of many current and controver-sial medico-legal issues through a human rights perspective,with a focus on the English legal system. Each chapterpresents a distinct legal issue for which the author discussesthe relevant law in England, presents the human rights per-spective, offers criticism or praise to the status quo, and occa-sionally weaves in proposals or solutions. She concludes eachchapter with a concise summary and “Recommended FurtherReading” for those who want to explore a particular issue indepth.

The fundamental premise of the book, and the broadestargument made by its author, is that the human rights per-spective should be an essential consideration in analyzing andreforming English medical law. The human rights perspectivemakes the rights of the individual patient the essential inquiry,establishing a presumption that her rights are the most impor-tant while still allowing interference with these rights whennecessary within a democratic society.

In the first chapter, the author introduces the role ofhuman rights in health care. She outlines the important



sources of human rights law for the purposes of this book: in-ternational human rights treaties, the British Constitution andcommon law rights, and the Human Rights Act of 1998, whichsought to incorporate the European Convention on HumanRights (ECHR) into domestic English law. Next, Wicks out-lines the human rights that are relevant to medical law: pri-vacy-related rights, the right to life, the right to dignity, includ-ing the prohibition of inhuman or degrading treatment, andthe right to reproductive autonomy.

Chapter two addresses the threshold issue of whetherthere is a right to receive medical treatment within the UnitedKingdom. This right would impose a positive duty on the stateto take steps to preserve life. The European Court of HumanRights (ECtHR) has recognized that such a right exists underarticle 2 of the ECHR (which provides for the right to life) butthat a duty to take positive steps is only invoked where there isa “real and immediate risk to life” and that the duty cannotimpose a “disproportionate burden on the authorities.” Thisproportionality requirement has significance in England, be-cause the reality of limited resources in the British health caresystem means that some patients will be denied medical treat-ment that they need. Wicks argues that an absolute right toreceive all necessary treatment is not realistic; nevertheless, pa-tients have a limited right to some form of treatment. Specifi-cally, each patient is entitled to “equal consideration withother patients in the same position,” to not be refused treat-ment on a discriminatory basis, and “to have his request fortreatment assessed on the basis of individual need.” Addition-ally, Wicks interprets the case law as suggesting that a patientwho wishes to remain alive has a legal entitlement to receivebasic life-sustaining treatment in the form of artificial nutri-tion and hydration.

Chapter three turns to the issue of quality of treatment.Wicks outlines English case law, which imposes a minimumstandard of care through the law of torts, arguing that the le-gal requirements of negligence are inadequate for assertingpatient rights. Wicks’ concern with negligence as the primarycause of action is that it focuses on doctors’ duties more thanon patients’ rights. For example, if a doctor acts with due carebut a patient suffers injury, the patient has no remedy. Whena doctor acts negligently, the patient still must prove causa-tion. Wicks argues that strict application of this requirement



can result in injustice, emphasizing that the courts have morerecently construed the requirements in a way that increasinglyvindicates patients rights—a positive step. She then addressesno-fault alternatives as a way to promote both doctor and pa-tient rights but concludes that this solution still does not “ad-dress the issue of patients’ rights in a convincing manner.”

Chapter four focuses on autonomy and patient consent tomedical treatment, a fundamental issue because autonomyprovides the theoretical foundation for human rights. Wicksbroadly introduces the concept of autonomy from an ethicalstandpoint and as a key legal principle in international humanrights law. She then outlines the need for actual, voluntary,competent, and informed consent under English common lawand the problems these requirements can pose for autonomy.She argues that these requirements should be read narrowly sothat as many patients as possible can make their own decisions.The chapter provides several examples of British courts tend-ing to respect a patient’s decision to say yes to a particulartreatment more than his or her decision to say no. Accordingto Wicks, a patient must have the right to make an irrationaldecision in regards to treatment.

Chapter five considers the treatment of patients fromwhom informed consent cannot be obtained—namely, thosewho lack consciousness, mental capacity, or maturity. Wicksemphasizes the principle of beneficence—a moral obligationto act for the benefit of others—as important to the humanrights approach where autonomy cannot provide the answer.Several human rights are particularly pertinent to the issue:the right to physical integrity, the right to be free from degrad-ing treatment, and the right to life. Wicks stresses that a best-interests test, often used to make treatment determinations forincompetent patients, should focus solely on the patient’srights and criticizes decisions that consider the interests ofthird parties such as family members.

Chapter six is about medical confidentiality and the rightto privacy, an issue that the author considers “one of the mostobvious candidates [in medical law] for a human rights con-ceptualization.” Unsurprisingly, she considers the right to pri-vacy to be of the utmost importance and is concerned that pa-tients’ privacy rights in England are being threatened frommany angles. She cites as examples of alarming trends the re-lease of personal information to an entire health care team,



regulations allowing public authorities to gather confidentialinformation about patients, and plans for a centralizeddatabase of medical records. According to Wicks, the right toprivacy must be considered a right which can be restrictedonly in narrow circumstances.

Chapter seven treats the issue of whether a patient hasproperty rights in his or her body. After examining the con-tentious history of the issue, the chapter introduces the U.S.case Moore v. Regents of the University of California, which Wicksconsiders “an extremely unsatisfactory decision.” Wicks arguesfor a limited property right and right of possession over ourbodies, reasoning that the protection of human dignity andthe right of autonomy can be combined with such rights toprovide a basis from which to allow the owner some controlover what happens to his or her body without granting an ab-solute right to sell the body. She argues fairly convincinglythat “a restriction on commercial use does not preclude self-ownership.” Additionally, self-ownership may provide patientswith the ability to choose how their bodies are disposed of af-ter death, although Wicks allows that few human rights are en-gaged once a person is dead.

Chapter eight questions whether there is a right toreproduce and focuses on the issue of medically assisted con-ception. Wicks argues that there should be a right toreproduce which is supported by the right to respect for familylife and the right to respect for private life, and which, in es-sence, amounts to a freedom to make reproductive choicewithout interference from the state. In the context of assistedconceptions (e.g., surrogacy), the right to reproduce will besubject to and must be balanced against the interest of otherparties to the reproductive process. In addition, the right toreproduce does not include a right to publicly funded treat-ment because, according to Wicks, this is not “an economicallyviable possibility.”

Chapters nine and ten cover issues of reproductivechoice. The human rights approach provides “few definitiveanswers” to the issue of abortion. This is largely because thereis not a clear consensus on whether a fetus has a right to lifeand, if so, at what stage of development. The ECtHR avoidedgiving an opinion on this issue in the 2005 case of Vo v. France.Wicks reminds us that abortion is even more complicated thana conflict between the mother and fetus, since the father’s and



state’s interests may also be engaged. She maintains, however,that the woman should ultimately be the one who decideswhether to undergo the procedure or not. A woman’s free-dom of choice, according to Wicks, includes a freedom to actin a way harmful to the fetus, which may include declining toundergo a particular medical treatment (e.g., a Caesarean sec-tion), or taking drugs or drinking alcohol during pregnancy.Wicks makes the interesting point that if we are to start blam-ing a mother for fetal harm resulting from such behavior, whatabout poor nutrition resulting from poverty, or defect fromliving in an apartment with lead paint? Responsibility for fetalharm may be shared with many, including the father andbroader society, and Wicks concludes that a pregnant woman’sright to make autonomous choices must apply to all choices.Her examination of English case law establishes that althoughthe court clearly declares the principle of a pregnant woman’sautonomous choice, the court will in certain situations ques-tion a woman’s competence, which in turn has the effect ofundermining her autonomy.

The final issue the author grapples with is whether thereis a right to end life. She concludes that there does not exist a“right to die” under the ECHR or English law. There should,however, be a limited exception to the criminal prohibition onassisted suicide “where a doctor follows strict guidelines to en-sure a voluntary and well considered autonomous request by apatient enduring unbearable suffering and unable to commitsuicide unaided.”

Human Rights and Healthcare is a helpful overview of perti-nent medical-legal issues viewed from a human rights perspec-tive. The book is not an in-depth treatise on a particularhuman right or medical issue, but the author capably toucheson many important and controversial topics. The work is wellorganized, clear, and not overly complex—it can be read bysomeone with little to no expertise in either human rights ormedical law. Because the book is more of an overview, someof the issues or arguments are glossed over and may leave thereader wanting a slightly deeper analysis from the author.(This is probably an inevitable critique for any legal analysisthat is kept somewhat brief.) The book weaves between beingdescriptive and being critical. As a result, the author offersher opinion on many decisions, doctrines, and issues but noton all, and there were instances where a description seemed



lacking the requisite critique. Similarly, the author occasion-ally made proposals for ways to address problems or changethe law; other times, she did not. Again, the reader may be, asI was, occasionally left wondering if she had a proposed solu-tion.

It appears from the author’s critiques that in many waysthe human rights perspective is very focused on process. Ofcourse, there are important substantive goals encompassed inhuman rights treaties, but sometimes the author was as criticalof a judge’s reasoning (or a judge’s inattention to a particularway of looking at the case) as she was of the decision. Humanrights is often about balancing countervailing rights, and oneof the main critiques that popped up again and again was thatthe judge did not balance or give enough consideration to aparticular right, or that the court needed to consider the issuefrom an angle which they missed. Thus, sometimes the cor-rect (or best) decision was debatable, but it was imperative thata patient’s rights be considered as primary. Such proceduralchanges should, in many situations, lead to different out-comes, but it is noteworthy that the human rights movementseems concerned not only with the ends but very much withthe means that are used to get there.

Overall, the book is an interesting and well-written workthat prods the reader to think of medical issues in new waysand particularly to focus on the human rights implications formedical law.

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