The Twenty-fifth Amendment to the Constitution evolved as a response to the need to relieve a sick and disabled president fromthe responsibilities of office, in the best interests of both the sick president and the nation. The congressional hearings that preceded and accompanied its enactment made clear that some members of Congress understood the need for objective medical information to be available to the vice president andCabinet before they couldmake the political determination of disability.Nevertheless, not a single physician was called to testify or advise in the Senate or the House despite the fact that they represent the only societal repository of expertise on physical and mental impairment. Nor was any mechanism defined whereby a dispassionate medical appraisal of the cognitive competence of the president could be obtained if it were in question. Instead, there was an implicit reliance on the physician to the president, whose conflict of interest is so strong that he or she has been used in the past more to conceal than to reveal the true state of the president’s health. The Twenty-fifth Amendment remains a vital mechanism for ensuring the stability of the presidency. But its disability provisions (sections 3 and 4) have not been implemented as the framers intended. Sooner or later, the nation will be confronted with a president who has Alzheimer’s disease, brain trauma, or illness such that his cognitive faculties are not up to the demands of office. A powerful antidote to the White House cover-ups of the past would be a medical advisory committee on the health of the president, created by congressional action. The committee would review the president’s health annually and report to the nation on its significant findings; it also would be convened urgently to assess his health status whenever it was in serious question. It would then advise the vice president and Cabinet of the degree of presidential impairment to provide a scientific medical foundation for the political decision as to the presence or absence of disability. The independence, breadth of expertise, lack of conflict of interest, availability, and credibility of the committee would assure the public of an objective appraisal and would preclude inaction by the executive branch in the face of disability. The arguments against such an advisory committee—that physicians would decide rather than advise; that they might disagree; that they might harass the president or violate confidentiality; and that the committee is unnecessary,would function poorly,
could not assemble quickly, and would infringe on the separation of powers doctrine —have been carefully analyzed and been found wanting. Because the advantages of establishing a medical advisory committee are compelling, it should be the subject of congressional action before, rather than after, the next medical cover-up in the White
House and the accompanying public crisis of confidence.

This report and the conference it is based on are motivated by the sharp debate stemming from NATO's decision at Madrid to invite three new members to join its ranks. This debate is not partisan: it cleaves parties. It is profound because it has kindled the first truly geostrategic inquiry among Americans in the post-Cold War era. This inquiry has led Americans to advance from celebrating the end of the Cold War to confronting the design of Eurasia's future security system and America's role in it.

The Revolution in Business Affairs (RBA) is an effort to improve the overall effectiveness of the Department of Defense (DOD) by increasing the efficiency of its support operations. Waste and inefficiency within the DOD represent a major internal threat - an "enemy within" -- that, by drawing money away from needed modernization, could steadily erode our ability to meet the challenges of the post-Cold War era. The RBA seeks to change the way DOD does business.

The Cross-Industry Working Team (XIWT), with the support of Stanford University Consortium for Research on Information Security and Policy (CRISP), sponsored a symposium on cross-industry activities aimed at improving the reliability, dependability, and robustness of the information infrastructure. The purpose of this meeting was to identify the steps required to get to a reliable and dependable information infrastructure serving the needs of society. The emphasis in the meeting was on cross-industry and potentially cross-sector (government, industry, and academia) activities to accomplish that goal. The symposium dealt with the following generic topics: organizational activities to identify and pursue critical issues, issues in data transport and communications, issues in applications and services, and potential research and development activities.

The presentations and discussions of the meeting identified several potential cross-industry activities that could further the effort toward a more reliable and trustworthy information infrastructure. These activities fell into four general categories:

• Information Exchange Activities
  
• Consensus Activities
  
• Collaborative Operational Activities
  
• Collaborative R&D Activities
  

Two specific activities were discussed in some detail.

Government Sharing of Best Practices

It was observed that many of the government agencies have undertaken extensive efforts to improve the trustworthiness of their information systems, enabling them to withstand both failures and attacks. There is an opportunity for these agencies to be exemplars for the community— sharing what they have learned in the process of trying to make their systems more robust. This was felt to be an example of how the government and industry could work together to improve the trustworthiness of the overall information infrastructure.

Collaborative Experimental Environments

A potentially very productive collaborative R&D activity was discussed, involving industry, academia, and government. Universities and university consortia are investigating new techniques for building reliable systems of unreliable components, and for dealing with large complex systems. There is a need to evaluate, validate, and assimilate such research results into the industry environment. To that end, a collaborative, multi-industry experimental environment was discussed. This environment, distributed across multiple organizations, could provide such an evaluation, validation, and assimilation opportunity.

A number of other potential cross-industry activities were also mentioned throughout the meeting, and are discussed briefly in the proceedings.

Attendees agreed (based on a follow-up survey and informal comments) that the symposium was well worthwhile, and that continued dialogue is important to achieving the shared goal of a trustworthy information infrastructure. XIWT plans on helping foster such dialogue as well as collaborative activities toward that goal.

Dr. Lapidus summarizes factors, both domestic and international, pushing for and against regional separatism from the Russian Federation. Attention then turns to factors influencing the further devolution of authority from central to regional officials. A typology is offered of types of issues animating conflict in center-periphery relations. The article then discusses the impact of the August 1998 crisis on these trends and on prospects for the future.

Can the current global moratorium on nuclear weapon testing survive the May 1998 tests by India and Pakistan and the refusal of US Senate leaders to permit consideration of the Comprehensive Test Ban treaty (CTBT) by the Senate? If nuclear testing resumes by India or Pakistan - or by Britain, China, France, Russia, or the United States - will it be condemned by most of the world as if an international norm against testing was already in effect? What will be the likely consequences for nonproliferation if tests resume? This article seeks to show that there are norms operating against nuclear testing even though the CTBT has not been ratified, and that renewal of testing would have widespread consequences.

This report is the result of a workshop held in April 1998, when fifty policy experts, government officials and scholars met in Washington, DC. to discuss an issue of great import: the future of the relationship between Ukraine and NATO, This event, the Workshop on Ukraine-NATO Relations, was sponsored by the Harvard University Project on Ukrainian Security and the Stanford-Harvard Preventive Defense Project. The express goal of the workshop was to bring together representatives of Ukraine, NATO, and the United States so that they could collaborate on developing concrete recommendations for short and long-term next steps to broaden and deepen Ukraine-NATO relations.

The conveners of this workshop believed that the relationship developing [at that time] between Ukraine and NATO had the capacity to evolve into an important force for stability and security in Europe and the world, and to serve as a model for other countries in the region. While the NATO-Ukraine Charter and Ukraine's participation in the Partnership for Peace and the NATO peacekeeping mission in Bosnia provided a strong foundation, the longer-term direction of this very important relationship continued to be largely undefined. Further, they strongly believed that the Charter on a Distinctive Partnership signed by Ukraine and NATO in the summer of 1997 was only the first step towards institutionalizing the growing Ukraine-NATO relationship. Ensuring that the Charter was meaningful depended on concrete implementation of the cooperation anticipated in that document. Thus they decided that a concerted effort needed to be made to develop a gameplan for the future.

India's nuclear tests in May 1998 shocked the world. On May 11 and 13, India conducted a total of five tests. According to official Indian statements, the tests comprised three low-yield explosions, a 12 kiloton (kt) fission bomb, and a 43 kt thermonuclear device. The Indian tests triggered a quick response from Pakistan. On May 28 Pakistan conducted five nuclear tests, followed by a further test on May 30. Although some Western analysts have cast doubt on whether the two countries actually carried out the number and size of tests they claimed, India and Pakistan did conduct nuclear testing. These tests run counter to the global trend of nuclear arms reduction and have undermined not only the peace and stability of South Asia but of the world as well.

India and Pakistan have long been regarded by the international arms-control community as "nuclear threshold" or "de facto" nuclear-weapon states. They have now become declared nuclear-weapon states. The nuclear testing in South Asia will inevitably have a serious impact on regional and world politics, security, and diplomacy. This paper, which draws upon Chinese sources, analyzes the motivations of India and Pakistan and the consequences of the nuclear tests.

History has demonstrated that national leadership, time, and diplomatic genius will be needed to solve the thorny issue of the nuclear arms race in South Asia, so closely connected is it to the underlying and enduring Indian-Pakistani hostility. A Chinese source has quoted a senior Indian official as saying: "[t]he Cold War does not end in South Asia." The Chinese estimate that this confrontation will last well into the twenty-first century. How the international community responds to the tests will be crucial in determining whether the nonproliferation norm survives with credibility or is further eroded.

The nuclear crisis in South Asia is serious. However, "crisis" in the Chinese language is composed of two characters: wei--danger--and ji--opportunity. The new international situation, characterized by the coexistence of "opportunity" and "challenge," does hold out some hope that the nuclear arms race in South Asia can be capped. The challenge that confronts the international community is to turn this threat into an opportunity. The international community must move urgently in the matter. China recognizes this challenge and will play its role in this regard.

Work on ethnic and nationalist violence has emerged from two largely non-intersecting literatures: studies of ethnic conflict and studies of political violence. Only recently have the former begun to attend to the dynamics of violence and the latter to the dynamics of ethnicization. Since the emergent literature on ethnic violence is not structured by clearly defined theoretical oppositions, we organize our review by broad similarities of methodological approach: (a) Inductive work at various levels of aggregation seeks to identify the patterns, mechanisms, and recurrent processes implicated in ethnic violence. (b) Theory-driven work employs models of rational actions drawn from international relations theory, game theory, and general rational action theory. (c) Culturalist work highlights the discursive, symbolic and ritualistic aspects of ethnic violence. We conclude with a plea for the disaggregated analysis of the heterogenous phenomena we too caually lump together as "ethnic violence."

Background: In the 1980s, many medical organizations identified the prevention of nuclear war as one of the medical profession's most important goals. An assessment of the current danger is warranted given the radically changed context of the post–Cold War era.

Methods: We reviewed the recent literature on the status of nuclear arsenals and the risk of nuclear war. We then estimated the likely medical effects of a scenario identified by leading experts as posing a serious danger: an accidental launch of nuclear weapons. We assessed possible measures to reduce the risk of such an event.

Results: U.S. and Russian nuclear-weapons systems remain on high alert. This fact, combined with the aging of Russian technical systems, has recently increased the risk of an accidental nuclear attack. As a conservative estimate, an accidental intermediate-sized launch of weapons from a single Russian submarine would result in the deaths of 6,838,000 persons from firestorms in eight U.S. cities. Millions of other people would probably be exposed to potentially lethal radiation from fallout. An agreement to remove all nuclear missiles from high-level alert status and eliminate the capability of a rapid launch would put an end to this threat.

Conclusions: The risk of an accidental nuclear attack has increased in recent years, threatening a public health disaster of unprecedented scale. Physicians and medical organizations should work actively to help build support for the policy changes that would prevent such a disaster.