The majority of patients with Alzheimer's disease in an outpatient setting did not have healthcare proxies, yet had the capacity and motivation to complete this advance directive. With physician input regarding the presence of decisional capacity, a lay counselor successfully implemented the counseling process. These results support the initiation of similar counseling programs for Alzheimer's outpatients.

Responding to requests for an earlier introduction to psychiatric ethics, the authors added "An Introduction to Psychiatric Ethics Through Literature" seminar to their institution's first-year curriculum. The authors' primary objective was to increase the sensitivity of beginning psychiatric residents to ethical dilemmas. The 11-session seminar was co-led by a psychiatrist and a literary scholar. At each session, the group discussed a short story selected by the seminar leaders, with the discussion centering on ethical considerations raised by the story and their relevance to the practice of psychiatry. The residents gave the seminar high ratings for its increasing their ethical sensitivity and the stimulating content of the stories.

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This paper is one of the very few that have attempted to formulate the basic principles of a state mental health program. For this reason it merits the attention of all those who are concerned with the problem of applying public health philosophy and practice to the area of mental illness and health.

A long-range plan for mental health services in California is described and its relation to services for the rmentally retarded is presented. How such services could be organized in comprehensive centers is discussed, and the lines of development so far are sketched. A timely subject well worth attention.