N intrusion by government cuts deeper into personal autonomy than does guardianship. An adult on whom guardianship is imposed loses a precious right: the right to choose. The individual can no longer decide where to live, what medical treatment to receive, how to handle her or his own money. The purported overuse of guardianship, the extent of intrusion, and the nonfeasance and misfeasance of guardians have led commentators to variously describe the proceeding and its sequelae as a “gulag,” a “hydra,” and “colonialism.” Given the impact of guardianship, one might assume it has been given great study. Quite the contrary is true. We might take the most elementary question: how many adults in the United States have a guardian? A recent study puts the number between 500,000 and 1,500,000, an extraordinary range. Unfortunately, we have no baseline of demographic data on which to evaluate the effect of change in our laws and policies. Social scientists have made some forays into the field. A leader in such endeavors is Winsor Schmidt, Jr., a political science professor at the University of Memphis. This book is a collection of articles he wrote or coauthored between 1981 and 1990. The author admits to only slight editing of the individual pieces and some resultant overlap in the material. A distillation of the articles would have resulted in a more efficient route to two important goals he achieves: an overview of problems with our guardianship system, and a synopsis of social science research. Professor Schmidt correctly identifies many problems in the process and product of guardianship: madequate counsel, confusion between mental and physical disability, hearings without the respondent, an increasing rate of institutionalization, and serving of third-party interests. He adroitly presents a historical view of squeezing the l)alloon in our control of “deviants.” Changes in commitment proceedings reduced hospitalization, but nursing home placements and guardianships increased. As due process protections were added to guardianship proceedings, social service intervention through “protective services” was born. Each proceeding produced a threat to autonomy in the wake of government beneficence. Unfortunately, the solution proposed by Professor Schmidt of a model public guardianship statute may miss the mark. Given substantial statutory reform in such states as Michigan, Florida, and New York over the past decade, we may now question whether mere legislative enactment has the potential for changing behavior. And given that form follows funding, inappropriate use may be inevitable. Establishing Medicaid created the nursing home industry; 30 years later we fight to obtain support for home-based longterm care. Necessary components in effecting guardianship reform include educating health care providers, social service staff, the bench, and the bar on guardianship and alternatives; convincing the public to plan for the possibility of incapacity; and altering our attitudes and stereotypic notions of older adults. We must also determine whether the societal goal is to protect older individuals through maximizing their safety or to promote their opportunity for independence and seif-determination. An answer might remove the irony from Professor Schmidt’s subtifle designating guardianship as the court oflast resort. Breach of Trust Sexual Exploitation by Health Care Professionals and Clergy edited byJobn C. Gonsiorek; Thousand Oaks, California, Sage Publications, 1995, 427 pages, $59.95