This article explores the ways in which competing institutional logics influence the knowledge base of the police, ideas about good police practice and organizational identities. A tension between the humanistic professional police logic and the instrumental New Public Management (NPM) logic is discussed in the context of policing. While the humanistic professional police logic gradually emerged in the 1960s and 70s, over the past twenty years the police force has been reformed in line with the NPM logic. Through (...) qualitative interviews and a quantitative study of the police force, the article investigates the ways in which the ideas of what constitutes a normative good practice are shaped in relation to these two, opposing, logics. A central finding is that despite many years of NPM as the dominant steering logic, a humanistic professional logic persists. However, the shift towards the NPM logic transforms the knowledge base in a more evidence-oriented direction and affects the ideas of normative good practice, especially among police management. (shrink)

_New Public Management and the Reform of Education_ addresses complex and dynamic changes to public services by focusing on new public management as a major shaper and influencer of educational reforms within, between and across European nation states and policy actors. The contributions to the book are diverse and illustrate the impact of NPM locally but also the interplay between local and European policy spheres. The book offers: A critical overview of NPM through an analysis (...) of debates, projects and policy actors A detailed examination of NPM within 10 nation states in Europe A robust engagement with the national and European features of NPM as a policy strategy The book actively contributes to debates and analysis within critical policy studies about the impact and resilience of NPM, and how through a study of educational reforms in a range of political systems with different traditions and purposes a more nuanced and complex picture of NPM can be built. As such the book not only speaks to educational researchers and professionals within Europe but also to policymakers, and can inform wider education and policy communities internationally. (shrink)

This study aimed to explore the conditions for nurses' daily patient education work by focusing on managers' way of speaking about the patient education provided by nurses in hospital care. An explorative, qualitative design with a social constructionist perspective was used. Data were collected from three focus group interviews and analysed by means of critical discourse analysis. Discursive practice can be explained by the ideology of hegemony. Due to a heavy workload and lack of time, managers could ‘see’ neither their (...) role as a supporter of the patient education provided by nurses, nor their role in the development of nurses' pedagogical competence. They used organisational, financial, medical and legal reasons for explaining their failure to support nurses' provision of patient education. The organisational discourse was an umbrella term for ‘things’ such as cost‐effectiveness, which were prioritised over patient education. There is a need to remove managerial barriers to the professional development of nurses' patient education. Managers should be responsible for ensuring and overseeing that nurses have the prerequisites necessary for providing patient education as well as for enabling continuous reflective dialogue and opportunities for learning in practice. (shrink)

ABSTRACTThe purpose of this paper is to criticize the New Public Management in the higher education of Iran with a moral lens. Qualitative content analysis was used for this purpose and the fourth to sixth National Development Plans as well as the Comprehensive Scientific Map of Iran were investigated. The model of NPM that is promoted in the Iranian higher education mostly emphasizes corporatization and the diversification of financial resources, while less attention has been paid to the other (...) dimensions, such as customer-orientation and accountability. The findings revealed that the NPM in Iranian higher education is not only incompatible with the Islamic moral goals, but there are also significant contradictions. NPM is based on the commodification of knowledge and the homo economicus, while in Islam, emphasis is on the value of knowledge too, and the truth-seeking is the important mission of knowledge. (shrink)

In this study, we argue that contemporary nursing care has been overtaken by new public management strategies aimed at curtailing budgets in the public hospital sector in Australia. Drawing on qualitative interviews with 15 nurses from one public acute hospital with supporting documentary evidence, we demonstrate what happens to nursing work when management imposes rounding as a risk reduction strategy. In the case study outlined rounding was introduced across all wards in response to missed care, (...) which in turn arose as a result of work intensification produced by efficiency, productivity, effectiveness and accountability demands. Rounding is a commercially sponsored practice consistent with new public management. Our study illustrates the impact that new public management strategies such as rounding have on how nurses work, both in terms of work intensity and in who controls their labour. (shrink)

In order to shorten queues to healthcare, the Swedish government has introduced a yearly “queue billion” that is paid out to the county councils in proportion to how successful they are in reducing queues. However, only the queues for first visits are covered. Evidence has accumulated that queues for return visits have become longer. This affects the chronically and severely ill. Swedish physicians, and the Swedish Medical Association, have strongly criticized the queue billion and have claimed that it conflicts with (...) medical ethics. Instead they demand that their professional judgments on priority setting and medical urgency be respected. This discussion provides an interesting illustration of some of the limitations of new public management and also more generally of the complicated relationships between medical ethics and public policy. (shrink)

The diffusion of New Public Management reforms across the globe is based on the assumption of the universal applicability of managerialism, driven by instrumental rationality, individualism, independence and competition. The aim of this article is to challenge this conception and to fill a significant gap in the existing research by analysing potential problems arising from the implementation of the NPM philosophy in non-Western public organisations. In-depth interviews and a large-scale survey were conducted across six public organisations (...) in Thailand based on the Competing Values Framework (CVF). Thematic analysis of the data revealed that the traditional cultural model of the organisations studied was characterised by a combination of hierarchical and clan-based cultures, which remained largely unaltered despite massive-scale reform. The persistence of this hybrid cultural system appears to be rooted in the deep-seated Confucian ethical values governing Thai society, in which the organisations are embedded. Based on the research findings, the paper underlies the importance of a symbolist viewpoint of culture and argues that a rational perspective underpinning a functionalist cultural management must be challenged. (shrink)

Although universities have undergone changes since the dawn of their existence, the speed of change started to accelerate remarkably in the 1960s. Spectacular growth in the number of students and faculty was immediately followed by administrative reforms aimed at managing this growth and managing the demands of students for democratic reform and societal relevance. Since the 1980s, however, an entirely different wind has been blowing along the academic corridors. The fiscal crisis of the welfare states and the neoliberal course of (...) the Reagan and Thatcher governments made the battle against budget deficits and against government spending into a political priority. Education, together with social security and health care, were targeted directly. As the eighties went on, the neoliberal agenda became more radical—smaller state and bigger market—attacking the public sector itself through efforts to systematically reduce public expenditure by privatizing public services and introducing market incentives. At the same time the societal relevance of the universities demanded by critical students was turned on its head to become economic relevance to business and industry in the knowledge society. (shrink)

At Danish universities, the governance structure is regulated by law. This structure was radically changed in 2003, abolishing the republican rule of the senate consisting of academics, students, and staff in favour of an authoritarian system assigning all executive power to the vice-chancellor, or as we say in Denmark, the rector. To introduce the current situation at Danish universities, in the first two sections of this article, I will compare them with more well-known counterparts in other countries. This situation is (...) reflected in exemplary cases, and in the third section, I focus on the most dramatic controversy ever encountered at a Danish university, the Koldau case, which reached national newspaper headlines and broadcasting in two rounds in 2011 and 2012. In the fourth section, I will interpret the case as an educational controversy in light of two conflicting ideas of the modern university, which may be attributed to two leading Enlightenment figures, Wilhelm von Humboldt and Denis Diderot. The conclusion is that to some extent, the failure to resist the neo-liberal university reforms in Denmark and the UK, and the drama of the Koldau case, may be explained with reference to the conflicting ideologies of those involved in these controversies. (shrink)

At the intersection of science studies and higher education research, this contribution looks at the way in which the requirements of universities as organizations release development dynamics in academic disciplines and it analyses the interaction between discipline and organization. We will analyse German educational science, bearing in mind it is an example of disciplines that are fractured and consequently have little consensus in terms of fundamental theories and basic concepts. Firstly, we take on a quantitative approach and analyse the changes (...) in degree courses at the structural level and the symbolic boundaries or conceptual distinctions following the transition to the Bachelor and Master system. Secondly, we take a close look at the negotiating processes and practices, as well as at the disciplinary orientations that determine these boundary shifts, using a qualitative approach that focuses on the actors. In group discussions with representatives of the German educational science at different universities it stood out that actors involved in course design are compelled to find an equilibrium between the demands of the discipline and those of the organization, and do so in very different ways. Finally, we discuss the extent to which close interaction between higher education reforms and academic disciplines can be figured out, particularly for disciplines seen as fractured and which do not have consensual common disciplinary standards. (shrink)

This collection of case studies in public management bridges the gap between mainstream CSR - confined to the for-profit corporations - and the vast bodies of workers and organizations that make up government and its public administration. The variety and discretion of managerial endeavours in public management calls for accountability and responsibility of government beyond current legal instruments: The book argues that CSR must be brought to bear with government. In government in fact, knowledge (...) class='Hi'>management is not a linear process, but the result of working with passion of the parts, implying discretionary behaviour and creativity which in turn imply choice and responsibility. Cases ranging from the USA to Central America, New Zealand and Europe all confirm the complex nature of public management, entailing partnership synergy for disaster recovery, the intertwined link between management and new technology and mindfulness at individual level. The cases are set in a framework by theoretical essays on bureaucratic behaviour and unknown stakeholders. Public-sector management has long drawn upon principles, tools, and techniques developed in the private sector, aiming to infuse bureaucracies with touches of efficiency and productivity. But good governance is also central to good management. This fascinating, wide-ranging volume shows how ideas from the Corporate Social Responsibility movement apply to the governance and administration of public agencies. A series of detailed and informative case studies, written by researchers and practitioners with deep knowledge of their industries and agencies, explores the challenges of managing public and government agencies in a socially responsible manner. The book offers a nuanced and balanced portrait that calls for greater public involvement and oversight in keeping public organizations on track. Highly recommended! Peter G. Klein University of Missouri Norwegian School of Economics and Mises Institute Here are six compelling case studies that reveal the relevance, even the imperative, of Corporate Social Responsibility (CSR) in the public sector. In doing so, the authors simultaneously expand the role of CSR and provide us with a refreshed concept of government and public management. The authors then lay the theoretical groundwork for their observations in ways that enrich our understanding of both CSR and the evolving roles of government in our lives. This is "must reading" for corporate officers and for public managers. Thomas R. Sexton Stony Brook University, NY College of Business and School of Professional Development. (shrink)

Based on empirical data from a qualitative study, this paper explores the complexity of ‘real world’ management in Hong Kong’s public sector, as contrasted with various paradigmatic claims under ‘new public management’ (NPM). A plurality of sub-worlds within the broad public sector is identified, which makes the management roles and responsibilities much less ‘homogenised’ than depicted in NPM exhortations. The instrumental rationality underpinning NPM is identified as too restrictive in understanding the way in which (...) public managers reach decisions. When the daily challenges of reconciling values and practices arising from the complexities of politics, policies and service delivery are considered it is necessary to incorporate ideas related to procedural and expressive rationality to fully appreciate the nature of management in public organisations. (shrink)

Pollitt and Bouckaert and their neo-Weberian state (NWS) have been chosen as the subject for this essay because the book has become a standard work in the public management movement. It is frequently cited and has been re-published in multiple editions (most recently in 2017). The authors also refer explicitly to Max Weber.This contribution seeks to draw attention to three important aspects, which inevitably overlap with one another:1. There is no Weber in the neo-Weberian State (introduction, 1; section (...) II). Pollitt and Bouckaert fail to grasp that Weber’s understanding of the state [the state as an “institution” (Anstalt); and the state as an “idea of validity” (Geltungsvorstellung)] is not identical to his ideal type of modern bureaucracy; it is the features of the latter on which they draw. The ideal type is a standard measure constructed in order to establish how close any concrete, given instance of bureaucracy comes to it (introduction, 3). Meanwhile, the “neutral official” insisted upon by Weber has “taken their leave” in Germany from important positions (section III, 3). Furthermore, Weber did not address those structures and processes internal to the administration which are precisely the object of interest for the new public management reformers. Weber’s lack of interest arises from the fact the members of anAnstalt, whether it is the state or the Church (WuG, § 15, no. 2), are subject to imposed orders (oktroyierte Ordnungen) and, as such, do not enjoy the “right to have a say”. Scharpf (1973a) was the first to pay particular attention to the problems brought about by specialisation and by the division of labour within the administration that are responsible for an incremental form of politics (section III, 3); even if he later ascribes advantages to the combination of “negative” and “positive coordination” (Scharpf 1991: 18ff.).2. The “legalistic culture” that characterises Germany will be considered in a more differentiated way, drawing on empirical studies which provide information, for example, on how laws (i.e. programmes)actuallyoriginate inside the ministerial apparatus (introduction, 2; section III, 2 and 3) or how use is made of the power of authority (Weisungsrecht) in practice (introduction, 2; section III, 2 and 3), even when, formally, it claims to have validity (section III). In this way, only empirical studies (Benz 1994; Bohne 1981; Dose 1997; Dose/Voigt 1995; Treiber 2007a) prove that the administration that implements laws has often, in practice, become a “negotiative administration” (introduction, 2). Such a phenomenon as a “co-operative administration”, which negotiates rather than rules, is a “foreign concept” in Weber’s discussion of the state and modern bureaucracy. Scharpf’s (1970) comparison between constitutional governance in Germany and legal relief in America is enlightening when it comes to the meaning of the constitutional state (Rechtsstaat) (introduction, 2; section III); the same applies to his discussion of the failed federalist reforms, which sought, among other things, to mitigate, if not entirely eliminate, the opportunities for blockades provided by political entanglement (Politikverflechtung) (section III). Neither was it possible to realise long overdue proposals to reform administrative law (Verwaltungsrecht) (section III, 1), which involved weakening or removing altogether three important assumptions in the dominant administrative doctrine (the “dogmatic normality”) and which also included the ambitious intention for the law to achieve tangible impact (Hoffmann-Riem 1994). Nonetheless, while no-one would dispute that reform of the federal government and administration remained “on the agenda” (Scharpf 1991, Mayntz/ Scharpf 1973), the priorities of such a reform were, and still are, different to those of new public management reform [the key terms here arePlanung(“planning”) and the term that replaced it,Steuerung(“management”)]1.3. Pollitt and Bouckaert ascribe to the neo-Weberian state extremely varied functions without providing any (theoretical) basis for them. In this way, the notion of public management reform that they present acquires the status of a “reformist philosophy” (introduction, 3; section IV). See Scharpf (1991) for a theoretically well-founded argumentation on the State’s ability to act in our days. Scharpf’s essay will be discussed briefly (section IV).ConclusionThere is no Weber in the neo-Weberian state. According to the discussion presented here, the neo-Weberian state can only mean: how would a modern state constituted by Weber look today? (shrink)

Within the field of education management studies, recent reforms promoting devolution and choice are often seen to provide exciting new opportunities. It is claimed that the 'new' education management, with its emphasis on site-based decision-making and consumer accountability, will enable headteachers and principals to 'take control' of their schools and make them more productive environments in which to work and study. However, our review of research findings from five different countries that are putting in place devolution and choice (...) policies suggests that these new opportunities are more illusory than real. Positioned between the competing demands of the state and the market, school managers are becoming increasingly isolated from colleagues and classrooms - leading to a growing divergence between the managers and the managed. The paper considers the implication of recent developments for managers in general and for women managers in particular and concludes by discussing the relationship between the personalisation of responsibility and the legitimation of crises within the state and public education. (shrink)

Based on results of an experiment, hypotheses are tested concerning the effects of computer use on decision commitment. The experiment required subjects to make an adoption decision regarding a hypothetical government agency's innovation. Subjects could choose from a variety of information sets, some computer based, some not, before making the decision. After their decision the subjects were given “new evidence” that contradicted their initial position. Two experimental treatments included more difficult access to the computer-based information and higher cost for the (...) computer-based information. Results indicate that access difficulty diminishes confidence in decisions and leads to lesser commitment. However, the cost of the computer information seems to have little bearing on decision commitment. (shrink)

This article reviews the relationship between managed care and public health. Managed care, with its seemingly infinite structural and organizational variation, dominates the modern American health-care system for the non-elderly U.S. population. Through its emphasis on standarhzed practice norms and performance measurement, coupled with industrial purchasing techniques, prepayment, risk downstreaming, and incentives-based compensation, managed care has the potential to exert considerable influence over the manner in which the health-care system is organized and functions. Given the degree to which the (...) attainment of the basic public health goal of protecting the public against population health threats for which there are known and effective medical interventions depends on the successful interaction between public health policy and the medical care system, the importance of a viable working relationship between public health and managed care is difficult to overstate.The potential for conflict between public health and medical care is nothing new; indeed, delineating the boundaries of public health to shape and influence medical practice has occupied the energies of policymakers and the medical industry for well over a century. (shrink)

This article reviews the relationship between managed care and public health. Managed care, with its seemingly infinite structural and organizational variation, dominates the modern American health-care system for the non-elderly U.S. population. Through its emphasis on standarhzed practice norms and performance measurement, coupled with industrial purchasing techniques, prepayment, risk downstreaming, and incentives-based compensation, managed care has the potential to exert considerable influence over the manner in which the health-care system is organized and functions. Given the degree to which the (...) attainment of the basic public health goal of protecting the public against population health threats for which there are known and effective medical interventions depends on the successful interaction between public health policy and the medical care system, the importance of a viable working relationship between public health and managed care is difficult to overstate.The potential for conflict between public health and medical care is nothing new; indeed, delineating the boundaries of public health to shape and influence medical practice has occupied the energies of policymakers and the medical industry for well over a century. (shrink)

By Jerome Rothenberg. Contributions by Steven Clay, Rodney Phillips.

As public administrations adopt artificial intelligence (AI), we see this transition has the potential to transform public service and public policies, by offering a rapid turnaround on decision making and service delivery. However, a recent series of criticisms have pointed to problematic aspects of mainstreaming AI systems in public administration, noting troubled outcomes in terms of justice and values. The argument supplied here is that any public administration adopting AI systems must consider and address ambiguities (...) and uncertainties surrounding two key dimensions: the algorithms’ results, and how public managers make decisions for and about AI systems’ design. The article is based on bibliographic research in institutional theory perspective that relates the design of AI systems and relevant literature on the decision-making process in public policy. The main finding is to explain why autonomous decision systems continue to reproduce ambiguities and uncertainties when applied in public administration and propose a reflection on AI governance in public administration. This article points to the need for design institutions that immerse themselves in understanding the nuances, details, and potential outcomes of AI governance for public administration. Such institutions would reconcile consequentialist logic with a logic of appropriateness to help navigate and mediate ambiguities and uncertainties. (shrink)

The way pollution is managed in Western countries is based on the preservation of the taboo character of waste, which is conceived to be privately produced and seen as a threat to public health. Public authorities have been given the responsibility to isolate waste and hide it from public eyes. However, this dominant approach is challenged by the emergence of new forms of pollution. New conceptual and policy frameworks to manage environmental degradation have to be developed. The (...) prevailing institutional structures, however, obstruct the successful societal uptake of alternative frameworks. (shrink)

Ethics in Public Policy and Management: A global research companion showcases the latest research from established and newly emerging scholars in the fields of public management and ethics. This collection examines the profound changes of the last 25 years, including the rise of New Public Management, New Public Governance and Public Value; how these have altered practitioners' delivery of public services; and how academics think about those services. Drawing on research from (...) a broad range of disciplines, Ethics in Public Policy and Management looks to reflect on this changing landscape. With contributions from Asia, Australasia, Europe and the USA, the collection is grouped into five main themes: theorising the practice of ethics; understanding and combating corruption; managing integrity; ethics across boundaries; expanding ethical policy domains. This volume will prove thought-provoking for educators, administrators, policy makers and researchers across the fields of public management, public administration and ethics. (shrink)

As next‐generation genomic sequencing, including whole‐genome sequencing information, becomes more common in research, clinical, and public health contexts, there is a need for comprehensive communication strategies and education approaches to prepare patients and clinicians to manage this information and make informed decisions about its use, and nowhere is that imperative more pronounced than when genomic sequencing is applied to newborns. Unfortunately, in‐person counseling is unlikely to be applicable or cost‐effective when parents obtain genomic risk information directly via the Internet. (...) As a rule, communication strategies should match how people are accessing health information. Today, many people can obtain health information in a variety of settings, including through direct‐to‐consumer services, via websites, and through other digital channels or settings. In response to these changes, new communication strategies need to be considered. Adopting a comprehensive communication model means understanding the multiple levels of influence experienced by parents and the clinicians who serve them. In addition, applying communication‐science principles can help in addressing some key challenges to effectively communicating genomic information to parents. (shrink)

ABSTRACT Research ethics is the most developed aspect of bioethics in Africa. Most African countries have set up Institutional Review Boards (IRBs) to provide guidelines for research and to comply with international norms. However, bioethics has not been responsive to local needs and values in the rest of the continent. A new direction is needed in African bioethics. This new direction promotes the development of a locally‐grounded bioethics, shaped by a dynamic understanding of local cultures and informed by structural and (...) institutional problems that impact the public's health, as well as cognisant of the salient contribution of social sciences and social epidemiology which can bring a lasting impact on African local communities. In today's post‐Structural Adjustment Africa, where healthcare has been liberalized and its cost increased, a bioethics agenda that focuses essentially on disease management and clinical work remains blind in the face of a structural marginalization of the masses of poor. Instead, the multidimensional public health crisis, with which most African countries are confronted, calls for a bioethics agenda that focuses primarily, but not exclusively, on health promotion and advocacy. Such an approach to bioethics reckons with the macro‐determinants of health and well‐being and places clinical and research ethics in the broader context of population's health. The same approach underscores the need to become political, not only by addressing health policymaking processes and procedures, but also by becoming an advocacy forum that includes other constituencies equipped with the potentialities to impact the population's health. (shrink)

This article presents a "new" theory of management for the new millennium: "new" not because singularly the ideas are recent, but because the combination of these older ideas collectively is novel. To some extent, this article represents the reestablishment of previously existing employment ethics that for various and sundry reasons lapsed into disuse in the past several decades. This article discusses employee relations ethics (ERE) in terms of an ERE credo and a set of assumptions. The modern millennium mission (...) states that all organizations (public and private) should primarily be employee centered, not owner or administrator controlled, customer or client driven, or both. (shrink)

Antibiotic resistance, arising when bacteria develop defences against antibiotics, is creating a public health threat of massive proportions. This raises challenging questions for standard notions in bioethics when suitable policy is to be characterized and justified. We examine the particular proposal of expediting innovation of new antibiotics by cutting various forms of regulatory ‘red tape’ in the standard system for the clinical introduction of new drugs. We find strong principled reasons in favour of such a lowering of the ethical (...) standards of research and the clinical introduction of new antibiotic formulas. However, this support is undermined by pragmatic challenges owing to expected responses from stakeholders, creating uncertainty about which policies could actually be effectively implemented. We describe an underlying dilemma on how to rationally justify compromises between ideal ethical justification and pragmatic risks that needs to be further addressed in this light. We suggest a solution to this dilemma related to proposals of expediting antibiotic drug innovation. (shrink)

This paper seeks to expand our appreciation of the gene editing tool, clustered regularly interspaced short palindromic repeats‐associated protein 9 (CRISPR‐Cas9), its function, its benefits and risks, and the challenges of regulating its use. I frame CRISPR's emergence and its current use in the context of 150 years of formal exploration of heredity and genetics. I describe CRISPR's structure and explain how it functions as a useful engineering tool. The contemporary international and domestic regulatory environment governing human genetic interventions is (...) reviewed and shown to be increasingly ineffective in its ability to restrain, guide, and optimize the emerging use of CRISPR. Several reasons for this lack of consensus are discussed. In conclusion, I suggest a number of public policy recommendations that might allow us to simultaneously embrace our most important moral values and manage the inevitable power CRISPR will come to have in our lives. (shrink)

There are several Africas; the continent does not have a single homogeneous reality. Instead we should talk of shifting territorialities. The crucial questions, when thinking about emergent humanisms, have to do with the exegesis of the political, and at its heart democracy, citizenship and the management of violence, which obstinately appears as a constant in the political experience in Africa. It operates as one of the political idioms at the very moment when democracy is becoming essential as a universal, (...) unavoidable reference. The African state seems unable any longer to guarantee its citizens’ security. The human body is becoming an integral part of the territories where conflict is occurring. What is being challenged is the sovereignty of the state, which means that the symbolic construction of a people transforming the state into a nation state is no longer possible. So how can we imagine a space for interaction where collective issues are put up for discussion? The case of Côte d’Ivoire, the reform of the Family Code in Senegal, and the tragedy in Rwanda are examined. The author wishes to follow the perspective set out by Wiredu, the principle of compassionate impartiality, the principle on which moral universality is based and built up. (shrink)

Manipulation of the publication process is a relatively new form of misconduct affecting the publishing industry. This editorial describes what it is, why it is difficult for individual journal editors and publishers to handle and the background to the development of the new COPE guidelines on how to manage publication process manipulation.These new guidelines represent an important first step towards encouraging openness and collaboration between publishers to address this phenomenon.

This paper addresses the theoretical framework on corporate social reporting. Although that corporate social reporting has been analysed from different perspectives, legitmacy theory currently is the dominating perspective. Authors employing this framework suggest that social and environmental disclosures are responses to both public pressure and increased media attention resulting from major social incidents such as the Exxon Valdez oil spill and the chemical leak in Bhopal (India). More specifically, those authors argue that the increase in social disclosures represent a (...) strategy to alter the public''s perception about the legitimacy of the organisation. Therefore, we suggest using corporate communication as an overarching framework to study corporate social reporting in which corporate image and corporate identity are central. (shrink)

Wherever a government or state is concerned with the welfare of its citizens, there will probably also exist policies which compel the individual citizen to undertake or abstain from activities which affect that citizen alone. The set of theories behind such policies is collectively known as ‘paternalism’. It is not hard to understand why this term has developed strong pejorative overtones. Policies of this type appear to offend a fundamental tenet of liberal societies: namely, that the individual is best placed (...) to know what is in his or her interests. Paternalistic policies imply, and are concerned with correcting, failures of precisely this kind of judgement. And yet, at the same time, there is a popular consensus that compelling people to wear a seat belt when driving a car is a reasonable restriction of personal liberty. Paternalism may be difficult to accept in principle, but it is equally difficult to avoid in practice. Not surprisingly, the literature reveals a long heritage of debate in a wide range of academic disciplines. This debate reveals a failure to make progress in two areas in particular. First, analyses of paternalism often confuse policies which are actually concerned with correcting failures of market exchange — in particular, those concerned with insufficient or imperfect information — with those which are genuinely paternalistic. One objective of this paper will be to clarify the difference between these two kinds of policy. (shrink)

This is a volatile time for health insurance policy. Medicare and Medicaid are in turmoil, as is the private health insurance market. Public and private health insurance costs constitute eighty percent of healthcare spending in the United States. Public health professionals depend on the insurance system to behave in ways that are responsive to public health in prevention and crisis management.Seventy-five percent of the American population, excluding the elderly, has coverage through the private health insurance system. (...) Ninety percent of this group receives their insurance through employer-sponsored programs, and the remaining ten percent buy their own coverage. Approximately ten percent of the non-elderly population has insurance through a government program, and fifteen percent of the non-elderly population, almost forty-one million Americans, is uninsured. (shrink)

This paper analyses social practices within public health services in Morocco, suggesting that current management orientations toward models like New Public Management obscure the social relations that often make under-resourced healthcare effective. Health policy in Morocco has increasingly adopted principles that reflect neoliberal influence in international development. Citing the work of Moroccan philosopher Mohammed Abed al-Jabri and American philosopher John Searle, the paper calls for policymakers to recognise the capacity of institutions to frame social relations. Likewise, (...) policy administration and management should be guided by reflection on the social role of institutions and related social practices at the level of service delivery. (shrink)

Australia, along with other countries, has introduced New Public Management (NPM) into public sector hospitals in an effort to contain healthcare costs. NPM is associated with outsourcing of service provision, the meeting of government performance indicators, workforce flexibility and rationing of resources. This study explores the impact of rationing of staffing and other resources upon delivery of care outside of business hours. Data was collected through semistructured interviews conducted with 21 nurses working in 2 large Australian metropolitan (...) hospitals. Participants identified four strategies associated with NPM which add to workload after‐hours and impacted on the capacity to deliver nursing care. These were functional flexibility, vertical substitution of staff, meeting externally established performance indicators and outsourcing. We conclude that cost containment alongside of the meeting of performance indicators has extended work traditionally performed during business hours beyond those hours when less staffing and material resources are available. This adds to nursing workload and potentially contributes to incomplete nursing care. (shrink)

The article reveals the issues of interdependence of the development of human capital in public administration on the level of its provision by the state in the context of COVID-19. In a democratic, civil, postmodern society, one of the main tasks is the development of systems for managing the efficiency of human capital in the context of public administration, as a means of obtaining higher levels of labor productivity. Today we have to state that the achievement of this (...) efficiency in the use of human resources can be better achieved by orienting the performance management system to promote the attraction of new human potential in public administration at all levels. In this context, a new approach to the human capital management process is being actualized, which includes employee engagement and key factors of employee engagement at every stage. We are talking about a management model that includes the main ideas and offers a new perspective on how to develop and manage the involvement of human resources to achieve high levels of labor productivity in public administration in the context of COVID-19. The purpose of the article is to study the essence, characteristics and role of human capital in the context of public administration in the context of the existence of the epidemic danger of COVID-19. (shrink)

Amid public health concerns over climate change, “precision public health” is emerging in next generation approaches to practice. These novel methods promise to augment public health operations by using ever larger and more robust health datasets combined with new tools for collecting and analyzing data. Precision strategies to protecting the public health could more effectively or efficiently address the systemic threats of climate change, but may also propagate or exacerbate health disparities for the populations most vulnerable (...) in a changing climate. How PPH interventions collect and aggregate data, decide what to measure, and analyze data pose potential issues around privacy, neglecting social determinants of health, and introducing algorithmic bias into climate responses. Adopting a health justice framework, guided by broader social and climate justice tenets, can reveal principles and policy actions which may guide more responsible implementation of PPH in climate responses. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Managed Health Care: New Ethical Issues for All*Martina Darragh (bio) and Pat Milmoe McCarrick (bio)Changes in the way that health care is perceived, delivered, and financed have occurred rapidly in a relatively short time span. The 50-year period since World War II encompasses enormous growth in medical technology, soaring health care costs, and significant fragmentation of the two-party patient- physician relationship. This relationship first grew to include the third-party (...) payer, the health insurance industry, and now “with great speed and relatively little public awareness, a significant change has occurred in the way some decisions are made about a patient’s medical care” (III, Institute of Medicine 1989).The new means of providing health care bring an increasing number of parties into clinical decision-making processes. With this change, ethical issues that once concerned only health care professionals, the physician or the nurse, have expanded to include the patient and the groups who “manage” care—e.g., health maintenance organizations (HMOs), preferred provider organizations (PPOs), point of service groups (POSs), independent practice associations (IPAs), insurance reviewers, hospital administrators, institutional managers, and, the most recent players, purchasers of group health care who base their decisions on competitive pricing.The term “managed care” refers to a variety of continually adapting and developing arrangements that involve four groups. These groups, which have been labeled by the world of business, not health, are the “consumer” (once the patient), the “provider” (the physician and other health care professionals), the “insurer” (the reimburser for any care), and the “purchaser of care” or the primary buyer of health services (the large employer organization). Capitation is a common way to pay for health services in managed care systems. A certain dollar amount is negotiated for health services for a specified number of patients whether the care is delivered or not; the provider shares with the [End Page 189] insurer any financial risk for the actual cost of care (III, Centers for Disease Control 1995).When the Clinton administration’s health care reform movement failed to gain support in the U.S. Congress, the use of managed care to control rising health care costs accelerated. The literature on managed care and its effect on the patient-physician relationship reflects this shift. During the era of health care reform, “debate centered on how managed care could control costs, on the use of technology and patient satisfaction, [and] on access and barriers to care” (IV, Emanuel and Dubler 1995). When managed care organizations began contracting with physicians to provide health care services subject to the plans’ provisions, these plans became agents in clinical decision making on a wide-spread basis. HMO enrollment grew to 51 million persons by 1994 (III, Centers for Disease Control 1995). This “corporatization” of health care has sparked a plethora of articles about the effects of the marketplace on the physician’s ability to do what is best for the patient, and on the patient’s ability to trust the physician to do so.Many authors make it clear that managed care itself is not the problem, but rather the development of for-profit managed care plans by “corporate conglomerates with billions of dollars in assets that compensate their executives as grandly as basketball players” (V, Kassirer 1995) “in a marketplace that is largely unregulated” (I, Zoloth-Dorfman and Rubin 1995). “Some, mostly older plans that were created when cost containment was an unexpected benefit rather than their central purpose, deliver high-quality care economically. Unfortunately, others cut costs by recruiting the healthiest patients, excluding the sickest, rationing care by making it inconvenient to obtain, and denying care by a variety of mechanisms” (V, Kassirer 1995).These cost-containment features now play an intimate role in clinical practice. When a managed care plan contracts with a physician, the doctor becomes a “double agent” with contractual obligations to the plan to provide a preset amount of services and professional responsibilities to each patient to authorize necessary treatment (V, Angell 1993). This duality can undermine the physician’s fiduciary responsibility to the patient wherein the physician “has power over the affairs of [the patient]...and is required by law to act on that person’s... (shrink)

Contemporary thinkers have not been hesitant to talk about the end of religion, the end of philosophy, or the end of morality. In such a context, our society is based on what Lipovetsky calls a minimal ethics. We live at the crossroads of two types of discourses: one proclaiming moral decadence, and another that speaks about the revival of morality. The fact that ethical maximalism quits the contemporary scene does not necessarily mean that it leaves a complete vacuum. The emptiness (...) opens towards the manifestation of ethical creativity in the space of minimal ethics. In public space, and in administrative ethics, the secularization of ethics offers the possibility of feeling comfortable with promoting a form of moral relativism that does not alienate people from the sensation of ethical certainty that offers existential comfort through its firm values. (shrink)

BackgroundSolitary death (kodokushi) has recently become recognized as a social issue in Japan. The social isolation of older people leads to death without dignity. With the outbreak of COVID-19, efforts to eliminate solitary death need to be adjusted in line with changes in lifestyle and accompanying changes in social structure. Health monitoring services that utilize wearable devices may contribute to this end. Our goals are to outline how wearable devices might be used to (1) detect emergency situations involving solitary older (...) people and swiftly connect them with medical treatment, to (2) reduce the frequency of deaths that remain undiscovered and (3) to reduce social isolation by promoting social interaction. MethodsTheoretical and philosophical approaches were adopted to examine ethical issues surrounding the application of wearable devices and cloud-based information processing systems to prevent solitary death in the world with/after COVID-19.Main body(1) Technology cannot replace social connections; without social support necessary to foster understanding of the benefits of health management through wearable devices among older adults, such devices may remain unused, or not used properly. (2) Maturity of the technology; systems face the difficult task of detecting and responding to a wide range of health conditions and life-threatening events in time to avert avoidable morbidity and mortality. (3) Autonomy and personhood; promoting the voluntary use of wearable devices that are a part of larger efforts to connect isolated individuals to a community or social services might be effective. Legal force should be avoided if possible. There is some concern that landlords may require an older person to sign a contract agreeing to wear a device. The autonomy of solitary older people should be respected. (4) Governance: policies must be developed to limit access to data from wearables and the purposes for which data can be used.ConclusionIf thoughtfully deployed under proper policy constraints, wearable devices offer a way to connect solitary older people to health services and could reduce cases of solitary death while respecting the personhood of the user. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Martin Heidegger and OntologyEmmanuel Levinas (bio)The prestige of Martin Heidegger 1 and the influence of his thought on German philosophy marks both a new phase and one of the high points of the phenomenological movement. Caught unawares, the traditional establishment is obliged to clarify its position on this new teaching which casts a spell over youth and which, overstepping the bounds of permissibility, is already in vogue. For once, (...) Fame has picked one who deserves it and, for that matter, one who is still living. Anyone who has studied philosophy cannot, when confronted by Heidegger’s work, fail to recognize how the originality and force of his achievements, stemming from genius, are combined with an attentive, painstaking, and close working-out of the argument—with that craftsmanship of the patient artisan in which phenomenologists take such pride. In this study, it is important for us to understand, above all, the true intentions of our author, to illuminate what he thinks really needs to be said, and to surmise what is most critical for him.To get to the heart of Heidegger’s system, it seems fitting to begin with a problem that is generally familiar. We choose the problem of knowledge, a deeper understanding of which takes us to the very threshold of Heidegger’s thought. For this problem, central to modern philosophy, is one of the main obstacles of modern philosophy that Heidegger wishes to surmount. Neo-Kantianism, which takes knowledge as the philosophical problem of the first rank, is the movement against which Heidegger rebels with all his strength. We have, thus, every chance of gaining access to his thought by the main door, so to speak. Once inside the system we will try to trace its outlines, 2 reserving, for a second part of our work, the determination of Heidegger’s place in the history of ideas, especially in the phenomenological movement, as well as of his relations with the philosopher to whom he owes so much—Edmund Husserl. 31In its most general form, the problem of the theory of knowledge has a critical significance. It consists in delineating a domain where knowledge can be certain and in determining the criteria for the legitimate scope of knowledge. But this problem, as normal and as simple as it may appear, has deeper roots. That knowledge should need a criterion at all presupposes that truth is not identical to all that is known and that the course [End Page 11] of things can fail to correspond with the course of thought. “How does knowledge correspond to being?” is a more profound formulation of the problem of knowledge.But we are not going to touch anymore on the primordial phenomenon that generates the problem. The problem of correspondence between thing and thought presupposes a free activity of thought and its isolation in relation to the object. It is precisely this presupposition which renders their harmony and even their contact problematic. “How does the subject take leave of itself to attain the object?” is what the problem of knowledge, in the last analysis, boils down to. Its true source is thus the concept of “subject” as elaborated by modern philosophy. The cogito presided over the subject’s birth. The cogito was the affirmation of the privileged nature of the subject’s immanent sphere, of its unique place in existence; hence, the cogito was the specificity of the subject’s connection to the rest of reality, the sui generis nature which opens up the passage from immanence to transcendence, the passage from ideas contained in the thinking substance to 4 their “formal existence.”The concept of the subject, understood as a substance having a specific position in the entire domain of being, presents us with difficulties of two kinds. First, how do we understand this leave-taking from the self which the thinking substance brings about and which displays an entirely original aspect? Indeed, we could say that thought, in reaching out toward objects, does not actually take leave of itself, since its objects—considered as ideas and contents of thought—are, in a certain sense, already within it. In order to make sense of this paradox, Descartes... (shrink)