Health care reform that includes universal coverage could lower a major barrier to care for people of color and ethnic minorities—the inability to pay for care. But universal coverage alone, even with comparable fee-for-service payment or appropriately risk-adjusted capitated reimbursement, will not eradicate the racial and ethnic inequities in health care delivery. Restrictive admissions practices, geographic inaccessibility, culture, racial stereotypes, and the failure to employ minority health care professionals will still create barriers to minority health care. In addition to universal (...) financing, health care reform should include new civil rights legislation to address and reduce these noneconomic barriers to minority health care. (shrink)

This new edition of Psychiatric Ethics continues to serve as the most authoritative and comprehensive text on the many complex ethical dilemmas which face the clinician in everyday practice. In addition to addressing questions about drug therapy, sex therapy, suicide, and child psychiatry, among others, this up-to-date revision adds six new chapters discussing abuses in psychiatry in Japan and Nazi Germany; a conceptual analysis of what mental illness is; psychiatry as a profession; the ethical aspects of psychogeriatrics; and deinstitutionalization. This (...) book is essential reading for all mental health professionals. (shrink)

Sponsored by the Argentine Association for the Progress of Sciences, Ciencia e Investigación magazine released its first issue in 1945. In order to circulate the discoveries in the areas of medical and natural sciences, and to instruct on scientific thought, the magazine was introduced as a knowledge disseminating one and attempted to address a general audience. However, during its first publication decade the CEI editors faced two challenges related to scientific communication. On the one hand, they exhibited the conflicts implied (...) in research writing and the typical conditions of the language of science. On the other, they manifested their interest to bestow a discursive style on the magazine which, although simple and oriented to a wide audience, would not corrupt scientific veracity. This paper follows the French approach to discourse analysis, whose purpose is the simultaneous and reciprocal study of the verbal and the socio-institutional dimension of discourses, and analyses the sociolinguistic representations of the language of science and of its dissemination formulated in CEI between 1945-1955, a period - besides - complex for the scientific development in Argentina, characterized by state interventionism in different institutions. To this aim, editorials and articles that address the aforementioned problems have been selected and examined. The results exhibit the discursive complexities of scientific dissemination in an environment unaware of this practice and, consequently, the difficulty of determining a reader profile for the magazine. In general terms, they reveal the importance of the reflection on the language for the development and communication of science. (shrink)

Health care reform that includes universal coverage could lower a major barrier to care for people of color and ethnic minorities—the inability to pay for care. But universal coverage alone, even with comparable fee-for-service payment or appropriately risk-adjusted capitated reimbursement, will not eradicate the racial and ethnic inequities in health care delivery. Restrictive admissions practices, geographic inaccessibility, culture, racial stereotypes, and the failure to employ minority health care professionals will still create barriers to minority health care. In addition to universal (...) financing, health care reform should include new civil rights legislation to address and reduce these noneconomic barriers to minority health care. (shrink)

Work requirements are the centerpiece of HHS's Trump Administration strategy to undo the ACA expansion for low income working age adults. This article examines the June 29, 2018 trial court opinion in Stewart v. Azar which held that HHS's approval of Kentucky's Section 1115 work demonstration was “arbitrary and capricious.” The purpose of Medicaid is to provide health coverage and HHS may not ignore the loss of coverage that will result from a work requirement.

We study decision under uncertainty in an Anscombe–Aumann framework. Two binary relations characterize a decision-maker: one incomplete relation, reflecting her objective rationality, and a second complete relation, reflecting her subjective rationality. We require the latter to be an extension of the former. Our key axiom is a dominance condition. Our main theorem provides a representation of the two relations. The objectively rational relation has a Bewley-style multiple prior representation. Using this set of priors, we fully characterize the subjectively rational relation (...) in terms of the most optimistic and most pessimistic expected utilities. (shrink)

What is the right thing to do? -- "You have nothing to fear if you've done nothing wrong" -- Between culpable and blameless -- Are all mistakes equal? -- Report, disclose, protect, learn -- A just culture in your organization -- The criminalization of human error -- Is criminalization bad for safety? -- Without prosecutors, there would be no crime -- Three questions for your just culture -- Why do we blame?

Development projects in Sub-Saharan Africa propose to alleviate hunger in rural areas by introducing new agricultural practices and technologies, yet there is limited empirical evidence of how an agricultural intervention can lead farming households to transition to food security. Research on food security pathways considers agricultural interventions that increase farmers’ income to be particularly effective for reducing food insecurity. Consistent with this stance, Malawian agricultural policy aims to address hunger by encouraging smallholder farmers to intensify and commercialize maize production. This (...) paper explores if smallholders’ market and livelihood orientations do indeed lead them to favor an income pathway to food security. Qualitative analysis of 60 smallholder farmer interviews in Malawi found that, upon achieving improvements in production yields and diversity, rather than commercialize, many farmers re-organized their production and consumption to reduce market dependency. Farmers deployed this strategy to increase their food security, explaining that the choice to self-provision food and farming inputs was both an expression of farming identity and a lived understanding of their marginal position in commodity markets. The author finds that, in failing to consider how production relations affect food access, scholarship inadequately theorizes farm-level food security transitions and reproduces discursive framings of hunger. Food sovereignty narratives more accurately captured what mattered for Malawian smallholders’ food security, suggesting that engagement with this concept could improve scientific understandings of food security transitions. (shrink)

Pain is one of the most frequent presenting symptoms for patients who come to a physician's office. Despite the frequency of this presentation, little consistent, systematic information is provided to medical students or physicians about the treatment of pain. In addition, relatively little information is given about the recognition and prevention of drug abuse and about how to prescribe analgesics rationally to minimize the chances for abuse. This lack of educational preparation for both pain and addiction contributes to significant fear (...) and inability on the part of health professionals to diagnose and treat both conditions. It creates a barrier of fear to prescribe adequate doses of pain medications for patients who present with both acute and chronic pain problems. Inadequate medicating can be caused by the physician's overriding worry about creating addiction in a patient. Morgan has called this problem “opiophobia.”. (shrink)

Pain is one of the most frequent presenting symptoms for patients who come to a physician's office. Despite the frequency of this presentation, little consistent, systematic information is provided to medical students or physicians about the treatment of pain. In addition, relatively little information is given about the recognition and prevention of drug abuse and about how to prescribe analgesics rationally to minimize the chances for abuse. This lack of educational preparation for both pain and addiction contributes to significant fear (...) and inability on the part of health professionals to diagnose and treat both conditions. It creates a barrier of fear to prescribe adequate doses of pain medications for patients who present with both acute and chronic pain problems. Inadequate medicating can be caused by the physician's overriding worry about creating addiction in a patient. Morgan has called this problem “opiophobia.”. (shrink)

This paper studies an economy whose agents perceive their consumption possibilities subjectively, and whose preferences are defined on what they subjectively experience, rather than on those alternatives that are objectively present. The model of agents' perceptions is based on intuitionistic logic. Roughly, this means that agents reason constructively: a solution to a problem exists only if there is a construction by which the problem can be solved. The theorems that can be proved determine how an agent perceives a set of (...) alternatives. A dual model relates perceived alternatives to a shared language, which the agents use in trading. So perceptions relate objective alternatives to an agent's subjective view of them, and reporting dually relates an agent's subjective world to a shared language. It turns out that an appropriately modified notion of competitive equilibrium always exists. However, in contrast with standard results in economic theory, competitive equilibrium need not be efficient. (shrink)

Este artículo presenta los resultados de una investigación de corte cualitativo realizada los años 2007 y 2008 en Santiago de Chile, la que tuvo como uno de sus objetivos el describir y comprender las condiciones y la experiencia de trabajo de un grupo de hombres y mujeres de bajo nivel ocupacional empleados en la sala de venta de una gran cadena nacional de supermercados. A partir de la presentación y discusión de estos hallazgos se busca contribuir a una mejor comprensión (...) de los profundos procesos de flexibilización y modernización experimentados por el sector del retail en Chile en las últimas décadas, especialmente en lo que respecta al impacto de los mismos en la experiencia de trabajo de los sujetos empleados en dicho sector. Se espera de este modo arrojar luces desde una perspectiva psicosocial sobre los aspectos laborales de los cambios en el mundo del retail, los que han tendido a quedar invisibilizados ante los enfoques que han enfatizado las dimensiones económicas, o culturales y de consumo, de dichas transformaciones. (shrink)

After a mild indoctrination into the Christian faith, at the age of 15 I discovered myself to be a non-believer: the idea of an invisible, omniscient, omnipotent, omnipresent God suddenly seemed simply unbelievable. Years later I decided to re-examine the question. Perhaps I had missed something. This in turn led to a fascination with God questions and religious belief, but a re-confirmation of my earlier discovery: the traditional Christian concept of God was not only unbelievable, but incoherent and morally muddled. (...) But further reflection has yielded a qualifying conclusion: God—or rather gods, many gods—do exist but as ideas, tremendously powerful ideas that shape our reality. The crucial concern is that these be good ideas, which has not always been the case. (shrink)

Ethical issues are pivotal to the practice of psychiatry. Anyone involved in psychiatric practice and mental healthcare has to be aware of the range of ethical issues relevant to their profession. An increased professional commitment to accountability, in parallel with a growing "consumer" movement has paved the way for a creative engagement with the ethical movement. The bestselling 'Psychiatric Ethics' has carved out a niche for itself as the major comprehensive text and core reference in the field, covering a range (...) of complex ethical dilemmas which face clinicians and researchers in their everyday practice. This new edition takes a fresh look at recent trends and developments at the interface between ethics and psychiatric practice. Coming ten years after the third edition, the editors have observed several emerging aspects of psychiatric practice requiring coverage, as a result, 5 new chapters have been added, including cutting edge topics - such as neuroethics. All other chapters have been fully revised and updated. The book will continue to be essential reading for psychiatrists, psychologists, other mental health professionals, and bioethicists, as well as of interest to policy makers, managers and lawyers. (shrink)

The New Transnational Activism shows how even the most prosaic activities can assume broader political meanings when they provide ordinary people with the experience of crossing transnational space. This means that we cannot be satisfied with defining transnational activists through the ways they think. The defining feature of transnationalism in this book is relational, and not cognitive. This emphasis on activism's relational structure means that even as they make transnational claims, transnational activists draw on the resources, the networks, and the (...) opportunities in which they are embedded, and only then - if at all - on more distant transnational links. But we can no more sharply draw a line between domestic and international politics in studying transnational activism than we could ignore local politics in studying its national equivalent. Understanding the processes that link the local, the national and the international is the major undertaking of the book. (shrink)

In the rationalist tradition in ethics, the emotions are morally suspect. In a corrective swing of the pendulum, burgeoning philosophical interest is “rehabilitating” the emotions in ethical decisionmaking. The emotions and reason should be mutually correcting resources in moral reflection.

In this paper I will focus on what might be meant by fairness in a democratic regime. There may be more general fairness criteria applicable to any political system, democratic or authoritarian, but fairness in relation to political decisions is especially central in a democracy. Democratic regimes are supposed to be run by the citizenry, or at least the citizenry ought to be the ultimate authority. Democracies depend on legitimacy to function effectively; only when a regime is considered legitimate can (...) it rule by consent rather than coercion. Democratic regimes cannot rely on coercion to govern and long remain democratic. Thus, public acceptance is important. This also explains why the public determination of what is fair, both as a matter of principle and in the evaluation of particular actions of particular governments, is central in democratic rule. (shrink)

Recent events demonstrated to the world a growing sense of interconnection and interdependence that will call for universal values and ethical behaviors on the part of journalists. In this article I look at journalism, likening this profession of inquiry to that of scientists, and I look at journalism ethics as a body of knowledge before identifying universal characteristics and suggesting that because of the many universal values that bond humans at whatever location, journalists should be able to agree on common (...) ethical principles. (shrink)

Este artículo analiza la novela Jardín, de la escritora cubana Dulce María Loynaz, deteniéndose en las estrategias que despliega para subvertir distintos modelos de feminidad. La novela sostiene un diálogo productivo con distintas corrientes estéticas, cuyas formas de expresión asume y a la vez critica por las limitaciones que le imponen al desarrollo de la subjetividad femenina. A través del recorrido que realiza en Jardín por distintas propuestas estéticas e ideológicas que han contribuido a la configuración del sujeto moderno, Loynaz (...) despliega una crítica a las formas en que estas construyen el sujeto femenino y su posición en el orden de género sexual. Este recorrido se realiza desde dentro de estas estéticas, desde su apropiación productiva en la textualidad de la novela, la que transita por el lenguaje del romanticismo, del simbolismo, del modernismo y de las vanguardias. En Jardín se muestra cómo estos movimientos abren, pero también cierran, posibilidades de expresión y desarrollo para las mujeres. (shrink)

This paper discusses the characteristic properties of List PR systems and FPTP systems, as given in Hout 2005 and Hout et al. 2006. While many of the properties we consider are common to both systems, it turns out (see Hout 2005) that the British system distinguishes itself by satisfying the district cancellation property, while the Dutch system distinguishes itself by satisfying consistency and anonymity. For scoring rules, topsonlyness is equivalent to being party fragmentation-proof (see Hout 2005; Hout et al. 2006). (...) One might present this as an argument in favour of requiring topsonlyness. However, we will also give counter-arguments against insisting upon the property of being party fragmentation-proof. (shrink)

The nature and aim of science, by E. Nagel.--Truth and provability, by L. Henkin.--Completeness, by L. Henkin.--Computability, by S. C. Kleene.--Necessary truth, by W. V. Quine.--What is a scientific theory? By P. Suppes.--Science and simplicity, by N. Goodman.--Scientific explanation, by C. G. Hempel.--Observation and interpretation, by N. R. Hanson.--Probability and confirmation, by H. Putnam.--Utility and acceptance of hypotheses, by I. Levi.--Space and time, by A. Grünbaum.--Problems of microphysics, by P. Feyerabend.--Aspects of explanation in biological theory, by M. Beckner.--Psychologism and methodological (...) individualism, by S. Morgenbesser.--Science, fact, and value, by M. Scriven.--The justification of induction, by M. Black. (shrink)

In these probing essays, Sidney K. Robinson re-examines the picturesque in its late eighteenth-century phase.