Digital communications technology isreconfiguring democratic governance. Federalagencies increasingly rely on Internet-basedapplications to improve citizen-governmentinteraction. Early efforts in the area ofdigital government have created newparticipatory opportunities as well asformidable governance challenges. Federalagencies are working within and across theirboundaries to find an e-rulemaking format thatis cost-effective, legally appropriate,user-friendly, and well suited to diverse modesof rulemaking activities. One of the overridingissues emerging from this process is thedefinition of meaningful public participationin rulemaking. An examination of an early caseinvolving the USDA's National Organic (...) Programproposed rule summarizes comments related togenetic engineering, biosolids, irradiation,and the role of the National Organic StandardsBoard. The USDA's experience suggests a numberof complex challenges that must be met toeffectively integrate Web-based communicationsinto the federal rulemaking process. (shrink)

The analysis distinguishes two types of standards for defining organic produce; process standards and product standards. Process standards define organic products by the method and means of production. Product standards define organic by the physical quality of the end product. The National Organic Program (NOP) uses process standards as the basis for defining organic. However, the situation is complicated by agricultural production practices, which sometimes result in the migration of NOP prohibited substances from (...) conventional to organic fields. When this interaction alters the value of the product or the costs of production, a production externality is said to exist. Defining organic using process, rather than product standards, influences the burden and character of production externalities. The NOP’s emphasis on process standards reduces the likelihood that production externalities will emerge. (shrink)

Much research about organic foods standards and certification in the United States employs a critical political economic perspective to interrogate links between certification politics and the “conventionalization” of organic agriculture. While helpful, this literature tends towards a dualistic framework, which emphasizes conflicts between movement-oriented and agribusiness wings of the organic community but obscures deliberative processes that sustain the organic market as an alternative economic space. This article develops a different approach by taking up E. Melanie DuPuis (...) and Sean Gillon’s invitation to “begin a conversation about the everyday forms of civic engagement” involved in the governance of the organic foods market and other alternative economies (DuPuis and Gillon in Agric Hum Values 26:43, 2009). I merge DuPuis and Gillon’s analysis of civic “modes of governance” in the organic sector with a theory of deliberative discourse developed by the cultural sociologist Jeffrey Alexander. I then apply this approach to examine a 2017 dispute about whether hydroponic growing operations were eligible for certification under the National Organic Program rules. The data indicate that (1) several features of this dispute did not follow the lines of movement/agribusiness conflict emphasized by political economic research and (2) both supporters and opponents of hydroponic certification drew from a common discursive repertoire to advocate for their preferred outcomes. I argue that while this common repertoire does not prevent conflict over the organic standards, it does sustain the importance of civic—as opposed to purely economic or technical—considerations in the sector’s governance. (shrink)

A major strategy in the creation of sustainable economies is the establishment of alternative market institutions, such as fair trade and local market systems. However, the dynamics of these alternative markets are poorly understood. What are the rules of behavior by which these markets function? How do these markets maintain their separate identity as “alternative”: apart from the conventional (“free”) market system? Building on Lyson’s notion of civic agriculture, we argue that alternative markets maintain themselves through civic engagement. However, we (...) argue that the civically-engaged practices of alternative markets are poorly understood. We seek, therefore, to begin a conversation about the everyday forms of civic engagement in alternative practice and to do this we introduce a few useful conceptual tools. Building upon ideas in science studies about the collaboration of scientists (Hess, Alternative pathways in science and industry, 2007) we argue that civic markets have their own “market fields” and “modes of governance” (Bulkeley et al., Environment and Planning A 39:2733–2753, 2007), their own fields of social interaction in which rules of behavior become stabilized and determine how the market works. The creation of a social field also requires the demarcation of boundaries, referred to in the science studies literature as “boundary work” (Gieryn, Cultural boundaries of science: Credibility on the line, 1999). We apply the idea of boundary work to understand how alternative market actors maintain boundaries between alternative and conventional markets. Finally, studies of collaboration in science have often centered on the object created through these interactions, an object that is partially material and partially a product of knowledge, what (Rheinberger, Toward a history of epistemic things: Synthesizing proteins in the test tube, 1997) calls an “epistemic object.” We use this idea to understand that the creation of alternative objects of exchange, such as organic food, are epistemic objects in that they combine both particular materialities and particular ways of knowing. Using these concepts, we will carry out a close analysis of the mode of governance in the national organic market, looking specifically a recent governance crisis in organic agriculture known as the Harvey lawsuit. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Organ Transplant AllocationPat Milmoe McCarrick (bio)The introduction of the antibiotic, cyclosporin, which enhances the success rate of transplantation surgery, has resulted in the steady growth of organ transplantation since the mid-1980s. This growth increasingly focuses ethical interest on both the procurement and the allocation of human organs. Not everyone who might benefit from organ transplants can receive them since the number of patients in need of organs far exceeds (...) the number of organs available. Each year the waiting list for transplants increases by 20 percent, but the number of donated organs has remained stable for the past five years (Lawry 1994).Organ transplantation surgery performed on rock stars, sports heroes, politicians, and television celebrities brings questions about the fair allocation of scarce resources to the attention of everyone. Abigail Trafford, editor of Washington Post Health, wonders whether "new livers for hard livers" can be deserved when not enough organs are available for everyone who needs them. Writing about the dilemma of just allocation of organs, she calls famous recipients "poster patients" or "health care celebrities of medical catastrophe" (Trafford 1994). Personal responsibility—the viewpoint that "medical treatment should not be an entitlement program for profligate living"—is an emerging moral consideration according to Trafford. Deciding whose standards and values should apply to the allocation of organs raises many questions. Popular arguments for keeping the current criteria for allocation include: these patients are sick and therefore should be treated, regardless of the cause of their illness; former substance abusers should be able to benefit from their present abstention; physicians should treat anyone who is ill; and although many human illnesses may be caused by individual behavior, such behavior is not always used as a reason to deny care (Trafford 1995).Prior to 1984, when the government established regulations governing organ transplantation, organs routinely were given to the patients of the surgeons who excised them (Prottas 1994). In an effort to achieve a more equitable method of distribution, Congress passed the National Organ Transplant Act of 1984 (Pub. [End Page 365] L. No. 98-507, amended by Pub. L. No. 100607 and Pub. L. No. 101-616), which established a national Organ Procurement and Transplantation Network (OPTN) to improve the effectiveness of organ procurement, organ distribution, and transplant activities. The United Network for Organ Sharing (UNOS) received the federal government contract to be the OPTN.UNOS and its 66 regional organ procurement organizations (OPOs) around the nation have carried out the mandate since 1986. It requires hospitals that receive Medicare or Medicaid funds and perform transplants to belong to the network and to allocate organs according to network policies. UNOS maintains the national computer registry to match donor organs with individual recipients. In distributing organs, UNOS is required by law to use a fair and equitable system based on accepted medical criteria. UNOS regularly reevaluates its policies to ensure that organ donation and recipient selection meet criteria of efficiency and equity (UNOS Update 11 (8), 1995).At the end of June 1995, 278 transplant centers were in operation in the United States: almost all of them (247 centers) transplanted kidneys; 167 did hearts; 119, pancreases; 114, livers; 93, heart-lung; 88, lungs; 26, intestines; and only 19 centers performed pancreas islet cell transplants (UNOS Update 11 (8): 28, 1995). The number of patients waiting for organ transplants in July 1995 totalled 41,075: 29,274 were waiting for a kidney transplant; 4,937, liver; 3,298, heart; 1,816, lung; 1,223 kidney-pancreas; 240, pancreas; and 211, heart-lung (UNOS Update 11 (8): 40-41, 1995).OPOs are located in different geographic areas across the country, each with different organ needs, lengths of waiting lists, or with lists in areas with large older populations making it more difficult to find suitable donors. Black recipients often wait longer due to complex reasons including sensitization or rarer blood and antigen types (UNOS 11 (8): 31-32, 1995). When an organ becomes available, the OPO involved identifies a potential recipient from the UNOS list and offers it to the patient's surgeon. If no match can be made locally, the organ is next offered within a UNOS region, and finally, to... (shrink)

The United Nations Global Compact (UNGC) was created in 2000 to leverage UN prestige and induce corporations to embrace 10 principles incorporating values of environmental sustainability, protection of human rights, fair treatment of workers, and elimination of bribery and corruption. We review and analyze the GC’s activities and impact in enhancing corporate social responsibility since inception. First, we propose an analytical framework which allows us to assess the qualities of the UNGC and its principles in the context of external and (...) internal elements that influence code effectiveness and implementation. Second, we analyze UNGC performance in encouraging companies to become signatory members and bring about demonstrable change in corporate CSR-sustainability activities. In its 10-year report, UNGC has proclaimed growth in both membership and program activity. However, all credible and publicly available data and documentation conclusively demonstrate that the UNGC has failed to induce its signatory companies to enhance their CSR efforts and integrate the 10 principles in their policies and operations. The result has been a loss of public trust and support of UNGC from important constituencies among civil society organizations, and those individuals and groups adversely impacted by corporate activities and resultant negative externalities. This diminished credibility has also made UNGC largely dependent on the corporate sector for its very survival. We conclude that this dependence has in turn impaired and would continue to hinder UNGC’s ability to fulfill its mission. Such an outcome raises serious questions as to the viability, usefulness, and continued existence of UNGC. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Ethical, Legal, and Social Implications Research Program at the National Human Genome Research InstituteEric M. Meslin (bio), Elizabeth J. Thomson (bio), and Joy T. Boyer (bio)Organizers of the Human Genome Project (HGP) understood from the beginning that the scientific activities of mapping and sequencing the human genome would raise ethical, legal, and social issues that would require careful attention by scientists, health care professionals, government officials, (...) and the public. The establishment of the ELSI (ethical, legal, and social implications) programs at the National Human Genome Research Institute (NHGRI) and the Department of Energy (DOE) was thought to be vital to the success of the HGP in the United States. It also provided a novel approach to the simultaneous study of ethical, legal, and social issues and basic scientific issues. Eric Juengst, the first director of the ELSI program, described its origins in a previous issue of the Kennedy Institute of Ethics Journal (Juengst 1991). Now in its seventh year, the ELSI program has accomplished much. This article summarizes the evolution and goals of the ELSI program at NHGRI, outlines the program’s current research priorities with examples of activities within each priority area, and provides a look to the future, including the initiation of a strategic planning process.Evolution and Goals of the ELSI Research ProgramThe HGP’s “genomic” goals are unique: to map and sequence the entire human genome—some 3 billion base pairs that make up approximately 80–100,000 genes—and the genomes of related model organisms by the year 2005. This goal was particularly ambitious since, when it was proposed, the technologies for mapping and sequencing had yet to be developed. When the HGP was first established, its organizers also elaborated a set of ELSI goals, which they saw as vital to the success of the genome project. The original ELSI goals were: (1) to anticipate and address the implications of the HGP for individuals and society and (2) to examine the ELSI consequences of mapping and sequencing the human genome in order to stimulate public discussion. To meet these goals, the NHGRI created its ELSI research program in 1990. Along with mapping, sequencing, [End Page 291] and mammalian genetics, ELSI was one of four original branches in the NHGRI Division of Extramural Research that funded research in those areas. Although the individual “branches” no longer exist, the mechanisms for funding research remain much the same. While the overall goals of the program have not changed, the specific ways of achieving the goals have continued to evolve. The importance of the ELSI program lies not in the collection of a full set of data that will be valuable in and of itself, but in the value of using and interpreting this new set of information.Early on, the NHGRI described a set of somewhat more specific goals: (1) to develop a program to help understand the ethical, legal, and social implications of the human genome project and (2) to identify and define the major issues of concern and develop policy options to address them. These more specific goals have been largely met. As the most recent biennial NHGRI Progress Report notes, “a robust ELSI research and education program has been established, many of the most urgent ELSI issues have been identified, and many policy options to address these issues have been proposed” (NCHGR 1995, p. 21). Between 1990 and 1996, ELSI provided more than $32.5 million in funding through 128 research and education grants in more than 30 states and in Canada (Table 1). The ELSI research budget is unique in that when originally created, it was specifically tied to the amount of money provided for the overall NHGRI budget. The NHGRI originally devoted 3 percent of its extramural budget to fund ELSI projects, but in FY 1991, it increased the ELSI budget to 5 percent, a figure that remains today. Table 2 lists the expenditures for each fiscal year since 1990 and the cumulative expenditures to date. The ELSI research budget at NHGRI this year will be about $7 million. When other sources of funding—e.g., co-funding arrangements with other institutes and agencies and the funding of ELSI... (shrink)

The state of national economies development varies and is characterized by many indicators. Economically developed countries are known as doubtless leaders that are in progress and form political stability, social and economics standards, scientific and technical progress and determine future priorities. It is worth mentioning that the progressive development of national economies in conditions of globalization can take place only in case of the increase of their intellectualization level, through saturation of people`s life, economic relations and production by (...) brain activity, knowledge, creativity, innovation, culture, ethical considering of the historical heritage. The main aim of the research is national economies intellectualization evaluating in globalization conditions. In order to gain this aim, the following tasks were defined: to identify existing indices of the national economies intellectualization level evaluation, develop the authors’ methodological approach to the national economies intellectualization level, determine the areas of measurement results application. While conducting the research, systematic approach, the methods of analysis, synthesis, grouping, abstracting, generalization, imaginary experiment and grounding were used. In the modern world, there are a large number of indicators which characterize differences in intellectual state of the national economy. When comparing the state of national economies intellectualization, the problems arise with different number of countries, duplication of indicators, disproportionate number of the components of indicators, various years of publication, etc. Therefore, to ensure comparability, we choose four general indicators – the index of human development, the global innovation index, the global competitiveness index and the knowledge economy index. Using these indices, we do the research and determine the state of national economies intellectualization in the world economy. According to the calculated results, as of 2013, we have divided 190 national economies by level of intellectualization into five groups: countries with the highest (30 countries), high (30 (countries), low (30 countries), the lowest (35 countries) and the countries with uncertain state of intellectualization (65 countries). The leaders in the state of intellectualization are Switzerland, Sweden, The Netherlands, Finland and the USA. The countries with the highest level of intellectualization serve as an example to all other countries of the world. These countries are characterized by developed market economy; a dominant position in the international economy, which allows actively engaging own and imported resources in the economic turnover; the shift of the center of gravity of economic activity into the services sector and the dominance of service economy; the greatest exhaustion of sources and factors of industrial development; advanced post-industrial development. The economic policy of the first group of countries has a decisive influence on the state and dynamics of the global economy, defining the main directions of its scientific and technological development and structural adjustment. The average index of the national economy intellectualization (AINEI), calculated by the authors, shows the place of each country in the world community as to their intellectual capital. Considering the continued deployment of R&D progress, the growing role of high-tech production and the complexity of social and economic relations, AINEI can serve as a reliable indicator of the macroeconomic environment intellectualization state. Therefore, the following organizations, bodies and individuals can use the comparative results of this study: the international organizations while developing international economic development programs; the state authorities of the countries in foreign and domestic policy forming; companies that create innovative and investment policy; migrants, tourists and persons who perform professional and transit activity for the formation of human potential and capital; scientists and teachers who develop mechanisms of intellectualization. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 13.1 (2003) 53-64 [Access article in PDF] Incentives for Providing Organs Patricia Milmoe McCarrick and Martina Darragh After a contentious debate at its 2002 annual meeting, the American Medical Association's House of Delegates voted to endorse the opinion of its Council on Ethical and Judicial Affairs that the impact of financial incentives on organ donation should be studied (Josefson 2002). The shortage of organs (...) for transplantation has been an ongoing problem for more than 20 years. In June1981, Representative Philip Crane (R-IL) introduced legislation in the U.S. House of Representatives proposing a $25,000 income tax deduction and a $25,000 estate tax exclusion for donating an organ (Tax Incentives 1981). Still the National Organ Transplant Act enacted in October 1984 prohibited the offering of any "valuable consideration" in return for organs (United States 1984).The developments of a legal market for tissues in the United States and a black market for organs around the world have raised the question of whether donation without compensation is the only ethically viable option. Some critics of the current system claim reliance on donation actually promotes a black market in organs (Kaserman and Barnett 2002, p. 38; Palmer 1999, p. 36). In addition, a new set of compensation issues has arisen as living kidney donor transplantations begin to rival those performed with cadaveric organs (United States 2001).As a result, current suggestions for incentives go far beyond the traditional death benefit payment to include such ideas as medals of honor for donors, reimbursement for funeral expenses, exchange programs for organ donation, and special medical insurance for living organ donors. Numerous bills introduced into the 107th Congress have proposed such incentives (Delmonico et al. 2002.) In October 2002, the U.S. Department of Health and Human Services awarded $5.2 million in grants to study both clinical and behavioral interventions for increasing organ donations that do not involve incentives. The inspiration for some of the funded proposals comes from the successes of Spain's social services and the United Kingdom's clinical administration of organ procurement programs (Robeznieks 2002). [End Page 53]With a nod to evidence-based medicine, the underlying concern expressed in much of the current literature is that no idea for increasing the supply of organs should be discounted before it is studied. This bibliography provides a short introduction to the range of opinions expressed on the issue of incentives for providing organs.al-Mousawi, M.; Samhan, M.; al-Mezairee I.; Razzak, M.A.; and Khawari, F. Cadaver Organ Procurement in Kuwait. Transplantation Proceedings 31 (8): 3375-76, 1999.The authors describe a protocol that significantly increased cadaveric organ donation and credit it with fostering the expansion of an organ sharing program among the Arab Gulf states. Developed by Kuwaiti neurologists and anesthetists after a continuing education course on transplantation, the protocol places a special emphasis on the role of local transplant coordinators who facilitate the investigation of brain death cases by neurologists.Arnold, Robert; Bartlett, Steven; Bernat, James; et al. [Ethics Committee of the American Society of Transplant Surgeons] Financial Incentives for Cadaver Organ Donation: an Ethical Reappraisal. Transplantation 73 (8): 1361-67, 27 April 2002.To prepare for proposed studies of financial incentives for organ donation, the American Society of Transplant Surgeons convened a panel to develop a methodology for evaluating the ethics of such research. Comprised of organ procurement organization executives, physicians, surgeons, and ethicists, the panel generated a list of nine criteria for use in judging any incentives proposal. While opposed to direct payment or tax incentives for organ donation, a majority of the members support funeral expense reimbursement or charitable contributions as incentives that would not violate or undermine the ideal of altruism.Cameron, J. Stewart, and Hoffenberg, Raymond. The Ethics of Organ Transplantation Reconsidered: Paid Organ Donation and the Use of Executed Prisoners as Donors. Kidney International 55 (2): 724-32, February 1999.After reviewing arguments for and against payment for organ procurement, the authors apply these arguments to the specific case of obtaining organs from executed... (shrink)

We present a perspective of the national transplant program based on organizational theory and complexity theory, framing the system’s allocation of donor organs as an interorganizational directed multiplex of agents with diverse belief formation in a cooperative-competitive environment. Simulation and analysis of this macroscale complexity may help explain known behavioural variations across member organizations. However, the transplant community still relies on system-scale simulations since effective macroscale methodologies are not well established. Therefore, we offer this perspective of the (...) class='Hi'>national transplant program as a means to stimulate new methods that capture macroscale impacts of policy development for deceased donor organ allocation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Experiences of the Live Organ Donor: Lessons Learned Pave the FutureDianne LaPointe RudowIntroductionThe experience of a live organ donor is multi–faceted and is as unique as each person who agrees to take a risk to save another. Factors include: type of organ donated (kidney vs. liver), relationship to the recipient (related—biological or non–biological vs. non–related), decision–making and motivation for donation, support systems available within and outside of the transplant (...) program, and outcomes of the donation for both recipient and donor. The variety of experiences is apparent in the narratives within this special issue. I want to thank the authors of each story for sharing their experiences of the live donation process. As difficult as it must have been to write, it was difficult for someone like me, a transplant professional who is a strong advocate for quality donor care, to hear. But with each success and failure of transplantation, we can learn in the hopes of improving things for the next.Despite the fact that the field of transplantation is over 50 years old and the first kidney donors were live donors, viewing the field of live donation as a subspecialty of transplantation is a new concept (LaPointe Rudow, 2011). Live donation is, in fact, as specialized as lung transplant, liver transplant, transplant infectious disease, and kidney transplant. All of those subspecialties have clinicians and researchers with expertise in the area. Live donation experts exist and teams of live donor professionals staff most transplant programs today. Additionally regulatory bodies, professional societies, and advocacy groups strive to improve the care of the live organ donor (Medicare Conditions of Participation, 2007; Organ Procurement and Transplant Network, 2011; National Kidney Foundation 2011). Many years have been spent perfecting the surgical procedure and refining the proper testing to ensure that donation is safe for the donor. Live donation is, however, more than a surgery; in recent years, transplant professionals acknowledge that the psychosocial impact of donation on donors, whether positive or negative, can be significant but it is not yet completely understood.Much debate has occurred as to the components of the psychosocial evaluation, length and type of follow up, and the role of the independent live donor advocate (Amsterdam Forum, 2005; Ommen et al. 2011; Pruett et. al. 2006; Schroder et. al. 2008; Simpson & Pomfret 2012). The ethical concepts of paternalism and autonomy are in tension as we attempt to justify live donation. Perhaps nowhere else is ethical deliberation more vigorous than in the debate regarding whether informed consent for live donation is attainable, driven largely by the plight of the patient and the consequent vulnerability of the donor in an effort to help the patient. These quandaries are illustrated in the compelling narratives of this special issue. [End Page 45]Narrative ThemesBased on an analysis of the narratives, I will present a series of dominant themes that emerged from the stories; these will be exemplified by illustrative quotations from the live donor’s narratives.Live Donation has Psychological Effects on the DonorThere are many psychological effects of live donation both pre–and post–donation. The narratives describe feelings such as “I felt like a hero,” “feelings of anxiety, anger and ambivalence,” “it’s the best thing I ever did,” “I would do it all over again,” “a sense of loss,” and feelings of “suicidal thoughts.” The dichotomy of feelings expressed demonstrates the uniqueness of the live donor experience. One donor has nothing but good things to report regarding his or her experience while another feels lasting ill emotional affects requiring ongoing counseling even though the recipient has done well.Pre–donation psychological issuesTraditionally, the psychosocial evaluation explores the pre–donation emotional and family stressors to ensure that there are no issues or underlying psychiatric disorders that will make donation high risk for psychological complications. All donors writing the narratives were found to be suitable donors. That being said, there is no standardized approach to the psychological evaluation. Organ Procurement and Transplant Network (OPTN)/United Network for Organ Sharing (UNOS) (Organ Procurement and Transplant Network, 2011) have policies and guidelines and the Centers for Medicare Conditions of Participation (COP) (Medicare Conditions of... (shrink)

This volume has its already distant or1g1n in an inter national conference on Evolutionary Epistemology the editors organized at the University of Ghent in November 1984. This conference aimed to follow up the endeavor started at the ERISS (Epistemologically Relevant Internalist Sociology of Science) conference organized by Don Campbell and Alex Rosen berg at Cazenovia Lake, New York, in June 1981, whilst in jecting the gist of certain current continental intellectual developments into a debate whose focus, we thought, was (...) in danger of being narrowed too much, considering the still underdeveloped state of affairs in the field. Broadly speaking, evolutionary epistemology today con sists of two interrelated, yet qualitatively distinct inves tigative efforts. Both are drawing on Darwinian concepts, which may explain why many people have failed to discriminate them. One is the study of the evolution of the cognitive apparatus of living organisms, which is first and foremost the province of biologists and psychologists (H. C. Plotkin, Ed. , Learning, Development, and Culture: Essays in Evolu tionary Epistemology, New York, Wiley, 1984), although quite a few philosophers - professional or vocational - have also felt the need to express themselves on this vast subject (F. M. Wuketits, Ed. , Conce ts and Approaches in Evolutionary Epistemology, Dordrecht Boston, Reidel, 1984). The other approach deals with the evolution of science, and has been dominated hitherto by (allegedly) 'naturalized' philosophers; no book-length survey of this literature is available at present. (shrink)

After having accomplished an observation of the different problematic that affect the daily life of our city, as reflect of what happens in the rest of the national territory, we have been attracted to implement a juridical analysis to the situation of the donation and organ transplantation in the legal ambit of our country, with the objective to identify the level of efficacy and the normative scope with respect to the situation of people who need a transplant. This restlessness (...) born from the analysis of the law 1716 and its regulation, which ambiguously delimits the functions of the centers of health in what respect to this topic, also to establish the creation of a waiting list and a record, tool which objective would be norm the permanent supply of organs through donation programs. These do not accomplish their objective or being attached to a public policy in the ambit that allow the continuity of the institutions and benefit of the people in need. (shrink)

We hypothesize that recent uses of the Internet as a public-participation mechanism in the United States fail to overcome the adversarial culture that characterizes the American regulatory process. Although the Internet has the potential to facilitate deliberative processes that could result in more widespread public involvement, greater transparency in government processes, and a more satisfied citizenry, we argue that efforts to implement Internet-based public participation have overlaid existing problematic government processes without fully harnessing the transformative power of information technologies. Public (...) comments submitted in two United States Department of Agriculture rulemaking processes—the National Organic Program’s organic standard and the Forest Service’s Roadless Area Conservation Rule—compose our data. We conclude that the Internet provides an arena for playing out three types of conflicts that have long plagued environmental decision-making processes: conflicts over trust of federal agencies, the use of science, and the role of public values. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Veterans Affairs National Center for Clinical EthicsJames L. Bernat (bio)The veterans health administration is the largest health care system in the United States and, indeed, is larger that the health care system of many foreign countries. In February 1991 the Department of Veterans Affairs (V.A.) in Washington, D.C. awarded a contract to the clinical ethics group at the Veterans Affairs Medical Center in White River Junction, Vermont (...) to establish the V.A. National Center for Clinical Ethics. In this article I describe the organizational context, mission, operation, and future direction of the Center, which William A. Nelson, Ph.D., and I co-direct.The Veterans Health AdministrationThe Department of Veterans Affairs operates 171 hospitals providing services ranging from primary, secondary, and tertiary medical care to psychiatric hospitals, rehabilitation centers, and nursing homes. The V.A. also provides outpatient services at all hospitals and at dozens of free-standing outpatent clinics. V.A. medical centers employ over 14,000 physicians and serve approximately 4.5 million veteran patients (Hollingsworth and Bondy 1990; Mirvis 1990).The V.A. serves an important educational function, providing training sites for medical students, postgraduate physicians, and trainees in other health-related fields. Approximately 78 percent of V.A. medical centers are affiliated with medical schools. Over one-third of all American medical students and over 40 percent of interns and residents spend a portion of their training in V.A. medical centers. More than 100,000 students in all health-related fields train in V.A. facilities annually (Hollingsworth and Bondy 1990).Research is another mission of the V.A. Many academic physicians and scientists derive their research and salary funding from V.A contracts and awards. The V.A. Research Career Development Program provides the means for many medical school faculty members to achieve successful careers as scientists and clinical investigators. Although research accounts for only slightly more than 1 percent of the V.A. medical budget, two V.A. researchers have been awarded the Nobel Prize (Hollingsworth and Bondy 1990). [End Page 385]In comparison to other medical care settings, the average V.A. patient is likely to be older, poorer, male, less well-educated, more chronically ill, and more expensive to care for. Many patients first patronize the V.A. system after they have been bankrupted by the costs of a major illness. Unlike young, healthy patients ideally favored by health maintenance organizations, these patients immediately require large expenditures for hospitalizations, medications, and other treatments. Additional burdens have been placed on V.A. facilities by a record of chronic federal underfunding over the past decade, despite expanded patient censuses at every facility.Bioethical issues arise in V.A. facilities with great frequency for several reasons. Older and poorer patients are often sicker, have fewer home-support resources, and have completed fewer advance directives for health care. Chronic operational underfunding requires explicit health care rationing systemwide. Academic physicians within the V.A. system have multiple professional duties that have the potential for conflict. Although their primary duty is to their patients, they also must serve the federal government and their medical school academic supervisors. The practice of medical care rationing pits the physician's professional duty to his patient against his duty to the system (Mirvis 1990).The V.A. has responded to these bioethical demands with several initiatives. Hospital ethics advisory committees have been developed in nearly every V.A. medical center. The V.A. National Bioethics Committee has been empaneled to encourage uniform policies across the V.A. system concerning bioethical issues. Most recently, funds were provided for the V.A. National Center for Clinical Ethics.Functions of the National Center for Clinical Ethics (NCCE)The NCCE has a fourfold mission: 1) to enhance the quality of clinical ethics programs at all 171 V.A. medical centers nationwide; 2) to staff the V.A. National Bioethics Committee; 3) to assist administrators and planners in the V.A. Central Office on policy development concerning bioethical issues; and 4) to study, organize, and coordinate clinical, educational, and research bioethics programs throughout the system.Enhancing the quality of clinical ethics programs at V.A. medical centers is largely an... (shrink)

Government-sponsored school lunch programs have garnered attention from activists and policymakers for their potential to promote public health, sustainable diets, and food sovereignty. However, across country contexts, these programs often fall far short of their transformative potential. It is vital, then, to identify policies and organizing strategies that enable school lunch programs to be redesigned at the national scale. In this article, we use document analysis of historical newspapers and government data to examine the motivating factors and underlying conditions (...) that allowed South Korea’s universal free, eco-friendly school lunch program to become a tool for advancing social justice and ecological goals at the national scale. We analyze the socio-historical evolution and current status of the Korean school lunch program, combining the multi-level perspective with insights from environmental sociology and critical food studies, in order to shed light on the factors that enabled the program to become an innovative niche and articulate the opportunities and challenges it now faces. We identify the state-sponsored creation of what we call “precautionary infrastructure” as a key anchoring mechanism between the school food niche and agri-food regime. Precautionary infrastructure includes new supply chains, certification standards, and sourcing policies that provide a stable market for eco-friendly farms and small-scale producers, while minimizing the environmental health risks of school lunch by delivering organic and pesticide-free ingredients to on-site kitchens that serve free lunches to all students. This analysis offers insight into how public school-lunch programs can become protected niches that help drive sustainability transitions within agri-food systems. (shrink)

The ELSI Program: Closing the Loop was an interpretive policy study undertaken to identify how the research and the researchers funded through the program to study the ethical, legal, and social implications of mapping the human genome contributed to the construction of a public policy agenda. The stated goals of this federal grant program, known as ELSI and administered through the National Center for Human Genome Research within the National Institutes of Health, was to maximize (...) the benefits and minimize the harms of the genetic information developed as a result of the government supported genomic research. The purpose of the research project was to generate meaning and understanding regarding the social constructions of this community of researchers. Specifically, identifying themes in the process and outcomes of the research activity was intended to inform future public policy actions, thereby, closing the loop on the reflexive activity generated by the ELSI Program. The activities of the sixty-four researchers granted awards between 1990 and 1993 comprised the core sample for the study. The research process was embedded in a constructivist philosophy and the design included participant observation and an analysis of textual materials generated by the grantees. Data included periodical articles, authored and edited books, videos, popular print and visual media materials, conference papers and presentations, forum reports, interviews, and materials generated by the researcher in the process of the research--notes and analytic memos. Data analysis was an interpretive synthesis of a content analysis, contextual analysis, grounded theory coding categories, and the reflexive process of the researcher. ;The phenomena under investigation were the interactional activities of the ELSI group of researchers through which meaning was shaped on the ethical, legal, and social implications of genomic mapping. A theoretical model of the constructions of the researchers as developed included two core categories: "Framing Academic Constructions" and "Institutionalizing the Myth". The ELSI researchers used a variety of strategies, including rhetorical questioning, professional blocking and impersonalizing, plying a trade, and academic time in generating constructions. The research and researchers contributed to institutionalizing a myth of a genome through strategies that included being the expert, narrowing the focus, and marveling. The consequence of these social interactions was a process of "Making Points Not Meaning", participation in symbolic activities that generated few issues for the public policy agenda. The constructions of the policy study were then situated in the context of the discipline of public administration and policy studies. Significant to the impact of the research findings was understanding how the cooptation of these researchers might effect an health care delivery system dominated by commercial interests such as biotechnology and managed care organizations. The study concluded with a discussion of how situated knowledge constructions, social epistemology, interdisciplinarity, and interpretive research methods might contribute to enhanced credibility in public policy actions. (shrink)

Following the unsuccessful attempt to get a woman appointed as UN secretary-general in 2016 and the drop in women in senior posts in 2015, it appeared that gender equality at the UN was as distant as ever. Yet, gender equality within the Secretariat and UN system has been on the organization's agenda since 1970, with goals and target dates set for the level of women's participation and achievement. These have been met in some issue areas and organizations, but not others. (...) As part of the special issue on “The United Nations at Seventy-Five: Looking Back to Look Forward,” this essay traces the evolution of efforts to increase the representation of women in the UN system and takes stock of their current representation therein, analyzing the data on the Secretariat and appointments to senior posts as well as in various operations and programs. (shrink)

This article presents and evaluates arguments supporting that an approval procedure for genome-edited organisms for food or feed should include a broad assessment of societal, ethical and environmental concerns; so-called non-safety assessment. The core of analysis is the requirement of the Norwegian Gene Technology Act that the sustainability, ethical and societal impacts of a genetically modified organism should be assessed prior to regulatory approval of the novel products. The article gives an overview how this requirement has been implemented in the (...) regulatory practice, demonstrating that such assessment is feasible and justified. Even in situations where genome-edited organisms are considered comparable to non-modified organisms in terms of risk, the technology may have—in addition to social benefits—negative impacts that warrant assessments of the kind required in the Act. The main reason is the disruptive character of the genome editing technologies due to their potential for novel, ground-breaking solutions in agriculture and aquaculture combined with the economic framework shaped by the patent system. Food is fundamental for a good life, biologically and culturally, which warrants stricter assessment procedures than what is required for other industries, at least in countries like Norway with a strong tradition for national control over agricultural markets and breeding programs. (shrink)

BackgroundKnowledge and attitude towards organ donation are critical factors influencing organ donation rate. We aimed to assess the knowledge and attitude towards organ donation in adolescents in Austria and Switzerland.MethodsA paper-based survey was performed in two secondary schools (age range 11–20 years) in Austria and Switzerland. 354/400 surveys were sufficiently answered and analyzed.ResultsOur study found that knowledge on organ donation is scarce in adolescents. Less than 60% of those surveyed thinks that a person is dead when declared brain dead. 84.6% (...) would authorize organ donation after brain death for themselves, but only 69% would authorize organ donation after brain death for a close relative. 93.7% would accept a donor organ if they needed one. Family discussions, rather than school discussions, influenced knowledge on organ donation, the percentage of respondents who have a firm opinion on organ donation and the rate of declaration of this opinion. Age, gender, nationality and religion also influenced knowledge and attitude towards organ donation. Nearly one third of adolescents are of the opinion that selling non-vital organs should be legalized.ConclusionSince having had family discussions, a potentially modifiable factor, was positively associated with knowledge and attitude towards organ donation, we postulate that educational programs stimulating family discussions on organ donation may be a promising strategy to increase knowledge. (shrink)

Engaged scholarship is an intellectual movement sweeping across higher education, not only in the social and behavioral sciences but also in fields of natural science and engineering. It is predicated on the idea that major advances in knowledge will transpire when scholars, while pursuing their research interests, also consider addressing the core problems confronting society. For a workable engaged agenda in science and technology studies, one that informs scholarship as well as shapes practice and policy, the traditional terms of engagement (...) must be renegotiated to be more open and mutual than has historically characterized the nature of inquiry in this field. At the same time, it is essential to protect individual privacy and preserve government confidentiality. Yet there is a scientific possibility for and benefit to introducing more collaborative and deliberative research approaches between scholar and subject in ways that will not violate these first-order ethics. To make the case, this article discusses the possibilities and perils of engaged science and technology scholarship by drawing on our own recent experiences to conduct and apply STS research while embedded in the National Science Foundation. Brief accounts of these experiences reveal the opportunities as well as the challenges of engaged scholarship. They also provide lessons for those fellow travelers who might follow the authors to this or other like host organizations with ambitions of increasing fundamental knowledge about and applying research to the policies, programs, and decisions of the scientific enterprise. (shrink)

: Presently more than 80,000 Americans await an organ transplant, while 10 to12 people die each day because of the lack of organs. The program proposed here would allow federal inmates additional "time off" for agreeing to become living donors or to provide organs or their bodies upon death. Such a program could add 100 to 170 thousand new organ donors to the pool, with another 10 to 12 thousand added annually. If the program were applied to (...) all state inmates, up to 4 million new donors might be added, with another 10 to 13 thousand added annually. Given the extreme need for more organ donors and the need for more living donors, the current National Transplant Act of 1984 and the Uniform Anatomical Gift Act must be amended, while still retaining control of donation procedures. (shrink)

Whether the nation of Israel has become a “light unto the nations” in terms of ethical behavior among its business community remains in doubt. To examine the current state of business ethics in Israel, the study examines the following: (1) the extent of business ethics education in Israel; (2) the existence of formal corporate ethics program elements based on an annual survey of over 50 large Israeli corporations conducted over 5 years (2006–2010); and (3) perceptions of the state of (...) business ethics based on interviews conducted with 22 senior Israeli corporate executives. In general, and particularly as a young country, Israel might be considered to have made great improvements in the state of business ethics over the years. In terms of business ethics education, the vast majority of universities and colleges offer at least an elective course in business ethics. In terms of formal business ethics program elements, many large companies now have a code of ethics, and over time continue to add additional elements. Most respondents believed they worked in ethical firms. Despite these developments, however, there appears to be significant room for improvement, particularly in terms of issues like: nepotism/favoritism; discrimination; confidentiality; treatment of customers; advertising; competitive intelligence; whistle-blowing; worker health and safety; and the protection of the environment. When compared with the U.S. or Europe, most believed that Israeli firms and their agents were not as ethical in business. A number of reasons were suggested that might be affecting the state of business ethics in Israel. A series of recommendations were also provided on how firms can better encourage an ethical corporate culture. The paper concludes with its limitations. (shrink)

The proposed national PrEP program would serve people who are uninsured as well as those enrolled in Medicaid. In this article, the authors propose a set of recommendations for the proposed program’s implementers as well as state Medicaid agencies and Medicaid managed care organizations to ensure PrEP access for people enrolled in Medicaid, addressing gaps without undermining the important role of the Medicaid program in covering and promoting PrEP.

In lieu of an abstract, here is a brief excerpt of the content:230 Feminist Studies 47, no. 1. © 2021 by Feminist Studies, Inc. Nneka D. Dennie The State and Future of Black Women’s Studies: The Black Women’s Studies Association and the National Women’s Studies Association in Conversation On February 25, 2021, the Black Women’s Studies Association (BWSA) and National Women’s Studies Association (NWSA) partnered for one of NWSA’s Kitchen Table Talks—a new initiative spearheaded by NWSA President Kaye (...) Wise Whitehead to foster dialogue between NWSA and other organizations. The event, titled “Space Making: State/Future of Black Women’s Studies,” featured three panelists and was moderated by Whitehead. The featured speakers were Stephanie Andrea Allen (BWSA conference chair), Jacinta R. Saffold (BWSA co-founder and treasurer), and Erica L. Williams (member of the NWSA Governing Council). Allen is a Black lesbian writer and publisher whose scholarship examines how lesbian literature and film responds to and resists the heteropatriarchal systems that invisibilize Black lesbians; she is a postdoctoral fellow and visiting assistant professor of gender studies at Indiana University. Saffold is an assistant professor of English at the University of New Orleans who researches twentieth- and twenty-first-century African American literature, hip hop studies, and digital humanities. Williams is an associate professor of anthropology at Spelman College, whose work has examined sex tourism and Black feminist activism in Brazil. Together, Whitehead, Allen, Saffold, and Williams explored their hopes for Black Women’s Studies and illuminated the challenges and joys of advancing the field. News and Views 231 The collaboration between BWSA and NWSA is a testament to how far Black Women’s Studies has come over the past fifty years and a promise of where it may continue to go in the future. NWSA was founded in 1977 and has since served as a hub for researchers, educators, and practitioners who interrogate questions of women and gender in their work. For decades, NWSA has been central to the nationwide US institutionalization of women’s, gender, and sexuality studies. By contrast, BWSA is a young organization that is continuing to grow. In 2018, Saffold and I co-founded BWSA in order to provide a community for scholars working in the field of Black Women’s Studies. BWSA is the only professional association specifically designed to bring scholars from a variety of disciplines into conversation about research that centers Black women. We launched BWSA with the goal of ensuring that future generations of scholars can readily access networks and mentorship from researchers who encounter a common question: when your work is simultaneously “too Black” and “too woman” for your field, department, or institution, what do you do? Drawing inspiration from well-established organizations in which we frequently participated, such as NWSA, the Association for the Study of African American Life and History (ASALH), the Association of Black Women Historians (ABWH), and the African American Intellectual History Society (AAIHS), Saffold and I sought to build a space that cultivated a Black feminist ethic of care for both the research and the researchers. In that spirit, BWSA provides resources to help scholars do their best work, including a mentorship program, a virtual writing community, a calls-for-papers list for publications, and article as well as graduate student paper prizes. It was an honor to join an organization as trusted and respected as NWSA for a dialogue about our shared visions for Black Women’s Studies. Three key themes emerged from the panelists’ conversation with each other. They repeatedly returned to the importance of making financial commitments to Black Women’s Studies, creating conditions to support Black women’s intellectual labor, and practicing self-care. Speakers explored the interplay between the responsibilities that institutions, communities, and individuals have to Black Women’s Studies and Black feminist scholars. They observed that in order for departments and universities to foster interdisciplinary work on Black women, they need to move beyond paying lip service to the idea that diversity, equity, and inclusion matter; there needs to be permanent funding for work on race, 232 News and Views gender, class, and sexuality. Panelists also emphasized that Black women being in community with each other and supporting one another have always been central to... (shrink)

Ruth Myrtle Patrick was a pioneering ecologist and taxonomist whose extraordinary career at the Academy of Natural Sciences of Philadelphia spanned over six decades. In 1947, an opportunity arose for Patrick to lead a new kind of river survey for the Pennsylvania Sanitary Water Board to study the effects of pollution on aquatic organisms. Patrick leveraged her already extensive scientific network, which included ecologist G. Evelyn Hutchinson, to overcome resistance within the Academy, establish a new Department of Limnology, and carry (...) out the survey, which was a resounding success and brought much needed money to the Academy. As demand for her expertise grew among industrial companies, such as the chemical company DuPont, Patrick became more active in the world of applied science. She repurposed data and instruments from her river surveys to run new experiments, test ecological theories, and conduct long-term ecological studies. Through these studies, she advanced an argument that biologist Thomas Lovejoy dubbed the “Patrick principle,” the idea that the ecological health of a body of water could be measured by the relative abundance and diversity of species living there. Patrick was elected to the National Academy of Sciences in 1970, became a board member of DuPont in 1975, and received two of the most prestigious awards in ecology: the Eminent Ecologist Award from the Ecological Society of America in 1972 and the Tyler Ecology Award in 1975. This article analyzes Patrick’s unusual success in bridging the worlds of science and industry and her unusual ability to cross, and redefine, the perceived boundary between basic and applied fields in biology. It argues that Patrick’s position at the Academy, an institution of natural history that was both willing and able to accept money from industrial corporations, is key to understanding her success in, and influence on, the field of river ecology. (shrink)

The field of health care ethics continues to grow as the ethics structures in health care organizations become well established. While the literature is saturated with reports on clinical ethics consultation services, very little is known about the development and success of ethics programs. The following describes the development and growth of an ethics program at the largest health care provider in Georgia. With a focus on nine key components of an ethics program, the paper reviews what one (...) system did on its path to a flourishing program and what others can learn from it. (shrink)

Since publication of the 1986 Carnegie Commission report, A Nation Prepared: Teachers for the 21st Century, the professional teaching standards movement has gained noticeable momentum. The professional standards movement in teaching has been fueled by national organizations such as the National Council for Accreditation of Teacher Education, the Interstate New Teachers Assessment and Support Consortium, the National Board for Professional Teaching Standards, the National Commission on Teaching and America's Future, and by close collaboration among these four (...) entities. Further, nearly all of the fifty states are embracing the professional standards movement through formal participation in the work of one or more of these organizations. Although the professional standards movement in teaching is strong and growing stronger, its implications are not clear for instructional programs in social foundations of education, either at the teacher preparation or the advanced graduate levels. In response to the standards movement, social foundations educators have a number of options before them, three of which are to (1) largely ignore these developments, as "this too shall pass"; (2) critically interpret and resist these developments through scholarship and collective professional action, as social foundations scholars did with Competency Based Teacher Education in the 1970s; and (3) critically interpret these developments while working to strengthen the potential of the professional teaching standards movement to achieve its stated goal of providing caring and qualified teachers for every classroom in the nation. Of these three options, the last is most advisable, but it presents a considerable challenge to social foundations educators. Although the absence of social foundations skills, perspectives, and understanding should make it very difficult for teacher candidates and teachers to perform well on standards-based teaching assessments, there is no guarantee that these assessments will hold candidates accountable for social foundations learning. Implications for social foundations educators and activists are significant. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 10.1 (2000) 75-80 [Access article in PDF] Bioethics Inside the Beltway: A New Basis for Allocating Livers for Transplant Robert M. Veatch The Department of Health and Human Services (DHHS) and the United Network for Organ Sharing (UNOS), the private organization with the government contract to manage the national organ transplant program, are in the midst of a protracted dispute over how (...) livers for transplant should be allocated. UNOS, which is based in Richmond, Virginia, has for many years set the national policy for allocating cadaver organs. UNOS had a policy that, in effect, gave healthy local recipients priority over much sicker, more urgent cases beyond the local level. In April of 1998, Donna Shalala, the Secretary of Health and Human Services, issued a regulation requiring that organs must be allocated according to uniform medical criteria and that organ sharing must take place over broad enough areas to ensure that organs can reach the patients who need them most. In effect, she sought to overturn the strict local priority in favor of a more uniform national list based on medical need or at least an approach that extended allocation beyond the strict locals-first approach.UNOS has put up great resistance, expressing a strong preference for retaining local priority even though doing so means some desperately sick people at more distant centers almost certainly will die for lack of organs. What sounds at first like a rather esoteric dispute over government regulation turns out to raise some fascinating issues involving questions of ethics and moral epistemology. The Background For several years, UNOS followed a policy of dividing all potential liver transplant recipients into four categories based on how urgently the person needed a transplant. Status 1 patients were the sickest, essentially those in intensive care. Status 2 patients were the next most ill-in the hospital, but not the ICU. Status 3 patients were ill enough to be at home, while Status 4 patients were still up and about. UNOS coordinates 62 local organ procurement organizations (OPOs), each serving a metropolitan area. These are grouped into 11 regions.The long-term allocation rule gave first priority to local Status 1 patients. If no Status 1 patient was available locally, rather than sending the organ to another OPO, it would be assigned to a Status 2 patient in the same OPO where the [End Page 75] organ was procured, then to a local Status 3 patient, and then to one at Status 4. Only if no patients could use the organ locally would it be "exported" to another OPO. It would then be offered to another OPO in the same region, starting once again with patients at the most urgent status. Only if no patients in the region could use the organ would it be offered outside the region. The effect of this policy was that in some cases quite well-off local patients could get priority over more distant patients who only had hours or days to live if they did not get transplanted. (It was because of this policy that Mickey Mantle-who was Status 2-got an organ so quickly. There were no other suitable Status 1 or 2 patients in the Dallas area. He did not have to compete with any of the thousands of liver transplant patients on the waiting lists beyond his local area.)The realization that critically ill patients beyond the local area were dying while healthy local patients got organs even though they still could wait for perhaps months or years led DHHS to issue its mandate. The goal was to get more organs to people who were in desperate need.The response at UNOS has been hostile. UNOS is made up primarily of representatives from the OPOs, which, in turn are often dominated by transplant surgeons. They did not like the idea that locally-procured organs were being shipped to other communities when they had their own patients who needed them.Spokespersons for this position offered two primary arguments. First, they believed that people would be more... (shrink)

What was it like to be a woman scientist battling the “old boy’s” network during the 1960s and 1970s? Neena Schwartz, a prominent neuroendocrinologist at Northwestern University, tells all. She became a successful scientist and administrator at a time when few women entered science and fewer succeeded in establishing independent laboratories. She describes her personal career struggles, and those of others in academia, as well as the events which lead to the formation of the Association of Women in Science, and (...) Women in Endocrinology, two national organizations, which have been successful in increasing the numbers of women scientists and their influence in their fields. The book intersperses this socio-political story with an account of Schwartz’s personal life as a lesbian and a description of her research on the role of hormones in regulating reproductive cycles. In a chapter titled “Don’t Ask, Don’t Tell,” she examines the “evidence” from a scientist’s point of view for the hormonal and genetic theories for homosexuality. Other chapters provide advice on mentoring young scientists and a discourse on why it matters to all of us to have more women doing and teaching science. She also describes the process of putting together an interdisciplinary Center on Reproductive Science at Northwestern, which brought together basic and clinical scientists in an internationally recognized program of research and practice. (shrink)

Building Better Health Care Leadership for Canada explains the development and implementation of the Executive Training in Research Application program. Managed and funded by the Canadian Health Services Research Foundation in partnership with the Canadian Medical Association, the Canadian Nursing Association, and the Canadian College of Health Care executives, EXTRA is a two-year national fellowship program that uses the principles of adult learning theory as well as practical projects to educate senior health care leaders in making more (...) consistent use of research evidence in their management roles. Fellows apply the theory learned in residency sessions and educational activities to projects within their home organizations. The authors identify the imperative for better use of evidence, outline the core elements of the curriculum, and capture the real-world experience of regional leaders and fellows involved in making specific changes informed by research-based evidence within their organization. Contributors include Jean-Louis Denis, Terrence Sullivan, Owen Adams, Malcolm Anderson, Lynda Atack, Robert Bell, Sam G Campbell, Sylvie Cantin, Ward Flemons, Dorothy Forbes, J. Sonja Glass, Paula Goering, Karen Golden-Biddle, Jeffrey S. Hoch, Paul Lamarche, Ann Langley, John N. Lavis, Jonathan Lomas, Margo Orchard, Raynald Pineault, Brian D. Postl, Christine Power, Trish Reay, Jean Rochon, Denis A. Roy, Andrea Seymour, Samuel B. Sheps, Micheline Ste-Marie, Nina Stipich, David Streiner, Carl Taillon, and Muriah Umoquit. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 12.2 (2002) 215-224 [Access article in PDF] Bioethics Inside the Beltway Expanding Human Research Oversight Ellen Holt [Table]Overwhelmed by all the changes and proposed changes in the system to ensure human subject protection? It is an important subject and one in which everyone is interested. Being for human subject protection is like being for Mom. However, we all know that Mom sometimes can be (...) a handful! So I shall quickly review how we got to where we are, what is being done, and who is doing it. The table at the end of this article provides an additional summary of the current state of human subject protections. How We Got Here The current system of human subject protection was built 30 years ago with Institutional Review Boards (IRBs) as the cornerstone. Some well-publicized system failures in the last decade prompted evaluations that identified increasing volume and research complexity as primary threats to the system's effectiveness. In response, the Department of Health and Human Services (DHHS) Office of Inspector General (OIG 1998), and the National Bioethics Advisory Commission (NBAC 2001) issued recommendations calling for education and reform. Since then, initiatives in pursuit of these objectives have been rolling out non-stop. What Is Being Done The Office of Human Research Protections (OHRP) is leading the effort for DHHS, holding noncompliant research organizations accountable, while expanding the government's capacity for oversight, monitoring, and educating the research community. OHRP already has leveraged resources by: (1) implementing a unified federal registration system for all IRBs that identifies where IRBs are, how they are constituted, what kinds of research they are reviewing, and what volume of work they handle; (2) implementing a streamlined assurance process allowing all federal agencies to recognize a single, common assurance and avoid redundancy. The assurance is a commitment from any entity that receives federal funds for research to follow federal rules for protection of research subjects; and (3) redeploying resources from the process of negotiating assurances to supporting [End Page 215] quality improvement, including increasing the number site visits and providing IRBs with tools for self assessment and guidance for improvement.The goal is to prevent problems before they occur, and positive reinforcement and supportive training are the preferred themes. OHRP does wield a big stick and can shut down clinical studies in response to lax oversight, but it also has developed a big carrot by creating a national awards program to recognize excellence in protection of human research subjects—e.g., best practices, innovations in protecting research volunteers, and lifetime achievement for outstanding protection activities.Dr. Greg Koski, Director of OHRP, also is working with other government agencies to consolidate and build a comprehensive program. OHRP has four goals for a new oversight framework: Simplicity, Uniformity, Efficiency and Effectiveness. Selecting representatives from throughout the federal government, Dr. Koski has created the "SUEE" task force to identify and eliminate inefficiencies between the various agencies' human testing regulatory approaches. In addition, the SUEE task force will suggest improvements to current OHRP practices that can be achieved relatively quickly and easily.OHRP is working in concert with the Food and Drug Administration (FDA), which in October 2001, established the Office of Good Clinical Practice (OGCP) to improve the conduct and oversight of clinical research and to promote the protection of participants in FDA-regulated clinical research. Congressional Developments Although Dr. Koski is leading an aggressive charge to consolidate oversight across the federal government, many feel that reform will require legislation to succeed.Action on Capitol Hill is encouraging Bush administration efforts to reform oversight of clinical research. The House International Relations Committee has approved a measure that protects individuals in clinical trials overseas. A six-part Washington Post series (17-22 December 2000), "The Body Hunters," prompted an amendment to the Export Administration Act that, if finalized, will require drug companies to show that a U.S. ethics committee has approved the clinical trial as part of the application for authorization to export the investigational product.Members of Congress also are considering legislation to expand federal oversight of... (shrink)

Chapter 6 looks at efforts outside the PTEV to revitalize liberal learning by integrating the academic and social apprenticeships around themes of purpose, service, and community. The chapter examines programs at Harvard University, Wagner College, and Wake Forest University The chapter then proceeds to examines several efforts to spur similar endeavors by national organizations such as the Bringing Theory to Practice program of the Association of American Colleges and Universities, arguing that these developments take on fuller significance when (...) they are recognized as forms of humanistic education aiming at the cultivation of practical wisdom. It has been the mission of liberal learning to provide both training in detached, analytical thinking and yet also cultivate engagement with the world and a search for values. These capacities, at least as much as any specialized skills, are likely to prove key resources for confronting the challenges of the 21st century. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:preface In this issue, one cluster of articles presents scholarly and creative work focused on Latin American queer politics. Each article reveals queer challenges—theoretical, aesthetic, political, ideological, libidinal, corporeal—to prevailing logics of heteronormativity and neoliberalism, and to asymmetrical processes of knowledge production and circulation. Rafael de la Dehesa examines how political responses to AIDS in Brazil enabled surprising alliances between NGOs, activists, and the state, which produced radical social (...) change and, at times, engendered exclusion and vulnerability. Christine Keating and Amy Lind’s essay explores indigenous and transfeminist efforts to transform the Ecuadorian constitution, producing new conceptions of both state and family. Constanza Tabbush and Melina Gaona trace the rise and fall of a neighborhood organization in Argentina called Tupac Amaru, which provided a space of encounter for lesbian, non-gender normative, and marginalized women. In a review of recent work on Latin American sexualities, Juan Camilo Galeano Sánchez finds LGBT people across Latin America and the diaspora deploying “queer revolutionary gestures” as a form of resistance to social, political, and economic marginalization. María Amelia Viteri’s commentary examines the intellectual trajectories of a network of queer scholars from across the Americas. The art essay by Tara Daly engages Iquitos artist Christian Bendayán’s visual efforts to queer prevailing conceptions of the Amazon, and tatiana de la tierra’s* poems offer a deep celebration of female eroticism. * We have spelled tatiana de la tierra’s name in lower case in accordance with the wishes of her literary executors. 256Preface Another cluster of essays highlights reproductive rights and race in Mexico, Central America, and the Caribbean. Gabriela Arguedas Ramírez and Lynn M. Morgan study the tactics that right-wing, US-based organizations deploy against sexual and reproductive rights in Mexico and Central America. Jennifer L. Shoaff examines the Dominican cultural construction of the Haitian mother as “beggar-mother,” which shores up ideas of pathological black maternity. Ana-Maurine Lara’s article considers the gendered and sexual logics of anti-blackness, and anti-Haitianism, in the Dominican Republic. The provocation for our cluster on representations of queer identities and politics in Latin America came, broadly, from developments in Latin America in recent decades: the wave of LGBT organizing around issues from same-sex marriage to transgender rights, alongside the continued, if not escalated, violence against trans, travestis, and other queer people in countries throughout the region. More immediately, it came from a symposium on Latin American/Latin@ queer and sexuality studies, cosponsored by the Center for Latin American, Caribbean, and Latino Studies (CLACLS) and the Women, Gender, Sexuality Studies Department at the University of Massachusetts (UMass), Amherst, in March 2013. Several of the papers published here were initially presented at that event and have been complemented and extended by other analytical essays and creative material on similar questions. Based on their familiarity with the debates, Sonia Alvarez, UMass CLACLS Director and professor of political science, and Amy Lind, head of the Department of Women’s, Gender, and Sexuality Studies at the University of Cincinnati, offered invaluable input for this issue, and we thank them for their intellectual generosity and collaborative spirit. Three of the articles in the cluster take us inside the complex relations between queer movements and neoliberal institutions, illustrating the distinctive ways these dynamics play out in different national contexts and political configurations. In “NGOs, Governmentality, and the Brazilian Response to AIDS: A Multistranded Genealogy of the Current Crisis,” Rafael de la Dehesa argues that the AIDS crisis served as a “doorway to the state” for marginalized actors, such as sex workers and LGBT activists. These groups pushed for and won a national AIDS program that dramatically reduced rates of mortality and new infections in Brazil in the 1990s through universal access to treatment and a nonstigmatizing approach to prevention. Its success was based, in part, on World Bank Preface 257 loans and, in part, on a participatory model of public-private partnerships characteristic of neoliberal government. De la Dehesa argues that, “Far from encapsulating activism in a seamless web of biopolitical management... nodes of articulation between officials and activists became sites of conflict and productive tension.” However, while the alliances between NGOs... (shrink)

The Resolution of the Seimas of the Republic of Lithuania on the Approval of the State Sports Development Strategy for 2011-2020 states that it is important to create and develop a horizontal structure of public administration of sport, which includes many state administration areas and municipal institutions, which would allow to develop cooperation with non-governmental sports organizations and private sector of sports activities. To create legal and economic conditions for the fast development of active and healthy lifestyle and universal sports (...) clubs as primary subjects of the national sport system; to promote their contribution to non-formal sports education and employment of children and young people, development of various sports, interaction between amateur and professional sports. In this respect, the tasks have been set to create a multi-tier system of strategic cooperation with non-governmental sport organizations with public administration structures, to expand cooperation between municipal institutions in the field of sport, authorized by the Government of the Republic of Lithuania so that these resolutions include the National Sport for All Development Program implementation, enhancing the vitality of communities through sport, ensuring healthy lifestyle conditions and developing sports infrastructure through territorial planning documents and investment programs; to create and develop a system of partnerships in the field of sport between public and private sectors; to develop cooperation between institutions of all fields of management by developing and implementing physical activity, healthy lifestyles and work ability, social cohesion through sport, leisure employment and social prevention and other interinstitutional programs, accordingly reorganizing and expanding functions of the institution authorized by the Government, strengthening its administrative capacity. The implementation of the strategy is particularly relevant, as is the case at the level of municipal administrations and councils, to which functions are delegated to implement the priority functions of sport policy. Problems in the implementation of sport policy are analyzed by scientists as well as representatives of sports policy legislators. The aim of the research is to analyze how the sports policy of the Republic of Lithuania is formulated and implemented in the activities of municipal administrations and councils. Research methods -analysis of scientific literature, analysis of laws, analysis of sports management system. Research results and conclusions. The real role of municipalities and the priority to develop community sport, to promote the vitality of communities has not been realized yet. The role of private business for private investment in sports infrastructure for the development of sports movement and cooperation with socially responsible business representatives, the independent role of clubs and non-governmental organizations as a priority have also not been understood and finally not implemented. In the functional division of activities in the sport policy process, all chains of interaction between organizations, acting within the competence, must strive to implement laws and strategic goals of sports policy. In order to achieve these objectives, the activities of the institutions depend on the political decisions adopted jointly by the central government, public programs and projects. It is important that the executive structures are delegated the same kind of functions, so that the implementation of the policy is carried out consistently in all areas of the republic.Improvement of the process of implementing sports policy and the search for the improvement, trying to achieve the efficiency of activities of municipal administrations and councils must be the main goal of all institutions involved in it. The whole system of institutions involved in the development and implementation of sport policy is too centralized. Institutional differences in the management of interdependence and in the resolution of structural problems between national organizations and municipal organizations are very pronounced. This has a negative impact on the status of municipal territorial sports divisions, when grants are distributed from the state budget, selecting sportsmen, performing medical technological examination of promising sportsmen, setting up sports bases, and so on. (shrink)

Inequities in HIV pre-exposure prophylaxis (PrEP) use persist in the United States. Although scientific advancement in delivery options and social acceptance of PrEP has occurred in the past decade, gaps remain in ensuring that this sexual health program is available to all. Components of what a national PrEP program for all would look like are discussed.

Cuba's National Food Program aims to assure its population a minimum degree of food security during the current period of transition from dependency upon the ex-Socialist trading bloc. A number of important elements of the Food Program, however, were conceived before the demise of COMECON in an effort to deepen food import substitution. This paper reviews the degree of Cuba's food import dependence before the breakup of the Socialist bloc, the initial targets of the National Food (...) Program, and how these have been modified due to the severe reduction in Cuba's normal level of imports of petroleum and other agricultural inputs. It is argued that Cuba's reliance upon scientific advances combined with a return to traditional, ecologically-benign agricultural practices and large-scale labor mobilizations have allowed it to overcome a drastic shortfall in production as a result of the reduced level of imports of modern agricultural inputs. At the same time, it has been exceedingly difficult for the country to maintain production levels at the trend of the late 1980s or to continue to aspire to meet the ambitious targets of the initial Food Program plan. (shrink)

National scientists have elaborated the reform's gist, approaches, stages and consequences in the Ukrainian agricultural sector during the XX - XXI centuries. These studies have been conducted by N. Zhulkanych, S. Zhyvora, M. Zyza, M. Lendiel, E. Mazur, O. Malyarchuk, V. Nechytailo and many others. The paper aims to perform the comprehensive study of general trends and peculiar features of the agricultural development of the Ukrainian SSR in 1963-1990 and to define actual advances and drawbacks on the basis of (...) analysis of historical records and scientific literature. The object of research is agriculture as part of socialist economy in the USSR. The subject of research is the implementation features of agricultural policy of the Soviet power in the Ukrainian SSR, using the Western region of the Republic as an example. The economic strategy of the Soviet power involved a long-term industrialization of the agricultural sector. A distinguishing feature of the industrialization process was the use of systems of machinery in all branches of agriculture. The technological chain had to embrace the process from the sporadic application of machinery to the overall mechanization and automation of crop and livestock farming. The industrial background of production predetermined the implementation of the system of machinery with extensive power consumption, i.e. with the new technical bases. The resolutions of the March Plenum of the CPSU Central Committee defined the economic priorities and capacity development of the Republic. Capital investments were the economic basis for the increase of production potential of collective and state farms, solution of social problems in rural regions. The land productivity was increased mainly by means of land reclamation and production chemization, use of organic and mineral fertilizers, pesticides, fungicides, etc. The supply of mineral fertilizers increased, but most of them were of low quality, non-concentrated and unbalanced in nutritional ingredients. In its turn it caused irreparable damage to the environment and polluted agricultural products with chemicals. The chemization undermined the population health and disrupted the ecological balance. Despite ultimate achievements in the rise of the industrial level of agriculture of the Ukrainian SSR, it didn't meet the needs of collective and state farms. A great number of labour-intensive processes in animal and crop farming were performed manually. In state farms, contrary to collective farms, the stock of tractors was newer, but much smaller. For many years the USSR was in the top ten countries of the world in terms of consumption of energy and proteins, contained in food products per capita. However, the food patterns were inconsistent with the scientifically grounded norm. Structural imbalance of the food ration was the manifestation of the food crisis in the USSR. To meet primary needs of Soviet citizens in food products the May Plenum of the CPSU Central Committee adopted the "Food Program of the USSR for the Period until 1990 and Measures of Its Implementation". The main issue of the Food program was to increase grain harvest. Grain production was the basis for food and fodder supply of the country. Alongside with a substantial increase in food products output in public economy the attention was given to the development of subsidiary individual holdings and fruit-and-vegetable cooperatives. The cooperatives and subsidiary holdings produced a great number of dairy and meat products, vegetables and fruits both for their own needs and for sale in collective farm markets. The state food program predetermined the solution of agricultural problems by means of formerly used methods. The major problem of agriculture had to be solved by means of increase in the gross grain harvest. Thus, the implementation of agricultural policy of Soviet power in the Ukrainian SSR lead to great changes in agricultural production. At that time there appeared such new branches of economy specialized in services to agricultural production as waterworks and land reclamation, feed mill industry, farm building, machine engineering for animal farming and fodder production, procurement of agricultural products and agricultural processing. The study of this policy implementation proves that the average annual rates of agricultural production increased but they were inconsistent with high investments. On the one hand, the Food program testified the "food crisis in the USSR", demonstrating the lag of the world socialist community from capitalist states. On the other hand, it had to increase the level of food self-sufficiency, decrease the procurement of agricultural products from abroad and promote the solution of the world food problem in general. (shrink)

President Bush and his Council of Economic Advisors have claimed that the U.S. shouldn’t adopt a national health program because doing so would slow innovation in health care. Some have attacked this argument by challenging its moral claim that innovativeness is a good ground for choosing between health care systems. This reply is misguided. If we want to refute the argument from innovation, we have to undercut the premise that seems least controversial -- the premise that our current (...) system produces more innovation than a national health program would. I argue that this premise is false. The argument requires clarifying the concept ‘national health program’ and examining various theories of human well-being. (shrink)

Doctoral programs at U.S. universities play a critical role in the development of human resources both in the United States and abroad. This volume reports the results of an extensive study of U.S. research-doctorate programs in five broad fields: physical sciences and mathematics, engineering, social and behavioral sciences, biological sciences, and the humanities. Research-Doctorate Programs in the United States documents changes that have taken place in the size, structure, and quality of doctoral education since the widely used 1982 editions. This (...) update provides selected information on nearly 4,000 doctoral programs in 41 subdisciplines at 274 doctorate-granting institutions. This volume also reports the results of the National Survey of Graduate Faculty, which polled a sample of faculty for their views on the scholarly quality of program faculty and the effectiveness of doctoral programs in preparing research scholars/scientists. This much-anticipated update of such an essential reference will be useful to education administrators, university faculty, and students seeking authoritative information on doctoral programs. (shrink)

Purpose: The purpose of the study was to assess the role of the Faith Based Organizations in alleviating poverty in Western Kenya.Methodology: This study is a cross-sectional research that sought to give an examining and descriptive scrutiny of the death beliefs surrounding FBO’s activities in Emuhaya District. This study targeted Emuhaya District which has a population of 180,000 people who are members of the FBO’s. To obtain data for analysis, qualitative methods of data collection, which include in-depth oral interviews, focus (...) group discussion, observation and documentary analysis, were employed. Questionnaires were prepared and administered according to the information required from the specific groups of respondents. This study utilized secondary sources, which were derived from published books, minutes of developmental meetings in the FBO, reports of the development projects of the church, articles and records from Kenya National Archives. Data collected through the questionnaires and personal interviews, was synthesized systematically and logically compiled to determine the role of FBO in alleviating poverty in Emuhaya District. Data was coded manually and organized under different themes. The researcher then investigated the concepts of liberation and reconstruction in improving the well-being of the poor through an analysis and interpretation of the theological methods of induction (TMI).Results: Based on the findings the study concluded that the CoG-K’s teachings are largely pertinent in the development of FBO members and their participation in activities that are designed along people’s development needs. Also, the CoG-K has a role to play through her programs like Sisi kwa Sisi and Child Development Centres.Unique contribution to theory, practice and policy: This research recommends that if Emuhaya District is to develop, it has to place the FBO teachings and theology of option for the poor at the top of the agenda and to consider it as is so often the case, as adjunct to the real core of the work that is, development. The study proposes that for the FBO to improve her input in social concerns of the people, it should reshape its theology of development so that it can fully address the plight of the poor. (shrink)

This essay provides a brief overview of the rise of organ trade in Pakistan towards the end of the last century and the concerted, collective struggle—of physicians and medical associations aided by the media, journalists, members of civil society, and senior judiciary—in pressuring the government to bring about and implement a national law criminalizing such practices opposed by an influential pro-organ trade lobby. It argues that among the most effective measures to prevent re-emergence of organ trafficking in the country (...) is increasing ethical live donations and above all, establishing sustainable, public supported deceased donor programs. To do this, the transplant community must recognize that organ transplantation is not merely a donor-recipient-physician transaction but a complex issue in which decisions to donate an organ are influenced by indigenous values and belief systems about human illness, life and death. (shrink)

Ethics training is commonly cited as a primary method for increasing employees' ethical decision making and conduct. However, little is known about how the presence of ethics training can enhance other components of an organization's ethical environment such as employees' perception of company ethical values. Using a national sample of 313 business professionals employed in the United States, the relationship between ethics training and perceived organizational ethics was explored. The results of the analysis provide significant statistical support for the (...) notion that businesspersons employed in organizations that have formalized ethics training programs have more positive perceptions of their companies' ethical context than do individuals employed in organizations that do not. The analysis also indicated that job satisfaction was related to employees' attitudes about their ethical context. The managerial implications of the results are outlined, along with the limitations of the study and recommendations for future research. (shrink)

Ethics training is commonly cited as a primary method for increasing employees ethical decision making and conduct. However, little is known about how the presence of ethics training can enhance other components of an organization's ethical environment such as employees perception of company ethical values. Using a national sample of 313 business professionals employed in the United States, the relationship between ethics training and perceived organizational ethics was explored. The results of the analysis provide significant statistical support for the (...) notion that businesspersons employed in organizations that have formalized ethics training programs have more positive perceptions of their companies ethical context than do individuals employed in organizations that do not. The analysis also indicated that job satisfaction was related to employees attitudes about their ethical context. The managerial implications of the results are outlined, along with the limitations of the study and recommendations for future research. (shrink)

The scarcity of human organs requires the transplant community to make difficult allocation decisions. This process begins at individual medical centers, where transplant teams decide which patients to place on the transplant waiting list. Each transplant center utilizes its own listing criteria to determine if a patient is eligible for transplantation. These criteria have historically considered preexisting affective and psychotic disorders to be relative or absolute contraindications to transplantation. While attitudes within the field appear to be moving away from this (...) practice, there is no data to confirm that eligibility criteria have changed. There are no nationwide guidelines detailing the manner in which affective and psychotic disorders should impact transplant eligibility. Individual transplant centers thus form their own transplant eligibility criteria, resulting in significant inter-institution variability. Data from the 1990s indicates that the majority of transplant programs considered certain psychiatric illnesses, such as active schizophrenia, to be absolute contraindications to transplantation. A review of literature reveals that no comprehensive data has been collected on the topic since that time. Furthermore, the limited data available about current practices suggests that psychiatric illness continues to be viewed as a contraindication to transplantation at some transplant centers. In light of this finding, we review psychiatric literature that examines the impact of affective and psychotic disorders on transplant outcomes and conclude that the presence of these disorders is not an accurate predictor of transplant success. We then discuss the requirements of justice as they relate to the creation of a just organ allocation system. We conclude that transplant eligibility criteria that exclude patients with affective and psychotic disorders on the basis of their psychiatric diagnosis alone are unjust. Just listing criteria must incorporate only those factors that have a causative effect on posttransplant morbidity and mortality. Justice also demands that we eliminate current inter-institution practice variations in favor of national transplant eligibility criteria. Given the limited data available about current practices, we call for an updated study investigating the manner in which affect and psychotic disorders impact transplant eligibility determinations. (shrink)

Amidst expanding interest in local food and agriculture, food banks and allied organizations across the United States have increasingly engaged in diverse gleaning, gardening, and farming activities. Some of these programs reinforce food banks’ traditional role in distributing surplus commodities, and most extend food banks’ reliance on middle class volunteers and charitable donations. But some gleaning and especially gardening and farming programs seek to build poor people’s and communities’ capacity to meet more of their own food needs, signaling new roles (...) for some food banks in promoting community food security and food justice. This article reports the results of a national survey and in-depth case studies of the ways in which food banks are engaging in and with local agriculture and how this influences food banks’ roles in community and regional food systems. The patterns it reveals reflect broader tensions in debates about hunger relief and food security. (shrink)