Following the confirmation of U.S. Supreme Court Justice Brett Kavanaugh in one of the most sensational jurisprudence events of the modern era, we examine potential repercussions across multiple themes in public health, law, and policy stemming from his ideology and the confirmation process.

The author created a new course, called “Seminar in Public Health Law and Policy in an Interprofessional Setting” to address the need for interprofessional education to equip graduate and professional students for collaborative practice at the systemic and policy levels in the health care and public health fields. Despite important work being done at the clinical practice level, limited existing IPE models examine larger systemic issues. The course is designed specifically to enable students in social work, (...) law, and public health to recognize the reciprocal relationships between policy and interprofessional collaborative practice, including the need for understanding of the impact of team-practice work at the system and policy levels. (shrink)

Introduction -- The rise of regulatory governance -- Theories of regulation -- Regulatory space and regulatory regimes -- Policy processes and the regulatory policy cycle -- Bad, better and legitimate regulation -- Define: agenda-setting, issue diagnosis and objective setting -- Design: regime variables; option generation -- Decide: regime assessment and selection -- Implement: regime deployment, application and execution -- Evaluate: assessment of regulatory policy and regime -- The future of regulatory governance -- Conclusion.

This article describes implementation of a longitudinal curriculum in public health law, building on doctrinal coursework with skills-based coursework and opportunities for interdisciplinary, community-based engagement and service learning. It specifically describes development of a Policy Practicum, giving an example of how law students can learn policy skills and skills of effective community coalition work through a healthy homes partnership, highlighting areas where the curriculum can incorporate interdisciplinary education. It offers lessons learned during the curriculum-building process, and concludes (...) with a more intensive service-learning strategy through the development of a Policy Lab. (shrink)

This article outlines a discursive framework for understanding public policy uses in different narrative contexts. The framework describes a definition of the term «discourse,» its historic and intuitionally related nature, and how descriptions of «state» and «policy» transforms into legal, political science, managerial, and «public/state policy» discursive practices. The author postu- lates that the discourse of public policy is a place of a «clash of rationalities» in the industry. Because of this, the SS (...) concludes that the essence of public policy, its perception, understanding, and reaction to it are determined by the dominance of certain institutional discourses and the dominance of their bearers: «political scientists», human rights defenders, lawyers, managers and their ideas about the nature of the state and its «politics». The dominant discourses have the na- ture of uncritical extrapolations, or transfers of certain rationality inherent in one area to another, qualitatively different from it. The consequence of such an expansion of rationality from one sphere to another is the «inadequacy» of the discourse. It then discusses a comparative explica- tion of fundamentals, which constitute the narrative practices of each discourse. Furthermore, it proposed an explanation of the subject specifics of «public policy» as an area centered around «problems,» «options,» «impacts,» and «interests / stakes,» and then traces the significant distor- tions and contortions of this topic in the semantic horizons of related discourses. The article focuses on the rising issues of public policy, depending on the specifics of the discourse — whether «political», «legal,» or «managerial». For example, «political science» discourse emphasizes the problems of the consequences of one of the dimensions of influence for the interests of different parts of society; «Legal» discourse focuses on one group of instruments of influence (norms); «Managerial» discourse draws attention to a separate stage of implementation of already estab- lished public policy. Finally, this paper indicates the dominance of such discourses and their dependency on the historical context of contemporary Ukraine. (shrink)

It seemed like only minutes after a team of Scottish scientists announced, in late February 1997, that they had successfully cloned a sheep, that governmental officials and private citizens throughout the world called for a ban on cloning human beings. The rush to legislate or issue executive orders was so swift, it is reasonable to wonder why the news that a mammal had been cloned ignited such a stampede to prohibit, even criminalize, attempts to clone humans. These events raise a (...) series of separate, yet related questions. Why does the prospect of cloning human beings incite such strong reactions? What reasons have been proposed for enacting national laws or international conventions to prohibit cloning? Can these prohibitions be justified by sound ethical arguments? Before attempting to answer these questions, let us look first at the responses that called for public policy measures to ban human cloning. (shrink)

Thirty-four states, the District of Columbia, and Puerto Rico have legalized medical cannabis. While no two state medical cannabis programs are alike, public health concerns related to advertising, packaging and labeling, pesticide use, scientific research, and the role of medical cannabis in the opioid crisis are emerging across the country. This article examines these issues, the policy approaches states are adopting to protect patients and the public, and an assessment of the underlying federal legal landscape.

In newly emerging democracies, succeeding governments have numerous policy tasks for the purpose of developing the free market and the democratic process. In such legal systems, policy-oriented views of law, which regard law as a policy tool for diminishing public problems, seem descriptively pertinent and prescriptively helpful. This is also the case in mature democratic legal systems, where the public problems faced by governments become more and more complex. Policy-directional views of law do not (...) necessarily imply that law is a value-neutral means that can serve any possible political ends. It is widely recognized among legal theorists and practitioners, with notable exceptions represented by exclusive legal positivists, that the law involves moral values, including justice and liberty. In the present essay, I focus on one version of policy-oriented views of law that is based on the fundamental ideals of justice and interest. By sketching out this version, I attempt to shed new light on some concepts and issues in jurisprudence. To begin, I articulate the concept of justice and identify the difficulties that interest-based conceptions of justice encounter, by referring to some classical works. I also make a distinction between different conceptions of interest. Next, the two basic concepts in law — rights and liberty — are explained in terms of justice and interest. Efficiency, which has been largely neglected in traditional jurisprudence notwithstanding its practical significance, is also briefly discussed. Then, I turn to exploring the implications that the law-as-policy theory grounded on justice and interest might have for the foundations of two legal domains: criminal law and laws governing political participation. Some allegations and objections against this theory are described, and responses to them are given. The essay concludes by noting the questions that remain open in this theory. (shrink)

Drawing on Sir Ian Kennedy's extensive experience in healthcare law, ethics and public policy-making, this book explores vital issues in the law surrounding healthcare and regulation. The book contains a range of published and unpublished essays and speeches with the addition of notes and commentaries by the author that bring the pieces up to the present day. Those who want to understand developments, from transplants to confidentiality, from COVID-19 to public inquiries to regulation will find a rich (...) seam of rigorous, informed analysis. The author's unique range of experience allows him to share insights on a variety of issues; from the conduct of the disgraced breast surgeon, Ian Paterson, to research at Porton Down, to the economics of innovation in drug development at NICE. His abiding interest in the welfare of children informs his trenchant forensic examination of how children fare in the NHS. Those involved in or with an interest in law, moral philosophy, and public policy will find much food for thought. (shrink)

This study is an ethical reflection on the formulation and application of public policies regarding reproductive health in Brazil. The Integral Assistance Program for Women's Health (PAISM) can be considered advanced for a country in development. Universal access for family planning is foreseen in the Brazilian legislation, but the services do not offer contraceptive methods for the population in a regular and consistent manner. Abortion is restricted by law to two cases: risk to the woman's life and rape. This (...) reality favors the practice of unsafe abortion, which is the third largest cause of maternal death in Brazil. Legal abortion is regulated by the State and the procedure is performed in public health centers. However, there is resistance on the part of professionals to attend these women. Prenatal care is a priority strategy for promoting the quality of life of these women and of future generations. Nonetheless, it is still difficult for these women to access the prenatal care services and to have the required number of consultations. Moreover, managers and health professionals need to be made aware of the importance of implementing the actions indicated by the public policies in the area of sexual and reproductive health, favoring respect for autonomy in a context of personal freedom. (shrink)

Self-authorship has been established as the basis of an influential liberal principle of legislation and public policy. Being the author of one’s own life is a significant component of one’s own well-being, and therefore is better understood from the viewpoint of the person whose life it is. However, most philosophical accounts, including Raz’s conception of self-authorship, rely on general and abstract principles rather than specific, individual psychological properties of the person whose life it is. We elaborate on the (...) principles of self-authorship on the basis of self-determination theory, an empirically based psychological theory that has been at the forefront of the study of autonomy and self-authorship for more than 45 years. Our account transcends distinctions between positive and negative freedom and attempts to pinpoint the exact properties of self-authorship within the psychological processes of intrinsic motivation and internalization. If a primary objective of public policy is to support self-authorship, then it should be devised on the basis of how intrinsic motivation and internalization can be properly supported. Self-determination theory identifies three basic psychological needs: autonomy, competence, and relatedness. The satisfaction of these needs is associated with the support and growth of intrinsic tendencies and the advancement of well-being. Through this analysis, we can properly evaluate the significance of rationality, basic goods, and the availability of options to self-authorship. Implications for law and policy are discussed with an emphasis on legal paternalism and what many theorists call “liberal perfectionism,” that is, the non-coercive support and promotion of the good life. (shrink)

The purpose of this chapter is to analyse approaches to the sharing economy from the perspective of public policy science. In the first part of the text, attention is paid to perceiving the development of the emerging sharing economy not only as phenomenon with positive economic effects but also as a set of public problems (e.g., on the labour market and for existing economic structures) that require intervention at the level of national governments as well as at (...) international level. Subsequent sections identify possible actions for regulating the development of the sharing economy. The role of soft law, stakeholders’ networks, self-regulation and standardisation are discussed in the chapter. The summary includes potential directions for further research. (shrink)

The Erasmus Journal for Philosophy and Economics(EJPE) interviewed Adler about his formative years (section I); his work on the theoretical foundations of public policy, zooming in onwelfare-consequentialism and social welfare functions(section II), welfarism and interpersonal comparisons(section III), the ethical deliberator and the role of the philosopher (section IV); and, finally,his views and visions for interdisciplinary work in law, economics, and philosophy,as well as his advice for graduate students in the field (section V).

Cooperation in evil or wrongdoing is one of the most perplexing areas in bioethics, both for those working in the field and those seeking their advice. The papers collected in this book are written by philosophers, theologians and lawyers who have studied these problems and / or by those who have faced these problems in their own work in law, healthcare and research, and political campaigning. The volume includes both general treatments of the subject of cooperation and conscientious objection, and (...) more specific treatments of topics such as voting to improve unjust laws, research on fetal / embryonic cells, and care of suicidal patients. The book is offered as a guide to a field which is both of academic interest and of personal concern to those who face cooperation problems in their own life and work. Contributors include: Bishop Donal Murray, Bishop Anthony Fisher OP, Jane Adolphe, Mike Delany, John Finnis, Luke Gormally, Colin Harte, Cathleen Kaveny, Richard Myers, Charlie O'Donnell, Alexander Pruss, Neil Scolding and Helen Watt. (shrink)

This collection explores the subject of conflicts of interest. It investigates how to manage conflicts of interest, how they can affect well-meaning professionals, and how they can limit the effectiveness of corporate boards, undermine professional ethics, and corrupt expert opinion. Legal and policy responses are considered, some of which (e.g., disclosure) are shown to backfire and even fail. The results offer a sobering prognosis for professional ethics and for anyone who relies on professionals who have conflicts of interest. The (...) contributors are leading authorities on the subject in the fields of law, medicine, management, public policy, and psychology. The nuances of the problems posedby conflicts of interest will be highlighted for readers in an effort to demonstrate the manyways that structuring incentives can affect decision making and organizations' financial well-being. (shrink)

The importance of preserving trust in physicians and in medical institutions has received widespread attention in recent years. Primarily, this is due to the threats to trust posed by managed care, but there is a general and growing recognition that trust deserves more attention than it traditionally has received in all aspects of medical ethics, law, and public policy. Trust has both intrinsic and instrumental value. Trust is intrinsically important because it is a core characteristic that affects the (...) emotional and interpersonal aspects of the physician/patient relationship. As an instrumental value, trust is widely believed to be essential for effective therapeutic encounters. It has been hypothesized or shown to affect a host of important behaviors and attitudes relating to care, including seeking care, disclosing private information, complying with treatment, and being satisfied with care. Moreover, trust may be a mediator of measurable clinical outcomes and a key factor in the mind–body interactions that underlie placebo/nocebo effects and the effectiveness of alternative medicine. It is no surprise, then, that preserving, justifying, and enhancing trust is the fundamental goal of much of medical ethics, and is a prominent objective in healthcare law and public policy. Discussions of trust and related concepts were commonplace in professionally based medical ethics prior to the 1970s. a 1 2. (shrink)

Community-level legal and policy innovations or “experiments” can be important levers to improve health. States and localities are empowered through the 10th Amendment of the United States Constitution to use their police powers to protect the health and welfare of the public. Many legal and policy tools are available, including: the power to tax and spend; regulation; mandated education or disclosure of information, modifying the environment — whether built or natural ; and indirect regulation. These legal and (...) policy interventions can be targeted to specific needs at the community level and are often relatively low-cost, but high impact interventions. As every community is different, effective laws and policies will vary. This freedom allows states and localities to, as Justice Louis Brandeis argued, truly serve as “laboratories of democracy.”. (shrink)

ABSTRACT This study is an ethical reflection on the formulation and application of public policies regarding reproductive health in Brazil. The Integral Assistance Program for Women's Health (PAISM) can be considered advanced for a country in development. Universal access for family planning is foreseen in the Brazilian legislation, but the services do not offer contraceptive methods for the population in a regular and consistent manner. Abortion is restricted by law to two cases: risk to the woman's life and rape. (...) This reality favors the practice of unsafe abortion, which is the third largest cause of maternal death in Brazil. Legal abortion is regulated by the State and the procedure is performed in public health centers. However, there is resistance on the part of professionals to attend these women. Prenatal care is a priority strategy for promoting the quality of life of these women and of future generations. Nonetheless, it is still difficult for these women to access the prenatal care services and to have the required number of consultations. Moreover, managers and health professionals need to be made aware of the importance of implementing the actions indicated by the public policies in the area of sexual and reproductive health, favoring respect for autonomy in a context of personal freedom. (shrink)

This paper considers how best to approach dilemmas posed to global health and biosecurity policy by increasing advances in practical applications of nanotechnology. The type of nano-technology policy dilemmas discussed include: expenditure of public funds, public-funded research priorities, public confidence in government and science and, finally, public safety. The article examines the value in this context of a legal obligation that the development of relevant public health law be calibrated against less corporate-infuenced norms (...) issuing from bioethics and international human rights. (shrink)

Though religious belief may be the foundation for private morality and therefore supply such morality with inviolable principles, it has no such role in the case of public policy-making, even where the policy is concerned with matters agreed to be matters of morality. It could have such a role only if the certainty of the principles supplied by religion were generally shared, or were held themselves to be enforceable by law (i.e. in a theocratic state).

The author draws on his own experience of helping to make and deliver public policy to indicate the wider context in which ethical decisions have to be made: the law, contested interpretations of the law which have to be settled in the courts, and wider political and economic factors. He argues that the concept of respect for the early embryo does have substance because of the strict regulatory regime of the Human Fertilisation and Embryology Authority (HFEA). He considers (...) the arguments that the early embryo ‘[e]njoys the full rights of the human being and should be accorded respect owed to a human being’. He concludes that these arguments are not finally convincing. He also looks at the moral status of the early embryo in Christian tradition and argues that perhaps from the fourth and certainly from the seventh century in the West until 1869, offences against the early embryo were regarded as less serious than offences against the embryo when developed further. For these reasons he concludes that there should be no absolute prohibition against research on an early embryo up to fourteen days. He also looks at recent cases involving pre-implantation diagnosis (PGD) and tissue typing with a view to obtaining matching tissue from an early embryo for a sibling suffering from a life-threatening disease. Although a distinction has been made between what might be licit in the case of a genetic disorder in the sibling but illicit if the disorder is not genetic, he argues that it could be in the best interests of the early embryo, the child that is to be, if in either case if it was selected with a view to matching the tissue of a sibling. (shrink)

The status of marijuana as an illegal drug has greatly evolved in recent years. Many countries have decriminalized possession of marijuana for personal use. Others have not decriminalized it but simply “tolerate” it for private personal use. Four countries have passed laws legalizing medical marijuana and one other tolerates the use of marijuana for medical purposes without having legislated a specific right for such possession and use. To date, 17 of the United States and the District of Columbia have also (...) passed laws regarding medical marijuana. However, state medical marijuana laws are at odds with the federal Controlled Substances Act, which prohibits possession of marijuana. This fact, in tandem with employer requirements under the Drug-Free Workplace Act, has created a dilemma for employers who have employees with medical conditions for which medical marijuana has been recommended. Given that 18 additional states currently have medical marijuana legislation pending, medical marijuana in the workplace is an issue which is not going to go away. As a result, it is time to examine the interface between federal and state laws as well as the public policy issues surrounding the lack of rights which medical marijuana patients have in their workplaces. (shrink)

This contribution marks a dual milestone at the intersection of public health law and JLME: my 50th publication of a substantive manuscript in the 50th anniversary of the Journal in 2022. In recognition of these coinciding landmarks, this installment of the Public Health Law column for JLME features observations and reflections of the field based largely on prior publications.

We investigate the relationship of corporate social responsibility (CSR) (often assumed to reflect corporate voluntarism) and government (often assumed to reflect coercion). We distinguish two broad perspectives on the CSR and government relationship: thedichotomous(i.e., government and CSR are / should be independent of one another) and therelated(i.e., government and CSR are / should be interconnected). Using typologies of CSR public policy and of CSR and the law, we present an integrated framework for corporate discretion for engagement with (...) class='Hi'>public policy for CSR. We make four related contributions. First, we explain the dichotomous and the related perspectives with reference to their various assumptions and analyses. Second, we demonstrate that public policy for CSR and corporate discretion coexist and interact. Specifically, we show, third, that public policy for CSR can inform and stimulate corporate discretion and, fourth, that corporations have discretion for CSR, particularly as to how corporations engage with such policy. (shrink)

This article explores a unique opportunity for shaping public health law and policy to reflect a greater balance between public and private goods in two areas of primary concern to human well-being: medicine and human biosecurity. This opportunity is presented both by the rapid changes likely to occur in these areas as a result of nanotechnology and the fact that multinational corporate actors have not yet had the opportunity to use their well-honed techniques of governance influence to (...) modify public health policy and law in this area to their own narrowly focused advantage. Such a rare opportunity to rethink some fundamental assumptions about a regulatory framework for globally important health issues in advance is one reason why issues concerning nanotechnology regulation in medicine and human biosecurity should have considerable interest to health law and policy scholars. (shrink)

Some people hate themselves. But if I say, “I hate myself,” who is this “I” that stands apart from “myself”? And notice how in the expression “I am not myself today,” the “I” and “myself” change places. Now it is “myself” who is the authentic, the authoritative, the judgmental “I,” and it is “I” who is the self that is judged and found wanting. Some people talk to themselves; when they do, who is speaking and who is listening?

Immunization plays a crucial role in global health security, preventing public health emergencies of international concern and protecting individuals from infectious disease outbreaks, yet these critical public health benefits are dependent on immunization law. Where public health law has become central to preventing, detecting, and responding to infectious disease, public health law reform is seen as necessary to implement the Global Health Security Agenda. This article examines national immunization laws as a basis to implement the GHSA (...) and promote the public's health, analyzing the scope and content of these laws to prevent infectious disease across Sub-Saharan Africa. Undertaking policy surveillance of national immunization laws in 20 Sub-Saharan African countries, this study: developed a legal framework to map the legal attributes relevant to immunization; created an assessment tool to determine the presence of these attributes under national immunization law; and applied this assessment tool to code national legal landscapes. An analysis of these coded laws highlights legal attributes that govern vaccine requirements, supply chains, vaccine administration standards, and medicines quality and manufacturer liability. Based upon this international policy surveillance, it will be crucial to undertake legal epidemiology research across countries, examining the influence of immunization law on vaccination rates and disease outbreaks. (shrink)

This paper explores the extent to which behavioral public policies can be both efficient and democratic by reflecting on the conditions under which individuals could rationally consent to them. Consent refers to a moral requirement that a behavioral public policy should respect what I call a person’s value autonomy and conception of the good. Behavioral public policies can take many forms. Based on a social choice framework, I argue that fully paternalistic and prudential behavioral public (...) policies are unlikely to trigger a hypothetical form of rational consent. Non-fully paternalistic behavioral public policies with partially non-prudential motivations are less problematic in this perspective. In any case, a public deliberative stage preceding the implementation of policies seems to be the best democratic way to justify them. (shrink)

After three decades of intensive debate in academic and activist circles, intersectionality has progressively been adopted in public policies. Yet, the challenges of its application are still largely unexplored. This article adopts a discursive approach to study the process of policy implementation of an intersectionality-informed plan in Madrid City Council, Spain. The analysis of materials retrieved through interviews, a focus group, and participant observation enables us to explore how the technical staff interpret intersectionality and links it with other (...) established approaches in equality and antidiscrimination law and policy, namely gender and diversity. We argue that preconceptions and positionality within the institutional structure deeply affect the interpretation of intersectionality and the subsequent action or non-action taken by implementing actors. Our study shows the challenges and opportunities to implement intersectionality in public policies that result from its discursive construction through the frames of gender and diversity. (shrink)

Intelligent design creationism (ID) is a religious belief requiring a supernatural creator's interventions in the natural order. ID thus brings with it, as does supernatural theism by its nature, intractable epistemological difficulties. Despite these difficulties and despite ID's defeat in Kitzmiller v. Dover Area School District (2005), ID creationists' continuing efforts to promote the teaching of ID in public school science classrooms threaten both science education and the separation of church and state guaranteed by the U. S. Constitution. I (...) examine the ID movement's failure to provide either a methodology or a functional epistemology to support their supernaturalism, a deficiency that consequently leaves them without epistemic support for their creationist claims. My examination focuses primarily on ID supporter Francis Beckwith, whose published defenses of teaching ID, as well as his other relevant publications concerning education, law, and public policy, have been largely exempt from critical scrutiny. Beckwith's work exhibits the epistemological deficiencies of the supernaturally grounded views of his ID associates and of supernaturalists in general. I preface my examination of Beckwith's arguments with (1) philosopher of science Susan Haack's clarification of the established naturalistic methodology and epistemology of science and (2) discussions of the views of Beckwith's ID associates Phillip Johnson and William Dembski. Finally, I critique the religious exclusionism that Beckwith shares with his ID associates and the implications of his exclusionism for public policy. (shrink)

The development of a human right to water and sanitation under international law has created an imperative to implement human rights in water and sanitation policy. Through forty-three interviews with informants in international institutions, national governments, and non-governmental organizations, this research examines interpretations of this new human right in global governance, national policy, and local practice. Exploring obstacles to the implementation of rights-based water and sanitation policy, the authors analyze the limitations of translating international human rights into (...) local water and sanitation practice, concluding that system operators, utilities, and management boards remain largely unaffected by the changing public policy landscape for human rights realization. To understand the relevance of human rights standards to water and sanitation practitioners, this article frames a research agenda to ensure that human rights aspirations lead to public policy reforms and public health outcomes. (shrink)

Whether the law should permit voluntary euthanasia or physician-assisted suicide is one of the most vital questions facing all modern societies. Internationally, the main obstacle to legalisation has proved to be the objection that, even if they were morally acceptable in certain 'hard cases', voluntary euthanasia and physician-assisted suicide could not be effectively controlled; society would slide down a 'slippery slope' to the killing of patients who did not make a free and informed request, or for whom palliative care would (...) have offered an alternative. How cogent is this objection? This book provides the general reader with a lucid introduction to this central question in the debate, not least by reviewing the Dutch euthanasia experience. It will interest all in any country whether currently for or against legalisation, who wish to ensure that their opinions are better informed. (shrink)

This book brings together a large and diverse collection of philosophical papers addressing a wide variety of public policy issues. Topics covered range from long-standing subjects of debate such as abortion, punishment, and freedom of expression, to more recent controversies such as those over gene editing, military drones, and statues honoring Confederate soldiers. Part I focuses on the criminal justice system, including issues that arise before, during, and after criminal trials. Part II covers matters of national defense and (...) sovereignty, including chapters on military ethics, terrorism, and immigration. Part III, which explores political participation, manipulation, and standing, includes discussions of issues involving voting rights, the use of nudges, and claims of equal status. Part IV covers a variety of issues involving freedom of speech and expression. Part V deals with questions of justice and inequality. Part VI considers topics involving bioethics and biotechnology. Part VII is devoted to beginning of life issues, such as cloning and surrogacy, and end of life issues, such as assisted suicide and organ procurement. Part VIII navigates emerging environmental issues, including treatments of the urban environment and extraterrestrial environments. (shrink)

This article examines two currently disputed issues regarding public policy for mentally retarded people. First, questions are raised about the legal tradition of viewing mental competence as an all-or-nothing attribute. It is argued that recently developed limited competence and limited guardianship laws can provide greater freedom for retarded people without sacrificing needed protection. Second, the question of who should act paternalistically for retarded people incapable of acting for themselves is examined. Rothman's claim that special formal advocates are the (...) best representatives for retarded people is discussed and criticized. It is argued that parents, professionals and legal advocates should share decision-making authority on behalf of those who are incompetent. (shrink)

The market changes sweeping the U.S. health care industry have a distinctive impact on communities that rely on religiously affiliated health care providers. When a sectarian sponsor subsumes multiple providers, its assertion of religious beliefs can preclude the provision of certain health care services to the entire community. In addition, the sectarian provider's refusal to offer certain services may violate state certificates of need, licensing, Medicaid managed care, or even professional liability law. This situation challenges both the provider and the (...) state: the provider seeks adherence to religious law, and the state seeks compliance with its law and citizens access to health care.I propose that the state attempt to ameliorate tensions between civil and religious laws through negotiated accomodation. This concept encourages the sectarian institution to reassess its mission in the current market and to identify alternative avenues of health care delivery that will preserve patients' access to care without excessively diluting religious identity or beliefs. (shrink)

At the mid-point of the twentieth century, many philosophers in the English-speaking world regarded political and moral philosophy as all but moribund. Thinkers influenced by logical positivism believe that ethical statements are merely disguised expressions of individual emotion lacking propositional force, or that the conditions for the validation of ethical statements could not be specified, or that their content, however humanly meaningful, is inexpressible. Philosophical Dimensions of Public Policy presents thirty-four articles written by research scholars numerous fields-philosophy, political (...) theory, medicine, law, biology, economics, ecology and sociology-treating a broad range of topics in practical philosophy. The Institute for Philosophy and Public Affairs has been home for these ideas, pioneering a distinctive method of conducting inquiry into the moral dimensions of public life, and contributing to public discussion and deliberation. Members of the Institute reject the idea that public philosophy means reaching into the philosopher's tool-kit and "applying" prefabricated theories to particular problems. They set in motion a dialogue between the distinctive moral features of practical problems and the more general moral theories or considerations that seem most likely to elucidate these problems. The volume is divided into five areas: "Politics, Civic Life, and Moral Education"; "Diversity, Identity, and Equal Opportunity"; "Human Rights, Development Ethics, and International Justice"; "Biotechnology, Genetic Research, and Health Policy"; and "Natural Environment, Human Communities." Philosophical Dimensions of Public Policy presents empirical data and philosophical arguments with the intention of informing public policy and public deliberation. Scholars as well as graduate and undergraduate students are certain to find it useful to their research work. Verna V. Gehring is editor at the Institute for Philosophy and Public Policy at the School of Public Affairs, University of Maryland. She serves as editor of Philosophy & Public Policy Quarterly, reviewer of ethics manuscripts for Oxford University Press, and moderator for the Aspen Institute. William A. Galston is director at the Institute for Philosophy and Public Policy at the School of Public Affairs, University of Maryland. He is a political theorist who both studies and participates in American politics and domestic policy. Galston is the author of nearly one hundred articles on moral and political theory, American politics, and public policy, and the author of five books, including Liberal Purposes. (shrink)

This paper examines normative and political aspects of the peer review, scientific consensus and public policy processes related to harmful algal blooms of Pfiesteria in estuarine waters of North Carolina and Maryland in the 1990s. After laying out a brief science and policy case history, the tension between the scientific consensus and public policy processes in this case is analyzed in terms of conflicts between scientific norms, public values and political expediency. The relationship between (...) scientific consensus and public policy in general is then questioned in light of this case. (shrink)

It seems intuitive to the believer that God intended through instruction in the Law to define morality, intended to lead humankind to “the right and the good.” Further, God's love for humankind, exemplified by the incarnation, atonement and teachings of Jesus, and empowered by the Holy Spirit, should lead to a better world. Indeed, the Christian worldview is a coherent and valid way to look at bioethical issues in public policy and at the bedside. Yet, as this paper (...) explores, in a pluralistic society such as the United States, it is neither possible nor desirable for Christians to try to force their views on others. Still, it is obligatory for Christians to stand up and articulate their views in the public square. We should try to persuade others using either prudential or moral arguments. While we must be willing to live with “the will of the people,” at the same time, we must not be intimidated into accepting the position that our voice is not valid because it has a religious basis. (shrink)

Moral status is the moral value that something has in its own right, independently of the interests or concerns of others. Research using human embryonic stem cells implicates issues about moral status because the current method of extracting hESCs involves the destruction of a human embryo, the moral status of which is contested. Moral status issues can also arise, however, when hESCs are transplanted into embryonic or fetal animals, thereby creating human/ nonhuman stem cell chimeras. In particular, one concern about (...) chimera research is that it could confer upon an animal the moral status of a normal human adult, but then impermissibly fail to accord the animal the protections it merits in virtue of its enhanced status. Understanding the public policy implications of this ethical conclusion is complicated by the fact that certain views about the moral status of the embryo cannot legitimately be used to justify public policy decisions. Arguments like those employed in the abortion debate for the conclusion that abortion should be legally permissible even if abortion is not morally permissible also support, to a more limited degree, a liberal policy on hESC research involving the creation of chimeras. (shrink)