With a new foreword by Paul Kelly 'I regard Hayek's work as a new opening of the most fundamental debate in the field of political philosophy' - Sir Karl Popper 'This promises to be the crowning work of a scholar who has devoted a lifetime to thinking about society and its values. The entire work must surely amount to an immense contribution to social and legal philosophy' - Philosophical Studies Law, Legislation and Liberty is Hayek's major statement of political (...) philosophy and one of the most ambitious yet subtle defences of a free market society ever written. A robust defence of individual liberty, it is also crucial for understanding Hayek's influential views concerning the role of the state: far from being an innocent bystander, he argues that the state has an important role to play in defending the norms and practices of an ordered and free society. His arguments had a profound influence on the policies of Thatcher in the 1980s and resonate today in visions of the 'Big Society'. First published in three separate volumes, this Routledge Classics edition makes one of his most important books available in a single volume. Essential reading for understanding the background to the recent world economic turmoil and financial crisis, it also foreshadows the subsequent heated debate about regulation and political governance if such disasters are to be avoided in the future. (shrink)

Although transplantation surgeries are relatively successful and save the lives of many, only few are willing to donate organs. In order to better understand the reasons for donation or refusing donation and their implications on and influence by public policy, we conducted a survey examining public views on this issue in Israel. Between January and June 2010, an anonymous questionnaire based on published literature was distributed among random and selected parts of Israeli society and included organ recipients, organ donors, (...) soldiers, university and high school students, and the general population. The analysis of 799 questionnaires revealed that, although 74.7 percent have not signed a donor card, 60.8 percent of participants consider doing so. Additionally, 54.3 percent of respondents objected to giving or receiving compensation for donation, and, if at all, priority in transplantation care is the most desired form of such compensation. The health status of the donor and knowing that donation saves lives or that there exists a shortage of organs for transplantation are the two factors most affecting motivation to donate. Lack of information, relatives’ views on donation, and type of organ involved in donation are factors most inhibiting donation. Willingness to donate is significantly affected by the proximity of the recipient to the donor. With regard to most organs, their contribution to one’s sense of “self” and its symbolic role strongly affects motivation to donate, except for donation to relatives. Compensation for organ donation has little effect on motivation to donate during life and after death. Our findings suggest new ways to construct a more effective public policy on this issue. (shrink)

Minnesota's recently enacted HealthRight legislation places the state at the forefront of American health reform. How did the state manage to overcome the policy gridlock in evidence in other states and at the national level? And how well does the legislation fare under close ethical scrutiny? Among the most important factors that permitted Minnesota to enact reforms were the explicit linkage in the legislative debate of the goal of cost containment to the desire to expand access, the (...) public perception that HealthRight is incremental and consistent with earlier reform efforts in Minnesota, and the lengthy public debate that preceded the enactment of HealthRight. Although it endeavors to create a fair and efficient health care system, it is not at all certain that HealthRight, in its present form, will achieve these normative goals. (shrink)

“Nudging” is commonly seen as an appealing form of “Smart legislation” based on the findings of Behavioural sciences and alternative to traditional forms of regulation. However, notwithstanding the ever increasing references and a growing body of literature on its acceptability, a proper definition of the concept seems still lacking, since all the attempts to date have only provided over- or under-inclusive definitions. This chapter purports to offer a more plausible definition. Firstly, the received view and especially Thaler’s and Sunstein’s (...) descriptions of nudging will be examined and subjected to a first critical assessment. Secondly, a few examples will be made of policies enacted all around the world which are usually referred to as cases of nudging. Thirdly, some of the elements which have often been associated to nudging as its definitional features will be tested against the set of examples: such test will show that most of those elements must be done away with. Lastly, a “minimal” definition will be offered. While allowing us to distinguish nudging from other forms of conduct-influencing interventions, the minimal definition will exclude many features as its necessary conditions: among others, those related to specific ends and political ideologies. (shrink)

Examining the ways and extent to which systemic factors affect health outcomes with regard to quality, affordability and access to curative healthcare, this explorative book compares the relative merits of tax-funded Beveridge systems and insurance-based Bismarck systems. The Law and Policy of Healthcare Financing charts and compares healthcare system outcomes throughout 11 countries, from the UK to Colombia. Thematic chapters investigate the economic and legal explanations for the relevant similarities, variations and trends across the globe. Concluding that systemic factors (...) may be less significant than previously believed, this comprehensive book notes that no one system consistently outperforms the others, yet incentives and funding improvements may lift performances across all curative healthcare systems. Analytical and comparative, this book will be of interest to academics working in the fields of health law and health economics. Public authorities including health ministries, policymakers and international health organisations will also find this to be an invaluable resource. (shrink)

Purpose: Despite various comparative studies in the field of cultural heritage protection in the world, there is still a significant lack of comparative research on policies related to the legal system of countries' governance. The purpose of this study is to address the comparative policies in Iran and Italy, with a particular focus on the results of the executive experiences of two different types of policies in the cities of Oroumieh (North-West of Iran) and Turin (in North-West of Italy). Design/methodology/approach: (...) Utilising the comparative, analytical, bibliographic and descriptive historical research methodology, which is based on the study of the local, national and international comprehensive review of regulations and policy-making of cultural heritage preservation policies in Iran and Italy. In this research, the related documents in three languages (Persian, Italian and English) have been examined to compare profoundly and comprehensively the policies and regulations adopted in these two countries to be able to analyze the national and transnational regulations and local policies in the cultural heritage sector. Findings: In addition to many cultural similarities and numerous commonalities, especially in the multiplicity of urban cultural heritage in historical centers, the results suggest that the legislation structure in Iran is much more centralized than in Italy. Also, the findings suggest that Italy focuses on aligning its previously centralized national legislative system in line with contemporary European heritage and preservation policies. Originality/value: The paper outlines how to use historical and cultural similarities through comparative study to benefit the experiences of two historical countries in urban heritage conservation and policy-making part despite their differences. (shrink)

Laws and policies are vital tools in preventing outbreaks and limiting the further spread of disease, but they can vary in content and implementation. This manuscript provides insight into challenges in responding to recent vaccine-preventable disease outbreaks by examining legislative changes in California, policy changes on certain university campuses, and the laws implicated in a measles outbreak in Minnesota.

The extent to which society utilises the law to enforce its moral judgments remains a dominant issue in this era of embryonic stem cell research, preimplantation genetic diagnosis, and human reproductive cloning. Balancing the potential health benefits and diverse moral values of society can be a tremendous challenge. In this context, governments often adopt legislative bans and prohibitions and rely on the inflexible and often inappropriate tool of criminal law. Legal prohibitions in the field of reproductive genetics are not likely (...) to reflect adequately the depth and diversity of competing stakeholder positions. Rather, a comprehensive and readily responsive regulatory policy is required. Such a policy must attend to the evolving scientific developments and ethical considerations. We outline a proposal for effective, responsive, and coherent oversight of new reproductive genetic technologies. (shrink)

In Righting Health Policy, MacDougall argues that bioethics has not developed the tools best suited for justifying health law and policy. Using Kant’s practical philosophy as an example, he explores the promise of political philosophy for making normatively justified recommendations about health law and policy.

The governance of human (germline) genome modification at the international and transnational level -- The regulation of human germline genome modification in Canada (E Kleiderman) -- The regulation of human germline genome modification in the United States (Kerry Macintosh) -- The regulation of human germline genome modification in Mexico (M Medina Arellano) -- The regulation of human germline genome modification in Europe (J Almqvist, C Romano) -- The regulation of human germline genome modification in the United Kingdom (J Lawford Davies) (...) -- The regulation of human germline genome modification in Germany (T Faltus). (shrink)

"In this paper I shall attempt to sketch a defense of the plain man's view that the job of the judge, qua judge is to apply the law." What seems to have lead to the other view is the pervasive role of policy and principle in the justification of judicial decisions. This is no argument, however, for the existence of discretion: "For while it must be admitted that judges are entitled to appeal to certain general policies and principles, this (...) by no means implies that they are entitled to exercise discretionary judgment in the formulation of such standards." With Dworkin, distinguishes weak and strong discretion: the former means merely final or controversial; the latter implying that judges are at some point free to reach decisions not controlled by authoritative standards. Agrees with Dworkin that non-rule standards are part of law. "Both Dworkin and I are in agreement that law is a system of entitlements, although, as we shall see, we differ as to what is their basis." "At any rate, we share the view that a litigant before a court of law is not in the position of one begging a favor from a potential benefactor, but rather in that of one demanding a particular decision as a matter of right, as something to which the law entitles him. Such a demand has two aspects: a claim that a right exists which the law recognizes; a claim that this right takes precedence over any competing legal rights or obligations involved. Let us refer to these two sorts of claims respectively as ones involving decisions as to recognition, and weight.:" Argues that we cannot distinguish between legal moral principles and non-legal moral principles without a rule of recognition. The same is true for the problem of establishing weight between various principles - here we have to consider how well a principle coheres with the institutional practice of a legal system. "[I]t is the distinctive feature of the institutionalized role of the judiciary, in contrast to the legislative, that it may not directly base decisions on substantive considerations of the value of competing social policies." "The theoretical possibility of the law being indeterminate with regard to what it requires...does not imply any correspondign indeterminacy with regard to what is required of the judge.". (shrink)

About 6% of women in the world live in countries that ban all abortions, and 34% in countries that only allow abortion to preserve maternal life or health. In the USA, over the last decades—even before Dobbs v. Jackson Women’s Health Organization overturned the federal right to abortion—various states have sought to restrict abortion access. Often times, this legislation has been advanced based on legislators’ personal moral values. At the bedside, in contrast, provision of abortion care should adhere to (...) the normative principles of medical ethics and reproductive justice, centreing patients and their individual reproductive intentions and desires. Abortion regulations, through their influence on patients and providers, may facilitate or impede such ethical care at the bedside. In this paper, we present a framework to model how abortion legislation should fit into the patient–provider relationship and to clarify the dynamics by which legislation may affect healthcare encounters. Our proposed framework serves as a tool to analyse the ethical impact of abortion regulations. We propose a model for assessing abortion policies based not on legislators’ or advocates’ individual moral claims, but on the shared, normative framework of clinical medical ethics. Through contrasting case studies, we demonstrate how a robust normative ethical framework can recentre patients and their reproductive needs. Our model is one way to account for—and safeguard—patients’ diverse viewpoints and needs in the development of abortion policy, and it can serve to ground narratives for advocacy by healthcare workers and their professional organisations. (shrink)

Is realism in political theory compatible with utopianism? This article shows that it is, by reconstructing a highly restrictive realist approach to political theory for guiding legislation and public policy, drawn from the work of Adam Smith, and showing how it can accommodate Piketty’s utopian proposal for a global tax on capital. This shows not only that realism and utopianism are compatible; but how realist and utopian political theory can be carried out in concrete cases. This moves debates (...) to more interesting questions of which forms of utopianism are permissible within which forms of realism; contributes to moving the contemporary realism debates from a Methodenstreit to questions of how it can and ought to be done; and contributes to an important contemporary debate about the permissibility of utopian proposals for political and economic reform in general and Piketty’s proposed global tax on capital in particular. (shrink)

This study explores the individual-level activities of legislators in parliament, which have been largely ignored in the literature on parliamentary democracies. Individual legislators are extensively involved in parliamentary activities such as drafting private members’ bills and posing questions, even though these activities have only been considered to play marginal roles in parliamentary democracies. Moreover, their engagement varies significantly. By using unique data from Japan, this study demonstrates that the personal attributes of legislators affect their choice of parliamentary activities. Under electoral (...) systems with intra-party competition, legislators use parliamentary activities as an important means to inform their constituents about what they can do for them and how they differ from other legislators. In elections, candidates cultivate personal votes by exploiting the image drawn from their personal attributes and, once elected, they behave in accordance with their attributes in order to maintain their electoral ground. Thus, they devote themselves to different activities in parliament. The data analyzed here support this argument. The results of empirical analyses show that legislators with local-level political experience engage in particularistic pork-barrel activities that will benefit their local interests, while legislators with legal-work experience allocate their time and energy to general policy-making activities that will enhance their public image and visibility as legal experts. (shrink)

The basic hypothesis tested in the article is that the existence of Freedom of Information legislation in a state enhances utilization of evaluation research. The investigation of this research question leads to a tentative rejection of this hypothesis. Factors such as weak Freedom of Information Acts, unsympathetic implementation, and the lack of useful and timely information in agency-sponsored evaluations may discourage legislatures from actively using Freedom of Information provisions to obtain such studies.

My purpose is to provide an update on recent Texas regulatory and statutory changes adopted, since the passage in Texas of the Intractable Pain Treatment Act in 1989. First, I describe the rules adopted by the Texas State Board of Medical Examiners that authorize physicians to prescribe opioids for the treatment of pain. Second, I detail recent statutory changes that pertain to education of physicians and medical students about pain treatment. All of these changes attempt to create a better legal (...) environment for the treatment of chronic pain in Texas.Before describing the Pain Rules adopted in Texas, the question Why adopt rules, rather than simply ask TSBME to issue a policy statement? must be answered. Many states, most notably California, have issued policy statements that clarify for physicians the parameters within which they may treat pain? Policy statements, unlike administrative regulations, do not have the force of law. (shrink)

My purpose is to provide an update on recent Texas regulatory and statutory changes adopted, since the passage in Texas of the Intractable Pain Treatment Act in 1989. First, I describe the rules adopted by the Texas State Board of Medical Examiners that authorize physicians to prescribe opioids for the treatment of pain. Second, I detail recent statutory changes that pertain to education of physicians and medical students about pain treatment. All of these changes attempt to create a better legal (...) environment for the treatment of chronic pain in Texas.Before describing the Pain Rules adopted in Texas, the question Why adopt rules, rather than simply ask TSBME to issue a policy statement? must be answered. Many states, most notably California, have issued policy statements that clarify for physicians the parameters within which they may treat pain? Policy statements, unlike administrative regulations, do not have the force of law. (shrink)

This article explores the background to the conclusive drop in Irish fertility rates over the last two decades, from a total fertility rate of 3.55 in 1975 to 1.87 in 1995. This steep decline marks the end of Ireland's position as demographic outlier in Europe, which has proved a compelling topic of investigation for demographers. The decline also marks the end of a society which was characterized by an ideology of largely rural values which placed stringent restrictions on women in (...) order to secure a vision of society which saw the family as its cornerstone. The article analyses the collective impact of women's battles for personal autonomy which have brought about dramatic changes in public policies about contraception, abortion and divorce, changes which have consistently lagged behind these dramatic shifts in fertility. (shrink)

After the establishment of the independent Slovak Republic, legal and institutional ground rules were set for providing asylum to foreigners present on the territory of the Slovak Republic. The national legislation of the last twenty years was adopted in compliance with international treaties and the European Union instruments covering asylum matters. In the field of asylum policy, the Slovak Republic complies with its traditional pillars and supports new forms of protection following the new challenges faced by the international (...) community. The currently valid Asylum Act regulates the international protection of aliens in the Slovak Republic, by defining the conditions and procedures related to granting asylum and provision of subsidiary protection and temporary shelter. The Asylum Act also covers the rights and obligations of different categories of persons, stay in asylum facilities and, partially, the integration of persons that are granted asylum. This article describes and analyses the development of the Slovak asylum legal framework and the concept of asylum policy. Furthermore, it looks at different protection statuses granted to foreigners and finally deals with the refugee migration trends in the Slovak Republic. (shrink)

"Whole brain death" (neurological death) is well-established as a legal standard of death across the country. Recently, New Jersey became the first state to enact a statute recognizing a personal religious exemption (a conscience clause) protecting the rights of those who object to neurological death. The Act also mandates adoption through the regulatory process of uniform and up-to-date clinical criteria for determining neurological death.

Over the past twenty years there has been a shift in medical law and practise to increasingly distrust the judgement of health professionals. An increasing number of codes of conduct, disciplinary bodies, ethics committees and bureaucratic policies now prescribe how health professional and health researchers should act and relate to their patients. The result of this, Mark Henaghan argues, has been to undermine trust and professional judgement in health professionals, while simultaneously failing to trust the patient to make decisions about (...) their care. This book will look at the issue of health professionals and trust comparatively in a number of countries including the USA, Canada, Australia, New Zealand and the UK. The book will show by historical analysis of legislation, case law, disciplinary proceedings reports, articles in medical and law journals and protocols produced by management teams in hospitals, how the shift from trust to lack of trust has happened. Drawing comparisons between situations where trust is respected such as in emergency situations, and where it is not for example routine decisions such as obtaining consent for an anaesthetic procedure, the book shows how this erosion of trust has the potential to dehumanise the special nature of the relationship between healthcare professionals and patients. The effect of this is that the practice of health care is turned into a mechanistic enterprise controlled by "management processes" rather than governed by trust and individual care and judgement. This book will be an invaluable resource for students and scholars of medical law and medical sociology, public policy-makers and a range of associated professionals, from health service managers to medical science and clinical researchers. (shrink)

In 2002 the Netherlands and Belgium both adopted a law on euthanasia. In the Netherlands the law was a codification of a longstanding practice of condoning euthanasia. In Belgium it was a political novelty, without extended prior legal or medical discussion. The developments in the Netherlands and in Belgium will certainly give rise to debates in other countries. The Dutch example has already elicited international discussion. The Belgian policy is interesting because it shows that legalisation of euthanasia can be (...) enacted quite quickly in a country that has no longstanding tradition in this area. John Keown’s book is therefore timely. He has taken part in the debate on euthanasia for a decade and combines an analytic style with a thorough knowledge of the literature on euthanasia. Moreover, he takes a firm stand in the debate. The subtitle of the current book clearly shows Keown’s position. As a critique of legislation of euthanasia, his book is a challenge to the developments in the Netherlands and Belgium.In the first part of the book, Keown tries to clear away common confusions and misunderstandings in the debate by developing clear definitions. Euthanasia is defined as an intentional termination of life. Keown distinguishes between active euthanasia and termination of treatment with the intention to terminate life, or passive euthanasia . Euthanasia is either at the patient’s request, that is voluntary euthanasia , or without the patient’s request, that is non-voluntary euthanasia . Keown distinguishes between euthanasia and medical interventions that foresee the shortening of the patient’s life, but do not primarily aim to bring this about, with reference to the intention of the physician. According to Keown, intentions and foresights are different states of mind, which are morally distinct. …. (shrink)

Kentucky and West Virginia are among the states most severely affected by opioid poisonings and deaths. The legislatures of both states have enacted a broad range of bills intended to address related issues. We present an overview of legislation enacted in 2017 and 2018, along with an approach to analysis of practitioner response to one type of legislation.

An empirical exploration of the effects on legislative structure, distribution of influence, power, and decision outcomes, of recent changes in the Congress and state legislatures. The book focuses on changes in rules, parties, and committees and the impact or lack of impact of these changes on subsequent activity. Originally published in 1978 by D.C. Heath and Company. Co-published with the Policy Studies Organization.

Those involved in end-of-life decision making must take into account both legal and ethical issues. This book starts with a critical reflection of ethical principles including ideas such as moral status, the value of life, acts and omissions, harm, autonomy, dignity and paternalism. It then explores the practical difficulties of regulating end-of-life decisions, focusing on patients, healthcare professionals, the wider community and issues surrounding 'slippery slope' arguments. By evaluating the available empirical evidence, the author identifies preferred ways to regulate decisions (...) and minimise abuses at the end of life, and outlines an ethical theory which can provide practical guidance for those engaged in end-of-life decisions"--Provided by publisher. (shrink)

Sex selection, which refers to the attempt to choose or control the sex of a child prior to its birth, has become the subject of increasing ethical scrutiny and many jurisdictions have criminalized it except for serious sex-linked diseases or conditions that cannot easily be ameliorated or remedied. This paper argues that such a blanket prohibition is ethically unwarranted because it is based on a flawed understanding of the difference between sexist values and mere sex-oriented preferences. It distinguishes between ethics (...) and public policy, and suggests a way of allowing preference-based sex selection as a matter of public policy without permitting value-based sex selection. It further argues that medically-based sex selection should be publicly funded but that preference-base sex selection should not be paid for by society, and that the prohibition against value-based sex selection should be enforced through legislation that controls the licensing of health care facilities and through disciplinary procedures against health care professionals. (shrink)

This book approaches the problems and circumstances confronting blacks in the context of black values, the black community, and the role of government. ^BContents:: The Black Community's Values as a Basis for Action; The Community as Agent of Change; and The Government's Role in Meeting New Challenges.

This new edition of Charles Fried's 'Medical Experimentation' includes a general introduction by Franklin Miller and the late Alan Wertheimer, a reprint of the 1974 text, an in-depth analysis by Harvard Law School scholars I. Glenn Cohen and D. James Greiner, and a new essay by Fried reflecting on the original text and how it applies to the contemporary landscape of medicine and medical experimentation.

Abortion, particularly late‐term abortion, and neonaticide, selective non‐treatment of newborns, are feasible management strategies for fetuses or newborns diagnosed with severe abnormalities. However, policy varies considerably among developed nations. This article examines abortion and neonatal policy in four nations: Israel, the US, the UK and Denmark. In Israel, late‐term abortion is permitted while non‐treatment of newborns is prohibited. In the US, on the other hand, late‐term abortion is severely restricted, while treatment to newborns may be withdrawn. Policy (...) in the UK and Denmark bridges some of these gaps with liberal abortion and neonatal policy. Disparate policy within and between nations creates practical and ethical difficulties. Practice diverges from policy as many practitioners find it difficult to adhere to official policy. Ethically, it is difficult to entirely justify perinatal policy in these nations. In each nation, there are elements of ethically sound policy, while other aspects cannot be defended. Ethical policy hinges on two underlying normative issues: the question of fetal/newborn status and the morality of killing and letting die. While each issue has been the subject of extensive debate, there are firm ethical norms that should serve as the basis for coherent and consistent perinatal policy. These include 1) a grant of full moral and legal status to the newborn but only partial moral and legal status to the late‐term fetus 2) a general prohibition against feticide unless to save the life of the mother or prevent the birth of a fetus facing certain death or severe pain and suffering and 3) a general endorsement of neonaticide subject to a parent's assessment of the newborn's interest broadly defined to consider physical harm as well as social, psychological and or financial harm to related third parties. Policies in each of the nations surveyed diverging from these norms should be the subject of public discourse and, where possible, legislative reform. (shrink)

Embryo litigation -- Access to ART treatment : insurance and discrimination -- General professional liability litigation -- Paternity and donor insemination -- Maternity and egg donation -- Traditional and gestational surrogacy arrangements -- Posthumous reproduction : access and parentage -- Same-sex parentage and ART -- Genetics (PGD) and ART -- ART-related embryonic stem cell legal developments -- ART-related adoption litigation -- ART-related fetal litigation and abortion-related litigation.

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)

Train crashes cause, on average, a handful of deaths each year in the UK. Technologies exist that would save the lives of some of those who die. Yet these technical innovations would cost hundreds of millions of pounds. Should we spend the money? How can we decide how to trade off life against financial cost? Such dilemmas make public policy is a battlefield of values, yet all too often we let technical experts decide the issues for us. Can philosophy (...) help us make better decisions? Ethics and Public Policy: A Philosophical Inquiry is the first book to subject important and controversial areas of public policy to philosophical scrutiny. Jonathan Wolff, a renowned philosopher and veteran of many public committees, such as the Gambling Review Body, introduces and assesses core problems and controversies in public policy from a philosophical standpoint. Each chapter is centred on an important area of public policy where there is considerable moral and political disagreement. Topics discussed include: Can we defend inflicting suffering on animals in scientific experiments for human benefit? What limits to gambling can be achieved through legislation? What assumptions underlie drug policy? Can we justify punishing those who engage in actions that harm only themselves? What is so bad about crime? What is the point of punishment? Other chapters discuss health care, disability, safety and the free market. Throughout the book, fundamental questions for both philosopher and policy maker recur: what are the best methods for connecting philosophy and public policy? Should thinking about public policy be guided by an ‘an ideal world’ or the world we live in now? If there are ‘knock down’ arguments in philosophy why are there none in public policy? Each chapter concludes with ‘Lessons for Philosophy’ making this book not only an ideal introduction for those coming to philosophy, ethics or public policy for the first time, but also a vital resource for anyone grappling with the moral complexity underlying policy debates. (shrink)

KEY POINTS In Canada, commercial data brokers collect deidentified patient data from pharmacies, private drug insurers, the federal government and medical clinics without patient consent. Although pharmaceutical companies are the data brokers’ primary customers, academics and nonprofit and public entities also use commercial data sets, given the absence of a coordinated public approach to collecting these data across Canada. Risks of commercialized patient data include loss of anonymity, surveillance and marketing, discrimination and violation of Indigenous data sovereignty. Coordinated infrastructure for (...) the collection and coordination of health data across Canada and updated privacy legislation would protect individuals and communities and enable appropriate data uses. (shrink)