Background: Nurses, social workers, and medical residents are ethically mandated to engage in policy advocacy to promote the health and well-being of patients and increase access to care. Yet, no instrument exists to measure their level of engagement in policy advocacy. Research objective: To describe the development and validation of the Policy Advocacy Engagement Scale, designed to measure frontline healthcare professionals’ engagement in policy advocacy with respect to a broad range of issues, (...) including patients’ ethical rights, quality of care, culturally competent care, preventive care, affordability/accessibility of care, mental healthcare, and community-based care. Research design: Cross-sectional data were gathered to estimate the content and construct validity, internal consistency, and test–retest reliability of the Policy Advocacy Engagement Scale. Participants and context: In all, 97 nurses, 94 social workers, and 104 medical residents were recruited from eight acute-care hospitals in Los Angeles County. Ethical considerations: Informed consent was obtained via Qualtrics and covered purposes, risks and benefits; voluntary participation; confidentiality; and compensation. Institutional Review Board approval was obtained from the University of Southern California and all hospitals. Findings: Results supported the validity of the concept and the instrument. In confirmatory factor analysis, seven items loaded onto one component with indices indicating adequate model fit. A Pearson correlation coefficient of.36 supported the scale’s test–retest stability. Cronbach’s α of.93 indicated strong internal consistency. Discussion: The Policy Advocacy Engagement Scale demonstrated satisfactory psychometric properties in this initial test. Findings should be considered within the context of the study’s limitations, which include a low response rate and limited geographic scope. Conclusion: The Policy Advocacy Engagement Scale appears to be the first validated scale to measure frontline healthcare professionals’ engagement in policy advocacy. With it, researchers can analyze variations in professionals’ levels of policy advocacy engagement, understand what factors are associated with it, and remedy barriers that might exist to their provision of it. (shrink)

State health departments are at the core of the United States public health infrastructure. Surveillance to monitor trends in disease and injury; the development, coordination, and delivery of services; and public education are some of the core functions health department employees oversee every day. As such, agencies and their employees are well positioned to inform policy decisions that affect the public’s health. However, little is known about the role of health department staff — a sizeable proportion of the public (...) health workforce — as advocates for public health policies, independent of their agency roles. Anecdotally, some health department employees with whom we have spoken expressed reluctance to engage in policy advocacy for fear of violating little known or understood agency or state rules. (shrink)

Among other things, the philosophical tradition of pragmatism provides a theory of inquiry and a theory of collective action. The theory of inquiry frames how humans investigate their problems and devise solutions; the theory of collective action frames how we work together to implement solutions to shared problems. Though philosophical, pragmatism aims to integrate philosophy and practice by developing theory that is useful for solving the problems that press on people’s lives. In spite of this intention, and perhaps because of (...) disciplinary boundaries, practitioners in the social sciences, sciences, and professions do not always see pragmatism as being as relevant and useful as philosophers have hoped and.. (shrink)

This article addresses three questions: How can we define and measure what constitutes a foreign policy in human rights? How is it possible to explain both the activism of a state and its ideological orientation in the international promotion of human rights? What is the empirical evidence found when we try to answer these questions in intermediate states? Research done on four cases (Argentina, Australia, Brazil and South Africa) suggests a correlation between domestic efforts in the promotion of human (...) rights and international advocacy. It also shows that the greater the power of intermediate states, the greater their activism in human rights. Further, as development grows states show less support for economic, social and cultural rights. Last, the strategic relation with the USA shapes how states vote regarding human rights violators states. (shrink)

Background:The concept of patient advocacy is still poorly understood and not clearly conceptualized. Therefore, there is a gap between the ideal of patient advocacy and the reality of practice. In order to increase nursing actions as a patient advocate, a comprehensive and clear definition of this concept is necessary.Research objective:This study aimed to offer a comprehensive and clear definition of patient advocacy.Research design:A total of 46 articles and 2 books published between 1850 and 2016 and related to (...) the concept of patient advocacy were selected from six databases and considered for concept analysis based on Rodgers’ evolutionary approach.Ethical considerations:This study was approved by the Research Ethics Committee of Tarbiat Modares University.Findings:The attributes of patient advocacy are safeguarding (track medical errors, and protecting patients from incompetency or misconduct of co-workers and other members of healthcare team), apprising (providing information about the patient’s diagnosis, treatment, and prognosis, suggesting alternatives of healthcare, and providing information about discharge program), valuing (maintaining self-control, enabling patients to make decisions freely, maintaining individualization and humanity, maintaining patient privacy, and acting in the patients’ values, culture, beliefs, and preferences), mediating (liaison between patients, families, and healthcare professionals, being patients’ voice, and communicate patient preferences and cultural values to members of the healthcare team), and championing social justice in the provision of healthcare (confronting inappropriate policies or rules in the healthcare system, identifying and correcting inequalities in delivery of health services, and facilitating access to community health services and health resources).Discussion and conclusion:The analysis of this concept can help to develop educational or managerial theories, design instruments for evaluating the performance of nurses in patient advocacy, develop strategies for enhancing patient advocacy, and improve the safety and quality of nursing care in the community and healthcare system. (shrink)

Patient advocacy organizations (PAOs) advocate for increased research funding and policy changes and provide services to patients and their families. Given their credibility and political clout, PAOs are often successful in changing policies, increasing research funding, and increasing public awareness of medical conditions and the problems of their constituents. In order to advance their missions, PAOs accept funding, frequently from pharmaceutical firms. Industry funding can help PAOs advance their goals but can also create conflicts of interest (COI). Research (...) indicates that bias may occur, even among well-meaning professionals, when people and organizations have financial COI. Industry funding may therefore influence PAOs to act in ways that favor the interests of their donors, which may increase the risk of harm to patients. This article extends the analysis developed in the Institute of Medicine report, Conflicts of Interest in Medical Research, Education, and Practice, and applies the analysis to understand PAOs and their relationships with industry. It argues that the preferred goal of institutional COI policies should not be to promote trust, but to promote trustworthiness and appropriately placed trust. (shrink)

One of harm reduction’s most salient features is its pragmatism. Harm reduction purports to distinguish itself from dominant prohibitionist and abstinence-based policy paradigms by being grounded in what is realistic, in contrast with the moralism or puritanism of prohibition and abstention. This is reflected in the meme “harm reduction works”, popular both in institutional and grassroots settings. The idea that harm reduction is realistic and effective has meant different things among the main actors who seek to shape harm reduction (...) policy. Drawing on scholarly literature about harm reduction, as well as examples from recent harm reduction advocacy efforts in relation to drug policy in Canada, this paper argues that harm reduction distinguishes itself through a unique “way of knowing”. Grassroots harm reduction advocates, particularly as they argue through human rights frameworks, do more than simply make claims for the provision of particular services—like needle exchange, safe consumption sites, safe supply and the like—on the basis that these are realistic paths toward the health and well-being of people who use drugs. Rather, as they marshal lived experience in support of these policy changes through peer-driven initiatives in contexts of prohibition, they make particular claims about what constitute valid, methodologically rigorous evidence bases for action in contexts where policies to date have been driven by ideology and have developed in ways that have excluded and marginalized those most affected from policymaking. In doing so, they advocate for the centrality of people who use drugs not only in policy-making processes, but in evidence production itself. (shrink)

Professions have traditionally treated advocacy as a collective duty, best assigned to professional associations to perform. In North American nursing, advocacy for issues affecting identifiable patients is assigned instead to their nurses. We argue that nursing associations’ withdrawal from advocacy for patient care issues is detrimental to nurses and patients alike. Most nurses work in large institutions whose internal policies they cannot influence. When these create obstacles to good care, the inability of nurses to affect change can (...) result in avoidable distress for them and for their patients. We illustrate this point with a case study: the circumstances of the death of Michael Joseph LeBlanc, an inmate at Kingston Penitentiary Regional Hospital (Ontario). We conclude that patients and their nurses will suffer unnecessarily unless or until nursing associations cease to burden individual nurses with the responsibility for patient advocacy. (shrink)

Background: Advocacy is an important role of psychiatric nurses because their patients are ethically, socially, and legally vulnerable. This study of Japanese expert psychiatric nurses’ judgments of interventions for patient advocacy will show effective strategies for ethical nursing practice and their relationship with Japanese culture. Objectives: This article explores Japanese psychiatric nurses’ decision to intervene as a patient advocate and examine their ethical, cultural, and social implications. Research design: Using semi-structured interviews verbatim, themes of the problems that required (...) interventions were inductively summarized by a qualitative analysis and their contexts and nursing judgments were examined. Participants and research context: The participants were 21 nurses with 5 or more years of experience in psychiatric nursing. Ethical considerations: The research was approved by Institutional Review Board of research site and study facilities. The participants gave written informed consent. Findings: Analysis of 45 cases showed that nurses decided to intervene when surrounding people’s opinions impeded patients’ safety, healthcare professionals’ policies impeded patients’ decision-making, own violent behaviors impeded treatment and welfare services for patients, own or families’ low acceptance of illness impeded patients’ self-actualization, inappropriate treatment or care impeded patients’ liberty, and their families abused patients’ property. Discussion: To solve conflicts between patients and their surrounding people, the nurses sought reconciliation between them, which is in accordance with Japanese cultural norms respecting harmony. When necessary, however, they protected patients’ rights against cultural norms. Therefore, their judgments cannot be explained by cultural norms alone. Conclusion: The findings indicate that the nurses’ judgments were based on respect for patients’ rights apart from cultural norms, and they first sought solutions fitting the cultural norms before other solutions. This seems to be an ethical, effective strategy if advocates know the culture in depth. (shrink)

When considering the persuasive characteristics and prospective influences of Darwin‐skeptic mass media, uncertainties remain about how to reciprocally promote evolutionary theory to skeptical audiences. This study aims to improve evolution advocacy by translating some of the most successful methods of science endorsement to Evolution Wars contexts. In particular, strategies used to address vaccine hesitancies and enhance immunization uptake policies are reinterpreted for those seeking to improve pro‐evolution communications to religious publics. What results are three recommendation categories described as General (...) Guiding Principles, Proximate Interventions, and Auxiliary Interventions. (shrink)

Nurses have moral obligations incurred by membership in the profession to participate knowingly in health policy advocacy. Many barriers have historically hindered nurses from realizing their potential to advance health policy. The contemporary political context sets additional challenges to policy work due to polarization and conflict. Nursing education can help nurses recognize their role in advancing health through political advocacy in a manner that is consistent with disciplinary knowledge and ethical responsibilities. In this paper, the (...) authors describe an exemplar of Elizabeth Barrett's “Power as Knowing Participation in Change” theory as a disciplinary lens within a doctoral nursing health policy course. Barrett (radically) emphasizes “power as freedom” instead of “power as control.” This approach is congruent with nursing disciplinary values and enhances awareness of personal freedom and building collaborative relationships in the policy process. The theory was used in concert with other traditional policy content and frameworks from nursing and other disciplines. We discuss the role of nursing ethics viewed as professional responsibility for policy action, an overview of Barrett's theory, and the design of the course. Four student reflections on how the course influenced their thinking about policy advocacy are included. While not specific to policymaking, Barrett's theory provides a disciplinary grounding to increase students' awareness of freedom and choices in political advocacy participation. Our experience suggests that Barrett's work can be fruitful for enhancing nurses' awareness of choices to participate in change across settings. (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)

This article discusses how advocacy can be taught to both law and public health students, as well as the role that public health law faculty can play in advocating for public health. Despite the central role that advocacy plans in translating public health research into law, policy advocacy skills are rarely explicitly taught in either law schools or schools of public health, leaving those engaged in public health practice unclear about whether and how to advocate for (...) effective policies. The article explains how courses in public health law and health justice provide ideal opportunities to teach advocacy skills, and it discusses the work of the George Consortium, which seeks to engage public health law faculty in advocacy efforts. (shrink)

The Great Recession of 2008 underscored the precarity of housing for many people living in the United States, as well as the unequal conditions that structure housing policy and practices. Victimized by predatory lending practices, many families lost their homes as a speculative housing bubble burst. Facing tremendous uncertainty, these families joined tens of thousands of others across the country who struggle with housing for a variety of reasons—leaving an abusive partner, struggling with medical and other unforeseen expenses, coping (...) with addiction and/or mental illness, and more. Indeed, as Melanie Loehwing explains in her important new book, “housed” and “unhoused” represent not fixed categories or stable life... (shrink)

Halley et al. (2023) highlight important equity challenges emerging out of existing health policy’s reliance on self- and family advocacy. As advocacy capacity varies dramatically across groups, pu...

Purpose The proliferation of surveillance-enhancing laws, policies and technologies across African countries deepens the risk of privacy rights breaches, as well as the risks of adverse profiling and social sorting. There is a heightened need for dedicated advocacy and activism to consistently demand accountability and transparency from African states, governments and their allies regarding surveillance. The purpose of this paper is to understand the issue frames that accompany anti-surveillance and privacy advocacy in Ghana and the related implications. Design/methodology/approach (...) Using a qualitative and interpretivist approach, the author focuses on three different surveillance-oriented incidents/programs in Ghana and analyzes the frames underpinning the related advocacy and narratives of various non-state actors. Findings Privacy and anti-surveillance advocacy in Ghana tends to be less framed in the context of privacy rights and is more driven by concerns about corruption and value for money. Such pecuniary emphasis is rational per issue salience calculations as it elevates principles of economic probity, transparency and accountability and pursues a high public shock value and resonance. Practical implications Economics-centered critiques of surveillance could be counterproductive as they create a low bar for surveillance promoters and sustains a culture of permissible statist intrusions into citizens’ lives once economic virtues are satisfied. Originality/value While anti-surveillance and privacy advocacy is budding across African countries, little is known about its nature, frames and modus compared to such advocacy in European and North American settings. To the best of the author’s knowledge, this is likely the first paper or one of the first dedicated fully to anti-surveillance and advocacy in Africa. (shrink)

The purpose of Christian social ethics is primarily that of advocating particular positions on social policy based on Christian ethical criteria. This is especially true at a time of malaise in liberalism. In contrast to suggestions by some that the primary purpose of the field is the analysis of moral discourse by Christians on questions of social policy, or the critical evaluation of social theory, what is suggested here is concentration on the practical formulation of specific policy (...) choices facing the churches as institutions as well as individual Christians. Though this exposes practitioners in universities to the problem of being generalists in settings that are enamored of and controlled by sub-specialists, this particular problem may be mitigated somewhat as various university departments begin to organize around the major policy issues confronting the world. (shrink)

Background:Choice to live and die at home is supported by palliative care policy; however, health resources and access disparity impact on this choice in rural Australia. Rural end-of-life home care is provided by district nurses, but little is known about their role in advocacy for choice in care.Objectives:The study was conducted to review the scope of the empirical literature available to answer the research question: What circumstances influence district nurse advocacy for rural client choice to live and (...) die at home?, and identify gaps in the knowledge.Method:Interpretive scoping methodology was used to search online databases, identify suitable studies and select, chart, analyse and describe the findings.Results:34 international studies revealed themes of ‘the nursing relationship’, ‘environment’, ‘communication’, ‘support’ and ‘the holistic client centred district nursing role.Discussion:Under-resourcing, medicalisation and emotional relational burden could affect advocacy in rural areas.Conclusion:It is not known how district nurses overcome these circumstances to advocate for choice in end-of-life care. Research designed to increase understanding of how rural district nurses advocate successfully for client goals will enable improvements to be made in the quality of end-of-life care offered. (shrink)

The purpose of this discussion paper is to explore how nurses can be strategically poised to advocate for needed policy change in support of greater income equality and other social determinants of health. We adapted Bronfenbrenner's social‐ecological model to highlight how four broad pervasive subsystems shape the opportunities that nurses have to engage in advocacy at the policy level. These subsystems include organizations (the microsystem), professional bodies (the mesosystem), public policies (the exosystem), and societal values (the macrosystem). (...) On the basis of this adapted model, we recommend changes among modifiable elements of the microsystem and mesosystem that can help position nurses (ecologically and collectively) to advocate for public policy change and use examples from a Canadian context to illustrate these points. We believe that the ideas arising from this model can be widely used where policy action on the social determinants of health is needed to inform, guide, and frame change efforts and advocacy work. (shrink)

A current issue in environmental ethics concerns the role of scientists as advocates for environmental policy. Some have argued that scientists should not be permitted to be policy advocates. I will argue that it is morally permissible for scientists to be advocates for environmental policies for four reasons. First, since scientists are also citizens it is improper to deny them the opportunity to advocate for certain policies. Second, scientists possess some expertise in these areas should be sought out (...) to advocate for these positions precisely because they are the ones with the knowledge, understanding and access to objective studies relating to policy issues. Third, I will argue that while objectivity is required for research, advocacy for policy issues does not entail the failure of objectivity. Last, scientists advocating for environmental policy meets the ethical requirements for advocacy generally offered by Robert Audi. These give us good reason to think it is morally permissible for scientists to act as advocates for environmental policy. (shrink)

In Brazil, abortion is only allowed in cases of rape, serious risk to a woman's life or fetal anecephaly. Legal abortion services cover less than 4% of the Brazilian territory and only 1,800 procedures are performed, in average, per year. During the COVID‐19 pandemic, almost half of the already few Brazilian abortion clinics shut down and women had to travel even longer distances, reaching abortion services at later gestational ages. In this paper, we describe three bottom‐up advocacy strategies that (...) emerged from difficulties deepened during the COVID‐19 pandemic at a single abortion service in Brazil, amidst anti‐gender policies from the federal government. Telemedicine abortion, outpatient surgical abortion and the provision of abortion after 20 weeks' gestation are important strategies that may reduce inequalities that impact the most vulnerable populations, such as black and indigenous women, children, adolescents and women experiencing domestic violence. (shrink)

Drawing on insights from scholarship on contentious action frames, this article examines the framing of demands for social justice for migrant farmworkers in Spain, Italy and Canada during the COVID-19 pandemic. We focus particularly on how activists in each country aligned their action frames with prevalent public discourses on the essential contribution migrants make to agricultural production, the need to guarantee “health for all,” and “increased vulnerability” of migrants’ lives during the global health crisis. Using these diagnostic frames, activists in (...) the three countries called for secure legal status for all migrants. Drawing on the literature on contentious action frames, we then analyze if action frames advanced by activists during the COVID-19 pandemic “resonated” with the understanding of these issues by policymakers. We challenge an approach to understanding resonance in binary terms as either present or absent. Instead, we introduce the notion of “ambivalent resonance” to draw attention to the fact that some frames are accepted only partially or only by some policymakers but not the others, as was the case in the three countries under study. We then situate this ambivalent resonance in the context of immigration priorities and recent trends in immigration policy development in these three countries and suggest that activists can build on ambivalences to advance migrant rights to status. (shrink)

Approximately 11.2 million undocumented immigrants have settled in the United States. Providing health care to these residents is an everyday concern for the clinicians and health care organizations who serve them. Uncertain how to proceed in the face of severe financial constraints, clinicians may improvise remedies–a strategy that allows our society to avoid confronting the clinical and organizational implications of public policy gaps. There is no simple solution‐no quick fix‐that will work across organizations (in particular, hospitals with emergency departments) (...) in states with different concentrations of undocumented immigrants, varying public and private resources for safety‐net health care, and differing approaches to law and policy concerning the rights of immigrants. However, every hospital can help its clinicians by addressing access to health care for undocumented immigrants as an ethical issue. We offer some recommendations for doing this in a structured, fair, and transparent way. We also describe the problems that may result when clinicians are forced to grapple with this issue on their own. (shrink)

The objective of Working Group 4 of the COST Action NET4Age-Friendly is to examine existing policies, advocacy, and funding opportunities and to build up relations with policy makers and funding organisations. Also, to synthesize and improve existing knowledge and models to develop from effective business and evaluation models, as well as to guarantee quality and education, proper dissemination and ensure the future of the Action. The Working Group further aims to enable capacity building to improve interdisciplinary participation, to (...) promote knowledge exchange and to foster a cross-European interdisciplinary research capacity, to improve cooperation and co-creation with cross-sectors stakeholders and to introduce and educate students SHAFE implementation and sustainability. To enable the achievement of the objectives of Working Group 4, the Leader of the Working Group, the Chair and Vice-Chair, in close cooperation with the Science Communication Coordinator, developed a template to map the current state of SHAFE policies, funding opportunities and networking in the COST member countries of the Action. On invitation, the Working Group lead received contributions from 37 countries, in a total of 85 Action members. The contributions provide an overview of the diversity of SHAFE policies and opportunities in Europe and beyond. These were not edited or revised and are a result of the main areas of expertise and knowledge of the contributors; thus, gaps in areas or content are possible and these shall be further explored in the following works and reports of this WG. But this preliminary mapping is of huge importance to proceed with the WG activities. In the following chapters, an introduction on the need of SHAFE policies is presented, followed by a summary of the main approaches to be pursued for the next period of work. The deliverable finishes with the opportunities of capacity building, networking and funding that will be relevant to undertake within the frame of Working Group 4 and the total COST Action. The total of country contributions is presented in the annex of this deliverable. (shrink)

BackgroundPatient advocacy organizations (PAOs) have an increasing influence on health policy and biomedical research, therefore, questions about the specific character of their responsibility arise: Can PAOs bear moral responsibility and, if so, to whom are they responsible, for what and on which normative basis? Although the concept of responsibility in healthcare is strongly discussed, PAOs particularly have rarely been systematically analyzed as morally responsible agents. The aim of the current paper is to analyze the character of PAOs’ responsibility (...) to provide guidance to themselves and to other stakeholders in healthcare.MethodsResponsibility is presented as a concept with four reference points: (1) The subject, (2) the object, (3) the addressee and (4) the underlying normative standard. This four-point relationship is applied to PAOs and the dimensions of collectivity and prospectivity are analyzed in each reference point.ResultsUnderstood as collectives, PAOs are, in principle, capable of intentionality and able to act and, thus, fulfill one prerequisite for the attribution of moral responsibility. Given their common mission to represent those affected, PAOs can be seen as responsible for patients’ representation and advocacy, primarily towards a certain group but secondarily in a broader social context. Various legal and political statements and the bioethical principles of justice, beneficence and empowerment can be used as a normative basis for attributing responsibility to PAOs.ConclusionsThe understanding of responsibility as a four-point relation incorporating collective and forward-looking dimensions helps one to understand the PAOs’ roles and responsibilities better. The analysis, thus, provides a basis for the debate about PAOs’ contribution and cooperation in the healthcare sector. (shrink)

Abstract:This essay criticizes recent trends in disability policy as restrictive of individual liberty and informed by too narrow a definition of what constitutes human flourishing. I defend the value of intentional community settings as one legitimate residential option for people with intellectual and developmental disabilities. Recent federal regulations (HCBS Final Rule) define intentional communities or disability-specific housing as presumptively institutional in nature, misunderstanding the positive, noninstitutional features of intentional, integrated communities created by and for people with developmental disabilities. In (...) addition, current disability policy, despite its stated concern for the autonomy of people with intellectual and developmental disabilities, limits individual liberty by strictly defining the types of settings eligible for Medicaid waiver funding, expressly excluding agricultural communities, disability-specific residential settings, and intentional communities. A robust commitment to the autonomy of people receiving Medicaid waiver services would allow them to choose to direct their program dollars, recognizing that some individuals may choose a life in intentional community or with others facing similar challenges to themselves over an illusory “integration” into a wider society that remains too often unwelcoming and difficult to navigate. (shrink)

This is an advocacy essay that documents the undignified and inhumane conditions of social inequality to which the members of "Al-Akhdam" minority group are subjected in the Republic of Yemen. By focusing on the interaction between culture and collective violence, it examines the exclusionary socio-cultural and economic practices by which Al-Akhdam are denied basic human rights. In so doing, the article locates the root cause of such practices in ethnic prejudices; the Al-Akhdam are persecuted on account of their being (...) of African-descent in a country with an Arab-majority. Finally, the article advocates the protection of the collective human rights of the Al-Akhdam minority and proposes cogent measures for restoring social justice through the implementation of specific actions, including international condemnation of their persecution; official recognition of the violence meted to them; national international recognition and promotion of their rights; cessation of Yemeni government-supported policy of Al-Akhdam forced labor; formal extension of constitutionally-guaranteed economic and social rights and the establishment of a program designed to integrate them into the mainstream of Yemeni society. This list of concrete steps represents a practical advocacy plan for fostering changes in the conditions of Al-Akhdam in Yemen through numerous venues, including the Yemeni government, the United Nations, and local and international human rights NGOs. It is hoped that this documentation will significantly elevate international awareness of, and instigate responses to, the ethno-cultural violence being perpetrated against Al-Akhdam in Yemen. (shrink)

Many countries find their information and digital policies still dominated by traditional stakeholders, particularly the content industry, major telecom companies, and marketing groups, yet Canada has experienced a notable shift in perspective with a strong and influential public interest voice. This shift toward public interest and participation in the development of Canadian information and digital policies has led to legislation, regulation, and policy outcomes that once seemed highly unlikely. This Article seeks to better understand the changing role of the (...) public in Canadian information and digital policymaking by framing the developments as an ongoing policy development process featuring a series of closely linked changes and responses. The emergence of public participation on information and digital policy issues occurred across a spectrum of issues, yet the traits were strikingly similar: grassroots efforts reliant on social media and the Internet to capture media and public attention and focus it on consumer perspectives, minimal interest from government and regulators; and initial dismissal giving way to hostility from incumbent stakeholders. The Article identifies some of the reasons behind the shift, including the growing importance of information and digital policies, the impact of digital advocacy tools, and the shifting policy pyramid in which users have now largely leapfrogged corporate interests as policy influencers. While the shift does not mean the public interest wins on every issue, it does suggest an important change in influence with long-term ramifications for the development of information and digital policy in Canada that others may seek to emulate. (shrink)

The main argument in this article is that the Australian government in power from 1996 to November 2007 failed women's domestic security by denying the central policy role of women's organizations in the struggle against domestic violence and by successfully expunging public debate on gender issues in Australian governance, while participating in the ‘war on terror’ to guard national security. In bringing together a discussion about the war on terror and the importance of feminism for women's security, key issues (...) about feminism, race and gender are considered. This article also explores the prevalence of violence against women and the social implications of the lack of leadership in public debate about the gendered nature of violence against women. Under the Australian government led by Prime Minister John Howard that gained power in 1996 and was defeated in 2007, women's organizations lost financial support and women's policy infrastructure was decimated. Violence against women, however, continued to increase, reaffirming women's place in Australian society as insecure and dangerous. After more than 30 years of struggle to maintain domestic violence and sexual assault as serious social policy problems, provide services, support and advocacy for women who are victims of violence and assault, women's organizations are coming to terms with a society where there is a blindness to the role of gender in violence against women. (shrink)

This article begins by explaining the concepts of proprietary and open source software technology, which are now competing in the marketplace. A review of recent individual and cooperative technology development and public policy advocacy efforts, by both proponents of open source software and advocates of proprietary software, subsequently follows, with supporting positions articulated. This is followed by an analysis of the results of a recent draft of a Center for Strategic & International Studies global study of government initiatives (...) to incorporate open source software as an option in their institutional operations. The article concludes with analysis and recommendations on public policies for appropriate software technology assessment policy. For governments, the encouragement of neutral standards (i.e., not favoring one software business model), open competition for research funding of software development, and nondiscrimination in computer software procurement policies will result in the most effective and efficient procurement decisions. (shrink)

The article is focused on some aspects of development adult learning and education policy in Ukraine from stakeholders` perspective, and active role of the Ukrainian civil society in this discourse. This was facilitated by conducting analytical research and further advocacy activities on the protection and representation of interests in Ukraine in 2018-2019. Adult learning and education following the change in UNESCO’s terminology from «adult education» to «adult learning and education» (abbreviated - ALE), is interpreted as a permanent activity (...) aimed at acquiring, recognizing and applying key skills. Acquisition of new skills, abilities and knowledge by adults usually occurs after they receive basic education and enter the labour market. In European practice, this covers formal, non-formal and informal forms of adult learning. Stakeholders were involved in the analytical re- search through a survey of experts; participation in a practical seminar on peer review workshop, which was held in the format of a progress meeting to present the Policy Research Report and discuss the preliminary results; virtual discussion of analytical documents. Usually, adult learning policy promotes social well-being and integration, employment and active civil participation. Ukraine lack of consolidate active state adult learning policy during the whole period of its independence since 1991. The problem-solving options proposed in the research and validated by stakeholders are presented in this article. The article will be interesting for social philosophy, educational & learning academic and non-academic researchers, policy-makers and practitioners. (shrink)

This article reports the results of research that uses policy network theory and advocacy coalition theory to deduce the implications for the future of public policy in EU Member States of king trends: all those technological, economic, environmental, and social trends that can be empirically verified, affect the lives of large numbers of people and are expected by relevant experts to continue for at least the next 20 years. The resulting policy implications can be summarized as (...) more assertive security policies, more business-friendly economic policies, more liberal social policies, and increased public spending. (shrink)

Documenting how the Japanese state responded to increasing social discontent during initiation of unpopular welfare reforms, this study examines the factors that hindered the political empowerment of civil society despite the timely introduction of participatory policymaking institutions. The Japanese government opted in the early 2000s to introduce a participatory method to initiate the unpopular pension reform. Deliberation councils were established to encourage open discussions among government policymakers and committee members, including citizen representatives. The final outcomes of the deliberations, however, were (...) mostly about parametric adjustments and did not adequately consider the urgent demand of the general public. The participatory measure did not significantly improve the public's trust in the pension programs, but it did justify the government's reform initiatives. The welfare bureaucracy that set the goal, defined the scope of the agenda, and steered the discussions toward technical issues structurally restricted the voices of the citizen members in the deliberation councils. The lack of citizen advocacy groups, which could otherwise have effectively supported the citizen members on the committee, contributed to the limited roles and influences of the citizens. It is argued that the traditional conservative corporatism of Japan was reinforced during this time period, despite the introduction of the idea of participatory governance. (shrink)

Abstract: This essay critically examines whether there are ethical dimensions to the way that expertise, knowledge claims, and expressions of skepticism intersect on technical matters that influence public policy, especially during times of crisis. It compares two different perspectives on the matter: a philosophical outlook rooted in discourse and virtue ethics and a sociological outlook rooted in the so-called third-wave approach to science studies. The comparison occurs through metaphilosophical analysis and applied claims that clarify how the disciplinary orientations appear (...) to lead to different judgments about matters related to Robert Paarlberg's condemnation of activists who advise African politicians to ban genetically modified food. (shrink)

This paper analyses the history of the South American Secretariat of the Communist International. The objective is to carry out a critical study of the policies and strategy of the Secretariat, considering how its relationship with the Comintern and the South American Communist Parties changed over time. Our hypothesis is that during its first years of existence (1925–8) the Secretariat developed a policy based on the United Front. This changed during a transition period (July 1928–July 1929) in which it (...) developed a stagist programme of bourgeois-democratic revolution, and the implementation of its front tactics was increasingly questioned. From 1929 to 1934, the organisation abandoned all concrete alliance tactics in the workers’ movement and electoral politics while nevertheless proclaiming its advocacy of the ‘United Front from below’. This paper is based on an analysis of primary sources, including the Secretariat’s publications, correspondence, and internal documents. (shrink)

Although at first glance it may seem an unlikely alliance, frogs and cyberfrogs certainly benefit from an unusual friendship that connects the virtual world of dissection simulation and the physical realm of nonhuman animal advocacy.This paper focuses on the symbiotic relationship of dissection simulation designers and animal advocates. Dissection simulation manufacturers benefit from this relationship through the purchasing and promotion of their products by animal advocacy organizations, and also they benefit from policy changes that encourage the use (...) of dissection simulations as alternatives to dissection. Reciprocally,animal advocacy organizations benefit by saving animal lives, gaining a new tool for convincing teachers to stop dissecting, and demonstrating that they are a pro-technology movement. The knowledges and values embedded in cyberfrogs make them both boundary objects and cyborgs. (shrink)

American policymakers delegate the administration of many welfare programs to states, where officials implement them in increasingly diverse ways. Welfare state scholarship has little to say about this subnational policy divergence, and it portrays the complexity of delegated governance as a barrier to nonelite legislative influence. Drawing on an ethnographic study of one state’s Medicaid program, this article shows that delegated governance offers ample opportunity for nonelite influence and policy divergence, but through regulatory governance rather than legislative (...) class='Hi'>advocacy. Medicaid is opaque to politicians, whose inability to monitor program details creates conditions of bureaucratic autonomy and even activism: health-care agency personnel sequence regulatory tweaks to protect and expand entitlements. But budget cuts, outsourcing, and fraught provider relations also deprive bureaucrats of street-level know-how, and bureaucrats depend on beneficiaries’ advocates who selectively illuminate a path to reform. A full rendering of subnational divergence in American federalism requires attention to underexamined factors such as bureaucratic activism, agency advocacy, and regulatory governance. (shrink)

Protecting the public's health has always been an inherently political endeavor. The field of public health, however, is conspicuously and persistently absent from sustained, sophisticated engagement in political processes, particularly elections, that determine policy outcomes. This results, in large part, from widespread misunderstanding of rules governing how, and how much, public advocates working in tax-exempt organizations can participate in public policy development.This article briefly summarizes the rules governing public policy engagement by exempt organizations. It then describes different (...) types of exempt organizations, and how they can work together to expand engagement. Next, it identifies several key mechanisms of policy development that public health advocates could influence. Finally, it suggests some methods of applying the tax rules to increase participation in these arenas. (shrink)

In response to theJournal of Religious Ethics(JRE) editors' request for reflections on “how religious ethicists have interacted with, and ought to interact with, public policy decision makers,” this essay focuses on doing religious ethics in the context of doing public bioethics, especially through participating in public bioethics bodies (PBBs) established to provide advice to public policymakers in what might be called “mediated advocacy.” Drawing heavily on the author's experience as a member of and a consultant to several PBBs, (...) it features case studies of PBBs deliberating about and recommending public policies to address the scarcity of postmortem organs for transplantation, the equitable allocation of COVID‐19 vaccine, cloning humans, and human embryonic stem cell research. (shrink)

Scientists have the ability to influence policy in important ways through how they present their results. Surprisingly, existing codes of scientific ethics have little to say about such choices. I propose that we can arrive at a set of ethical guidelines to govern scientists’ presentation of information to policymakers by looking to bioethics: roughly, just as a clinician should aim to promote informed decision-making by patients, a scientist should aim to promote informed decision-making by policymakers. Though this may sound (...) like a natural proposal, I show it offers guidance that conflicts with standard scientific practices. I conclude by considering one cost of the proposal: that it would prevent scientists from acting as advocates in a way that is currently common in certain fields. I accept that the proposal would restrict scientists’ political advocacy rights, but argue that the benefits of adopting it — promoting democratic governance — justify the restriction. (shrink)

Theories of citizenship have largely focused on the provision of rights by law and policy measures, as if rights are universally beneficial and cost-free and the invitations of rights will be accepted once offered. I challenge this assumption and highlight the need to empirically address how people negotiate with the benefit and cost of claiming rights. Based on ethnographic research in South Korea, this article delves into the everyday lives of migrant women in two feminized sectors of migration—cross-border marriage (...) and sexual commerce—to situate the act of claiming rights in relation to the gendered pursuit of moral respect. I show that feminist groups in South Korea relied on the discourse of victimization and trafficking in pressuring the South Korean state to account for the human rights of migrant wives and migrant hostesses, while reinforcing the moral hierarchy that renders problematic migrant women’s work and intimate relationships. I argue that the distinctive material and moral costs that accompanied human rights–based provisions compelled migrant wives and hostesses to pursue divergent paths in seeking alternate bases to citizenship that would support their inclusion as moral equals. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 15.2 (2005) 199-210 [Access article in PDF] Conflict-of-Interest Policy at the National Institutes of Health: The Pendulum Swings Wildly* Evan G. DeRenzo **This article addresses the National Institutes of Health (NIH) employee conflict-of-interest (COI) policy that went into effect February 2005. It is not, however, merely an account of another poorly crafted government policy that cries out for revision. Instead, it (...) is also a story about one of our nation's most important and prestigious institutions and its struggles to navigate the crosscurrents of scientific aspirations, power politics, public ambivalence toward capitalist economics in the biosciences, and the media's inclination to exaggerate problems and under report complicated facts. It is also a tale of greed, politics, purgatory, and redemption. The dramatic and abrupt change in the NIH COI policy demonstrates the difficulty of balancing the production of cutting-edge science with the demands for transparency resulting from work performed in the public interest on the public tab. It is an unhappy chapter in the life of a government agency that is also a national treasure. And, one hopes, it will be an example of how harmful and ill-conceived law can be revised and amended to advance national health and well-being. What is the New NIH COI Policy? The new NIH COI employee policy, more accurately referred to as the Interim Final Rule (Federal Register 2005), is a sweeping set of prohibitions on activities and holdings to reduce the possibility that NIH employees will have any actual [End Page 199] or apparent conflicts of interest. For the most part, the prohibitions are applied across-the-board—i.e., without distinction to employee category or function. The new policy includes prohibitions on outside activities, stock holdings, and awards. It prohibits all NIH employees from engaging in any compensated or uncompensated employment, including consulting, serving on advisory or other such boards, and compensated teaching, speaking, writing, or editing with certain kinds of entities. The first class of such entities is referred to as substantially affected organizations, defined as biotechnology, pharmaceutical, medical device companies, and others with similar interests. But these are not the only entities included in the prohibitions. Other organizations from which NIH employees now are cut off are hospitals, clinics, and other health care institutions; health, science, or health research-related professional associations and consumer and advocacy groups. Included also are educational institutions and not-for-profit independent research institutes that are, or were, recent NIH funding applicants, grantees, contractors, or cooperative research and development agreement (CRADA) partners. The only exemptions appear to be for health care institutions at which NIH employees provide clinical care and some forms of writing—e.g., an NIH physician who moonlights at her/his local hospital's emergency room or submits a manuscript to a peer-reviewed journal that receives only unrestricted funding from a prohibited entity. Prohibited and/or restricted holdings include stock in biotechnology, pharmaceutical, and medical device companies and others in research, development, or manufacture of medical devices, equipment, preparations, treatments, or products. The prohibitions apply to senior NIH employees; restrictions in the amount of such holdings apply to all remaining employees. Both apply to the spouses and minor children of NIH employees. If an NIH employee wins an award, the monetary allowance in most cases is limited to $200. In sum, the scope of this policy is vast, too vast to be reasonable. Too many employees are restricted in too many ways. Where appropriate restrictions have been placed on senior NIH employees, even these constructive aspects of the policy are overshadowed by the unfairness and destructiveness of other aspects. This policy far exceeds anything that could be considered sound. Fortunately, the policy has a built-in assessment process to begin at the end of the policy's first year of implementation. One can only hope that a fair and open evaluation will be conducted, the results of which surely must result in major revisions to what is now bad regulation. Why the Policy... (shrink)

Public Health Science and practice expanded during the course of the 20th century. Initially focused on controlling infectious disease through basic public health programs regulating water, sanitation and food, by 1988 the Institute of Medicine broadly declared that “public health is what we, as a society, do collectively to. assure the conditions for people to be healthy.” Commensurate with this definition, public health practitioners and policymakers today work on ;in enormous range of issues. The 2002 policy agenda of the (...) American Public Health Association reflects positions on genomics’ role in public health; national health and safety standards for child care programs; sodium in Americans’ diets; the health and safety of emergency rescue workers; and war in Central Asia and the Persian Gulf. (shrink)