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Henri Hubert developed early Durkheimian critiques of racial sciences such as anthroposociology from his perspective as an archeologist, historian, and ethnographer of primitive European religions. His major works on the "primitive" Celts and Germans continue these critiques of racism. But Hubert also engaged in the political mythologizing of French national identity by trading in the republican myth of "celtisme."
This case study of an inter-university controversy over the publication of research from an interdisciplinary social science project on the forced migration and long-term internment of West Coast Japanese-Americans during World War II shows some of the difficulties of maintaining ownership of research materials. In this particular instance the junior employee was able to override his seniors' demand for control of the dissemination of research results by playing on the concerns about even appearing to suppress work for political reasons. The paper discusses conflicting norms of science and rhetorics of justification ranging from proprietary self-interest through "good science" to "the national interest" and onto "the needs of a free society."
The range of services provided by the Austrian health care system has been greatly extended over the last few decades. The accompanying measures for long-term care bring the situation closer to the ideal concept of a 'seamless web' between primary, secondary and tertiary care. Due to the expansion in services it has become increasingly difficult to ensure the balance between the financing and degree of usage of the services. The reiterated political aim has been to achieve balanced financing via legally fixed social health insurance (SHI) contributions and taxation. A steadily expanding part is contributed by the private sector. In the 1980s, measures for SHI expenditure containment were implemented; in 1997 a new hospital financing system based on flat rates was introduced. In order to guarantee hospital financing, the historical financing shares of the SHI for the hospitals were introduced in the form of valorised global budgets. The contradictory incentives arising from the flat rates and global budgets lead hospitals to shift services to the primary and tertiary care sector, causing additional expenditure for SHI. Currently, attempts are being made to secure the financing by increasing the SHI contribution rates and patients' co-payments.
On June 15, 1994, the Israeli Parliament voted to enact the National Health Insurance bill (NHI). The bill marks the end of a process that lasted for virtually as long as Israel's almost 50 year history. Israel's attempts at health reform began long before the current spate of reforms in many Western countries. Faced with many of the same problems of access, equity and cost control common to many of its counterparts, Israel initiated a reform process based on the recommendations of a prominent State Commission of Inquiry into the Israeli Health System (the Netanyahu Commission) which reported to the Government in 1990. The Commission's proposals were based on a diagnosis indicating that the major problems of the system stem from the lack of clarity regarding the rights of citizens to health care, the lack of a clear allocation of responsibility and accountability among government, insurance or sick funds, and providers in the system, and undue centralization of system operations. This diagnosis led to three major planks for reform: (1) enactment of national health insurance legislation granting a basic package of care to each citizen and hence bringing most of the system's finance under public auspices; (2) divesting the Government from the organization, management and provision of care; hence integrating the management of preventive and psychiatric services provided by the government with the primary and other services provided by sick funds, and granting financial and operational independence to at least government hospitals; and (3) restructuring the Ministry of Health. As is often the case in public policy, more consensus surrounds the diagnosis than the solutions. As a result, nearly four years of implementation efforts have only recently resulted in a major breakthrough. In this paper we make an effort to outline the inherent weaknesses of the Israeli health care system that have led to the crisis in the mid 1980s, summarize the recommendations of the State Commission for structural change in the system, and review the politics of implementing the recommended reforms.
Palestinians were given control over their own health services in late 1994. Since then they have been facing the challenge of reorganizing disordered health services into a cohesive, regulated and sustainable health care system. This paper focuses on the experience of organizing health care during political instability. It considers the ways that health care is currently provided and funded in the Palestinian Territories. The patterns of accessibility to health care services in terms of insurance coverage and provision (physical allocation) of services are discussed. Finally, the major health care policy changes in this transitional period are examined.
Event lists are commonly applied for measuring exposure to various kinds of potentially stressful and traumatizing life events. Before making general conclusions about the psychological effects of exposure to such events, problematic issues related to the use of event-list data need to be discussed and resolved. This article focuses on issues related to the construction and application of event lists for measuring exposure to political violence such as issues related to reliability, the applicability of the additive assumption, whether to weight event-list items, and the possible consequences of incomplete event lists. Alternative future approaches to these measurement issues are also discussed.
The relationship between reflection and action is an enduring question for those interested in promoting moral development among young people. Educators struggle to find effective methods for helping youth reason carefully about moral problems and also to show moral commitment in their everyday lives. One place where reflection and action come together is in youth activism, where young people engage in social action campaigns to improve their schools and communities. What are the moral concerns that urban youth raise when given the opportunity? How do these concerns get translated into action? Drawing on original and secondary sources, this chapter discusses four social action campaigns organized by youth in the San Francisco Bay Area, in which youth combined critical moral judgments with social action. The chapter is not an empirical study, but instead an effort to bring attention to the moral and ethical perspectives that politically engaged youth raise. These social action projects suggest that for youth living in low-income neighborhoods with limited resources, the capacity for critical moral reflection about one's surroundings is an important dimension of healthy development. Helping youth assess and transform their local environments represents a promising direction for moral education and youth development.
There are many macrosocial studies of the political organisation of health and mental health care in South Africa, and the maldistribution of resources by race is well known. Little attention, however, has been given to the minutiae of the negotiation of power in the clinical setting. This article, which reports on part of a larger study of aspects of culture in South African psychiatry, focuses on interactions in ward-rounds on the 'Black side' of a South African psychiatric hospital. Through analysis of cases, the complexity of interpreting what transpires in such a setting and the central role that the concept of culture has in debates amongst staff members are demonstrated. Close analysis demonstrates the inadequacy of models which seek to locate the institutional racism of apartheid psychiatry in the motives of individual clinicians. Clinicians may simultaneously reproduce and subvert aspects of apartheid practice. A consideration of the social positioning of the clinician both as a South African and as a practitioner of psychiatry is central to the development of psychiatry in a post-apartheid South Africa.
This essay addresses the space between a cultural critique and a class analysis of HIV transmission. It explores how injection drug users, as a disempowered group, resist hegemony through dissent. Distrust of the medical establishment and severe social and legal constraints force injection drug users to reconstruct the AIDS message. Economic and political survival inflates the need for trust and reciprocity within their social network. This makes the meaning of AIDS a continually ambiguous one for drug users. The ways in which dissent to domination is enacted and the effect this has on HIV prevention is explored.
This essay explores connections between political institutions, forms of power, and women's health care concerns from a cultural anthropological perspective. I focus on the roles of different medical establishments among the Kel Ewey Tuareg of Niger--Western-European sponsored, central state, traditional herbalism and Islamic scholarship--in creating, maintaining, and disputing these constructs, through the invention and elaboration of disease categories and through the selective application of medical and reproductive models and technology to women. I also explore women's attempts to manage these forces, as they draw upon a cultural inventory that is alternately supportive and in conflict with their interests.
The paper discusses a recent international conference in Munich (FRG) on brain-laterality research. An open letter on the goals of the conference is considered. In this letter, the "automatic" moral and intellectual decay of "left brain" modern society was predicted, and a clarion call for the reinsertion of "whole brain" values into our over-mechanized culture was sounded. Discussion of the conference itself focuses on the political and social risks involved in selling irrationalist ideologies - even well-meaning ones - in the name of science. The paper calls for a more responsible attitude among modern brain-laterality researchers who would participate in scientific conferences that blur the distinction between description and social prescription.
The relationship between the nature and severity of experiences of torture and ill-treatment and posttraumatic stress disorder (PTSD) symptoms was studied in 550 male nonhelp-seeking Palestinian political ex-prisoners from the Gaza Strip. Results showed that the more a prisoner had been exposed to physical, chemical and electric torture, psychological ill-treatment, and sensory deprivation or bombardment, the more he subsequently suffered from intrusive reexperiencing, withdrawal and numbness, and hyperarousal. Existential problems were not related to torture experiences. Furthermore, duration of imprisonment, health problems during the imprisonment, harassment during arrest and after release, family, marriage and economic difficulties all predicted intrusive reexperiences of trauma. Also, ex-prisoners who continued to be harassed by military authorities and had economic problems suffered more from withdrawal, numbness, and hyperarousal than others.
Local area boards wield significant power over programs for the developmentally disabled, the mentally ill, and substance abusers. Significant shifts in the composition of these boards, from a combination of professional and lay individuals to a majority of consumer and special interest groups, is occurring. In addition, increased local political activism focusing on services for the handicapped is affecting decisions made by these boards. This article describes some of the difficulties caused by these developments and provides recommendations for training programs and policy consideration.
This article reviews the legislative process that resulted in the most significant reform of California's public mental health system in nearly 25 years. The reform, termed "Program Realignment," decentralized administrative and fiscal control of the mental health system from the state to the county level. The system prior to Program Realignment is discussed here to reveal an already diverse and decentralized county mental health system, fiscal distress, and general dissatisfaction with the system. From these conditions, the objectives of the relevant political actors arose. By tracing the policy development process of Program Realignment, several independent variables are revealed that help explain how and why this legislation came into being and allow generalization of this case to other states' experiences. These independent variables are an urgent need for action within a limited timeframe, a preexisting knowledge base and well-developed policy networks, a spirit of bipartisan cooperation, and the presence of strong leadership. Preliminary evidence suggests that consolidation of fiscal and programmatic authority at the local level has reduced fragmentation of services and increased fiscal flexibility. However, there is concern that the quality of care offered by the state's 59 local mental health programs will become increasingly disparate and that increased financial flexibility may not be used to improve services for clients but to save money for local governments. Lessons from California's experience can alert other states to the pros and cons of this policy approach to providing mental health services and inform policymakers in other states of the steps involved in bringing about such a policy change.
This statement, first presented at a plenary session of the Pavlovian Society on 9 October 1992, in Los Angeles, California, attempts to assess the recently released speech delivered by Ivan Pavlov in 1923, but publicly brought to light only in 1991, on the subject of "Communist Dogmatism and the Autonomy of Science." This speech, noteworthy for the courage of the delivery under adverse circumstances no less than the contents of its remarks, compels a new estimate of the place of science in a totalitarian system boasting an ideology of physiological psychology. It also sheds new light on the Russian Nobel laureate and pioneer in the areas of behavior modification induced by the functions of the higher nervous system. These remarks take an in-depth view of American radical and Marxian appraisals--how they followed the Soviet lead in harnessing Pavlov to the Communist cause, and in attempting to discredit the work of Sigmund Freud. This lethal combination of Communist political needs and ideological proclivities served to rationalize the implementation of slave labor as work therapy during the Stalinist era. The linkage of Pavlov to Makarenko in education and Michurin in biology serves as a case study in the manufacture of tradition. The collapse of the Soviet system permits a recasting of the history of science and Pavlov's place in Russian life. Such new conditions also provide a lesson in the distortive role of ideology in the evolution of modern science.
What will be the future of Internal Medicine in Europe? Because of rapidly growing concerns regarding the position of Internal Medicine in many European countries, the European Federation of Internal Medicine (EFIM) has established a working group to analyze the situation. Being well aware of the variation of working practices in the different countries, the members of the group used an "all-European" approach to answer the following questions: -- Are there problems for Internal Medicine, what problems and why? -- Why do health care systems of the European countries need Internal Medicine? -- Why do the patients need Internal Medicine? -- What needs to be done? Internal Medicine is the modern, clinical and scientific medical discipline taking care of adult patients with one or more complex, acute or chronic illnesses. Internal Medicine is the cornerstone of integrated health care delivery service that is needed today. Decision-makers in politics and hospitals, insurers, journalists and the general public need a better understanding of what Internal Medicine can offer to the health care systems and to the individual patient.
The fight against venereal diseases (VD) has often been influenced by the prevailing political and social conditions. At the end of 19th century the increase of VD demanded new strategies. In 1902 the German Society for the Control of VD was founded in Berlin. It was then followed by the foundation of the International Society against VD in Brussels in 1899. In the German empire and during the Nazi regime, authoritarian structures dominated the strategies against VD. The individual had to submit the interests of the society. Sociopolitical aspects influenced the discussions in the fight against VD during the Weimar republic. In 1927 the new laws to control VD met liberal demands.
While researchers and decision-makers increasingly recognize the importance of public participation in environmental decision-making, there is less agreement about how to involve the public. One of the most controversial issues is how to involve citizens in producing scientific information. Although this question is relevant to many areas of environmental policy, it has come to the fore in watershed management. Increasingly, the public is becoming involved in the sophisticated computer modeling efforts that have been developed to inform watershed management decisions. These models typically have been treated as technical inputs to the policy process. However, model-building itself involves numerous assumptions, judgments, and decisions that are relevant to the public. This paper examines the politics of public involvement in watershed modeling efforts and proposes five guidelines for good practice for such efforts. Using these guidelines, I analyze four cases in which different approaches to public involvement in the modeling process have been attempted and make recommendations for future efforts to involve communities in watershed modeling.