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PubMed2005

In the democracies of DNA: ontological uncertainty and political order in three states.

This paper compares the regulation of biotechnology in Britain, Germany and the United States and shows that systematic differences have developed around four issues: abortion, assisted reproduction, stem cells, and genetically modified crops and foods. Policy choices with respect to these issues reflect the capacity of each nation's regulatory institutions to deal with the scientific, social and ethical uncertainties around biotechnology. National regulatory frameworks constitute an apparatus of collective sense-making through which governments and publics interpret biotechnology's risks and promises. Specifically, regulatory choices position the novel ontologies created by biotechnology either on the side of the familiar and manageable or on the side of the unknown and insupportably risky. The comparison shows that public responses to biotechnology are embedded within robust and coherent political cultures and are not ad hoc expressions of concern that very unpredictably from issue to issue.

Abortion, Legal↗
PubMedDate not supplied

The psychology of perpetrators of 'political' violence in South Africa--a personal experience.

My journey embarks with our daughter Lyndi's death at the Heidelberg Massacre in December 1993 and follows the tortuous route of the criminal trial at the end of 1994, through the Truth and Reconciliation Commission (TRC) Hearings in October 1997, to the discovery that there is no formal provision made by the TRC for counselling of Amnesty Seekers. My concern is for those who have received a militarist socialisation and are now being released into a society already burdened with one of the highest 'political' death rates in the world. What is the way forward? Current local models of dealing with trauma for survivors may be helpful in debriefing for those granted amnesty. However, a large-scale effort is necessary to bring about reconciliation and healing in our broken society, some suggestions are made in this regard.

Anecdotes as Topic↗
PubMed2006

History from the ground up: bugs, political economy, and God in Kirby and Spence's Introduction to Entomology (1815-1856).

William Kirby and William Spence's Introduction to Entomology is generally recognized as one of the founding texts of entomological science in English. This essay examines the ideological allegiances of the coauthors of the Introduction. In particular, it analyzes the ideological implications of their divergent opinions on animal instinct. Different vocational pursuits shaped each man's natural history. Spence, a political economist, pursued fact-based science that was shorn of references to religion. Kirby, a Tory High Churchman, placed revelation at the very heart of his natural history. His strong commitment to partisan sectarianism cautions against reference to a homogeneous "natural theology" that was an agent of mediation. Fissures in the "common intellectual context" reached beyond the clash between natural theologians and radical anatomists to render the intellectual edifice of natural theology structurally less sound for the future.

Agriculture↗
PubMed2004

Biological citizenship: the science and politics of Chernobyl-exposed populations.

In the transition out of socialism to market capitalism, bodies, populations, and categories of citizenship have been reordered. The rational-technical management of group affected by the Chernobyl disaster in Ukraine is a window into this contested process. Chernobyl exemplifies a moment when scientific knowability collapsed and new maps and categories of entitlement emerged. Older models of welfare rely on precise definitions situating citizens and their attributes on a cross-mesh of known categories upon which claims rights are based. Here one observes how ambiguities related to categorizing suffering created a political field in which a state, forms of citizenship, and informal economies were remade.

Biological Science Disciplines↗
PubMed1996

Washington politics and genetic engineering research: when worlds collide.

In earlier research, I developed a notion of "biopolitics" to help explain, first, the recombinant DNA debate of the 1970-1980s, and, second, the human gene transfer-therapy debate of the 1980-1990s. Drawing upon results gleaned from two recent meetings of high moment in the nation's capital, I expand upon the theoretical and empirical parameters of the biopolitical argument to elucidate the clash of policy preferences arising from two new areas of genetic experimentation: (i) human embryo research and (ii) the creation of commercially viable therapeutics to combat disease. I show the manner in which members of the biological science community and their policy allies are forced to cope with the realities of the "Washington political game," and why it is necessary for them to develop a sophisticated sense of what that "game" is.

Advisory Committees↗
PubMed2006

Constructing public and political discourse on alcohol issues: towards a framework for analysis.

AIMS: To examine the possibilities for research into news reporting and its role in reflecting and informing public and political beliefs and action in relation to alcohol and drinking practices. METHOD: Studies on media and alcohol, focusing on the role of media in relation to alcohol consumption and drinking-related practices, policies and beliefs. RESULTS: Most research on alcohol and media has focused on either advertising or entertainment media content, rather than on news reporting and its wider social implications. CONCLUSION: The role of news reporting could usefully be widened. We offer a framework for analysing the role of news media in relation to public debate and practice with regard to alcohol and drinking.

Accidents, Traffic↗
PubMed2004

Education of deaf students in Spain: legal and educational politics developments.

This article examines the legal instruments and educational politics affecting deaf persons' educational rights in Spain. We present a historical view of deaf education in Spain before and after the Congress of Milan (1880) and then introduce educational legislation and practices in recent decades. At present, Spanish legislation is moving toward recognition of sign languages and the suitability of bilingual education for deaf students at all educational levels. This is a consequence of taking into account the low academic achievement of two generations of deaf students educated in a monolingual model. Bilingual projects are now run throughout Spain. We emphasize that efforts must be made in the legal sphere to regulate the way in which professionals who know sign language and Deaf culture-teachers, interpreters, deaf adult models-are incorporated in bilingual deaf schools.

Adult↗
PubMed2003

The physician/care provider and politics: life and society viewed from different angles: a cross-cultural issue.

PREAMBLE: This article is written by the "Médecin cantonal" (Chief Medical Officer) of the Swiss Canton of Vaud (capital city, Lausanne). Under the Swiss Constitution, responsibility for most health-related issues lies with the Cantons. The "Médecin cantonal" is the medical advisor to the health minister and the cantonal government. His or her traditional role concerned the organisation of health care delivery, such as the distribution of hospitals and licencing of practitioners, as well as health promotion, school health and disaster preparedness. However this has changed considerably in the face of health threats, such as HIV/AIDS and the rise in drug addiction. These bring new and complex challenges, and in particular bioethical concerns. In this personal view the author discusses his experience at this intersection between medicine, health care, the exercise of public authority, politics and civil society. In particular he reflects on how physicians and politicians have different perspectives on the circumstances of collective life.

Delivery of Health Care↗
PubMed1995

The market is a strange creature: family medicine meeting the challenges of the changing political and socioeconomic structure.

This paper examines the extent to which family medicine is prepared to face today's political and socioeconomic trends. A modest assumption is that most countries will avoid the threats of food and energy crisis, environmental disasters, social collapse and even wars. Given that privilege, family medicine is faced with recent trends of market liberalism throughout the world, giving rise to new perspectives of economic prosperity, as well as widening gaps between the rich and affluent, and a growing number of unemployed, poor, and 'marginalized'. The recent UN World Summit for Social Development in Copenhagen highlighted the fact that poverty and long-term unemployment is becoming a permanent problem even in the rich world. The distinction between rich and poor countries might be better understood as widening gaps between rich and poor people in both kinds of countries. The challenge to family medicine will be twofold: 1) To develop a broader understanding of the associations between social risk factors on a population level, and its clinical expressions in individual patients in terms of illness, sick role behaviour and manifest disease, as well as potentials for constructive coping; 2) To contribute to a universally available primary health care, meeting the needs also of those who are not in the best position to pay. We are reminded of the classic 1971 Lancet paper by Julian Tudor Hart on "The inverse care law", implying that "the availability of good medical care tends to vary inversely with the need for it in the population served". In a world plagued with unforeseen discontinuities, general practice will need to maintain its core of 'personal doctoring'. Meeting people at the primary care level provides unique opportunities of being sensitive and responsive also to unexpected changes in society, and in some areas even making contributions to the directions of change.

Developed Countries↗
PubMed1992

Seniors for Justice: a political and social action group for nursing home residents.

This article describes a political and social action group of cognitively intact nursing home residents. Organized in response to residents' desire to "do something" about social issues, the group is coordinated by one of the nursing home's recreational therapists, who expected participation in the group to maximize residents' autonomy and sense of control. Benefits mentioned by the participants included: the opportunity to communicate their thoughts, keeping busy, and feeling part of the larger community.

Aged↗
PubMed1996

The changing face of aging politics.

The future of aging politics and age-based public policy are in considerable turmoil. Traditional age-based health and social service policies, such as those long associated with Medicare and the Older Americans Act, have increasingly moved in the direction of functional means-testing, through the use of activity-of-daily-living scales and similar mechanisms. Renewed pressure in the income area is also pointing in that direction, whether through benefit taxation (President Clinton) or means-testing of benefits (Concord Coalition). Yet, how this reining in of old age benefits plays out against the real or presumed power of older voters (cf. AARP and Gingrich proposal) remains an intriguing question. As they say, "stay tuned."

Aged↗
PubMed1996

The politics of mixing older persons and younger persons with disabilities in Federally assisted housing.

Beginning in the late 1980s, government-assisted housing for elderly persons, a popular and successful housing type, began to experience an in-movement of younger persons with disabilities. Advocates for the elderly population expressed alarm about the negative consequences for elderly persons of such "mixing" and of the turnover of this housing to other groups. Based on interviews with key participants and an analysis of documents, this article uses interest group theory and a model of agenda setting to explain why "mixing populations" attained prominence on the Federal housing agenda, the different perspectives of advocates for elderly individuals and younger persons with disabilities concerning the issue, and the implications of the conflict for housing policy and interest group politics.

Adult↗
PubMed2001

A political analysis of corporate drug donations: the example of Malarone in Kenya.

This paper describes the introduction of the Malarone Donation Programme in KENYA: Using a policy analysis approach it illustrates the political nature of donation programmes and how they are affected by a large and varied group of national, regional and international stakeholders, with different levels of influence and experience. The paper shows that interaction between these different groups may affect the development and implementation of the donation programme. It ends by raising some more general questions about public/private partnerships and corporate donation programmes, and their potential impact on national drug policies.

Antimalarials↗
PubMed1987

Politics and policies on self-help: notes on the international scene.

This paper identifies and describes a few key milestones in the development of policies on self-help at an international level. At its core lies a paradox. Self-help groups are essentially a very local activity; they are generated by individuals coming together to help themselves and each other in their own local communities. They neither need nor are derived from international (or even national) policies for their development. Yet in the last few years, growing attention has been given, at international as well as national level, to the formulation of policies on self-help. It seems appropriate to take a look at what these are and in what ways they have had any local impact, if not directly, on groups, then indirectly, by affecting the climate in which they operate. The policies of two international bodies, both operating in Europe, are considered here. These are the European Community and the World Health Organization, including both its headquarters and the Regional Office for Europe. First, it is useful to set the context, to explore what is meant by a policy on self-help and to introduce some political considerations.

Europe↗
PubMed1983

An example of medical audit under political pressure.

Management of medical services necessitates decisions regarding the possibly ineffective treatment programmes, hospitals and (even) individual practitioners. Although rigorous evaluations of effectiveness can only be achieved by randomized trials there has been, in recent years, much increase in audit (or peer review) activity. Ideally medical audit is undertaken as a collaborative exercise, and follows preplanned methods of data collection and evaluation of outcome. However, real management situations frequently do not conform to the ideal, as when the medico-political finger of accusation points at one particular hospital and asks for an immediate enquiry. This audit analyses the mortality and morbidity after coronary artery bypass graft surgery in the 'suspect' hospital and in control hospitals. The paper describes the difficulties of obtaining comparable records post hoc and the interpretations of small differences, mostly non-significant statistically yet possibly 'real', both in the characteristics of patients operated on and in the outcomes of operations.

Aged↗
PubMed1989

Blue-ribbon commissions and political ethics in the Federal Republic of Germany.

The paper presents an overview of political and professional committees in the Federal Republic of Germany dealing with issues of biomedical ethics. The prevailing tendencies of paternalistic attitudes, the worst-case-scenario argumentation method, and the unfortunate practice of applying general principles rather than mid-level principles in the assessment of concrete challenges in treatment and regulation are analyzed.

Advisory Committees↗
PubMed1995

Rationing health care: the political perspective.

The politics of rationing are messy and treacherous. As long as rationing remained implicit, politicians were shielded from the impact of decisions about who to treat and who not to treat. Explicit rationing changes all this by making the process of reaching choices more visible. However, implicit rationing may actually be a better way of dealing with difficult and complex issues. There is, nevertheless, scope for improving the process and making it more open and accountable. While efforts to terminate ineffective treatments are welcome and overdue, they are not a substitute for rationing. Finally, while politicians are being called upon to set national priorities and guidelines for rationing care, there is resistance to doing so when the decisions are so context specific and can only be made effectively at a micro level.

Decision Making↗
PubMed2002

A tale of two experts: thalidomide and political engagement in the United States and West Germany.

The physicians, Widukind Lenz and Frances Kelsey, played crucial roles in the thalidomide drama of the early 1960s. Widespread use of the drug in West Germany was only halted when the paediatrician, Lenz, publicized its association with the birth of nearly 4,000 children exhibiting abnormal limb growth. Few cases were reported in the United States because Kelsey, a medical officer at the US Food and Drug Administration, repeatedly delayed thalidomide's marketing approval. Experts in both countries were expected to demonstrate publicly the professional 'objectivity' of medicine and the institutional 'disinterestedness' of regulatory bodies. These norms were invoked both by industry representatives seeking to undermine the two experts and by critics desiring stronger regulatory controls. Comparing Lenz and Kelsey demonstrates how institutional structures shape an expert's social and scientific roles. While the United States provided important protection from external pressure for Kelsey through her regulatory position at the FDA, Lenz was open to sharp criticism, especially when giving expert testimony during a lengthy court trial. The degree of exposure to politically motivated attacks differed for these two experts; they nevertheless faced similar threats to their professional credibility and personal integrity when they publicized links between thalidomide and birth defects.

Abnormalities, Drug-Induced↗