Medical Research Council, Capetown, South Africa Nasheen Naidoo Medical Research Council, Capetown, South Africa Shamagonam James Medical Research Council, Durban, South Africa Priscilla Reddy Medical Research Council, Capetown, South Africa * Corresponding author: 306 Arnold House, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA 01003, USA. Tel.: (413) 545 1005; Email: Buchanan{at}schoolph.umass.edu ' + u + '@' + d + ' '//--> . Abstract The analysis presented here lays out the ethical warrants for requiring community (...) oversight of health research conducted in international settings. It reviews the inadequacies with the current standards of individual informed consent and research ethics committee review, and then, shows how a broader population-based public health perspective raises new demands on justice involving due consideration of the rights, harms and benefits to the community as a whole. As developed here, an ethical standard that requires community oversight of health research is justified on three principled grounds: respect for community autonomy and their right to self-determination; due consideration of the consequences of the research for the community as a whole; and, a more complete understanding of human autonomy. The paper concludes with practical recommendations regarding the composition of Community Advisory Boards to ensure that they have legitimate decision-making authority in diverse socio-cultural contexts. CiteULike Connotea Del.icio.us What's this? (shrink)
Florida International University, USA edwardj{at}fiu.edu ' + u + '@' + d + ' '//--> Several authors have analyzed the optimal k -majority rule based on a variety of criteria. Buchanan and Tullock argued that, in constitutional settings, the criterion should be that all changes meet the Pareto criterion; otherwise the status quo should be preferred (we call this the BT (...) criterion). They then asserted that unanimity rule would be the preferred voting rule in this setting. In parliamentary settings, they claimed that a near majority rule would be preferred because it minimizes the sum of decision costs and external costs. This article investigates both claims in an N -voter, two-alternative setting. We show the conditions under which unanimity rule is less likely to select BT preferred alternatives than other k -majority rules and prove that the difference in performance can be negligible when N is large and certain weak conditions are met. Furthermore, if we define external costs as the expected number of losers from a BT-inferior vote, then external costs become negligible for a range of supermajority rules. This implies that unanimity rule and a range of supermajority rules should be equally preferred when decision costs are added. Finally, we show that the external cost function can actually increase for certain populations. Many of the broader conclusions should also hold for multiple alternatives. Key Words: constitutional design Pareto criterion external costs social contract. (shrink)
In this article, we provide a description of the good in health promotion based on an empirical study of health promotion practices in New South Wales, the most populous state in Australia. We found that practitioners were unified by a vision of the good in health promotion that had substantive and procedural dimensions. Substantively, the good in health promotion was teleological: it inhered in meliorism, an intention to promote health, which was understood holistically and situated in places and environments, a (...) commitment to primary rather than secondary prevention and engagement with communities more than individuals. Procedurally, the good in health promotion arose from qualities of practices that they developed over time in respectful relationships, were flexible and responsive to communities, built capabilities in communities and were sustainable. We discuss our findings with reference to Martha Nussbaum’s normative list of functional capabilities for a good human life, David Buchanan’s vision for health promotion ethics and common concerns in health promotion ethics regarding the relationship between paternalism and freedom. Our thick, vague conception of the good in health promotion, founded in the values and practical reason of people engaged daily in health promotion work, contributes to the development of a more complete theory of health promotion ethics. (shrink)