All health care systems face problems of justice and efficiency related to setting priorities for allocating a limited pool of resources to a population. Because many of the central issues are the same in all systems, the United States and other countries can learn from the successes and failures of countries that have explicitly addressed the question of health care priorities. We review explicit priority setting efforts in Norway, Sweden, Israel, the Netherlands, Denmark, New Zealand, the United Kingdom and the (...) state of Oregon in the US. The approaches used can be divided into those centered on outlining principles versus those that define practices. In order to establish the main lessons from their experiences we consider the process each country used, criteria to judge the success of these efforts, which approaches seem to have met these criteria, and using their successes and failures as a guide, how to proceed in setting priorities. We demonstrate that there is little evidence that establishment of a values framework for priority setting has had any effect on health policy, nor is there evidence that priority setting exercises have led to the envisaged ideal of an open and participatory public involvement in decision making. (shrink)

It has been suggested that focusing on procedures when setting priorities for health care avoids the conflicts that arise when attempting to agree on principles. A prominent example of this approach is “accountability for reasonableness.” We will argue that the same problem arises with procedural accounts; reasonable people will disagree about central elements in the process. We consider the procedural condition of appeal process and three examples of conflicts over coverage decisions: a patients’ rights law in Norway, health technologies coverage (...) recommendations in the UK, and care withheld by HMOs in the US. In each case a process is at the center of controversy, illustrating the difficulties in establishing procedures that are widely accepted as legitimate. Further work must be done in developing procedural frameworks. (shrink)

Despite increased general awareness of suicide in U.S. adult correctional facilities as well as the availability of research and correctional standards that advocate increased attention and services to potentially suicidal inmates, prevention efforts within correctional facilities remain piecemeal and inmate suicide continues to be a serious public health problem. A robotic state of mind excuse, that inmate suicide is not preventable, impedes prevention efforts. In the following discussion, the key ingredients to comprehensive suicide prevention programming are offered to dispel these (...) obstacles.Suicide is a leading cause of death in jails across the United States, with well over 400 inmates taking their lives each year. In some urban jail facilities, deaths related to acquired immune deficiency syndrome slightly outnumber deaths by suicide. The rate of suicide in county jails is estimated to be approximately nine times greater than that of the general population. Overall, most jail suicide victims are young white males who have been arrested for nonviolent offenses and were intoxicated when arrested. (shrink)

Despite increased general awareness of suicide in U.S. adult correctional facilities as well as the availability of research and correctional standards that advocate increased attention and services to potentially suicidal inmates, prevention efforts within correctional facilities remain piecemeal and inmate suicide continues to be a serious public health problem. A robotic state of mind excuse, that inmate suicide is not preventable, impedes prevention efforts. In the following discussion, the key ingredients to comprehensive suicide prevention programming are offered to dispel these (...) obstacles.Suicide is a leading cause of death in jails across the United States, with well over 400 inmates taking their lives each year. In some urban jail facilities, deaths related to acquired immune deficiency syndrome slightly outnumber deaths by suicide. The rate of suicide in county jails is estimated to be approximately nine times greater than that of the general population. Overall, most jail suicide victims are young white males who have been arrested for nonviolent offenses and were intoxicated when arrested. (shrink)

The target article discusses a model of how brain circuits mediate social behaviors such as imitation and mindreading. Hurley suggests potential mechanisms for development of shared circuits. We propose that empirical studies can be designed to differentiate the influence of genetic and learning-based factors on the development of shared circuits. We use the mirror neuron system as a model system.

An organization's management control system can play an important role in influencing ethical behavior among employees. In this paper a theoretical framework of control is developed by linking various ethics related control mechanisms reported in the literature to the primary components of a management control system. In addition, the findings of a survey of the Financial Post's Top 1 000 Canadian industrial and service companies are reported. The survey investigated organizations' use of ethical codes of conduct, whistleblowing systems, ethics committees, (...) judiciary boards, employee training in ethics, and ethics focused corporate governance and reward systems. The findings indicate that ethics related control mechanisms, particularly codes of conduct, are being used by a good number of organizations. However, closer analysis of the data suggests that many companies may only be paying lip service to the importance of promoting ethical behavior. (shrink)

Over a whole range of challenges, the world is essentially undergoverned. New institutions are needed that recognize how much the world has changed and that mobilize those states most capable of meeting the dangers we confront.

A t first glance you might not noorder, which afflicts about 0.5 percent of tice anything odd on meeting a American children. Neither researcher young boy with autism. But if had any knowledge of the other’s work, you try to talk to him, it will and yet by an uncanny coincidence each quickly become obvious that gave the syndrome the same name: autism, something is seriously wrong. He may not which derives from the Greek word autos, make eye contact with (...) you; instead he may meaning “self.” The name is apt, because avoid your gaze and fidget, rock his body the most conspicuous feature of the disorto and fro, or bang his head against the der is a withdrawal from social interacwall. More disconcerting, he may not be tion. More recently, doctors have adopted able to conduct anything remotely resemthe term “autism spectrum disorder” to bling a normal conversation. Even though make it clear that the illness has many rehe can experience emotions such as fear, lated variants that range widely in severity rage and pleasure, he may lack genuine but share some characteristic symptoms. empathy for other people and be oblivious Ever since autism was identified, reto subtle social cues that most children searchers have struggled to determine would pick up effortlessly. what causes it. Scientists know that sus- In the 1940s two physicians—Americeptibility to autism is inherited, although.. (shrink)

There is public support in the United States and Europe for accounting for animal welfare in national policies on food and agriculture. Although an emerging body of research has measured animals’ capacity to suffer, there has been no specific attempt to analyze how this information is interpreted by the public or how exactly it should be reflected in policy. The aim of this study was to quantify Americans’ preferences about farming methods and the suffering they impose on different species to (...) generate a metric for weighing the trade-offs between different approaches of promoting animal welfare. A survey of 502 residents of the United States was implemented using the online platform Mechanical Turk. Using respondent data, we developed the species-adjusted measure of suffering-years, an analogue of the disability-adjusted life year, to calculate the suffering endured under different farming conditions by cattle, pigs, and chickens, the three most commonly consumed animals. Nearly one-third of respondents reported that they believed animal suffering should be taken into account to a degree equal to or above human suffering. The 2016 suffering burden in the United States according to two tested conditions was approximately 66 million SAMYs for pigs, 156 million SAMYs for cattle, and 1.3 billion SAMYs for chickens. This calculation lends early guidance for efforts to reduce animal suffering, demonstrating that to address the highest burden policymakers should focus first on improving conditions for chickens. (shrink)

Phillips & Singer's compelling presentation is weakest in its demonstration of commonalities between sensory plasticity and higher forms of learning and behavior. We propose that available data on schizophrenia can provide such evidence, because of the presence of impairments in a number of functions central to their model, and strong relationships between these dysfunctions and behavior.

Even as it skirts mainstream contemporary culture, pornography remains a social taboo; there still exist strong biases both in favor and against it. With chapters addressing imagination, gender, power relationships, truth claims, aesthetics, and both pro and anti-porn slants, this book presents a balanced view of pornography in modern society.

Charisivs, in his chapter on Adverbs, cites for Hispane a line of Ennius' Annals : Hispane, non Romane memoretis loqui me. Professor Norden , the apostle of Combinations-forschung, combines this fact with another fact mentioned by Livy , the celebre per Hispaniam responsum of a Spanish town to a Roman embassy. But why does he ignore a third fact which must be brought into any combination that can be convincing—the quotation of this line of Ennius by Festus in a paragraph (...) which apparently deals with Graeco-Roman affinities ? (shrink)