Outcomes research is topical in discussions about health-related research. Its emphasis on effectiveness creates an important opportunity for nurse researchers to strengthen the linkages between theory, outcomes research and nursing practice but, before care can be more effective, it is logical to establish patients’ desired outcomes. A thorough review of the implications of this requirement for the care of hospice patients is needed, but is lacking in the literature. Therefore, the literature on a ‘good death’ is reviewed as a step (...) towards assisting hospice patients to achieve what they regard as an acceptable death. The starting point is to define more clearly what it means to die a good death. The relationship between hospice care and achieving a good death is then examined. (shrink)
Attendance at 12-step programs has become part of the orthodoxy of treating clients with substance abuse disorders. However, concerns have been raised about the assumptions on which 12-step programs are based. I argue that antirepresentationalism is the moral principle that underpins such concerns. After clarifying the principle of antirepresentationalism, I explore strategies for reconciling antirepresentationalism with 12-step programs. However, all the strategies I try fail. Consequently, I adopt an alternative way of thinking about antirepresentationalism that leaves mental health professionals free (...) to refer clients to 12-step programs. However, such referrals can continue only at the cost of accepting objectionable assumptions about motivation, spirituality and human agency. Therefore, it might well be time to find an alternative to 12-step programs. (shrink)
El estudio de la retórica política empleada por Clinton durante sus dos mandatos en la Casa Blanca, ofrece un panorama plural y sugerente de las expectativas que genera entre sus ciudadanos el sistema político de Estados Unidos, así como de las funciones simbólicas e institucionales que debe asumir ..
The Tuskegee Syphilis Experiment (TSE) has shaped African Americans’ views of the American health care system, contributing to a reluctance to participate in biomedical research and a suspicion of the medical system. This essay examines public discourses surrounding President Clinton’s attempt to restore African Americans’ trust by apologizing for the TSE. Through a narrative reading, we illustrate the failure of this text as an attempt to reconcile the United States Public Health Service and the African American public. We conclude (...) by noting the limitations of rhetoric when equal prominence is not given to policy proposals in national apologies. (shrink)
President Clinton, already facing formidable obstacles in reforming the health care system, denies that it will involve any rationing. This is politically understandable, but wrong. Infinite needs are rapidly overtaking finite resources. Most health providers recognize that the genius of modern medicine has outpaced our ability to pay. But the public still has unlimited expectations and a blind faith that everything can be provided to everyone by simply eliminating "waste, fraud, and abuse." Rationing is inherent in any health care (...) system. As government undertakes to define what is "medically necessary or appropriate," it will unavoidably undertake a series of rationing decisions. Health care is being transformed from a private good to a public good. Government, when it reforms the health care system, must inevitably ask: How do we buy the most health for the public? Keywords: Clinton Health Plan, public good, rationing CiteULike Connotea Del.icio.us What's this? (shrink)
November 17 was a grand day in the career of Bill Clinton, the day when he proved that he is a man of firm principle, and that his "vision" -- the term has become a journalistic reflex -- has real substance. "President Emerges As a Tough Fighter," the New York Times announced on the front page the next day. Washington correspondent R.W. Apple wrote that Clinton had now silenced his detractors, who had scorned him for his apparent willingness (...) to back down on everything he claimed to stand for: "Mr. Clinton retreated early on Bosnia, on Haiti, on homosexuals in the military, on important elements of his economic plan [namely, the minuscule stimulative package]; he seemed ready to compromise on all but the most basic elements of his health-care reforms. Critics asked whether he had a bottom line on anything. On NAFTA, he did, and that question won't be asked much for a while.". (shrink)
Cet article propose une analyse du procès Clinton en se penchant sur les différentes étapes de l’affaire, les stratégies des acteurs en jeu et les choix de l’opinion publique américaine. En nous révélant l’image d’une société américaine à la recherche d’un modèle politique s’appuyant tant sur le libéralisme interventionniste que sur le conservatisme, le procès Clinton a mis en lumière la dérive partisane dont il a été l’objet. L’auteur nous montre cependant à quel point l’opinion publique américaine a (...) su rester en dehors du débat politicien et préserver sa confiance au président. (shrink)
Many accounts of analogy based on sentential semantics owe their continued popularity more to a lack of theoretical specificity than to their superior explicative power. I examine a recent attempt to remedy this situation.Conclusion: Once the sentential semantics account of analogy is spelled out in sufficient detail to permit its systematic application to a variety of cases, it quickly becomes apparent why it must fail, and why we should give preference to a multi-constraint theory of cognitive process instead.