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1
Brown, Mark S., and Cheryl A. Brown. "Circumcision Decision: Prominence of Social Concerns." Pediatrics 80, no. 2 (August 1, 1987): 215–19. http://dx.doi.org/10.1542/peds.80.2.215.
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Despite policy statements against routine circumcision of newborns by the American Academy of Pediatrics and the American College of Obstetrics and Gynecology more than 10 years ago, there has been virtually no change in circumcision practices in the United States. In addition, controlled trials of programs to educate parents about the lack of medical indications for routine newborn circumcision have shown that parental education has little impact on the circumcision decision. We hypothesized that parents based their circumcision decision predominantly on social concerns rather than on medical ones. We prospectively surveyed parents of 124 newborns soon after they made the circumcision decision to learn their reasons for the decision. The strongest factor associated with the circumcision decision was whether or not the father was circumcised (P.0001). The survey also showed that concerns about the attitudes of peers and their sons' self concept in the future were prominent among parents deciding to circumcise. The circumcision decision in the United States is emerging as a cultural ritual rather than the result of medical misunderstanding among parents. In counseling parents making the circumcision decision, the health care provider should provide a knowledgeable and honest discussion of the medical aspects of circumcision. Until information is available that addresses parents' social concerns about circumcision, it is unreasonable to expect a significant change in circumcision customs in the United States.
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Banks, Dwayne A. "The Economic Attributes of Medical Care: Implications for Rationing Choices in the United States and United Kingdom." Cambridge Quarterly of Healthcare Ethics 5, no. 4 (1996): 546–58. http://dx.doi.org/10.1017/s0963180100007441.
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The healthcare systems of the United States and United Kingdom are vastly different. The former relies primarily on private sector incentives and market forces to allocate medical care services, while the latter is a centrally planned system funded almost entirely by the public sector. Therefore, each nation represents divergent views on the relative efficacy of the market or government in achieving social objectives in the area of medical care policy. Since its inception in 1948, the National Health Services (NHS) of the United Kingdom has consistently emphasized equity in the allocation of medical services. It has done so by creating a system whereby services are universally free of charge at the point of entry. Conversely, the United States has relied upon the evolution of a perplexing array of public and private sector insurance schemes centered more around consumer choice than equity in allocation.
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Pacula, Rosalie L., Anne E. Boustead, and Priscillia Hunt. "Words Can Be Deceiving: A Review of Variation among Legally Effective Medical Marijuana Laws in the United States." Journal of Drug Policy Analysis 7, no. 1 (January 1, 2014): 1–19. http://dx.doi.org/10.1515/jdpa-2014-0001.
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AbstractWhen voters in two US states approved the recreational use of marijuana in 2012, public debates for how best to promote and protect public health and safety started drawing implications from states’ medical marijuana laws (MMLs). However, many of the discussions were simplified to the notion that states either have an MML or do not; little reference was made to the fact that legal provisions differ across states. This study seeks to clarify the characteristics of state MMLs in place since 1990 that are most relevant to consumers/patients and categorizes those aspects most likely to affect the prevalence of use, and consequently the intensity of public health and welfare effects. Evidence shows treating MMLs as homogeneous across states is misleading and does not reflect the reality of MML making. This variation likely has implications for use and health outcomes, and thus states’ public health.
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Domen, Ronald E. "A survey of ethics committees in national medical organizations in the United States." HEC Forum 7, no. 6 (November 1995): 333–38. http://dx.doi.org/10.1007/bf01789033.
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JOHNSON, NIA, and LANCE WAHLERT. "Urban Bioethics: A Call for the Prestige." Cambridge Quarterly of Healthcare Ethics 28, no. 3 (July 2019): 509–21. http://dx.doi.org/10.1017/s0963180119000434.
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Abstract:Many teaching hospitals in the United States were founded on philanthropic principles and aimed to aid the urban poor and underserved. However, as times have changed, there has been a divide created between the urban poor and teaching hospitals. There is a plethora of reasons why this is the case. This paper will specifically focus on the histories of ten hospitals and medical schools and the effect that white flight, segregation, elitism, and marginalization had on healthcare institutions all over the United States. It will call for a reexamination of the values of Ivy League and Ivy Plus teaching hospitals and medical schools and for them to take an intentional look into their communities.
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Landa, Amy Snow, and Carl Elliott. "From Community to Commodity: The Ethics of Pharma-Funded Social Networking Sites for Physicians." Journal of Law, Medicine & Ethics 41, no. 3 (2013): 673–79. http://dx.doi.org/10.1111/jlme.12077.
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In September 2006, a small start-up company in Cambridge, MA called Sermo, Inc., launched a social networking site with an unusual twist: only physicians practicing medicine in the United States would be allowed to participate. Sermo, which means “conversation” in Latin, marketed its website as an online community exclusively for doctors that would allow them to talk openly (and anonymously) about a range of topics, from challenging and unusual medical cases to the relative merits of one treatment versus another. “Sermo enables the private and instant exchange of knowledge among MDs,” the company announced in its first press release. Even better, participation was free and the site carried no advertising.
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Schneiderman, Lawrence J., and Sharyn Manning. "The Baby K Case: A Search for the Elusive Standard of Medical Care." Cambridge Quarterly of Healthcare Ethics 6, no. 1 (1997): 9–18. http://dx.doi.org/10.1017/s0963180100007556.
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An anencephalic infant, who came to be known as Baby K, was born at Fairfax Hospial in Falls Church, Virginia, on October 13, 1992. From, the moment of birth and repeatedly thereafter, the baby's mother insisted that aggressive measures be pursued, including cardiopulmonary resuscitation and ventilator support, to keep the baby alive as long as possible. The physicians complied. However, following the baby's second admission for respiratory failure, the hospital sought declaratory relief from the court permitting it to forgo emergency life support on the grounds that “a requirement to provide respiratory assistance would exceed the prevailing standard of medical care,” and that “because any treatment of their condition is futile, the prevailing standard of medical care for infants with anencephaly is to provide warmth, nutrition, and hydration.” The United States Court of Appeals for the Fourth Circuit ruled in favor of the baby's mother, citing the federal Emergency Medical Treatment and Active Labor Act (popularly known as the “anti-dumping” act), which contained no “standard of care” exception to the requirement to provide “treatment necessary to prevent the material deterioration of the individual's condition.” An appeal to the United States Supreme Court was rejected. The baby died some two and one-half years later of cardiac arrest during her sixth visit to the emergency department of Fairfax Hospital for respiratory failure.
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Somerville, Martha H., Laura Seeff, Daniel Hale, and Daniel J. O'Brien. "Hospitals, Collaboration, and Community Health Improvement." Journal of Law, Medicine & Ethics 43, S1 (2015): 56–59. http://dx.doi.org/10.1111/jlme.12217.
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Medical care in the United States traditionally has focused on the treatment of disease rather than on its prevention. Heart disease, cancer, hypertension, diabetes, and other chronic diseases are the primary drivers of American health care costs; compared to other high-income countries, U.S. health indices are lowest and costs are highest.A “triple aim” — “improving the individual experience of care, improving the health of populations, and reducing the per capita costs of care for populations” — has gained traction, as the social determinants of health (non-genetic, non-clinical factors including health behaviors, social and economic factors, and the physical environment) are recognized as having significant effects on health outcomes.
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White, Mary Terrell. "Guidelines for IRB Review of International Collaborative Medical Research: A Proposal." Journal of Law, Medicine & Ethics 27, no. 1 (1999): 87–94. http://dx.doi.org/10.1111/j.1748-720x.1999.tb01440.x.
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The increase in the scope of international collaborative medical research involving human subjects is raising the problem of whether and how to maintain Western ethical standards when research is conducted in countries with very different social and ethical values. Existing international ethical guidelines for research largely reflect Western concepts of human rights, focusing on the bioethical principles of respect for persons, beneficence, and justice. However, in countries and societies where these values are understood differently or are not expressed in local cultures and institutions, it may be impossible or of no practical value to insert them into the research setting.In the United States, individual informed consent is considered ethically imperative for research involving human subjects. However, this imperative may be difficult to instill in societies that define persons by their relations to others, and important decisions are commonly made by heads of households or group leaders rather than by individuals. The baseline economic and health care conditions in foreign communities may also create ethical conflicts.
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Im, Yong Jin, and Kyu Dong Park. "The Deviation and Responses in the Construction of Criminal Policy System Algorithm." Korean Association of Public Safety and Criminal Justice 31, no. 2 (June 30, 2022): 161–98. http://dx.doi.org/10.21181/kjpc.2022.31.2.161.
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A discussion is urgently needed to identify the efficiency and effectiveness of the criminal justice algorithm, which is intended to develop and operate in an automated decision-making form and to reduce the bias that is understood as a negative effect of the algorithm. In the method of Active Crime Prediction, which comprehensively analyzes current data and accessible public data and transmits the predicted and analyzed information to the on-site police in real-time, it utilizes pure social data rather than on-site information or front-line information. It is defined as a predictive police activity that determines the target of crime prevention or police intervention through statistical prediction and is facing a change to the establishment of criminal justice procedures through an algorithmic system as a type.
Overseas, systems such as DAS, PredPol, and COMPAS are being produced and operated by private companies. However, in Korea, it is only at the stage of technical discussion and testing of the evolved method so far, and there are many issues and issues regarding the elements and algorithms that must be equipped legally and institutionally. Nevertheless, the realm of these debates and issues is obscured by technological advances. Therefore, it is important to exclude technical aspects and identify the problems and issues through the examples of the United States and the United Kingdom, which are leading countries in introducing criminal justice algorithm systems in the humanities and social sciences.
In this study, the problems that appeared through previous studies and cases were classified and explored according to the system operation stage (construction, utilization, management). The various issues and problems analyzed are ultimately problems that appeared in the use of the algorithm. It also had a structure that reduced it to a problem created by the person using the technology. It is interpreted as a limitation in that it cannot provide a clear solution to the ongoing debate or reflect it in the field. Therefore, in the field of criminal policy dealing with predictive policing and recidivism prediction, we examine the bias accompanying the automated judgment of algorithms, and envision the prerequisite for detailed complementation and construction in terms of normative aspects and data collection and utilization to solve problems.
11
Duffourc, Mindy Nunez. "Filling Voice Promotion Gaps in Healthcare through a Comparative Analysis of Error Reporting and Learning Systems and Open Communication and Disclosure Policies in the United States and Germany." American Journal of Law & Medicine 44, no. 4 (November 2018): 579–606. http://dx.doi.org/10.1177/0098858818821137.
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Voice in healthcare is crucial because of its ability to improve organizational performance and prevent medical errors. This paper contends that a comparative analysis of voice promotion in the American and German healthcare industries can strengthen a culture of safety in both countries. It provides a brief introduction to the concept of voice in healthcare, including its impact on safety culture, barriers to voice, and the dual influences of confidentiality and transparency on voice promotion policies. It then examines the theoretical basis, practical workings, and legal aspects of voluntary error reporting and error disclosure as avenues for exercising voice in the U.S. and Germany. Finally, it identifies transferable practices that can remedy shortcomings in each country's voice promotion policy.
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APPEL, JACOB M. "Smoke and Mirrors: One Case for Ethical Obligations of the Physician as Public Role Model." Cambridge Quarterly of Healthcare Ethics 18, no. 1 (January 2009): 95–100. http://dx.doi.org/10.1017/s0963180108090142.
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As a result of workplace clean air regulations and strict guidelines imposed by the Joint Commission on Accreditation of Healthcare Organizations in 1993, most hospitals in the United States are now virtually smoke free. Although evidence suggests that these restrictions both cause smoking employees to consume fewer cigarettes per day and induce some employees to quit smoking entirely, the policies have also driven many healthcare providers—including physicians—onto the public sidewalks for their cigarette breaks. Patients entering many hospitals pass white-coated medical students and residents puffing away at the curbside.
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Appel, Joseph M. "Name Dropping: Toward a Uniform Best Practice on Historical Commemoration in Medicine." Cambridge Quarterly of Healthcare Ethics 31, no. 1 (January 2022): 16–22. http://dx.doi.org/10.1017/s0963180121000438.
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AbstractThe removal of controversial names and monuments from the public sphere in the United States has gained traction in the context of efforts to achieve social justice for historically mistreated and marginalized communities. Such debates are increasingly raising issues in the healthcare setting as hospitals and medical schools grapple with the legacies of figures whose scientific contributions are clouded with ethical transgressions. Present efforts to address these challenges have largely occurred at the institutional level. The results have been guidelines that are complex, highly inconsistent across institutions, and largely downplay the symbolic importance of such historical redress. This paper proposes a simpler three-part test for name and monument removal in the medical and hospital settings that places greater weight on the symbolic importance of the renaming process itself instead of only considering the outcomes.
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Safyer, Steven M., Lynn Richmond, Eran Bellin, and David Fletcher. "Tuberculosis in Correctional Facilities: The Tuberculosis Control Program of the Montefiore Medical Center Rikers Island Health Services." Journal of Law, Medicine & Ethics 21, no. 3-4 (1993): 342–51. http://dx.doi.org/10.1111/j.1748-720x.1993.tb01259.x.
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“Recognizing that prisons disproportionately confine sick people, with mental illness, substance abuse, HIV disease among other illnesses; and that prisoners are subject to further morbidity and mortality in these institutions, due to lack of access and/or resources for health care, overcrowding, violence, emotional deprivation, and suicide.…(APHA) condemns the social practice of mass imprisonment.”After decades of steady decline, tuberculosis has emerged as a significant public health threat in the United States. The rising rates of tuberculosis cases, an increasing proportion of which are resistant to standard chemotherapies, are linked to the many scourges threatening our communities: the explosion of poverty, drug use, violence, the HIV epidemic, and the concomitant rise in congregate housing including homeless shelters, residential drug treatment programs and incarceration facilities. Jails and prisons have disproportionately high rates of tuberculosis infection and have been implicated as points of tuberculosis spread and, as such, are a critical point for tuberculosis control interventions.
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BITTLINGER, MERLIN. "Call of Duty at the Frontier of Research: Normative Epistemology for High-Risk/High-Gain Studies of Deep Brain Stimulation." Cambridge Quarterly of Healthcare Ethics 27, no. 4 (September 10, 2018): 647–59. http://dx.doi.org/10.1017/s0963180118000142.
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Abstract:Research participants are entitled to many rights that may easily come into conflict. The most important ones are that researchers respect their autonomy as persons and act on the principles of beneficence, nonmaleficence, and justice. Since 2014, research subjects from numerous states in the United States of America also have a legal “right to try” that allows them, under certain circumstances, to receive experimental (i.e., preliminarily tested) interventions, including medical devices, before official approval from the United States Food and Drug Administration. In the context of experimental interventions, such as deep brain stimulation (DBS) for Alzheimer’s disease, this article argues that research participants ought never to have a legal “right to try” without a corresponding “right to be sure.” The latter refers to external epistemic justification construed in terms of reliance on reliable evidence. This article demonstrates that the mere complexity of intervention ensembles, as in the case of DBS for Alzheimer’s disease which serves as a paradigm example, illustrate how unanswered and/or unasked open questions give rise to a “combinatorial explosion” of uncertainties that require epistemic responses that no single research team alone is likely able to provide. From this assessment, several epistemic asymmetrical relations between researchers and participants are developed. By elucidating these epistemic asymmetries, this article unravels the reasons why open science, transparent exhaustive data reporting, preregistration, and continued constant critical appraisal via pre- and postpublication peer review are not scientific virtues of moral excellence but rather ordinary obligations of the scientific work routine required to increase reliability and strength of evidence.
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Shamoo, Adil E., and Timothy J. Keay. "Ethical Concerns About Relapse Studies." Cambridge Quarterly of Healthcare Ethics 5, no. 3 (1996): 373–86. http://dx.doi.org/10.1017/s0963180100007180.
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It is universally accepted that informed consent to participate in medical research should be given by subjects. People have the fundamental human right to freely choose, without coercion or withholding of information necessary to make a reasonable choice, whether they will undergo any risks associated with a research project. United States researchers have known for some time that they have the duty to inform potential subjects of the nature of proposed research and the risks and possible benefits, and to seek consent. Investigators also have the duty to design the research so that it will be scientifically valid while minimizing foreseeable and avoidable harms.
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GRAZI, RICHARD V., JOEL B. WOLOWELSKY, and DAVID J. KRIEGER. "Sex Selection by Preimplantation Genetic Diagnosis (PGD) for Nonmedical Reasons in Contemporary Israeli Regulations." Cambridge Quarterly of Healthcare Ethics 17, no. 3 (May 21, 2008): 293–99. http://dx.doi.org/10.1017/s0963180108080353.
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We report here on recent developments in Israel on the issue of sex selection for nonmedical reasons by preimplantation genetic diagnosis (PGD). Sex selection for medical reasons (such as in cases of sex-linked genetic diseases) is generally viewed as uncontroversial and legal in European and American law. Its use for nonmedical reasons (like “balancing” the gender ratio in a family) is generally illegal in European countries. In the United States, it is not illegal, although in the opinion of the Ethics Committee of the American Society for Reproductive Medicine (ASRM), it is problematic. This position is undergoing reconsideration, albeit in a limited way.
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Hoffmann, Diane E., J. Dennis Fortenberry, and Jacques Ravel. "Are Changes to the Common Rule Necessary to Address Evolving Areas of Research?" Journal of Law, Medicine & Ethics 41, no. 2 (2013): 454–69. http://dx.doi.org/10.1111/jlme.12055.
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The proposed changes to the Common Rule, described in the recent Advanced Notice of Proposed Rulemaking (ANPRM), come more than 20 years after the U.S. Department of Health and Human Services adopted the Rule in 1991. Since that time, human subjects research has changed in significant ways. Not only has the volume of clinical research grown dramatically, this research is now regularly conducted at multiple collaborative sites that are often outside of the United States. Research takes place not only in academic medical centers, but also at outpatient clinics, community hospitals, and other nontraditional venues. In addition, technological advances, such as sophisticated computer software programs, the Internet, social media, new research methods, and mobile applications have exponentially increased the volume of data available and the possibilities for accessing, analyzing, and sharing that data.
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DOUKAS, DAVID J. "Where Is the Virtue in Professionalism?" Cambridge Quarterly of Healthcare Ethics 12, no. 2 (April 2003): 147–54. http://dx.doi.org/10.1017/s0963180103122037.
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There is a wind of change about to affect the training of all house officers in the United States. The Accreditation Council of Graduate Medical Education (ACGME) has promulgated a set of general competencies for all U.S.-trained residents, with a major thrust focused on bioethics and professionalism that will likely catch residency directors unaware. The ACGME's General Competencies document globally addresses many relationship-based ethical roles and responsibilities of house officers in healthcare. Of note, this document contains a specific section on professionalism. However, the entire document is woven with a sustained thread of medical ethics throughout its other sections. The intent is to imbue each physician with those skills, rules, and aspects of character that will be a foundation for humane, ethical, professional conduct. Professionalism does indeed go beyond ethical principles, accounting for competency and commitment to excellence and, most of all, implying a virtue ethics account of medical practice. The need to address the central place of virtue ethics in house-staff education is apparent, and we now have the right tool for the job—the ACGME General Competencies.
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MEHLMAN, MAXWELL J., JESSICA W. BERG, ERIC T. JUENGST, and ERIC KODISH. "Ethical and Legal Issues in Enhancement Research on Human Subjects." Cambridge Quarterly of Healthcare Ethics 20, no. 1 (January 2011): 30–45. http://dx.doi.org/10.1017/s0963180110000605.
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The United States, along with other nations and international organizations, has developed an elaborate system of ethical norms and legal rules to govern biomedical research using human subjects. These policies govern research that might provide direct health benefits to participants and research in which there is no prospect for participant health benefits. There has been little discussion, however, about how well these rules would apply to research designed to improve participants’ capabilities or characteristics beyond the goal of good health. When mentioned at all in the literature, this so-called enhancement research, as opposed to research aimed at diagnosing, preventing, curing, or treating illnesses or medical conditions, is usually dismissed without explanation.
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Ziegler, Stephen J. "Collaborated Death: An Exploration of the Swiss Model of Assisted Suicide for Its Potential to Enhance Oversight and Demedicalize the Dying Process." Journal of Law, Medicine & Ethics 37, no. 2 (2009): 318–30. http://dx.doi.org/10.1111/j.1748-720x.2009.00375.x.
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Medicalized Death and the Right to Die Movement Prior to the 20th Century, most Americans died at home, surrounded by family, friends, and neighbors. Religion, not medicine, governed the death bed for there was little physicians could do for the dying. Eventually, however, advances in medicine and technology would lead to dramatic changes in the timing and location of death: patients not only began living longer, they were also dying longer, and unlike their predecessors, were more likely to die alone, in institutions, and among strangers. Modern medicine, in its zeal to conquer death, had become obsessed with its curative function and ability to extend the lives of the dying. To many in the medical community, death represented failure and was something to be avoided at all costs, and like many other social problems in the United States, had become medicalized.
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Yang, Y. Tony, and Gilbert Gimm. "Caring for Elder Parents: A Comparative Evaluation of Family Leave Laws." Journal of Law, Medicine & Ethics 41, no. 2 (2013): 501–13. http://dx.doi.org/10.1111/jlme.12058.
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The call for family and medical leave reform in the United States was largely the result of sweeping demographic shifts that occurred in the workforce after the 1950s, coupled with an ever-increasing life expectancy and changing social norms concerning the role of women as caretakers. By the early 1990s, the number of women in the workforce had nearly tripled from 1950. During that same period, life expectancy increased by six years for males and seven for females. Meanwhile, the first wave of the Depression-era generation began to reach the age of retirement. In short, the parents of American workers were living longer and retiring in greater numbers while more women, who were more likely to be informal caregivers, decided to join the workforce. As a result, many families with ill or elder parents began to turn to institutional long-term care.
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MURPHY, TIMOTHY F. "Justice in Residency Placement: Is the Match System an Offense to the Values of Medicine?" Cambridge Quarterly of Healthcare Ethics 12, no. 1 (January 2003): 66–77. http://dx.doi.org/10.1017/s0963180103121081.
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Medical residency—specialty training after the completion of medical school—is an essential component of medical education and is required in order to be a licensed, independent medical practitioner in most jurisdictions. As things currently stand in the United States, the match between medical school graduates and residency programs is governed by a match between rank-order lists prepared by candidates and residencies alike. An applicant picks a number of residency programs and ranks them according to order of interest. The residency program prepares a similar list, ranking the candidates it most wants in its program. A computer program compares the rankings and makes assignments according to a certain algorithm. Using these lists, the match system assigns approximately 24,000 applicants to approximately 21,000 training positions in pediatrics, obstetrics and gynecology, internal medicine, and the rest. These assignments are then announced to all parties on specific days. The system has been in place since 1952 and is overseen by the National Residency Match Program (NRMP), a nonprofit organization. This system has several advantages. First of all, it standardizes the timetable for decisions, and applicants are in no position to tie up offers while waiting to hear from other institutions. Institutions are not held captive, either, in making assignments while waiting to hear from particular parties.
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Sasse, Kent. "Prognostic Scoring Systems: Facing Difficult Decisions with Objective Data." Cambridge Quarterly of Healthcare Ethics 2, no. 2 (1993): 185–91. http://dx.doi.org/10.1017/s096318010000089x.
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In the United States, at least 6% of all hospital beds are in the intensive care unit (ICU) or coronary care unit. The cost of treating a patient in an intensive care unit averages from $2,000 to $3,500 per day. At least 10–40% of intensive care patients will not survive to hospital discharge. Today, every major category of disease may be found in the modern ICU; common diagnoses are septicemia, postsurgical complications, cerebrovascular accidents, gastrointestinal bleeding, neoplasia, and respiratory failure. ICUs employ some of the most sophisticated medical technology, routinely monitoring the cardiopulmonary performance of patients and often providing assisted ventilation. ICUs are high intensity in terms of their staffing, involving 24-hour physician supervision and nurse:patient ratios from 1:3 to 1:1.
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Brown, Kate H. "Outside the Garden of Eden: Rural Values and Healthcare Reform." Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 329–37. http://dx.doi.org/10.1017/s0963180100005144.
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It should surprise no one familiar with the problems in rural healthcare that 87% of a randomly selected sample of Nebraskans recently called for either fundamental or complete change of the healthcare system. Rural communities in the United, States have been hard hit by the rising cost of healthcare at a time of economic and demographic decline. Unable to sustain operating costs and personnel needs, rural hospitals and medical, practices have been forced to close their doors at an, alarming rate.Furthermore, rural patients are decreasingly able to afford what services are available to them. Most must purchase insurance privately because they are unlikely to be insured through employment. Therefore, they pay dearly because they are not eligible for corporate rates and because insurance companies use experience instead of community rating to assess risk.
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Cavanagh, Denis. "Right to Life in the American Medical System." Medicina e Morale 45, no. 6 (December 31, 1996): 1151–61. http://dx.doi.org/10.4081/mem.1996.895.
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The article deals with the impact of the so called “culture of death” on medical practice in United States (US). In fact, in America, while the pretence is being kept up on the importance of the Hippocratic oath and the evangelic benevolence of the Good Samaritan, the strategy of the secular humanists is to try to make these irrelevant in the twin interests of social convenience and fiscal security. This campaign has been quietly waged in the media, in the courts, in public schools and universities. According this strategy, the threats to human life are, namely, two: abortion and euthanasia.
On the first issue, in US the situation is discouraging because the US Supreme Court rulings Roe v. Wade and Doe v. Bolton in 1973, that have made abortion a woman’s choice for any reason in the first and second trimester and available with medical consultation for almost any reason in the third trimester of pregnancy.
Regarding the euthanasia, the campaign strategy is following the same pattern as that used to legalize abortion: the Euthanasia Lobby is claiming that millions of people in America are suffering unbearable pain because of terminal illness and so ought to have the right to end their pain with physician- assisted suicide.
On the contrary, the author assert that there is no right to destroy any human life or participate in its destruction and there is no good moral reason for abortion or euthanasia, including the physician-assisted suicide. Finally, the author think that it is vital that Catholic activists, allied with Christian church-going brethren, should resist with all the power they can muster to the “culture of death”.
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Minat, V. N. "Dynamics of Spatial Inequality in the Development of us Healthcare and State Regional Policy." Federalism 27, no. 1 (March 28, 2022): 130–49. http://dx.doi.org/10.21686/2073-1051-2022-1-130-149.
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One of the key aspects that reveals the essence of the uneven distribution of social benefits in economically developed countries is the dynamics of spatial inequality that has been characteristic of the US healthcare sector for many decades. The results of an empirical study of this inequality as a dynamic process with the properties of historicism, carried out by decomposition of the Theil index according to the intragroup and intergroup characteristics of the corresponding groups of indicators, indicate an increase in the polarization of territories in terms of the provision of the population with medical benefits. Given the organizational and economic inconsistency in the health care of American citizens and the predominance of the spontaneous and commercial nature of free pricing in the relevant markets of American medical goods and services, the center-peripheral spatial structure of inequality in the development of US health care, traditional for capitalist reproduction, is confirmed.The objective nature of the long-term formation of such a structure is complemented by the subjective factor of state regional regulation of health care in the subregional and transregional sections, through the implementation of differently directed typologically relevant policies – from traditional and proactive to selective. It is shown that not only the economic situation, but also the socio-political and ideological expediency are the subjects that determine the tools for activating, polarizing, stimulating or restraining the development of healthcare in specific areas of the United States.
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RICH, BEN A. "Oregon v. Ashcroft: The Battle over the Soul of Medicine." Cambridge Quarterly of Healthcare Ethics 12, no. 3 (July 2003): 310–21. http://dx.doi.org/10.1017/s0963180103123158.
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When one considers the protracted and continuing struggle of the citizens of Oregon to include physician-assisted suicide (also known as “physician aid in dying”) among the panoply of measures available to dying patients and the physicians who care for them, the depth and breadth of the issue becomes inescapable. The potential intractability of the dispute is illustrated by the very fact, noted in the preceding parenthetical phrase, that consensus eludes us on even the most basic of semantic points—how we are to most aptly characterize the conduct in question? The case featured in this issue's The Caduceus in Court must be examined as the latest battle in a long war of attrition waged by opponents of physician-assisted suicide against the Oregon Death with Dignity Act (“the Oregon Act”). After briefly reviewing that history, I will then consider the details of Oregon v. Ashcroft and the implications of the litigation not only for the care of dying patients but also for the regulation of medical practice in the United States and, more broadly still, the search for resolution of serious medical disputes in a democratic society.
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Hereth, Blake, and Nicholas Evans. "Can We Justify Military Enhancements? Some Yes, Most No." Cambridge Quarterly of Healthcare Ethics 31, no. 4 (October 2022): 557–69. http://dx.doi.org/10.1017/s0963180122000421.
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AbstractThe United States Department of Defense has, for at least 20 years, held the stated intention to enhance active military personnel (“warfighters”). This intention has become more acute in the face of dropping recruitment, an aging fighting force, and emerging strategic challenges. However, developing and testing enhancements is clouded by the ethically contested status of enhancements, the long history of abuse by military medical researchers, and new legislation in the guise of “health security” that has enabled the Department of Defense to apply medical interventions without appropriate oversight. This paper aims to reconcile existing legal and regulatory frameworks on military biomedical research with ethical concerns about military enhancements. In what follows, we first outline one justification for military enhancements. The authors then briefly address existing definitional issues over what constitutes enhancement before addressing existing research ethics regulations governing military biomedical research. Next, they argue that two common justifications for rapid military innovation in science and technology, including enhancement, fail. These justifications are (a) to satisfy a compelling military need and (b) strategic dominance. The authors then turn to an objection that turns on the idea that we need not have these justifications if warfighters are willing to adopt enhancement, and argue that laissez-faire approaches to enhancement fail in the context of the military due to pressing and historically significant concerns about coercion and exploitation. The paper concludes with what is referred to as the “least-worst” justification: Given the rise of untested enhancements in civilian and military life, we have good reason to validate potential enhancements even if they do not satisfy reasons (a) or (b) above.
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Stone, Deborah. "Protect the Sick: Health Insurance Reform in One Easy Lesson." Journal of Law, Medicine & Ethics 36, no. 4 (2008): 652–59. http://dx.doi.org/10.1111/j.1748-720x.2008.00319.x.
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In most other nations, insurance for medical care is called sickness insurance, and it covers sick people. In the United States, we have “health insurance,” and its major carriers — commercial insurers, large employers, and increasingly government programs — strive to avoid sick people and cover only the healthy. This perverse logic at the heart of the American health insurance system is the key to reform debates.Focusing on sick people versus healthy people might seem a strange way to view the coverage issue. Most discussions of insurance categorize people into other groupings: the insured versus the uninsured; Caucasian whites versus other racial and ethnic groups; men versus women; poor and low-income people versus everybody else; children, adults, and the elderly; or citizens versus immigrants and undocumented aliens. More recently, health researchers have begun talking about “vulnerable populations,” using most of the same demographic groupings and adding other illness-inducing factors such as social isolation, stress, and impoverished neighborhoods. But as I will show, insurance plans now use premiums, cost-sharing, and other design features in ways that indirectly divide each of these groups into the sick and the healthy, to the detriment of the sick. By shifting the costs of illness onto people who use medical care — that is, sick people — market-oriented reforms of the last few decades have eroded insurance in the name of strengthening it.
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Cassel, Christine K. "Narratives on Pain and Comfort: Dr. M's Story." Journal of Law, Medicine & Ethics 24, no. 4 (1996): 290–91. http://dx.doi.org/10.1111/j.1748-720x.1996.tb01868.x.
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Dr. M is a fifty-nine-year-old internist with a successful practice in a major Eastern United States city. He has lived in this city his whole life and is a highly esteemed citizen. Because of his broader social concerns and energetic support of activities to improve access to health care and quality of care for the underserved, Dr. M became involved in a number of local and regional medical organizations and quickly rose to prominence as as a director of a board of a major national organization. In this position, he was an effective, articulate spokesperson, highly respected for his integrity and thoughtfulness.Before one of the meetings of thithis s board, Dr. M personally contacted the organization's other directors, including me, to warn us that we might be hearing some scandalous news about him. He wanted us first to hear it from him personally. This was the scandalous news.Dr. M had assumed the care of a patient of a recently retired colleague. The patient was an older woman with multiple musculoskeletal complaints related to lumbar stenosis and advanced degenerative arthritis of the spine, which left her in immense pain.
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ANKENY, RACHEL A. "A View of Bioethics from Down Under." Cambridge Quarterly of Healthcare Ethics 12, no. 3 (July 2003): 242–46. http://dx.doi.org/10.1017/s0963180103123043.
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When I immigrated to Australia from the United States a few years ago, at first I found many similarities between the countries. But underneath the apparent similarities, notably a shared language, lay much deeper differences in history, politics, and culture that have considerable impacts on attitudes and approaches to issues in bioethics and medicine. For instance, debates continue regarding cloning and embryonic stem cell research, particularly given the long history of research in reproductive medicine and reproductive technologies in Australia. Although there are individuals and groups opposed to such research on grounds associated with pro-life or anti-abortion stances, the discussions more often hinge on what should be funded by the government and eventually what should be provided to all within the public system of healthcare. This theme is one common thread that unites many current controversies in bioethics, but perhaps not for the reasons that an outsider might at first expect. Indeed, allocation of limited resources is part of what is considered relevant, but money is rarely presented as the decisive issue in these debates. Instead, considerations such as what is medically necessary (based on a broad definition of what is medical), what contributes to a “good life” (as defined by what are increasingly heterogeneous community standards), and how to respect and enable fulfillment of autonomous decisions by individuals and families in this rapidly changing context are key to many of the disputes. This brief report is necessarily selective, but it is designed to give a flavor of the terms of the debates as they are currently developing.
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Dotsenko, Tetiana, and Svitlana Kolomiiets. "Bibliometric analysis of research of the behavioral and social dimension of the public health system of the world." SocioEconomic Challenges 6, no. 3 (2022): 97–106. http://dx.doi.org/10.21272/sec.6(3).97-106.2022.
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The paper emphasizes the importance of human health as the most valuable, most important resource at the individual and national level, affecting the country’s socio-economic development and competitiveness. It states that it is necessary for the actors ensuring the public health system to form a new concept for the functioning of the health system, taking into account the current state of public health, the functioning of medical institutions, and the resource support of the healthcare industry. The primary purpose is to conduct a bibliometric analysis of scientific publications dealing with the global behavioral and social dimension of the public health system. The systematization of literary achievements and approaches to solving this problem has been carried out, which indicates the need for proper attention and high-quality, conceptual, international research by world scientists on issues related to the state and level of public health, satisfaction with the healthcare system. The relevance of the analysis of research on the behavioral and social dimension of the public health system of the world implies that the further development of the healthcare industry necessitates research, intensive development, and dissemination of available scientific and methodological international experience in solving this issue of the public health system in different countries worldwide. The research consisted of four stages. A map of the interrelationships of key concepts with other scientific categories has been constructed; a content-contextual study of the constructed blocks of bibliometric analysis has been implemented; an inter-cluster analysis has been carried out. A map of the interrelationships of the key concepts under study with other scientific categories has been constructed, reflecting the dynamics in the form of a contextual-time block; the evolutionary-time prospects of the study have been determined. A geographically extensive map of the scientific bibliography of the categories under study has been constructed; the spatial component of the study has been analyzed. A territorially branched map of the spatio-temporal dimension of the category under the study in dynamics has been constructed. The methodological tools of the research are theoretical (grouping, abstraction, synthesis) and empirical methods (observation, description), research methods, services of the Scopus information platform, and VOSViewers tools.1.6.15. The study was conducted based on the publications indexed by the Scopus database for 2000-2020. The objects of research were the following scientific categories: “health care system, medical services, behavioral aspect, social aspect,” the countries United States, Germany, Norway, Greece, United Kingdom, Australia, Canada, India, Netherlands, China, Brazil, Switzerland, Denmark, Belgium, Iran, Japan, Italy, Spain, because these two groups of objects allowed to conduct two-directional analysis of the problem under study. The results of the bibliometric analysis presented in the paper showed that the aspect of the behavioral and social dimension of the public health system was relatively young and insufficiently developed; the attention of the scientific community for a long time on this issue was mainly concentrated in the United States and the United Kingdom. China, Iran, and Japan were less involved in this process at an earlier time interval, but this research became relevant for them in recent years. The study results can be used to identify the most potential priority areas for forming the policy and strategy of the state health system, based on determining the main significant, modern, relevant characteristics of the healthcare industry.
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Sherwin, Susan. "Women in Clinical Studies: A Feminist View." Cambridge Quarterly of Healthcare Ethics 3, no. 4 (1994): 533–38. http://dx.doi.org/10.1017/s0963180100005417.
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There is significant evidence that the health needs of women and minorities have been neglected by a medical research community whose agendas and protocols tend to focus on more advantaged segments of society. In response, the National Institutes of Health (NIH) and Food and Drug Administration (FDA) in the United States have recently issued new policies aimed at increasing the utilization of women in clinical studies. As well, the U.S. Congress passed the NIH Revitalization Act of 1993, which specifically mandates increased inclusion of women and racial and ethnic groups in clinical studies. On the face of it, such gender and race-specific policies would appear to be morally problematic because traditionally ethics opposes the use of sex or race as legitimate criteria for distributions of benefits or burdens in social policies. Hence, these policies pose some significant moral questions. Feminist ethics provides us with a framework for evaluating such policies because of its readiness to recognize that socially and politically significant factors such as sex and race are morally relevant in setting public policy. Of course, feminist ethics does not simply endorse all appeals to sex and race but only the policies in which attention to such factors will contribute to social justice. In this essay, I Identify some of the Important ethical questions that a feminist ethics perspective raises about research policies devised to promote the Inclusion of women in clinical studies.
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Hem-Lee-Forsyth, Shivaughn, Bibiana Sandoval, and Hanna Bryant. "A tridimensional view of the Hispanic Health Paradox: Its relationship with faith, the enclave theory, and familism." Advances in Social Sciences Research Journal 8, no. 12 (December 31, 2021): 317–45. http://dx.doi.org/10.14738/assrj.812.11476.
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This paper examines the "Hispanic (American) Health Paradox," the juxtaposition of Hispanics’ longer lifespan than the average American amid numerous inequities regarding social determinants of health. Hispanic Americans endure multiple health disparities with a higher incidence and prevalence of chronic conditions. They also experience multiple psychosocial and physical health challenges, including higher rates of food insecurity, poverty, segregation, discrimination, and limited or no access to medical care. Nevertheless, Hispanics enjoy better physical well-being and lower mortality rates when compared to non-Hispanics in the United States (Ruiz et al., 2021). This project aims to analyze the sources of this group’s biosocial advantages and resilience, allowing them to have a longer lifespan amidst their lower health status and increased risk for chronic conditions. It explores the political and social justice implications of these inequities. It also examines the strategies to close the gap on Latinos' current health care disparities via public policy aspects of federal and state legislature. A narrative review method was utilized to examine the existing literature on this paradoxical effect. Keywords based on Medical Subject Headings (MeSH) used to search resources for relevant studies included: Hispanic health paradox (health paradox, immigrant paradox), ethnic minorities (Latinos, LatinX), health disparities (disproportionate health, health inequities), social justice (healthcare stakeholders, health inequities solutions, inequities recommendations), mental health, physical health, and co-morbidities. A quality assessment of full-text peer-reviewed articles yielded 80 articles to compile this narrative review. The research revealed that, despite glaring disparities in social determinants of health, Hispanic Americans have overall experienced better health outcomes through a culture that emphasizes spirituality, community support, and strong family ties.
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Popa, Adela Laura, Naiana Nicoleta Ţarcă, Dinu Vlad Sasu, Simona Aurelia Bodog, Remus Dorel Roşca, and Teodora Mihaela Tarcza. "Exploring Marketing Insights for Healthcare: Trends and Perspectives Based on Literature Investigation." Sustainability 14, no. 17 (August 23, 2022): 10499. http://dx.doi.org/10.3390/su141710499.
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The study aims to provide a series of information that will contribute to the understanding of the concept of healthcare marketing and other associated concepts from the perspective of how research in the field has evolved. We aim to quantify the scientific interest in the field of healthcare marketing and to extract aspects that will contribute to a better understanding of the trends that characterize the specific vision of this topic. The research involves a bibliometric analysis, and the conduct of the study is based on the investigation of the academic literature from the Scopus and PubMed databases based on the PRISMA methodology. The study investigates 1077 papers published between 2000 and 2022. According to our study, the most productive countries in the field of healthcare marketing academic publications are the United States, the United Kingdom, and India. As research themes, the study revealed that customer/patient satisfaction, medical tourism, social marketing, and hospital-related marketing topics are highlighted based on cluster analysis of authors keywords. We also discuss the significant lack of research to clarify the use of the concepts such as patient/client/customer in healthcare marketing and to understand the role of prevention services as essential in sustainable healthcare.
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Manchikanti, Laxmaiah. "Physician Payment 2008 for Interventionalists: Current State of Health Care Policy." September 2007 5;10, no. 9;5 (September 14, 2007): 607–26. http://dx.doi.org/10.36076/ppj.2007/10/607.
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Physicians in the United States have been affected by significant changes in the pattern(s) of medical practice evolving over the last several decades. These changes include new measures to 1) curb increasing costs, 2) increase access to patient care, 3) improve quality of healthcare, and 4) pay for prescription drugs. Escalating healthcare costs have focused concerns about the financial solvency of Medicare and this in turn has fostered a renewed interest in the economic basis of interventional pain management practices. The provision and systemization of healthcare in North America and several European countries are difficult enterprises to manage irrespective of whether these provisions and systems are privatized (as in the United States) or nationalized or semi-nationalized (as in Great Britain, Canada, Australia and France). Consequently, while many management options have been put forth, none seem to be optimally geared toward affording healthcare as a maximized individual and social good, and none have been completely enacted. The current physician fee schedule (released on July 12, 2007) includes a 9.9% cut in payment rate. Since the Medicare program was created in 1965, several methods have been used to determine physicians’ rate(s) for each covered service. The sustained growth rate (SGR) system, established in 1998, has evoked negative consequences on physician payment(s). Based on the current Medicare expenditure index, practice expenses are projected to increase by 34.5% from 2002 to 2016, whereas, if actual practice inflation is considered, this increase will be 90%. This is in contrast to projected physician payment cuts that are depicted to be 51%. No doubt, this scenario will be devastating to many practices and the US medical community at large. Resolutions to this problem have been offered by MedPAC, the Government Accountability Office, physician organizations, economists, and various other interested groups. In the past, temporary measures have been proposed (and sometimes implemented) to eliminate physician payment cuts. At present, the US Senate and House of Representatives are separately working on 2 different mechanisms to address and rectify these cost-payment discrepancies. The effects of both the problem and the potential solutions on interventional pain management may be somewhat greater than those on other specialties. Physician payments in interventional pain management may evidence cuts of 10% to 15%, whereas if procedures are performed in an office setting, such cuts may range from 29% to 39% over the period of the next 3 years if the proposed 9.9% cut is not reversed. Medicare cuts also impact other insurance payments, incurring a “ripple effect” such that many insurers will seek to pay at or around the Medicare rate. In this manuscript, we discuss universal healthcare systems, the CMS proposed ruling and its attendant ripple effect(s), historical aspects of the Medicare payment system, the Sustained Growth Rate system, and the potential consequences incurred by both proposed cuts and potential solutions to the discrepant cost-payment issue(s). As well, ethical issues of policy development upon the infrastructure and practice of interventional pain management are addressed. Key words: Health policy, physician payment policy, physician fee schedule, Medicare, sustained growth rate formula, interventional pain management, regulatory reform, ethics
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Murphy, Timothy F. "War Surgery in Afghanistan and Iraq: A Series of Cases, 2003–2007, edited by Shawn C. Nessen, Dave E. Lounsbury, and Stephen P. Hertz. Falls Church, VA: Office of the Surgeon General, United States Army; Washington, DC: Borden Institute: Walter Reed Army Medical Center; 2008." Cambridge Quarterly of Healthcare Ethics 19, no. 2 (March 12, 2010): 261–64. http://dx.doi.org/10.1017/s0963180109990545.
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Readers are invited to contact Greg S. Loeben in writing at Midwestern University, Glendale Campus, Bioethics Program, 19555 N. 59th Ave., Glendale, AZ 85308 (gloebe@midwestern.edu) regarding books they would like to see reviewed or books they are interested in reviewing.
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Sukhoverkhov, Anton V., and Svetlana A. Kalitko. "The theory of happiness in the 21st century: In search of the socioeconomic foundations." Vestnik Tomskogo gosudarstvennogo universiteta, no. 478 (2022): 50–57. http://dx.doi.org/10.17223/15617793/478/6.
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The article considers the modern revision of the problem of happiness in philosophy, economics, social policy and architecture. It shows that in the 21st century interest has increased in studies of external socioeconomic, environmental and urban planning aspects of happiness. In the article, this view is called externalistic and is contrasted with the earlier internalistic approaches that searched for and developed the internal (mindset-dependent) foundations of happiness. Examples of effective social and economic policies aimed to design external conditions for social well-being and happiness are considered. In the context of modern socioeconomic research, relevant philosophical approaches to happiness and conditions for its achievement are revised. The article juxtaposes theories of happiness as peace of mind and happiness as the pursuit of a dream (self-realization). The second paradigm is actively popularized in the modern society and in business management; however, it gives rise to people's overestimated expectations from and impracticable requirements for themselves. The results of recent research in the field of “happiness economics” demonstrate that happiness has scaled up in recent years from a private task of an individual to a system task that needs to be solved by society and government. Happiness has become a criterion of political and economic efficiency, as well as a significant factor in the company's high productivity and popularity. The article shows that both external (economic, political, environmental) and internal (philosophical, psychological) factors of happiness are broadly used in modern economic “happiness management”. Special attention in the research is paid to new investigations that reveal the dependence of happiness, as well as others human qualities (like altruism or egoism), on reasonably or unreasonably arranged design of the ur-ban/rural environment. The article also stresses that, among Silicon Valley developers, millionaire entrepreneurs and founders of large companies in the United States, the ideas of Stoic philosophy have gained great popularity. This philosophy is used as an effective “operating system” in conditions of constant stress and as a “mental tool” to overcome the fear of death. Stoic ideas of “negative thinking” and “defensive pessimism” are given in the article as examples of such “antistress” methods. Finally, the article cites research that show unique cultures in the world in which happiness is not the highest social value. Such studies allow reconsidering the universality of the category of happiness as a common measure of social well-being.
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KIM, Jinhyouk. "The Health Care System Debate and the Health Care Policy of a Unified Nation Immediately after the Liberation." Korean Journal of Medical History 30, no. 3 (December 31, 2021): 499–545. http://dx.doi.org/10.13081/kjmh.2021.30.499.
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Immediately after the liberation, the health care system debate was studied focusing on the orientation of the American and Soviet medical systems, roughly divided into Lee Yong-seol and Choi Eung-seok. However, the existence of people who are not explained in the American and Soviet health care systems’ orientation led to the need to reconsider the existing premise. Therefore, this study identifies the characters that were not explained in the perspective of existing studies, and reevaluates the arguments of Lee Yong-seol and Choi Eung-seok. This paper raises the following questions: First, what is the background of the policy orientation that Lee Yong-seol and Choi Eung-seok had? Second, if there are people who made different arguments from Lee Yong-seol and Choi Eung-seok, what direction did they set and argue? third, how the orientations of Lee Yong-seol and Choi Eung-seok and etc. converge into the answer to the Joint Soviet-American Commission? In response to theses questions, this study confirms the following: first, Lee Yong-seol’s and Choi Eung-seok’s health care policies were established based on realism and empiricism. As a policyholder, Lee Yong-seol emphasized withholding medical state administration and raising the level of medical education and medical systems according to the condition at that time, although the American system was mobilized by Lee as the basis for his judgment and administrative assets. On the other hand, Choi Eung-seok aimed for a Soviet-style systems in health care but this was realistically put on hold. Choi insisted on the establishment of the Medical Service Associations and rural cooperative hospitals that appeared in Japan’s medical socialization movement. In summary, immediately after the liberation, Lee Yong-seol’s and Choi Eung-seok’s policy arguments were based on policies that could be implemented in Korea, and the American system and Soviet system served as criteria for the policy resources. Second, Jeong Gu-chung and Kim Yeon-ju show that the topography of the health care debate immediately after the liberation was not represented only by Lee Yong-seol and Choi Eung-seok. Both Jeong and Kim were consequently led to medical socialization, which was the implementation of a health care system that encompasses social reform, but the context was different. Jeong drew the hierarchy of the health care system, which peaked in the United States, from the perspective of social evolution based on his eugenics, but the representation suitable for Korea was the Soviet model absorbed into his understanding. On the contrary, Kim argued that representations suitable for Korea should be found in Korea. As national medical care, Kim’s idea aimed at a medical state administration that provides equal opportunities for all Koreans. Third, the aspect of convergence to the Joint Soviet-American Commission reply proposal was complicated. Among the policies of Lee Yong-seol, the promotion of missionary medical institutions and the gradual planning of medical institutions converged into the three organizations’ proposal, and Choi Eung-seok’s policy was almost the same as that of the Democracy National Front and the South Korean Labor Party. However, the medical system of Japan, the colonial home country, appears to have been based on Lee Gap-soo, chairman of the Korean Medical Association in the colonial period, and the plan was in line with the use of the union system of the left-wing organizations’ proposal in the south. It was in accordance with a common task to expand health care from colonial conditions to different status.
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Konev, Kirill A. "In expectation of intervention: The image of the Entente countries and the United States in the non-Bolshevik periodical press of the East of Russia in November 1917 - August 1918." Vestnik Tomskogo gosudarstvennogo universiteta, no. 476 (2022): 14–23. http://dx.doi.org/10.17223/15617793/476/2.
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Under the conditions of society's movement towards a civil war at the end of 1917 - the first half of 1918, the images of “Others” (allies or opponents) acted as meaningful elements of the constructed identities of its potential participants and influenced the ideas they put forward. An analysis of the formation of the image of the UK, France, Japan and the USA in the non-Soviet periodical press of the East of Russia in the period from the end of 1917 to the summer of 1918 reveals the peculiarities of the foreign policy context's influence on public sentiment and the content of propaganda discourses of political opponents of the Bolsheviks. The aim of this work is to determine the content of the image of the Allies, constructed in the periodical press of the East of Russia, and to identify its influence on the ideological aspect of the formation of the anti-Bolshevik movement at this stage. The main source for the study were non-Soviet newspapers and magazines - party, cooperative and private publications published in the Urals, Siberia and the Far East in the period from November 1917 until August 1918. The author comes to the conclusion that the image of the Entente countries and the United States, which was formed in the non-Bolshevik periodical press of the East of Russia at that time, was distinguished by the duality of content. The change in value judgments, which were elements of this image, depended on a number of factors - the incoming information about the policies of the allied countries and the course of the World War, the perception of the external and internal political actions of the Bolsheviks, the peculiarities of the functioning of the information field itself. According to socialists (Social Democrats and SocialistRevolutionaries), the “imperialistic” Entente and the United States were no longer allies and helpers of Russia, which was sometimes expressed in the using of the term “former allies”. The analysis of the vicissitudes of international relations from the point of view of the class approach seriously forced the Siberian “revolutionary democracy” to fear an invasion from the East, which undoubtedly promoted to the formation of an opinion about the allies as a threat in the relevant publications. Liberals, in particular, the publications of constructive democrats, did not agree with their opponents from the left and viewed allies more as a potential helper, although they expressed concerns about the consequences of a possible intervention. At the same time, the key value-based attitude of the anti-Bolshevik forces was also being formed - the necessity of rallying society and creating a firm government capable of starting the revival of the country. Both socialists and liberals persistently sought to root in the minds of readers the idea that the unity of the whole society around the Constituent Assembly would create a new government - more effective than the Soviet one, thereby ensuring peace and avoiding the intervention of the Entente and the United States.
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Enekwe, Blessing. "Evaluating Social Services and Refugee Integration in Maryland." Practicing Anthropology 35, no. 4 (September 1, 2013): 8–12. http://dx.doi.org/10.17730/praa.35.4.k70007550215k051.
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As a child of immigrants, I have always been interested in issues facing the foreign-born, particularly to the United States. Being exposed to immigrants from around the world helped me understand the different factors that motivated my parents' migration to the United States while realizing that others throughout the world were also heavily impacted by ineffectual home governments. As I delved into political attitudes, international relations, and public policy, my attention continued to turn back to the ways in which policies and attitudes in the United States affect the lives of immigrants. Identifying aspects of social policy that enhance immigrant life in the United States became central to my research interests.
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Weingart, Peter. "Eugenics — Medical or Social Science?" Science in Context 8, no. 1 (1995): 197–207. http://dx.doi.org/10.1017/s0269889700001952.
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The ArgumentEugenics is the paradigmatic case of the conflict between biology and medicine over social influence. Commenting on as essay by Debora Kamrat–Lang(1995), the paper reconstructs the historical roots of eugenics as a form of preventive medicine. A comparision between the development of some crucial aspects of eugenics between Germany and the United States reveals that the prevalence of the value placed on the individual over hereditary health of a population ultimately determined the outcome of the conflict but collective concepts may be revived by new biological knowledge
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Johnson, Tricia J., Jaymie S. Youngquist, Andy N. Garman, Samuel Hohmann, and Paola R. Cieslak. "Factors influencing medical travel into the United States." International Journal of Pharmaceutical and Healthcare Marketing 9, no. 2 (June 1, 2015): 118–35. http://dx.doi.org/10.1108/ijphm-02-2013-0004.
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Purpose – This paper aims to evaluate the potential of 24 country-level measures for predicting the number of outbound international medical travelers into the USA, including health and healthcare system, economic, social and diplomatic and travel pattern factors. Medical travel is recognized as a growing global market and is an important subject of inquiry for US academic medical centers, hospitals and policy makers. Few data-driven studies exist to shed light on efficient and effective strategies for attracting international medical travelers. Design/methodology/approach – This was a retrospective, cross-sectional study of the 194 member and/or observer countries of the United Nations. Data for medical traveler volume into the USA between 2008 and 2010 were obtained from the USA Department of Commerce, Office of Travel and Tourism Industries, Survey of International Air Travelers. Data on country-level factors were collected from publicly available databases, including the United Nations, World Bank and World Health Organization. Linear regression models with a negative binomial distribution and log link function were fit to test the association between each independent variable and the number of inbound medical travelers to the USA. Findings – Seven of the 24 country-level factors were significantly associated with the number of outbound medical travelers to the USA These factors included imports as a per cent of gross domestic product, trade in services as a per cent of gross domestic product, per cent of population living in urban areas, life expectancy, childhood mortality, incidence of tuberculosis and prevalence of human immunodeficiency virus. Practical implications – Results of this model provide evidence for a data-driven approach to strategic outreach and business development for hospitals and policy makers for attracting international patients to the USA for medical care. Originality/value – The model developed in this paper can assist US hospitals in promoting their services to international patients as well as national efforts in identifying “high potential” medical travel markets. Other countries could also adapt this methodology for targeting the international patient market.
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Meyr, Andrew J., and John S. Steinberg. "Legal Aspects of Podiatric Pain Management." Journal of the American Podiatric Medical Association 100, no. 6 (November 1, 2010): 511–17. http://dx.doi.org/10.7547/1000511.
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The topic of pain management remains a minor component of the formal education and training of residents and physicians in the United States. Misguided attitudes concerning acute and chronic pain management, in addition to reservations about the legal aspects of pain management, often translate into a “fear of the unknown” when it comes to narcotic prescription. The intentionally limited scope of this review is to promote an understanding of the laws regulating pain management practices in the United States and to provide recommendations for appropriate pain management assessment and documentation based on the Model Policy for the Use of Controlled Substances for the Treatment of Pain established by the Federation of State Medical Boards of the United States. (J Am Podiatr Med Assoc 100(6): 511–517, 2010)
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Cohen, Miriam, and Michael Hanagan. "Politics, Industrialization and Citizenship: Unemployment Policy in England, France and the United States, 1890–1950." International Review of Social History 40, S3 (December 1995): 91–129. http://dx.doi.org/10.1017/s0020859000113616.
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With the “forward march of labor halted”, and labor movements everywhere in retreat, T.H. Marshall's state-based emphasis on social welfare as “social right” has reminded those interested in reform that appeals to membership in a national community, the essence of citizenship, have served to rally groups to successful struggles for reform. Those aspects of Marshall's ideas, best summarized in his classic 1949 address, “Citizenship and Social Class”, with the greatest resonance for modern social theorists revolve around the relationship between citizenship, rights and markets. For Marshall, “the universal status of citizenship” was a plane of equality such that “all who possess the status (of citizenship) are equal with respect to the rights and duties with which the status is endowed”. Rights were embodied in a common culture and enforced by state power. Marshall believed that, gradually, one particular kind of rights, “social rights”, would come to limit the power of the market. While markets would continue to exist and to generate social inequality, government redistribution would increasingly expand the plane of equality to include the most important aspects of material and cultural life. The distinctive feature of these social rights according to Marshall is that they were not exemptions, privileges or paternalistic solicitude for those excluded from what he labels the “national community”, but social rights were benefits given to members of the community to encourage and facilitate their continued participation.
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Filinson, Rachel. "Ethnic aging in Canada and the United States: A comparison of social policy." Journal of Aging Studies 6, no. 3 (September 1992): 273–87. http://dx.doi.org/10.1016/0890-4065(92)90005-q.
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MAKUSHINA, Elena Yu, Dar'ya M. KARMANOVA, and Aleksei S. KUCHER. "Tax reform initiated by D. Trump: Economic and social aspects." Finance and Credit 27, no. 3 (March 30, 2021): 693–720. http://dx.doi.org/10.24891/fc.27.3.693.
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Subject. The article addresses the tax reform of 2017, initiated by D. Trump. Objectives. The aim is to determine the relationship between the total volume of tax revenues to the budget of the U.S. Government and the growth of U.S. GDP in the long run. Methods. To identify the impact of the tax reform on the investment climate in the country and the subsequent GDP growth, we formulate a hypothesis and propose a regression model. The quarterly data from 04.01.1960 to 07.01.2019 serve as a statistical sampling, published by financial departments of the U.S. Office of Management and Budget and the U.S. Bureau of Economic Analysis. The study rests on the econometric analysis enabling to identify the impact of the volume of tax revenues from the corporate income tax and individual income taxes on the level of the GDP of the United States. Results. In the short term, we observe a decrease in tax revenues and a subsequent increase in the budget deficit, in the long term – an increase in business activity of the country, a growth in foreign direct investment, and, consequently, an increase in the GDP. The paper offers a model for assessing the economic growth of the GDP of the United States, in which tax predictors were used in combination with macroeconomic indicators. Conclusions. The experience of the United States and the results of this study may be used by the governments of developing countries and experts in the field of taxation for tax policy development.
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Ireni-Saban, Liza. "Genomics Governance in the United States and the United Kingdom." European Journal of Comparative Law and Governance 1, no. 3 (July 13, 2014): 244–65. http://dx.doi.org/10.1163/22134514-00103003.
Full textAbstract:
Technological innovation in the area of personalised genetic data poses novel regulatory concerns for state governance. Since personalised genetic data reveals highly sensitive and private information about a person’s susceptibility to illness, it may lead to stigmatisation, discrimination, and breach of privacy. Although legal arrangements for personal or medical data have always been governmental and legal concerns, the introduction of genetic technologies over the past two decades has breathed new life into the idea of privacy and non-discrimination protection for individuals and communities, leading to possible new types of social relationships that circulate in a global biomedical arena. Thus, our analysis of genetic information regulation is based on a comparative analysis of policy instruments by examining the appropriateness of various policy instrument choices made in the United States and in the United Kingdom for securing the rights for privacy, non-discrimination, and access to research benefits for individuals and communities.
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Mooney-Doyle, Kim, Jessica Keim-Malpass, and Lisa C. Lindley. "The ethics of concurrent care for children: A social justice perspective." Nursing Ethics 26, no. 5 (April 15, 2018): 1518–27. http://dx.doi.org/10.1177/0969733018765308.
Full textAbstract:
Recent estimates indicate that over 40,000 children die annually in the United States and a majority have life-limiting conditions. Children at end of life require extensive healthcare resources, including multiple hospital readmissions and emergency room visits. Yet, many children still suffer from symptoms at end of life—including fatigue, pain, dyspnea, and anxiety—with less than 10% of these children utilizing hospice care services. A critical barrier to pediatric hospice use was the original federal regulations associated with the hospice care that required a diagnosis of 6 months to live and the discontinuation of all curative treatments. The Concurrent Care Provision of the United States’ Affordable Care Act eliminated the need to forgo curative therapies in order to enroll in hospice for children in Medicaid or Children’s Health Insurance Program. Concurrent care for children can help mitigate the tension families experience in choosing between essential forms of care, as well as contribute to improved end-of-life outcomes for the child and possibly bereavement outcomes for the family. Understanding concurrent care for children from a social justice perspective has important advocacy and research implications for hospice and palliative care clinicians providing care for children and their families. We apply Powers and Faden’s theory of social justice “as the moral foundation of public health and health policy” to the provision of concurrent care to children near end of life and families in the United States. The goals of applying this theory are to explore additional insights and perspectives into concurrent care policy may provide and to assess the usefulness of this theory when applied to end-of-life health policy. We argue that concurrent care policy is socially just since it has potential to promote well-being in vulnerable children and families and can limit the inequity children at end-of-life experience in access to high-quality hospice care.