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PubMed1978

On the social control of industries.

One of the master trends of modern society is the emergence and growth of large, differentiated industry complexes. Yet out theory of social control is largely focused on the control of individuals, not industries. Understanding the processes of control requires integrating perspectives of several disciplines--economics, law, political science, and sociology. A relatively comprehensive theoretical framework of the middle range is proposed consisting of five main conceptual clusters, norms, performance curves, structural context, compliance capability and readiness, surveillance and sanction capacity of control agent. The framework helps us identify areas for further research and conceptualization, stakes out a sociological claim for involvement in an area of great policy relevance, and helps bridge the gap between two levels of analysis, society and complex organization.

Government Agencies↗
PubMed1989

The necessity for and evolution of multiple paradigms for nursing research: a poststructuralist perspective.

Viewing a phenomenon from a point beyond its boundaries permits a clearer understanding of it. The evolution of two paradigms, or world views, for nursing research--logical positivism and phenomenology/hermeneutics--is viewed by the author from a perspective beyond either paradigm. That perspective is poststructuralism, a philosophy developed to transcend the limitations of traditional philosophy and to encourage unique thought to develop. Using the ideas of Foucault, a poststructuralist philosopher, the author discusses power/knowledge and discipline as a backdrop for nursing's significant and growing acceptance of multiple paradigms for the conduct of research.

Humans↗
PubMed1997

Bioethics and law: a developmental perspective.

In most Western countries, health law [and] bioethics are strongly intertwined. This strong connection is the result of some specific factors that, in the early years of these disciplines, facilitated a rapid development of both. In this paper, I analyze these factors and construe a development theory existing of three phases, or ideal-typical models. In the moralistic-paternalistic model, there is almost no health law of explicit medical ethics, and the little law there is is usually based on traditional morality, combined with paternalist motives. The objections to this model are that its paternalism and moralism are unacceptable, that it is too static and knows no external control mechanisms. In the liberal model, which is now dominant in most Western countries, law and ethics closely cooperate and converge, both disciplines use the same framework for analysis: they are product-oriented rather than practice-oriented; they use the same conceptual categories, they focus on minimally decent rather than the ideal, and they are committed to the same substantive normative theory in which patient autonomy and patient rights are central. However, each of these four characteristics also results in a certain one-sidedness. In some countries, a third model is emerging. In this postliberal model, health law is more modest and acknowledges its inherent and normative limits, whereas ethics takes a richer and most ambitious self image. As a result health law and ethics will partly diverge again.

Bioethical Issues↗
PubMedDate not supplied

Unmanaged care: the need to regulate new reproductive technologies in the United States.

In the aftermath of allegations of the misuse of human eggs in the United States, questions are being raised about whether profitable reproductive services should continue to function in a free market under the aegis of physicians or should be regulated. Other countries in which reproductive technologies are employed to a significant degree have developed regulations governing their use, many as a result of recommendations made by inter-disciplinary commissions that solicited public input. Policy makers in the United States have been reluctant to regulate reproductive technologies, however, because their use is politically controversial, they want to whittle down government, some do not consider infertility an illness, and some believe regulation would interfere with the right to reproduce. Yet the unfettered use of reproductive technologies can create such harms as lack of informed consent, providing procedures not medically indicated for financial gain, practice by unqualified personnel, injury to patients and donors, failure to screen donated gametes, and inadequate medical record keeping. Americans place special value on the welfare of children and those who bring them into the world. Such values can outweigh individual procreative liberty when new reproductive technologies are at issue. Although the optimal course would be to establish a regulatory body to govern reproductive technologies, this is not politically feasible now. The newly established National Bioethics Advisory Commission provides a forum in which issues surrounding reproductive technologies should be addressed at this time in the United States.

Advisory Committees↗
PubMed1998

Female genital mutilation and cosmetic surgery: regulating non-therapeutic body modification.

In the UK, female genital mutilation is unlawful, not only when performed on minors, but also when performed on adult women. The aim of our paper is to examine several arguments which have been advanced in support of this ban and to assess whether they are sufficient to justify banning female genital mutilation for competent, consenting women. We proceed by comparing female genital mutilation, which is banned, with cosmetic surgery, towards which the law has taken a very permissive stance. We then examine the main arguments for the prohibition of the former, assessing in each case both (a) whether the argument succeeds in justifying the ban and, if so, (b) whether a parallel argument would not also support a ban on the latter. We focus on the following arguments. Female genital mutilation should be unlawful because: (1) no woman could validly consent to it; (2) it is an oppressive and sexist practice; (3) it involves the intentional infliction of injury; (4) it causes offence. Our view is that arguments (3) and (4) are unsound and that, although arguments (1) and (2) may be sound, they support not only a ban on female genital mutilation, but also one on (some types of) cosmetic surgery. Hence, we conclude that the present legal situation in the UK is ethically unsustainable in one of the following ways. Either the ban on female genital mutilation is unjustified because arguments (1) and (2) are not in fact successful; or the law's permissive attitude towards cosmetic surgery is unjustified because arguments (1) and (2) are in fact successful and apply equally to female genital mutilation and (certain forms of) cosmetic surgery. The people of the countries where female genital mutilation is practised resent references to 'barbaric practices imposed on women by male-dominated primitive societies', especially when they look at the Western world and see women undergoing their own feminization rites intended to increase sexual desirability: medically dangerous forms of cosmetic plastic surgery, for instance....

Adult↗
PubMed1989

The U.S. general population's experiences of responding to alcohol problems.

Respondents in a 1984 national adult sample report on the experiences of treatment for alcohol problems, of talking to someone about an alcohol problem of their own, and of others' suggestion that the respondent cut down. Most who have been treated (3.4% on a lifetime basis, 1.3% within the last year) have also encountered informal pressures. A majority of respondents have pressured others to cut down their drinking; such efforts do not appear to be clustered in a few 'control specialists', and heavier drinkers are about as likely as lighter drinkers to pressure others. Within the family, the flow of pressure is from older to younger generations, and from women to men, but a heavy-drinking woman is as likely to be pressured as a heavy-drinking man. Somewhat more men than women report applying pressure on friends.

Adult↗
PubMed1991

Mapping the human genome: some thoughts for those who say "There should be a law on it.

... It appears from this discussion that the most effective method of regulating the problems that may arise from the human genome project is to concentrate, not on the research involved in the project, but rather on the uses that may be made of the information gained from it. Furthermore, there is already a good deal of legislation and administrative machinery that is directly or incidentally relevant to the matters in question. This should obviously be used as much as possible, rather than new legislation, to reduce bureaucracy, overlapping provisions and costs.

Abortion, Therapeutic↗
PubMed1992

Instituting a research ethic: chilling and cautionary tales.

The ethical review of research on human beings, and indeed the ethical review of broader ranges of human activity, is a growth industry. I want to look here at the ethical review of research on humans and raise some questions about the direction it is taking. I am pessimistic about where the institutions that we have set up are leading us and I want to sound a warning note and suggest some changes that are needed in the practice of ethical review.

Behavioral Research↗
PubMed1995

The Ethics and Politics of Human Experimentation, by Paul M. McNeill.

...McNeill's book raises some very important questions about the ways in which a society comes to terms with the fact that the practice of medicine is more closely linked with experimentation than ever before. That often puts the doctor-patient relation into a new setting. We have registered our objection to McNeill's tendency to see that relationship, where experimentation is involved, in an adversarial form: there are, we must repeat, more than two sides to this argument, and the medical scientist's commitment is not only to truth at any cost any more than the medical practitioner's is to treatment in all circumstances. Objections do not mean that we cannot learn from this book: on the contrary they may help us to sharpen our perceptions of what should happen. Fair-mindedness would suggest that failure to fulfill expectations is nothing like as widespread or for that matter incurable as McNeill's polemical tone might lead us to believe. When McNeill ceases to be the prosecuting counsel the true worth of his comments will become more apparent.

Australia↗