Lots of great articles worth mentioning on SSRN, covering a wide variety of issues and approaches. Topics addressed below the fold include:
- Tipping Points in health law & politics;
- documentary filmmaking, obesity, and health inequities;
- women's motivations for participating in basic and clinical research;
- the aftermath of the Terri Schiavo case;
- strategies for urban health policy and governance; and
- coal mine safety.
All links are full-text unless otherwise noted.
Foreword: The Politics of Health Law: Any Tipping Points in View?
Frances H. Miller (Boston University - Law)
29 Western New England L. Rev. 265 (2007)
Abstract:
Malcolm Gladwell explored the way ideas and behaviors can proliferate “just like viruses do” once they achieve a critical mass in The Tipping Point, his best-seller about widespread and rapidly-adopted social phenomena he labels epidemics. Gladwell's subtitle, “How Little Things Can Make a Big Difference,” indicates that he does not think it has to take much to get one of these social epidemics rolling. He does believe, however, that three factors are essential: getting “people with a particular and rare set of social gifts” involved, packaging the ideas so they are “irresistible” under the circumstances, and making sure that both the right people and the right presentation can be deployed in the perfect context for change. That usually means inheriting or creating a situation where one can “tinker with the smallest details of the immediate environment” to unleash the idea's potential for reaching a tipping point, and thus morphing into an epidemic leading to change.
This Foreword analyzes the six articles in this Symposium on The Politics of Health Law in light of Tipping Point Theory, concluding that only the Schiavo controversy, among articles also dealing with palliative care, organ and tissue donation from children, structural change in the health sector, medical tourism and outsourcing, and The Health Care Choice Act of 2005, seems near to achieving Tipping Point momentum at the present time.
Regina Austin (Penn -- Law)
40 Loyola Los Angeles L. Rev. 683 (2007).
Abstract:
According to director Morgan Spurlock, the idea for "Super Size Me", the hugely popular documentary that explored the health impact of fast food, originated from a news report about "Pelman v. McDonald's", one of the fast food obesity cases. Over the course of his month-long McDonald's binge, Spurlock became the literal embodiment of fast-food's ill-effects on the seemingly generic American adult physique. Spurlock's take on the subject, however, ignores the circumstances that contributed to the overweight conditions of the "Pelman" plaintiffs who were two black adolescent females who ate their fast food in the Bronx. One of them was homeless during the relevant time period.
The paper discusses what the circumstances of the "Pelman" plaintiffs might have been, including the incidence of obesity and overweight and related diseases in minority populations, the correlation between obesity and food insecurity, the significance of fast food restaurants in poor urban minority communities, the relationship between fast food and soul food, race-specific cultural attitudes regarding women's weight, and race/ethnicity-related restraints on leisure. To be sure, based on past experience, a white male filmmaker like Spurlock might have found it difficult to tackle these subjects (especially in a film that is otherwise lighthearted and humorous) without encountering substantial criticism. Furthermore, most of the factors are irrelevant to the law of products liability, which pays little attention to inequities in the demographic distribution of risk. However, allowing generally disempowered subjects like the "Pelman" plaintiffs an opportunity to reveal their reflexivity about their situations is one way of combating disapproval and prompting deeper analysis of a social problem; Spurlock's television series "30 Days" is a fine example of that. Alternatively, filmmakers like Spurlock might display more reflexivity or critical self-assessment about their techniques for bringing only part of a complex issue to the screen . . . on the screen itself.
Fascinating. The public health policies and politics relating to obesity are quite important, for a variety of reasons, and it is vital, IMO, to adequately problematize the "epidemic" of obesity.
What Motivates Women to Take Part in Clinical and Basic Science Endometriosis Research?
(full-text unavailable)
Sanjay K. Agarwal (University of California San Diego - Med) et al.
Bioethics 21, no. 5 (2007): 263-269.
Abstract:
BACKGROUND: The objective of this study was to identify factors motivating women to take part in endometriosis research and to determine if these factors differ for women participating in clinical versus basic science studies.
METHODS: A consecutive series of 24 women volunteering for participation in endometriosis-related research were asked to indicate, in their own words, why they chose to volunteer. In addition, the women were asked to rate, on a scale of 0 to 10, sixteen potentially motivating factors. The information was gathered in the form of an anonymous self-administered questionnaire.
RESULTS: Strong motivating factors (mean score > 8) included potential benefit to other women's health, improvement to one's own condition, and participation in scientific advancement. Weak motivating factors (mean score < 3) included financial compensation, making one's doctor happy, and use of 'natural' products. No difference was detected between clinical and basic science study participants.
CONCLUSION: This study is the first study to specifically investigate the factors that motivate women to take part in endometriosis research. Understanding why women choose to take part in such research is important to the integrity of the informed consent process. The factors most strongly motivating women to participate in endometriosis research related to improving personal or public health; the weakest, to financial compensation and pleasing the doctor.
Without having read the study, I have to wonder whether the fact that women reported a hope of improving personal health is simply another sign of the pervasiveness of the therapeutic misconception, which remains deeply entrenched in the culture of biomedical research among participants, investigators, advocates, and funding sources.
Collateral Damage: The Aftermath of the Political Culture Wars in Schiavo
(full-text unavailable)
Kathy L. Cerminara (Nova Southeastern - Law)
29 Western New England L. Rev. 279 (2007)
Abstract:
Theresa Marie Schiavo died a celebrity at the age of 42 in Pinellas Park, Florida, in early 2005. She never sought the public spotlight; she never even knew she was a celebrity. She became a celebrity, one of the best-known figures in bioethics, because of politics. This Article examines the politics surrounding her death and draws some conclusions about the aftermath for those left behind in the America Ms. Schiavo departed.
The lessons of Schiavo are mixed. It unquestionably will impact end-of-life decisionmaking in America for years to come, in at least one positive but mostly negative ways. Both individuals and individual cases will be affected, and the general tone and pattern of end-of-life decisionmaking will change. Even beyond the realm of end-of-life decisionmaking law, the politics of Schiavo, for better or worse, can be seen as an example of a more general politicization of bioethics. Finally, Schiavo highlights some major lessons to be learned about the functioning of our American constitutional republican form of government.
Cerminara is an expert on the law regarding the right to die, and was also a consistent commentator during and after the Schiavo affair. Recommended.
Emerging Strategies for Healthy Urban Governance
Scott Burris (Temple - Law) et al.
Journal of Urban Health 84, no. 1 (2007): 154-163.
Abstract:
Urban health promotion is not simply a matter of the right interventions, or even the necessary resources. Urban (and indeed global) health depends to an important extent on governance, the institutions and processes through which societies manage the course of events. This paper describes the concept of governance, distinguishing between reforms aimed at improving how government works and innovations that more fundamentally reinvent governance by developing new institutions and processes of local stakeholder control. The paper highlights strategies urban governors can use to maximize their influence on the national and international decisions that structure urban life. It concludes with some observations on the limitations of local governance strategies and the importance of establishing a “virtuous circuit” of governance through which urban dwellers play a greater role in the formation and implementation of policy at the national and global levels.
Given that Sen published Poverty and Famines over 25 years ago, I have generally been surprised that policy wonks and ethicists have been so slow to pick up on the importance of social and political structures in promoting or preventing health. The article's emphasis on a virtuous circuit resonates of Keller's feedback loop metaphor, and also evokes the spirit of community-based participation in defining as well as implementing health policy. Recommended.
Approaching Coal Mine Safety from a Comparative Law and Interdisciplinary Perspective
Anne Marie Lofaso (West Virgina - Law)
111 West Virginia L. Rev. 1 (2008).
Abstract:
These remarks, given on March 21, 2007, as part of the West Virginia Law Review's Symposium: Thinking Outside of the Box: A Post-Sago Look at Coal Mine Safety, suggest a comparative and interdisciplinary approach to looking at workplace health and safety issues. The remarks in particular and the symposium in general use the Sago Disaster as a springboard for examining the various and complex questions related to the broader question - What role does or should the law play in protecting workers' health and safety. This, of course, leads to the obvious question - Does regulation work? An administrative law and comparative approach to the regulatory issue helps to identify best practices that may save lives. But more profound questions quickly surface. What do we citizens of a "just" society owe workers who daily risk their lives for our collective comfort? If the technology is available to save workers' lives, why hasn't it been made available? The remarks raise questions in hope that next year's symposium will commence a dialogue for presenting different perspectives and possible solutions.
The story of coal mine safety is in many ways the story of occupational health in the U.S. Unfortunately, the stories are not altogether happy. Markowitz and Rosner have an excellent article on the history of silicosis, which is generally known to most current observers only through the MDL silicosis litigation. Lofaso asks some important questions in this article, and I can obviously endorse interdisciplinary approaches to questions of health and illness.
There is a lot of useful blogs and articles about health care, more interesting, important informations that I can find here. Thanks.
Posted by: ahmad | July 30, 2007 at 12:56 AM
Its a medical humanities blog. There should be something related to Health.
Posted by: Chan | August 29, 2007 at 12:01 AM