This article deals with nurses’ ethical concerns raised by the consequences of changes in governmental and institutional policies on nursing practice and patient care. The aims of this project were to explore perspectives of registered nurses who provide or manage direct patient care on policies that affect nursing and patient care, and to provide input to policy makers for the development of more patient-centred policies. Four focus groups were conducted with a total of 36 registered nurse participants. The project (...) team identified major themes that emerged in the analysis of transcripts of the focus group discussions. The four major themes were: effects of policy focused on cost containment, effects on quality of care, effects on patient education and access to needed services, and effects on nurses and nursing. The participants identified primarily negative effects of changes in national health policy and legislation that influence institutional policies on patient care and nursing practice. The effects of identified policy changes raised concerns about meeting nurses’ ethical obligations to patients and families. Participants specified key points for consideration by legislators and other policy makers. They viewed nurses who are involved in direct patient care as a critical resource for legislators and other policy makers in the development of public and institutional policies that affect nursing and patient care. (shrink)

This study investigates how adoption of advisory governance policy encourages firms to become more responsive to their shareholders over time. Although shareholder activism is costly and often viewed as unable to drive meaningful change, we identify increasing shareholder voice as an underlying mechanism to explain how advisory policy adoption ultimately reshapes board–shareholder relations. Drawing on signaling theory and behavioral views of board–shareholder dynamics, we test our predictions following the broad shift in corporate board voting policies from plurality (...) to majority vote standards. While prior research shows that majority vote adoption has little to no direct impact on director elections, empirical results from 2,390 firm-year observations provide support for our hypotheses that adoption of this advisory electoral standard signals a willingness to hear shareholder concerns, leading to increased shareholder activism and, in turn, board responsiveness to shareholder proposals. Overall, our results help explain why some firms continue to fight the purely advisory policy and why an era of shareholder empowerment followed the majority vote campaign. (shrink)

To be successful, policy must anticipate a broad range of constituents. Yet, all too often, technology policy is written with primarily mainstream populations in mind. In this article, drawing on Value Sensitive Design and discount evaluation methods, we introduce a new method—Diverse Voices—for strengthening pre-publication technology policy documents from the perspective of underrepresented groups. Cost effective and high impact, the Diverse Voices method intervenes by soliciting input from “experiential” expert panels. We first describe the method. Then we (...) report on two case studies demonstrating its use: one with a white paper on augmented reality technology with expert panels on people with disabilities, people who were formerly or currently incarcerated, and women; and the other with a strategy document on automated driving vehicle technologies with expert panels on youth, non-car drivers, and extremely low-income people. In both case studies, panels identified significant shortcomings in the pre-publication documents which, if addressed, would mitigate some of the disparate impact of the proposed policy recommendations on these particular stakeholder groups. Our discussion includes reflection on the method, evidence for its success, its limitations, and future directions. (shrink)

Although recent government initiatives have drawn attention to the importance of listening to young people, attempts to pay attention to their views about their education experience are rare. Drawing on two studies of disaffected and disadvantaged pupils, this article analyses what can be learned from taking their views into account.

This paper focuses on the diaspora Chinese community in Limerick – an Irish county town in the southwest of the Republic of Ireland – and examines how Chinese parents have responded to the education policy shift resulting from the 2017 Irish foreign language strategy, which added Chinese to the official educational curriculum. A semi-structured group interview was conducted with four Chinese-speaking parents. Analysis of the data revealed that identity preservation and maintaining bonds with extended family are the predominant expressed (...) reasons for parents to cultivate their children’s Chinese proficiency. English and Irish are prioritized over Chinese. Though the parents hold positive attitudes towards the inclusion of Chinese as a school subject in Ireland, they are disempowered from taking advantage of participating in the implementation of this national language shift due to a lack of access to social, cultural, and economic capital. Analysed through a Bourdieuian lens, the findings further expose the limitations or constraints placed on family language policy and the discrepancy between macro- and micro-level language policies. The paper is intended to shed light on education, social justice, and equality, bridging the gap between micro-level family language practices and macro-level language policy. (shrink)

This comprehensive educational history of public schools in Hawai'i shows and analyzes how dominant cultural and educational policy have affected the education experiences of Native Hawaiians. Drawing on institutional theory as a scholarly lens, the authors focus on four historical cases representing over 150 years of contact with the West. They carefully link historical events, significant people, educational policy, and law to cultural and social consequences for Native Hawaiian children and youth. The authors argue that since the early (...) 1800s, educational policy in Hawai'i emphasizing efficiency has resulted in institutional structures that have degenerated Hawaiian culture, self-image, and sovereignty. Native Hawaiians have often been denied equal access to quality schools and resulting increased economic and social status. These policies were often overtly, or covertly, racist and reflected wider cultural views prevalent across the United States regarding the assimilation of groups into the American mainstream culture. The case of education in Hawai'i is used to initiate a broader discussion of similar historical trends in assimilating children of different backgrounds into the American system of education. The scholarly analysis presented in this book draws out historical, political, cultural, and organizational implications that can be employed to understand other Native and non-Native contexts. Given the increasing cultural diversity of the United States and the perceived failure of the American educational system in light of these changes, this book provides an exceptionally appropriate starting point to begin a discussion about past, present, and future schooling for our nation's children. Because it is written and comes from a Native perspective, the value of the "insider" view is illuminated. This underlying reminder of the Native eye is woven throughout the book in _Ha'awina No'ono'o_--the sharing of thoughts from the Native Hawaiian author. With its primary focus on the education of native groups, this book is an extraordinary and useful work for scholars, thoughtful practitioners, policymakers, and those interested in Hawai'i, Hawaiian education, and educational policy and theory. (shrink)

'Voices of Feminist Liberation' brings together a wide range of scholars to explore the work of Rosemary Radford Ruether, one of the most influential feminist and liberation theologians of our time. Ruether's extraordinary and ground-breaking thinking has shaped debates across liberation theology, feminism and eco-feminism, queer theology, social justice and inter-religious dialogue. At the same time, her commitment to practice and agency has influenced sites of local resistance around the world as well as on globalised strategies for ecological sustainability and (...) justice. 'Voices of Feminist Liberation' examines the potential of Ruether's thinking to mobilize critical theology, social theory and cultural practice. The scholars gathered here present their personal engagements with Ruether's thinking and teaching. The book will be invaluable to scholars, policy-makers, and activists seeking to understand how colonial and patriarchal oppression in the name of religion can be confronted and defeated. (shrink)

In the beginning, policy debates between critics and advocates of genetically modified (GM) crops focused on scientifically determined risks. Ten years later, the argument between environmentalists or consumers and regulators or industry has changed into a discussion about the implementation of more democratic policymaking about GM farming. A notable omission from the political debate about food biotechnology in the United States, however, is the opinion of farmers who cultivate the GM crops. Policymakers should value practical knowledge based on experiences (...) from farmers, not only scientific industry reports or consumer product opinions. This project uses in-depth interviews to create an original mail survey that uses the practical discourse of farmers in order to explore the relationship of farmer attitudes and GM agriculture. Although national research indicates that larger yields are the most common reason for GM adoption, qualitative information suggest that the potential of GM crops to increase revenue per acre does not truly reflect all the concerns of modern farmers. For example, farmers who use GM seeds indicate that they constantly question the social impacts of their agricultural practices. As such, GM policies should be restructured as a political rationalization of both economic modeling and political theory because this research suggests that farmers’ business decisions are utility calucations that consider economics without ignoring environmental and political contexts. Farmers’ concerns about non-economic risks suggest that they need more information about GM crops and that governmental policies should respond to their interests, as they are more democratic or pluralistic than industry or consumer arguments. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Whose Voice Matters? The Role of Ethics Consultation in Supporting the 16-Year-Old Healthcare Decision-Maker of a Critically Ill NeonateMichelle ProngEditor’s Note. The details of the patient case presented below have been modified to protect the family’s privacy. Despite these modifications, the author has made every effort to preserve the story’s clinical, social, and ethical nuances.The patient was born at 31 weeks with Trisomy 13 and lived her entire (...) life in the NICU. She was born to a 16-year-old mother (who I will call M.H.) as the result of an unintended pregnancy. This child was just about a month old when I became part of her care team. The patient was born with a severe congenital heart defect that our pediatric cardiac surgery team—as well as surgical teams at multiple other academic children’s hospitals—determined to be inoperable. Because of her severe heart defect, she required significant respiratory support throughout her life and continuous IV medications to keep her organs perfused.When I came on service, M.H. visited irregularly and depended on her mother (the patient’s grandmother, who I will call D.R.) for transportation. Social work had arranged for M.H. to have daily transportation to the hospital after school and work; however, M.H. was denied the opportunity to spend the night with her infant. It was against hospital policy for minors to stay overnight as visitors, and additional visitation guidelines related to COVID precautions were also in place at the time. As her biological mother, M.H. was designated as the patient’s healthcare decision-maker. The inability for M.H. to stay overnight on the basis of her age despite being the patient’s parent and healthcare decision-maker generated significant moral distress for several members of the care team. The social dynamic between M.H. and D.R. was such that D.R. was far more participatory in rounds and goals of care conversations, and M.H. was almost always reserved and withdrawn. On multiple occasions, different team members attempted to have conversations directly with M.H. She either was not engaged in the conversation, would answer with short phrases, or, when D.R. was present, would defer to D.R. to speak for her.Throughout the patient’s life, D.R. seemed to be the driving force behind most treatment and goals of care decisions. In multiple conversations I had with the family, both one-on-one with M.H. and jointly with M.H. and D.R., it was made clear that they wanted “everything done” and were hopeful for “a miracle.” D.R. emphasized that she didn’t want anyone to “give up” on the patient and wanted to exhaust all possible options for a cure. Overall, our team had become increasingly concerned that the medical decision makers for this patient did not comprehend the very poor prognosis of her congenital cardiac anomaly, either with or without surgery. As the medical team, we would be subjecting this child to harm that would be unlikely to change her prognosis. [End Page 19]Our NICU team, as well as various other teams, discussed the case repeatedly without a resolution that felt satisfactory. A complicating factor for this particularly socially and ethically challenging case was that the team turned over relatively frequently during the patient’s long-term stay, making it difficult for each successive team to understand what had already been done for this patient and her family. We decided to seek help from the Clinical Ethics Consulting (CEC) service. My expectation for the CEC service was that the consultant would help our team think differently about both the clinical and social elements of the situation and help us come to a resolution since we could not figure out a good solution on our own.Our consult question for the CEC was fourfold: 1) Did the patient’s mother meet criteria for an emancipated minor (to get around the visitation policy), 2) Is M.H. the appropriate healthcare decision maker given her lack of engagement in goals of care conversations and perceived understanding of the severity of her... (shrink)

ABSTRACT In Power Without Knowledge, Jeffrey Friedman develops a critique of technocracy and in doing so makes an epistemic case for exit over voice. He argues that a technocracy that fails to take people’s ideational heterogeneity into account is unlikely to possess the knowledge required to solve social problems, and that the alternative of “exitocracy” may, in some cases, overcome these limits. By creating the conditions under which individuals can exit from undesirable social situations, an exitocracy may allow people (...) to escape their social ills without knowing their society-wide causes or solutions. As Friedman recognizes, however, an exitocracy still requires technocratic knowledge, and this paper explores these requirements in further detail. First, it investigates the limits of exit as a solution to social problems, and the extent to which technocratic policies can be substituted for exit. Second, it considers the need for technocratic knowledge in the promotion of exit opportunities, and how this undermines Friedman’s defense of exitocracy. (shrink)

One of the essential ethical issues in the employment relationship is the loss of employee voice. Many of the ways employees have previously exercised voice in the employment relationship have been rendered less effective by (1) the changing nature of work, (2) employer preferences for flexibility that often work to the disadvantage of employees, and (3) changes in public policy and institutional systems that have failed to protect workers. We will begin with a discussion of how work (...) has changed in the last 20 years in countries like Australia and the United States, and then take up the issue of employees as organizational stakeholders and the ethical duties that are owed them, with special attention given to issues of power. We will then consider whether voluntary action by employers such as social auditing is sufficient to ensure equity for employees, and conclude with a discussion of how changes in public policy might ensure greater fairness in the employment relationship by bringing employers and employees together in partnership. (shrink)

Participatory action research always operates in the tension of extending the voice of people who are marginalised and unheard in the society. A workshop, ‘Extending Voice and Autonomy through Participatory Action Research: Ethical and Practical Issues’, was therefore organised to look at the issues arising from this tension. The workshop aimed to examine critically the potential of participatory action research to enable people whose voices are seldom heard and choices are often restricted to be seen, heard and to (...) influence practice and policy relevant to their lives. The paper first outlines the rationale for the workshop and then demonstrates how ‘co-impact’ of participatory action research projects can be achieved through having conversations and reflecting on the ideas of ‘voice and autonomy’, ‘knowledge’, ‘vulnerability’, ‘user involvement and participation’. Through reflecting on the experience of preparing for and delivering the workshop, we seek ways to transform the relationship(s) between service users/community partners and academic and service professionals in the hope of generating practical knowledge ethically. (shrink)

‘Pupil voice’ is a movement within state education in England that is associated with democracy, change, participation and the raising of educational standards. While receiving much attention from educators and policy makers, less attention has been paid to the theory behind the concept of pupil voice. An obvious point of theoretical departure is the work of Jürgen Habermas, who over a number of decades has endeavoured to develop a theory of democracy that places strong significance on language, (...) communication and discourse. This paper is an attempt to gauge the usefulness of Habermas’ approach to understanding the theory of pupil voice, in particular how his theory of universal pragmatics lends itself to a ‘philosophy of between’, a philosophy that finds echoes in the conflicted nature of schooling that ‘pupil voice’ is supposed to rectify to some extent. The paper also explores the drawbacks of a Habermasian approach, in particular his overreliance on rationality as a way of understanding communication. Lacan’s concept of the objet petit a is introduced as an alternative way of understanding pupil voice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Religious Voices in Public PlacesTimothy A Beach-VerheyReligious Voices in Public Places Edited by Nigel Biggar and Linda Hogan New York: Oxford University Press, 2009. 330 pp. $53.91Religious Voices in Public Places grew out of a conference at the University of Leeds in 2003. It makes an important contribution to continuing debates about religion and contemporary liberalism. Acknowledging that John Rawls provides the paradigmatic model for articulating modern liberal (...) ideals, the authors take [End Page 203] his work as a starting point; yet through critical engagement with his work, they move the discussion about liberal ideals forward in new directions. Although they recognize that the United States has long stood as the classical instance of a liberal polity, they widen their attention to other liberal nations that have different ways of relating to the religious sphere.The book is helpfully divided into four parts dealing with philosophical views, theological views, public policy issues, and national contexts. Each section investigates the proper role of religious voices in an increasingly global and pluralistic political environment. While the authors bring different perspectives to this principle concern, they all tend to agree that religious voices contribute to public discourse and that liberal democracy does not require their exclusion. “Indeed,” as Linda Hogan writes in the introduction, “running throughout the volume is an affinity for approaches that believe that the route to a durable political culture lies in serious and systematic engagement with different, and even opposing, comprehensive doctrines” (7).The essays in the section on philosophical views engage critically with John Rawls. Nicholas Wolterstorff and Raymond Plant each argue that Rawls’s version of public reason requires a degree of moral consensus that is both unrealistic and illiberal. Rawls’s view of public reason, they argue, stacks the deck in favor of particular (liberal) assumptions, making its ideals of freedom and equality a sham. In turn, Maureen Junker-Kenny looks for a more adequate conception of public reasoning in the discourse ethics of Jürgen Habermas. In the section on theological views, Luke Bretherton, P. Travis Kroeker, and Robert Gascoigne mine the Christian tradition for resources that engage pluralistic societies in ways that neither retreat into particularistic enclaves nor jettison Christianity’s distinctive faith for the sake of intelligibility. In their various ways, they call into question the prevailing view that religious convictions are a threat to a pluralistic society that values freedom, equality, and solidarity. In the section on public policy, Nigel Biggar, Paul Weithman, and Linda Hogan examine these questions through the lens of physician-assisted suicide, religion in public education, and international human rights; they make cogent arguments for including religious perspectives, in all their complexity and multiplicity, in the political life and public discourse of liberal democratic societies. The last section, on particular national contexts, makes it clear that there is more than one way for liberal societies to deal with religious voices. Peter Sedgwick examines the role of the Anglican Church in English public life; Brian Stiltner and Steven Michels study the role of religion in US political campaigns; and Jocelyne Cesari compares the way different liberal democratic polities in the West have responded to the expanding role of Islam in their societies.This fine volume of essays demonstrates that the discussion about religion and public life is moving beyond the stale binary categories of secular liberalism [End Page 204] and religious traditionalism. These essays exemplify and contribute to the more interesting discussion that is beginning to take place as we leave behind simplistic models in favor of more nuanced, rich, and realistic assessments of public discourse and political decision making in an increasingly diverse yet interdependent social environment. Nigel Biggar and Linda Hogan are to be thanked and commended for bringing this volume to fruition.Timothy A Beach-VerheyFaison Presbyterian ChurchCopyright © 2012 The Society of Christian Ethics... (shrink)

Over the last several years, regular evaluation of development programs has become essential in measuring and understanding their true impact. Feminist and gender-sensitive evaluations have gradually emerged, drawing attention to existing inequities--gender, caste, class, location, and more--and the cumulative effect of these biases on daily life. Such evaluations are also deeply political; they explicitly acknowledge that gender-based inequalities exist, show how they remain embedded in society, and articulate ways to address them. Based on four years of research, Voices and Values (...) offers critical insight into how gender, class, and nationality inflect and affect sociological research. It examines how feminist evaluations could make an effective contribution to new policy formulations oriented to gender and social equity. The essays here focus centrally on the structural roots of inequity: giving weight to all perspectives; adding value to marginalized groups and people under evaluation; and taking forward the findings of evaluation into advocacy for change. In doing so, each essay advances the understanding of feminist evaluation both conceptually and as practice. (shrink)

Biomedical research policy in recent years has often tried to make such research more ‘translational’, aiming to facilitate the transfer of insights from research and development to health care for the benefit of future users. Involving patients in deliberations about and design of biomedical research may increase the quality of R&D and of resulting innovations and thus contribute to translation. However, patient involvement in biomedical research is not an easy feat. This paper discusses the development of a method for (...) involving patients in biomedical research aiming to address its main challenges.After reviewing the potential challenges of patient involvement, we formulate three requirements for any method to meaningfully involve patients in biomedical research. It should enable patients to put forward their experiential knowledge, to develop a rich view of what an envisioned innovation might look like and do, and to connect their experiential knowledge with the envisioned innovation. We then describe how we developed the card-based discussion method ‘Voice of patients’, and discuss to what extent the method, when used in four focus groups, satisfied these requirements. We conclude that the method is quite successful in mobilising patients’ experiential knowledge, in stimulating their imaginaries of the innovation under discussion and to some extent also in connecting these two. More work is needed to translate patients’ considerations into recommendations relevant to researchers’ activities. It also seems wise to broaden the audience for patients’ considerations to other actors working on a specific innovation. (shrink)

Most empirical research examining physician views on physician-assisted suicide has used quantitative methods to characterize positions and identify predictors of individual attitudes. This approach has generated limited information about the nature and depth of sentiments among physicians most impassioned about PAS. This study reports qualitative data provided by 909 physicians as part of a larger survey regarding attitudes toward and experiences with PAS and palliative care. Emergent themes illustrate important clinical, social, and ethical considerations in this area. The data illustrate (...) the diverse and ardent responses that PAS evokes among certain physicians. The role of physicians' personal values is central to discussions about legalization of PAS. Polarized views such as those expressed by physicians in this study are not likely to be reconciled, thereby constraining the development of public policy regarding PAS. (shrink)

Maria Lugones and other writers of post-colonial discourse emphasize hybrid over univocal identities. I argue that a significantly expanded version of Mikhail Bakhtin’s notion of “dialogized heteroglossia” reveals that the linguistic community and the “voives” at play in the latter constitute a form of dialogic hybridity. This view of the linguistic community offers an alternative to the notion of pure identities and the politics of exclusion that it has supported either overtly or tacitly. Moreover, a political principle - “the interplay (...) of equally audible voices” - can be derived from this view; it permits us simultaneously to affirmmulticulturalism and to deny racism, sexism, classism and other exclusionary discourses the right to become policy-making voices.Maria Lugones et d’autres théoriciens du discours post-colonial mettent l’accent sur les identités hybrides par opposition à univoques. Je soutiens qu’une version significativement plus large de la notion bakhtinienne d’“hétéroglossie dialogisée” fait ressortir que la communauté linguistique et les “voix” en jeu dans cette dernière constituent une forme d’hybridité dialogique. Cette conception de lacommunauté linguistique offre une alternative à la notion d’identité pure et à la politique d’exclusion qu’elle a défendue, ouvertement ou de façon tacite. De plus, un principe politique - “le jeu de voix audibles au même degré” - peut être tiré de cette conception, lequel permettrait à la fois d’affirmer le multiculturalisme et d’empêcher que le racisme, le sexisme, le classicisme et tout autre discours d’exclusion puissent devenir des voix qui déterminent fes pofitiques du jour. (shrink)

This article aims to outline some of the ways in which issues of migration and employment relations have been studied in the European context, cross referencing recent interventions in the USA. The argument is a discussion of some of the different dimensions of migration and the way debates within Industrial Relations have been shaped. More specifically, the article will look at the way trade unions have made the ethical turn towards questions of migration and equality. The article will observe the (...) way these issues have been academically framed and the manner in which the ‘problem’ of migration is conceptualized. It will attempt to provide a framework for discussing the way we have been analysing these issues and the ethical dimensions of these discussions. The relevance of the article is that institutionally responding to migration is not solely a question of adjusting employment relations or Industrial Relations institutions to various ‘new’ constituencies. The article will show that the topic raises issues as to how we actually understand what the study of employment and especially Industrial Relations are. The article also argues that there is a growing need for researchers to be aware of ethical issues when studying in the area of migration, and to be sensitive to competing voices and methodologies in this area. In particular we need approaches that are multidimensional and that emphasize the history and context of change in social constituencies, the new mechanisms of representation within communities, the role of the political in terms of discourses and resources, and the broad play and spaces of regulation and social policy. (shrink)

Many countries find their information and digital policies still dominated by traditional stakeholders, particularly the content industry, major telecom companies, and marketing groups, yet Canada has experienced a notable shift in perspective with a strong and influential public interest voice. This shift toward public interest and participation in the development of Canadian information and digital policies has led to legislation, regulation, and policy outcomes that once seemed highly unlikely. This Article seeks to better understand the changing role of (...) the public in Canadian information and digital policymaking by framing the developments as an ongoing policy development process featuring a series of closely linked changes and responses. The emergence of public participation on information and digital policy issues occurred across a spectrum of issues, yet the traits were strikingly similar: grassroots efforts reliant on social media and the Internet to capture media and public attention and focus it on consumer perspectives, minimal interest from government and regulators; and initial dismissal giving way to hostility from incumbent stakeholders. The Article identifies some of the reasons behind the shift, including the growing importance of information and digital policies, the impact of digital advocacy tools, and the shifting policy pyramid in which users have now largely leapfrogged corporate interests as policy influencers. While the shift does not mean the public interest wins on every issue, it does suggest an important change in influence with long-term ramifications for the development of information and digital policy in Canada that others may seek to emulate. (shrink)

Three global developments situate the context of this investigation: the increasing use of social media by organizations and their employees, the burgeoning presence of social media policies, and the heightened focus on corporate social responsibility. In this study the intersection of these trends is examined through a content analysis of 112 publicly available social media policies from the largest corporations in the world. The extent to which social media policies facilitate and/or constrain the communicative sensibilities and values associated with contemporary (...) notions of CSR is considered. Overall, findings indicate that a large majority of policies, regardless of sector or national headquarters, increasingly inhibit communicative tenets of contemporary CSR and thereby diminish employee negotiation and participation in the social responsibilities of corporations. Moreover, policies generally enact organizational communication practices that are contrary to international CSR guidelines. Findings suggest that social media policies represent a relatively unrecognized development in the institutionalization of CSR communicative norms and practices that call into question the promising affordances of social media for the inclusion of various voices in the public negotiation of what constitutes corporate social responsibility. (shrink)

Over fifty years ago, Albert Hirschman argued that dissatisfied consumers could either voice complaint or exit when they were dissatisfied with goods or services. Loyal consumers would voice rather than exit. Hirschman argued that making exit easier from publicly provided services, such as health or education, would reduce voice, taking the richest and most articulate away and this would lead to the deterioration of public services. This book provides the first thorough empirical study of these ideas. Using (...) a modified version of Hirschman's account, examining private and collective voice, and viewing loyalty as a form of social investment, it is grounded on a dedicated five-year panel study of British citizens. Given government policies over the past decade or more which make exit easier from public providers, this is a timely publication for all those who care about the quality of government services. (shrink)

Advance care planning allows patients to articulate preferences for their medical treatment, lifestyle, and surrogate decision-makers in order to anticipate and mitigate their potential loss of decision-making capacity. Written advance directives are often emphasized in this regard. While these directives contain important information, there are several barriers to consider: veracity and accuracy of surrogate decision-makers in making choices consistent with the substituted judgement standard, state-to-state variability in regulations, literacy issues, lack of access to legal resources, lack of understanding of medical (...) options, and cultural disparities. Given these issues, it is vital to increase the use of patient and healthcare provider conversations as an advance care planning tool and to increase integration of such discourse into advance care planning policy as adjuncts and complements to written advance directives. This paper reviews current legislation about written advance directives and dissects how documentation of spoken interactions might be integrated and considered. We discuss specific institutional policy changes required to facilitate implementation. Finally, we explore the ethical issues surrounding the increased usage and recognition of clinician–patient conversations in advance care planning. (shrink)

The development and utility of genetically modified crops for smallholders around the world is controversial. Critical questions include what traits and crops are to be developed; how they can be adapted to smallholders’ ecological, social and economic contexts; which dissemination channels should be used to reach smallholders; and which policy environments will enable the greatest benefits for smallholders and the rural poor. A key question is how the voices of smallholders who have experience with or desire to use GM (...) technologies enter the larger debate. Africa has the greatest number of smallholders and poor with the least exposure to GM crops. Because of the well-established use of GM crops in South Africa by commercial farmers, we formed a community of practice involving smallholders, extension, researchers, non-profits and agribusiness in KwaZulu-Natal to examine the conditions under which GM crops are used by smallholders, how smallholders interact with GM technologies and what insights smallholders and other stakeholders can provide regarding these questions. One of the advantages of the CoP approach is that it brings stakeholders together in a non-hierarchical way that encourages new ways of thinking and new partnerships. Such interaction around a specific project can enhance the voice of smallholders in a variety of ways. In our project, smallholder participants have increased their knowledge and can make better decisions about GM technologies, which had been barriers for them. Notably, they have also improved their knowledge of maize production practices, accessed new practice networks, and met new researchers and resource providers. They are now being integrated into these networks in a way that should improve their livelihoods and make the wants and needs of smallholders better known. Such knowledge and experience has improved their voice in agriculture and rural development discussions. (shrink)

This paper presents a feminist analysis of corporate social responsibility in a male-dominated industry within a developing country context. It seeks to raise awareness of the silencing of women’s voices in CSR reports produced by mining companies in Tanzania. Tanzania is one of the poorest countries in Africa, and women are often marginalised in employment and social policy considerations. Drawing on work by Hélène Cixous, a post-structuralist/radical feminist scholar, the paper challenges the masculinity of CSR discourses that have repeatedly (...) masked the voices and concerns of ‘other’ marginalised social groups, notably women. Using interpretative ethnographic case studies, the paper provides much-needed empirical evidence to show how gender imbalances remain prevalent in the Tanzanian mining sector. This evidence draws attention to the dynamics faced by many women working in or living around mining areas in Tanzania. The paper argues that CSR, a discourse enmeshed with the patriarchal logic of the contemporary capitalist system, is entangled with tensions, class conflicts and struggles which need to be unpacked and acknowledged. The paper considers the possibility of policy reforms in order to promote gender balance in the Tanzanian mining sector and create a platform for women’s concerns to be voiced. (shrink)

The paper focuses on the manifestations of structural and symbolic violence against women during the communist regime by addressing the most important mechanisms and embedded beliefs that allowed the proliferation of spousal violence in communist Romania, in what I see as a continuation of the interwar patriarchal state, and a bridge to the new discriminatory policies developed by the democratic structures, after 1990.

Background The fourth section of the 1967 Abortion Act states that individuals (including health care practitioners) do not have to participate in an abortion if they have a conscientious objection. A conscientious objection is a refusal to participate in abortion on the grounds of conscience. This may be informed by religious, moral, philosophical, ethical, or personal beliefs. Currently, there is very little investigation into the impact of conscientious objection on service users in Britain. The perspectives of service users are imperative (...) in understanding the real-world consequences and potential impact of conscientious objection and should be considered when creating and reviewing policies and guidelines. This research provided a platform for women and those who can become pregnant to share their experiences and opinions at a time when these voices are largely excluded in the great tradition of Western political philosophy and law-making processes. Method Five service users were interviewed using a narrative interview approach to uncover their abortion journeys and experiences of conscientious objection. Findings The findings were presented as found poems and uncovered that doctors are not always: informing service users that they have a conscientious objection to abortion, giving service users enough information to access abortion (indirect referral), treating them non-judgmentally, and providing medically correct information. Service users did not experience burdens such as long waiting times and were still able to access legal abortion. However, service users did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred and/or were mistreated. Conclusions Findings indicate that conscientious objection could work in practice. However, it is currently failing some individuals on an emotional level, as not all doctors are adhering to guidelines. Conscientious objection in Britain needs to be addressed, to ensure service users receive fair, impartial, non-judgmental care. (shrink)

Dramatic, profound and far-reaching changes are being visited on schools worldwide that have their genesis a long way from the classroom but which impact heavily on teachers and their work. Most of this reform has been achieved with little or no involvement of teachers themselves. This book sets out to survey the contemporary context of what is happening to the work of teaching, and focuses on Advanced Skills Teachers. It shows how teachers are 'speaking' the changes that are occuring to (...) their work in protracted economically rationalist times. Arguing against the discourses of economy as the major shaping force, the authors present a persuasive case for focusing on the discourses of teaching itself as the only feasible and adequate basis on which to make sense of teaching. And by presenting a range of voices of practising teachers - allowing them to speak for themselves about the difficulty of trying to translate policy-makers' intentions into words and actions - the book graphically illustrates the devastating long-term consequences for the future of schools of poorly-conceptualised reform policies. (shrink)

Some 2000 years ago, Virgil wroteThe Georgics, a political tract on Romanagriculture in the form of a poem. Today, as aresult of rising global trade in food andagricultural products, growing economicconcentration, the merging of food andpharmacy, chronic obesity in the midst ofhunger, and new disease and pest vectors, weare in need of a new Georgics that addressesthe two key issues of our time: vigilance andvoice. On the one hand, vigilance must becentral to a new Georgics. Enforceablestandards for food safety, food (...) quality,environmental protection, worker health andsafety, sanitary and phytosanitaryrequirements, animal welfare, and appellationsmust be addressed. On the other hand, a newGeorgics must increase the range of persons whohave voice in the democratic governance of anew global agrifood system. New organizationsand institutions will be needed to accomplishthis task. (shrink)

Biomedical research policy in recent years has often tried to make such research more ‘translational’, aiming to facilitate the transfer of insights from research and development to health care for the benefit of future users. Involving patients in deliberations about and design of biomedical research may increase the quality of R&D and of resulting innovations and thus contribute to translation. However, patient involvement in biomedical research is not an easy feat. This paper discusses the development of a method for (...) involving patients in biomedical research aiming to address its main challenges. (shrink)

One of the essential ethical issues in the employment relationship is the loss of employee voice. Many of the ways employees have previously exercised voice in the employment relationship have been rendered less effective by (1) the changing nature of work, (2) employer preferences for flexibility that often work to the disadvantage of employees, and (3) changes in public policy and institutional systems that have failed to protect workers. We will begin with a discussion of how work (...) has changed in the last 20 years in countries like Australia and the United States, and then take up the issue of employees as organizational stakeholders and the ethical duties that are owed them, with special attention given to issues of power. We will then consider whether voluntary action by employers such as social auditing is sufficient to ensure equity for employees, and conclude with a discussion of how changes in public policy might ensure greater fairness in the employment relationship by bringing employers and employees together in partnership. (shrink)

This paper investigates the interaction of gender, disability and education in rural Iran, which is a relatively unexplored field of research. The responses of 10 female students with disabilities from Isfahan indicated that the obstacles they faced included marginalization, difficulties in getting from home to school, difficulties within the school building itself, and discrimination by teachers, classmates and school authorities. The data collected for the study contain a wide range of conservative gendered discourses, and show how traditional gender beliefs interact (...) with disability to aggravate the problems faced in education by young women with disabilities. It is hoped that the findings will raise awareness among policy-makers of the many formidable obstacles that make it difficult for young women with disabilities to achieve their full potential in education. (shrink)

We recognize a paradox of power and promise in the context of legislative and organizational changes in nurse regulation which poses constraints on nursing's capacity to bring voice and influence to pressing matters of healthcare and public policy. The profession is at an important crossroads wherein leaders must be well informed in political, economic and legislative trends to harness the profession's power while also navigating forces that may put at risk its central mission to serve society. We present (...) a critical policy analysis of the impact of recent regulatory trends on what the International Council of Nurses considers nursing's three ‘pillars’ – the profession of nursing, socioeconomic welfare of nurses and nurse regulation. Themes surfacing from this analysis include regulatory discontinuity, a tightening of regulatory control, and an increasingly managerial governance culture. These themes illuminate insights and strategies required to renew and revitalize the social mandate of our profession amidst a climate of urgency in the questioning of nurse scholars with respect to the future of the profession. At this historic juncture, nurses must clearly understand the implications of legislative and organizational regulatory changes to ensure the profession contributes to full capacity in achieving health and health equity globally. (shrink)

Mill advocates plural voting on instrumentalist grounds: the more competent are to have more votes. At the same time, he regards it as a ‘personal injustice’ to withhold from anyone ‘the ordinary privilege of having his voice reckoned in the disposal of affairs in which he has the same interest as other people’ (Mill 1861a, p. 469). But if electoral voice is justified by its contribution to good governance, why would it be an injustice to deny the vote (...) to those whose use of it would disserve this end? I propose the dual justification view to resolve this tension. Mill holds that electoral voice is to be justified in two complementary ways: both as communicating a person’s interests and perspective in order that they be accommodated in policy deliberations, and as advancing a vision of the common good and influencing the policy of the legislature. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Policy and the Political Life of Music Education ed. by Patrick Schmidt and Richard ColwellHung-Pai ChenPatrick Schmidt and Richard Colwell, eds., Policy and the Political Life of Music Education (Oxford: Oxford University Press, 2017)Policy and the Political Life of Music Education is a collection of discourses regarding music education policy and its practice across a wide range of perspectives and geographical background. The book, (...) edited by Patrick Schmidt and Richard Colwell, not only provides the general readership with a well-rounded basis for comprehending music education policy in various regions, but it also offers music education stakeholders’ perspectives regarding the meaning, value, and the importance of participating in policy development and its implementation.This book discusses various policy-related issues among music education systems in terms of education levels from kindergarten to higher education and institutional music education systems. It explores both general music learning and professional musician training. Further, the scope of its observations cover issues outside of the campus; for instance, the work of musicians/teachers at the community level (Chapter 11) and the hardships associated with performing organizations such as orchestras (Chapter 13). Besides, the editors survey policy implementation at national, state, local, and organizational levels in different countries and circumstances in the Anglo-American educational world as well [End Page 217] as other contexts including Brazil (Chapter 7), Taiwan (Chapter 8), and Norway (Chapter 12).The crucial issues raised in the book are also within the focus of global education; for example, multicultural education, assessment of policy/curriculum, social inclusion, and equality of access to music education. These all accord with the notion of current trends in education and provide directions for future development. Such comprehensive discussions indeed offer readers extensive information through the three sections of policy foundation, international perspectives on policy, and policy in context.The prerequisite of the overall practice of policy is to translate an education philosophy into comprehensive terms while convincing the public.1 However, many consider that policy development is the business of government, authorities, and politicians; some music educators even believe that the discourse of policy and political issues concerning music education is far beyond their control. My ongoing study also shows that a number of music educators, including school teachers, studio instructors, and student teachers, lack the understanding of and are ignorant in the interpretation of policy.2 Policy documents such as statutes, blueprints, and even curriculum guidelines/standards are often strictly followed as compelling legislation or mandates, despite the fact that public hearings, dialogues, and on-line forums are available for all stakeholders to contribute their thoughts and experiences in their on-going development and interpretation. In this book, the authors provide a clear range of views to explain the complexity of policy development and its future implementation, embracing factors such as social context, economic condition, political evolution, assessment, and research, as well as diverse populations including academics, principals, school teachers, parents, and students. Throughout the collection, cases are raised for stressing the significance of participating in policy development and implementation and, as such, nobody is a bystander.Further, this book advocates that the awareness and understanding of policy issues should be included in teacher preparation programs for better participation in and implementation of policy by teachers, while policy related masters and doctoral studies should be encouraged. This suggests that policy relevant courses in university curriculum, either at the undergraduate or post-graduate level, should be evaluated in view of cultivating students’ political literacy and, consequently, enabling them to participate more fully in their future career. This view links to Katherine Zeserson and Graham Welch’s argument (Chapter 14) that research, policy, and practice are the spinning triangle which could make music more inspiring for the next generation. Policy should not be alienated from music and its teaching; it has the ability to improve and change both. [End Page 218]David Elliott claims that all musicians, including students, are part of the artistic citizenship and therefore should develop a social-political identity and a commitment toward social change.3 Paul Woodford further expresses that children should be prepared to develop their voice for shaping the society.4 Margaret Barrett (Chapter 10... (shrink)

This article analyzes the contribution Christian ethics might be able to make to the ethical debate on policy and caregiving in health and social care in the United Kingdom. The article deals particularly with the concepts of solidarity and subsidiarity which are essential in Christian social ethics and health care ethics, and which may be relevant for the ethical debate on health and social caregiving in the United Kingdom. An important argument in the article is that utilitarian and market-driven (...) policies in the National Health Service (NHS) and the social care system have marginalized the position of the elderly and have seriously impoverished the quality of care for the elderly. The neglect of the elderly and other vulnerable groups is also the result of widespread consumerist attitudes among patients and of libertarian models of noninterference which are affirmed by a public ethos of self-sufficiency and counter-dependency. Those who need care dare not make their need known to others and ask for help, while simultaneously those who could help are so intimidated by the public affirmation of privacy and negative rights that they do not dare to offer help except if this is explicitly demanded. This distant and standoffish attitude is in an important way responsible for the fact that the voice of those in need is altogether lost to the public forum. Christian ethics puts much emphasis on responsibility and solidarity with the needy other but is not able to have much impact on the delivery of care in a secularized society and health care system like the NHS. Nonetheless, Christianity still has a powerful and respected voice, by speaking up for those who cannot speak for themselves, such as the elderly and the handicapped. Christians can find allies in the ethics of care and other relational approaches in health care ethics in order to combat libertarianism, consumerism, and utilitarianism. (shrink)

Can gender equality quality criteria developed for assessing EU internal policies be used unequivocally for evaluating EU external policies? Or might a methodological adaptation be necesary? To engage with this dilemma, the author evaluates the two-dimensional quality model of Krizsan and Lombardo and examines what a reorientation of the model would entail to better allow for the analysis of gender policy implemented outside of Europe. The author argues that to allow for an in-depth analysis of EU gender policy (...) abroad, the model’s procedural criteria ‘empowerment of women’s rights advocates’ and ‘transformation with reference to the prevailing context’ need to be brought centre stage and mainstreamed throughout the research design. The author suggests doing this by explicitly involving the views of gender activists from the national context in the analysis and using their perspectives as a touchstone for the evaluation of quality. To examine the proposed methodological model’s suitability for analysing the quality of gender policies in EU external relations, this operationalization is applied to the case of EU–South African development cooperation. The article concludes that the inclusion of gender advocates’ perspectives is necessary to avoid stereotypical, paternalist and Eurocentric ideas about the meaning of gender equality abroad and allow for a contextually grounded reflexivity on the quality of gender policy. Finally, it is argued that it is the role of feminist research to enhance women’s capacity for self-determination methodologically and to hear the voices of national actors that might otherwise not be heard in EU external relations. (shrink)

Internal due process systems are the formal mechanisms thatmany organizations use to address and resolve ethics conflicts.Problematical due process systems such asinvestigation-punishment and grievance-arbitration systemsnarrowly constrain the political and moral space needed formeaningful ethics voice, praxis, and community. The relativelyuncommon employee board and mediator-counselor types of systemscan help solve such problems. The employee board andmediator-counselor systems permit questioning not only of guiltwith respect to policy violations but also the appropriateness ofthe policies as well as potential biases in an (...) organization'sembedded tradition-system that may be contributing to unethicalbehavior. Theoretical implications for organization ethics,praxis, community, and integrative social contracts theories areexplored. Several case examples are discussed. (shrink)

After the American elections of 2016, an upset occurred with the victory of Donald Trump as the president of United States of America. From day one, he was in lime light due to his controversial polices and extremist behaviour towards Muslims and other countries of the world. Similarly, he had a very odd behaviour towards European Union and its member countries or in other words it would be accurate to say that he wanted to demolish European Union. In current scenario, (...) EU is facing multidimensional problems in the form refugee crisis from many parts of the world, Russian aggressive policies towards EU, ethnic movements in Europe, and above all critical elections in Italy, France and the Netherlands. Currently, it seems that the whole Europe is at stake and all these circumstances are leading EU towards a huge crisis. It seems that EU is facing the most difficult time period since its emergence. Critics are clearly indicating that EU could only survive with the active participation of France and Germany and that Europe needs serious changes by hearing the voice of the people and can gain its strength back by solving the major issues such as immigration problems and increased terrorism. (shrink)

In the 2000s, Turkey began to increase its efforts to transform from a model country to a central country by implementing an active foreign policy in its geopolitical region and neighboring regions. Starting from the 2000s, Turkey defined new principles guiding its foreign policy and implemented the strategies it followed. In addition to the basic foreign policy principles of Turkey in the regional and global arena, principles such as multi-vector diplomacy, proactive foreign policy, “zero problem” with (...) neighboring countries, transition from a “model country” to a “central country”, “soft power”, economic-centered foreign policy applied. At the beginning of the 21st century, Turkey increased its efforts to act as a voice in the region and emerged as a regional power. Taking a principled position, it began to actively participate in regional and international projects, geopolitical processes and solving global issues. During the rule of the Justice and Development Party (ADP), Turkey is implementing foreign policy principles based on the theory of neo-Ottomanism (New Ottomanism) founded in the 1990s, and is still pursuing the policy of spreading its sphere of influence and geopolitical influence in neighboring regions. (shrink)

From the perspectives of both an espoused core underlying value of nursing, and of public policy, the patient's voice should be central to our understanding of patient/client need, appropriate care and intervention. However, accessing and hearing the patient's voice is fraught with difficulty. Edwards reminds us that our raison d’être as nurses is human vulnerability; a vulnerability sometimes brought into sharp focus because of illness or disease. However, when people are at their most vulnerable, they are often (...) least able to identify, or indeed to express, their need – beyond the completely obvious. This paper provides a short descriptive record of one patient's experience of nursing care. This description is placed within the context of moral arguments about the nature of nursing and the impact this may have on decision‐making regarding the appropriate distribution of nursing time. One of our most acute deficits in knowledge, regarding nursing in the UK and Ireland, is a lack of knowledge of the day‐to‐day activities judgements, decisions and interventions of staff nurses at the sharp edge of patient care delivery. We also have little understanding of how, or indeed whether, staff nurses identify or articulate these activities, judgements, decisions and interventions as having a moral dimension that is rooted in respect for the needs and perceptions of the individual patient. Recent empirical work suggests that a substantial proportion of nursing time is spent in prioritizing and delegating care. We have little idea of the impact of prioritization and delegation on the quality of patient care, as perceived by the recipients of that care, our patients. It is urgent that these deficits in our knowledge and understanding are addressed. This is the case both from the perspective of providing high standards of patient care and from the point of view of linking perceptions of the moral dimension of nursing practice, organizational structure, manpower planning, nursing decisions and interventions, to patient outcomes. (shrink)

In the spring of 2013, project leaders who received funding from the John Templeton Foundation’s program “Can GM Crops Help to Feed the World?” met in England to discuss progress on funded projects and to identify common objectives and research interests. The collection of essays in this special symposium is one outcome of that meeting. This introduction provides background on the symposium’s theme of understanding the challenges to smallholder farmers having a voice. Farmer voice is important not only (...) in debates about genetically modified crops but also for policies, technologies and other efforts designed by interests seeking ostensibly to improve the livelihoods of smallholder farmers. (shrink)

ABSTRACT Political scientist James Fishkin has devised “deliberative polling” as a means to better informed, more autonomous, and more reflective participant opinion. After a deliberative poll, this improved form of public opinion can be disseminated to the general public and to policy makers so as to influence public opinion (as it is normally construed) and public policy. Close examination of the results of deliberative polling, however, suggests no evidence of a normatively desirable gain in informed, autonomous, or considered (...) opinion—as opposed to minor gains in participants' general political knowledge and in ideological constraint, which is likely attributable to the pre-packaged “expert” views set forth in the briefing materials provided to the participants. (shrink)

One of the major ethical issues in waste policy concerns the just distribution of waste facilities and the associated environmental risks. This essay provides an overview of the most important aspects to consider when assessing whether unequal exposure to waste facilities is unjust. It claims that the ethical principles that might warrant such injustices are problematic due to feasibility constraints. This is why appropriate democratic involvement in policy decisions about waste facilities is crucial. However, equal recognition of all (...) affected is given only if they all can have an effective and equal voice in policy-making about waste facilities. (shrink)