The title of this paper deserves an explanation—or rather two explanations, one for the portion preceding the colon, the other for that following as the subtitle. The first part is derived from a short essay by Emily Perl Kingsley, written in 1987 in response to questions she had received about what it is like to raise a child with Down Syndrome.1 Kingsley suggests that planning for a child is like planning a trip to some wonderful destination—in her example, Italy. She (...) asks us to imagine the anticipation: searching out guidebooks, learning important sites to visit, the excitement at being able to see things one has heard about an entire lifetime—seeing Michelangelo's David, for instance. But, when the plane. (shrink)

Although Emmanuel-Joseph Sieyès remains amongst the most studied thinkers of the French Revolution, his views on international politics remain largely unexplored, despite his significant role in shaping the foreign policy of the French republic after 1794. This article provides a new account of Sieyès as an international political thinker and actor, drawing on published and archival materials to reconstruct Sieyès' diplomatic programme and its intellectual roots. In so doing, it challenges both the notion that Sieyès was a committed (...) practitioner of an unideological realopolitik and the common assertion that Sieyès was a follower of Immanuel Kant's famous project for perpetual peace. Instead, this article shows that Sieyès charted a distinct course, based on a plan for the ‘republicanisation’ of Europe and its reorganisation into a league of militarily and economically linked states under French hegemony, oriented towards the preservation of republicanism in a hostile world. On this basis it re-evaluates the relationship between Sieyès' and Kant's conceptions of a confederation of republican states, presenting a new account of Kant's Perpetual Peace as a curtailment of his earlier cosmopolitan and pacifist idealism in response to the international situation of the 1790s and the foreign policy pursued by Sieyès and his allies. (shrink)

The article is devoted to the review and analysis of the results of the VIII International Scientific and Practical Conference “MEDIA Education. Digital environment: between positivity and destruction 2023”, held on November 21-23, 2023 at the Chelyabinsk State University with the support of the Main Directorate of Youth Policy of the Chelyabinsk Region as part of implementing the regional Plan for the Decade of Science and Technology in the Russian Federation in the Chelyabinsk Region.

In Planned Parenthood Affiliates of Michigan v. Engler ), the United States Court of Appeals for the Second Circuit held that § 400.109 of the Social Welfare Act of Michigan ) impermissibly conflicts with the Medicaid Act ) as modified by the 1994 Hyde Amendment ), insofar as the § 400.109 only provides state funding for abortions necessary to save the life of a mother, and not for abortions resulting from rape or incest. The court held that the (...) Hyde Amendment defines medically necessary abortions that must be funded by states participating in the federal Medicaid program, and that the amendment is not merely a federal appropriations bill. (shrink)

Objective To develop an ethically, legally, and clinically appropriate ventilator allocation policy for AdventHealth Tampa and AdventHealth Carrollwood in Tampa, Florida, which could be enacted swiftly during the Covid-19 pandemic. Methods During Spring 2020, a subcommittee of the Medical Ethics Committee established consensus on the fundamental principles of the policy, then built on existing ethical, legal, and clinical guidance. Results The plan was finalized in May 2020. The plan triages patients based on exclusion criteria (imminent mortality), prognosis and expected benefit (...) of ventilation (using the Sequential Organ Failure Assessment), and change in prognosis over time. Decisions are made by committee in order to minimize moral distress among individual patient care providers. Conclusions Due to international concerns about healthcare resource shortages during the Covid-19 pandemic, hospitals need allocation policies informed by the crisis standard of care, the hospital’s ethical duty to plan for an emergency, and federal civil rights laws Policy Implications: This type of policy can serve as a model for other institutions to develop crisis standards of care resource allocation policies, which are a necessary component of disaster planning. (shrink)

In 1992, the United States Supreme Court, in Planned Parenthood of Southeastern Pennsylvania v. Casey, upheld the ruling in Roe v. Wade, namely that women have a right “to choose to have an abortion before viability and to obtain it without undue interference from the State.”1 However, since this ruling, some states have imposed regulations that greatly limit this right by restricting access. Texas is a recent example of this. Two proposed restrictions in House Bill 2, which will (...) be discussed in detail below, will force all but eight clinics that are located in metropolitan areas to shut down. The U.S. Supreme Court put the proposed restrictions on hold in October 2014, allowing several clinics to remain open while the restrictions are being appealed in the U.S. Court of Appeals for the Fifth Circuit. If the restrictions are passed, however, those clinics will be forced to shut down and, as a result, many women in Texas will be required to travel more than 100 miles in order to access a safe and legal abortion. Much of the focus of these restrictions has been on women and rightly so. However, I want to turn the attention to physicians. The requirements exacerbate unfair treatment of abortion providers compared with other physicians. Abortion providers face threats from the public—some of which turn into violent attacks—and they are often ostracized by their fellow medical practitioners. There are so few abortion providers to begin with and the proposed requirements limit these physicians’ opportunities to practice the branch of medicine of their choosing. Although the HB 2 requirements may not result in an unconstitutional undue burden on physicians, the challenges created by the bill limit physicians’ abilities to provide abortions. As a result of these limits, HB 2 creates an unconstitutional undue burden for women seeking abortions by creating barriers directed at abortion providers and clinic staff who are willing and able to provide abortions. The first of the two controversial HB 2 requirements is the admitting privileges requirement: “A physician performing or inducing an abortion must, on the date the abortion is performed or induced, have active admitting privileges at a hospital that is located not further than 30 miles from the location at which the abortion is performed or induced.”2 The second requirement is the ambulatory surgical center requirement: “The minimum standards for an abortion facility must be equivalent to the minimum standards adopted under [Texas Health & Safety Code] [...] for ambulatory surgical centres.”3 In order to meet these state-mandated obligations, some abortion clinics would have to spend more than $1 million in upgrades if they wish to remain open. The District Court decided that the ambulatory surgical center requirement places an unconstitutional undue burden on women, and that the two requirements together place an undue burden on women in Texas and especially in the Rio Grande Valley where the nearest clinic is a couple hundred miles away.4 Later, the U.S. Court of Appeals for the Fifth Circuit reversed the District Court’s decision and argued, “the admitting privileges requirement is constitutional on its face.”5 While the regulations are being appealed, the Supreme Court granted a stay of injunction, allowing about twelve abortion clinics to reopen until a final decision regarding the regulations is made. The District Court ruled that the purpose of the two regulations was to create a substantial obstacle for women seeking abortions in Texas. While the defendants argued that the regulations were designed to make abortions safer and reduce risk, the Court decided that this was not the case. An abortion, especially a first-term abortion, is a very safe procedure and is safer than many other routine surgical procedures. As stated in Planned Parenthood v. Casey, “Unnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on the right.”6 The undue burden in this case is imposed, not through restricting women’s access directly, but by restricting physicians’ freedom to perform abortions. The admitting privileges requirement has reduced the number of physicians who can perform abortions and the ambulatory surgical center requirement has reduced the number of clinics where abortions can be performed. The American Medical Association states, “[t]he Principles of Medical Ethics of the AMA do not prohibit a physician from performing an abortion in accordance with good medical practice and under circumstances that do not violate the law.”7 This means that physicians are not required to perform abortions, except in emergency situations, but can as long as the procedure is done safely and does not violate the law. The new Texas regulations, however, are so restrictive that few abortion providers, limited to only four urban areas, can legally perform abortions. Physicians do not have an absolute right to perform abortions as opposed to women who have an absolute right to have access to an abortion. Physicians do face many challenges that other professionals face in terms of obtaining qualifications and finding work. Abortion providers, however, face challenges that most other physicians do not. The restrictions imposed by these regulations exacerbate unfair treatment toward abortion providers and place further obstacles in their path in terms of providing the service they want and are qualified to provide. Both abortion clinics and abortion providers are being treated differently from other medical clinics and physicians. For instance, “grandfathering of existing facilities and the granting of waivers from specific requirements is prohibited for abortion providers, although other types of ambulatory surgical facilities are frequently granted waivers or are grandfathered.”8 Many abortion clinics cannot afford the necessary upgrades. Furthermore, it is extremely expensive to open a brand new clinic that complies with the ambulatory surgical center requirements. Being grandfathered in would be the only option available to abortion clinics that cannot afford the upgrade. However, unfair treatment of abortion clinics and providers is preventing those clinics from being grandfathered into the new system. As a result, many abortion clinics may be forced to close. Admitting privileges are proving difficult or impossible for physicians both to obtain and, for those who have already been granted privileges, to keep. Dr. Sherwood Lynn, an obstetrician-gynecologist who has performed abortions for decades, describes the process of obtaining admitting privileges and the difficulties abortion providers face. After sending in an application a physician must wait for the hospital to send them the required materials, “but if the address of the practice on the application is of an abortion provider or clinic, [the hospital] won’t send [them] the package of materials required. [They] simply can’t apply.”9 Dr. Lynn and several other physicians have surmised that hospitals are only withholding privileges from qualified physicians who perform abortions and that other physicians do not face this discriminatory treatment. Hospitals have also revoked privileges granted to physicians after learning that the physicians perform abortions. For instance, in Texas two doctors, “received notices [...] informing them that their admitting privileges to the University General Hospital of Dallas have been revoked, with the hospital’s CEO claiming the hospital was unaware they were providing abortion care and that the hospital believed such care would damage its reputation.”10 What is curious about this revocation is that, “federal and state laws [...] forbid hospitals from discriminating against doctors who perform abortions,” and yet hospitals are clearly doing just that.11 Dr. Pamela Richter, another abortion provider in Texas, had her temporary admitting privileges revoked with no explanation and because of this, the clinic where she performed abortions, Reproductive Services, can no longer provide abortions at all.12 As the hospital gave no reason for the revocation, it not clear Dr. Richter’s privileges were revoked because she performs abortions. Dr. Richter, however, has performed over 17,000 abortions and her privileges were revoked soon after HB 2 was introduced.13 According to the Texas Hospital Association, giving admitting privileges to doctors who do not work for the hospital is expensive and time-consuming but this does not account for the fact that hospitals are revoking previously granted privileges from physicians whom they learn are providing abortion services.14 As mentioned previously, the District Court found that the admitting privileges requirement and the ambulatory surgical center requirement do not further ensure the health and safety of women undergoing an abortion. Several physicians have testified to this fact. Dr. Lynn stated in an interview: The admitting privileges requirements are [...] absolutely unnecessary. If you have a number of patients waiting for procedures, and something happens and a patient needs to be transferred to a hospital, you’re not going to leave everyone else and go to the hospital. That makes no sense. You’re going to refer that person to a gynecologist at the hospital. There is no safety issue involved here. If a patient shows up with an emergency, every hospital is required to admit that patient. They have to by law.15 It is rare that complications will arise from an abortion performed in a clinic. Dr. Richter, for example, has performed more than 17,000 abortions and not once had to send a patient to a hospital because of complications resulting from the procedure. According to Dr. Lynn even if abortion providers were granted privileges to hospitals, it is unlikely that they will exercise them. In essence, having admitting privileges at a hospital does nothing to further ensure the safety of an already safe procedure. The only result of the admitting privileges requirement is to limit certain physicians’ ability to perform legal abortions. Not only do the HB 2 requirements fail to further ensure the health and safety of women, the HB 2 requirements may actually create more health risks to women who cannot access the eight remaining clinics. The first risk is that the remaining clinics would have an influx of patients that they may not be able to handle, forcing women to wait longer for an appointment. As stated by the District Court, “[e]ven assuming every woman in Texas who wants an abortion [...] could travel to one of the four metropolitan areas where abortions will still be available, the cumulative results of HB 2 are that, at most, eight providers would have to handle the abortion demand of the entire state.”16 Furthermore, “[t]hat the State suggests that these seven or eight providers could meet the demand of the entire state stretches credulity.”17 Abortion is a time sensitive procedure. It is safest when performed early in a pregnancy. The increase in patients to these remaining clinics, assuming all women in Texas can access them, will increase wait times and may force women to have abortions later in pregnancy. In the worst-case scenario, a woman would not see an abortion provider at all before viability. Such instances may be rare, but they are possible. In such cases, women’s access to legal abortions becomes impossible and thereby violate the ruling in Roe. Clinics may be able to avoid the aforementioned problems if they hire more physicians. However, there are two barriers to hiring more physicians. First, as mentioned previously, admitting privileges to Texas hospitals are difficult, if not impossible, for abortion providers to obtain. Second, given the negative treatment of abortion providers by anti-abortion groups, many physicians are not willing to perform abortions. The harassment abortion providers face is unique to those physicians and many physicians will not perform abortions for that reason. In an article published in the Austin Chronicle, anti- abortion activist Abby Johnson, “discusses how her group investigated appraisal district records to find the new location of where an Austin abortion physician plans to work.”18 Johnson states, “These abortionists are feeling the pressure from the pro-life movement in Texas. I think they feel like they’re on the run. And that’s how we want to keep it.”19 If the HB 2 requirements are passed and there remain at most eight abortion providers in Texas, these activists will concentrate on those clinics and, “the dangerous impact of their intimidation tactics will be exacerbated.”20 Even if the number of physicians needed to meet the demand in Texas can obtain admitting privileges and work at one of the remaining clinics, they may choose not to do such work because they are putting themselves at risk. The harm abortion providers face from such anti-abortion groups is not unique to Texas. There are stories from all over the country and from other countries where abortion is legal of physicians receiving death threats. Dr. George Tiller, an abortion provider in Kansas, was killed outside his church and had received numerous death threats prior to this. The HB 2 requirements are making it so that abortion providers either cannot provide their services any longer or will face increased threats and increased danger to themselves. Physicians are allowed to conscientiously object to providing medical interventions in certain circumstances for moral and religious reasons. However, there are limits on this right. According to the American Congress of Obstetricians and Gynecologists, “[w]hen conscientious refusals conflict with moral obligations that are central to the ethical practice of medicine, ethical care requires that the physician provide care despite reservations or that there be resources in place to allow the patient to gain access to care in the presence of conscientious refusal.”21 I would argue fear for one’s safety in the face of immediate threats is perhaps a stronger ground on which to refuse to provide care than a personal belief that abortion is immoral or against one’s religion. ACOG also states, “[p]roviders with moral or religious objections should either practice in proximity to individuals who do not share their views or ensure that referral processes are in place so that patients have access to the service that the physician does not wish to provide.”22 This responsibility has been largely disputed by the medical community but in cases of rape, incest, and health risks to women, referrals must be made without exception. However, under the requirements of HB 2, working in proximity to an abortion provider may not be possible because they are so geographically limited. Referrals are supposed to be made within reason. Some areas of Texas, such as the Rio Grande Valley, are up to 200 miles away from the nearest clinic that would remain open if HB 2 is passed. Referrals may simply not be feasible given the geographical distances and the decreasing number of available physicians. As mentioned above, there are two risks to the health and safety of women as a result of HB 2. The second of these is that if a woman cannot access one of the remaining clinics, she may seek out a more convenient but illegal and unsafe abortion, which is far more likely to result in a dangerous complication. Dr. Lynn states, “[b]ecause of the restrictions lawmakers impose, women will seek abortions illegally, and we’re going to see a rise in septic abortions.”23 Some areas of Texas might effectively revert back to a pre-Roe era where abortions were performed in unsanitary conditions by unqualified people resulting in dangerous medical complications far more often than legal abortion procedures do now. Physicians like Dr. Lynn who want to prevent this from happening generally cannot do so without facing legal sanction. Physicians have a duty to provide safe medical care and if they cannot obtain admitting privileges, they cannot exercise this duty. ACOG released a statement expressing their objections to the new requirements. They state that HB 2 is, “plainly intended to restrict the reproductive rights of women in Texas through a series of requirements that improperly regulate medical practice and interfere with the patient-physician relationship.”24 Executive Vice-President of ACOG, Hal C. Lawrence III stated: The Texas bills set a dangerous precedent of a legislature telling doctors how to practice medicine and how to care for individual patients. ACOG opposes legislative interference, and strongly believes that decisions about medical care must be based on scientific evidence and made by licensed medical professionals, not the state or federal government.25 Abortion is one of only a few areas of medicine where the legislature imposes so many regulations restricting particular physicians’ ability to practice medicine. Not only are abortions providers being regulated by the state, they are also facing clear discrimination from others within the medical community. The state is closing down clinics that do not meet the ambulatory surgical center requirements and hospitals are denying physicians admitting privileges because they perform abortions. In summary, abortion providers are being discriminated against both by the legislature and other members of the medical community. Other physicians who do not perform abortions are not denied admitting privileges on discriminatory grounds. Clinics that cannot afford upgrades to become an ambulatory surgical center are being grandfathered in, while abortion clinics are being forced to close down. Ob-Gyns who conscientiously object to performing abortions and who are not located in close proximity to at least one abortion provider cannot effectively fulfill their duty to refer patients. Lastly, given the barriers these regulations will create, there will likely be a rise in complications resulting from abortions provided under grossly unsafe conditions. Physicians, whose duty it is to provide safe and effective medical care, are being denied the right to exercise this duty. While this denial may not be unconstitutional, it is certainly unjust and discriminatory and creates obstacles that other physicians do not face. Most importantly, these obstacles are creating an undue burden for women. The HB 2 requirements do not increase the health and safety of abortions; all they do is create substantial obstacles for women. In light of these observations, the requirements seem to me to be in clear violation of Casey, in which it was decided that, “[u]nnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on that right.”26 These regulations do just what Casey was meant to prohibit and this is accomplished through limiting physicians’ ability to practice safe abortions across the state of Texas. Therefore, the HB 2 requirements may not impose an undue burden on doctors but they do impose an undue burden on women. PDF available: Rachel Hill, "Texas HB 2," Voices in Bioethics. References: 1 Planned Parenthood of Southeastern Pennsylvania v. Casey, pg. 2. 2 Whole Women’s Health v. Lakey, pg. 2. 3 Ibid. 4 Ibid., 4. 5 Ibid., 2. 6 Planned Parenthood v. Casey, pg. 16 7 AMA Code of Medical Ethics, “Opinion 2.01 – Abortion,” American Medical Association. 8 Whole Women’s Health v. Lakey, pg. 10. 9 Dr. Sherwood Lynn, “A Texas Ob-Gyn Details the Horrific Consequences of Abortion Restrictions,” Cosmopolitan. 10 Feminist Newswire, “Texas Hospitals Revoke Admitting Privileges to Abortion Providers,” Feminist Majority Foundation Blog. 11 Ibid. 12 Ibid. 13 Ibid. 14 Glenn Hegar, “Texas Hospital Association’s Statement of Opposition to Section 2 of the Committee Substitute for Senate Bill 5,” Texas Hospital Association. 15 Dr. Lynn, “A Texas Ob-Gyn.” 16 Whole Women’s Health v. Lakey, pg. 10. 17 Ibid. 18 Mary Tuma, “Undercover Audio Reveals Anti-Abortion Tactics: Anti-abortion activists monitor and track providers, patients,” Austin Chronicle. 19 Ibid. 20 Ibid. 21 Committee on Ethics, “The Limits of Conscientious Refusal in Reproductive Medicine,” The American Congress of Obstetricians and Gynecologists. 22 Ibid. 23 Dr. Lynn, “A Texas Ob-Gyn.” 24 “Ob-Gyns Denounce Texas Abortion Legislation: Senate Bill 1 and House Bill 2 Set Dangerous Precedent,” The American Congress of Obstetricians and Gynecologists. 25 Ibid. 26 Planned Parenthood v. Casey, pg. 16. (shrink)

In this paper, I will examine the Supreme Court of the United States’ (SCOTUS) arguments in the majority decision in Dobbs v. Jackson Women’s Health Organization, and I will show how some of those arguments are flawed. Primarily, I will show that the right to bodily autonomy is a well-established right, both in the courts and in societal practices, and that the right to an abortion should be understood as an example of the right to bodily autonomy or bodily integrity. (...) Second, I will examine the justices’ arguments that viability is not a reasonable place to restrict abortion access, in contrast to both Roe v. Wade and Planned Parenthood v. Casey, and will offer arguments that defend viability as a valid point to limit abortion access. Third, I will highlight some politicians’ goals to enact a federal ban on abortion, and show how the attempt to pass Personhood Amendments is a pathway for doing so. The upshot of this essay to is show how the SCOTUS decision is flawed, and how granting personhood to “potential life” has consequences that extend beyond abortion access. (shrink)

This case is another in a series intended to highlight the new questions emerging from advances in mapping the human genome and the application of genetic findings to clinical practice. The National Human Genome Research Institute, a component of the National Institutes of Health, by law is directed to designate a portion of its annual budget to furthering understanding of the ethical, legal, and social questions emerging from research on the human genome. As part of the effort, the Institute supports (...) research by scientists and scholars around the nation with the aim of clarifying and resolving the tough ethical and research choices facing this endeavor. But recently it has launched an intramural program, which is expected to take a catalytic role in grappling with the array of issues the researchers face in carrying out investigations in human genetics. (shrink)

Cross jurisdictional collaboration efforts and emergency vaccine plans that are consistent with Tribal sovereignty are essential to public health emergency preparedness. The widespread adoption of clearly written federal, state, and local vaccine plans that address fundamental assumptions in vaccine distribution to Tribal nations is imperative for future pandemic response.

Katrina Karkazis, Fixing sex: Intersex, medical authority, and lived experience, Durham, N.C.: Duke University Press, 2008, reviewed by Ellen K. Feder Elizabeth Reis, Bodies in doubt: An American history of intersex, Baltimore: Johns Hopkins University Press, 2009, reviewed by Ellen K. Feder.

Recent state regulations require women, before undergoing abortions, to be subjected to unwanted and nonmedically necessary sonograms, often requiring an intrusive vaginal probe. Physicians, for their part, are forced to turn the viewing screens toward the faces of their patients and to describe to them the details on the screen. In this commentary, I explain these current laws and the various court responses to them to date. Further, I demonstrate why these abortion regulations violate the ethical principles governing informed consent (...) and why they should be declared unconstitutional based on women’s constitutional rights as settled by Planned Parenthood of Southeastern Pennsylvania v. Casey and physicians’ First Amendment rights. (shrink)

On January 18, 2006, the United States Supreme Court unanimously held that the constitutional challenge to New Hampshire's Parental Notification Prior to Abortion Act would be remanded to the United States Court of Appeals for the First Circuit, to determine whether the Court of Appeals could, consistent with New Hampshire's legislative intent, formulate a narrower remedy than a permanent injunction against enforcement of the parental notification law in its entirety.In 2003, New Hampshire enacted the Parental Notification Prior to Abortion Act. (...) The Act specifies, in pertinent part, that “No abortion shall be performed upon an unemancipated minor or upon a female for whom a guardian or conservator has been appointed… until at least 48 hours after written notice of the pending abortion has been delivered....” The Act allows for three exceptions where a physician may perform an abortion on a minor child without parental or guardian notification. (shrink)

As the mother of a daughter who has and will always require care to meet her most basic needs, I have seen firsthand how critical it is to have adequate means by which to meet those needs—for her sake, mine, and my family’s. Her flourishing life has contributed to enhancing not only our own, but those of all who care for her and who enter our lives. I have wanted to see us do better by all the families who struggle (...) and have to scratch and claw their way to access services and resources their children need. I have tried in my past writings to articulate the need and the reason why we as a society, as a community, are neither just nor caring as long as we leave their needs unmet. At the same time, I have watched as .. (shrink)

This is a follow up to my article on the Multilateral Agreement on Investment (MAI) in the May issue . That went to press a few weeks before the April 27 target date for signing of the MAI by the OECD countries. At the time, it was fairly clear that agreement would not be reached, and it was not—an important event, worth considering carefully. In part the failure resulted from internal disputes—for example, European objections to the U.S. federal system and (...) the extraterritorial reach of U.S. laws, concerns about maintaining some degree of cultural autonomy, and so on. But a much more significant problem was looming. It was becoming increasingly difficult to ensure that the rules of global order would continue to be “written by the lawyers and businessmen who plan to benefit” and “by governments taking advice and guidance from these lawyers and businessmen,” while “invariably, the thing missing is the public voice”—the Chicago Tribune’ s accurate description of the negotiations for the MAI, as well as ongoing efforts to “craft rules” for “global activity” in other domains without public interference. It was, in short, becoming more difficult to restrict awareness and engagement to sectors identified by the Clinton administration, with unusual and unintended clarity, as its “domestic constituencies”: the U.S. Council for International Business, which “advances the global interests of American business both at home and abroad,” and concentrations of private power generally—but crucially not Congress (which had not been informed, in violation of Constitutional requirements) and the general public, its voice stilled by a “veil of secrecy” that was maintained with impressive discipline during three years of intensive negotiations. (shrink)

Pollitt and Bouckaert and their neo-Weberian state (NWS) have been chosen as the subject for this essay because the book has become a standard work in the public management movement. It is frequently cited and has been re-published in multiple editions (most recently in 2017). The authors also refer explicitly to Max Weber.This contribution seeks to draw attention to three important aspects, which inevitably overlap with one another:1. There is no Weber in the neo-Weberian State (introduction, 1; section II). Pollitt (...) and Bouckaert fail to grasp that Weber’s understanding of the state [the state as an “institution” (Anstalt); and the state as an “idea of validity” (Geltungsvorstellung)] is not identical to his ideal type of modern bureaucracy; it is the features of the latter on which they draw. The ideal type is a standard measure constructed in order to establish how close any concrete, given instance of bureaucracy comes to it (introduction, 3). Meanwhile, the “neutral official” insisted upon by Weber has “taken their leave” in Germany from important positions (section III, 3). Furthermore, Weber did not address those structures and processes internal to the administration which are precisely the object of interest for the new public management reformers. Weber’s lack of interest arises from the fact the members of anAnstalt, whether it is the state or the Church (WuG, § 15, no. 2), are subject to imposed orders (oktroyierte Ordnungen) and, as such, do not enjoy the “right to have a say”. Scharpf (1973a) was the first to pay particular attention to the problems brought about by specialisation and by the division of labour within the administration that are responsible for an incremental form of politics (section III, 3); even if he later ascribes advantages to the combination of “negative” and “positive coordination” (Scharpf 1991: 18ff.).2. The “legalistic culture” that characterises Germany will be considered in a more differentiated way, drawing on empirical studies which provide information, for example, on how laws (i.e. programmes)actuallyoriginate inside the ministerial apparatus (introduction, 2; section III, 2 and 3) or how use is made of the power of authority (Weisungsrecht) in practice (introduction, 2; section III, 2 and 3), even when, formally, it claims to have validity (section III). In this way, only empirical studies (Benz 1994; Bohne 1981; Dose 1997; Dose/Voigt 1995; Treiber 2007a) prove that the administration that implements laws has often, in practice, become a “negotiative administration” (introduction, 2). Such a phenomenon as a “co-operative administration”, which negotiates rather than rules, is a “foreign concept” in Weber’s discussion of the state and modern bureaucracy. Scharpf’s (1970) comparison between constitutional governance in Germany and legal relief in America is enlightening when it comes to the meaning of the constitutional state (Rechtsstaat) (introduction, 2; section III); the same applies to his discussion of the failed federalist reforms, which sought, among other things, to mitigate, if not entirely eliminate, the opportunities for blockades provided by political entanglement (Politikverflechtung) (section III). Neither was it possible to realise long overdue proposals to reform administrative law (Verwaltungsrecht) (section III, 1), which involved weakening or removing altogether three important assumptions in the dominant administrative doctrine (the “dogmatic normality”) and which also included the ambitious intention for the law to achieve tangible impact (Hoffmann-Riem 1994). Nonetheless, while no-one would dispute that reform of the federal government and administration remained “on the agenda” (Scharpf 1991, Mayntz/ Scharpf 1973), the priorities of such a reform were, and still are, different to those of new public management reform [the key terms here arePlanung(“planning”) and the term that replaced it,Steuerung(“management”)]1.3. Pollitt and Bouckaert ascribe to the neo-Weberian state extremely varied functions without providing any (theoretical) basis for them. In this way, the notion of public management reform that they present acquires the status of a “reformist philosophy” (introduction, 3; section IV). See Scharpf (1991) for a theoretically well-founded argumentation on the State’s ability to act in our days. Scharpf’s essay will be discussed briefly (section IV).ConclusionThere is no Weber in the neo-Weberian state. According to the discussion presented here, the neo-Weberian state can only mean: how would a modern state constituted by Weber look today? (shrink)

Polarization in Western democracies and the collapse of centrally planned economies have led to calls for a redefinition of the state's core functions. This volume explores shifting conceptions of constitutional political economy anchoring the state from the viewpoints of theory, systems, and applications. It suggests why changes may be desirable and how these might be implemented. Part I addresses the writing of constitutions, the dynamic between constitutional order and civil society, the struggle between competitive and protectionist interests, the conflict (...) between protecting expectations and moral evolution, and the role of cultural explanations of constitutional development patterns. Part II explores the interplay between electoral systems and constitutional engineering, the internal costs of political coalitions, and campaigns in pluralistic elections. Part III investigates the quest for stable, dynamic federal states with particular attention to opportunities and pitfalls in Europe. With a foreword and contributions from Nobel Laureate James M. Buchanan. (shrink)

The Universal Core (UCore) is a central element of the National Information Sharing Strategy that is supported by multiple U.S. Federal Government Departments, by the intelligence community, and by a number of other national and international institutions. The goal of the UCore initiative is to foster information sharing by means of an XML schema providing consensus representations for four groups of universally understood terms under the headings who, what, when, and where. We here describe a project to create an (...) ontology-based supporting layer for UCore, entitled ‘Universal Core Semantic Layer’ (UCore SL), and describe how UCore SL can be applied to further UCore’s information sharing goals. (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...) distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

L’article traduit pour Clio HFS est le premier chapitre de Writing Women’s History : International Perspectives (1991), premier ouvrage édité par La Fédération internationale pour la recherche en histoire des femmes née en 1987. Il dissèque six dichotomies qui ont permis ou permettent encore de penser les relations entre hommes et femmes et l’écriture de leur passé. Si les trois premières (nature/culture, travail/famille, public/privé), profondément inscrites dans la culture occidentale moderne et source de hiérarchies et d’exclusions, ont été à (...) la fois utilisées et contestées par les historiennes des années 1970 et 1980, trois nouvelles ont surgi des débats intellectuels et politiques (sexe/genre, égalité/différence, intégration/autonomie). Ces nouvelles dichotomies doivent être aussi déconstruites et dépassées, pour aller de l’avant sur le plan politique et historiographique. (shrink)

Pour compléter ce numéro, nous avons voulu échanger avec Krassimira Daskalova, professeure d’histoire contemporaine à l’université St. Kliment Ohridski de Sofia. Ses recherches personnelles sur la Bulgarie et les Balkans, mais aussi ses activités de coordination de la recherche – qui l’ont conduite, notamment, à présider l’International Federation for Research in Women’s History entre 2005 et 2010 – font de K. Daskalova une actrice de premier plan dans le développement de l’histoire des femme...

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 22 (2002) 201-202 [Access article in PDF] Conference on Pure Land Buddhism in Dialogue with Christian Theology James Fredericks Loyola Marymount University As Charlie Parker devotees will attest, improvisation at its most thrilling, if not its most ingenious, is often the result of careful planning. Cannot something similar be said of interreligious dialogue? All our planning and study are best put to use when they suddenly become (...) mere prologue to an encounter that has forced us off the well-trodden path. A dialogue meeting at Loyola Marymount University, September 9-14, 2001, began with much planning and became highly improvisational on September 11th.The roots of this conference go back to discussions between Dennis Hirota and myself in Kyoto in 1998-1999. The two of us are interested in contributing to the future development of Shin Buddhism by placing it in dialogue with Christian theology. The focus here is on Christian theology as one aspect of Christianity's response to the modern world. We are both interested in investigating various theological methods as Christian responses to modernity, and the contributions these methods have made to the reform and renewal of Christian institutions. The ulterior purpose of these investigations is to think in new ways about how a Buddhist "theology" might contribute to the institutional reform and religious renewal of Shin Buddhism.A first dialogue meeting was held at Chikushi Jogakuen University (Dazaifu, Japan) in June of 2000. Participants included faculty from Chikushi Jogakuen, Charlie Hallisey (then of Harvard University), Peter McCormick (International Academy for Philosophy, Liechtenstein), and me (Loyola Marymount University). A second meeting was held at Loyola Marymount in September 2001. For one week, beginning September 6th, meetings were held at the Shin Buddhist temple and a neighboring Roman Catholic parish in the Little Tokyo district of Los Angeles, followed by an academic conference at Loyola Marymount starting on Monday, September 10th. These meetings brought together faculty from Chikushi Jogakuen and Loyola Marymount, Shin Buddhist specialists from the Eastern Buddhist Society in Tokyo, ministers from the Los Angeles Nishi and Higashi Honganji Temples, Charlie Hallisey (Wisconsin), and John Ross Carter (Colgate University). The visiting Buddhists had a chance to meet with the Buddhist-Catholic dialogue group in Los Angeles. Papers were presented on a number of subjects, including (1) Christian theology's [End Page 201] contribution to institutional reform and religious renewal in recent Roman Catholic history and its implications for Shin Buddhism in both the United States and Japan; (2) theological method and moral theology in relation to end of life issues from both a Shin and Christian perspective; (3) truth and history in interreligious understanding; (4) Shin Buddhism, Christianity and religious responses to social discrimination; and (5) Christian theology as a stimulus to the development of a Shin Buddhist theology.On the morning of September 11th, dialogue as formal academic presentations ended and dialogue as spontaneous improvisation began. With U.S. air transportation closed down by the federal government, prospects for return flights to Japan were indefinitely postponed. A planned outing to watch Ichiro Suzuki (of the Seattle Mariners) play the Angels had to be canceled (Anaheim stadium was also closed). Instead, Christians and Buddhists, Americans and Japanese suddenly were brought together in ways they could not have predicted and began to improvise. The campus ministry of Loyola Marymount organized an impromptu mass for the entire university on the evening of September 11th. The Buddhist visitors were given a place of honor at the liturgy and publicly welcomed as guests of the Catholic community. The psalm response for the mass was a musical setting of the words, "Shepherd me oh Lord, beyond my wants, beyond my fears, from death into life." In the days that followed, this text became the basis for very affecting conversations among the Buddhists and the Christians in response to the terrorist attacks. From the Shin perspective, Buddhists were able to bring a depth of meaning to these words even as they were interested in what the psalm might mean to Christians.Like improvisation in jazz, interreligious dialogue is sometimes at its... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"It Not the Only One":Womanist Resources for Reflection in Buddhist StudiesCharles HalliseyGood writers teach me that there is a world in our eye, but it not the only one.—Emily Townes1In this paper, I wish to consider some of the resources Womanism offers to those of us in Buddhist Studies that we can profitably take up for reflection as we look to the futures that our academic community can have.2 (...) At the outset of this essay, however, I am aware that some scholars of Buddhisms—whether their work is grounded in philology or historiography, or they also consider themselves engaged in Buddhist critical and constructive reflection—may, upon hearing my intent to explore this topic, react with their own versions of Tertullian's expletive, "What has Athens to do with Jerusalem?"3 It is with the possibility, indeed likelihood, of that expletive in mind that I want to make the case that Womanist analysis invites Buddhist Studies on a productive journey and suggests new interpretive possibilities. Womanism opens up a critically self-conscious space that helps us to reflect upon what we want to know and how we do know. What I have in mind is the lesson offered by Emily Townes, a Womanist ethicist, when she says, "Good writers teach me that there is a world in our eye, but it not the only one."4Over the years, I have had numerous occasions when speaking to students about their plans to pursue graduate work in the study of Buddhism to remember a question put to me by my own teacher, John Ross Carter. It happened when I was still an undergraduate and I was considering going to graduate school to continue studying Buddhism. He listened carefully to what I had to say, and when I was finished he said, "It all sounds good, quite good, but I only have one question. What good is it for anyone else?" Now, perhaps more than then, I see just how important that question is, both personally and institutionally; it is one that we should ask ourselves over and over. The institutional force of the question—what good is Buddhist Studies for anyone else besides those who engage in it?—is perhaps felt especially acutely today, [End Page 73] as the finances of higher education shift around us, and especially as the finances of international education shift around us, as with recent cuts in funding for the Title VI Language and Area Studies Programs and other federal programs that for decades have sustained American higher education in fields like Buddhist Studies.5Those of us in Buddhist Studies have many talents, both ones that we are born with and others that we learn and cultivate, but how are we servants, faithful servants, to others, in the sense that we nurture our professional talents for the benefit of others? In a personally significant way, my participation in the gatherings of Womanists to read Buddhist texts together was a small, ad hoc answer to my teacher John Ross Carter's question. Maybe what I had learned in getting my "union card" in Buddhist Studies and after, and in developing my abilities to be what Carolyn Medine calls a professional reader, could be good for these Womanists.From reading Buddhist texts with Womanists, I had come to a renewed sense of what the humanities are good for in our contemporary universities. I also had come to know that there is no single reason individual Womanists come to be interested in Buddhism, although their varied motives can be gathered together in Womanist self-reflection upon a present and particular moment in Womanism's evolving trajectories, a present moment that Melanie Harris and others have called "a third wave" in Womanism.6 But even in my limited experience, I could see that some Womanists had become involved in Buddhist practice personally, seeing in Buddhism a religion that is, as Alice Walker once put it, "mature enough for us"; other Womanists had begun to explore Buddhism because they saw possibilities in Buddhist meditation for the sort of "self-care" they felt was one of the talents Womanists need to cultivate among themselves... (shrink)

Smart grids are rolling out internationally, with the United States nearing completion of a significant USD4-plus-billion federal program funded under the American Recovery and Reinvestment Act. The emergence of smart grids is widespread across developed countries. Multiple approaches to analyzing the benefits of smart grids have emerged. The goals of this white paper are to review these approaches and analyze examples of each to highlight their differences, advantages, and disadvantages. This work was conducted under the auspices of a joint U.S.-China (...) research effort, the Climate Change Working Group Implementation Plan, Smart Grid. We present comparative benefits assessments of smart grid demonstrations in the U.S. and China along with a BA of a pilot project in Europe. In the U.S., we assess projects at two sites: the University of California, Irvine campus, which consists of two distinct demonstrations: Southern California Edison’s Irvine Smart Grid Demonstration Project and the UCI campus itself; and the Navy Yard area in Philadelphia, which has been repurposed as a mixed commercial-industrial, and possibly residential, development. In China, we cover several smart-grid aspects of the Sino-Singapore Tianjin Eco-city and the Shenzhen Bay Technology and Ecology City. In Europe, we look at a BA of a pilot smart grid project in the Malagrotta area west of Rome, Italy, contributed by the Joint Research Centre of the European Commission. The Irvine sub-project BAs use the U.S. Department of Energy Smart Grid Computational Tool, which is built on methods developed by the Electric Power Research Institute. The TEC sub-project BAs apply Smart Grid Multi-Criteria Analysis developed by the State Grid Corporation of China based on the analytic hierarchy process with fuzzy logic. The B-TEC and TNY sub-project BAs are evaluated using new approaches developed by those project teams. JRC has adopted an approach similar to EPRI’s but tailored to the Malagrotta distribution grid. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics ConsultationPat Milmoe McCarrick (bio)(John La Puma, M.D., from the Department of Medicine at Lutheran General Hospital in Chicago, contacted the National Reference Center for Bioethics Literature and suggested bioethics consultation as a topic for the Scope Note Series. He provided an extensive list of citations about ethics consultations collected by him and by David Schiedermayer, M.D., for their new book Ethics Consultation: A Practical Guide.)In Ethics Consultation in (...) Health Care, editors John Fletcher, Norman Quist, and Albert R. Jonsen (I, 1989) define ethics consultation as "the provision of specialized help in identifying, analyzing, and resolving ethical problems that arise in clinical care. In medical ethics the area of consultation has grown rapidly since 1978 when Edmund D. Pellegrino (II, 1978) noted, "we cannot separate technical-moral decisions from the philosophic principles we use to justify them. Medicine and ethics must be engaged with each other at every level."In 1980 Albert Jonsen raised the question of whether an ethicist could be a consultant and said that the ethicist as consultant is a casuist, one whose moral reasoning is based on a system of reasoning that is applied to particular cases. He describes historical casuistry in Western culture, comparing it to modern moral philosophy, and suggests that a "new casuistry seems timely" for ethics consultation (II, Jonsen 1980). By 1984 ethicist Ruth Purtilo recorded her thoughts following an ethics consultation. She raised questions about the ethicist's place on a hospital staff and how to make that role appropriate and beneficial to all concerned, saying that "the ethicist retreats after the consultation; under no circumstances would the outcome of an ethics consultation be that the ethicist became the primary care giver or assumed ongoing responsibility for the clinical management of a case" (II, Purtilo 1984). Nevertheless, in 1992 two physician-ethicists who had been called as ethics consultants for a patient who had requested that he be removed from his ventilator reported that they became the persons who turned off the ventilator and administered the drugs that eased his dying (II, Edwards and Tolle 1992).In recognition of the growing number of persons identifying themselves as [End Page 433] consultants, the Society for Bioethics Consultation was founded in October 1985 as a professional society of persons engaged in bioethics consultation. It encourages and supports consultation, assists in establishing clinical education programs, and raises funds for consultation education. Although the Society has no permanent office, the president (currently, George Kanoti in the Cleveland Clinic Foundation's Bioethics Department) conducts its work and plans an annual meeting.The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) established new criteria concerning ethics in its 1992 Manual (III, JCAHO 1992) and in a special issue of QRB devoted to ethics consultation (I, Defining Quality 1992). These publications undoubtedly have contributed to the increased use of experts in medical ethics. The Manual notes that all organizations seeking accreditation should have some sort of "mechanism for the consideration of ethical issues arising in the care of patients and to provide education to care givers and patients on ethical issues in health care." A health care institution's eligibility for JCAHO accreditation, which is required for federal reimbursement, requires adherence to this specification (III, JCAHO 1992).The new International Directory of Bioethics Organizations provides an index of 129 different groups that indicated to the authors that they offer bioethics consultations. Of these, 83 are in the United States and 46 are in other countries. The ethics consultants included in the directory encompass a broad group of professionals who will assist patients, families, and primary care medical staff in finding solutions to ethical dilemmas resulting from use of new technologies or new treatments in health care. Consultants often come from the health fields: physicians, nurses, and other health personnel, but other professionals are also active as ethics consultants. Lawyers, pastoral counselors, philosophers, and social workers also offer bioethics consultation services (III, Nolen and Coutts 1993).Drs. Siegler, Pellegrino, and Singer wrote in 1990 that "Physician-ethicists and professional ethicists will continue to work side by side in the future. One is not likely to replace the other, nor is this desirable, because... (shrink)

In the article the attitude of the social and political elite to the existence of independent Ukraine. For this purpose analyzed the major geopolitical concepts and legal documents on foreign policy that defined the Russian policy on post-Soviet states during the 1990s. Common to all these works have analyzed the declaration of the Russian Federation Centre the former Soviet Union and former Soviet territory republics - the Russian zone of vital interests. Also, attention is focused on the plans of (...) the Russian social and political elite to restore the former USSR new association with the dominant role of Russia in it. The emphasis is on the negative perception of independence of Ukraine in the Russian social and political thought. Also accented Russian politicians to substantiate the need to restore political unity of the Slavic peoples, to return the "natural" geopolitical status of Russia, provide a geopolitical control over the territories that were part of the USSR. Political, economic, military and informational relationship between Ukraine and Russia in terms of Russian politicians, the long-term national interests of Russia. On the contrary same integration of Ukraine to other international entities threat to the Russian Federation and the plan of building a "Great Russia". The influence of these concepts on the formation of foreign policy strategy, particularly in the current policy of Russia towards Ukraine. It is assumed that it is the political rhetoric of the Russian national patriots and left gave impetus to the efforts of great practical implementation of their geopolitical goals, including through the brutal interference in the internal affairs of Ukraine. (shrink)

This paper reviews codes of ethics and codes of conduct from different countries. The differences and similarities between code content and between attitudes are considered. Distinction is drawn between a code of ethics and a code of conduct. Recommendations are made for establishing a common framework for IFIP (International Federation for Information Process) Member or Affiliate Societies.

In the spring of 1937, the University of Chicago Press mailed hundreds of subscription forms for its latest enterprise – a projected series of twenty short monographs by various philosophers and scientists. Together the monographs were to form the first section of the International Encyclopedia of Unified Science. Included in each mailing was an introductory prospectus which began:Recent years have witnessed a striking growth of interest in the scientific enterprise as a whole and especially in the unity of science. (...) The concern throughout the world for the logic of science, the history of science, and the sociology of science reveals a comprehensive international movement interested in considering science as a whole in terms of the scientific temper itself. A science of science is appearing. The extreme specialization within science demands as its corrective an interest in the scientific edifice in its entirety. This is especially necessary if science is to satisfy its inherent urge for the systematization of its results and methods and if science is to perform adequately its educational role in the modern world. Science is gradually rousing itself for the performance of its total task. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Another Bioethics Commission?Renie Schapiro (bio)Ever Since the Ill-Fated Biomedical Ethics Advisory Committee (BEAC) ended almost before it began a few years ago, bioethicists and the members of Congress who take an interest in them have wondered whether a governmental commission is still a feasible way to address bioethics issues.The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in the 1970s, and the President's Commission (...) for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research in the early 1980s, have generally received high marks for their work. But since the expiration of the President's Commission in 1983, no federal body has been able to sustain the momentum.Tempers around the abortion issue couldn't be tamed enough even to elect a board chairman for the BEAC, or for the body to begin studying the issues. From its inception, abortion politics threatened to dog its work.Both the National Commission and the President's Commission studied issues touching on the abortion question. The President's Commission reported on genetic screening. The National Commission looked at fetal research. Both were able to produce respected reports that largely steered clear of the abortion acrimony.But that was then. The question facing policy makers inside the Beltway is how we can learn from the past experiences to make some new body work now. The question extends far beyond the abortion issue, of course.When certain people in Washington start asking questions, the answer usually comes by way of a study. Sometimes, as in this case, more than one study.In the March 1992 issue, this Journal reported on an Institute of Medicine study on ethics commissions. That study is still underway. It is scheduled to be completed in January 1994.More recently, the Office of Technology Assessment (OTA), an arm of Congress, also took on the issue. The OTA project is intended to be a quicker, more confined study. It began last fall and a final report is expected later this month.The primary force behind the OTA study is Senator Mark Hatfield. In a September 8, 1992 letter, co-signed by Senators Edward Kennedy and Dennis DeConcini, he asked OTA to prepare a background report to assist Congress in [End Page 77] "determining what is the best approach to explaining policy problems with biomedical and ethical dimensions."The letter noted: "As the 21st Century approaches, Congress will face policy dilemmas for which an informed decision can only be made through understanding not just the legal or economic dimensions of the questions, but the ethical considerations as well."Hatfield's interest in bioethics issues over the past few years has centered largely on biotechnology, and particularly patent rights. He had planned to introduce legislation to put a moratorium on patenting of genetically altered organisms, which according to Hatfield staffer Douglas Pahl caused a "firestorm" in the biotechnology community.As a result, Kennedy and DeConcini said they would hold hearings on the issue if Hatfield would withdraw the amendment. The three agreed to request a short-term OTA report on possible governmental structures for dealing with bioethics issues and a longer report looking at patenting issues.In their letter, the three senators asked OTA to prepare a history of bioethics in public policy. Referring specifically to the past commissions, they asked, "What lessons can we learn from each of these—or similar—entities? What worked, or did not work, and why?" The request also asked OTA to examine international institutions.In response to the request, OTA held a workshop entitled "Biomedical Ethics in U.S. Public Policy" on December 4, 1992. It brought together 15 people who had participated in commissions—from local to international—as well as observers of these bodies and health professionals who used their products.1According to project director Robyn Nishimi, the workshop was meant to be a free-wheeling discussion. Although there was no total consensus, the focus of the discussion tended to be on how to make a commission function effectively, rather than on whether there should be one. That workshop will be part of a report of about 40-60 pages OTA hopes to... (shrink)

Abstract The values of the healthcare sector are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. But their ability to honor these values is significantly determined by the nature of the system they work in. -/- The paper starts with a model of the prevailing pharmacist workforce model in Scotland, in which core roles are predominantly separated into hierarchically disaggregated jobs focused on (...) one professional ‘pillar’: Clinician /Practice Provider; Educator; Leader/Manager; and Researcher. This is the ‘Atomistic’ Model. This skills-segregation yields a workforce of individuals working in isolation rather than collaborating together, and lacking a shared information flow, purpose and identity. Key strategic flaws include suboptimal responsiveness to population and subpopulation needs, inconsistency and inequity of care, an erosion of professional agency, and lower job satisfaction. It is conjectured that this results from a lack of congruence between values, professional ethos, and organizational structure. ‘Atomism’ culminates in a syndrome of widespread professional-level cognitive dissonance. -/- The paper contrasts this with a new emerging workforce vision, The Collaborative Care Model. This new model defines a systems-first-approach, built on the principle that all jobs must include all four professional ‘pillars’. Vertical skills integration, involving education and task sharing, will support sustainability and succession planning. Horizontal skills integration (across practice, leadership and research) is included to improve responsiveness to population need and individual professional agency. The working conditions, supportive ethos, and career structure needed to make the model work are described. Moral theory and workforce theory are used to justify why the model may be more effective for population health, delivering greater job satisfaction for individuals and ultimately helping systematically realize and honor healthcare values. Finally, the paper sketches the first steps needed to implement the model at the national level, starting with the operationalization of new multi-pillar professional curricula across the career spectrum. Potential pitfalls and challenges are also discussed. -/- Co-Authors: 1. Paul Forsyth (PF) Lead Pharmacist Clinical Cardiology, Pharmacy, NHS Greater Glasgow & Clyde. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Writing - original draft (lead author), Writing - review & editing (lead author) 2. Andrew Radley (AR), Consultant in Public Health Pharmacy, NHS Tayside. Contribution: Conceptualization; Model curation; Model Theory; Writing - review & editing 3. Gordon Rushworth (GR), MPharm MSc FFRPS FRPharmS (Consultant). Programme Director, Highland Pharmacy Education & Research Centre, NHS Highland, Inverness. Contribution: Model curation; Writing - review & editing 4. Fiona Marra (FM) National Lead Clinician Scottish Infection and Immunology Network (SPAIIN) / Advanced Pharmacist HCV / HIV, NHS Greater Glasgow & Clyde. Contribution: Model curation; Writing - review & editing 5. Susan Roberts (SR) Associate Postgraduate Pharmacy Dean, NHS Education for Scotland. Contribution: Model curation; Writing - review & editing 6. Roisin O’Hare (RO) Lead Teacher Practitioner Pharmacist, Northern Ireland University Network, Southern Health and Social Care Trust. Contribution: Model curation; Writing - review & editing 7. Catherine Duggan (CD) Chief Executive Officer, International Pharmaceutical Federation (FIP). Contribution: Model curation; Writing - review & editing 8. Barry Maguire (BM) Senior Lecturer, School of Philosophy, Psychology and Life Sciences, The University of Edinburgh. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Supervision; Writing - original draft (senior academic supervisor), Writing - review & editing (senior academic supervisor) -/- . (shrink)

This paper reviews codes of ethics and codes of conduct from different countries. The differences and similarities between code content and between attitudes are considered. Distinction is drawn between a code of ethics and a code of conduct. Recommendations are made for establishing a common framework for IFIP (International Federation for Information Process) Member or Affiliate Societies.