John Balint, Martin Strosberg, Sean Philpott and Robert Baker
This volume of essays is based upon the proceedings of a conference on “Ethics and Epidemics” hosted in March 2004 by Albany Medical College and the Graduate College of Union…
Abstract
This volume of essays is based upon the proceedings of a conference on “Ethics and Epidemics” hosted in March 2004 by Albany Medical College and the Graduate College of Union University in the wake of the SARS epidemic. The SARS epidemic was a stark reminder of how quickly infectious disease can spread in our era of fast and frequent worldwide travel. Furthermore, it reawakened interest in and debate about major ethical, policy, political and social issues that arise as societies respond to such acute threats to health, life and liberty. Current concerns about the threat of avian influenza, due to the H5N1 virus, and its potential to evolve into a worldwide pandemic highlight the urgent need to address these issues.
Recent criticism of the UK's public sector has rekindled the debate about public service leadership in comparison with the private sector, particularly in the context of the…
Abstract
Recent criticism of the UK's public sector has rekindled the debate about public service leadership in comparison with the private sector, particularly in the context of the financial austerity we face for years ahead. This article first reviews recent research on leadership and compares the public and private sectors, finding both commonalities and differences. The article then considers the kind of leadership required of public service leaders in the present economic climate and to handle crises and emergencies. The place of individual leadership and collective leadership and consensus is discussed, with a suggestion that charismatic individual leadership may play a more important role in the public sector than it typically has done in less turbulent times in the past. The public sector is becoming more like the private sector in this respect. The article ends with key implications of the analysis for leadership in practice.
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Matthew Wynia and his co-authors and Charmers Clark, in their two chapters, take on thorny issues concerning the moral responsibilities of physicians – and, by implication, all…
Abstract
Matthew Wynia and his co-authors and Charmers Clark, in their two chapters, take on thorny issues concerning the moral responsibilities of physicians – and, by implication, all health care professionals – regarding preparation for and response to epidemics (Clark, 2006; Wynia, Kurlander, & Green, 2006). Their chapters are especially timely, inasmuch as they address ethical challenges associated with bioterrorism, which, should it occur, could create an epidemic of catastrophic proportions, at least for the locality or localities in which the bioterrorism occurs. In this commentary, I provide a critical assessment of their chapters. I begin with a review of the foundational concept of the Wynia et al. chapter, social-trustee professionalism, and of the Clark chapter, a covenant of public trust. I then take up four issues: the moral demands of social-trustee professionalism and how the social-contract theory of medical ethics advocated by the framers of the 1847 American Medical Association Code of Ethics (American Medical Association, 1847) should be understood; social-role related obligations as ethically-justified limits on fiduciary responsibility in bioterrorism events and how such obligations should be addressed in a preventive ethics fashion by health care organizations; legitimate self-interests as ethically-justified limits on fiduciary responsibility and how such interests should be distinguished from mere self-interests and be addressed in a preventive ethics fashion by health care organizations; and the nature and limits of the standard of care in the large-scale emergencies that bioterrorism events could create.
Martyn Sloman and John Philpott
The purpose of this paper is to consider whether the shift from training to learning is related to employment categories using a categorisation popularised by Robert Reich.
Abstract
Purpose
The purpose of this paper is to consider whether the shift from training to learning is related to employment categories using a categorisation popularised by Robert Reich.
Design/methodology/approach
Collation and analysis of existing CIPD research information and assessment of labour statistics.
Findings
An examination of the national data on training reveals an uncertain picture. There is a problem surrounding data capture. In short, what is measured is training, particularly off‐the‐job training. If the definition of learning as a process is accepted, there are both conceptual and practical problems involved in measuring the move to learning in different sectors.
Practical implications
The testing of this proposition and analysis of its consequences is of critical importance. It will affect public policy – what interventions promote learning as opposed to training? It should assist in determining the research agenda. Finally it central to the role of HRD practitioners in organisations: how do they develop and implement strategies for learning as opposed to delivering training?
Originality/value
As far as the authors are aware no‐one else has explored this topic using this approach. It is a speculative investigation at an early stage but the implications are considerable.
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Karl Marx could only pen the memorable line, “the history of all hitherto existing society is the history of class struggles” because he was heir to the sanitary and public health…
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Karl Marx could only pen the memorable line, “the history of all hitherto existing society is the history of class struggles” because he was heir to the sanitary and public health reforms of the nineteenth century (Marx [1848] 1972, p. 335). The Black Death, which had wiped out much of fourteenth-century Florence and which had regularly decimated sixteenth- and seventeenth-century London, was now but a faint memory. Yet had a historian of some earlier period of European history thought to pen a line as presumptuous as Marx's, it might have read: “the history of all hitherto existing society is the history of struggle with plague or pestilence.” Epidemics and pandemics have haunted human societies from their beginnings. The congregation of large masses of humans in urban settings, in fact, made the evolution of human infectious disease microorganisms biologically possible (McNeill, 1976; Porter, 1997, pp. 22–25). Epidemics have been as determinative of the course of economic, social, military and political history as any other single factor – emptying cities, decimating armies, wiping out generations and destroying civilizations.
Laurie Zoloth and Stephen Zoloth
If you go running in Chicago in the early morning, as the first light glances and reflects on Lake Michigan, you can hear the great flocks of wild geese stirring and calling…
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If you go running in Chicago in the early morning, as the first light glances and reflects on Lake Michigan, you can hear the great flocks of wild geese stirring and calling before you can see them. They have come down from the Arctic, where the winter comes to the Midwest just as the flu season begins. They crowd in the cove with the gulls and the dogs run toward them, and they scatter and fill the air. They will land at the high school in town, in the farms along the interstate, and in the City Zoo, with the ducks and the pigeons.
The modern human rights movement, like American bioethics, was born from the devastation of World War II. The multinational trial of the major Nazi war criminals at Nuremberg…
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The modern human rights movement, like American bioethics, was born from the devastation of World War II. The multinational trial of the major Nazi war criminals at Nuremberg following World War II was held on the premise that there is a higher law of humanity (derived from natural law rules based on an understanding of the essential nature of humans), and that individuals may be properly tried for violating that law. Universal criminal law includes crimes against humanity, such as murder, genocide, torture, and slavery. Obeying the orders of superiors is no defense: the state cannot shield its agents from prosecution for crimes against humanity.
Angela Wasunna and Daniel W. Fitzgerald
No other region of the world has suffered from such devastating epidemics in the recent past than sub-Saharan Africa. HIV/AIDS poses the worst single health threat on the…
Abstract
No other region of the world has suffered from such devastating epidemics in the recent past than sub-Saharan Africa. HIV/AIDS poses the worst single health threat on the continent and approximately 28.5 million of people infected with HIV/AIDS are in sub-Saharan Africa, yet, less than 8% have access to treatment. As African countries start or continue to expand their HIV/AIDS treatment programs with the assistance of international donors, they are facing several ethical and health policy challenges, including difficult decisions on how to ration available treatment, the high cost of drugs, the complexity of treatment regimens, the inadequacy of health and delivery systems, the lack of knowledge about treatment, and the threat of drug resistance.
Research sponsored by entities in developed countries, but conducted in developing countries, has recently been the focus of academic debate, international declarations and media…
Abstract
Research sponsored by entities in developed countries, but conducted in developing countries, has recently been the focus of academic debate, international declarations and media controversy. Much of this attention has focused on whether the trials are exploitative and if so what should be done to avoid exploitation. This chapter takes Alan Wertheimer's principles of mutually advantageous transactions and applies them to the question of exploitation in international research. In this chapter, I develop an analysis of exploitation and apply this to the hypothesis that some pharmaceutical companies who run drug trials in developing countries wrongfully exploit the trial participants.