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Larry I. Palmer - One of the best experts on this subject based on the ideXlab platform.

  • The Legal and Political Future of Physician-Assisted Suicide
    2018
    Co-Authors: Larry I. Palmer
    Abstract:

    289 JAMA 2283 (2003)

  • The Legal and Political Future of Physician-Assisted Suicide
    JAMA, 2003
    Co-Authors: Larry I. Palmer
    Abstract:

    IN 1997, THE US SUPREME COURT RULED THAT THERE IS NO federal constitutional right to physician-assisted suicide (PAS) but implied that individual states could nevertheless enact statutes permitting its practice. The lower federal courts promptly upheld the constitutionality of the Oregon Death With Dignity Act, the only US state statute authorizing PAS. Many observers of the court’s opinions thought that state legislatures would determine the Future of PAS. Instead, the legal consequences for physicians and pharmacists in Oregon who assist in the deaths of terminally ill patients will be determined by litigation concerning the scope of federal drug laws now working its way through the federal appellate courts. The debate over PAS has thus been transformed into a fundamental question: Which level of government should be the primary regulator of drugs in this country—federal or state? In November 2001, the US attorney general stated that physicians legally prescribing lethal doses of drugs to terminally ill patients under Oregon’s state law would nonetheless be violating federal drugs laws. He did not, however, threaten criminal prosecution of physicians who used the Oregon statute to assist the death of terminally ill patients. Rather, he instructed Drug Enforcement Agency officials to revoke the permission of these physicians to prescribe medications. This interpretation of the federal statute took account specifically of the need of health care professionals to prescribe drugs to alleviate pain, especially of terminally ill patients. The attorney general has stated that the use of controlled substances to control pain, even if it could lead to the death of a patient, was not prohibited under the statute. In addition, he described how federal officials could enforce the federal drug laws without examining the medical records of individual patients. Federal officials were instructed instead to gather their information about violations from the state registry of physician-assisted deaths that was established under the requirements of the Oregon Death With Dignity Act. Critics have argued that this interpretation will hamper efforts to provide aggressive palliative care in Oregon. The state of Oregon and some Oregon physicians promptly filed a lawsuit seeking to block the implementation of the attorney general’s ruling, thereby once again shifting the debate back to the federal courts. (In the current round of litigation, the state of Oregon has so far prevailed in the district court.) The district court judge ruled that state legislatures, not federal officials, can define the meaning of dispensing controlled substances “in the course of professional practice,” and determine when the use of a controlled substance is used for “a medical purpose.” The district court judge reasoned that the regulation of medical practice in the United States has traditionally been the province of the states rather than the federal government—and should remain so. As such, he concluded that Oregon’s legislative declaration that prescribing a lethal dosage of drugs to terminally ill patients is legitimate professional practice should prevail over the federal government’s interest in a particular drug enforcement policy. The federal government is currently appealing the district court’s ruling to the federal appeals court, arguing that the federal government can define “medical purpose” without reference to specific state statutes. The federal government’s argument is that no single state legislature can unilaterally change the definition of “medical purpose,” as this definition provides guidelines for federal officials and prosecutors. It is unclear how the US Supreme Court will decide the issue of access to barbiturates in Oregon for PAS. The court has previously allowed the federal government to limit access to marijuana for pain relief even when a state has declared such use legal. If the federal government is ultimately successful in its suit to use federal regulation to discourage, if not halt, the practice of PAS in Oregon, this will essentially end the Political debate over legalizing PAS at the state level. Proponents of legalizing PAS could then try to persuade Congress to modify the federal Controlled Substances Act. It is not clear that Congress would be willing to assist Oregon’s attempt to be the only US state to allow PAS. In 1997, for instance, Congress enacted a statute prohibiting the use of federal Medicare and Medicaid funds for PAS. No state has in fact followed Oregon’s lead in enacting PAS statutes. At least 2 states, Maine and Michigan, have defeated ballot measures that would have allowed PAS. If these votes represent the current Political sentiment on this issue, any new initiative to legalize assisted suicide seems unlikely to succeed.

Jack H Geiger - One of the best experts on this subject based on the ideXlab platform.

  • the Political Future of social medicine reflections on physicians as activists
    Academic Medicine, 2017
    Co-Authors: Jack H Geiger
    Abstract:

    The academic discipline of social medicine has always had a Political and policy advocacy component, in addition to its core functions of research and teaching. Its origins lie in the 18th and 19th centuries, in the work of Johann Peter Frank and Rudolph Virchow, among others. Virchow’s dictum that “politics is nothing else but medicine on a large scale” highlights that most social determinants of health are Politically determined and shape population health. Yet despite intense epidemiological and sociological research on the social determinants of health, less attention has been paid to this Political and policy dimension. During the 1960s, the author and many other clinicians were directly involved in attempts to use health care institutions to foster structural change. However, the author argues that efforts to assist individual patients and more effectively manage their interactions with the health care system, as described in the articles in this issue’s special collection on “structural competency,” while worthy and useful, do not confront root causes. Going forward, efforts to effect structural change must take place outside the arena of the clinical encounter and involve interprofessional teams and collaborations with nongovernmental organizations. They should intervene directly on the structures that contribute to illness such as poor housing, income and wealth inequality, inferior education, racism and residential segregation, and toxic concentrations of extreme poverty in urban areas. Collectively, these efforts—within and outside the spheres of medicine—represent the real operative form of structural competency.

Aoife Byrne - One of the best experts on this subject based on the ideXlab platform.

  • Improbabilities abound”: Daphne du Maurier’s Rule Britannia and the speculative Political Future
    2015
    Co-Authors: Aoife Byrne
    Abstract:

    Contextualising Daphne du Maurier’s  Rule Britannia  (1970) in what I tentatively identify as a speculative books boom of the late 1960s and 1970s, this paper posits that speculative fiction as a literary category is both a broad and hybrid one, but one that is often used synonymously with science fiction. Following this observation, this paper explores the effects of du Maurier’s amalgamation of genres and intertextual resonances on the mood of suspicion, unease and desolation that pervades this speculative work. This article explores how  Rule Britannia ‘s uneasy mood speaks to an equally troubled cultural moment for Britain.  Rule Britannia  interrogates cultural and national symbols at a moment of concentrated cultural and national anxiety. Examining what it means for du Maurier to write an invasion narrative for Britain in 1972, when British identity is at a cultural and historical crossroads, this paper argues that du Maurier takes a hard look at Britain in its post-war context, drawing attention to its perceived failings, its weakened global status and its shifting national identity. Du Maurier imagines a coloniser-turned-colonised invasion narrative for a previously powerful country coming to terms with post-war economic strife, bankruptcy, Cold War global tensions and the process of decolonisation.

  • improbabilities abound daphne du maurier s rule britannia and the speculative Political Future
    Sanglap: Journal of Literary and Cultural Inquiry, 2015
    Co-Authors: Aoife Byrne
    Abstract:

    Contextualising Daphne du Maurier’s  Rule Britannia  (1970) in what I tentatively identify as a speculative books boom of the late 1960s and 1970s, this paper posits that speculative fiction as a literary category is both a broad and hybrid one, but one that is often used synonymously with science fiction. Following this observation, this paper explores the effects of du Maurier’s amalgamation of genres and intertextual resonances on the mood of suspicion, unease and desolation that pervades this speculative work. This article explores how  Rule Britannia ‘s uneasy mood speaks to an equally troubled cultural moment for Britain.  Rule Britannia  interrogates cultural and national symbols at a moment of concentrated cultural and national anxiety. Examining what it means for du Maurier to write an invasion narrative for Britain in 1972, when British identity is at a cultural and historical crossroads, this paper argues that du Maurier takes a hard look at Britain in its post-war context, drawing attention to its perceived failings, its weakened global status and its shifting national identity. Du Maurier imagines a coloniser-turned-colonised invasion narrative for a previously powerful country coming to terms with post-war economic strife, bankruptcy, Cold War global tensions and the process of decolonisation.

Dmitry Gorenburg - One of the best experts on this subject based on the ideXlab platform.

John A Shuler - One of the best experts on this subject based on the ideXlab platform.

  • a new order of things the Political Future of documents librarians and a national system of federal depository libraries
    Government Information Quarterly, 1994
    Co-Authors: John A Shuler
    Abstract:

    Abstract This article places the efforts of documents librarians to reform the Federal Depository Library Program (DLP) in an historical and Political perspective. As with many other earlier efforts of reform, the recent “Reinventing Access to Federal Government Information,” held in October 1993, would raise doubts, once again, about the public institutions and national information policy arrangements that support the Government Printing Office and its DLP. The specific reforms calling for centralized information should be abandoned. The depository library system's Political power and public convictions were never fully expressed through the program's various national administrative incarnations. Its true community purpose flows from the local conditions and information needs of each depository library community. Democratic distribution of public information must begin and end within these local areas and regions.