Rewriting the future? Biomedical advances and legal dilemmas

Developments in medical science have sparked public debate about the legal and ethical implications of new technologies. Within these debates a number of distinct discourses are evident, including discourses about the positive and negative implications of technological advances, the influence of globalisation on regulatory choice, and the challenges of articulating common values in a pluralistic society. This article argues that an understanding of these discourses is an essential part of understanding the nature of contemporary regulatory dilemmas.     

Issues surrounding a reduction in the use of internal autopsy in the coronial system

In 2003 it was estimated that 2,700 full internal coronial autopsies were performed in Queensland at a cost of approximately A$5.3 million. This large number of internal coronial autopsies (almost 95% of all matters referred to the coroner) is of concern not only due to the economic cost but also because of the public heath risks, availability of specialist staff and significant religious and cultural sensitivities surrounding internal autopsies. In 2005 the authors began research funded by the Australian Research Council (ARC) to determine if unnecessary internal autopsies are being performed in Queensland and to establish guidelines for when an internal autopsy is required. This article highlights areas of potential concern when the issue of autopsy is reviewed within the coronial system through an examination of international literature on the issue of autopsy diagnosis and error rates more generally, and through preliminary discussion of the data obtained. The article considers the role and purpose of the autopsy generally as well as within the coronial system specifically; compares diagnostic error rates in hospital autopsies with those in the coronial system; the current situation internationally with regard to internal autopsies; and finally the specific circumstances existing in Queensland.     

Translating Policies into Informal Settlements' Critical Services: Reframing,Anchoring and Muddling Through

This paper examines how policies and plans are translated into informal settlements' practice. It builds on literature on policy implementation practice and organization studies, and more particularly, it applies the concepts of reframing, anchoring and muddling through. The paper is informed by the case of Kisumu City in Kenya and its Kisumu Integrated Solid Waste Management Plan and its implementation on Kisumu's informal settlements. The plan was funded by the Swedish International Development Agency through the United Nations Human Settlement Programme and implemented from 2007 to 2009. The study is based on action research carried out by a multidisciplinary and transdisciplinary group of researchers, through focus groups, participatory workshops, collaborative action, in‐depth interviews, document analysis and observations. The paper examines what original aspects of Kisumu Integrated Solid Waste Management Plan were translated, that is, which ones faded out and which ones became stabilized into and travel as ‘best practices’ to other locations. The paper shows how the generation of ‘best practices’ can be loosely coupled with the practices that policy seeks to change. It concludes, in line with previous research in the field, how successful policy implementation is based on cultural and political interpretations rather on evidence of improved practices. Copyright © 2016 John Wiley & Sons, Ltd.     

Indigenous peoples vs peasant unions: land conflicts and rural movements in plurinational Bolivia

Agrarian reforms do not constitute linear processes: rather, they are based on the interconnection between the crystallization of land governance in formal tenure rules and the way societies organize around a set of identities and power mechanisms. This paper focuses on how the misinterpretation of this two-way relationship, in setting up a new normative framework, can generate unintended consequences in terms of conflict. The recent wave of land conflicts in Bolivia shows how changes in the allocation of strategic resources inspired by the so-called ‘politics of recognition’ triggered processes of political ethnicization and organizational fragmentation, eventually contributing to fuelling new tensions between indigenous groups and peasant unions.     

An Unusual Cause of Headache and Sudden Death of a Young Sailor—Postmortem Computed Tomography and Histological Findings of a Fatal Retroperitoneal Malignant Mixed Germ Cell Tumor

A 26‐year‐old Caucasian sailor, with no past medical history aside from headache for the last 1 week, was found dead in his cabin. The body was stored in a refrigerator on board and disembarked for autopsy 3 days later. Autopsy showed a large, nodular, necrotic and hemorrhagic retroperitoneal mass, and smaller hemorrhagic nodules in the brain, lungs, liver, and left kidney, with the brain being markedly edematous. Both testes were descended and normal. Histologically, the retroperitoneal mass showed a malignant mixed germ cell tumor comprising choriocarcinoma, embryonal carcinoma, and teratoma components. Retroperitoneal extragonadal germ cell tumors are uncommon, and this case of a young male who presented with headache and sudden death due to metastases is extremely rare.     

Experimentation at the interface of science and policy: a multi-case analysis of how policy experiments influence political decision-makers

For decades now, scholars have grappled with questions about how knowledge producers can enhance the influence of their knowledge on users and improve policy making. However, little attention has been paid to how policy experiments, a flexible and ex ante method of policy appraisal, obtain influence over political decision-making. To address this gap, an exploratory framework has been developed that facilitates systematic analysis of multiple experiments, allowing hypotheses to be tested regarding how an experiment’s institutional design can influence the views of political decision-makers. Cash’s categories of effectiveness are used to describe an experiment’s conceptual influence; being how credible, salient, and legitimate decision-makers perceive an experiment to be. The hypotheses are tested using 14 experiment cases found relevant to climate adaptation in the Netherlands, with complete survey responses from over 70 respondents. The results show that although, in general, the experiments had medium to high influence on decision-makers, institutional design does have a noticeable impact. Organisers should make choices carefully when designing an experiment, particularly in order to maintain relevance during an experiment’s implementation and to build community acceptance. Suggestions for future research include a comparison of experiment effects with the effects of non-experimental forms of appraisal, such as piloting or ex ante impact assessment.