Desorganisation mit System

Zusammenfassung In der Diskussion über die Entwicklung westlicher Wohlfahrtsstaaten spielte zuletzt eine wachsende Rolle, wie und mit welchen Auswirkungen sich deren Steuerungssysteme ver?ndern. Als ein wesentliches Merkmal des Wandels gilt die Aufwertung nicht-staatlicher Instanzen und marktf?rmiger Koordinationsmechanismen. Bezüglich der Interpretation der Ver?nderungsdynamik stehen sich allerdings verschiedene Diagnosen gegenüber. Ausgehend von einem ganzheitlichen Konzept der „governance of welfare” und mit einem Fokus auf die Praxis nicht-staatlicher Tr?ger der Wohlfahrtsproduktion wird untersucht, inwieweit diese Diagnosen den Wandel zutreffend charakterisieren. Die Analyse nimmt zwei Organisationsfelder aus drei verschiedenen L?ndern in den Blick, um zu prüfen, ob l?nderübergreifende Transformationstendenzen auszumachen sind. Sie zeigt, dass sich überall eine Konstellation abzeichnet, in der soziale Wohlfahrtsproduktion einer spezifischen Vermarktlichung sowie neuartigen Formen der sozialstaatlichen und zivilgesellschaftlichen Moderation unterliegt. Auf diese Weise entsteht „Desorganisation mit System”, d.h. eine Neuordnung, in der es durchg?ngig mehr Kreativit?t und ebenso durchg?ngig mehr Output-Heterogenit?t gibt — was systematisch zu mehr, aber unübersichtlicherer Ungleichheit führt.

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Summary Recent debates on the evolution of Western welfare states have paid increasing attention to the recasting of governance systems and its consequences. An increasing importance of non-public agencies and market-based coordination mechanisms are deemed to be key elements of this change. However, there are varying approaches to the interpretation of this transformation. Drawing on a holistic understanding of the governance of welfare and setting the focus on the activity of nonpublic providers, this article explores whether these approaches do adequately grasp the dynamics of change. Two organisational fields from three different countries are considered in order to examine if cross-country tendencies of transformation can be singled out. It is shown that, by and large, a new constellation takes shape, with the provision of welfare becoming subject to a specific type of marketization and to new patterns of statutory and civic mediation. The result is systemic disorganization, i.e., a new regime producing, as a principle, more creativity but also more output heterogeneity, the consequence being increasing albeit opaque inequality.

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Résumé Les mutations des systèmes de protection sociale et les effets qui en découlent ont pris récemment une place de plus en plus centrale dans le débat sur l’évolution des Etats providence occidentaux. La montée en puissance des instances non-étatiques et des mécanismes de coordination par le marché est considérée comme une caractéristique essentielle des mutations en cours. Cette dynamique de changement fait l’objet d’interprétations divergentes. Cet article se propose de vérifier la pertinence de ces interprétations en partant du concept général de„gouvernance de la protection sociale“ (governance of welfare) et en se focalisant sur la pratique des acteurs nonétatiques de la protection sociale. Notre analyse porte sur deux champs organisationnels dans trois pays différents afin de déterminer si des tendances internationales se font jour. Elle démontre qu’une conjoncture se dessine partout dans laquelle la protection sociale est soumise à des modes spécifiques de commercialisationainsi qu’à de nouvelles formes de médiation étatique et sociale. Nous assistons ainsi à une „désorganisation méthodique“ de la protection sociale, c’est-à-dire à l’émergence d’un nouvel ordre social générant, dans l’ensemble, plus de créativité mais aussi plus d’hétérogénéité, ce qui conduit automatiquement à une croissance des inégalités, mais aussi à un effacement de leurs contours.

     

Cerebral hemorrhage after the consumption of amphetamine

Cerebral hemorrhages are rare complications that occur after the consumption of amphetamine; the mortality rate is estimated at 50 %. It is assumed that cerebral hemorrhages are caused by amphetamine-induced hypertensive crises coinciding with pre-existing vascular alterations (congenital vascular malformations, vasculitis). In the present case report, a 40-year-old man, who is said to have regularly consumed hashish, heroin and speed, died of a massive cerebral hemorrhage located in the region of the basal ganglia shortly after the intravenous administration of amphetamine and heroin. In the course of the post-mortem investigation, neither vascular malformations nor vasculitis could be detected in the brain. Even if the evidence for the existence of such alterations was missing, this does not exclude their presence for certain. Other potential amphetamine-induced vascular alterations are discussed.     

Kontingenzprobleme sozialer Interventionen

Welfare state moderated social interventions into private life are faced with high expectations, which are often unrealistic, as this article shows for the case of child endangerment. A multidimensional analysis of this field, in which the diagnosis of institutional malfunction was put forward recently, shows considerable problems of contingency for such interventions. This results from field specific institutional regulations and organizational arrangements as well as peculiarities of the private sphere, at which the interventions are aiming. Due to those problems of contingency, optimal intervention trajectories cannot be taken for granted. The article develops this hypothesis on the basis of a scattered (and only marginally sociologically reasoned) technical literature and preliminary findings of an empirical field research currently undertaken. It highlights the restrictions, tensions and contradictions which render the interventional dynamic as a process remarkably governed by chance.     

Fatal MDMA-intoxication with postmortem diagnosis of hyperthermia

Hyperthermia is one of the main symptoms of the toxic MDMA effect. In a fatal intoxication, the premortal increase in body temperature may lead to a false assessment of the time of death. The problems of drug-induced hyperthermia faced by forensic pathologists and criminal investigators are discussed on the basis of a death from the autopsy material of the Berlin Institute of Legal Medicine (CCM).     

Interpretation of the term "hydrocution"

Based on a literature study, several interpretations of the term "hydrocution" are presented and discussed. It is difficult to differentiate between hydrocution and atypical drowning. Therefore, the history, the pathogenetic mechanism and the autopsy findings must be considered to establish a clear diagnosis when assessing a sudden death in the water. Practicable diagnosis criteria are recommended.     

Suicide by means of a charcoal grill. Casuistic report with review of the literature

Due to the conversion of the gas supply from city gas to CO-free natural gas and the introduction of the catalytic converter technology for motor vehicles the number of suicides by CO poisoning has decreased considerably. Nevertheless suicides by CO poisoning are still committed once in a while. In the described case from the autopsy material of the Institute of Legal Medicine at Münster, the suicide used a charcoal grill as the source of carbon monoxide.     

Negligent homicide caused by exhaust gas escaping from a manipulated chimney

A chimney built and operated according to the instructions is supposed to ensure that the combustion gases coming from the fireplace can escape safely. If the operational reliability is impaired, this presents a risk of acute poisoning. The report deals with a negligently caused carbon monoxide poisoning of a married couple as a consequence of improper installation of a cover of the chimney opening. Various causes of fatal poisoning due to defective exhaust systems are discussed in connection with the presented case report.