Between morality and rationality: framing end-of-life care policy through narratives

This paper analyzes the nature of the debate generated prior to the implementation of the Act Respecting End-of-Life Care in 2015 in Québec (Canada). Including medical assistance in dying (MAID) along existing palliative care services, the act is an important policy change on a very sensitive issue. As such, MAID could be categorized as a morality policy issue, the latter being defined as a particular category of policy because of its specific features (issues of first principle, technical simplicity, high salience, public interest, and public participation). In line with Mucciaroni’s proposition, we rather analyze this issue by understanding morality policy as one of two framing strategies (moral and/or rational-instrumental frame). Our research reconstructs four public opinion framings as advanced and transmitted through the media between 2005 and 2015. It shows that although opponents to the bill unsurprisingly framed the debate in deontological terms, mostly referring to sanctity of life as one of the most important values in society, they also framed it on rational-instrumental grounds in a similar proportion, alleging the danger of a slippery slope and potential abuse. As well, if some of the proponents favored a moral framing centered on the argument that dignity and individual autonomy take precedence over all other values, others put forward a rational-instrumental one, where the slippery slope/abuse argument is used as a cautionary statement against the artificial prolongation of life. Our analysis reinforces Mucciaroni’s and Ferraiolo’s assertions that sensitive issues classified as morality policy cannot be apprehended solely through the unidimensional frame of morality.     

A Nolan Committee for the German ethics infrastructure?

Abstract. An international trend towards establishing and conforming standards of ethical behaviour in the public sector has repeatedly been stated. Germany, however, remains surprisingly reluctant to adopt such recommendations. This article argues that the likelihood of German decision makers implementing new, and especially soft, ethics measures depends on the demand for such measures, on the one hand, and their supply, on the other. The analysis shows that contradictory forces have an impact on Germany. The demand for new ethics measures is relatively low as a high level of hard ethics measures incorporated in the longstanding formal legal system of rules and regulations make the implementation of new measures seem unnecessary. Also, the demand for soft ethics measures is less marked in Germany than in the United Kingdom. This comparatively weak pressure meets the natural inertia caused by cognitive and institutional path–dependency in institutional choices of political decision makers. On the other hand, external bodies (such as the Organisation for Economic Cooperation and Development – OECD) provide blueprints for soft ethics measures and encourage the implementation of uniform standards across countries. Which of these forces will prevail in the long run, however, cannot be deduced from the present situation.     

The reciprocal dynamics of organizing and sense‐making in the implementation of major public‐sector reforms

Abstract: Drawing on a longitudinal study from the early years of implementation of health‐care networks in Quebec, this article describes how public‐sector managers deal with complex challenges when both organizational structures and organizational strategies are radically transformed simultaneously. The new organizations studied had to completely re‐shuffle roles and responsibilities of their management teams while making sense of their new mandate of developing a population‐focused approach to health problems – all the time maintaining day‐to‐day operations. The four health‐care networks studied proceeded somewhat differently to meet these reciprocal challenges. The study reveals the importance of balancing organizing initiatives (focused on structures) with “sense‐making” initiatives (focused on strategies), of developing capacities for sense‐making through the creation of key “sense‐maker/sense‐giver” positions whose occupants are able to ensure that conceptual activities engage people working at different levels, even as organizational structures are in flux, and of mobilizing external constraints and influences as opportunities and resources in sense‐making and organizing. Sommaire : Se fondant sur une étude longitudinale des premières années de la mise en œuvre des réseaux de soins de santé au Québec, cet article décrit la manière dont les gestionnaires du secteur public font face à des défis complexes, alors que les structures et les stratégies organisationnelles sont radicalement transformées simultanément. Les nouveaux organismes étudiés ont dû complètement remanier les rôles et les responsabilités de leurs équipes de gestion et comprendre leur nouveau mandat d'élaborer une approche axée sur la population pour ce qui est des problèmes de santé, tout en maintenant leurs activités au jour le jour. Les quatre réseaux de soins de santéétudiés ont travailléà relever ces défis réciproques d'une manière assez différente. L'étude révèle l'importance de trouver un équilibre entre les initiatives consistant à organiser (axées sur les structures) et les initiatives consistant à interpréter les faits (axées sur les stratégies) ; de perfectionner les capacités à interpréter les faits grâce à la création de postes clés d'«interpréteurs de faits», dont les titulaires veilleraient à ce que des activités conceptuelles fassent intervenir les gens travaillant à différents niveaux même lorsque les structures organisationnelles fluctuent continuellement; et enfin de tirer parti des contraintes et influences externes comme autant d'occasions et de ressources pour interpréter et organiser les faits.     

Horizontalité et gouvernance décentralisée: les conditions de collaboration dans le contexte de l'action communautaire

Sommaire: Cet article s'interroge sur les formes de gouvernance qui caractérisent le secteur communautaire en s'appuyant sur l'étude de deux cas de partenariats locaux initiés par l'organisme Québec en forme (QEF) dans les régions de l'Outaouais et de la Mauricie. La participation croissante des organismes communautaires à la prestation des services publics met en relief l'importance de la collaboration et du partenariat interorganisationnels dans le cadre d'une gouvernance plus horizontale. L'article présente certaines difficultés posées par la construction d'une telle gouvernance dans le secteur communautaire. Le poids des structures de pouvoir traditionnelles, de même que les innovations proposées dans la littérature sur la gouvernance et l'horizontalité (élargissement des partenariats, développement de nouveaux objectifs partagés, etc.), ont beaucoup de difficultéà prendre assise dans la pratique communautaire. Abstract: This article examines the forms of governance that characterize the community sector, referring to two case studies of local partnerships initiated by the group “Québec en forme” (QEF) in the Outaouais and Mauricie regions. The increasing participation of community organizations in the delivery of public services highlights the importance of cross‐jurisdictional cooperation and partnerships within the framework of a more horizontal governance. The article presents some of the challenges surrounding governance construction in the community sector. The weight of traditional power structures, as well as the innovations proposed in the literature on governance and the implementation of a horizontal approach (securing broader partnerships, developing new shared objectives, etc.), are not easily adopted in community practice.     

Do Competitive Examinations Promote Diversity in Civil Service?

The representative bureaucracy literature provides a growing body of empirical evidence that a representative public workforce enhances the efficacy and legitimacy of public services. However, little attention has been paid to the capacity of civil service competitive examinations to give equal opportunity of access to public jobs to equally competent citizens. To fill this gap, the authors use French databases to analyze whether competitive examinations comprising both written and oral tests ensure equality of treatment for all candidates regardless of gender, place of residence, or place of birth. The results challenge the capacity of these examinations to treat candidates equally, identifying inequalities in the written tests as well as evaluation biases in the oral tests. However, oral evaluation biases tend to offset inequalities in the written tests. Therefore, selection boards take a sort of affirmative action toward the sole successful members of groups suffering such inequalities.     

Sentencing private benefits in takeover contest

We present a model of profit diversion into a takeover environment. The model incorporates a legal environment characterized by a probability of being convicted, a monetary sanction (ex-ante protection) and the costs of administrating the takeover (ex-post protection). We show that the extraction of private benefits is reduced by the existence of such a legal environment, which is consistent with a number of empirical studies. It also predicts that legal environment can conduct the bidder to acquire more than 50% of the share due to the impact of the final holding of the bidder on the fine. The paper contributes to the current debate on regulation of white-collar crime. It highlights the trade-off between the ex-post profit diversion and minority protection, and the ex-ante probability of efficient takeovers. But, considering simultaneously two tools of protection, the ex-ante and the ex-post ones, which do not have the same impact, we derive some guidelines in order to analyze the current trend of the US and the EU laws.     

Hostage-Taking in the Context of Domestic Violence: Some Case Examples

Initial reports of domestic violence are generally made to law enforcement officers who must respond and intervene. A subset of these episodes involves cases in which the victim, and, in many instances her child(ren), have been taken hostage by her husband or partner. Moreover, there are indications that the number of such incidents is growing. The purpose of this project was twofold: (1) to provide one of the first reports on the prevalence and characteristics of these events, and (2) to more closely analyze domestic crisis (hostage) situations using actual case examples. All information was obtained from the Hostage Barricade Database System (HOBAS) of the FBIs Crisis Negotiation Unit. HOBAS is a postincident information collection tool which stores historical data from law enforcement agencies across the nation on hostage/barricade incidents. An examination of this database yielded different types of domestic hostage-taking acts and outcomes (e.g., tactical vs. negotiated resolutions, survival vs. death/injury of perpetrator and/or victim[s]). Implications of the findings, for future crisis negotiation efforts directed toward nonviolent resolution of these high-risk critical incidents, are discussed.