Ethics and the Physician-Patient Relationship

Book Reviews in This Article:
Getting Rid of Patients: Contradictions in the Socialization of Physicians . By Terry Mizrahi
Physicians and Social Change . By John Colombotos and Corinne Kirchner
Changing Values in Medicine . Edited by Eric J. Cassell and Mark Siegler
Professional Ethics and Primary Care Medicine: Beyond Dilemmas and Decorum . By Harmon L. Smith and Larry R. Churchill
Physician—Patient Decision-Making: A Study in Medical Ethics . By Douglas N. Walton
With Dignity: The Search for Medicare and Medicaid . By Sheri I. David
The Dismissal of Students with Mental Disorders. Legal Issues, Policy Considerations, and Alternative Responses .
Courtroom Toxicology . By Marshall Houts, Randall C. Baselt, and Robert H. Cravey     

A Contractualist Defense of Democratic Authority

Abstract.  This paper provides a defense of the following thesis: When there is reasonable disagreement over the design of morally necessary collective action schemes, it would not be reasonable to reject the authority of a democratic decision procedure to settle these disputes. My first argument is a straightforward application of contractualist reasoning, and mirrors T. M. Scanlon's defense of a principle of fairness for the distribution of benefits produced by a cooperative scheme. My second argument develops and defends the intuition that treating others morally requires respecting their exercise of moral judgment, or a sense of justice. I conclude by addressing the problem of disagreement over the design of the democratic decision procedure itself, and rebutting Jeremy Waldron's claim that democratic authority is incompatible with judicial review.     

Policy networks and market opening: Telecommunications liberalization in Spain

Abstract.  For a broad range of policy sectors, liberalization was the predominant goal during the 1990s, and the policy change involved gave rise to a wide range of academic debates. In this article we analyze the consequences of these far-reaching policies for the policy process itself. We ask whether the policy changes significantly altered the characteristics of policy processes by considering the timing and extent of the changes in policy networks during those years. More concretely, we discuss the extent to which policy networks changed as a result of market opening, considering the case of the telecommunications policy network in Spain. Using data from two successive surveys, we compare the network structure before and after market opening. Our findings show that only slight changes occurred during this period, making the network denser but not more open. Thus, we suggest that a more successful liberalization probably would have required a network that was more open to new entrants and in which power was less centralized and so able to guarantee a competitive environment.     

General systems theory and criminal justice

Criminal justice agencies are organized sequentially — “output” from one agency is “input” to the next — but most scholars argue that criminal justice is not a system in a theoretical sense. In this article, it is argued that general systems theory (GST) reveals important insights into criminal justice structures and functions. Specifically, it is argued that the criminal justice system processes “cases” rather than people, and that the common goal of criminal justice processing is to “close cases so that they stay closed.” It also is argued that processing capacity progressively declines, in that at each system point the subsequent agency cannot input as many cases as the previous agency can output. Each agency therefore experiences “backward pressure” to close cases in order to reduce input to the next agency. Overall, this article highlights that criminal justice agents and agencies are best understood as operating in the context of the larger whole, thus it is concluded that criminal justice is a system in the sense of general systems theory.