Attitudes of people with disabilities toward physician-assisted suicide legislation: broadening the dialogue

This article presents the methods, findings, and implications of a participatory action research project that attempted to shed additional light on the debate over death with dignity (DWD) or physician-assisted suicide (PAS) legislation. In-depth, qualitative interviews with forty-five physically disabled residents of the San Francisco Bay Area, conducted by others with disabilities, revealed a wide breadth of opinions about and attitudes toward such legislation. For close to half of the participants, the desire for autonomy in making end-of-life decisions was a primary concern, yet fear that PAS legislation could violate this autonomy in various ways was a deep concern as well. Also reported were widespread accounts of disability-based discrimination and frequent expressions of fear about openly discussing positions that diverge from the official, publicly held opinions of disability leaders who oppose such legislation. The findings support those of a recent Harris poll demonstrating considerable diversity of opinion about PAS legislation among people with disabilities. The findings further suggest the need for additional research on the apparent disjunction between the diversity of attitudes held by those interviewed and the more unified position taken by many disability activists. Use of the study findings to promote greater dialogue within the community and to better position people with disabilities to take their place at the policy table also is discussed. In addition, the findings are seen as reinforcing the need for the public health community to become more engaged in this central ethical debate.     

To Manage Is to Govern

Governance structures constrain and enable the actions of public managers. Principal–agent theory has played a dominant role in our understanding of governance structures. This theory suggests that politicians create relatively static governance structures in a top–down fashion and hold managers accountable for mandated results. In other words, public managers are influenced by governance structures but do not affect governance structures. However, we argue that public managers do affect governance structures, and, in order to understand how this influence takes place, we need a new way of thinking about governance structures. We propose thinking about governance structures as relationships created through the interactions of people in different and reciprocal roles that are relatively dynamic. Public managers are an important source of the multiple, reciprocal, and dynamic interactions that produce governance (relationship) structures. As such, managers are accountable not only for policy outcomes, but also for the appropriateness of the relationships they create and support.     

Popular Culture, Power Relations and Urban Discipline: The Festival of the Holy Spirit in Nineteenth-Century Rio de Janeiro

The Festival of the Holy Spirit was considered the most important religious celebration in nineteenth‐century Rio de Janeiro. I discuss the popular practices of music, dance and theatre during the festival. By merging European waltz and the African batuque, the heterogeneous public re‐created and re‐invented a number of new genres that are at the roots of twentieth‐century Brazilian popular music. The festival of the Holy Spirit allows an examination of elite strategies and municipal policies regarding popular culture. In this respect, it is remarkable how much political use the Brazilian Empire made of the festival of the Holy Spirit and how its revellers fought for their celebration.     

Millean Liberty and Sexual Orientation: A Discussion of Edward Stein's The Mismeasure of Desire

Law and Philosophy -     

The responsiveness of approval voting: Comments on Saari and Van Newenhizen

Saari and Van Newenhizen (1987) misinterpret their findings about the indeterminacy of voting systems: far from being a vice, indeterminacy is a virtue in allowing voters to be more responsive to, and robbing them of the incentive to misrepresent, their preferences. The responsiveness of approval voting, in particular, means that the cardinal utilities that voters have for candidates can be reflected in voters' strategy choices, which ultimately translate into better social choices. Empirical data from a recent election support these claims, showing, among other things, that the Borda system, a determinate voting system favored by Saari and Van Newenhizen, is highly vulnerable to manipulation by strategic voters.