Advancing Health Rights in a Globalized World: Responding to Globalization through a Collective Human Right to Public Health

The right to health was codified in Article 12 of the International Covenant on Economic, Social and Cultural Rights as an individual right, focusing on individual health services at the expense of public health systems. This article assesses the ways in which the individual human right to health has evolved to meet collective threats to the public's health. Despite its repeated expansions, the individual right to health remains normatively incapable of addressing the injurious societal ramifcations of economic globalization, advancing individual rights to alleviate collective inequalities in underlying determinants of health. By examining modern changes to underlying determinants of health, this article concludes that responding to globalized health threats necessitates a collective right to public health.     

The wrong kind of crisis: Why oil booms and busts rarely lead to authoritarian breakdown

Economic crisis has been a central catalyst to Third Wave democratic transitions by contributing to authoritarian breakdown, yet crises in oil-exporting states have generally failed to catalyze such breakdowns, which are a crucial precondition to democratization. This article argues that oil wealth produces two distinct political trajectories, depending on its timing relative to the onset of late development. The dominant trajectory in the oil-exporting world is durable authoritarianism which has forestalled all but a few regime collapses. And, when the alternate trajectory produces vulnerable authoritarianism, oil-catalyzed authoritarian breakdown tends to generate new authoritarian regimes. I use case materials from Iran and Indonesia during the 1960s and 1970s to illustrate the two oil-based trajectories, and I conduct a broader test of the theory against data for 21 oil-exporting, developing countries, which provides suggestive support for a two-path theory of oil-based aturhoritarian persistence. Benjamin Smith is an assistant professor of political science and Asian studies at the University of Florida. His first book,Hard Times in the Land of Plenty: Oil, Opposition, and Late Development, is under contract with Cornell University Press. Other work has appeared in theAmerican Journal of Political Science, World Politics, and theJournal of International Affairs. He is currently at work on a book-length study of durable authoritarianism with Jason Brownlee (University of Texas-Austin) and on a study of the conditions under which democracy can consolidate in oil-rich countries with Joseph Kraus (University of Florida). Thanks to Jason Brownlee, Sam Huntington, Joel Migdal, Pete Moore, Jon Pevehouse, Susan Pharr, Dan Slater, David Waldner, Patricia Woods, participants in the Sawyer Seminar in comparative politics at Harvard University; participants in the “Transforming Authoritarian Rentier Economies and Protectorates” seminar at the Friedrich Ebert Foundation in Bonn; and three anonymous reviewers for comments on earlier versions of this article.     

全球化与非洲

过去几十年来,在日益加速的全球化过程中,非洲是受益最少的大陆,尤其是撒哈拉以南地区。非洲的历史与其现状有着内在的关联,并值得密切关注。由于非洲各国遭受过长期殖民统治,因此独立后的非洲国家不可能在短期内拥有完善的民主和繁荣的经济。在日益全球化的今天,只有西方跨国公司从中获利,而非洲国家却身处难以扭转的劣势。在这种情况下,南南合作是非常必要的,其最终目标就是要尽力摆脱工业富国的掌控。     

Aligning Ethics with Medical Decision-Making: The Quest for Informed Patient Choice

Clinical evidence suggests that many patients undergo surgery that they would decline if fully informed. Failure to communicate the relevant risks, benefits, and alternatives of a procedure violates medical ethics and wastes medical resources. Integrating shared decision-making, a method of communication between provider and patient, into medical decisions can satisfy physicians' ethical obligations and reduce unwanted procedures. This article proposes a three-step process for implementing a nationwide practice of shared decision-making: (1) create model integration programs; (2) provide legal incentives to ease the transition; and (3) incorporate shared decision-making into medical necessity determinations.     

Retrospective ideological representation and its impact on democratic satisfaction*

Congruence between government policies and citizen preferences is a key element that increases the quality of democracy. While scholars have shown that governments generally adopt ideological positions and propose policies close to citizen preferences, they have neglected to consider whether citizens respond to promises or to actual enactments. The paper addresses this gap in two ways. First, we propose a new measure that captures how close a citizen is on average to the policies enacted by the incumbent government, namely retrospective ideological representation – the ideological distance between the position of a respondent and the incumbent government at the end of its term in office. We show that this measure captures retrospective information associated with governments’ actions and in particular whether the government increases or decreases social spending during its mandate period. Second, we show that retrospective ideological representation has a substantial impact on citizens’ democratic satisfaction and greater than prospective ideological representation – an established measure of congruence – which is the ideological distance between the positions of a respondent and the elected government after an election.