Free to choose,free to win,free to lose: the phenomenology of ethical space

This paper argues that, contrary to some points of view, most public administrators have sufficient discretion to act ethically; they have ‘ethical space’ within field constraints. This conclusion is arrived at by way of a theoretical perspective called phenomenology. Along the way we describe this orientation and try to show its relevance to practitioners.     

Sharing governmental authority: Blue Cross and hospital planning in New York City.

Hospital planning in New York has been since the 1930s an intensely political process with high stakes. The leaders of Blue Cross and their allies used the hospital planning process in the city and the state as a means to extend and protect corporate authority in what they took to be the public interest. When Blue Cross was established in the 1930s, its leaders used the mechanisms of formal planning as part of their solution to pressing problems in the organization and distribution of hospital services. In the decade after World War II, Blue Cross had an immense impact on hospital planning in New York as a result of its growth and its underwriting policies. Conflicts between Blue Cross and state regulators beginning in the 1950s led to a new formulation of the politics of planning. Blue Cross became a partner with the state in regulating hospitals. The state and Blue Cross behaved as co-regulators until the 1980s. The interpretation in this paper revises the earlier accounts of health politics in New York by Law (1976) and Alford (1975).     

Effect of hypothermia on breath-alcohol analysis

Mild hypothermia, induced by experimental immersion of ten subjects in cold water, distorted the decay curve of breath ethanol of intoxicated subjects by as much as 22% while not altering overall ethanol clearance rate. The results provide in vivo verification of the in vitro temperature correction factor of 6.8% X degrees C-1, and support previous recommendations that temperature monitoring be included in procedures for breath-ethanol testing. We recommend that mouth temperature be obtained before breath sampling to screen for abnormal body temperature and to allow for potential use of a temperature correction factor. This modification to existing analytical procedures would help to optimize the reliability of breath-ethanol analysis in predicting blood-ethanol concentration.