Policy Recommendations for Carrier Testing and Predictive Testing in Childhood: A Distinction That Makes a Real Difference

The genetic testing of children raises many ethical concerns. This paper examines how five position statements from Canada, UK and USA, which present guidelines for good practice in this area produce different recommendations for carrier testing and predictive testing. We find that the genetic information generated through carrier testing is routinely presented as less serious than that generated from predictive testing. Additionally, the reproductive implications of predictive testing are also routinely erased. Consequently, the papers argue strongly against predictive testing but advise caution against carrier testing in somewhat weaker terms. We argue that these differences rest on assumptions about the status of reproduction in people’s lives and on an ethical stance that foregrounds the self over others. We propose that questioning the crude and sharp distinction between carrier and predictive testing in principle may enable practitioners and parents/families to make more nuanced decisions in practice. Parts of this work have been presented in the 1st International CESAGen Conference, London, 2004, and Genetics and Society Meetings, Wales.     

Developmentalism And The Child In Nineteenth-Century Science

In recent years, public science events have been designed as a means to foster a dialogue between science and the public and to contribute to ongoing policy processes. Regardless of their tangible outcome, such events rely on a certain framing, reconfigure scientific knowledge and conceptualise the public in specific ways. These constructs are exemplified by a science festival that was held in the train station hall in Zurich. Novel insights can be gained from a spatial, an object and an actor-related approach borrowed from the artistic context: the discussions about the White Cube can be adapted to contribute to the analysis of the science festival. When we look into the spatial situation created to foster exchange about scientific knowledge, we find how the exhibition display is taking care of minor details. While the organisers transformed the station hall into a laboratory, they created a kind of dialogic situation that filled an authority gap as it equally enabled exchange. The objects put in place in the exemplary case helped to design a customer–supplier relationship between the public and science. Under the umbrella of the science event, a range of diverse research endeavours was homogenised and unified. The audience, finally, was invited to familiarise itself with scientific knowledge. However, they were allocated a consumer role that obliged them to remain guests in the laboratory environment of the station hall. Thus, public science events may be successful in attracting large attendance and allowing more experiences with science, but while they create novel forms of familiarisation with science for visitors, they do not necessarily remedy public doubts about science and technology.     

Gender Mainstreaming and Healthcare Policy

This review addresses how The Palgrave Handbook of Gender and Healthcare structures and analyzes the themes that emerge from its own interrogation of the complex concepts of gender, equality, health and policy. Overall the review takes a complimentary tone towards the handbook's arguments and premises and the unique research that sets it apart from other more scientifically or development based gender health texts. It points out, however, that the book maintains its focus on the global north and the efficacy of state policy as the primary tool for gender equality, however defined. The author suggests that in future discussions, the alternative routes and different countries that are only just touched on in the text should be more thoroughly explored.     

THE RATIONAL SOCIETY: A CRITICAL STUDY OF SANTAYANA'S SOCIAL THOUGHT,Beth J. Singer

Anthropocentric and individualistic foundations result in forest management policy based on linear, single‐dimensional, marginal analysis detrimental to the well‐being of the forest ecosystem. Recent theories from the fields of ethics, economics, and policy analysis find that nonlinear, multidimensional analysis is possible, provided one can divorce oneself from anthropocentric and individualistic tendencies. Deep policy is introduced as a policy perspective that encourages questioning the fundamental values upon which policy decisions are made, just as deep ecology encourages a similar questioning of ecological values. An experiment is proposed for forest management in the Pacific Northwest, in which a self‐realizing Forest Board demonstrates punctuated equilibrium in forest management policy.     

Cognitive maps and the energy‐culture interaction

This analysis considers the link between energy alternatives and cultural attitudes through the postulation of individual and collective energy‐related cognitive maps. The relationship between energy and society is described through the systems approach of General Evolution Theory. The need for cognitive maps is assessed in relation to contemporary global socio‐cultural dynamics. The concept of such maps is explicated and its implication for energy policy formulation is suggested. Finally, the first phase of a research agenda for mapping society's energy‐related cognitive maps through a systems history perspective is presented and discussed.     

The Future of Public Policy

This article reports the results of research that uses policy network theory and advocacy coalition theory to deduce the implications for the future of public policy in EU Member States of king trends: all those technological, economic, environmental, and social trends that can be empirically verified, affect the lives of large numbers of people and are expected by relevant experts to continue for at least the next 20 years. The resulting policy implications can be summarized as more assertive security policies, more business-friendly economic policies, more liberal social policies, and increased public spending.     

Pediatric Do-Not-Attempt-Resuscitation Orders and Public Schools: A National Assessment of Policies and Laws

Some children living with life-shortening medical conditions may wish to attend school without the threat of having resuscitation attempted in the event of cardiopulmonary arrest on the school premises. Despite recent attention to in-school do-not-attempt-resuscitation (DNAR) orders, no assessment of state laws or school policies has yet been made. We therefore sought to survey a national sample of prominent school districts and situate their policies in the context of relevant state laws. Most (80%) school districts sampled did not have policies, regulations, or protocols for dealing with student DNARs. A similar majority (76%) either would not honor student DNARs or were uncertain about whether they could. Frequent contradictions between school policies and state laws also exist. Consequently, children living with life-shortening conditions who have DNARs may not have these orders honored if cardiopulmonary arrest were to occur on school premises. Coordinated efforts are needed to harmonize school district, state, and federal approaches in order to support children and families' right to have important medical decisions honored.     

Religiously Affiliated Continuum of Care Retirement Communities

SUMMARY

The paper introduces an action research initiative called Spirited Scotland, an embryonic movement seeking to restore spirituality to an appropriate place in health and social care. It locates the initiative in the changing social and spiritual circumstances of post-industrial Scotland and identifies some challenges it faces associated with the prevailing understandings of health, becoming ill, and successful ageing. The paper also considers some policy and practice challenges raised by Spirited Scotland, in terms both of content and process.     

The Spirituality of Compassion: A Public Health Response to Ageing and End-of-Life Care

SUMMARY

The recent revival of interest in spirituality in later life marks a significant step forward in the person-centred care of ageing people. The benefits will, however, be of limited value if we do not attend to the settings in which spirituality is to be lived. In contemporary society many aged people are located in environments unsympathetic to spiritual belief and practice. Health care settings focus on professionally-assessed physical needs and are dominated by concerns about the cost of services. The national social policies that direct health care services and less directly shape older people's place in contemporary society are strongly influenced by globalised neoliberal economic policies characterised by individualism, competition, and greed. For robust and viable spirituality to develop at the individual level we need compassionate social policies that support interdependence within communities and between nations.