Boundaries Of Authority Research Articles

Judicial Discretion to Condition

Judicial Discretion to Condition

Editor's notes

New Directions for Child and Adolescent DevelopmentVolume 2005, Issue 108 p. 1-3 Editor's notes Judith Smetana, Judith Smetana University of Rochester, Rochester, New YorkSearch for more papers by this author Judith Smetana, Judith Smetana University of Rochester, Rochester, New YorkSearch for more papers by this author First published: 10 June 2005 https://doi.org/10.1002/cd.123Citations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume2005, Issue108Special Issue: Changing Boundaries of Parental Authority During AdolescenceSummer 2005Pages 1-3 RelatedInformation

A New Era in Drug Regulation?

A New Era in Drug Regulation? Rebecca Dresser (bio) The Food and Drug Administration has a difficult job. With a small staff and budget, the agency is assigned to regulate about one-fifth of the nation's economy. And it must do so with several policy considerations in mind, considerations that often cannot be neatly reconciled. The FDA is expected to protect the public health by ensuring that drugs and devices are safe and effective, but it must not be so cautious as to unnecessarily delay patients' access to novel interventions. It is expected to ensure that new products are carefully evaluated, but it must not unduly impede manufacturers' legitimate interests in delivering their products to market. Though the FDA has extensive power, Congress sets the boundaries of FDA authority. When members of Congress believe the agency's policy concerns are out of balance, they enact legislation designed to rectify the problem. High-profile drug tragedies, corporate lobbying, and patient advocacy are just a few of the forces that can trigger congressional action. For most of the twentieth century, both Congress and the FDA focused on protecting patients from dangerous drugs. This philosophy emerged after drug disasters such as those involving elixer sulfanilamide and thalidomide revealed the harm that could come from inadequate government controls. But the 1980s brought increasing dissatisfaction with the status quo. Business and patient groups claimed that the FDA's product approval process had become too rigid and time-consuming. New drugs and devices desperately needed by HIV and other seriously ill patients were being kept from the market by narrow-minded bureaucrats. In an effort to promote faster access to new products, Congress passed new legislation, including the Prescription Drug User Fee Act and FDA Modernization Act.1 By late 2004, however, another policy shift seemed imminent. New disclosures about risks posed by arthritis and antidepressant drugs triggered worries about the adequacy of FDA review. After two decades of emphasizing the need for speedy decisions and broad availability of new products, members of Congress were loudly proclaiming the value of rigorous testing and oversight. They called for legislative and regulatory action to promote drug safety and effectiveness. Reform Proposals Reformers endorse two major changes. One is to expand access to research information through establishing a clinical trials registry. This congressional proposal builds on the International Committee of Medical Journal Editors' decision to start demanding registration for the studies they publish.2 The Fair Access to Clinical Trials Act would require sponsors to register trials before subjects were enrolled and report results upon trial completion. The bill makes registration a condition for Institutional Review Board approval of human trials. Registration would also be a prerequisite for receiving federal research funding. The bill describes information that sponsors would be required to report and authorizes audits by federal officials. Violations could result in large fines.3 Supporters say a mandatory registry is needed for many reasons. Without such a registry, information about investigational and clinical interventions remains incomplete. The scientific literature presents only a partial picture of research findings. This is because investigators and professional journals are prone to "publication bias," preferring to publish studies showing benefits from novel interventions. Sponsors may also suppress or manipulate trial results so that investigational drugs appear better than they are. Trials finding new approaches less effective or linked to serious side effects may never see the light of day. Because a fraction of trial findings are presented to the wider world, physicians and patients are denied an accurate picture of medical options. Moreover, the dangers and relative ineffectiveness of new products may go unrecognized until they materialize in the general patient population. The situation has economic costs, as well. Limited resources can be wasted rediscovering information produced in earlier unreleased studies. Because new drugs tend to be more expensive, publication bias can also elevate demand for high-priced products. Unpublished trials conflict with human subjects protections, too, for they expose subjects to risks and burdens without adequate justification. To be consistent with the principle of beneficence, human research must contribute to social knowledge. But when results go undisclosed, no one can learn from them.4 Proposals for trial registries are not...

Narrative in the Time of AIDS: Postcolonial Kenyan Women's Literature

Confessions of an AIDS Victim (1993) and Chira (1997) portray AIDS in postcolonial Kenya as a painful social experience that blurs and shifts cultural values until the search for a new normative and narrative community becomes inevitable. In the midst of such turbulent change, the possibility for dissent and subversion grows, but so does the desire to integrate split subjectivities into a meaningful narrative with a clearly defined moral center. The protagonists in both novels respond to the advance of a potentially terminal disease with the need for a clear sense of right and wrong. Hybrid identities return once more to the reliable and deceptively stable boundaries of religious or experiential authority. The relationship between identity and authority, however, remains precarious, and the ambiguity applies to both the moral authority that the characters long for and the narrative authority that legitimizes such longing.

Narrative in the Time of AIDS: Postcolonial Kenyan Women's Literature

Confessions of an AIDS Victim (1993) and Chira (1997) portray AIDS in postcolonial Kenya as a painful social experience that blurs and shifts cultural values until the search for a new normative and narrative community becomes inevitable. In the midst of such turbulent change, the possibility for dissent and subversion grows, but so does the desire to integrate split subjectivities into a meaningful narrative with a clearly defined moral center. The protagonists in both novels respond to the advance of a potentially terminal disease with the need for a clear sense of right and wrong. Hybrid identities return once more to the reliable and deceptively stable boundaries of religious or experiential authority. The relationship between identity and authority, however, remains precarious, and the ambiguity applies to both the moral authority that the characters long for and the narrative authority that legitimizes such longing.

The Adventures of Managerial Hegemony: Teamwork, Ideology, and Worker Resistance

New forms of work organization have spread throughout much of the corporate world. Critics warn that team systems may encourage workers to internalize managerial definitions of their work situations, and-as a result-strengthen management's hegemony over them. This article presents an ethnographic analysis of four manufacturing plants in which team initiatives have been introduced. The findings cast doubt on the hegemony thesis. Analyzing data bearing on the degree of managerial legitimacy, the salience of class boundaries, and instances of worker defiance in both traditionaland team-based production areas, I find only occasional evidence of increased worker integration or incorporation within a nascent managerial regime. Indeed, by drawing attention to the limited authority that workers were actually allowed, team systems tended to heighten worker suspicion and distrust and to foster patterns of solidarity that were difficult for managers to control. The most significant feature of the new production concepts may not be their siren-like appeal, but rather the tensions and contradictions they introduce into work organizations. In fact, such concepts provide workers with subtle yet strategic resources with which to renegotiate the boundaries of managerial authority.

Bridging Liberalism and Multiculturalism in American Education

What should the civic purposes of education be in a liberal and diverse society? Is there a tension between cultivating citizenship and respecting social diversity? What are the boundaries of parental and state authority over education? Linking political theory with educational history and policy, Rob Reich offers provocative new answers to these questions. He develops a liberal theory of multicultural education in which the leading goal is the cultivation of individual autonomy in children. Reich draws out the policy implications of his theory through one of the first sustained considerations of homeschooling in American education. He also evaluates three of the most prominent trends in contemporary school reform - vouchers, charter schools, and the small school movement - and provides pedagogical recommendations that sharply challenge the reigning wisdom of many multicultural educators. Written in clear and accessible language, this book will be of interest to political theorists, philosophers, educators, educational policymakers, and teachers.

Claims and disclaimers: Whose expertise counts?

Medical anthropologists have long recognized that interactions between state, clinical, scientific and lay participants transform understandings of illness. There are competing claims to knowledge in such interactions, which may be in tension with concepts of jurisdictional authority and assumptions about what constitutes different types of expertise. This paper focuses on the regulatory processes of the Food and Drug Administration in order to examine the social processes involved in negotiating and sustaining domains of knowledge across various boundaries of authority. I use the example of the way roles of commercial interests, patient interest groups and federal oversight agencies in defining and caring for health "problems" appear to be shifting with new modes of circulating information about prescription drugs. What counts as "medical expertise" when decisions about taking pharmaceuticals are moved away from former gatekeepers (physicians and insurance plans) to patients who are reframed as consumers? In this reordering new questions are raised about the location of risk and responsibility, and relations of credibility, authority and expertise.

THE SETTLERS' CATTLE COMPLEX: THE ETIQUETTE OF CULLING CATTLE IN COLONIAL ZIMBABWE, 1938

This paper examines the 1938 cattle culling and sales in Gutu and Victoria reserves, colonial Zimbabwe. What began as a routine culling very quickly became a crisis of authority for the Native Affairs Department since critics of the Department forced an inquiry into the sales. The criticism and defence of the culling facilitated a debate on state and personal justice, as well as a dialogue about the proper behaviour towards Africans, settlers and animals. The critics of the cullings as well as the colonial officers all believed themselves to be experts in African affairs. Thus what began as a criticism of cattle culling revealed tensions within white society, and in particular the need to refashion boundaries of expertise and authority within the Native Affairs Department. A close examination of the scope and development of the ensuing commission of inquiry reveals the importance of etiquette to the colonial enterprise in colonial Zimbabwe.

The anatomy of the professional lapse: bridging the gap between traditional frameworks and students' perceptions.

To support students' developing professionalism, it is necessary to understand the professional challenges and dilemmas they perceive in the clinical setting. This study systematically documented and catalogued students' reports of professional lapses. Six focus groups were conducted with senior medical students (n = 29) at three universities. Using a grounded-theory approach, three researchers analyzed the students' reports of specific lapses in professionalism for recurrent themes. The resulting coding structure was applied using NVivo qualitative data analysis software. A total of 120 pages of text yielded 48 specific incidents of professional lapses, which were analyzed by three researchers using grounded theory. Most incidents were witnessed (n = 34) or known about (n = 4), as opposed to self-reported (n = 10). Six critical "issues" emerged: communicative violations (to or about patients or other health care professionals); role resistance (individuals chafing against constraints or expectations of their perceived roles); objectification of patients (ignoring patients or treating patients as vehicles for learning); accountability (to colleagues or patients, including avoiding patients, failing to disclose information, or failing to treat appropriately); physical harm (to patients or others); and crossfire (being put in the middle of a struggle between superiors). This study explored how students experienced and operationalized professionalism in clinical settings at a variety of universities. Interestingly, the critical issues they reported as salient did not map easily onto standard, abstract definitions of professionalism. This incongruence suggested that the development of effective curricula in this domain must bridge the gap between traditional taxonomies and students' perceptions of professionalism.

Mediating Boundaries of Race, Class, and Professorial Authority as a Critical Multiculturalist

Despite the ongoing debate about the nature, goals, and politics of multicultural education, the discipline has taken hold in the minds and hearts of educators— prekindergarten through graduate school. However, for some of us who teach multicultural education, we approach our classrooms far more confident about what we want to teach, than about how we will teach it. Moreover, an examination of the assumptions underlying a multiculturalist discourse leads to questions about pedagogy; that is, what kind of pedagogy is necessary to teach multiculturalism, and how is pedagogy informed by a reconceptualization of the discipline's underlying assumptions. This article presents one professor's reflections on the challenges of mediating the boundaries of race, class, and professorial authority in an undergraduate multicultural education course.

Mediating Boundaries of Race, Class, and Professorial Authority as a Critical Multiculturalist

Despite the ongoing debate about the nature, goals, and politics of multicultural education, the discipline has taken hold in the minds and hearts of educators— prekindergarten through graduate school. However, for some of us who teach multicultural education, we approach our classrooms far more confident about what we want to teach, than about how we will teach it. Moreover, an examination of the assumptions underlying a multiculturalist discourse leads to questions about pedagogy; that is, what kind of pedagogy is necessary to teach multiculturalism, and how is pedagogy informed by a reconceptualization of the discipline's underlying assumptions. This article presents one professor's reflections on the challenges of mediating the boundaries of race, class, and professorial authority in an undergraduate multicultural education course.

Sovereignty and Suspicion

Academics are virtually unanimous that search and seizure law is a mess, with vacillating interpretations producing a thoroughly confusing and unwieldy doctrine. Although legal scholarship has offered a variety of solutions to the muddle, few authors have attempted to connect Fourth Amendment jurisprudence with overarching theoretical justifications. Instead, critics have either described the Court's precedents or prescribed change within the narrow confines of criminal procedure law. What is needed is a framework that unites the Fourth Amendment with modern constitutional theory. Professor Luna proposes a new approach founded on a sovereignty-based theory of the Constitution. Under this model, government searches and seizures of an individual's zones of personal sovereignty receive the strongest presumption of invalidity. Absent one of three theoretically consistent exceptions, government intrusions into the body and home are beyond the boundaries of official authority. By protecting zones of personal autonomy, the individual rights model fits the constitutional text, context, and precedents while providing a theoretical justification that connects neo-Kantian philosophy and American constitutionalism. Professor Luna contrasts the individual rights model with what he calls an approach to the Fourth Amendment, which focuses on group participation in the political process rather than coercive effects on the individual. He identifies an important flaw in the antidiscrimination model: the lack of a constitutional floor protecting individuals and constraining government. Professor Luna's individual rights model provides content to that constitutional floor--tangible zones of individual sovereignty.

The Treaty of Waitangi and Its Relationship to Contemporary American Indian Sovereignty Issues

In 1993 my dissertation fieldwork took me to the North Island of New Zealand, where I collected the life history of an elder Maori woman. While there, I also began comparing the national indigenous policies of New Zealand to those of the United States.' It was interesting to discover that the historical relationships between American Indians and Maori and their respective colonizing governments bear striking similarities in terms of treaty relationships and cyclical policy waves. In this essay, I review these parallels and their legacies, and then concentrate on questions of sovereignty that are at the heart of a political comparison between the United States and New Zealand. I suggest that indigenous sovereignty is composed of three parts: economic, legislative, and political. Legislative and political sovereignty, on the one hand, are periodically enhanced or limited by the paternalism of federal governments, which continually circumscribe the uncertain boundaries of tribal authority. Economic sovereignty, on the other hand, is among other things the mechanism by which a human community successfully commands its own history. Economic sovereignty initiatives are what that the Tainui 3 45 tribe of Maori have distilled from interpreting their treaty, the Treaty of Waitangi. This interpretation has relevance to American Indian tribes who are grappling with the same difficult questions and social problems the Tainui faced for most of the twentieth century. The Tainui are thus an appropriate example for those American Indian tribes who want to reclaim and retain tribal authority.

Realms of Ritual: Burgundian Ceremony and Civic Life in Late Medieval Ghent (review)

Reviews 163 Arnade, Peter, Realms of Ritual: Burgundian Ceremony and Civic Life in Late Medieval Ghent, Ithaca and London, Cornell Univesity Press, 1996; cloth; pp. xvi, 298; 1 m a p , 9 b / w illustrations; R.R.P. US$47.50, £35.50. Symbolism as a subject for research has had a revival in the last decade, as historians, influenced by the ideas of Barthes and others, have realised that rituals to which chroniclers gave considerable space must have represented events highly significant to their contemporaries. Peter Arnade presents the ceremonies of the Burgundian court and the public entries and entertainments offered by the city of Ghent as a theatre of power which casts a unique light on the tense relationships between the ruler and the merchants on whose wealth the ruler depended. The role of p o m p and spectacle in reinforcing the idea of the distance which existed between a quasi-sacred monarch and the people has been recently re- examined in a number of states, especially at the court of Louis XIV. In thefifteenthcentury, Burgundy, as Huizinga and Cartellieri showed over seventy years ago, w a s the state whose formal and elaborate ceremonials had influenced other courts, including England and France. In reconsidering theirfindings,Arnade draws on more recent developments in anthropological and historical theory. Ritual, he believes, is a subtle means of communication in which the c o m m o n p l a c e classical images a n d stories are remodelled in each presentation to fit a n d c o m m e n t on contemporary political events and the sense of individual and group identity. In particular, A r n a d e thinks that the n e w confraternities which arose were critical both in the embodiment of civic identity and accomplishment and in confirming the tacitly accepted dominance of the prince. Their activities were more than 164 Reviews merely cultural. Thus, the socially prestigious, elite brotherhood of archers and crossbowmen ran highly managed and extremely expensive competitions with rival cities. These culminated in prizes both for the elaborate appearance and argument of the teams, who appeared in costume and with poets, players, jesters and clowns in their suite, as well as for proficiency with the bow—competitions in which the prince might participate. In some ways the sports leagues of the day, their military significance gave them an additional and overdetermined role. The confraternities of the poets and dramatists, the rhetoricians w h o had responsibility for the tableaux and performances in all public ceremonial, not only shaped the recorded memory of events but also commented on state and urban power. They too ran competitions and awarded prizes. In this way, through celebrations designed to entertain they also delimited the boundaries of authority. Entry ceremonies, to Arnade, are avenues through which change could be effected. This is perhaps to exaggerate the power which theatre possessed. That it was a means of signalling an attitude or a stand on one part or the other—as through the parading of banners which had been formally banned—one cannot doubt. That i t determined, rather than reflected, behaviour, seems less evident. Arnade perceives a link between court hierarchy, these urban developments, and the process by which the princes enforced their will on the cities and reduced or revoked their privileges, trampled on their autonomy, limited their self-government and imposed a penal tax regime. This m a y overstate the power of representation. Military force also had some effect. The city of Ghent, or some of its inhabitants attempted revolt more than once, most famously in 1447-52, in support of their traditional autonomous identity. Their ultimate military defeat was terminated by public humiliation and Reviews 165 ritual subservience. Arnade does not, however, clearly demonstrate that this itself was more than the accepted means of spelling out the consequences of a defeat which had its explanation elsewhere. The prince was able to undermine apparent urban solidarity and s p l i t its hierarchy because there were divisions to be exploited. In 1467 i t was the continuing disaffection of parts of the inhabitants which turned an entry...

Authority in Science and Technology Policy

Many persistent issues in science and technology policy derive from confusion about the boundaries of internal and external authority. One of the most important questions within science and technology policy is how to balance the creative energy of individual scientists with institutional needs, the requirements of research sponsors, and their own professional norms.

Does environmental impact assessment really support technological change? Analyzing alternatives to coal-fired power stations in Denmark

Danish energy policy calls for development of decentralized, cleaner technologies to replace conventional power stations and, since 1990, aims to reduce CO 2 emissions in 2005 to 20% below their 1988 level. These political goals require a technological change, from conventional, central power stations to cleaner, decentralized technologies such as energy conservation, cogeneration, and renewable energy. In principle, environmental impact assessment (EIA) supports this change on a project-by-project basis. The EU directive on EIA (European Council 1985) was based on the preventive principle: to eliminate pollution source rather than attempting to counteract it subsequently. According to the Danish implementation of the directive, an EIA must review a project's main alternatives and the environmental consequences of the alternatives. If this were done properly, EIAs could assist Denmark in meeting its CO 2 reduction goals. However, because EIA is implemented on a restricted, regional basis, it does not support technological change. Responsibility for the preparation of the EIA is given to the regional authorities through a law which does not require alternatives to be assessed that extend geographically beyond the boundaries of a regional authority. Thus, there is no certainty of serious analysis of cleaner technology alternatives to large coal-fired power stations. This conclusion is based on examination of three case studies using a participatory research method.

Testing acuity of vision in general practice: reaching recommended standard

Measurements of acuity of vision are highly reliable with a reliability in excess of 98% according to one important study1—because a standard protocol exists. The British Standards Institution specifies the minimum illumination for externally illuminated charts and the distance that patients should be from the chart.2 Compliance with this standard helps to ensure comparable results in the measurement of acuity of vision. Patients' acuity of vision measured in the eye department at this hospital, however, sometimes differs from the measurement given in their referral letter. I examined whether general practice surgeries complied with standards on illumination and distances. I randomly selected 24 of the 48 main general practices that fell within the boundaries of the former Torbay District Health Authority. Branch surgeries were excluded from the survey. In September …

Selecting Heritage/BookshelF‐PC for the District Library, Queen Mary's University Hospital, Roehampton

The District Library at Queen Mary's University Hospital, Roehampton provides a comprehensive service to all staff employed by the National Health Service within the boundaries of Richmond, Twickenham and Roehampton Health Authority. In 1987 the library moved into a new building which is shared with the postgraduate medical centre. The stock consists of approximately 3000 books and 180 current journal titles. There is one full‐time librarian and at the time of buying BookshelF‐PC only one assistant for 18 hours a week. There is an annual issue of books of about 3000 and it was becoming increasingly difficult to control the stock. Being so short staffed meant that activities other than stock control, such as inter‐library loans and literature searching took precedence. Overdues were issued very infrequently, and since the readers filled in their own issue slips it was often impossible to match the slip to a book or a reader. There was also no way of keeping a check on readers who were leaving the hospital (and with junior doctors staying only six months, and medical students only six weeks this was important), nor readers who had not completed membership forms before borrowing books. The District Library is part of a cooperative network of libraries within the South West Thames (SWT) Region and already contributed to the union catalogue of books held on the regional database. This database is administered from the SWT Regional Library Service at Guildford using the INMAGIC software; individual library records are sent to Guildford where they are added to the database. Participating libraries receive back a disc to update their own local database of stock and a microfiche copy of the whole database.

Toward a Phenomenology of Boundaries in Medicine: Chronic Illness Experience in the Case of Stroke

In this article I explore the ambiguous nature of the boundaries of authority and responsibility in medicine by discussing two dimensions of patients' response to long‐term ramifications of stroke. A phenomenological examination of the chronic illness experience is employed to identify how and the extent to which medicine's power both responds to and affects the individual sufferer. Rather than interpret the illness process as a dichotomy between medical control and patient autonomy, this article presents some assumptions about the boundaries of medical authority that are held by patients and practitioners alike. I suggest that dilemmas that patients face following a stroke are responses to medicine's limits and scope as well as reflections of medicine's goals and values. I argue that phenomenological studies of existential responses to illness are necessary in order to understand cultural sources of unmet expectations resulting from chronic conditions.