Status Of Claims Research Articles

Judicial Evaluation of Religious Belief and the Accessibility Requirement in Public Reason

Many theories of liberal public reason exclude claims derived from religion on grounds that religious beliefs are not publicly ‘accessible’, because they are not amenable to meaningful evaluation by outsiders to the faith. Some authors, though, have argued that at least some religious beliefs are, in fact, publicly accessible. This paper examines the consequences of these arguments by exploring the accessibility requirement in relation to U.S. judicial precedent concerning religious accommodation. I first show that precedent accords de facto with the accessibility requirement by precluding judicial evaluation of the content of religious beliefs. I then show that this norm is independent of the status of religious claims vis-a-vis accessibility: even granting the accessibility of religious beliefs, other important political ends weigh against judicial evaluation of the content of those beliefs. I then generalize this conclusion to the broader enterprise of public reason, suggesting the general inadequacy of the accessibility requirement.

Merleau-Ponty and the Myth of Human Incarnation

ABSTRACT In this article I argue that Merleau-Ponty's initial reinterpretation of Husserlian phenomenology is premised methodologically on a certain mythic understanding of human embodiment—what I term “the myth of human incarnation.” This is not an objection but a clarification of how Merleau-Ponty resolved the problem of the external horizonality of phenomenological experience on an intuitional (rather than speculative) basis. This methodological priority of myth is implicated in the epistemic status of phenomenological claims concerning prereflective phenomena such as “bodily” intentionality and thus has important consequences for questions concerning the “naturalization” of phenomenology.

Effect of Diabetes Mellitus, Peripheral Neuropathy, or Charcot Arthropathy on Workers Compensation Claims

Category: Diabetes Introduction/Purpose: Charcot neuroarthropathy is a complication of peripheral neuropathy commonly resulting from diabetes mellitus. The actual trigger for a Charcot neuroarthropathy episode is unknown. Due to the chronic nature and multifactorial causality of the disease, affected patients frequently have difficulty with workers’ compensation claims resulting in appeals or even outright denials. This study retrospectively reviewed patient’s charts with workers’ compensation claims in a foot and ankle practice to determine the incidence of diabetes mellitus, peripheral neuropathy, and Charcot neuroarthropathy. The study will then review each affected patient to determine if there is a correlation between his or her health status and claim status. Methods: From January 2011 to January of 2015, 331 patients were seen in a tertiary foot and ankle clinic with a worker’s compensation claim. A chart review identified patients with diabetes mellitus, peripheral neuropathy, or Charcot neuroarthropathy. The claims database was reviewed to determine the number of claim appeals submitted for each patient. Results: There were 43 patients (13% of workers compensation patients) with diabetes, 12 (4% of workers compensation patients) with peripheral neuropathy, and 3 (7% of diabetics, 1% of workers compensation patients) with Charcot. There were a total of 115 appeals in patients without Diabetes Mellitus, peripheral neuropathy, or Charcot arthropathy, 23 appeals in patient with Diabetes, 8 appeals in patients with peripheral neuropathy, and 6 appeals in the patients with Charcot. Conclusion: Diabetes alone did not increase the number of appeals. Patients with peripheral neuropathy, however, were two- times more likely to have an appeal than a patient without peripheral neuropathy. Patients with Charcot had eight times more appeals than patients without Charcot. Thus, Charcot arthropathy and peripheral neuropathy are strong indicators an increased claim appeals in the Worker’s Compensation system. This data only reflects appeals of claims for services provided and does not reflect difficulty with obtaining approvals for planned procedures.

The association between seeking financial compensation and injury recovery following motor vehicle related orthopaedic trauma.

BackgroundMotor vehicle related moderate-severe orthopaedic trauma has a major impact on the burden of injury. In Australia, all states and territories provide access to financial compensation following injury in a motor vehicle crash. The aim of this study was to investigate the influence of seeking financial compensation (i.e., making a claim) on injury recovery following motor vehicle related moderate-severe orthopaedic trauma.MethodsPatients admitted with upper/lower extremity fractures after a motor vehicle crash were recruited from two trauma hospitals. Baseline data were collected in person by written questionnaire within two weeks of injury. Follow up data were collected by a mailed written questionnaire at six, 12 and 24 months. Additional (demographic/injury-related) information was collected from hospital databases, all other measures were self-reported. Outcomes were: Short Form-36 Version 2.0 (SF36v2), Physical/Mental Component Scores (PCS/MCS); Post Traumatic Stress Disorder (PTSD) Checklist Civilian Version (PCL-C); and Global Rating of Change (GRC) scale. Analysis involved descriptive statistics and linear mixed models to examine the effect of compensation status on injury recovery over time.ResultsThere were 452 study participants. Baseline characteristics showed: mean age 40 years (17.1 Standard Deviation [SD]); 75 % male; 74 % worked pre-injury; 67 % in excellent-very good pre-injury health; 56 % sustained serious injuries, Injury Severity Score (ISS) 9–15; 61 % had a low-middle range household income.Overall, after controlling for possible confounders, the compensable group had poorer recovery compared to the non-compensable group for PCS (−2.97 Mean Difference (MD), 95 % CI −4.73, −1.22); MCS (−3.44 MD, 95 % CI −5.62, −1.26); PCL-C (3.42MD, 95 % CI 0.87, 5.99); and GRC (−0.66MD, 95 % CI −1.15, −0.17). Injury recovery over time for all participants showed: PCS improved from 6–12 and 12–24 months; MCS and GRC improved from 6–12 months; and PCL-C did not significantly improve from 6–12 and 12–24 months. Injury recovery over time continued for compensable and non-compensable groups but compensable participants had poorer scores at each time period, especially MCS and PCL-C.ConclusionsMaking a claim was associated with poor injury recovery following motor vehicle related orthopaedic trauma, mainly for mental health. Irrespective of claim status, the majority had poor injury recovery, especially for mental health.

Imaginary Worlds: A Systematic Review of the Status of Modeled Cost-Effectiveness Claims Published in the Journal of Medical Economics from January 2015 to December 2015

The purpose of this review is to evaluate the credibility of modeled claims for cost-effectiveness studies published in the Journal of Medical Economics (JME) in the period January 2015 to December 2015. Credibility is assessed in terms of the standards of normal science. Are the claims made capable of falsification and replication? Following the PRISMA-P recommendations, abstracts of all papers published in the JME were evaluated by both authors independently against a MeSH terms checklist: cost, cost-effectiveness, cost-utility, outcomes, QALY and Markov. A total of 32 studies were identified. A systematic review of each study was then evaluated. The consensus was that all studies be included in the review. Each study was judged against four criteria: (i) Is the model capable of generating evaluable claims? (ii) did the author(s) attempt to generate evaluable claims? (iii) did the author(s) suggested how the claims might be evaluated? and (iv) did the author(s) caution readers as to the implications of generating non-evaluable clams for the credibility of the analysis? None of the studies presented their claims or projections in an evaluable form and none suggested how they might be evaluated. None met the standards of normal science. The claims made for cost-effectiveness were either impossible to verify, or if potentially verifiable, were not presented in an evaluable form. The studies lacked credibility. There was no basis for assessing whether the claims were right or even if they were wrong. The JME is not alone. As part of an ongoing systematic review program, covering the leading journals and focusing on chronic condition areas, it is clear that the majority of cost-effectiveness papers also fail the test of credibility. Of course, it might be that the consensus opinion among practitioners is that non-evaluable projections are acceptable. Evidence is not discovered, but is constructed through models and simulations. This lack of scientific credibility is a major concern. If medical economics is to advance through the formulation and testing of hypotheses, then editors of journals should consider whether or not to set standards for the acceptance of publications to include the requirement for evaluable claims and the results of claims assessment. If this is not acceptable, then it should be made clear that published papers are simply imaginary worlds or thought experiments.
 
 Type: Commentary

Country Differences in the History of Use of Health Claims and Symbols

Health-related claims and symbols are intended as aids to help consumers make informed and healthier food choices but they can also stimulate the food industry to develop food that goes hand in hand with a healthier lifestyle. In order to better understand the role that health claims and symbols currently have and in the future potentially can have, the objective of the CLYMBOL project (“Role of health-related claims and symbols in consumer behaviour”, Grant no 311963) is to investigate consumers’ understanding of health claims and symbols, and how they affect purchasing and consumption [1]. As part of this endeavour, it is important to understand the history of use of claims and symbols in Europe. What have consumers been exposed to and how were these health-related messages used and discussed among the public? In this study, we interviewed key stakeholders across Europe about how health claims have been regulated in their country, how health symbols have been and currently are being treated, what form of monitoring there is or should be and how both health claims and symbols have been debated in the public opinion. In 26 European Union (EU) Member States, opinions from 53 key informants from up to three different stakeholder groups were gathered: national food authorities, representatives of the food industry, and consumer organisations. While 14 Member States reported (at least partial) regulation of the use of health claims and/or symbols before the introduction of the EU Regulation (EC 1924/2006) on nutrition and health claims made on foods [2], mandatory reporting of use had only been in place in three EU Member States. A number of voluntary codes of practice for health claims and/or symbols (i.e. pre-approval or justification when challenged) was said to be in use in 15 Member States. There are only a few national databases on health claims and symbols available, the data for which is often incomplete. Only eight Member States reported having some form of database from which information about health claims and symbols could be extracted. The stakeholders interviewed expressed a strong interest in measuring the impact of health claims and symbols, particularly research into the effects on consumer behaviour (e.g. awareness and understanding, attitudes towards products carrying claims and symbols and purchase/consumption effects), public health (health outcomes and changes in national health status due to the introduction of claims and symbols on food products) and economic aspects including sales, return on investment and reputation measurements. Public debates were said to have evolved around the topics of consumer understanding of claims, acceptance as well as trust in the information presented but also the effects on vulnerable groups such as children and elderly consumers. Another field of debate was said to have been the question of the effectiveness of health claims and symbols. Lastly, stakeholders reported that public debates focussed mainly on the legislative aspects, i.e. how to apply the EU Regulation (No 1924/2006) with regards to wording issues, the evaluation process at the European Food Safety Authority (EFSA), the status of various claims and the nutrient profile modelling to be introduced in Europe.

Does injury claim status and benefit status predict low back pain outcomes?

In New Zealand the Accident Compensation Corporation (ACC) is a state-funded insurance agency that accepts claims for accidental injuries, including lumbar spine injuries. It is unknown whether ACC claim status (accepted, not accepted) affects low back pain (LBP) outcomes, or whether benefit status (e.g., sickness, disability) further affects outcomes in patients without ACC cover. This study aimed to determine whether ACC claim and benefit status are likely to influence a range of outcomes for people with LBP in New Zealand. A prospective survey of low back pain patients was performed (April 2008-October 2010). ACC claim status was recorded, and individuals without accepted claims indicated benefit status. Surveys were sent at multiple time points; pain, functional limitation, psychological factors, and general health were assessed. Statistical analysis was undertaken using ANCOVA and ANOVA (p<0.05). In total, 168 patients completed the study. Six-month measures showed individuals with no ACC claim for LBP to overall have poorer outcomes (mental health, p=0.039; pain, p=0.045; functional limitation, p=0.049); sub-group analysis (no ACC claim) between those with or without a benefit showed those on benefits to have significantly higher functional limitation (p<0.001), poorer physical health (p=0.002), greater pain (p=0.027), and stronger fear avoidance behaviours for both work (p=0.047) and physical activity (p=0.35). Findings indicate individuals with accepted ACC claims for LBP have significantly better outcomes than those without, and patients on benefits with no accepted ACC claim for LBP have even poorer outcomes.

Cognitive Bias and Claims of Quasiperiodicity in Traditional Islamic Patterns

In this article we discuss whether traditional Islamic geometric patterns exhibit the distinguishing structural properties of quasicrystals. We present two case studies that examine candidate examples from the western and eastern schools of Islamic ornament. In both cases, researchers made a hypothesis that the Islamic patterns have quasiperiodic features, both found that their model does not match the data, yet both found reasons to discard the errors and accept the model, rather than search for an alternative explanation. This has led to widespread confusion about the status of claims concerning quasiperiodic Islamic ornament, a situation that became clear to me during discussions at a recent conference, and which motivated me to write up these notes. In both case studies, the language and tools of crystallography are applied to analyse Islamic patterns. In each case, we shall show that the conclusions are incorrect, and also propose a different method of construction that agrees with the evidence and the wider context. The analysis of crystals is based on statistical properties of large samples, and real-world crystals display a range of defects when compared to our mathematically perfect models. We suggest that approaching the problem from a crystallographic perspective predisposes the mind to regard defects as anomalies rather than errors. This bias, together with flaws such as confirmation bias in the methodology, may explain how the researchers reached their conclusions.

How to Shape a Better Future? Epistemic Difficulties for Ethical Assessment and Anticipatory Governance of Emerging Technologies

Empirical research into the ethics of emerging technologies, often involving foresight studies, technology assessment or application of the precautionary principle, raises significant epistemological challenges by failing to explain the relative epistemic status of contentious normative claims about future states. This weakness means that it is unclear why the conclusions reached by these approaches should be considered valid, for example in anticipatory ethical assessment or governance of emerging technologies. This paper explains and responds to this problem by proposing an account of how the epistemic status of uncertain normative claims can be established in ethical and political discourses based on Jurgen Habermas’ discourse ethics. To better understand the nature of the problem, the relationship between norms, facts and the future is explored in light of potential meta-ethical fallacies faced in the field of empirical ethics. Weaknesses of current approaches to anticipatory ethical assessment and governance are then explored, including the Precautionary Principle and Technology Assessment. We argue that the epistemic status of uncertain normative claims can be understood within Habermas’ approach to political discourse, which requires ‘translation’ of uncertain claims to be comprehensible to other stakeholders in discourse. Translation thus provides a way to allow for uncertain normative claims to be considered alongside other types of validity claims in discourse. The paper contributes a conceptual account of the epistemic status of uncertain normative claims in discourse and begins to develop a ‘methodology of translation’ which can be further developed for approaches to research and ethical assessment supporting anticipatory evidence-based policy, governance and system design.

The role of interpretation in inferring student knowledge and understanding from research data

RecentlyCERPpublished its first articles in the categories of Comments and Replies. These are peer reviewed articles that address specific issues raised in articles published in the journal. A Comment is an article by new authors who argue that something in a published article should not stand in the literature without further comment, and a Reply is a response by the original authors to the Comment. The option of publishing articles of this kind is common among research journals, such as those published by the Royal Society of Chemistry.CERPis not seeking to actively encourage readers to submit comments on the papers they read in the journal as a matter of course, but rather is offering the possibility of challenging assertions made in published articles where readers strongly feel that there is some form of misrepresentation or limitation in an article that should be pointed out to the chemistry education community. These types of article raise issues about the definitiveness of research contributions, the status of knowledge claims made in published papers, and the conversational nature of the research literature in general.

Unsettling Business: The BP Settlement Agreement

Two years since the settlement agreement between BP and plaintiffs of the Deepwater Horizon oil spill, myriad challenges to the agreement by BP related to the calculation of business economic loss payments and causation have been filed. While BP has been successful in its efforts to revise the rules for calculation of payments, it has been less successful on the causation issue. This article reviews the history of the settlement agreement, summarizes the status of business economic loss payment claims, and discusses the impact of BP challenges on claimants at all stages of the claims process, including businesses that have previously received payments. © 2015 Wiley Periodicals, Inc.

What is a Lien? Lessons from Municipal Bankruptcy

From the outset of Detroit’s bankruptcy, an unlikely set of issues kept coming up: What exactly is a lien? Who has a property interest or its equivalent in bankruptcy? Did general obligation bondholders have special status, due to Detroit’s promise to use its “full faith and credit” for repayment? What about Detroit’s pension beneficiaries, who could point to a provision in the Michigan Constitution stating that accrued pension benefits cannot be diminished or impaired. In this Article, I explore these and related issues that have arisen in Detroit and other recent municipal bankruptcy cases.Part I of the Article briefly compares liens and a variety of lien substitutes. In Part II, I recount the history of bankruptcy’s statutory lien provision, which honors state liens but not state priorities, and requires that the lien be good both in bankruptcy and outside of bankruptcy. My focus in Part III is the status of general obligation bonds in Detroit, a question which has turned out to have different answers for the two different types of Detroit GO bonds. In Part IV, I explore Rhode Island’s remarkable statute purporting to give a sweeping lien to GO bondholders. I then discuss the question whether pensions can be restructured in bankruptcy in Part V. I conclude that they can, and that the precise status of pension claims turns in large part on bankruptcy’s treatment of trusts.

Avoidable Ignorance and the Role of Cochrane and Campbell Reviews

The Campbell and Cochrane Collaborations were created to reveal the evidentiary status of claims focusing especially on the effectiveness of specific interventions. Such reviews are constrained by the population of studies available and biases that may influence this availability such as preferred framing of problems. This highlights the importance of attending to how problems are framed and the validity of measures used in such reviews, as well as the importance of reviews focusing on questions concerning problem framing and the accuracy of measures. Neglecting such questions, both within reviews of effectiveness and in separate reviews concerning related claims, results in lost opportunities to decrease avoidable ignorance. Domains of avoidable ignorance are suggested using examples of Cochrane/Campbell reviews. Without attention to problem framing, systematic reviews may contribute to maintaining avoidable ignorance.

Dividend Withholding Tax Claims in the European Union

This article provides an overview of the current status of dividend withholding tax claims filed by collective investment vehicles, pension funds and life insurance companies throughout the European Union. In particular, the article describes the local procedure (including formalities to be complied with) when filing such claims, the time frame and the likelihood of success in the different jurisdictions covered, from the perspective of both claimants established in the European Union and claimants established in third countries.

No Turning Point: The Saratoga Campaign in Perspective by Theodore Corbett (review)

No Turning Point: The Saratoga Campaign in Perspective. By Theodore Corbett. (Norman: University of Oklahoma Press, 2012. Pp. xii + 436. Cloth, $39. 95.)Reviewed by Benjamin L. CarpAnyone with a passing knowledge of Revolutionary War remembers Saratoga campaign of 1777 as a key turning point. The British surrender on October 17 exposed John Burgoyne and William Howe as foiled military commanders; it ruined Crown's best chance to drive a wedge between New England and Middle Colonies and bolstered French confidence in American rebellion. The perennial emphasis on Saratoga reflects traditional historians' preference for focusing on machinations of statesmen and military campaigns of senior commanders.Theodore Corbett insists that we revisit this conventional wisdom. It's not that he thinks these conclusions are wrong-in fact, he spends almost no time on diplomacy or on British ministry's overall direction of war effort. Instead, he hopes to refocus our attention on the regional war that surrounded and penetrated Saratoga battlefields (369), essentially Hudson-Champlain region north of Albany, just east of areas covered in Alan Taylor's The Divided Ground: Indians, Settlers, and Northern Borderland of American Revolution (New York, 2006). From this perspective, he argues, Burgoyne's surrender was no turning point at all, but a reverberating regional conflict that distressed inhabitants for almost a decade.Corbett begins by tracing white settlement of Hudson-Champlain region after 1763, and then he analyzes region's experience of war. He stresses importance of Guy Carleton's 1776 victory at Lake Champlain, which neutralized Fort Ticonderoga and gave Britain a staging area for five more years of invasions. While a narrative like Richard Ketchum's Saratoga: Turning Point of America's Revolutionary War (New York, 1997) ends abruptly with Burgoyne's surrender and its immediate global consequences, Corbett's discussion of British defeat occurs two-thirds of way through book. The remaining pages animate continued civil war, subsequent British raids, Loyalist migrations, political squabbles among American civil authorities, and agrarian unrest of 1780s. The author casts this series of incidents as an unbroken chain of civil conflict that destabilized various localities in region. Corbett is finely attuned to local political geography, and he criticizes military officers who paid it too little attention.The book spends less time on armies' strategy and provisioning than on politics, security, and recruitment in region surrounding Burgoyne's march. Corbett offers a wide array of narratives: We observe Burgoyne's pacification policy; Albany Committee of Correspondence raising special militia units for suppressing Loyalism; General Philip Schuyler ordering settlers to evacuate, to prevent them from becoming Loyalists; and settlers in Charlotte County's Argyle Patent and elsewhere attempting to claim status of protectioners for their own security, rather than out of strong Loyalist conviction. He tracks reign of Arlington Junta who took power in Vermont and dominated process of confiscating Loyalist property.Corbett is right to reaffirm Revolution as civil war, a perspective that still receives too little attention outside war's southern theater. …

The Justice of Inequality: Argumentation Ethics and Radical Non-Aggression

Questions of inequality of wealth frequently arise during times of economic hardship. The stagnant recovery from the 2008 global financial crisis is no exception. Many are quick to condemn inequality as an unjust social phenomenon. This article considers the ethical status of such claims by examining whether inequality is fair or not. Using a neo-Kantian framework first put forward by Hans-Hermann Hoppe, the paper elucidates the presuppositions implied by human action and uses these as a basis for political rights. Once inviolable rights to ownership of one’s person and property are established, it follows that income inequality in the absence of coercion is fair. However, since such a condition does not describe modern society, little can be immediately said about the justice of current levels of inequality.

Evaluasi Sistem Informasi Akuntansi terhadap Pembayaran Klaim Nasabah pada Asuransi Perorangan di Asuransi Jiwa B

Life Insurance B is a company engaging in the services of people protection. Evaluation of accounting information system which relates with the customer claims payments made by the company has the objective to identify the weaknesses in the system of disbursement procedures and to provide the new recommendations. In doing the research, the author conducted literature research and field research. Fieldwork was conducted in order to obtain accurate and real data. Based on the research, writers found some weaknesses in the payment process customer claims, including the claim that the document is not to be numbered prints, the differences in the status of the policy and double claim status. There are weaknesses in the control applications such as sequence check, check and reasonable limits, total control check, which have not been applied to the company as well. In the company’s report, there has been no report on the problems that occur in a given period. To overcome these weaknesses, writers suggest a new document in the form of proposals that have been accompanied by a serial number printed. Should the company implement a weekly batch system with a view to have the latest report from branches every week, not every month. And finally the employees should make report any problems that occur in the company, so that problems that occur can be easily monitored by the authorities.

Responsibility in the Time of Cholera: Liability of International Organisations for Wrongful Conduct

The reference point for the present paper is the outbreak of cholera in Haiti in 2010, which has been argued to have resulted from the deployment of Nepali peacekeepers to the United Nations Stabilization Mission in Haiti (MINUSTAH). The outbreak killed close to 8000 people and infected 6% of the Haitian population. In 2011, the Institute for Justice and Democracy in Haiti (IJDH) filed a law suit against the United Nations (UN), on behalf of over 5000 plaintiffs, claiming compensation for those deceased and injured in the cholera epidemic. It also sought a public apology and acknowledgment of responsibility for causing the outbreak of the epidemic on part of the UN. While there has been significant criticism levied at the UN, the organization has absolved itself of any responsibility by claiming immunity. Not surprisingly, MINUSTAH is not the only UN mission to have come under criticism. In 2012, an internal report of the UN leaked to the press severely criticized the dereliction of duty on part of senior UN officials in Sri Lanka during the civil war in 2009, which led to the death of many civilians. Other UN peacekeeping missions, notably the UN Stabilization Mission in DR Congo (MONUSCO) have also been severely criticized for rampant sexual abuse and exploitation cases perpetrated by its peacekeeping troops. Nevertheless, the Haiti cholera case remains a significant precedent for the potential implications it holds for future activities of the UN in the field of peacekeeping. This paper proposes to study the liability of the United Nations (UN) for wrongful acts committed during a UN authorized mission. The present paper does not seek to establish the nature of human rights and humanitarian law obligations that the UN is bound by. Rather, it begins with the assumption that given the legal personality vested in the UN such an obligation is implicit, derived from customary international law as well as principles of human rights and humanitarian law. Beginning with this assumption, the paper seeks to answer the following questions1) Whether the UN can claim immunity from prosecution and compensation for acts which are (i) manifestly wrong and/or (ii) reckless and fail to meet due diligence standards set by the organization and (iii) do not further the objective of a UN mission. 2) If the answer to the aforesaid question is yes, what are the pre-conditions that have to be fulfilled before such attribution of responsibility can take place?The paper proposes to examine the aforesaid questions by studying the interplay between institutional immunity granted to the UN as well as taking into consideration the 2011 ILC Draft Articles on the Responsibility of International Organizations. Another aspect, which will be covered is the issue of third party claims procedure and Status of Forces Agreement, traditionally signed between the UN and the host country before a peacekeeping mission is deployed.

Magnifying Loupes Versus Microscope for Microdiscectomy and Microdecompression

Consecutive case series of 51 patients in each group--single-surgeon experience. Comparing magnifying loupes and microscopes for microdiscectomy and microdecompression. Prospective peroperative data and retrospective outcome data. All patients had unilateral single-level magnetic resonance imaging-proven radicular pain. All relevant preoperative, peroperative, and postoperative data were collected prospectively, including operating time, complications, and return to the preprolapse functional level. Retrospective patient satisfaction, employment level, workman's compensation claim status, smoking status, pain, and functional outcome scores were collected through a telephonic interview. The microscope group was significantly (P < 0.05) better than the loupes group with respect to patient outcome and earlier return of the preprolapse functional level. Patient satisfaction scores, Visual Analogue Scores for pain, and rate of complications were also better in the microscope group but were not statistically significant at P < 0.05. Microscopes are better than loupes as they provide a much better visualization, are more comfortable for the surgeon, and are a much better teaching tool.

The right to health versus good medical care?

There are two discourses that are used in connection with the provision of good healthcare: a rights discourse and a beneficial design discourse. Although the logical force of these two discourses overlaps, they have distinct and incompatible implications for practical reasoning about health policy. The language of rights can be interpreted as the ground of a well-designed healthcare system stressing the values of equality and inclusion, but it has less application when dealing with questions of cost-effectiveness. This difference reflects the distinction between the deontological status of rights claims and a teleological approach presupposed in the language of beneficial design. However, the value of the separateness of persons contained in the discourse of rights can impose constraints on the adoption of a simple maximizing principle when thinking about the allocation of healthcare resources within a social contract for health. Throughout these issues are discussed by reference to the work of Peter Jones.