Potable Recycled Water Research Articles

Effect of ocean outfall discharge volume and dissolved inorganic nitrogen load on urban eutrophication outcomes in the Southern California Bight

Climate change is increasing drought severity worldwide. Ocean discharges of municipal wastewater are a target for potable water recycling. Potable water recycling would reduce wastewater volume; however, the effect on mass nitrogen loading is dependent on treatment. In cases where nitrogen mass loading is not altered or altered minimally, this practice has the potential to influence spatial patterns in coastal eutrophication. We apply a physical-biogeochemical numerical ocean model to understand the influence of nitrogen management and potable wastewater recycling on net primary productivity (NPP), pH, and oxygen. We model several theoretical management scenarios by combining dissolved inorganic nitrogen (DIN) reductions from 50 to 85% and recycling from 0 to 90%, applied to 19 generalized wastewater outfalls in the Southern California Bight. Under no recycling, NPP, acidification, and oxygen loss decline with DIN reductions, which simulated habitat volume expansion for pelagic calcifiers and aerobic taxa. Recycling scenarios under intermediate DIN reduction show patchier areas of pH and oxygen loss with steeper vertical declines relative to a “no recycling” scenario. These patches are diminished under 85% DIN reduction across all recycling levels, suggesting nitrogen management lowers eutrophication risk even with concentrated discharges. These findings represent a novel application of ocean numerical models to investigate the regional effects of idealized outfall management on eutrophication. Additional work is needed to investigate more realistic outfall-specific water recycling and nutrient management scenarios and to contextualize the benefit of these management actions, given accelerating acidification and hypoxia from climate change.

Associations between conspiracism and the rejection of scientific innovations.

Public opinion regarding scientific developments such as genetically modified food can be mixed. We suggest such science-based technological innovations are rejected by some because they are perceived to be advanced as part of a conspiracy. In nationally representative samples (Australia n = 1011; New Zealand n = 754), we report the associations between five conspiracism facets and anti-science attitudes. Results indicate broad public opposition to genetically modified food and use of nuclear power, but more acceptance of renewable power, potable recycled water, 5G networks, and childhood vaccinations. There were small to moderate associations between the rejection of scientific innovations and conspiracism. Multivariate models estimating unique associations of conspiracism facets with anti-science attitudes suggested several novel and important relationships, particularly for childhood vaccination, genetically modified food, and 5G networks. We discuss the importance of examining factors such as conspiracism in understanding what may motivate and sustain rejection of scientific evidence-based claims about socially contentious technological innovations.

Direct potable water recycling in Texas: case studies and policy implications

ABSTRACT Direct potable water recycling (DPR) is increasingly recognized as an important strategy in the face of water shortage. DPR often is challenged by a lack of public support and in some cases has been overturned by public opposition alone. Severe drought in Texas in recent years has resulted in several cities in that state considering and passing DPR policies for the first time in the United States. We present three case studies–two from cities that passed and implemented DPR policies and one that considered and ultimately tabled a DPR plan. We use multiple data sources including public surveys and policy maker interviews, newspaper articles, and city meeting minutes to examine the discourse on these policies in public, media, and political spheres. Importantly, we explore the connection between regulatory, structural, environmental, political, and communication factors in each case as they intersect with public attitudes, including expressions of disgust and perceived risk which have featured in experimental research on perceptions of water recycling. By exploring these factors holistically, we are able to examine some of the ways these public attitudinal factors interact in real-world contexts with implications for future policy making and studies of local decision-making under uncertainty.

Newspaper Coverage of Potable Water Recycling at Orange County Water District’s Groundwater Replenishment System, 2000–2016

Water planners in water-strapped communities in the western United States and beyond increasingly consider potable water recycling an important water management strategy. Although potable water recycling can increase an otherwise limited urban water supply, the threat of public or political opposition often looms large. This paper examines newspaper coverage of the most widely celebrated potable water reuse project in the world—the Groundwater Replenishment System (GWRS) in Orange County, California, USA. The case study examines the coverage of GWRS contained in local, national, and international newspapers during an era of significant investment and repeated expansion. Despite the potential controversy associated with drinking recycled wastewater, there was no negative newspaper coverage of GWRS from 2000–2016. Much of the coverage was mundane, however several articles embraced infrastructure and technology as key to developing new water resources while protecting public and environmental health. Although potable water recycling is presented as an innovative solution capable of solving several problems at once, a close analysis reveals that recycled water may not fulfill the promise of an uninterruptible urban water supply.

Life-cycle energy impacts for adapting an urban water supply system to droughts

In recent years, cities in some water stressed regions have explored alternative water sources such as seawater desalination and potable water recycling in spite of concerns over increasing energy consumption. In this study, we evaluate the current and future life-cycle energy impacts of four alternative water supply strategies introduced during a decade-long drought in South East Queensland (SEQ), Australia. These strategies were: seawater desalination, indirect potable water recycling, network integration, and rainwater tanks. Our work highlights the energy burden of alternative water supply strategies which added approximately 24% life-cycle energy use to the existing supply system (with surface water sources) in SEQ even for a current post-drought low utilisation status. Over half of this additional life-cycle energy use was from the centralised alternative supply strategies. Rainwater tanks contributed an estimated 3% to regional water supply, but added over 10% life-cycle energy use to the existing system. In the future scenario analysis, we compare the life-cycle energy use between “Normal”, “Dry”, “High water demand” and “Design capacity” scenarios. In the “Normal” scenario, a long-term low utilisation of the desalination system and the water recycling system has greatly reduced the energy burden of these centralised strategies to only 13%. In contrast, higher utilisation in the unlikely “Dry” and “Design capacity” scenarios add 86% and 140% to life-cycle energy use of the existing system respectively. In the “High water demand” scenario, a 20% increase in per capita water use over 20 years “consumes” more energy than is used by the four alternative strategies in the “Normal” scenario. This research provides insight for developing more realistic long-term scenarios to evaluate and compare life-cycle energy impacts of drought-adaptation infrastructure and regional decentralised water sources. Scenario building for life-cycle assessments of water supply systems should consider i) climate variability and, therefore, infrastructure utilisation rate, ii) potential under-utilisation for both installed centralised and decentralised sources, and iii) the potential energy penalty for operating infrastructure well below its design capacity (e.g., the operational energy intensity of the desalination system is three times higher at low utilisation rates). This study illustrates that evaluating the life-cycle energy use and intensity of these type of supply sources without considering their realistic long-term operating scenario(s) can potentially distort and overemphasise their energy implications. To other water stressed regions, this work shows that managing long-term water demand is also important, in addition to acknowledging the energy-intensive nature of some alternative water sources.

Common sense principles governing potable water recycling in the southwestern US: Examining subjectivity of water stewards using Q methodology

The potential to supplement potable water supplies with highly treated municipal wastewater, or sewage, is of increasing interest to water planners in many parts of the world. Most of the current social science focuses on public acceptance, however there is a relative lack of research that explores the subjectivity of people who are involved with water recycling or water planning. This study draws on Gramscian theories of governance and Q Methodology to analyze common sense principles that are held by water stewards who currently govern potable water reuse in the southwestern United States. Two competing perspectives emerged from the analyses, which I label neosanitarian and ecosanitarian. Drawing upon tenets established in the Progressive Era, neosanitarians believe that use of recycled water is an appropriate way to expand urban drinking water supplies. Drawing upon tenets established in ecology, ecosanitarians are not opposed to potable water recycling, however they are also interested in radical alternatives to the sanitary status quo. For example, neosanitarians favor advanced wastewater treatment, while ecosanitarians prefer composting toilets and preventative actions. Differences between the common sense views pivot on ideas about the most appropriate technology but also reflect contested visions of ideal society.

Small Scale Direct Potable Reuse (DPR) Project for a Remote Area

An Advanced Water Treatment Plant (AWTP) for potable water recycling in Davis Station Antarctica was trialed using secondary effluent at Selfs Point in Hobart, Tasmania, for nine months. The trials demonstrated the reliability of performance of a seven barrier treatment process consisting of ozonation, ceramic microfiltration (MF), biologically activated carbon, reverse osmosis, ultra-violet disinfection, calcite contactor and chlorination. The seven treatment barriers were required to meet the high log removal values (LRV) required for pathogens in small systems during disease outbreak, and on-line verification of process performance was required for operation with infrequent operator attention. On-line verification of pathogen LRVs, a low turbidity filtrate of approximately 0.1 NTU (Nephelometric Turbidity Unit), no long-term fouling and no requirement for clean-in-place (CIP) was achieved with the ceramic MF. A pressure decay test was also reliably implemented on the reverse osmosis system to achieve a 2 LRV for protozoa, and this barrier required only 2–3 CIP treatments each year. The ozonation process achieved 2 LRV for bacteria and virus with no requirement for an ozone residual, provided the ozone dose was >11.7 mg/L. Extensive screening using multi-residue gas chromatography–mass spectrometry (GC–MS) and liquid chromatography–mass spectrometry (LC–MS) database methods that can screen for more than 1200 chemicals found that few chemicals pass through the barriers to the final product and rejected (discharge) water streams. The AWTP plant required 1.93 kWh/m3 when operated in the mode required for Davis Station and was predicted to require 1.27 kWh/m3 if scaled up to 10 ML/day. The AWTP will be shipped to Davis Station for further trials before possible implementation for water recycling. The process may have application in other small remote communities.

Illuminating elimination: public perception and the production of potable water reuse

Given the scope of water and sanitation challenges posed by climate change and continued urbanization, potable water recycling is gaining traction as a means to expand urban water supply and decrease wastewater disposal into waterways. No longer regarded as a system by‐product without value, planners increasingly consider wastewater a displaced resource in need of recirculation. The literature suggests that public perception and institutional barriers are the limiting factors to greater recapture and reuse of wastewater. Implicitly accepting water recycling as a sustainable alternative, much of the research is aimed at overcoming public opposition. However, the trend toward potable water recycling disrupts the normally hidden processes of urban water delivery, treatment, and disposal. In doing so, it provides a rare opportunity to contemplate taken‐for‐granted technologies of waterborne sanitation and to recognize alternative modes of managing human excrement, including composting toilets and dry sanitation. WIREs Water 2016, 3:537–547. doi: 10.1002/wat2.1149This article is categorized under: Engineering Water > Planning Water Human Water > Water as Imagined and Represented

Comment on “Providing information promotes greater public support for potable recycled water” by Fielding, K.S. and Roiko, A.H., 2014 [Water Research 61, 86–96

Recently, Fielding and Roiko found that information provision affects knowledge of and support for potable recycled water. However, recent cultural–sociological insights suggest that such effects are not universal. A re-analysis of the original data reveals the relevance of cultural predispositions: significant effects only exist in specific subgroups of the population. Only those who are comfortable with new technologies prove receptive to new information about potable recycled water. These findings are relevant for scholars aiming to uncover the mechanisms through which information affects public opinion, and for policymakers trying to overcome community resistance to alternative water sources.

Developing effective messages about potable recycled water: The importance of message structure and content

AbstractCommunity opposition is a barrier to potable recycled water schemes. Effective communication strategies about such schemes are needed. Drawing on social psychological literature, two experimental studies are presented, which explore messages that improve public perceptions of potable recycled water. The Elaboration‐Likelihood Model of information processing and attitude change is tested and supported. Study 1 (N = 415) premeasured support for recycled water, and trust in government information at Time 1. Messages varied in complexity and sidedness were presented at Time 2 (3 weeks later), and support and trust were remeasured. Support increased after receiving information, provided that participants received complex rather than simple information. Trust in government was also higher after receiving information. There was tentative evidence of this in response to two‐sided messages rather than one‐sided messages. Initial attitudes to recycled water moderated responses to information. Those initially neutral or ambivalent responded differently to simple and one‐sided messages, compared to participants with positive or negative attitudes. Study 2 (N = 957) tested the effectiveness of information about the low relative risks, and/or benefits of potable recycled water, compared to control groups. Messages about the low risks resulted in higher support when the issue of recycled water was relevant. Messages about benefits resulted in higher perceived issue relevance, but did not translate into greater support. The results highlight the importance of understanding people's motivation to process information, and need to tailor communication to match attitudes and stage of recycled water schemes' development.

Providing information promotes greater public support for potable recycled water

In spite of the clear need to address water security through sourcing new and alternative water supplies, there has been marked resistance from some communities to the introduction of recycled water for potable use. The present studies tested the effectiveness of providing relatively brief information about the recycled water process and the safety of recycled water on cognitive, emotional and behavioral responses. Three information conditions (basic information or basic information plus information about pollutants in the water, or information that puts the risk of chemicals in the water in perspective) were compared to a no information control condition. Across three experiments there was general support for the hypothesis that providing information would result in more positive cognitive, emotional, and behavioral responses to recycled water. Information increased comfort with potable recycled water and, in general, participants in the information conditions expressed more positive emotions (Experiment 1 & 3), less negative emotions (Experiment 3), more support (Experiment 1 & 3), and lower risk perceptions (Experiment 1 & 3) than those in the no information control condition. Participants who received information also drank more recycled water than control participants (Experiment 1 & 2, although the differences between conditions was not statistically significant) and were significantly more likely to vote in favor of the introduction of a recycled water scheme (Experiment 3). There was evidence, however, that providing information about the level of pollutants in recycled water may lead to ambivalent responses.

Consumers’ acceptance of recycled water in meat products: The influence of tasting, attitudes and values on hedonic and emotional reactions

Community opposition to potable recycled water may extend to recycled water in food production. Past research on recycled potable water indicates that the closer the risk of personal contact or ingestion, the less acceptable it is. Despite purification and expert assurances, emotional responses, including disgust, may present as major psychological barriers to the environmental and commercial benefit of recycled water use in food production. Consumers (n=101) were presented with meat products purported to be processed or containing recycled water (3 levels of proximity to ingestion) along with a control product (containing tap water). Hedonic and 18 emotional responses were elicited. Validated survey instruments were used to measure world views (values), beliefs supportive of environmental actions and food technology neophobia seeking to explain variation in hedonic and emotional responses. Surprisingly, consumers were found to be generally accepting and willing to try foods containing or in close proximity to recycled water when that water was collected, treated and returned to drinking water standards within the factory. All hypotheses pertaining to associated values, beliefs and neophobia were rejected. The study suggests that recycling water within a food factory, when supported by a credible and trustworthy source of information, is likely to be met with positive emotional and affective responses. Using a broad range of affective and emotional responses was useful in understanding acceptance of foods that may be associated with perceived risk.

Social trust, risk perceptions and public acceptance of recycled water: Testing a social-psychological model

Faced with a severe drought, the residents of the regional city of Toowoomba, in South East Queensland, Australia were asked to consider a potable wastewater reuse scheme to supplement drinking water supplies. As public risk perceptions and trust have been shown to be key factors in acceptance of potable reuse projects, this research developed and tested a social-psychological model of trust, risk perceptions and acceptance. Participants (N = 380) were surveyed a few weeks before a referendum was held in which residents voted against the controversial scheme. Analysis using structural equation modelling showed that the more community members perceived that the water authority used fair procedures (e.g., consulting with the community and providing accurate information), the greater their sense of shared identity with the water authority. Shared social identity in turn influenced trust via increased source credibility, that is, perceptions that the water authority is competent and has the community's interest at heart. The findings also support past research showing that higher levels of trust in the water authority were associated with lower perceptions of risk, which in turn were associated with higher levels of acceptance, and vice versa. The findings have a practical application for improving public acceptance of potable recycled water schemes.

Supporters and Opponents of Potable Recycled Water: Culture and Cognition in the Toowoomba Referendum

Public opposition to potable recycled water remains an implementation barrier. A potable recycled water scheme was rejected in a referendum by the Toowoomba community of Queensland, Australia. Toowoomba is treated here as a case study. Focus groups were undertaken with supporters and opponents of recycled water to qualitatively explore influences on their voting behavior in the referendum. The theoretical frameworks of cultural theory and motivated social cognition are used together to analyze the values, beliefs, and psychological needs shaping recycled water attitudes and policy preferences. The results illustrate how popular value-basis theories play out at the local level through community recycled water discourse. Differences were observed in attitudes to uncertainty and change, and reliance on worldview arguments. Biases in information processing were revealed, with supporters and opponents selectively attending to information aligned with their own values. Worldview and selective cognition influenced levels of trust in authorities and perceived risk.

Evolution of water recycling in Australian cities since 2003

The prolonged Australian drought which commenced in 2002, and the agreement between Australia's Commonwealth and States/Territories governments to progress water reform through the National Water Initiative, has resulted in many new recycling projects in Australia's capital cities. Dual reticulation systems are being advanced in new subdivision developments in Sydney, Melbourne and Adelaide. Brisbane has installed three large Advanced Water Treatment Plants that are designed to send indirect potable recycled water to the Wivenhoe Dam which is Brisbane's principal water reservoir. Numerous water recycling projects are serving industry and agriculture. Experimental managed aquifer recharge is being undertaken with wetland-treated stormwater in Adelaide and reverse osmosis treated wastewater in Perth. New National Water Quality Management Strategy recycled water guidelines have been developed for managing environmental risks, for augmentation of drinking water supplies, for managed aquifer recharge and for stormwater harvesting and reuse. Many recent investments are part-supported through Commonwealth government grants. Desalination plants are being established in Melbourne and Adelaide and a second one in Perth in addition to the newly-operational plants in Perth, South-East Queensland and Sydney. Despite there being numerous examples of unplanned indirect potable recycling, most governments remain reluctant about moving towards planned potable recycling. There is evidence of some policy bans still being maintained by governments but the National Water Commission continues to reinforce the necessity of an even-handed objective consideration of all water supply options.

Balancing the budget of environmental estrogen exposure: the contribution of recycled water

Estrogenic endocrine disrupting compounds (e-EDCs) are present in treated sewage and there is concern about estrogenicity of potable recycled water. However e-EDCs are also present in other environmental media and intake from water needs to be considered in relation to these other sources. The concentrations of 13 e-EDCs in foodstuffs and drinking water are reviewed, their predicted concentrations in recycled water are estimated, and the daily estrogenic intake as 17beta-estradiol equivalent (EEq) based on both in vitro and in vivo potencies is calculated as 1.39 and 9.65 microg EEq/d, respectively. Dietary intake accounts for more than 99.8% of that total, and more than 84.2% is due to phytosterols. Drinking 2 L of recycled water per day is expected to add 0.001 to 0.016 microg EEq/d based on in vitro and in vivo potencies, respectively. Exposure to e-EDCs in recycled water is therefore likely to be insignificant compared to current dietary intakes.

Religious, philosophical and environmentalist perspectives on potable wastewater reuse in Durban, South Africa

Durban is South Africa’s second most populous city and home adherents of many faiths, as well as a wide variety of political, cultural, religious, ethnic and environmental groups who might hold deep philosophical objections to wastewater reuse. It is also widely known that where wastewater recycling has been considered, public concerns have been intense, sometimes leading to the abandonment of initiatives. Project objectives were to determine if there are groups in Durban with — specifically — religious or philosophical objections to the potable reuse of wastewater. The goal was to gain knowledge of the presence of related “show stopping” objections likely to emerge out of Durban’s diverse communities should eThekwini Municipality (formerly City of Durban) embark upon a more comprehensive feasibility study of wastewater recycling to potable standards. This study was conducted in four stages: 1) literature review, (2) email survey to international experts, (3) local qualitative interviews, and (4) focus group discussion. The main findings of the study are: (a) No fundamental religious objections to potable wastewater reuse appear to exist either internationally or locally. (b) Concerns among local groups around the environment, global warming, water scarcity and pollution are present. (c) People are willing to think creatively about sustainability. (d) Key concerns, in Durban, are emotional (the “yuk” factor) and/or related to concerns about flagging technical competency. (e) Initiatives would be prone to politicization around equity/justice issues. In general, people are not comfortable with the idea of potable water recycling. People interviewed expressed that potable reuse was something they could consider with more information, understanding, and satisfactory quality assurance. By contrast, in a mixed focus group setting, a small and diverse group gravitated towards concerns that potable reuse shifted the burdens of inequitable and unjust water allocation patterns (residual from apartheid) to those who least benefited from the current system. Most people expressed a willingness to reject potable water reuse on the grounds that other interventions were possible that had better equity implications. This is echoed in the broader acceptability literature, which suggests that people feel that water reuse initiatives should start with big users and industry before households. Consensus converged around potable reuse as a last resort, indicating that potable reuse was “thinkable”, but not to maintain existing patterns of allocation and use.

The Justification of Paternalism

Previous articleNext article No AccessDiscussionThe Justification of PaternalismBernard Gert, and Charles M. CulverBernard Gert Search for more articles by this author , and Charles M. Culver Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Ethics Volume 89, Number 2Jan., 1979 Article DOIhttps://doi.org/10.1086/292097 Views: 45Total views on this site Citations: 27Citations are reported from Crossref Copyright 1979 The University of ChicagoPDF download Crossref reports the following articles citing this article:Dana Mahmoud‐Elhaj, Braden Tanner, David Sabatini, Adam Feltz Measuring objective knowledge of potable recycled water, Journal of Community Psychology 48, no.66 (Jul 2020): 2033–2052.https://doi.org/10.1002/jcop.22402Helen Etchanchu, Marie-Laure Djelic Old Wine in New Bottles? Parentalism, Power, and Its Legitimacy in Business–Society Relations, Journal of Business Ethics 160, no.44 (May 2018): 893–911.https://doi.org/10.1007/s10551-018-3928-9David Archard Parental power, children’s rights, and normative theory, Journal of Political Power 11, no.11 (Feb 2018): 115–119.https://doi.org/10.1080/2158379X.2018.1433760Radomír Masaryk, Mária Hatoková Qualitative inquiry into reasons why vaccination messages fail, Journal of Health Psychology 22, no.1414 (Jul 2016): 1880–1888.https://doi.org/10.1177/1359105316656770Robert M. Veatch Prescription Paternalism: The Morality of Restricting Access to Pharmaceuticals, (Feb 2017): 135–152.https://doi.org/10.1007/978-94-024-0979-6_9 Sangdeuk Kim A Study on the Justification of Paternalism in Medical Practic, Korean Journal of Medical Ethics 19, no.44 (Dec 2016): 447–469.https://doi.org/10.35301/ksme.2016.19.4.447Christophe Salvat Behavioral Paternalism, Revue de philosophie économique Vol. 15, no.22 (Jan 2015): 109–130.https://doi.org/10.3917/rpec.152.0109Gerald Dworkin Defining Paternalism, (Jan 2015): 17–29.https://doi.org/10.1007/978-3-319-17960-5_2Tim Fowler Perfectionism for children, anti-perfectionism for adults, Canadian Journal of Philosophy 44, no.3-43-4 (Jan 2020): 305–323.https://doi.org/10.1080/00455091.2014.925620D. B. Resnik Paternalistic Food and Beverage Policies: A Response to Conly, Public Health Ethics 7, no.22 (Jun 2014): 170–177.https://doi.org/10.1093/phe/phu014 References, (Mar 2013): 177–214.https://doi.org/10.1002/9781118606957.refsNeil C. Manson Informed Consent, (Feb 2013).https://doi.org/10.1002/9781444367072.wbiee062david j. garren PATERNALISM, PART II, Philosophical Books 48, no.11 (Jan 2007): 50–59.https://doi.org/10.1111/j.1468-0149.2007.00429.xKenneth R. Greene Paternalism in supervisory relationships, Social Thought 21, no.22 (Jan 2002): 17–31.https://doi.org/10.1080/15426432.2002.9960314Carolyn Fluehr-Lobban Informed Consent in Anthropological Research: We Are Not Exempt 1, Human Organization 53, no.11 (Mar 1994): 1–10.https://doi.org/10.17730/humo.53.1.178jngk9n57vq685James F. Childress Ethical Theories, Principles, and Casuistry in Bioethics: An Interpretation and Defense of Principlism, (Jan 1994): 181–201.https://doi.org/10.1007/978-94-015-8362-6_9John A. Robertson The Geography of Competency, (Jan 1991): 127–148.https://doi.org/10.1007/978-94-011-3614-3_6ERNESTO GARZÓN VALDÉS On Justifying Legal Paternalism, Ratio Juris 3, no.s1s1 (Mar 1990): 173–184.https://doi.org/10.1111/j.1467-9337.1990.tb00079.xRuth Macklin Ethical Theory and Applied Ethics, (Jan 1989): 101–124.https://doi.org/10.1007/978-1-4612-3708-2_6Marilee Schmelzer, Marion G. Anema Should Nurses Ever Lie to Patients?, Image: the Journal of Nursing Scholarship 20, no.22 (Oct 2007): 110–112.https://doi.org/10.1111/j.1547-5069.1988.tb00042.xClifford J. Powell Ethical Principles and Issues of Competence in Counseling Adolescents, The Counseling Psychologist 12, no.33 (Sep 1984): 57–68.https://doi.org/10.1177/0011000084123006William J. Winslade Informed consent in psychiatric practice: The primacy of ethics over law, Behavioral Sciences & the Law 1, no.44 (Jan 1983): 47–56.https://doi.org/10.1002/bsl.2370010408Robert Young Autonomy and Paternalism, Canadian Journal of Philosophy Supplementary Volume 8 (Jan 2020): 47–66.https://doi.org/10.1080/00455091.1982.10715823James Woodward Paternalism and Justification, Canadian Journal of Philosophy Supplementary Volume 8 (Jan 2020): 67–89.https://doi.org/10.1080/00455091.1982.10715824Charles M. Culver, Bernard Gert The Morality of Involuntary Hospitalization, (Jan 1981): 159–175.https://doi.org/10.1007/978-94-009-8407-3_10Mark Siegler, Ann Dudley Goldblatt Clinical Intuition: A Procedure for Balancing the Rights of Patients and the Responsibilities of Physicians, (Jan 1981): 5–31.https://doi.org/10.1007/978-94-009-8407-3_2 Regionalization of Surgical Services, New England Journal of Medicine 302, no.1818 (May 1980): 1034–1035.https://doi.org/10.1056/NEJM198005013021821