A Class by Herself Woloch, Nancy
2015, 2015., 20150420, Volume:
126
eBook
A Class by Herselfexplores the historical role and influence of protective legislation for American women workers, both as a step toward modern labor standards and as a barrier to equal rights. ...Spanning the twentieth century, the book tracks the rise and fall of women-only state protective laws-such as maximum hour laws, minimum wage laws, and night work laws-from their roots in progressive reform through the passage of New Deal labor law to the feminist attack on single-sex protective laws in the 1960s and 1970s.
Nancy Woloch considers the network of institutions that promoted women-only protective laws, such as the National Consumers' League and the federal Women's Bureau; the global context in which the laws arose; the challenges that proponents faced; the rationales they espoused; the opposition that evolved; the impact of protective laws in ever-changing circumstances; and their dismantling in the wake of Title VII of the Civil Rights Act of 1964. Above all, Woloch examines the constitutional conversation that the laws provoked-the debates that arose in the courts and in the women's movement. Protective laws set precedents that led to the Fair Labor Standards Act of 1938 and to current labor law; they also sustained a tradition of gendered law that abridged citizenship and impeded equality for much of the century.
Drawing on decades of scholarship, institutional and legal records, and personal accounts,A Class by Herselfsets forth a new narrative about the tensions inherent in women-only protective labor laws and their consequences.
The cost of prescription drugs in the United States continues to be a source of concern for patients, caregivers, and policymakers. Drug prices typically decline rapidly once generic drugs receive US ...Food and Drug Administration (FDA) approval and enter the market, but the past decade has witnessed rising costs and shortages of generic drugs. We describe the strategies used by brand‐name manufacturers to undermine generic competition and the reasons underlying the price increases of off‐patent drugs, some of which continue to lack any competition from generic versions, and others that have increased in price despite having generic versions. We discuss the FDA's role in addressing drug prices and promoting competition, including recent agency policies to modify its process of reviewing generic drug applications and to prioritize applications for off‐patent drugs with few competitors. We also examine proposed policy solutions and research areas that could help address the price increases of off‐patent drugs.
Photography and electronic media are indispensable tools for dental education and clinical practice. Although previous research has focused on privacy issues and general strategies to protect patient ...privacy when sharing clinical photographs for educational purposes, there are no published recommendations for developing a functional, privacy‐compliant institutional framework for the capture, storage, transfer, and use of clinical photographs and other electronic media. The aims of this study were to research patient rights relating to electronic media and propose a framework for the use of patient media in education and clinical care. After a review of the relevant literature and consultation with the University of Washington's director of privacy and compliance and assistant attorney general, the researchers developed a privacy‐compliant framework to ensure appropriate capture, storage, transfer, and use of clinical photography and electronic media. A four‐part framework was created to guide the use of patient media that reflects considerations of patient autonomy and privacy, informed consent, capture and storage of media, and its transfer, use, and display. The best practices proposed for capture, storage, transfer, and use of clinical photographs and electronic media adhere to the health care code of ethics (based on patient autonomy, nonmaleficence, beneficence, justice, and veracity), which is most effectively upheld by a practical framework designed to protect patients and limit institutional liability. Educators have the opportunity and duty to convey these principles to students who will become the next generation of dentists, researchers, and educators.
Medical devices are indispensable for cancer management across the entire cancer care continuum, yet many existing medical interventions are not equally accessible to the global population, ...contributing to disparate mortality rates between countries with different income levels. Improved access to priority medical technologies is required to implement universal health coverage and deliver high-quality cancer care. However, the selection of appropriate medical devices at all income and hospital levels has been difficult because of the extremely large number of devices needed for the full spectrum of cancer care; the wide variety of options within the medical device sector, ranging from small inexpensive disposable devices to sophisticated diagnostic imaging and treatment units; and insufficient in-country expertise, in many countries, to prioritise cancer interventions and to determine associated technologies. In this Policy Review, we describe the methods, process, and outcome of a WHO initiative to define a list of priority medical devices for cancer management. The methods, approved by the WHO Guidelines Review Committee, can be used as a model approach for future endeavours to define and select medical devices for disease management. The resulting list provides ready-to-use guidance for the selection of devices to establish, maintain, and operate necessary clinical units within the continuum of care for six cancer types, with the goal of promoting efficient resource allocation and increasing access to priority medical devices, particularly in low-income and middle-income countries.
STUDY QUESTION
How do the different forms of regulation and public financing of IVF affect utilization in otherwise similar European welfare state systems?
SUMMARY ANSWER
Countries with more liberal ...social eligibility regulations had higher levels of IVF utilization, which diminished as the countries' policies became more restrictive.
WHAT IS KNOWN ALREADY
Europe is a world leader in the development and utilization of IVF, yet surveillance reveals significant differences in uptake among countries which have adopted different approaches to the regulation and and public financing of IVF.
STUDY DESIGN, SIZE, DURATION
A descriptive and comparative analysis of legal restrictions on access to IVF in 13 of the EU15 countries that affirmatively regulate and publicly finance IVF.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Using 2009 data from the European Society of Human Reproduction and Embryology study of regulatory frameworks in Europe and additional legislative research, we examined and described restrictions on access to IVF in terms of general eligibility, public financing and the scope of available services. Multiple correspondence analysis was used to identify patterns of regulation and groups of countries with similar regulatory patterns and to explore the effects on utilization of IVF, using data from the most recent European and international IVF monitoring reports.
MAIN RESULTS AND THE ROLE OF CHANCE
Regulations based on social characteristics of treatment seekers who are not applicable to other medical treatments, including relationship status and sexual orientation, appear to have the greatest impact on utilization. Countries with the most generous public financing schemes tend to restrict access to covered IVF to a greater degree. However, no link could be established between IVF utilization and the manner in which coverage was regulated or the level of public financing.
LIMITATIONS, REASONS FOR CAUTION
Owing to the lack of data regarding the actual level of public versus private financing of IVF it is impossible to draw conclusions regarding equity of access. Moreover, the regulatory and utilization data were not completely temporally matched in what can be a quickly changing regulatory landscape.
WIDER IMPLICATIONS OF THE FINDINGS
Whether motivated by cost, eligility restrictions or the availability of particular services, cross-border treatment seeking is driven by regulatory policies, underscoring the extra-territorial implications of in-country political decisions regarding access to IVF.
STUDY FUNDING/COMPETING INTEREST(S)
There was no funding source for this study. The authors have no conflicts of interest to declare.
Objectives:
Death by suicide is widely held as an undesirable outcome. Most Western countries place emphasis on patient autonomy, a concept of controversy in relation to suicide. This paper explores ...the tensions between patients' rights and many societies' overarching desire to prevent suicide, while clarifying the relations between mental disorders, mental capacity, and rational suicide.
Methods:
A literature search was conducted using search terms of suicide and ethics in the PubMed and LexisNexis Academic databases. Article titles and abstracts were reviewed and deemed relevant if the paper addressed topics of rational suicide, patient autonomy or rights, or responsibility for life. Further articles were found from reference lists and by suggestion from preliminary reviewers of this paper.
Results:
Suicidal behaviour in a person cannot be reliably predicted, yet various associations and organizations have developed standards of care for managing patients exhibiting suicidal behaviour. The responsibility for preventing suicide tends to be placed on the treating clinician. In cases where a person is capable of making treatment decisions—uninfluenced by any mental disorder—there is growing interest in the concept of rational suicide.
Conclusions:
There is much debate about whether suicide can ever be rational. Designating suicide as an undesirable event that should never occur raises the debate of who is responsible for one's life and runs the risk of erroneously attributing blame for suicide. While upholding patient rights of autonomy in psychiatric care is laudable, cases of suicidality warrant a delicate consideration of clinical judgment, duty of care, and legal obligations.
Unhealthy diets represent one of the major risk factors for non‐communicable diseases. There is currently a risk that the political influence of the food industry results in public health policies ...that do not adequately balance public and commercial interests. This paper aims to develop a framework for categorizing the corporate political activity of the food industry with respect to public health and proposes an approach to systematically identify and monitor it. The proposed framework includes six strategies used by the food industry to influence public health policies and outcomes: information and messaging; financial incentive; constituency building; legal; policy substitution; opposition fragmentation and destabilization. The corporate political activity of the food industry could be identified and monitored through publicly available data sourced from the industry itself, governments, the media and other sources. Steps for country‐level monitoring include identification of key food industry actors and related sources of information, followed by systematic data collection and analysis of relevant documents, using the proposed framework as a basis for classification of results. The proposed monitoring approach should be pilot tested in different countries as part of efforts to increase the transparency and accountability of the food industry. This approach has the potential to help redress any imbalance of interests and thereby contribute to the prevention and control of non‐communicable diseases.
Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. ...Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses.
A review was conducted of the English literature with search terms 'online pharmacies', 'Internet pharmacies', 'cyber pharmacies', 'rogue pharmacies', and 'e-pharmacies' using PubMed, JSTOR, and Google Scholar from 1999-2005.
Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors.
Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime.
Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective.
There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies.
In recent years, advocates for increasing access to medical and oral health care have argued for expanding the scope of practice of dentists and physicians. Although this idea may have merit, ...significant legal and other barriers stand in the way of allowing dentists to do more primary health care, physicians to do more oral health care, and both professions to collaborate. State practice acts, standards of care, and professional school curricula all support the historical separation between the 2 professions. Current laws do not contemplate working across professional boundaries, leaving providers who try vulnerable to legal penalties. Here we examine the legal, regulatory, and training barriers to dental and medical professionals performing services outside their traditional scope of practice.
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