'If we do not cut social spending, we will end up like Greece': Challenging consent to austerity through social work action

'If we do not cut social spending, we will end up like Greece'. Establishment politicians and media figures use this new ideological mantra throughout the Western world to frighten people into consenting to further neo-liberal restructuring along with cuts in social spending. This phrase and other ideologically laden assertions hide the real causes of the Greek public debt crisis. This commentary challenges the dominant discourse by contextualizing the Greek case within the larger global neo-liberal restructuring processes and then, drawing upon Gramsci's concept of the organic intellectual, proposes ways that the members of the Professional Association of Social Workers (PASW) can engage in a war of ideas and action, as organic intellectuals, to delegitimize the dominant discourse, which seeks consent for social spending cuts and further neo-liberal restructuring of society. © The Author(s) 2013.

Large panel-survey data demonstrated country-level and ethnic minority variation in consent for health record linkage

Objectives
To investigate individual, household and country variation in consent to health record linkage.

Study Design and Setting
Data from 50,994 individuals aged 16-74 years recruited to wave 1 of a large UK general purpose household survey (January 2009 – December 2010) were analysed using multi-level logistic regression models.

Results
Overall, 70.7% of respondents consented to record linkage. Younger age, marriage, tenure, car ownership and education were all significantly associated with consent, though there was little deviation from 70% in subgroups defined by these variables. There were small increases in consent rates in individuals with poor health when defined by self-reported long term limiting illness (adjusted OR 1.11; 95%CIs 1.06, 1.16), less so when defined by General Health Questionnaire score (adjusted OR=1.05; 95%CIs 1.00, 1.10), but the range in absolute consent rates between categories was generally less than 10%. Larger differences were observed for those of non-white ethnicity who were 38% less likely to consent (adjusted OR 0.62; 95%CIs 0.59, 0.66). Consent was higher in Scotland than England (adjusted OR 1.17; 95%CIs 1.06, 1.29) but lower in Northern Ireland (adjusted OR 0.56; 95%CIs 0.50, 0.63).

Conclusion
The modest overall level of systematic bias in consent to record linkage provides reassurance for record linkage potential in general purpose household surveys. However, the low consent rates amongst non-white ethnic minority survey respondents will further compound their low survey participation rates. The reason for the country-level variation requires further study.

Can Consent Training End Sexual Violence On Campus?: Students, Consent and Sexual Ethics

The ongoing, potentially worsening problem of sexual violence and harassment on university campuses has emerged in the last few years as an area of concern. Female students have been identified as one of the most likely groups to experience sexual violence and this violence is exacerbated by contemporary student cultures around alcohol consumption and gendered and sexual norms. University campuses have also become central to prevention efforts in many countries due to their relatively accessible populations and an ability to implement social policies at an institutional level.
Many of these measures are based around promoting or educating students about sexual consent, and particularly notions of affirmative consent, expressed as ‘Yes means Yes’. However, there exists little research around sexual ethics with students exploring whether consent is in fact the best way to tackle cultural problems of sexual violence on campus. This paper makes use of existing literature on sexual ethics and focus group research undertaken with Australian university students to argue for an approach to the problem of sexual ethics on campus that is broader than simply focusing on training programs in sexual consent. It identifies a number of limitations to the consent framework and argues that prevention efforts need to more seriously engage with broader cultural norms around heterosexuality and gendered relationships.

The obligation to provide information where valid consent is not needed

Accounts of consent in medical ethics typically assume that consent plays the same role irrespective of the type of treatment. In this paper I argue that this assumption is false. Because of this, obligations to provide information to patients that stem from the need for consent to be valid will not apply to all types of treatment. This does not mean that there are no reasons to provide such information. The second part of the paper maps out what these reasons are and argues that they are grounded in the obligation of beneficence and a duty to warn, not in considerations of respect for autonomy.

Do Gifts Increase Consent to Home-based HIV Testing? A Difference-in-differences Study in Rural KwaZulu-Natal, South Africa

Background Despite the importance of HIV testing for controlling the HIV epidemic, testing rates remain low. Efforts to scale-up testing coverage and frequency in hard-to-reach and at-risk populations commonly focus on home-based HIV testing. This study evaluates the effect of a gift (a food voucher for families, worth US$ 5) on consent rates for home-based HIV testing.
Methods We use data on 18,478 men and women who participated in the 2009 and 2010 population-based HIV surveillance carried out by the Wellcome Trust Africa Centre for Health and Population Studies in rural KwaZulu-Natal, South Africa. Our quasi-experimental difference-in-differences approach controls for unobserved confounding in estimating the causal effect of the intervention on HIV testing consent rates.
Results Allocation of the gift to a family in 2010 increased the probability of family members consenting to test in 2010 by 25 percentage points (95% CI 21-30; p<0.001). The intervention effect persisted, slightly attenuated, in the year following the intervention (2011), further increasing intervention value for money.
Conclusions In HIV hyperendemic settings a gift can be highly effective at increasing consent rates for home-based HIV testing. Given the importance of HIV testing for treatment uptake and individual health, as well as for HIV treatment-and-prevention strategies and for monitoring the population impact of the HIV response, gifts should be considered as a supportive intervention for HIV testing initiatives where consent rates have been low.

The Colour of Electronic Consent

This paper is a translation of the first part of an article published in Cahiers de propriété intellectuelle (2003).