715 resultados para Politics of place
Resumo:
Background: Futile medical treatments are interventions that are not associated with a benefit to the patient. The definition and concept of medical futility are controversial. The Texas Advance Directives Act (TADA) was passed in 1999 to address medically inappropriate interventions by allowing providers to withdraw inappropriate interventions against a surrogate decision maker's wishes following a review, attempt to transfer the patient, and 10-day waiting period. The original legislation was a negotiated compromise by players across the political spectrum. However, in recent years there has been increasing controversy regarding TADA and attempts to alter its applicability in Texas. ^ Purpose: The purpose of this project was to apply Paul Sabatier's advocacy coalition framework (ACF) to gain understanding into the historical, ethical, and political basis of the initial compromise, and determine the sources of conflict that have led to increased opposition to TADA. ^ Methods: Using the ACF model, key actors within the medical futility policy debate in Texas were aggregated into coalitions based on shared beliefs. A narrative summary based analysis identified the core elements of the policy subsystem, as well as the constraints and resources of the subsystem actors. Externalities that promoted adjustments to coalition beliefs and tactics used by coalition participants were analyzed. Data sources included review of the published literature regarding medical futility, as well as analysis of published newspaper accounts and editorials regarding the medical futility issue in Texas, legislative testimony, and review of weblogs and online commentaries dealing with the issue. ^ Results: Primary coalition participants in developing compromise legislation in 1999 were the Providers and Vitalists, with Autonomists gaining a prominent role starting in 2006. Internal factors associated with the breakdown of consensus included changes to the makeup of the governing coalition and changes in individual case information available to the Vitalist coalition. Externalities related to the intertwining of the Sun Hudson case and the Terri Schiavo case generated negative publicity for the TADA from progressive and conservative viewpoints. Dissemination of information in various venues regarding contentious cases was associated with more polarization of viewpoints, and realignment of coalition alliances. ^ Conclusions: The ACF provided an outline for the initial compromise over the creation of the Texas Advance Directives Act as well as the eventual loss of consensus. The debate between the Provider, Vitalist, and Autonomist coalitions has been affected by internal policy evolution, changes in the governing coalition, and important externalities. The debate over medical futility in Texas has had much broader implications in the dispute over Health Care Reform.^
Resumo:
Fil: Fernández, Claudia Nélida. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.
Resumo:
Fil: Fernández, Claudia Nélida. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.
Resumo:
Toponomastics is increasingly interested in the subjective role of place names in quotidian life. In the frame of Urban Geography, the interest in this matter is currently growing, as the recently change in modes of habitation has urged our discipline to find new ways of exploring the cities. In this context, the study of how name's significance is connected to a urban society constitutes a very interesting approach. We believe in the importance of place names as tools for decoding urban areas and societies at a local-scale. This consideration has been frequently taken into account in the analysis of exonyms, although in their case they are not exempt of political and practical implications that prevail over the tool function. The study of toponomastic processes helps us understanding how the city works, by analyzing the liaison between urban landscape, imaginaries and toponyms which is reflected in the scarcity of some names, in the biased creation of new toponyms and in the pressure exercised over every place name by tourists, residents and local government for changing, maintaining or eliminating them. Our study-case, Toledo, is one of the oldest cities in Spain, full of myths, stories and histories that can only be understood combined with processes of internal evolution of the city linked to the arrival of new residents and the more and more notorious change of its historical landscape. At a local scale, we are willing to decode the information which is contained in its toponyms about its landscape and its society.