Opposition u[nd] Gleichgültigkeit

Fritz Kaufmann

Strange bedfellows: The ethics and politics of medical futility in Texas

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.^

Dragonetti, Carmen and Fernando Tola, On the Myth of the Opposition between Indian Thought and Western Philosophy, Hildesheim-Zürich-New York, Georg Olms Verlag, 2004, 293 pp

Fil: Rollié, Emilio Federico. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Dragonetti, Carmen and Fernando Tola, On the Myth of the Opposition between Indian Thought and Western Philosophy, Hildesheim-Zürich-New York, Georg Olms Verlag, 2004, 293 pp

Fil: Rollié, Emilio Federico. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Water polo throwing speed and body composition: an analysis by playing positions and opposition level

The aim of this study was to develop an anthropometric profile on highly skilled male water polo players by specific playing positions. Also, to identify significant relationships between these features an overhead throwing speed in highly skilled male Water Polo players by specific playing positions. Methods: A total of 94 male water polo players (24.5±5.3 yrs) who were playing in the Spanish King´s cup were studied. Subjects were grouped according to their specific playing positions: 15 goalkeepers, 45 offensive wings, 20 center backs and 14 center forwards. Anthropometric assessment was made following ISAK protocols. Hand grip and throwing speed in several situations were also assessed. A one-way analysis of variance (ANOVA) was used to determine if significant differences existed among the four playing positions. Pearson product-moment correlation coefficients (r) were used to determine the relationships of all anthropometric measures with throwing speed and hand grip. The total player’s somatotype was endomorphic-mesomorphic (2.9–5.8–2.3). Center forwards exhibit important anthropometric differences compared with the other specific playing positions in elite male water polo players, but no differences were found in throwing speed by specific playing positions in each throwing conditions. Moreover, a higher number of relationships between anthropometric and throwing speed were found in wings and also in center backs but no relationships were found in center forwards. The data reflects the importance of muscle mass and upper body in the throwing skill. Coaches can use this information in order to select players for the different specific positions.

The strength of the Christian Democrats, the weakness of the opposition. Germany before the parliamentary elections. OSW Commentary No. 114, 12.09.2013

The political campaign before Germany’s parliamentary elections to be held on 22 September has in all its glory reflected the trends visible during the last four years of the government of Chancellor Angela Merkel – the strength of the Christian Democrats, the weakness of the opposition and the increasing marginalisation of the coalition partner, the FDP. The CDU/CSU remains the most popular political choice in Germany, largely because Angela Merkel has consistently remained the most popular German politician. Everything indicates that the CDU/CSU will win the election, even though it has been running a passive campaign and the Chancellor herself has been avoiding confrontation, presenting herself as a kind of cross-party representative of the interests of all social groups. The Christian Democrats’ main competitors, the Social Democrats, have been unable to play to their strengths and present themselves as a serious alternative to the CDU/CSU. The Christian Democrats, despite their difficult cooperation with the liberal FDP, have declared their willingness to continue doing so during the next parliamentary term. If the numbers make that impossible, and the Social Democrats and the Greens have too few votes to be able to form a government, a grand coalition of the Christian Democrats and the SPD will be formed in Germany.

Government failure, opposition success? Electoral performance in Portugal and Italy at the time of the crisis. Jean Monnet Occasional Paper 05/2014

The costs of the crisis in Southern European countries have not been only economic but political. Economic crises tend to lead to government instability and termination while political challengers are expected to exploit this contingent window of opportunity to gain an advantage over incumbents in national elections. The current crisis seems to make no exception, looking at the results of the general elections recently held in Southern Europe. However, this did not always lead to a clear victory of the main opposition parties. In most of the elections, in fact, the incumbent parties’ loss did not coincide with the official opposition’s gain. The extreme case is represented by Italy, where both the outgoing government coalition led by Silvio Berlusconi – setting aside for the moment the technocratic phase – and its main challenger, the centre left coalition, ended up losing millions of voters and a new political force, the Five Star Movement, obtained about 25 per cent of votes. On the opposite side there is Portugal. Only in Portugal did the vote increase for the centre right PSD, in fact, exceed the incumbent socialists’ loss. The present work aims at exploring the factors which might account for this significant divergence between the two cases.

The Ukrainian government's strategy towards the opposition. OSW Commentary No. 47, 2011-09-02

In recent months in Ukraine, there has been a toughening of measures targeted at opposition leaders, in particular the former Prime Minister Yulia Tymoshenko and the former interior minister Yuri Lutsenko. These two have been charged with abuses of office when in power. The way in which the criminal investigations are being conducted shows that these measures are actually meant to prevent the two politicians from conducting regular political activities, or at least to make this practically impossible for them. These actions are an element of the Party of Regions’ long-term strategy, as it tries during the pre-election period to eliminate Yulia Tymoshenko from political life and weaken or even destroy her powerbase. Similar measures, although to a more limited extent, are being taken against other opposition groups. These actions are leading to the lowering of democratic standards in Ukraine, although these are still much higher than in Belarus or Russia; this has been proved, among other things, by the militia’s more restrained behaviour towards the protesters, and the fact that abuses of the law during the current investigations have not yet slipped into actual violations. The Ukrainian opposition is fragmented and disorganised; even the Yulia Tymoshenko Bloc is unable to stage a major campaign in defence of its leader. This allows the authorities to feel free to tighten their policy towards the opposition.

Coalitions, Power and Institutional Change in Global Patent Politics. IES WORKING PAPER 2/2013

With the 1995 Agreement on Trade - related Aspects of Intellectual Property Rights (TRIPS), a centralised rule - system for the international governance of patents was put in place under the general framework of the World Trade Organisation (WTO). Since then, the number of patent – related institutions has increased monotonically on the multilateral, plurilateral and bilateral levels. I will explain this case of institutional change by focusing on the norm – setting activities of both industrialised and developing countries, arguing that both groups constitute internally highly cohesive coalitions in global patent politics, while institutional change occurs when both coalitions engage in those negotiating settings in which they enjoy a comparative advantage over the other coalition. Specifically, I make the point that industrialised countries’ norm – setting activities take place on the plurilateral and bilateral level, where economic factors can be effectively translated into political outcomes while simultaneously avoiding unacceptably high legitimacy costs; whereas developing countries, on the other hand, use various multilateral United Nations (UN) forums where their claims possess a high degree of legitimacy, but cannot translate into effective political outcomes. The paper concludes with some remarks on how this case yields new insights into ongoing debates in institutionalist International Relations (IR), as pertaining to present discussions on “regime complexity”.

A game played according to Lukashenka’s rules: the political opposition in Belarus. OSW COMMENTARY NUMBER 176, 08.07.2015

The Belarusian opposition is currently experiencing its deepest crisis since Alyaksandr Lukashenka took power in 1994. Following many months of negotiations, opposition leaders failed to select a joint candidate for the presidential election scheduled for 11th October. The failure of this latest round of talks has proven that not only is the opposition unlikely to threaten Lukashenka’s rule; it will not even be able to demonstrate to society that it could provide a genuine alternative to the present government.

Something Worth Fighting For: The Evolution of Lobbying Coalitions in the Emissions Trading System. Bruges Political Research Papers 50/2015.

This thesis attempts to understand who fought for influence within the European Union’s policy area of the Emissions Trading System (ETS). The ETS is a key aspect of the European Union’s (EU) climate change policy and is particularly important in light of the conclusions at the 2015 United Nations Climate Change Conference in Paris. It was first established in 2003 with Directive 2003/87/EC and completed its first major revision in 2008 with Directive 2009/29/EC. Between these two key Directives, the interplay between industrial and environmental incentives means that the ETS has created a dynamic venue for divergent interest groups. So as to identify the relevant actors, this paper applies the Advocacy Coalition Framework (ACF) of Sabatier. Using position papers, semi-structured interviews, and unpublished documents from the EU institutions, this paper answers it primary research question in its identification of an economy-first and an environment-first lobbying coalition. These coalitions have expanded over time with the environment-first coalition incorporating Greenpeace and the economy-first coalition expanding even further in both scope and speed. However, the economy-first coalition has been susceptible to industry-specific interests. In its application of the ACF, the research shows that a hypothesised effect between the ACF’s external events and these lobbying coalitions is inconclusive. Other hypotheses stemming from the ACF relating to electricity prices and the 2004 enlargement seem to be of significance for the relative composition of the lobbying coalitions. This paper finds that there are certain limitations within the ACF. The findings of this thesis provide a unique insight into how lobbying coalitions within a key EU policy area can form and develop.

Looking beneath the Surface: Differences in Decision-Making Structures across Processes

The previous chapter presented the overall decision-making structure in Swiss politics at the beginning of the 21st century. This provides us with a general picture and allows for a comparison over time with the decision-making structure in the 1970s. However, the analysis of the overall decision-making structure potentially neglects important differences between policy domains (Atkinson and Coleman 1989; Knoke et al. 1996; Kriesi et al. 2006a; Sabatier 1987). Policy issues vary across policy domains, as do the political actors involved. In addition, actors may hold different policy preferences from one policy domain to the next, and they may also collaborate with other partners depending on the policy domain at stake. Examining differences between policy domains is particularly appropriate in Switzerland. Because no fixed coalitions of government and opposition exist, actors create different coalitions in each policy domain (Linder and Schwarz 2008). Whereas important parts of the institutional setting are similar across policy domains, decision-making structures might still vary. As was the case with the cross-time analysis conducted in the two previous chapters, a stability of 'rules-in-form' might hide important variations in 'rules-in-use' also across different policy domains.

Socio-technical transitions and policy change - Advocacy coalitions in Swiss energy policy

Policies and politics are an integral part of socio-technical transitions but have not received much attention in the transitions literature so far. Drawing on the advocacy coalition framework, our paper addresses this gap with a study on actors and coalitions in Swiss energy policy. Our results show that advocacy coalitions in Switzerland have largely remained stable despite the Fukushima shock. However, heterogeneity of beliefs has increased and in 2013, even a majority of actors expressed their support for the energy transition – an indication that major policy change might be ahead. It seems that in socio-technical transitions, changes in the policy issue and in the actor base also work toward policy change, next to changes in core beliefs. We make suggestions how the advocacy coalition framework can inform analysis and theory building in transition studies. We also present first ideas about the interplay of socio-technical systems and policy systems.