In 1841 the American sailing ship William Brown struck an iceberg. About half of the passengers and all of the crew were saved in two small, open boats. The next night, half of the passengers in the larger long-boat were thrown overboard because the boat was overfull. This was the first case of "lifeboat ethics," of hard choices in the face of scarcity. Since then the question has been "who should die so that others, equally needy, might live?" Both the case of the William Brown and the ethics it spawned have been used in recent years to describe the problem of health care rationing generally, and organ transplantation specifically. Koch reexamines and reinterpretes the paradigm case of lifeboat ethics, the story of the William Brown, not as an unavoidable tragedy, but as an avoidable series of errors. Its relation to more general issues of distributive justice are then considered. The lessons learned from both the historical review and its application to distributive principles are then applied to the problem of graft organ distribution in the United States. Through the use of maps, the problem of organ distribution is considered at a range of scales, from the international to the urban. The contextual issues become more evident as one moves from international to hemispheric, fron national to regional, and then local systems. Finally, Koch reviews the lessons in light of other problems of distribution in the face of scarcity. The central lesson-that scarcity is exacerbated where it is not in fact created by our distributive programs-is explored thoroughly. The result is "no good choices" for anyone and the continuation of the scarcity that for most seems inevitable, but, from theevidence provided, is itself an outcome of inequalities of distribution at different scales of society. Of particular interest to students, scholars, and policymakers involved with issues of planning and health care economics, medical geography, and concepts of justice.

Volume 19 in the "Research in Political Sociology" series is devoted to health problems, challenges and accomplishments in democratic societies. It includes papers addressing health systems, health policies, obstacles to societal healthy behaviors, and/or health conditions that are experienced in democratic societies in the world. The democratic society is understood in a broadly defined term. It includes developed Western democracies, as well as less developed or underdeveloped countries that have democratic system. According to such definition, the category "democracies" includes democratic countries that have well established democratic system and respect broad network of people rights, as well as democracies that are formally consider democratic states but de facto respect only a few rights or their governments are guided by limited democratic principles. Therefore, the collection of the 19th volume of "Research in Political Sociology" includes papers addressing these issues in a broad spectrum of countries from India, Sri Lanka and Tanzania, to Sweden, Canada and the United States.

The World Health Organization's concept of health as "the condition of psychophysical and social well-being" must be translated into opera tional terms. The objective is to place the human person within the social system, given that mental health, mental illness, and suffering are individual, despite the fact that their causes are to be sought in the society and environment that surround and interact with the indi vidual. One dimension that must be emphasized in this field is the contin uum that exists between social environment and cerebral development. This continuum consists of the physical and biological features of the two interacting systems: on one hand, the brain managed and con trolled by the genetic program, and, on the other hand, the environ ment, be it natural or social. A simple dichotomy of individual and environment is no longer a sufficient concept in understanding the etiology of mental health and illness. Needless to say, socioepidemiological research in psychiatry and transcultural psychiatry is useful in reaching these ends. However, at the root of mental illness, one can always find the same causal elements: informational chaos, inadequate dietary intake, substance abuse, trauma, conditioning, and so on, which make the interactive systems dysfunctional. Subsequent organic and psychotic disorders occur to the detriment of both the individual and society. Current biological psychiatry is inadequately equipped in treating mental illness."

Globalization affects human health in wide-ranging and multifaceted ways, ranging from the behaviors of individuals to broad social, political, and economic contexts within which health and disease occur. This book provides an introduction to these complex linkages through an exploration of the spatial, temporal and cognitive dimensions of global change. Challenging the neglect of health issues within the globalization literature, the book draws on diverse empirical evidence to argue that urgent attention to these impacts is needed.

Bringing together recent international research in the field of hospital communication and interaction, the contributors to this book contextualize clinical professional work by focussing on the rising intensity of information and communication practices in organizations generally, and in health care in particular.

Given the fundamental and growing importance of health to the economy and society, this book addresses some of the key questions being asked in relation to health in the future. What will the health system look like, how much will it cost, what ethical framework will underlie future health policy and can we really have a system that is designed to improve health as well as provide health care? Based on the "Policy Futures for UK Health" project, this collection explores the shape of the health system and its key components, taking a multidisciplinary approach to health policy questions that is designed to appeal to the specialist and those who want to know more about our health system and what it might look like in the future.

Research on social inequalities has a very long tradition in sociological research, and discussion of the impact of social inequalities on health and health care delivery has long been one of the more important topics covered by medical sociologists. The research presented in this volume varies in its coverage and its approach to issues of social inequality in health and health care delivery. This volume includes both theoretical and quantitative papers, and deals with complex understandings of macro system issues, the impact of the patient and individual factors on health and health care and the impact of the provider and interaction between providers and patients. The first section focuses on macro system issues and includes both theoretical approaches to the topic and quantitative approaches. The second section includes articles with a greater focus on patient characteristics. These articles vary greatly in their coverage, with some focusing on the US as a whole, and others on specific sections of the US or subgroups within the population such as African American women or the elderly. The third section focuses on providers and issues of social inequality and health care delivery. These papers examine issues of gender, race and poverty as examples of sources of inequality in modern societies. In contrast to the second section these papers pay more attention to individual factors and the focus of the chapters is on aspects of health care providers. Research on providers of care is another long, important research tradition within medical sociology. Social Inequalities, Health and Health Care Delivery should be useful reading for medical sociologists and people working in other social science disciplines studying health-related issues. The volume also provides information for health services researchers, policy analysts and public health researchers.

There has been a dramatic increase in the utilization of wireless technologies in healthcare systems as a consequence of the wireless ubiquitous and pervasive communications revolution. Emerging information and wireless communication technologies in health and healthcare have led to the creation of e-health systems, also known as e-healthcare, which have been drawing increasing attention in the public and have gained strong support from government agencies and various organizations. E-Healthcare Systems and Wireless Communications: Current and Future Challenges explores the developments and challenges associated with the successful deployment of e-healthcare systems. The book combines research efforts in different disciplines including pervasive wireless communications, wearable computing, context-awareness, sensor data fusion, artificial intelligence, neural networks, expert systems, databases, and security. This work serves as a comprehensive reference for graduate students in bioengineering and also provides solutions for medical researchers who are faced with the challenge of designing and implementing a cost-effective pervasive and ubiquitous wireless communication system.

Who determines whether persons are disabled and eligible to receive the billions of dollars that are awarded in benefits under federal disability programs today in the United States? What kinds of standards are applied in making awards to millions of applicants? And how are disability determinations made and claims adjudicated? Frank S. Bloch provides a careful study of disability determinations in five major federal programs. His findings, models, and calls for reform, including the greater use of medical personnel, should interest those who want to know more about the medical-legal issues relevant to disability determination, the many factors that impact on disability decisionmaking, and the administrative process for making disability decisions. This survey covers the disability determination process in U.S. social security, railroad retirement, civil service, veteran, and black lung disability programs at the federal level. Dr. Bloch defines various standards, key issues, the current use of medical personnel and models for their fuller use and for reforming the disability determination process.

Systematically updated throughout, the sixth edition of this leading text takes the story of health policy to the end of the Blair era and into the early years of the Brown premiership. It offers a clear and thorough introduction to the history of the NHS, its funding and priorities, and to the process of policy making.

This international survey defines mental health as a basic human right, and tracks the emergence of mental health prevention and promotion as a global priority. Locating mental illness within a cycle of negative causes and effects affecting human quality of life, the editors identify modern policy barriers to promotion/prevention initiatives, particularly the favoring of the biomedical health model by major stakeholders. The book's selection of successful programs from diverse countries displays a lifespan approach, emphasizing the centrality of interdisciplinary educational settings in providing primary and secondary prevention and promotion interventions, and the ongoing fight against missing financial investigations, discrimination and stigma. Together, these papers make a forceful argument for rights- based responses to worldwide mental health needs as part of the commitment toward global human rights and long-term development goals. Included in the coverage: * Mental health priorities around the world. * Social determinants of mental health. * Mental health and stigma: aspects of anti-stigma interventions. * Promoting social and emotional wellbeing and responding to mental health problems in schools. * The promotion and delivery of mental health services in primary care settings. * Economic evaluation of mental health promotion and mental illness prevention. Bringing to the fore public health concerns that are too often marginalized, Global Mental Health is necessary reading for health professionals, health and clinical psychologists, psychiatrists, medical sociologists, and policymakers.

Through the framework of understanding health inequalities as a 'wicked problem' the book develops an applied approach to researching, understanding and addressing them by drawing on complexity theory. Case studies illuminate the text, illustrating and discussing the issues in real life terms and enabling public health, health promotion and health policy students to understand and address the complexities of health inequalities.

The nations of the EU have long led the world in universal health coverage. Recent economic developments have created problems ranging from inequities of care to growing numbers of uninsured - a progression analyzed by Win de Gooijer in Trends in EU Health Care Systems. His ideas may be startling, and the book is bound to be controversial. This is critical reading for health care managers and policymakers, politicians and insurors - anyone looking to Europe to understand this far-reaching evolution.

By following the daily lives of rural women in the Sitapur district of Uttar Pradesh, an agricultural region with high rates of infant mortality, where maternal health services are poor while family planning efforts are intensive, from a range of castes and communities, the author considers the women's own experiences of birth and infant death, their ways of making-do, and the hierarchies they create and contend with. This book develops an approach to access to care that focuses on emotion, domestic spaces, illicit and extra-institutional biomedicine, and household and neighborly relations. It shows that, as part of the concatenation of affect and access, globalized moralities about reproduction are dependent on ambiguous ideas about caste. Through the unfolding of birth and death, a new vision of untouchability emerges that is integral to visions of progress.

Forced hospitalization of people with mental disorders has long been a critical issue in the mental health services. Coercion and Aggressive Community Treatment is the first sustained description and analysis of what happens when aggressive' treatment becomes coerced' treatment. Mental health professionals poignantly discuss the tension they feel between wanting to do everything to treat desperately ill people and the need to respect the rights of these same people who want to make their own decisions, even if this means forgoing treatment.

Based on original research and analysis by a group of health policy experts and economists from across the world, this book analyzes the causes and consequences of the expanding global and local commercialization of health care. It argues for the necessity and possibility of effective policy responses to develop good quality, universally inclusive health systems worldwide. The book aims to contribute to a shift in the international 'common sense' in health policy towards a more humane, inclusive, egalitarian, and ethical framework for policy formulation.

Innovations in Health Care is the fourth title in an ongoing series from the biennial conference Organizational Behaviour in Health Care. It compiles case examples of innovations within complex healthcare settings that are working, providing some credible and valuable examples of what can be and has been accomplished through organizational change. It also explores a range of cases where innovations were hindered or blocked from completing or sustaining across time, critically examining where current theories and practices are falling short and why there are problems that remain unsolved.

From the medical use of marijuana to organ donations to animal testing, the medical profession is rife with controversial issues. Students and teachers can now use this reference resource to explore all sides of these issues. Narrative chapters, each one devoted to a specific topic, encourage students to consider all the facts surrounding the various controversies. Case studies and first-person accounts bring the issues to life and concluding questions for each chapter challenge students to use their critical thinking skills to draw their own conclusions.This collection provides historical as well as contemporary contexts for an examination of government structures in the United States and the states of the former U.S.S.R. Throughout, the contributors look at federalism at both local and national levels, and they try to assess how and why the two systems developed as they did.

Each of the fifteen chapters analyzes the pro and con arguments and current status of a specific controversy, illuminating the philosophical dilemmas faced by medical professionals as well as their patients and the general public as a whole. The Goldsteins present opposing arguments on the sources and nature of each controversy, providing readers with an understanding of the causes and effects of medical controversies. This basic introduction to these many different issues, including, among others, the arguments surrounding a need for national health insurance, the arguments surrounding the ethics of cloning, the arguments surrounding the needs and dangers of childhood vaccinations, and the arguments surrounding end-of-life issues will provide a starting ground for students interested in researching these topics further, while also encouraging them to begin dialogues with their peers to help them develop their ability to analyze complicated issues.

The theme of this volume is Health Care Services, Racial and Ethnic Minorities and Underserved Populations: Patient and Provider Perspectives. The volume is divided into five sections. The first section discusses the overall issue of health care disparities and underserved populations and also provides introductory material about the rest of the volume. The next section focuses on issues that relate to gender. The third section provides papers on some other specific examples of underserved populations: those with mental health concerns, those with concerns related to emotional well being, the elderly population and sex workers. The fourth section includes papers that discuss treatment disparities and providers of care. The final section includes papers that relate to policy concerns.

The topic of health care services and underserved populations is one of growing importance within the US health care system and one of importance in health care systems across the world. Concern about equity in health care is not new. There is a long tradition in medical sociology of studies of inequities in health status and use of health care services. Over the past ten to twenty years, there have been many studies that have documented that race and socioeconomic status (SES) influence the use of health care services. Within the US in the past decade, this area of concern is often described as studies of health disparities and this volume is a contribution to that research. This volume examines the issue more broadly, by including some issues in countries besides the US and examining the role of providers in treatment disparities and important policy concerns.

Health and mental health organizations are undergoing major changes in policies, procedures, structures, and emphasis. Many of these changes appear related to what may be termed the managed care revolution. This upheaval in delivery systems related to health and mental health care has been associated with great changes and rapid turnover in leaders and in leadership positions. It appears that many leaders are not able to lead their organizations into this or other new territories. The purpose of this book is to describe stages that organizations go through as they move rapidly to adapt to new and sometimes unwanted changes. The emphasis is on the aspects of leaders and of leadership that appear tied to successful or unsuccessful outcomes for organizations in the midst of these rapid changes. Particular challenges and expectations that are likely to be present in organizations and in individuals facing change are described. Methods are presented that might be employed by leaders to confront various difficulties in order to direct successful outcomes for themselves, as leaders, and for their organizations. Throughout the book, the essential and sometimes differing goals of leaders as individuals and of leadership as a professional process are highlighted. This book will be of interest to leaders and managers at all levels in various health and mental health care organizations, as well as graduate students in health care management, health care services, health care administration, and business administration. It will also be of interest to mental health professionals and graduate students in industrial and organizational psychology.