: State legislatures consider numerous bills to regulate managed care organizations. After identifying the legal, political, and economic barriers to state reform efforts, the paper assesses recent types of state regulation, particularly mandated benefits and disclosure requirements. Two prerequisites to future reform, coalition building and the diffusion of information about managed care, are analyzed.

State laws dictating “informed consent” about surgical and chemical abortions sometimes ensnare emergency contraceptives, as the science surrounding EC shows. Courts evaluating mandated disclosures gravitate to professional norms rather than the information most women would value: basic factual information about EC so that they can decide for themselves whether to use these drugs.

This paper analyses J.S. Mill's theory on the relationships between individual autonomy and State powers. It will be argued that there is a significant discrepancy between Mill's general liberal statements aimed to secure individual largest possible autonomy and the specific examples which provide the government with quite wide latitude for interference in the public and private spheres. The paper outlines the boundaries of government interference in the Millian theory. Subsequently it describes Mill's elastic paternalism designed to prevent people from (...) inflicting harm upon others as well as upon themselves, from soft paternalism on issues like compulsory education to hard paternalism on very private matters such as marriage, having children, and divorce by consent. (shrink)

The United Nations Educational, Scientific, and Cultural Organization's (UNESCO) Universal Declaration on Bioethics and Human Rights announces a significant array of welfare entitlements—to personal health and health care, medicine, nutrition, water, improved living conditions, environmental protection, and so forth—as well as corresponding governmental duties to provide for such public health measures, though the simple expedient of announcing that such entitlements are “basic human rights.” The Universal Declaration provides no argument for the legitimacy of the sweeping governmental authority, taxation, and (...) class='Hi'>regulation to create and impose such “rights.” As this paper explores that some action promotes a purported good, such as “health,” does not thereby make the action morally permissible. Just as there are moral limits on legitimate personal actions, there are also moral limits on legitimate governmental actions to promote purported goods, including health. A core question of any governmental regulation, therefore, is whether it is a legitimate application of moral political authority or an unauthorized act of state coercion. Pace UNESCO's wide-ranging assertions, this paper argues that promoting health only falls within the legitimate authority of governments in very narrowly defined circumstances. As the paper critically explores, at stake are foundational moral and political questions concerning the limits of governmental authority to intervene in the consensual interaction of persons. Imposing such duties on others, including citizens of a state through regulatory activity and taxation, must be justified, nonarbitrary, and demonstrably within the limits of moral political authority. UNESCO's assertions do not meet this burden of proof. (shrink)

If the Supreme Court affirms either Compassion in Dying v. State of Washington or Quill v. Vacco, state legislatures will be presented with a new and unwelcome task: regulating physician-assisted suicide. This article focuses on the states task of specific policy making in light of the due process reasoning in Compassion in Dying and the equal protection reasoning in Quill. Policy makers must try to predict whether a particular regulation would in practice achieve its intended objective. They (...) must also try to predict whether the regulation would survive constitutional review if challenged. Finally, they must consider the extent to which they could, or should, maintain two different regulatory regimes: a more permissive one for decisions to forgo life-sustaining medical treatments, and a more restrictive one for decisions to obtain a prescription for a lethal dose of medication. This last issue will be especially challenging if the equal protection analysis in Quill prevails. (shrink)

In this paper, I examine the question of whether there is justification for regulations that place limits on food choices. I begin by discussing Sarah Conly’s recent defense of paternalist limits on food choice. I argue that Conly’s argument is flawed because it assumes a particular conception of health that is not universally shared. I examine this conception of health in some detail, and I argue that we need to shift our focus from individual behaviors and lifestyle to the broader (...) social and environmental context. Such a shift allows us to see the ways in which industry practices are negatively impacting our well-being (a broader concept than “health”). I argue that state regulatory activity surrounding the conditions under which food is grown, processed, marketed, and sold needs to be strengthened. As a result, there are likely to be some indirect limitations on food choice. These indirect limitations are justified, but regulations in which the goal is to change individual behavior or lifestyle are not. (shrink)

In Habermas’s discourse theory of law, the guarantee of citizens’ private and public autonomy is a prerequisite of legitimate law. This includes social entitlements. They provide the living conditions necessary for equal opportunities in the use of private and public freedoms. A proceduralist paradigm of the welfare state ensures private and public autonomy in shaping social rights. This makes welfare state regulations a legitimizing institution. This legal theoretical approach is outlined and defended against objections. The focus falls on (...) examining the critique of the justification and quality of social entitlements. Also considered are possible measures to strengthen the basis of legitimation in shaping social rights. (shrink)

Explainable AI (XAI) provides methods to understand non-interpretable machine learning models. However, we have little knowledge about what legal experts expect from these explanations, including their legal compliance with, and value against European Union legislation. To close this gap, we present the Explanation Dialogues, an expert focus study to uncover the expectations, reasoning, and understanding of legal experts and practitioners towards XAI, with a specific focus on the European General Data Protection Regulation. The study consists of an online questionnaire (...) and follow-up interviews, and is centered around a use-case in the credit domain. We extract both a set of hierarchical and interconnected codes using grounded theory, and present the standpoints of the participating experts towards XAI. We find that the presented explanations are hard to understand and lack information, and discuss issues that can arise from the different interests of the data controller and subject. Finally, we present a set of recommendations for developers of XAI methods, and indications of legal areas of discussion. Among others, recommendations address the presentation, choice, and content of an explanation, technical risks as well as the end-user, while we provide legal pointers to the contestability of explanations, transparency thresholds, intellectual property rights as well as the relationship between involved parties. (shrink)

Using a comprehensive sample of U.S. non-profit hospitals from 2011 to 2015, we examine the effects of state community benefits regulation on the amount of charity care provided by and the operational efficiency of U.S. non-profit hospitals. First, we document that, under such regulations, non-profit hospitals provide more charity care and less compensated care as a proportion of net revenue. We infer from these findings that CBR has the potential to increase both non-profit hospitals’ amount of charity care (...) and their efficiency of operations. Second, by examining variation in CBR types, we find no differences between having provision or having reporting requirements on the amount of charity care offered. Moreover, when we consider CBR with both provision and reporting requirements, the combination of these two requirements does not incrementally enhance charity care offerings, suggesting that the requirements may serve as substitutes with comparable effect. Lastly, we show that several state-level characteristics influence the relationship between CBR and charity care: CBRs in states with a higher gross domestic product and percentage of revenue received in taxes have incrementally lower associations with charity care, while hospitals in states where populations have, on average, higher household incomes have greater associations between CBR and charity care. Our findings highlight the effects that state-enacted regulation can have on socially beneficial behavior by non-profits. (shrink)

John Tillson’s Children, Religion and the Ethics of Influence develops and deploys the ‘epistemic criterion’ for deciding whether teachers should promote belief in particular propositions. He defends that criterion by arguing that it promotes human well-being and enables individuals to fulfil their duty to pursue the truth. In this article I draw on John Rawls’ conception of political liberalism to suggest that the epistemic criterion is an inappropriate basis for the political community’s shaping of children’s beliefs.

Action orientation is a volitional mode that promotes flexible self-regulation of emotional and motivational states; state orientation represents the conceptually opposite volitional mode that promotes fixation on (particularly negative) emotional and motivational states (Kuhl & Beckmann, 1994a). The present research investigated the link between action versus state orientation and implicit emotion regulation under demanding conditions. After inducing a demanding context, action-oriented participants displayed reduced affective priming effects of negative primes relative to state-oriented individuals (Studies 1–3). (...) Action versus state orientation did not moderate affective priming effects of positive prime words (Studies 1–3). Effects of action versus state orientation emerged only for a limited number of trials (Study 2) and were reversed under low-demanding conditions (Study 3). These findings support the notion that implicit emotion regulation is closely linked to volitional action control. (shrink)

Offering a novel and pragmatic perspective, this timely book critically examines the development of a culture of machinist regulation and questions whether this approach is appropriate in an era of rising biological technologies. Adopting an ontological approach, James Griffin considers how current regulatory frameworks favour digital technology and how this may change in the future. Griffin adeptly investigates how regulation can impact the nature of new technologies, especially as biological computing is becoming more commonplace. Chapters provide a wealth (...) of critical analysis, considering cutting-edge technologies such as AI, prosthesis, and biological computing. Griffin outlines a proposed reformative system which focuses on the biological substrate in the creation of cultural works. The book serves to highlight the ever-increasing need for awareness of the importance of biological substrates and for a regulatory system which reflects this. The State of Cultural Biology will be an essential read for academics and students interested in intellectual property law, law and technology, legal philosophy and law's role in society. It will also prove invaluable to policymakers and professionals looking to broaden their knowledge on the regulation of modern technology. (shrink)

The availability of new genetic testing technologies to identify individuals as at risk for a particular disease has inspired tremendous concern that individuals with gene mutations will soon be universally identified, for both insurance and employment purposes, as a genetic underclass. Scholarship in science and technology studies, however, suggests that understandings of genetic knowledge might be locally contingent, while research in comparative politics helps us understand how national context might play an important role in framing approaches to the regulation (...) of genetic information. What role does national context play in defining genetic risk and shaping approaches to the privacy of genetic information? Using data from interviews, document analysis, and ethnographic observation, the author follows debates among advocacy groups, insurers, and governments in the United States and Britain about the appropriate use of genetic information in insurance underwriting to understand how national context frames the definition of genetic risk as well as its regulation. (shrink)

In the United States, patients who lose the ability to make their own medical decisions are subject to the laws of their respective states. Laws governing advance directives and physician orders for life-sustaining therapies (POLST), and establishing a surrogate in the absence of an advance directive, vary substantially by jurisdiction. This article traces those laws from their origins, describes current practices and challenges with their application to patient care, and considers future avenues for ethics research and legislative reform.

According to the Institute of Medicine, chronic pain affects at least 116 million adults in the United States, which is more than the total affected by heart disease, cancer, and diabetes combined. Pain costs the nation up to $635 billion each year in medical treatment and lost productivity. It has been conceptualized as a public health problem due to its prevalence, seriousness, disparities, vulnerable populations, the utility of population health strategies, and the importance of prevention at both the population and (...) individual levels. For many patients, treatment of pain is inadequate due to uncertain diagnoses, societal stigma, the lack of effective treatments, and inadequate patient and clinician knowledge about the best ways to manage pain. This article explores the inadequate treatment of pain in the U.S. and the subsequent rise of prescription painkiller abuse, misuse, and overdoses. This is followed by a review of the actions taken by states to regulate the prescribing of controlled substances. (shrink)

State-directed but market-oriented forms of regulation, especially environmental examples like cap-and-trade and ecological offsetting, have proliferated in the past two decades, but sociologists have been slow to theorize these broad institutional shifts. This article offers a framework for explaining these processes of regulatory marketization. First, I argue that institutions of this sort are examples of what I call command-and-commodify regulation, a mode of regulation that distinctively hybridizes economic and authoritative dimensions of power. Second, I explain how (...) and why one example of command-and-commodify regulation, species conservation banking, emerged and remained concentrated in California, but did not so easily develop in other American states. Finally, abstracting from the case, I argue that the concept of market reconstruction is useful for developing a more general theory of the ways that social conflicts and mobilization reconfigure regulatory power and thus give rise to new modes of regulation. Together, a theory of command-and-commodify regulation and market reconstruction may be useful for explaining the development of a wide variety of environmentally focused and other regulatory institutions. (shrink)

This chapter reviews Europe's contributions to basic assumptions made in international law and governance. It examines the internal legal models that Europe created and that became foundational blueprints for modern liberal democracies. The chapter also focuses on international legal structures that were designed to operate in a manner consistent with the domestic European model e.g., liberalization of trade, legal protections for foreign investors, or uniform codes of commercial law for international transactions. The post‐Second World War regulation of commerce and (...) livelihood in the European statecraft model came hand‐in‐hand with the protection of personal rights. The modern liberal democratic state derived its legitimacy from management of a social and political structure that bettered the material lot of its nationals. The historical process of formation of the European nation‐states’ geographical map created blocs that had clear boundaries associated with national identity. (shrink)

Public policy in post-apartheid South Africa has been characterized by a mix of state regulation and ‘neo-liberalism’. This article argues that this mix is rooted in the model of economic modernity adopted in South Africa in the 1920s and 1930s, and underpinned by the institutions of a modern state. In an economy transformed by mining and subsequent secondary industrialization, the state played a central role in facilitating capitalist growth, including through the regulation of labour. I (...) argue that, contrary to the conventional understanding, the enduring characteristic of the political economy of modernization in South Africa was not so much the mobilization of cheap African labour, mostly migrants from across Southern Africa, but was rather the institutionalization of high wages and protected incomes for economic, social and political insiders. Anglo-centric institutions and conceptions of industrial and social citizenship were adapted to the colonial context in South Africa. The imperatives of both gold-led capitalist industrialization and the governance of a society in which the settler or immigrant population remained a minority required that the African population was excluded from most dimensions of this citizenship. But the institutions, discourses and ideologies associated with high wages (for citizens) continued to structure economic life in South Africa through and after the apartheid period. South Africa’s mode of economic modernization thus reflects the possibly unique interaction of a British model of economic modernization with the social, economic and political realities of a colonial society. (shrink)

The end of the federal COVID-19 public health emergency (PHE) on May 11, 2023, marked a pivotal shift in the landscape of telehealth regulation in the US. Kwan, Jolin, and Shachar analyze the implications of this transition by exposing inconsistencies in access to care. We agree that we now face a “convoluted patchwork of permanent and temporary changes to telehealth law and policy.”1.

The regulation of Native identity has been central to the colonization process in both Canada and the United States. Systems of classification and control enable settler governments to define who is "Indian," and control access to Native land. These regulatory systems have forcibly supplanted traditional Indigenous ways of identifying the self in relation to land and community, functioning discursively to naturalize colonial worldviews. Decolonization, then, must involve deconstructing and reshaping how we understand Indigenous identity.

Positive Psychology has turned its attention to the study of emotions in a scientific and rigorous way. Particularly, to how emotions influence people’s health, performance, or their overall life satisfaction. Within this trend, Flow theory has established a theoretical framework that helps to promote the Flow experience. Flow state, or optimal experience, is a mental state of high concentration and enjoyment that, due to its characteristics, has been considered desirable for the development of the performing activity of performing (...) musicians. Musicians are a population prone to health problems, both psychological and physical, owing to different stressors of their training and professional activity. One of the most common problems is Musical Performance Anxiety. In this investigation, an electronic intervention program was carried out for the development of psychological self-regulation skills whose main objective was to trigger the Flow response in performing musicians and the coping mechanism for Musical Performance Anxiety. A quasi-experimental design was used with a control group in which pre- and post-measures of Flow State, Musical Performance Anxiety and, also, Social Skills were taken. Sixty-two performing musicians from different music colleges in Spain participated in the program. Results indicated that the intervention significantly improved Flow State, and Sense of Control, and decreased Music Performance Anxiety, and self-consciousness of the participants in the EG but not CG. The changes in the EG after the program showed the inverse relationship between Flow and Anxiety. Two important theoretical factors of both variables, such as worry and the feeling of lack of control, could be involved. The results are under discussion and future lines of research are proposed. (shrink)

Exploiting the regulatory change in China’s Environmental Protection Law in 2015 as a plausibly exogenous shock to the stringency of pollution control, we evaluate the joint role of state ownership and environmental regulation in shaping firms’ environment-friendly (green) investments. Using a difference-in-differences methodology, we find that state-owned enterprises (SOEs) make significantly more green investments than non-SOEs in response to the regulatory change. We propose and empirically analyze four potential mechanisms that may drive this result: (i) environment-related government (...) subsidies granted to SOEs, (ii) political promotion incentives of SOEs’ top management, (iii) government administrative intervention, and (iv) SOEs’ concern for social welfare. We find strong support for the last mechanism whereby SOEs undertake greater green investments due to their greater concern for social welfare, as evidenced by the fact that SOEs making greater charitable donations and those controlled by local governments (and thus more bonded with local communities) make greater green investments. Consistent with this interpretation, we show that regions where SOEs have a greater economic influence improved their air quality to a greater extent after 2015 than regions where non-SOEs are more dominant. In sum, we demonstrate that state ownership and environmental regulation complement one another in motivating corporate green investment. Our results highlight the important implications for the effectiveness and interplay of different government tools in addressing environmental issues. (shrink)

Firearms were associated with 30,136 deaths in the United States in 2003; of these, 11,920 were homicides. For every firearm homicide, there are four people who suffer non-fatal firearm assaults. Like many other consumer products in the US, most guns are initially sold to the public through a network of retail dealers. Persons in the business of selling firearms must obtain a federal firearm dealer's license. There were more than 54,000 federally licensed gun dealers in the United States in 2005, (...) though this reflects a seventy-eight percent decline since 1994. Some states also require a state license to sell firearms.Licensed firearm dealers are an important source of guns for criminals and gun traffickers. In one analysis of gun trafficking investigations conducted by the Bureau of Alcohol, Tobacco and Firearms, licensed dealers accounted for a plurality of all guns diverted to the illegal market. (shrink)

The incidence of elder abuse has led to a growing trend of states taking various methods to regulate the use of electronic monitoring in institutional settings through programs, guidelines, regulations, and laws. This article attempts evaluate how the regulation of electronic monitoring has evolved and may be advanced in the future with the anticipated increase of elder abuse.

Past research has demonstrated that employees’ perceptions of abusive supervision are positively associated with the enactment of bullying behaviors. However, an investigation of the factors influencing employees’ decision to bully others at work has yet to be completed. In this study, we propose that the relationship between perceptions of abusive supervision and the enactment of bullying behaviors is mediated by state self-regulation, and that active coping moderates the relationship between state self-regulation and bullying. Further, we analyze (...) how the situational context affects employees’ levels of self-regulatory resource depletion and ultimately, the extent to which they engage in bullying behaviors. A moderated mediation analysis using time-separated data provided support for our hypotheses, suggesting that employees’ state self-regulation helps explain why abusive supervision is associated with bullying and that active coping helps to reduce bullying behaviors. Further, the results suggest that negative environments are associated with more bullying. Contributions, practical implications, and future research directions are discussed. (shrink)

Diverse legal and regulatory measures are used internationally to control the information provided during pharmaceutical sales visits. Little is known about the comparative effectiveness of these measures however. We analyzed the perceptions of regulators, pharmaceutical industry officials, health professionals, and consumer respondents concerning these approaches in Canada, France, and the United States using an empirical realist interests-based approach. Interviews focused on the aims and effectiveness of regulation, barriers and enablers to regulation and suggestions for improvement. An alignment was (...) found in North America regulator and industry respondents' satisfaction with the status quo and their view that further intervention is unfeasible and unnecessary. Health professionals generally expressed a lack of confidence in the impact of regulations on sales visit information while consumer advocates voiced their disappointment in both regulators and health professionals for their failure to counteract the influence of pharmaceutical marketing. Regulator and industry respondents in France differed from their North American counterparts in their willingness to increase and diversify the scope of regulatory interventions. As the first international comparison of regulatory experiences in this sector, the findings highlight the universal need for more focused and inclusive discussions among groups about how to tailor regulations to achieve public health goals. (shrink)

Many studies have shown that marijuana can negatively affect the cognitive development of adolescents. For some individuals, marijuana use may also initiate opioid use, dose escalation, and opioid use disorder. States that legalize marijuana should help adolescents through regulation of advertising and availability of marijuana-infused edibles. Such policies may assist in protecting neurodevelopment of the adolescent and young adult brain. The federal government should also remove its prohibition of marijuana sales and use, leaving their regulation to state (...) law-makers. (shrink)

ABSTRACTAlthough social anxiety symptoms are robustly linked to biased self-evaluations across time, the mechanisms of this relation remain unclear. The present study tested three maladaptive emotion regulation strategies – state post-event processing, state experiential avoidance, and state expressive suppression – as potential mediators of this relation. Undergraduate participants rated their social skill in an impromptu conversation task and then returned to the laboratory approximately two days later to evaluate their social skill in the conversation again. Consistent (...) with expectations, state post-event processing and state experiential avoidance mediated the relation between social anxiety symptoms and worsening self-evaluations of social skill, particularly for positive qualities. State expressive suppression did not mediate the relation between social anxiety symptoms and cha... (shrink)

This open peer commentary examines the regulation of home birth in Australia from a relational autonomy perspective. The authors argue that rather than focusing solely on risk-based judgments or individual decision-making, a relational approach that emphasizes supportive relationships and communication between pregnant women and healthcare providers offers a better framework. Drawing on recent cases in Australia, the commentary suggests that fostering respectful dialogue and principled compromise between women and caregivers can help balance autonomy with safety concerns while keeping women (...) engaged with the healthcare system, even in high-risk situations. (shrink)

The nanotechnologies and nanomaterials sector is a huge and growing industry. The amount of legislation already in place and still to be produced in order to regulate it will be very substantial. What process is used to produce such regulation? The answer is that very diverse regulatory approaches are and will be used. The approach taken by the European Commission diverges from the one taken by the European Parliament. Moreover, at national level, Member States add their own contribution to (...) the process. This article attempts to describe the landscape and various regulatory actions that have been undertaken by all these actors in the European Union. It first describes the role played by the European Commission and Parliament. It then looks at specific regulatory initiatives from a more sectoral perspective: Cosmetics, Food information, Restriction of the Use of Certain Hazardous Substances in Electrical and Electronic Equipment, Waste Electrical and Electronic Equipment and Biocides. The third part of the paper describes some major national initiatives, in particular those concerning the establishment of reporting systems for nanomaterials, mixtures, articles and consumer products containing them, as an example of how to improve the current governance in the EU and to prevent the risks to human health and the environment. The fourth part gives the perspective of the European Trade Union Confederation. Finally it presents some conclusions and policy recommendations, taking into consideration the diversity of regulatory approaches. (shrink)

In this essay, Bruce Maxwell, David Waddington, Kevin McDonough, Andrée-Anne Cormier, and Marina Schwimmer compare two competing approaches to social integration policy, Multiculturalism and Interculturalism, from the perspective of the issue of the state funding and regulation of conservative religious schools. After identifying the key differences between Interculturalism and Multiculturalism, as well as their many similarities, the authors present an explanatory analysis of this intractable policy challenge. Conservative religious schooling, they argue, tests a conceptual tension inherent in Multiculturalism (...) between respect for group diversity and autonomy, on the one hand, and the ideal of intercultural citizenship, on the other. Taking as a case study Québec's education system and, in particular, recent curricular innovations aimed at helping young people acquire the capabilities of intercultural citizenship, the authors illustrate how Interculturalism signals a compelling way forward in the effort to overcome the political dilemma of conservative religious schooling. (shrink)

Systems of private regulation based on certification have recently emerged to address environmental issues in the forest products industry and labor issues in the apparel industry. To explain why the same regulatory form has emerged across these fields, the author uses a historical and comparative case study approach, closely examining early moments and paying attention to “roads not taken.” Two types of factors led to the initial emergence of private certification: social movement campaigns targeting companies and a neo-liberal institutional (...) context. The analysis shows specific ways in which these factors led states, nongovernmental organizations, and companies to build or support certification associations. (shrink)

The evidence linking tobacco product advertising to adolescent smoking initiation and resulting long-term addiction, premature death, and disability is well established. Each link in the causal chain has been substantiated: children and adolescents are especially vulnerable to advertising; point-of-sale advertising comprises 92.1% of cigarette advertising and marketing expenditures by manufacturers and 71.3% of smokeless tobacco advertising; tobacco companies have targeted youth through advertising; advertising exposure causes adolescents to start and to continue smoking; among adults who become daily smokers, nearly all (...) first use of cigarettes occurs by 18 years of age; adolescents who smoke are at high risk for long-term addiction because their brains are still developing; and long-term addiction results in the tremendous personal, social and financial costs of tobacco-related illnesses. (shrink)