Over the past decade, a series of studies have found that physicians-in-training who work extended shifts are at increased risk of experiencing motor vehicle crashes, needlestick injuries, and medical errors. In response to public concerns and a request from Congress, the Institute of Medicine conducted an inquiry into the issue and concluded in 2009 that resident physicians should not work for more than 16 consecutive hours without sleep. They further recommended that the Centers for Medicare & Medicaid Services and the (...) Joint Commission work with the Accreditation Council for Graduate Medical Education to ensure effective enforcement of new work hour standards.The IOM's concerns with enforcement stem from well-documented non-compliance with the ACGME's 2003 work hour rules, and the ACGME's history of non-enforcement. In a nationwide cohort study, 84% of interns were found to violate the ACGME's 2003 standards in the year following their introduction. (shrink)

In July 2011, the ACGME implemented new rules that limit interns to 16 hours of work in a row, but continue to allow 2nd-year and higher resident physicians to work for up to 28 consecutive hours. Whether the ACGME's 2011 work hour limits went too far or did not go far enough has been hotly debated. In this article, we do not seek to re-open the debate about whether these standards get matters exactly right. Instead, we wish to address the (...) issue of effective enforcement. That is, now that new work hour limits have been established, and given that the ACGME has been unable to enforce work hour limits effectively on its own, what is the best way to make sure the new limits are followed in order to reduce harm to residents, patients, and others due to sleep-deprived residents? We focus on three possible national approaches to the problem, one rooted in funding, one rooted in disclosure, and one rooted in tort law. (shrink)

This paper describes one style of functional analysis commonly used in the neurosciences called task-bound functional analysis. The concept of function invoked by this style of analysis is distinctive in virtue of the dependence relations it bears to transient environmental properties. It is argued that task-bound functional analysis cannot explain the presence of structural properties in nervous systems. An alternative concept of neural function is introduced that draws on the theoretical neuroscience literature, and an argument is given to show that (...) this alternative concept of may help to overcome the explanatory limitations of task-bound functional analysis. (shrink)

This collection examines questions of medical accountability and ethics. It analyses how the criminal justice system regulates health care practice, and to what extent it is appropriate to use it as a tool to resolve ethical conflict in health care.

The problem of Philo's ambivalence about the physical world -- The context for Philo's ambivalence toward the physical world -- Philo's negative terminology for the physical world : [ousia, hylē, genesis, genētos] -- Philo's positive terminology for the physical world : [kosmos] -- Philo's positive terminology for the physical world : [physis] part 1 -- Philo's positive terminology for the physical world : [physis] part 2 -- Higher and lower approaches to God -- The ambiguity of the physical world : (...) a multiperspectival approach -- Conclusions. (shrink)

The first book to investigate the relevance of Theodor W. Adorno's work for theorizing the age of neoliberal capitalism. Through an engagement with Adorno's critical theory of society, Charles Prusik advances a novel approach to understanding the origins and development of neoliberalism. Offering a corrective to critics who define neoliberalism as an economic or political doctrine, Prusik argues that Adorno's dialectical theory of society can provide the basis for explaining the illusions and forms of domination that structure contemporary life. (...) Prusik explains the importance of Marx's critique of commodity fetishism in shaping Adorno's work and focuses on the related concepts of exchange, ideology, and natural history as powerful tools for grasping the present. Through an engagement with the ideas of neoliberal economic theory, Adorno and Neoliberalism criticizes the naturalization of capitalist institutions, social relations, ideology, and cultural forms. Revealing its origins in the crises of the Fordist period, Prusik develops Adorno's analyses of class, exploitation, monopoly, and reification to situate neoliberal policies as belonging to the fundamental antagonisms of capitalist society. (shrink)

The numerous historical episodes of free banking have invariably ended in the establishment of central banking. Was the failure of free banking due to ?theory,? ?seignorage??the attempt by governments to use central banks for revenue purposes?or to ?crises?? Would a free banking system be stable, free of crises? This is the crux of the theoretical and historical debate.