BMQ

BMQ: Boston Medical Quarterly was published from 1950-1966 by the Boston University School of Medicine and the Massachusetts Memorial Hospitals

Discourse and Regulation Failures: The Ambivalent Influence of NGOs on Political Organizations

In the last decades, NGOs have become an important participant in the work of political organizations (e.g., national authorities, the EU or the UN). This development brings many opportunities and also some challenges, including discourse failure which is one of the topics discussed in this paper. We present a case study that illustrates the interdependence of discourse failure and regulations failure. We conclude that discourse failure is frequently not merely an accidental by-product, but rather, a non-intended consequence of deliberate NGOs’ campaigns. We make particular note of probable discourse failure when campaigns attempt to deal with complex issues in an environment rife with wide-spread prejudices and where the NGO’s work is transparent. In this situation, regulation failure may be consequent upon discourse failure. We present collectively binding commitments for NGOs and binding services enforced by political organizations to prevent discourse failure. In conclusion, we argue that the field of political economy can benefit from this challenging environment if it systematically researches the interdependencies between discourses and regulations.In den letzten Jahrzehnten kamen NGOs als wichtige Akteure im politischen Regelsetzungsprozess hinzu (z. B. in der EU, der UN und auch auf den nationalen Ebenen). Aus dieser Entwicklung ergeben sich für die Zivilgesellschaft vielfältige Chancen, allerdings auch einige Herausforderungen. Zu den Herausforderungen zählt unter anderem Diskursversagen, woraus häufig Regulierungsversagen resultiert. Der Beitrag präsentiert eine Fallstudie, die das Zusammenspiel aus Diskurs- und Regulierungsversagen aufzeigt. Das Beispiel illustriert, dass Diskursversagen nicht nur ein zufälliger Nebeneffekt von öffentlichen Diskursen ist, sondern eine nicht-intendierte Folge zielgerichteter Kampagnen von NGOs sein kann. Insbesondere Kampagnen, die sich mit komplexen Themen auseinandersetzen, über die es in der Öffentlichkeit weitverbreitete Vorurteile gibt, neigen zu Diskursversagen. Durch transparente Kampagnen seitens der NGOs wird dies sogar begünstigt. Zur Überwindung dieser Defizite stellt der Beitrag verschiedene Bindungsmechanismen für NGOs und Bindungsservices durch Behörden und Politik vor. Abschließend zeigt der Beitrag auf, dass die Politische Ökonomik davon profitieren kann, wenn sie systematisch das Zusammenspiel zwischen Diskurs und Regulierung erforscht

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries