8 research outputs found
Regret, Remorse and Accidents: Where the New Apology Laws Go Wrong
Apologies have proven dramatically effective at resolving conflict and preventing litigation. Still, many injurers, particularly physicians, withhold apologies because they have long been used as evidence of liability. Recently, a majority of states in the U.S. have passed âApology Lawsâ designed to lift this disincentive, by shielding apologies from evidentiary use. However, most of the new laws protect only expressions of benevolence and sympathy (such as âI feel bad about what happened to youâ). They exclude full apologies, which express regret, remorse or self-criticism (âI should have prevented it,â for example). The laws thereby reinforce a prevailing legal construal of apologies as partial proof of liability. This paper argues that the new laws and the prevailing legal practice thereby misread apologetic discourse in a crucial way. Drawing on developments in ethical theory, I argue that full, self-critical apologies do not imply culpability or liability, because they are equally appropriate for innocent, non-negligent injurers. Neither the statement nor the act of an apology is probative of liability, each for separate reasons, and that suggests their admission up to now has been premised on a mistake. The paper closes with a proposed means of protecting apologies from evidentiary use, beyond the âApology Laws,â which is modeled on Rule 409 of the Federal Rules of Evidence
Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study
<p>Abstract</p> <p>Background</p> <p>Widespread adoption of information and communication technologies (ICT) is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care.</p> <p>Design</p> <p>A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care.</p> <p>Discussion</p> <p>A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially <it>disruptive innovation </it>that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care delivery. Such views have stifled debate as well as wider explorations of ICT's potential benefits, yet firm evidence of the effects of role changes on health service outcomes is limited. This project will provide important evidence about the role of ICT in supporting new models of care delivery across multiple healthcare organizations and about the ways in which innovative work practice change is diffused.</p
The Impact of Long-Term Exposure to Space Environment on Adult Mammalian Organisms: A Study on Mouse Thyroid and Testis
Hormonal changes in humans during spaceflight have been demonstrated but the underlying mechanisms are still unknown. To clarify this point thyroid and testis/epididymis, both regulated by anterior pituitary gland, have been analyzed on long-term space-exposed male C57BL/10 mice, either wild type or pleiotrophin transgenic, overexpressing osteoblast stimulating factor-1. Glands were submitted to morphological and functional analysis
Regret, Remorse and Accidents: Where the New Apology Laws Go Wrong
Apologies have proven dramatically effective at resolving conflict and preventing litigation. Still, many injurers, particularly physicians, withhold apologies because they have long been used as evidence of liability. Recently, a majority of states in the U.S. have passed âApology Lawsâ designed to lift this disincentive, by shielding apologies from evidentiary use. However, most of the new laws protect only expressions of benevolence and sympathy (such as âI feel bad about what happened to youâ). They exclude full apologies, which express regret, remorse or self-criticism (âI should have prevented it,â for example). The laws thereby reinforce a prevailing legal construal of apologies as partial proof of liability. This paper argues that the new laws and the prevailing legal practice thereby misread apologetic discourse in a crucial way. Drawing on developments in ethical theory, I argue that full, self-critical apologies do not imply culpability or liability, because they are equally appropriate for innocent, non-negligent injurers. Neither the statement nor the act of an apology is probative of liability, each for separate reasons, and that suggests their admission up to now has been premised on a mistake. The paper closes with a proposed means of protecting apologies from evidentiary use, beyond the âApology Laws,â which is modeled on Rule 409 of the Federal Rules of Evidence
Adapting systems thinking and safety reporting in high-consequence industries to healthcare
\u3ci\u3eDrosophila\u3c/i\u3e Muller F Elements Maintain a Distinct Set of Genomic Properties Over 40 Million Years of Evolution
The Muller F element (4.2 Mb, ~80 protein-coding genes) is an unusual autosome of Drosophila melanogaster; it is mostly heterochromatic with a low recombination rate. To investigate how these properties impact the evolution of repeats and genes, we manually improved the sequence and annotated the genes on the D. erecta, D. mojavensis, and D. grimshawi F elements and euchromatic domains from the Muller D element. We find that F elements have greater transposon density (25â50%) than euchromatic reference regions (3â11%). Among the F elements, D. grimshawi has the lowest transposon density (particularly DINE-1: 2% vs. 11â27%). F element genes have larger coding spans, more coding exons, larger introns, and lower codon bias. Comparison of the Effective Number of Codons with the Codon Adaptation Index shows that, in contrast to the other species, codon bias in D. grimshawi F element genes can be attributed primarily to selection instead of mutational biases, suggesting that density and types of transposons affect the degree of local heterochromatin formation. F element genes have lower estimated DNA melting temperatures than D element genes, potentially facilitating transcription through heterochromatin. Most F element genes (~90%) have remained on that element, but the F element has smaller syntenic blocks than genome averages (3.4â3.6 vs. 8.4â8.8 genes per block), indicating greater rates of inversion despite lower rates of recombination. Overall, the F element has maintained characteristics that are distinct from other autosomes in the Drosophila lineage, illuminating the constraints imposed by a heterochromatic milieu