Feds 200, Indians ): the Burden of Proof in the Federal / Indian Fiduciary Relationship

Great nations, like great men, should keep their word. \u27 Justice Black, in his dissent in Federal Power Commission v. Tuscarora Indian Nation, encapsulated the failures of two centuries of the United States\u27 relationship with its native Indians. Since establishing the first tentative treaties of the Revolutionary era, the United States has made many broad promises to the Indians. These promises, detailed first in treaties and later in statutes, drew the government and the Indians into a fiduciary relationship. Although this relationship would have consequences for federal/Indian interactions, raising the level of care with which the government would treat its native beneficiaries, its full potential has remained unrealized.4 In 1960, Justice Black\u27s simple principle fell on deaf ears. Today, courts have the opportunity to listen. The scope of the federal/Indian fiduciary relationship has escaped precise definition in part because of the elusive nature of all fiduciary interactions. A fiduciary relationship, like that between the federal government and the Indians, usually overlays statutorily regulated ties between parties in trust-based relationships. The fiduciary relationship regulates the manner in which the fiduciary fulfills legal duties to the dependant party, providing a veil through which courts view the fiduciary\u27s execution of other, more specific obligations. Because of its lack of independent shape, this notion of heightened responsibility may appear a concept in search of a principle.\u27 In fact, fiduciary responsibilities require substantive principles, existing only in symbiotic relationship with the firm guidelines of trust, agency, tort and contract law. This notion, adopted from equity\u27s breach of confidence concerns, boasts broad utilization in modern law. The two basic fiduciary duties, the duty of care and the duty of loyalty, evolved from courts\u27 progressive generalizations of the requirements con- trolling the interactions between certain parties. As courts grew to expect high standards of care and loyalty in specific types of interactions, like those between a doctor and patient or a trustee and beneficiary, they imposed a higher level of responsibility in instances in which the parties, based on the type of relationship entered, would expect such a standard to apply (the archetypal model). Courts soon expanded this notion, attaching fiduciary responsibilities to non-archetypal arrangements in which the purpose of the relationship suggested elements of reliance and high expectations for loyalty and care (the purpose model). Even if a relationship did not fit the archetypal or purpose models, courts often found facts or circumstances that could impose fiduciary responsibilities (the circumstantial model). When a relationship included elements of dominance, influence, vulnerability, trust, or dependency, courts frequently applied fiduciary obligations to the substantive statutory guidelines. The expansions of fiduciary responsibility, however, were not unlimited: a relationship found fiduciary in one respect may not be so characterized in other aspects. In the words of L.S. Sealy, one cannot assume that what is fiduciary for one purpose is fiduciary for all purposes

Framework for Adoption of Next-Generation Sequencing (NGS) Globally in the Oncology Area

Radical new possibilities of improved treatment of cancer are on offer from an advanced medical technology already demonstrating its significance: next-generation sequencing (NGS). This refined testing provides unprecedentedly precise diagnoses and permits the use of focused and highly personalized treatments. However, across regions globally, many cancer patients will continue to be denied the benefits of NGS as long as some of the yawning gaps in its implementation remain unattended. The challenges at the regional and national levels are linked because putting the solutions into effect is highly dependent on cooperation between regional- and national-level cooperation, which could be hindered by shortfalls in interpretation or understanding. The aim of the paper was to define and explore the necessary conditions for NGS and make recommendations for effective implementation based on extensive exchanges with policy makers and stakeholders. As a result, the European Alliance for Personalised Medicine (EAPM) developed a maturity framework structured around demand-side and supply-side issues to enable interested stakeholders in different countries to self-evaluate according to a common matrix. A questionnaire was designed to identify the current status of NGS implementation, and it was submitted to different experts in different institutions globally. This revealed significant variability in the different aspects of NGS uptake. Within different regions globally, to ensure those conditions are right, this can be improved by linking efforts made at the national level, where patients have needs and where care is delivered, and at the global level, where major policy initiatives in the health field are underway or in preparation, many of which offer direct or indirect pathways for building those conditions. In addition, in a period when consensus is still incomplete and catching up is needed at a political level to ensure rational allocation of resources—even within individual countries—to enable the best ways to make the necessary provisions for NGS, a key recommendation is to examine where closer links between national and regional actions could complement, support, and mutually reinforce efforts to improve the situation for patients

Culturally Responsive Pedagogy in Higher Education: A Collaborative Self-Study

In this article we discuss findings from a collaborative self-study of how seven teacher educators define, enact, and navigate their roles as culturally responsive educators across various programs within a higher education institution. All participants conducted an individual interview with another team member and engaged in prolonged team meetings in order to understand and conceptualize culturally responsive pedagogy (CRP). Findings include the participants\u27 difficulty with defining CRP in higher education; the importance of modeling and building relationships with students when enacting CRP; tensions related to students and institutions; and professional and personal opportunities to continuously evolve. The findings begin to fill in a void for an articulated framework of CRP beyond P-12 classrooms and illustrate the type of support and professional development higher education institutions need to provide for teacher educators to actualize this work

Fighting Cancer around the World: A Framework for Action

Tackling cancer is a major challenge right on the global level. Europe is only the tip of an iceberg of cancer around the world. Prosperous developed countries share the same problems besetting Europe–and the countries and regions with fewer resources and less propitious conditions are in many cases struggling often heroically against a growing tide of disease. This paper offers a view on these geographically wider, but essentially similar, challenges, and on the prospects for and barriers to better results in this ceaseless battle. A series of panels have been organized by the European Alliance for Personalised Medicine (EAPM) to identify different aspects of cancer care around the globe. There is significant diversity in key issues such as NGS, RWE, molecular diagnostics, and reimbursement in different regions. In all, it leads to disparities in access and diagnostics, patients’ engagement, and efforts for a better understanding of cancer