(WP 2010-02) The Demand for Historic Preservation

Historic preservation is commonly used to protect old buildings and neighborhoods from deterioration. In 1981, the City of Milwaukee established a historic preservation commission to develop and maintain a local register of places with historical importance to the area. The commission also reviews all applications for historic status as well as any requests for exterior alterations. As such, there are numerous rules and restrictions that are imposed on property owners once it has been declared a historic site. Thus, while historic designation can serve to internalize the externalities in neighborhoods with historic buildings, it also imposes costs on homeowners who wish to make improvements to their homes. This paper uses a hedonic model to estimate the impact of historic preservation on the sale price of a single family home in the Milwaukee area. Preliminary results show that the impact of historic preservation is positive when it is significant, with the average impact at 26.6%. However, there was significant variation between districts, with the impact significantly positive in 13 of 22 districts used in the sample. Specifically, the positive impact ranged between 11% and 65%, holding other factors constant. None of the 22 districts had a negative and significant impact. An evaluation of spillover effects reveal that just over one third of them displayed positive and significant spillover effects, whereas 21% had negative and significant spillover effects. The remainder were insignificant. An important question is what factors influence this variability in historic preservation effects. The eventual goal of this research is to extend our preliminary analysis to two stages using a recently developed method that employs spatial econometric methods to solve the unique identification problems inherent in hedonic models (Carruthers and Clark, forthcoming in Journal of Regional Science). This will permit us to determine the specific factors that influence these premiums. While the spatial estimates presented in this preliminary work do not permit a two-stage model, we did explore whether implicit prices appear to be correlated with the household income and racial makeup of the neighborhoods in which they are located. The findings show little evidence that the implicit values of historic districts are correlated, but the implicit price associated with historic district spillovers was positively correlated with both neighborhood measures

The Demand for Historic Preservation

Historic preservation is commonly used to protect old buildings and neighborhoods from deterioration. In 1981, the City of Milwaukee established a historic preservation commission to develop and maintain a local register of places with historical importance to the area. The commission also reviews all applications for historic status as well as any requests for exterior alterations. As such, there are numerous rules and restrictions that are imposed on property owners once it has been declared a historic site. Thus, while historic designation can serve to internalize the externalities in neighborhoods with historic buildings, it also imposes costs on homeowners who wish to make improvements to their homes. This paper uses a hedonic model to estimate the impact of historic preservation on the sale price of a single family home in the Milwaukee area. Preliminary results show that the impact of historic preservation is positive when it is significant, with the average impact at 26.6%. However, there was significant variation between districts, with the impact significantly positive in 13 of 22 districts used in the sample. Specifically, the positive impact ranged between 11% and 65%, holding other factors constant. None of the 22 districts had a negative and significant impact. An evaluation of spillover effects reveal that just over one third of them displayed positive and signficant spillover effects, whereas 21% had negative and significant spillover effects. The remainder were insignificant. An important question is what factors influence this variability in historic preservation effects. The eventual goal of this research is to extend our preliminary analysis to two stages using a recently developed method that employs spatial econometric methods to solve the unique identification problems inherent in hedonic models (Carruthers and Clark, forthcoming in Journal of Regional Science). This will permit us to determine the specific factors that influence these premiums. While the spatial estimates presented in this preliminary work do not permit a two-stage model, we did explore whether implicit prices appear to be correlated with the household income and racial makeup of the neighborhoods in which they are located. The findings show little evidence that the implicit values of historic districts are correlated, but the implicit price associated with historic district spillovers was positively correlated with both neighborhood measures.Hedonic housing model, historic preservation district, Milwaukee

The Brazilian Code of Medical Ethics : Ethical and bioethical limits

A evolução tecnocientífica tem imposto desafios à sociedade e, particularmente, à medicina. Mudanças sociais nas relações médico-paciente e entre profissionais da saúde demandam novas formas de regulação dessas relações. O atual Código de Ética Médica adota o modelo principialista norte-americano como referencial ético, universalista, baseado na autonomia, em descompasso com a emergente bioética latino-americana, que tem como pressupostos teóricos a pluralidade dos sujeitos morais e a prática multi, inter e transdisciplinar, orientada para saúde pública e coletiva e defesa dos mais vulnerados. O texto reflete sobre aspectos históricos conformadores das profissões e seus códigos e as razões do descompasso da evolução da bioética no Brasil e da revisão do Código de Ética Médica. Igualmente, reflete sobre os desafios contemporâneos para o poder médico, que impõem ampliação do debate ético para elaboração de formatos mais democráticos dos códigos profissionais, tendo como eixo estruturante a Declaração Universal sobre Bioética e Direitos Humanos.The technological and scientific evolution has imposed challenges on society and especially on medicine. Changes in the doctor-patient relationship and among healthcare professionals require new regulatory formats to such relationships. The current Brazilian Code of Medical Ethics adopts the principialist North American model as a universal ethical framework, based on autonomy that is out of step with the emerging bioethics in Latin America, whose theoretical assumptions on the plurality of moral subjects and multi-inter- transdisciplinarity are oriented to public health and the defense of the most vulnerable. The text reflects on the historical aspects that organize professions and their codes, and on the reasons for the gap in the evolution of bioethics in Brazil and the revision of the code. Equally, the text considers the contemporary challenges to the medical authority, which imposes the extension of the ethical debate to draft more democratic formats of professional codes, considering the Universal Declaration on Bioethics and Human Rights as the structural axis.La evolución tecnológica y científica le ha impuesto retos a la sociedad y, en particular, a la medicina. Los cambios sociales en la relación médico-paciente y entre los profesionales de la salud requieren nuevos formatos regulatorios para estas relaciones. El actual Código de Ética Médica adopta el modelo norteamericano principialista como marco ético, universalista, basado en la autonomía, fuera de sintonía con la bioética latinoamericana emergente, que tiene como presupuestos teóricos la pluralidad de sujetos morales y las prácticas multi, inter y transdisciplinarias orientadas a la salud pública y colectiva, y a la defensa de los más vulnerables. El texto reflexiona sobre los aspectos históricos configuradores de las profesiones y de sus códigos, sobre las razones de las diferencias en la evolución de la bioética en Brasil y de la revisión del código. Asimismo, reflexiona acerca de los desafíos contemporáneos del poder médico, que imponen la ampliación del debate ético para el desarrollo de formatos más democráticos de los códigos profesionales, basados en la Declaración Universal sobre Bioética y Derechos Humanos

La bioética como brecha

Bioethics, and bioethicists especially, has a challenge which is to open a gap through which the rights for all men can flow smoothly. So their first and fundamental attitude is to recognize that those who accompany the globalization process use the same concepts to hold the status of domain: for instance, they talk about autonomy, showing how individuals can decide for themselves, complying with certain conditions that have to do with knowledge. These talk about freedom making it conditional to a situation of absolute independence, which is impossible even to think about and finally bringing it down to a choice among options placed by the system. These refer to law as a vindication of each individual's wishes. These conceive solidarity as a gift for those who have to those who do not have; of dignity as selfesteem; of justice as a mode of distribution of goods. What we, as bioethicists, have to learn is what is played in bioethics and ethics, in general, which has to do with the meanings. That is to say, with the content of words and acts, in the sense of behaviors, and especially with the value of decisions.La bioética, los bioeticistas tienen un desafío, el de abrir una brecha por donde comiencen a fluir los derechos para todos los hombres. Para ello su primera y fundamental actitud es la de reconocer que quienes acompañan al proceso globalizador usan sus mismos conceptos para sostener la situación de dominio: hablan de autonomía por ejemplo, mostrando cómo los individuos pueden decidir por sí mismos cumpliendo con ciertas condiciones que tienen que ver sobre todo con el conocimiento; hablan de libertad condicionándola a una situación de independencia absoluta imposible ni siquiera de pensar y reduciéndola finalmente a una elección entre opciones puestas por el sistema; hablan de derecho como reivindicación de los deseos de cada uno; de solidaridad como dádiva de los que tienen a los que no tienen; de dignidad como autoestima; de justicia como modo de reparto de bienes. Lo que tenemos que aprender los bioeticistas es que lo que se juega en la bioética y en la ética en general tiene que ver con los significados. Es decir con los contenidos de las palabras y de los actos, con el sentido de las conductas, y sobre todo con el valor de las decisione

Conflictos bioéticos : atención fisioterapéutica domiciliaria a pacientes en condiciones terminales

O debate bioético enseja reflexões que propiciam a compreensão da morte e da terminalidade de modo a assegurar a observância de princípios como respeito à autonomia, beneficência e não maleficência e os direitos humanos. O objetivo do estudo foi analisar conflitos bioéticos no trabalho de fisioterapeutas em atendimento domiciliar a pacientes em condição de terminalidade. Trata-se de estudo qualitativo e descritivo. Dez fisioterapeutas do Distrito Federal participaram, respondendo a entrevista semiestruturada. Duas categorias foram identificadas: “desafios da atuação em domicílio com pacientes em condição de terminalidade”; e “o fisioterapeuta entre o tecnicismo e o humanismo”. O estudo descortina conflitos bioéticos potenciais no atendimento a esses pacientes e seus familiares, em que os limites para a utilização dos recursos terapêuticos se traduzem em posturas polarizadas – de aproximação ou distanciamento – e o desafio de promover cuidado pautado na humanização e na dignidade humana.The bioethical debate gives rise to considerations that foster understanding of death and terminal illness, in order to ensure compliance with principles such as respect for autonomy, beneficence, not maleficence, and human rights. The objective of the study was to analyze bioethical conflicts related to physiotherapy home care for terminal patients. This is a qualitative descriptive study. Ten physiotherapists from the Federal District, Brazil, participated, answering a semi-structured interview. Two categories were identified: “challenges of home care for patients with terminal conditions”; and “polarization of physiotherapists between technicality and humanism”. The study reveals potential bioethical conflicts in the care of these patients and their families, in which the limits for the use of therapeutic resources translate into opposite approaches – either attachment or detachment – and the challenge of promoting care guided by humanization and human dignity.El debate bioético da lugar a reflexiones que propician la comprensión de la muerte y de la terminalidad, con el fin de garantizar el cumplimiento de los principios como el respeto a la autonomía, la beneficencia y la no maleficencia y los derechos humanos. El objetivo del estudio fue analizar los conflictos bioéticos en el trabajo de los fisioterapeutas en la atención domiciliaria a pacientes en situación de terminalidad. Se trata de un estudio descriptivo y cualitativo. Participaron diez fisioterapeutas del Distrito Federal, Brasil, respondiendo a una entrevista semiestructurada. Se identificaron dos categorías: “desafíos de la atención domiciliaria con pacientes en condición de terminalidad”; y “el fisioterapeuta entre el tecnicismo y el humanismo”. El estudio revela posibles conflictos bioéticos en la atención de estos pacientes y sus familias, donde los límites para el uso de los recursos terapéuticos se traducen en posiciones polarizadas − de aproximación o distanciamiento − y el desafío de promover una atención basada en la humanización y la dignidad humana

The specialization in bioethics at the University of Brasilia : a case study of the first fifteen editions

O presente artigo tem como objetivo realizar um resgate histórico das quinze edições do curso de especialização em bioética da Universidade de Brasília, descrevendo e analisando criticamente a estrutura bem como os conteúdos programáticos abordados, o perfil e número de alunos e os temas trabalhados nas monografias. O curso tem como característica principal trabalhar uma bioética crítica, politizada e socialmente engajada, em oposição a uma bioética horizontalizada, meramente descritiva e neutral. Ao adotar e incorporar os princípios da Declaração Universal sobre Bioética e Direitos Humanos por meio da prescrição contida no Core Curriculum da Unesco, o curso não se restringe a analisar somente as questões sanitárias e educacionais, a interpretar as questões epidemiológicas e ambientais, mas propor e desenvolver mecanismos de intervenção capazes de definir novas frentes de pesquisa no campo biotecnocientífico, na formação de pessoal e no papel do Estado na proteção de seus cidadãos, principalmente os mais vulneráveis.This article aims to conduct a historical review of the fifteen editions of the specialization on bioethics at the University of Brasilia describing and critically analyzing its structure and syllabus, the profile and number of students, and the themes discussed in the final papers. The course presents a critical, politicized and socially engaged bioethics that opposes to a merely descriptive and neutral vision of this field. By adopting and incorporating the principles of UNESCO’s Universal Declaration on Bioethics and Human Rights contained in the UNESCO’s Core Curriculum, the course is not restricted to the analysis of health and educational issues, or to the interpretation of epidemiological and environmental issues, but to the proposal and development of intervention mechanisms that are able to define new research lines in the biotechnoscientific field, in the professional training and in the state’s role in protecting its citizens, especially the most vulnerable

Justicia y bioética ante las desigualdades en salud en Latinoamérica

Se parte de la elaboración de algunos datos que resaltan las inequidades y desigualdades en la atención de salud en los diferentes países de Latinoamérica, como datos éticamente relevantes, a la hora de profundizar en las exigencias del principio de justicia. Se revisan las diferentes concepciones de filosofía política sobre la justicia, con la revisión de las propuestas de Rawls y de la ética dialógica primero, y posteriormente de las corrientes desarrolladas en nuestro ámbito cultural que consideran la justicia como fundamento de la reflexión ética y bioética en América Latina: la ética discursiva, y sus críticas desde posicones de filosofía de la liberación, la erradicación de la pobreza como imperativo ético primordial, la bioética de protección, etc. Finalmente se realiza una propuesta de desarrollo de los principios éticos de la bioética en el plano de lasrelaciones individuales, de las relaciones institucionales y sociales, que lleve a una implementación concreta de las exigencias de la justicia tanto en la relación de los profesionales de la salud con los pacientes, como en el plano de las instituciones de salud, y de los sistemas y políticas generales de salud