Health professionals' attitude toward euthanasia: a cross-sectional study from Turkey

There is an ongoing debate on the definition of euthanasia and attempts to change laws about euthanasia and its practice in many countries. It is the medical doctors and the other health professionals who will elucidate the issue. Therefore, we performed this study to reveal attitude of Turkish health professionals toward euthanasia. This is an observational and cross-sectional study and data were collected with a questionnaire. The questionnaire was distributed to 545 health professionals in Samsun, a city in the Black Sea Region in Turkey. Data were analyzed with SPSS package programs. Of all health professionals included in the study, 43.5% were medical doctors and 45.5% auxiliary health professionals. Of all participants, 33.6% did not object to euthanasia and 7.9% were asked to perform euthanasia. Eighty point seven percent of the participants noted that euthanasia could be abused even if a euthanasia law were passed. It can be concluded that the health professionals should have a chance to discuss euthanasia and that their attitude toward and their expectations and worries about euthanasia should be taken into account when a euthanasia law is drafted.     

Turkey's physicians' attitudes toward euthanasia: a brief research report

Euthanasia and assisted suicide are subject to an ongoing debate and discussed with various aspects. Because physicians are in a profession closely related to euthanasia, their attitudes toward this subject are significant. Thus, research intending to explore their opinions is carried out in many countries. In this study, opinions of the physicians regarding euthanasia's definition, contents, legal aspects, and acceptable conditions for its application are addressed. The questionnaire was given to 949 physicians, more than 1% of the total working in Turkey. Of the physicians who participated in the study, 49.9% agreed with the opinion that euthanasia should be legal in certain circumstances. In addition, 19% had come across a euthanasia request and the majority of physicians (55.9%) believed that euthanasia is applied secretly in the country despite the prohibitory legislation. In conclusion, the authors infer from the study itself and believe that euthanasia should be legal in certain circumstances and that the subject, which is not in the agenda of the Turkish population, should continue to be examined.     

Exploring the impact of motivations on the attraction of innovation roles in open innovation web-based platforms

Recently, a large number of new innovative enterprises engaged in different competitive markets by promoting innovation both in products and in services through open innovation web-based platforms, which allow for the collaboration of individual users and companies and for so-called crowdsourcing. A key issue concerns the identification of the most important motivations that could attract users with a specific role to proactively participate and contribute to the open and collaborative innovation processes. This article, after highlighting the theoretical background, grounded on large body of psychology and sociology literature on the motivation behind collaboration, discusses the results of the analysis of 26 open innovation web-based platforms based on a multiple research methodology (qualitative empirical study, factor analysis and multi-dimensional scaling). It also discusses the effects of ‘motivational systems’ and platform models on the attraction of the individuals characterised by different innovation roles.     

Multi-Stage Model Estimates of Lung Cancer Risk from Exposure to Diesel Exhaust, Based on a U.S. Railroad Worker Cohort

A California Environmental Protection Agency (Cal/EPA) report concluded that a reasonable and likely explanation for the increased lung cancer rates in numerous epidemiological studies is a causal association between diesel exhaust exposure and lung cancer. A version of the present analysis, based on a retrospective study of a U.S. railroad worker cohort, provided the Cal/EPA report with some of its estimates of lung cancer risk associated with diesel exhaust. The individual data for that cohort study furnish information on age, employment, and mortality for 56,000 workers over 22 years. Related studies provide information on exposure concentrations. Other analyses of the original cohort data reported finding no relation between measures of diesel exhaust and lung cancer mortality, while a Health Effects Institute report found the data unsuitable for quantitative risk assessment. None of those three works used multistage models, which this article uses in finding a likely quantitative, positive relations between lung cancer and diesel exhaust. A seven-stage model that has the last or next-to-last stage sensitive to diesel exhaust provides best estimates of increase in annual mortality rate due to each unit of concentration, for bracketing assumptions on exposure. Using relative increases of risk and multiplying by the background lung cancer mortality rates for California, the 95% upper confidence limit of the 70-year unit risks for lung cancer is estimated to be in the range 2.1 x 10(-4) (microg/m3)(-1) to 5.5 x 10(-4) (microg/m3)(-1). These risks constitute the low end of those in the Cal/EPA report and are below those reported by previous investigators whose estimates were positive using human data.     

Reconsidering ordinary and dynamic capabilities in strategic change

Dynamic capabilities research explains the ability of firms to respond to dynamic environments by reconfiguring inert and insufficiently flexible ordinary capabilities. However, more recent research ascribes the routines that constitute ordinary capabilities the ability to evolve endogenously. This study aims to develop dynamic capability research by increasing our understanding of the relations between and the roles played by ordinary and dynamic capabilities in producing purposeful responses to environmental dynamism. Drawing on longitudinal, qualitative data, we show how ordinary capabilities make important contributions to organizational responses to dynamic environments. Our findings pose challenges to key assumptions of extant dynamic capabilities research and allow us to explicate new roles for ordinary and dynamic capabilities, thus advancing the understanding of the relation between dynamic and ordinary capabilities and advancing understanding of one of the central issues in dynamic capabilities research: firms’ capacity to respond to changing environments.     

Medical decision-making around the time of death of cognitively impaired nursing home residents: a pilot study

The purpose of this article is to describe the end-of-life process in the nursing home for three groups of cognitively-impaired nursing home residents: those who died with a medical decision-making process prior to death; those who died without such a decision-making process; and those who had a status-change event and a medical decision-making process, and did not die prior to data collection. Residents had experienced a medical status-change event within the 24 hours prior to data collection, and were unable to make their own decisions due to cognitive impairment. Data on the decision-making process during the event, including the type of event, the considerations used in making the decisions, and who was involved in making these decisions were collected from the residents' charts and through interviews with their physicians or nurse practitioners. When there was no decision-making process immediately prior to death, a decision-making process was usually reported to have occurred previously, with most decisions calling either for comfort care or limitation of care. When comparing those events leading to death with other status-change events, those who died were more likely to have suffered from troubled breathing than those who remained alive. Hospitalization was used only among those who survived, whereas diagnostic tests and comfort care were used more often with those who died. Those who died had more treatments considered and chosen than did those who remained alive. For half of those who died, physicians felt that they would have preferred less treatment for themselves if they were in the place of the decedents. The results represent preliminary data concerning decision-making processes surrounding death of the cognitively-impaired in the nursing home. Additional research is needed to elucidate the trends uncovered in this study.     

Examining the Influence of the Social Cognitive Factors and Relative Autonomous Motivations on Employees’ Knowledge Sharing Behaviors

By incorporating the perspectives of social cognitive theory and relative autonomous motivations, this study examines a model that depicts the influence of personal and environmental factors on employees’ knowledge sharing behaviors (KSBs). Data that were collected from 294 professionals in the industry were analyzed using component‐based structural equation modeling to examine the proposed model. The research results indicate that trust, relationship orientation, knowledge sharing self‐efficacy, and relative autonomous motivation regarding KSBs are the key influencing factors of KSBs of professionals. A key implication is that managers must consider the impact of the level of employee‐perceived autonomous motivation when they seek to facilitate KSBs. Finally, the theoretical and practical contributions are discussed, followed by the suggestions for future research directions.     

Evolving Perceptions of Clinical Management in Acute Hospitals in England

Clinical management is at the centre of organizational change in the contemporary British hospital sector, and throws up important questions about the relationship between medicine and management. Through the analysis of business planning as a key organizational process the interpretative frameworks which guide the perceptions of the roles of clinical directors and directorate managers can be understood. This paper presents empirical material from a study of an acute hospital trust going through a full business planning cycle, and traces the evolving interpretations of the nature, content and form of clinical management. It also provides insights into the changing face of the medical profession and its place within the health services domain.     

The Cost of Compensating Asbestos Victims Under the Occupational Disease Compensation Act of 1983

The potentially huge financial liability due to asbestos product suits and the resulting filings for reorganization in bankruptcy by Manville, UNR Industries, Inc., and Amatex, has become a major public policy concern. In response to the problem several bills have been introduced in the Congress to provide compensation for asbestos (and other occupational disease) victims. This paper estimates the cost of compensating asbestos victims under the provisions of the "Occupational Disease Compensation Act of 1983," introduced by Congressman George Miller. Utilizing fatality projections from studies by Enterline, Selikoff, and Walker, and assumptions regarding likely claims filing and success rates, duration and degree of disability, and medical expenses, first year costs for this legislation are estimated to range from a low of $131 million to a high of $ billion. Present value cost estimates at a 2% real discount rate range from $3 billion to $56 billion. The paper also estimates the impact of possible modifications to the compensation provisions of the legislation. Reducing medical payments by the amount received from medicare would lower costs by 3-4%. Providing survivors with a 3-year lump sum benefit rather than a 5-year lump sum payment would save 20-25% as would offsetting the 5-year lump sum by expected social security old age and disability benefits. Combining all of these changes would reduce costs by almost 50%.     

Motivations for Environmental Alliances: Generating and Internalizing Environmental and Knowledge Value

Environmental alliances are a common response to societal sustainability demands. In environmental alliances, firms collaboratively exploit and explore environmental technologies to address market opportunities while simultaneously generating positive environmental impacts. A striking idiosyncrasy is that in addition to economic value, environmental alliances generate two types of external value: environmental value from positive effects on air, water, land and biodiversity, and knowledge value from innovations in environmental technologies. Research on motivations for environmental alliances is dispersed and underdeveloped compared to the well‐established literature on motivations for strategic alliances that emphasize economic value. This study therefore develops a classification of motivations for environmental alliances by combining the literature on strategic alliances and that on environmental and knowledge value. The resulting classification includes motivations for environmental alliances to generate environmental and knowledge value as well as motivations to create economic value by internalizing environmental and knowledge value. A systematic review of 123 articles on environmental inter‐firm alliances identifies specific motivations to populate the new classification. We show that alliance partners are motivated to share sustainable resources, reduce sustainability risk, respond to stakeholders or invest in specific sustainable assets to generate external value. They collaborate to reduce costs or enhance competitive advantage, reputation or legitimacy to internalize external value. The resource‐based view, resource‐dependence view, institutional theory and transaction cost economics have not previously distinguished between motivations to generate and internalize external value. We extend their area of application from strategic alliances to environmental alliances, and thus beyond the exclusive pursuit of economic value.     

Michigan versus Kevorkian

Our personal reflections on the Michigan versus Kevorkian trial highlight the following issues: 1) the switch from physician-assisted suicide to euthanasia, 2) the television showing of the death, 3) the dropping of the prosecution of the charge of physician-assisted suicide, 4) Kevorkian serving as his own defense attorney, trying to argue that ALS was a secondary cause of Thomas Youk's death, 5) Kevorkian's attempt to employ a logical syllogism to demonstrate that euthanasia need not be murder, 6) Kevorkian's initial reference to the civil rights tradition but sudden change to the medical analogy of Nazi medicine: a final solution, 7) the insistence of Kevorkian on "all or nothing" sentencing, 8) the irony of Kevorkian being finally convicted by a prosecutor who was elected on a platform of not prosecuting Kevorkian, 9) Kevorkian hiring a lawyer after the verdict is in, and 10) Kevorkian's threat to starve himself to death if sent to prison.     

The impact of health care reform on group practice

Just two years ago, it would have been very difficult to imagine that reform of the health care system would today be a national domestic priority and that Congress would be considering one of the most significant and far-reaching pieces of legislation in the past 50 years. The issue is still in doubt, but it seems clear that, in this session of Congress or the next, legislation of far-reaching consequences will likely be passed. In fact, change on a widespread scale has already begun. During 1993, every state legislature except those of Nevada and Wyoming considered measures that would alter the way medical care is financed and delivered. Of the states that acted, both last year and in recent legislative sessions, eight have passed laws with the ultimate objective of ensuring access to medical care for all citizens. Government, at both the state and federal level, is clearly taking on the health care issue. The impact of reform on physicians, and thus on group practices, will be substantial. This article outlines the current course of health care reform and addresses its specific implications for the management of group practices.     

Are National Cultural Traits Applicable To Senior Firm Managers?

Researchers have applied Hofstede's categorization of national cultural traits not only in studies of 'average' employee samples, from which the categorization was originally derived, but also to élite senior executives, and even to firms, on the assumptions that top management teams (i) are culturally homogeneous with average employees and (ii) directly reflect cultural characteristics in strategic decision-making. Such assumptions are questioned by research finding that country sub-populations are culturally heterogeneous and that individuals' cultural characteristics are moderated by organizational and task contexts. Using the construct of collectivism/individualism, this study tests the applicability of Hofstede's generic national cultural norms to senior executives using Anglo-Saxon and Chinese samples. Results cast doubt on the applicability of Hofstede's classifications to senior manager populations and suggest several avenues for further research.     

Accounting for the formation of scientific fields in organization studies

There are few qualitative organizational accounts that explore the constitution of scientific fields in management. We developed a methodology for understanding the academic modes of scientific knowledge production in management research from the perspective of the sociology of scientific knowledge (SSK) and actor-network theory (ANT). SSK and ANT offer a way to account for how scientific fields in organization studies are enacted. Key to this process are splitting and inversion of statements; credibility and network formation; and the concepts of credit, trajectory, and position. Specific statements making key knowledge claims (e.g., handbooks, special editions) are situated in academic practices that obscure those rhetorical strategies that enable the production of a network of knowledge that can act, organizationally, as a more or less unified sub-field. We take as a starting point a collection of texts, dated 2011, which sought to systematize the main currents of a disciplinary sub-field during the last decade, focusing on how statements are transformed into scientific certainty and how the question of credibility is established. The sub-field is that of organizational learning (OL). The particular language of OL relies on approaches that make its epistemic assumptions intelligible within a network. It is a language that tends to reify and naturalize specific practices that become accredited as organization learning. The material/textual artifacts that sustain these practices, instead of being reified, can be reframed as enacting a scientific field whose resignification acts upon the network that enabled its existence.     

Demand rising for medicine's rarest birds

The prognosis from most quarters is that the U.S. health care delivery system is moving inexorably toward managed care. The final form that managed care takes under whatever health reform measure finally takes shape in Washington is still in doubt, but it is clear that care will be managed in the future. It also seems increasingly clear that the system evolving will require more primary care providers, and that they will occupy some very key decision-making roles in the clinical firmament. In this article, staff writer Donna Vavala brings together the thoughts and predictions of several health care leaders on this critical topic in medical management.     

Knowledge generation and governance in management research

We consider how historical developments led to an emphasis on positivistic research approaches in business schools, and we explain how alternative assumptions could be the basis for academic management knowledge. We then discuss the governance structures journals use to determine which articles to publish and how reviewer motivations may influence these processes. Given this academic research and publishing context, we argue that it is not surprising that management research relevant for management practice receives little support. We propose changes to encourage more innovative research that offers stronger ties between management research and practice.     

In transit from physician to manager--Part I

Physicians are finding themselves in increasing numbers in significant management roles. Physician managers interviewed about their experiences in changing careers identified six critical transitions, three involving psychological adjustments and three requiring development of new skills. A framework is developed in this two-part article that relates career events that trigger transitions, the transitions themselves, and the obstacles that can hinder or block success. The challenges that physicians encounter in management are similar to those faced by other professional groups, and the chances of successful transition can be improved by individual and organizational actions.     

Regulations, policies and practices concerning work stress in five European countries

A comparative inventory of regulations, policies and practices in The Netherlands, Sweden, UK, Germany and France with regard to the prevention of work stress was carried out. In each country data were collected by means of interviews with key informants and through exploring relevant documents and literature. It was found that Sweden, The Netherlands and the UK—those countries with framework legislation in the field of health and safety—recognize stress as an important health and safety topic, whereas Germany and France do not yet recognize stress as an important policy issue. However, even in the first group of countries less attention is being paid towards psychosocial work characteristics when compared with traditional health and safety issues, such as noise, machine safety and toxic agents. There is a clear lack of well-documented (national) 'examples of good preventive practice', even in Sweden and The Netherlands. Recommendations are being formulated concerning type of legislation, guidance and information, monitoring and risk assessment, costs and benefits, examples of good practice and European networking.     

Management knowledge and skills required by U.K. and U.S. medical directors

A survey was undertaken of the medical directors of National Health Service trusts in the South Thames Regional Health Authority of the United Kingdom. The purpose of the survey was to ascertain medical directors' views regarding the importance of various areas of administrative practice, their preparedness in these areas of administrative knowledge prior to taking up their roles as medical directors, and their views as to the body of knowledge required for future medical directors. The study was compared with a similar study undertaken in the United States. While there were many areas of agreement between the English and the American medical administrators, there were also areas of significant differences of opinion. The need to develop a recognized training program in medical administration is acknowledged.