Protecting hospital records from discovery

One of the more burdensome tasks confronting hospital administrators and defense counsel in hospital liability cases is attempting to protect sensitive or confidential information contained in hospital records. Plaintiffs' counsel continue to refine and broaden document requests as they become more sophisticated and experienced, learning about additional categories of documents that may be helpful to their cause. There are conditions that protect documents from discovery, but the rules of privilege are complicated and are frequently misunderstood.     

Touristic authenticity,touristic angst,and modern reality

The tourist has become the symbol of a peculiarly modern type of inauthenticity. This paper explores the criticisms that have been directed at the reality experiences of the tourist. In so doing, the following inexhaustive typology of touristic realities is developed: 1) the first-order or true tourist, 2) the second-order or Angst-ridden tourist, 3( the third-order or anthropological tourist, and 4) the fourth-order or spiritual tourist. Each of these types represents a progressively more intense search for reality through travel. Each is, however, criticized for participating in its own form of inauthenticity.After exploring the reality experiences and criticisms of each of these travellers, the paper turns the tables on the cultured despisers of tourism to argue that perhaps the lowly first-order tourist is not so inauthentic after all. True, this traveller may not be having a real heroic adventure, but such is not the goal. Rather, the reality experienced by the first-order tourist is a pleasurable liberation from the normal concerns of everyday life which simultaneously reaffirms commitment to that reality. Quite frequently the first-order tourist is less concerned about having a real experience in the visited place than in experiencing family and friendship relationships-relationships completely ignored by the anti-touristic tourists in their search for authenticity in someone else's reality.The author would like to thank Peter L. Berger, Harry C. Bredemeier, Warren I. Susman, and M. Kathy Kenyon for their comments and suggestions on earlier versions of this paper. This research was supported in part by NIMH grant no. 5 T32 NH14660.     

Poland's crisis and East European socialism

Conclusion We began this article by asking whether the Polish crisis is a socialist or a Polish disease. By citing the structural factors, we brought out the common difficulties affecting all East European societies in their political and economic development. These difficulties arose out of the transition from extensive to intensive economic growth and the consequent need to replace political mobilization of the population with their political integration. The structural contradictions occurred together with conjunctural developments in the world economy, the collapse of detente, the post-war demographic explosion, and natural calamities. Poland was least able to cope with these structural and conjunctural dynamics. The result was a society united on a national basis in its conflicts with the Party State apparatus. This conflict was never resolved by Solidarity nor by the subsequent military coup.While Poland and Romania had quite similar structural and conjunctural dynamics, it was only in Poland that the constellation of nation-specific factors yielded a societal reaction of system-threatening character. Looking at the rest of Eastern Europe, we do not see a similar constellation of factors. Rather, the combination of structural, conjunctural, and specific conditions has prevented the deeper contradictions from evolving into Solidarity-type mass movements of the Polish variety. Thus, we believe that the Polish developments will not be replicated in any of the other East European countries in the foreseeable future.Does this mean that the Polish experience is so unique that it is without relevance for the other East European states? On the contrary, the recognition of common structural problems points to fundamental conflicts in all the countries of actually existing socialism. The essence of these conflicts may be the same. It is the ability to identify and deal with them that distinguishes one East European regime from another. This ability varies with the specific and conjunctural factors as applied to each country. While there is little likelihood that the Polish disease will spread, this is partly because the other East European states are beginning to take preventive measures. In other words, they are learning from the Polish experience.There are several indicators that these regimes have learned from the Polish crisis. We can summarize them in the following predictions:First, we believe that state power and the repressive apparatus of the various East European countries will be reinforced and made more effective. This applies not so much to overt shows of force but to more sophisticated methods of social control and repression: e.g., limiting information channels, dispersing dissident groups, giving in to workers protests before they spread, taking practical measures to prevent consumer shortages from getting out of hand, and the like.Second, we can expect that oppositional forces, especially intellectuals, will be increasingly restricted in their ability to formulate and articulate system-threatening demands. The East European states will take any measures - jail, slander, internal deportation, cooptation, forced emigration - to make sure that intellectuals' contact with workers is weakened or at least strictly supervised.Third, we can expect the Eastern European states to take further measures to integrate potential system-threatening movements into the official system. We will see further attempts to improve the access possibilities for those social interests that have up to now been neglected, e.g. in physical and social infrastructures, neglected regions. Moreover, there will be renewed efforts to make the system of political socialization (education, propaganda, culture) more effective. Finally, we can expect anti-corruption campaigns within the State, Party, and industrial bureaucracies as the elites attempt to make these organs more legitimate in the eyes of the population.In recent months there seems to be considerable evidence that the East European regimes have taken all these measures. There have been attempts to re-invigorate the official trade unions. Yuri Andropov's succession was marked by a highly publicized anti-corruption campaign designed to win favor among rank-and-file workers. In Romania there have been exhortations towards more self-sufficiency and self-management, so that individual producers will be less dependent on State retail outlets, and the country less dependent on costly foreign imports. The reduction in East-West trade and decline of detente have also given more leeway for the East European repressive apparatus to crack down on dissidents and oppositional movements.With reduced trade, the economic benefits of detente no longer exist as a restraining factor on the authorities. The West now has reduced influence on domestic politics in East Europe. The combination of integration and repressive measures has so far prevented the structural contradictions from growing into true political crises of the Polish variety. Eastern Europe (and Poland) is remarkably quiet.With the broad enthusiasm fostered in the West by the rise of Solidarity, it is understandable that its brutal demise had generated parallel feelings of disillusionment. It would be erroneous to consider the Polish events as an archetype for Eastern Europe. The problems of East European regimes reflect a general system crisis (economic and political), each country's response depends on specific local conditions and fortuitous conjunctures. If the Polish events are to be understood, they must be explained as a variant in a larger East European context.Having concentrated on the crisis aspects in Poland and Romania should not blind us from the fact that these systems have an amazing ability to reproduce themselves - to muddle through. Actually existing socialism is more than simply brute force. Each of the East European societies exhibits a complex dialectic between the forces of functional stability and the forces of immanent contradictions. As such, in addition to their structural aspects, we must analyze each of these societies in their differing vulnerability to conjunctural events and in their specific political, social, and cultural characters.For those who seek to replace actually existing socialism with a more emancipatory socialism, the Polish crisis constitutes a key point of departure. It should be discussed both in terms of what it means for Poland, and for Eastern Europe. The Polish events provide further evidence that the tasks of social theory reside as much in explaining why societies muddle through as why they fall apart.     

Why China failed to create an endogenous industrial capitalism

Conclusion Weber almost anticipated the idea of the high-level equilibrium trap. Speaking about bureaucracy, he observed that as always in the area of'techniques' ... advance proceeded most slowly wherever older structural forms were in their own way technically highly developed and functionally particularly well-developed to the requirements at hand. It is a pity that he did not utilize this insight to analyze what he called the increasing stability of the economic situation under conditions of the economically self-sufficient and socially homogenously composed world-empire of China. Instead he pursued the idea that the absence of self-generated capitalism in China was due basically to the lack of a particular mentality. This inappropriate mentality had several aspects. One was the personalist principle. Others are listed in a catalog of alleged traits of personality taken largely from Arthur Smith's Chinese Characteristics. They include stolidity, patience, dislike of novelty, absence of curiosity, credulity, and a general distrust of and dishonesty towards all. Having acknowledged China's considerable technical endowments and inventions (Weber's own quotation marks), he argued that the magic stereotyping of technology and economics... completely precluded the advent of indigenous modern enterprises in communication and industry. The Chinese world, in a famous phrase, was a magic garden in which the ethical rationality of the miracle [was] out of the question. Certain points of detail may be disputed. Thus the miracles attributed to the piety of sons and the fidelity of widows were entirely ethically rational. But the crucial fact is that this conception of the problem led Weber in practice to place an excessive faith in the explanatory power of an analysis of ideas considered in relative isolation from their socioeconomic context. It probably also weakened his sense of the need to sort out more systematically the somewhat internally contradictory opinions that he held on the more specifically economic aspects of Chinese society.

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Demographic changes as a problem for social security systems

The relationship between demographic changes and the social security system is explored. The focus is on the current situation in the Federal Republic of Germany, but consideration is also given to comparable developments in other developed countries. Emphasis is placed on how changes in the age distribution of modern populations affect the relative proportion of the productive and the dependent populations.     

The ethical review of medical research: a social movement to protect the interests of research subjects

This paper is based upon observations made in the United States regarding the operation of the Institutional Review Boards. Institutional Review Boards are an essential part of the American system for the ethical review of human subjects research and it is argued that their importance is due in part to the American approach to the protection of minority groups. It is important to evaluate the effectiveness of the Institutional Review Boards since a similar model is being proposed by the National Health & Medical Research Council as part of the ethical review of medical research projects conducted in Australia.