The sexualization of the medical

The medicalization of sex is part of an already-in-place discursive problem that can be illuminated by looking at efforts to sexualize the medical. "Erectile dysfunction," "female sexual dysfunction," and their real and imagined pharmacopia, do not constitute the medicalization of sex; they are effects of sex already having been-to borrow a term from Peter Conrad ( 1992 )-healthicized. The equation of sex and health, as cultural common sense, has made health seem like the natural discourse for thinking about sex in the first place. Reversing the terms of this special issue, and using the methodology of rhetorical analysis, this article looks at the person with cancer as a sexualized subject-someone whose health is represented as intimately tied to his or her sex life. It suggests that, in public discourse-and notably in movies and on television-sex is the comic ending of the illness narrative. In light of this narrative move, the ability to have good sex joins the ability to be positive and cheerful as a (Western) cultural imperative of illness experience, in general, and cancer experience, in particular. Public representations of illness virtues often fail, then, to answer realistically the compelling question, "How shall I be ill?"     

No externalities: a characterization of efficiency and incentive compatibility with public goods

We show that efficient anonymous incentive compatible (dominant strategy) mechanisms for public goods eliminate externalities, i.e., each individual is unable to change the welfare of anyone else. The characterization is used to derive existence and non-existence results for models with a finite number of individuals and to explain existence results in the continuum. A similar characterization and conclusions are demonstrated for private goods in (J Econ Theory 85:169–225, 1999). However, unlike private goods, elimination of externalities with public goods implies that individuals cannot change the outcome. Hence, such mechanisms provide only weak incentives for truth-telling.     

Lost in Translation? Embracing the Challenges of Working With Families From a Refugee Background

This article describes the difficulties a mainstream family therapy service experienced in working with families from a refugee background. The experience of six therapists and five bicultural workers, who are also the referring agents, was captured in focus groups, and the reflections that emerged shaped a four‐part approach for working with families from a refugee background. Live consultation, either by the family therapist or bicultural worker, is suggested as a way to marry the expertise of family therapists who are not cultural ‘insiders’ with the ‘lived experience’ and cultural expertise of bicultural support workers. The process of reflecting on therapeutic failure resulted in several principles for working therapeu‐tically with families with a history of refugee trauma, unmet resettlement needs and family relationship challenges. These include maintaining a flexible approach to therapy, ascertaining a clear understanding of the referral context, defining an explicit therapeutic contract from the first session, being mindful of the important role that language plays and terminating therapy if it is contra‐indicated.     

Helping children express grief through symbolic communication

Communication barriers erected by grieving children delay problem resolution. Use of the expressive arts--music, art, and body movement--in symbolic communication helps them to express overwhelming feelings and cope with trauma and stress.     

All Ages and None: Commentary on Helene Moglen's Ageing and Transageing

Helene Moglen's article is especially welcome, given the paucity of psychoanalytic reflection on ageing. She usefully describes possible ways of managing the losses of ageing through accessing the multiple, decentered self-states embedded in our personal histories. However, I have some queries on her use of contrasting psychic topologies. In particular I wonder whether she is sometimes in danger of seeing images of former selves as being associatively “recovered” in the work of mourning that might be better seen as the more illusive “production” of presumptively anterior contexts and states of mind in the present. I also question how successfully Moglen's positioning of her notion of “transaging” somewhere between “transgender” and “transsexuality” serves to loosen up the vicious binary between “young” and “old. I would appreciate closer attention to the dreaded “feminization” of old age, noting the toxic sexism permeating cultures of ageing. Nevertheless, Moglen offers an excellent opening into this troubling topic.     

Social policy and intervention with chemically dependent women and their children

The increase in drug dependency among infants has significant implications for social service providers and must be addressed on the policy level. The policy debates and legislation which have surfaced to date need to be examined more closely and considered in the context of social service needs. This article considers policy options from the framework of social needs and individual needs in relation to the problem of maternal and infant chemical dependency.     

Non-expected utility risk premiums: The cases of probability ambiguity and outcome uncertainty

This paper discusses two problems. (a) What happens to the conditional risk premium that a decision maker is willing to pay out of the middle prize in a lottery to avoid uncertainty concerning the middle prize outcome, when the probabilities of other prizes change? (b) What happens to the increase that a decision maker is willing to accept in the probability of an unpleasant outcome in order to avoid ambiguity concerning this probability, when this probability increases? We discuss both problems by using anticipated utility theory, and show that the same conditions on this functional predict behavioral patterns that are consistent both with a natural extension of the concept of diminishing risk aversion and with some experimental findings.     

PROPERTY RIGHTS AND THE EFFICIENCY OF BARGAINING

We show that efficient bargaining is impossible for a wide class of economic settings and property rights. These settings are characterized by (i) the existence of “adverse efficient opt‐out types”, whose participation does not change the efficient allocation and who, when they opt out, are the worst type other agents can face, and (ii) non‐existence of the “marginal core”, and its multivaluedness with a positive probability. We also examine the optimal allocation of property rights within a given class that satisfies (i), such as simple property rights, liability rules, and dual‐chooser rules. We characterize property rights that minimize the expected subsidy required to implement efficiency. With two agents, simple property rights that are optimal in this way maximize the expected surplus at the status quo allocation, but this no longer holds with more agents. We also study “second‐best” budget‐balanced bargaining under a liability rule. The optimal “second‐best” liability rule may differ from, but is often close to, the expectation of the victim's harm, which would be optimal if there were no bargaining. However, liability rules that are close to a simple property right result in a lower expected surplus than the simple property right they are near.