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Significant Harm (significant + harm)

Distribution by Scientific Domains
Humanities and Social Sciences40%

Selected Abstracts

HAS WAL-MART BURIED MOM AND POP?: THE IMPACT OF WAL-MART ON SELF-EMPLOYMENT AND SMALL ESTABLISHMENTS IN THE UNITED STATES

ECONOMIC INQUIRY, Issue 4 2008
RUSSELL S. SOBEL
This paper explores the widely accepted view that Wal-Mart causes significant harm to the traditional, small "mom and pop" business sector of the U.S. economy. We present the first rigorous econometric investigation of this issue by examining the rate of self-employment and the number of small employer establishments using both time series and cross-sectional data. We also examine alternative measures and empirical techniques for robustness. Contrary to popular belief, our results suggest that the process of creative destruction unleashed by Wal-Mart has had no statistically significant long-run impact on the overall size and profitability of the small business sector in the United States. (JEL L81, D59, C21) [source]

Nontherapeutic Male Circumcision: Tackling the Difficult Issues

THE JOURNAL OF SEXUAL MEDICINE, Issue 8 2009
Caryn L. Perera BA (Lib & Info Mgt), Grad Cert EBP
ABSTRACT Introduction., Male circumcision is the most commonly performed surgical procedure in the world. Circumcision may be performed to treat an underlying pathological process ("therapeutic circumcision"). However there may be religious, cultural, and social indications. Aim., This article addresses the religious, cultural, social, and ethical issues surrounding nontherapeutic male circumcision (NTMC). Main Outcome Measures., Any religious, social, cultural, or ethical issues relating to NTMC. Methods., Because of the absence of high level evidence, a concise literature review was undertaken to identify articles published between January 1990 and February 2009 summarizing current knowledge on NTMC. Results., There are complex religious, cultural, social, and prophylactic incentives for NTMC. The procedure may have associated clinical and psychosocial adverse events and raises such ethical issues as bodily integrity and consent. Because of the strength of the incentives for NTMC, there may be important implications in denying patients the procedure. Several important issues must be considered when introducing mass circumcision as a preventative strategy for HIV/AIDS. Conclusion., When assessing whether NTMC will benefit or harm a patient, clinicians must take his religious, cultural, and social circumstances into account. Males requiring mandatory religious or cultural NTMC are likely to suffer significant harm if they do not receive circumcision and should be considered separately to males in general. Perera CL, Bridgewater FHG, Thavaneswaran P, and Maddern GJ. Nontherapeutic male circumcision: Tackling the difficult issues. J Sex Med 2009;6:2237,2243. [source]

ELECTIVE TWIN REDUCTIONS: EVIDENCE AND ETHICS

BIOETHICS, Issue 6 2010
LEAH MCCLIMANS
ABSTRACT Twelve years ago the British media got wind of a London gynecologist who performed an elective reduction on a twin pregnancy reducing it to a singleton. Perhaps not surprisingly, opinion on the moral status of twin reductions was divided. But in the last few years new evidence regarding the medical risks of twin pregnancies has emerged, suggesting that twin reductions are relevantly similar to the reductions performed on high-end multi-fetal pregnancies. This evidence has appeared to resolve the moral debate. In this paper I look at the role of clinical evidence in medical ethics. In particular I examine the role of clinical evidence in determining what counts as a significant harm or risk. First, I challenge the extent to which these empirical claims are descriptive, suggesting instead that the evidence is to some degree normative in character. Second, I question whether such empirical claims should count as evidence for what are essentially difficult ethical decisions , a role they appear to play in the case of elective reductions. I will argue that they should not, primarily because the value-laden nature of this evidence conceals much of what is ethically at stake. It is important to recognize that empirical evidence cannot be a substitute for ethical deliberation. [source]

The preoccupation with thresholds in cases of child death or serious injury through abuse and neglect

CHILD ABUSE REVIEW, Issue 5 2008
Marian Brandon
Abstract Thresholds into and between services emerged as a significant theme in the biennial analysis of cases of child death and serious injury through abuse and neglect ,serious case reviews' carried out in England for the (then) Department for Education and Skills between 2003,05. The preoccupation with thresholds was one of a number of interacting risk factors and many children's cases were on the boundary of services and levels of intervention. In most cases child protection did not come ,labelled as such' which reinforces the need for all practitioners, including those working with adults to be alert to the risks of significant harm. Policy makers should acknowledge that staff working in early intervention are working within the safeguarding continuum and not in a separate sphere of activity. The emotional impact of working with hostility from violent parents and working with resistance from older adolescents impeded engagement, judgement and safeguarding action. In the long term neglect cases that were reviewed, the threshold for formal child protection services was rarely met and some agencies and practitioners coped with feelings of helplessness by adopting the ,start again syndrome'. Adequate resources are essential but not sufficient to redress the problems. Effective and accessible supervision is crucial to help staff to put into practice the critical thinking required to understand cases holistically, complete analytical assessments, and weigh up interacting risk and protective factors. Copyright © 2008 John Wiley & Sons, Ltd. [source]

The Framework for the Assessment of Children in Need and Their Families

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 1 2001
Jenny Gray
The Framework for the assessment of children in need and their families (Department of Health et al., 2000) has been developed to provide a systematic way of analysing, understanding and recording what is happening to children and young people within their families and the wider context of the community in which they live. From such an understanding of what are inevitably complex issues and interrelationships, clear professional judgements can be made. These judgements include whether the child being assessed is in need, whether the child is suffering or likely to suffer significant harm, what actions must be taken, and which services would best meet the needs of this particular child and family. The Assessment Framework was issued jointly by the Department of Health, Department for Education and Employment and Home Office. It was issued as Section 7 Guidance under the Local Authority Social Services Act 1970, which means it must be complied with unless local authorities can justify why not. [source]