A Comprehensive Analysis of Litigation in Organ Transplantation for Allegations of Insufficient Policy Coverage, Discrimination and Malpractice.

Introduction: Transplantation is a field with unique medical and administrative challenges that involve an equally diverse array of stakeholders. Expectantly, the litigation stemming from this field should be similarly nuanced. There is a paucity of comprehensive reviews characterizing this medicolegal landscape. Design: The Caselaw Access Project Database was used to collect official court briefs of 2053 lawsuits related to kidney, liver, heart, lung, and pancreas transplantation. A thematic analysis was undertaken to characterize grounds for litigation, defendant type, and outcomes. Cases were grouped into policy, discrimination, poor or unsuccessful outcome, or other categories. Results: One hundred sixty-four court cases were included for analysis. Cases involving disputes over policy coverage were the most common across all organ types (N = 55, 33.5%). This was followed by poor outcomes (N = 51, 31.1%), allegations of discrimination against prison systems and employers (N = 37, 22.6%) and other (N = 21, 12.8%). Defendants involved in discrimination trials won with the greatest frequency (N = 29, 90.62%). Defendants implicated in policy suits won 65.3% (N = 32), poor outcomes 62.2% (N = 28), and other 70% (N = 14). Of the 51 cases involving poor outcomes, plaintiffs indicated lack of informed consent in 23 (45.1%). Conclusion: Reconsidering the informed consent process may be a viable means of mitigating future legal action. Most discrimination suits favoring defendants suggested previous concerns of structural injustices in transplantation may not be founded. The prevalence of policy-related cases could be an indication of financial burden on patients. Future work and advocacy will need to substantiate these concerns and address change where legal recourse falls short.

Understanding public support for workplace diversity and antidiscrimination policies in Europe.

Societal processes and public opinion can affect whether employers take action and which policy measures they choose to boost diversity, equal opportunities and inclusion, and to reduce discrimination in the workplace. Yet, public opinion regarding workplace diversity initiatives (other than affirmative action) has so far received little scholarly attention, especially in Europe. Consequently, we have very little evidence about how the general public feels about workplace diversity policies - particularly those that are more common or more often discussed in Europe - and about which factors shape public support for these workplace diversity initiatives. Yet, a better understanding of the patterns and antecedents of citizens' attitudes toward workplace diversity policies is of clear scientific and practical importance. Against this background, this study sheds light on public attitudes toward three different, commonly applied types of workplace diversity policies, and examines which individual-level and - innovatively - national-level conditions shape public support. To do so, we bring together insights from various different and so far largely disconnected strands of research and a range of theoretical perspectives. We use large-scale, representative survey data from two pooled waves of the Eurobarometer, covering 38,009 citizens across 26 European countries. We enrich these data with information on national-level income inequality as well as countries' labor market and antidiscrimination legislation and policies, obtained from Eurostat and the Migrant Integration Policy Index (MIPEX). Results show significant differences in public support across the three types of policies, with the strongest support for diversity training, followed closely by monitoring recruitment procedures, whereas support for monitoring workforce composition is clearly lower. This is in line with the idea that support tends to be lower for more preferential and prescriptive workplace policies. Furthermore, we find that, in addition to individual-level factors - particularly gender, ethnic minority group membership, personal experiences with discrimination, prejudice, intergroup contact and political orientation - national-level conditions are important antecedents of public support for workplace diversity policies. That is, differences in public attitudes regarding such policies are also shaped by country-level income inequalities, people's perceptions of how widespread discrimination and unequal opportunities are in society, and national-level laws and policies to fight unequal opportunities.

Equity and gender mainstreaming in public policy: A scoping review protocol.

BACKGROUND: Despite growing attention paid to health equity and efforts to promote gender mainstreaming-a global strategy to promote gender equality-how policymakers have 'institutionalized' this in their work is less clear. Therefore, this planned scoping review seeks to search the peer-reviewed and grey literature to compile evidence on the ways in which policymakers have routinely or systematically considered equity and/or gender in their work. METHODS: A scoping review will be undertaken by drawing on the PRISMA guidelines for Scoping Reviews (PRISMA-ScR). With the expert guidance of a research librarian, Ovid MEDLINE, Ovid EMBASE, PAIS Index, and Scopus databases will be searched, in addition to custom Google searches of government documents. The search will be conducted from 1995 and onwards, as there were no hits prior to this date that included the term "gender mainstream*" in these databases. The inclusion criterion is that: (i) texts must provide information on how equity and/or gender has been considered by government officials in the development of public policy in a routine or systematic manner (e.g., descriptive, empirical); (ii) both texts produced by government or not (e.g., commentary about government action) will be included; (iii) there are no restrictions on study design or article type (i.e., commentaries, reports, and other documents, would all be included); and (iv) texts must be published in English due to resource constraints. However, texts that discuss the work of nongovernmental or intergovernmental organizations will be excluded. Data will be charted by: bibliographic information, including the authors, year, and article title; country the text discussed; and a brief summary on the approach taken. DISCUSSION: This protocol was developed to improve rigour in the study design and to promote transparency by sharing our methods with the broader research community. This protocol will support a scoping review of the ways in which policymakers have routinely or systematically considered equity and/or gender in their work. We will generate findings to inform government efforts to initiate, sustain, and improve gender and equity mainstreaming approaches in policymaking.

Norms of prejudice: political identity and polarization.

The USA is fast becoming a 'majority-minority' country in which Whites will no longer comprise the numerically dominant racial group. Prior studies have linked Whites' status decline to heightened in-group solidarity and the feeling that Whites, as a group, face growing discrimination. In the light of these findings, we examine the extent to which a social norm controlling anti-White prejudice is now discernible in the USA. Drawing from an original survey measuring Americans' reactions to racially-offensive speech, we examine second-order beliefs about the social inappropriateness of offensive statements targeting White Americans. We find that White Americans (in comparison to non-Whites) are indeed more likely to profess a social norm governing anti-white prejudice. The pattern is most discernible among white Republicans whom we expect to be most fearful of demographic change. This article is part of the theme issue 'Social norm change: drivers and consequences'.

Age-Varying Associations Between COVID-19-Related Racial Discrimination and Chinese American Adolescents' Political Civic Engagement.

The COVID-19 pandemic has made historically rooted anti-Asian racism, xenophobia, and civic activism in the United States highly salient, creating a heightened need for Asian American youth to redress racial injustice through civic engagement. However, little is known about Chinese American adolescents' civic engagement in response to racial discrimination. The present study investigated the age-varying associations between Chinese American adolescents' experiences of COVID-19-related racial discrimination and their political civic engagement at the intersection of race and gender, as well as the moderating roles of ethnic identity affirmation and parental civic socialization in these associations. The participants were 295 10- to 18-year-old Chinese American adolescents (Mage = 14.1 years, SD = 2.2 years; 52% girls) and their parents (Mage = 44.2 years, SD = 6.0 years; 79% mothers). Time-varying effect modeling showed that experiences of racial discrimination were negatively associated with political civic engagement in middle adolescence. This negative association was found only among girls but not boys. High ethnic identity affirmation and parental civic socialization not only buffered Chinese American adolescents against the impact of racial discrimination but even promoted their greater political civic engagement across adolescence. These findings revealed the age trends and important individual and contextual facilitators of Chinese American adolescents' political civic participation in the context of the racialized pandemic of COVID-19, which can inform culturally and developmentally targeted education and intervention efforts that promote the civic development of Chinese American adolescents.

Canadian politicians' rhetoric on Twitter/X: Analysing prejudice and inclusion towards Muslims using structural topic modelling and rhetorical analysis.

We analysed tweets from five English-speaking Canadian political parties in the year leading up to the 2019 federal election to explore both prejudicial and inclusive rhetoric in relation to Muslim identities on social media. We used structural topic modelling to understand what topics were discussed before moving to a rhetorical approach to analyse how topics were discussed. We identified 10 topics. Seven talked about Muslim groups in primarily inclusive ways, including depicting the positive contributions to Canadian society, creating ideological space for Muslim religious practices and invoking superordinate identities with victims of hate crimes to cultivate solidarity. However, the effectiveness of inclusive rhetoric was sometimes questioned due to omitting the subgroup-specific prejudice faced by Muslims. Prejudicial rhetoric occurred in three of the topics due to the nativist populist PPC party depicting Muslims as a threat to Canadian values, as hostile to people from other religious faiths, and depicting 'elites' in society as concealing the 'true' information concerning Muslims. The study contributes to understanding how politicians attempt to cultivate minority inclusion/exclusion in multicultural contexts through social media, as well as understanding the rhetoric of nativist populism in Canada and its similarities to other Global North contexts.

Mental health-related structural stigma and discrimination in health and social policies in Nepal: A scoping review and synthesis.

AIMS: National policies can be used to reveal structural stigma and discrimination in relation to mental health. This review assesses how structural stigma and discrimination are manifested in the policies and legislations of Government of Nepal. METHODS: Scoping review methodology was followed to review policy documents (acts of parliament, legislation, policies, strategies, guidelines and official directives) drafted or amended after 2010. RESULTS: Eighty-nine policies were identified related to health, social welfare, development and regulations which were relevant to people with psychosocial and mental disabilities or have addressed the mental health agendas. Several critical policy failings and gaps are revealed, such as the use of stigmatizing language (e.g., 'insane' or 'lunatic'), inconsistencies within and between policies, deviation from international protocols defining legal capacity and consent, lack of inclusion of the mental health agenda in larger development policies and lack of cost-effective interventions and identification of financing mechanisms. Provisions for people living with mental health conditions included adequate standard of living; attaining standard mental health; the right to exercise legal capacity, liberty and security; freedom from torture or discrimination; and right to live independently. However, other policies contradicted these rights, such as prohibiting marriage, candidacy for and retention of positions of authority and vulnerability to imprisonment. CONCLUSION: Mental health-related structural stigma and discrimination in Nepal can be identified through the use of discriminator language and provisions in the policies. The structural stigma and discrimination may be addressed through revision of the discriminating policies, integrating the mental health agenda into larger national and provincial policies, and streamlining policies to comply with national and international protocols.

Systematic audit of Australian specialty colleges' policies on bullying, discrimination, and harassment.

Objective To support policy makers and healthcare workers to reduce high rates of bullying, discrimination, and harassment (BDH) that affect doctors in Australian specialty training sites. Methods This audit assessed the quality of policies regarding BDH and associated complaints of the Australian Medical Council-accredited Australasian specialty training Colleges (Colleges). Policies were systematically identified and scored against a national standard BDH policy checklist. Results Fourteen of the 16 Colleges have each written and curated their own BDH policies for their members, with wide variation between Colleges regarding content and processes. This impairs the efficacy of BDH handling in specialty training sites. Conclusions Key areas for improvement were identified. A checklist is proposed that is specific to College BDH policies and processes involving specialty training sites.

Codesigning Policy-Based Solutions to Discrimination and Harassment in Academic Medicine: An Inclusive Approach.

ABSTRACT: Academic medicine institutions have historically employed policies as a means to tackle various types of discrimination and harassment within educational and professional settings, thereby affirming their dedication to promoting diversity, equity, and inclusion. However, the implementation and effectiveness of policies are constrained by limitations, including a lack of awareness and barriers to reporting. Due to concerns about accountability and transparency, many groups and individuals experiencing discrimination have lost trust in policy-based solutions to address equity in academic medicine. To address such challenges, the authors offer an evidence-informed policy framework with actionable recommendations. First, policy should be cowritten through meaningful and participatory engagement. Second, organizations should publicly report on metrics of policy effectiveness. Third, to ensure accountability, external organizations or adjudicators should be involved in oversight of policy-based processes. Fourth, leadership commitment is essential for success. Overall, policy can be an effective mechanism to address discrimination and harassment; however, a more inclusive approach is needed.

Congresso de Psicanálise da Banana: Evidências Inaugurais da Discriminação na Política Institucional Lacaniana / Banana Psychoanalysis Congress: Inaugural Evidence of Discrimination in Lacanian Institutional Policy / Congreso de Psicoanálisis de Plátano: Evidencias Inaugurales de la Discriminación en la Política Institucional Lacaniana

Abordou-se a chegada do pensamento lacaniano ao Brasil e a sua divulgação no Congresso Psicanalítico da Banana, marco inaugural no qual se encontra uma expressão nacional da reprodução dos impasses político-institucionais nas escolas lacanianas. Procedeu-se a uma busca no sítio da hemeroteca digital da Fundação Biblioteca Nacional utilizando como descritores o nome do evento e/ou o nome de seus organizadores no período de fevereiro de 1980 a dezembro de 1989. Utilizou-se como referência do trabalho a perspectiva da Escola dos Annales,que considera que a escrita histórica deve se orientar por problemas específicos; a consideração da transferência como marca indelével da pesquisa realizada por psicanalistas pesquisadores; as reflexões de Ricouer sobre as etapas da construção do conhecimento historiográfico. As matérias publicadas apresentam de forma recorrente: as celeumas entre os psicanalistas lacanianos e os filiados à IPA; a busca de reconhecimento dos analistas lacanianos brasileiros pelos franceses; a proposta de discussão da conjuntura nacional por meio da psicanálise; a divergência entre analistas lacanianos brasileiros acerca da tutoria francesa nas instituições surgidas no Brasil. Propôs-se a consideração da dimensão transferencial como possibilidade de construção de uma política emancipatória nas instituições psicanalíticas.

This discussion is about the arrival of Lacanian thinking in Brazil and its dissemination at the Banana Psychoanalytic Congress, an inaugural milestone in which a national expression of the reproduction of political-institutional impasses in Lacanian schools can be found. A search was carried out on the website of the digital newspaper library of the National Library Foundation using as descriptors the name of the event and/or the name of its organizers, from February 1980 to December 1989. What was used as a reference for the work was the perspective of the Annales School which considers that historical writing must be guided by specific problems; the consideration of the transference as an indelible mark of research carried out by researchers of the psychoanalytic field; Ricouer's reflections upon the stages of the construction of the historiographical knowledge. The published articles present recurrently: the controversy between Lacanian psychoanalysts and those affiliated with the IPA; the search for recognition of Brazilian Lacanian analysts by the French; the proposal to discuss the national situation through psychoanalysis; the divergence between Brazilian Lacanian analysts about French tutoring in institutions that emerged in Brazil. It was proposed to consider the transferential dimension as a possibility of building an emancipatory policy in psychoanalytic institutions.

Se ha discutido la llegada del pensamiento lacaniano en Brasil y su difusión en el Congreso Psicoanalítico de Plátano, hito inaugural en el que se encuentra una expresión nacional de los impases político-institucionales en las escuelas lacanianas. Se realizó una búsqueda en la hemeroteca digital de la Fundación Biblioteca Nacional utilizando como descriptores el nombre del evento y/o el nombre de sus organizadores, en el período de febrero de 1980 hasta diciembre de 1989. Se utilizó como referente para el trabajo la perspectiva de la Escuela de los Annales, que considera que la escritura histórica debe guiarse por problemas específicos; la consideración de la transferencia como una marca de la investigación realizada por los psicoanalistas; las reflexiones de Ricouer sobre las etapas de la construcción del conocimiento historiográfico. Los artículos publicados presentan de manera recurrente: la controversia entre los lacanianos y los afiliados a la IPA; la búsqueda del reconocimiento de los lacanianos brasileños por parte de los franceses; la propuesta de discutir la situación nacional a través del psicoanálisis; la divergencia entre lacanianos brasileños sobre la tutoría de francés en instituciones surgidas en Brasil. Se propuso considerar la dimensión transferencial como posibilidad de construcción de una política emancipatoria en estas instituciones.

Is legislation to prevent genetic discrimination necessary in Japan? An overview of the current policies and public attitudes.

Genetic discrimination (GD) has not been discussed in East Asia as extensively as in Europe and North America. Influenced by UNESCO's universal declaration in 1997, the Japanese government took a stringent approach toward GD by releasing the Basic Principles on Human Genome Research in 2000. However, Japanese society has mostly been ignoring the prevention of GD for decades, and the principle of prohibiting GD was never adhered to in any of the Japanese laws. We conducted anonymous surveys among the general adult population in 2017 and 2022 to explore their experiences of GD and attitudes toward laws carrying penalties to prevent GD in Japan. In both years, approximately 3% of the respondents had experienced some unfavorable treatment regarding their genetic information. They showed higher recognition of the benefits of using genetic information and lower recognition of concerns about using genetic information and GD in 2022 than in 2017. However, the awareness regarding the need for legislation with penalties on GD had increased over the five-year period. In 2022, the framework of a bill to promote genomic medicine and prevent GD without any relevant penalties was released by the Bipartisan Diet Members Caucus. Considering that the absence of regulations may be a barrier to obtaining genomic medicine, as the initial step toward making the prohibition of GD more effective, legislation that no form of GD will be tolerated may stimulate education and awareness regarding respect for the human genome and its diversity.

Systemic structural gender discrimination and inequality in the health workforce: theoretical lenses for gender analysis, multi-country evidence and implications for implementation and HRH policy.

This commentary brings together theory, evidence and lessons from 15 years of gender and HRH analyses conducted in health systems in six WHO regions to address selected data-related aspects of WHO's 2016 Global HRH Strategy and 2022 Working for Health Action Plan. It considers useful theoretical lenses, multi-country evidence and implications for implementation and HRH policy. Systemic, structural gender discrimination and inequality encompass widespread but often masked or invisible patterns of gendered practices, interactions, relations and the social, economic or cultural background conditions that are entrenched in the processes and structures of health systems (such as health education and employment institutions) that can create or perpetuate disadvantage for some members of a marginalized group relative to other groups in society or organizations. Context-specific sex- and age-disaggregated and gender-descriptive data on HRH systems' dysfunctions are needed to enable HRH policy planners and managers to anticipate bottlenecks to health workforce entry, flows and exit or retention. Multi-method approaches using ethnographic techniques reveal rich contextual detail. Accountability requires that gender and HRH analyses measure SDGs 3, 4, 5 and 8 targets and indicators. To achieve gender equality in paid work, women also need to achieve equality in unpaid work, underscoring the importance of SDG target 5.4. HRH policies based on principles of substantive equality and nondiscrimination are effective in countering gender discrimination and inequality. HRH leaders and managers can make the use of gender and HRH evidence a priority in developing transformational policy that changes the actual conditions and terms of health workers' lives and work for the better. Knowledge translation and intersectoral coalition-building are also critical to effectiveness and accountability. These will contribute to social progress, equity and the realization of human rights, and expand the health care workforce. Global HRH strategy objectives and UHC and SDG goals will more likely be realized.

Predictors of support for anti-weight discrimination policies among Canadian adults.

Introduction: Weight discrimination of individuals with overweight or obesity is associated with adverse mental and physical health. Weight discrimination is prevalent in many sectors such as within workplaces, where individuals with overweight and obesity are denied the same opportunities as individuals with lower weight status, regardless of performance or experience. The purpose of this study was to understand the Canadian public's support or opposition of anti-weight discrimination policies and predictors of support. It was hypothesized that Canadians will show support of anti-weight discrimination policies to some extent. Methods: A secondary analysis was conducted on a previous cross-sectional sample of Canadian adults (N = 923, 50.76% women, 74.4% White) who responded to an online survey assessing weight bias and support of twelve anti-weight discrimination policies related to societal policies (e.g., implementing laws preventing weight discrimination) and employment-related policies (e.g., making it illegal to not hire someone due to their weight). Participants completed the Causes of Obesity Questionnaire (COB), the Anti-Fat Attitudes Questionnaire (AFA) and the Modified Weight Bias Internalization Scale (WBIS-M). Multiple logistic regressions were used to determine predictors of policy support. Results: Support for policies ranged from 31.3% to 76.9%, with employment anti-discrimination policies obtaining greater support than societal policies. Identifying as White and a woman, being over the age of 45 and having a higher BMI were associated with an increased likelihood of supporting anti-weight discrimination policies. There were no differences between the level of support associated with attributing obesity to behavioral or non-behavioral causes. Explicit weight bias was associated with a reduced likelihood of supporting 8/12 policies. Weight Bias Internalization was associated with an increased likelihood of supporting all societal policies but none of the employment policies. Conclusions: Support for anti-weight discrimination policies exists among Canadian adults, and explicit weight bias is associated with a lower likelihood of supporting these policies. These results highlight the need for education on the prevalence and perils of weight discrimination which may urge policy makers to consider weight bias as a form of discrimination that must be addressed. More research on potential implementation of anti-weight discrimination policies in Canada is warranted.

Reasonable Accommodation and Disparate Impact: Clean Shave Policy Discrimination in Today's Workplace.

This article examines Bey v. City of New York - a recent Second Circuit case where four Black firefights suffering from Pseudofolliculitis Barbae (a skin condition causing irritation when shaving which mostly affects Black men) challenged the New York City Fire Department's Clean Shave Policy - with an intersectional approach utilizing legal theories of racial, disability, and religious discrimination.