J. Michael Martinez

Managing scientific uncertainty in medical decision making: the case of the advisory committee on immunization practices.

This article explores the question of how scientific uncertainty can be managed in medical decision making using the Advisory Committee on Immunization Practices as a case study. It concludes that where a high degree of technical consensus exists about the evidence and data, decision makers act according to a clear decision rule. If a high degree of technical consensus does not exist and uncertainty abounds, the decision will be based on a variety of criteria, including readily available resources, decision-process constraints, and the available knowledge base, among other things. Decision makers employ a variety of heuristic devices and techniques, thereby employing a pragmatic approach to uncertainty in medical decision making. The article concludes with recommendations for managing scientific uncertainty in medical decision making.

Reconciling Anthropocentrism and Biocentrism Through Adaptive Management: The Case of the Waste Isolation Pilot Plant and Public Risk Perception

Environmental policy issues often cannot be resolved owing to differences between anthropocentrists who adhere to neoclassical economic principles and biocentrists who argue in favor of a broad conception of sustainable development. This article examines the two perspectives in the context of radioactive waste management by presenting a case study involving public risk perception of the Waste Isolation Pilot Plant (WIPP). WIPP is a mining program under-taken by the U.S. Department of Energys Office of Environmental Management to demonstrate the safe transportation and disposal of transuranic waste, a by-product of nuclear weapons production. The authors conclude that U.S. waste management programs such as WIPP can garner support only if a means for genuine, meaningful public participation is provided through adaptive management principles that “bridge the gap,” to the extent possible, between anthropocentric and biocentric perspectives.

The Luevano Consent Decree and Public Personnel Reform

The 1981 Luevano consent decree that resolved a legal challenge to the Professional and Administrative Careers Examination was one of the most influential public personnel developments of the 1980s and 1990s, widely influencing subsequent civil service reforms. The decree remains in effect as of this writing, although its effectiveness has been increasingly questioned in recent years. This article examines the terms of the decree and whether the stated goal of improving opportunities for blacks and Hispanics to secure positions in the federal civil service would be better accomplished through alternate measures.

Privatizing Professional Licensing Boards Self-Governance or Self-Interest?

Because professional licensing boards represent nondemocratic elements in a political system founded on democratic principles, their legitimacy has been questioned in recent years. This article examines legal and medical licensing boards in three states—Georgia, California, and Massachusetts—to determine whether developments in those states suggest a trend toward appointing citizen members to boards. The article concludes that although public acceptance of licensing boards might improve in the wake of appointing citizen members, such a cosmetic change does not necessarily ensure that the “public interest” is protected. Only when the private interests of democratically selected citizen board members are balanced against the private interests of professional board members will concerns about the legitimacy of licensing boards possibly be assuaged.

Teaching Administrative Ethics in Nonprofit Management: Recommendations to Improve Degrees, Certificates, and Concentration Programs

Abstract The first protection against ethical lapses in the nonprofit sector presumably is to provide a sound foundation in ethical training at institutions of higher learning. To understand what we hypothesized as the fragmented state of ethics pedagogy in the nonprofit management field, we surveyed educational programs that offer graduate degrees, certificates or concentration programs in the management or study of nonprofit organizations. We found that two-thirds of the respondents offered an ethics course, but fewer than 40 percent required completion of an ethics course. Moreover, the nature and content of ethics courses varied widely in scope, methods, and emphases. To improve the overall state of ethics pedagogy, we recommend instruction programs that equip students with the tools to master three steps in administrative ethics: (a) identifying the scope of an ethical administrator’s work; (b) defining the content of the appropriate ethical standards; and (c) developing a deliberative process so that an administrator can appropriately assess ethical questions and chart a satisfactory course for resolving salient issues.

Hazardous Materials Transportation in an Age of Devolution

The United States has entered an age of devolution. As political responsibility has begun to shift from the federal government back to the states, many questions concerning an appropriate intergovernmental relationship remain unclear. In the area of environmental law, for example, the D.C. Circuit Court of Appeals decided a case, Massachusetts v. U.S. Department of Transportation (DOT) (1996), that restricted DOT’s authority to preempt state bonding requirements for hazardous materials transporters. The court’s ruling ignored many precedents indicating that Congress intended to provide broad preemption authority to DOT under the Hazardous Materials Transportation Uniform Safety Act and arguably undermined standards articulated by the U.S. Supreme Court in Chevron U.S.A. v. Natural Resources Defense Council (1984). This article explores the court’s opinion and asks whether the Massachusetts case represents a deliberate change in federalism principles or whether the holding is an example of a de facto devolution of power.