Book review: Z. Feachem, M. Hensher and L. Rose, Implementing Health Sector Reform in Central Asia: Papers from an EDI Health Policy Seminar held in Ashgabat, Turkmenistan, June 1996, Washington DC: EDI Learning Resources Series, World Bank, 1999, ISBN 0-8213-4337-8, $25.00.
✍ Scribed by Tim Ensor
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 54 KB
- Volume
- 15
- Category
- Article
- ISSN
- 0749-6753
No coin nor oath required. For personal study only.
✦ Synopsis
brought out the particular issue intended: for example the chapter supposedly demonstrating the social construction of risk seemed more about the need for community participation. Perhaps it would have been better to bill the issues as being common to all cases, with each study emphasising some features more than others. I do not believe that this would have complicated the structure too much.
The authors use the term confronting risk' to stress that much more is at stake than risk communication' as usually understood. Indeed, one is tempted in some cases to question the centrality of the risk issue itself to the story. Are the participants confronting a risk, or does it make more sense to say that they are confronting each other, with claims and counterclaims about risk just one of the many weapons? When is risk actually the central problem, and when is it merely a catalyst for the surfacing of wider con¯icts? Despite its wide perspective, the book does not pose these questions.
Despite quibbles, there is much here of solid value. The individual case studies are well written and clearly structured (that on lead screening is a gem). The explicit discussion of values and ethical positions is both welcome and overdue: though misunderstandings often exist, there may be genuine con¯icts both between dierent interests and dierent ethical imperatives. For example, the need to respect citizens' autonomy may con¯ict with the demand for eciency or for bene®cence (e.g. measurable improvement in health outcomes): all may con¯ict with some defensible notion of justice. As the writers point out, those engaged in both risk management and communication need to do so from some considered ethical position rather thanÐas so often happensÐwishing away the dilemmas.