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With scientific progress occurring at a breathtaking pace, science and technology policy has never been more important than it is today. Yet there is a very real lack of public discourse about policy-making, and government involvement in science remains shrouded in both mystery and misunderstanding.  Who is making choices about technology policy, and who stands to win or lose from these choices?  What criteria are being used to make decisions and why?  Does government involvement help or hinder scientific research?  

Shaping Science and Technology Policy brings together an exciting and diverse group of emerging scholars, both practitioners and academic experts, to investigate current issues in science and technology policy.  Essays explore such topics as globalization, the shifting boundary between public and private, informed consent in human participation in scientific research, intellectual property and university science, and the distribution of the costs and benefits of research. 

Contributors: Charlotte Augst, Grant Black, Mark Brown, Kevin Elliott, Patrick Feng, Pamela M. Franklin, Carolyn Gideon, Tené N. Hamilton, Brian A. Jackson, Shobita Parthasarathy, Jason W. Patton, A. Abigail Payne, Bhaven Sampat, Christian Sandvig, Sheryl Winston Smith, Michael Whong-Barr

Seven in ten Americans over the age of age of sixty who require medical decisions in the final days of their life lack the capacity to make them. For many of us, our biggest, life-and-death decisions—literally—will therefore be made by someone else. They will decide whether we live or die; between long life and quality of life; whether we receive heroic interventions in our final hours; and whether we die in a hospital or at home. They will determine whether our wishes are honored and choose between fidelity to our interests and what is best for themselves or others. Yet despite their critical role, we know remarkably little about how our loved ones decide for us.
             
Speaking for the Dying tells their story, drawing on daily observations over more than two years in two intensive care units in a diverse urban hospital. From bedsides, hallways, and conference rooms, you will hear, in their own words, how physicians really talk to families and how they respond. You will see how decision makers are selected, the interventions they weigh in on, the information they seek and evaluate, the values and memories they draw on, the criteria they weigh, the outcomes they choose, the conflicts they become embroiled in, and the challenges they face. Observations also provide insight into why some decision makers authorize one aggressive intervention after the next while others do not—even on behalf of patients with similar problems and prospects. And they expose the limited role of advance directives in structuring the process decision makers follow or the outcomes that result.
           
Research has consistently found that choosing life or death for another is one of the most difficult decisions anyone can face, sometimes haunting families for decades. This book shines a bright light on a role few of us will escape and offers steps that patients and loved ones, health care providers, lawyers, and policymakers could undertake before it is too late.
 

Intensive care medicine today is as close to the miraculous as most of us are likely to see in our lifetime. Nowhere is this magic more effectively practiced than in neonatal nurseries. Infants who are born prematurely at twenty-four weeks gestation and who weigh less than a pound can now be treated successfully. No other type of medicine has a more dramatic payoff, for the infants who survive can look forward to seventy or more years of life.

But there is a dark underside to the exercise of these skills. A growing number of babies live only to be tethered to life-support systems, unconscious or suffering incessant pain for years and sometimes for the duration of their lives. The ethical issues raised by these children are among the most difficult in our society. Should life be maintained no matter what its quality? Or is there a point at which treatment should be stopped on humane grounds? Who is to make decisions on continuing or ending therapy for damaged children? Is the law a suitable instrument for regulating medical decisions in intensive care nurseries? Should the growing cost of intensive care influence therapy decisions?

Special Care explores the moral and legal issues in neonatal intensive care. Fred M. Frohock spent four months in a special care nursery, observing the daily actions of doctors and nurses and interviewing staff and parents of patients. This engaging, human drama is told through the author's own journal entries interspersed with generous excerpts from taped interviews that display the practical reasoning of staff and parents as they address the moral problems raised by intensive care medicine. Several case studies of infants highlight the often contradictory directions in which medical staffs are pulled and the painful decisions that doctors and parents together are often called upon to make. The result is a book that reconstructs the ordinary life of a neonatal nursery and presents the moral views of those who are most intimately involved in therapy decisions.

This book is an urgently needed entry in the current discussions of treatment for badly damaged babies. Frohock argues that our tradition of rights language, which rests on the premise that we know what a human being is, is inappropriate when dealing with the paradoxes of decision making in neonatal nurseries. Calling for a new moral vocabulary better adapted to the world of medicine, he introduces the notion of harm in place of rights, a concept drawn from medicine's Hippocratic oath that pledges to "do no harm," as a way to begin framing questions and making decisions. Special Care will interest anyone who wants to understand medical decisions at the margins of human life.

A taxi driver's life is dangerous work. Picking up a bad customer can leave the driver in a vulnerable position, and erring even once can prove fatal. To protect themselves, taxi drivers must quickly and accurately assess the trustworthiness of complete strangers. In Streetwise, Diego Gambetta and Heather Hamill take this predicament as a prototypical example of many trust decisions, where people must act on limited information and judge another person's trustworthiness based on signs that may or may not be honest indicators of that person's character or intent. Gambetta and Hamill analyze the behavior of cabbies in two cities where driving a taxi is especially perilous: New York City, where drivers have been the targets of frequent and violent robberies, and Belfast, Northern Ireland, a divided metropolis where drivers have been swept up in the region's sectarian violence. Based on in-depth ethnographic research, Streetwise lets drivers describe in their own words how they seek to determine the threat posed by each potential passenger. The drivers' decisions about whom to trust are treated in conjunction with the "sign-management" strategies of their prospective passengers—both genuine passengers who try to persuade drivers of their trustworthiness and the villains who mimic them. As the theory that guides this research suggests, drivers look for signs that correlate closely with trustworthiness but are difficult for an impostor to mimic. A smile, a business suit, or a skullcap alone do not reassure drivers, as any criminal could easily wear them. Only if attached to other signs—a middle-aged woman, a business address, or a synagogue—are they persuasive. Drivers are adept at deciphering deceitful signals, but trickery is occasionally undetectable, so they must adopt defensive strategies to minimize their exposure to harm. In Belfast, where drivers are locals and often have histories of paramilitary involvement, "macho" posturing often serves to deter would-be criminals, while New York cabbies, mostly immigrants who view themselves as outsiders, try simply to minimize the damage from attacks by appeasing robbers and carrying only small amounts of cash. For most people, erring in a trust decision leads to a broken heart or a few dollars lost. For cab drivers, such an error could mean losing their lives. The way drivers negotiate these high stakes offers us vivid insight into how to determine another person's trustworthiness. Written with clarity and color, Streetwise invites the reader to ride shotgun with cabbies as they grapple with a question of relevance to us all: which signs of trustworthiness can we really trust? A Volume in the Russell Sage Foundation Series on Trust

What influences decisions of the U.S. Supreme Court? For decades social scientists focused on the ideology of individual justices. Supreme Court Decision Making moves beyond this focus by exploring how justices are influenced by the distinctive features of courts as institutions and their place in the political system.

Drawing on interpretive-historical institutionalism as well as rational choice theory, a group of leading scholars consider such factors as the influence of jurisprudence, the unique characteristics of supreme courts, the dynamics of coalition building, and the effects of social movements. The volume's distinguished contributors and broad range make it essential reading for those interested either in the Supreme Court or the nature of institutional politics.

Original essays contributed by Lawrence Baum, Paul Brace, Elizabeth Bussiere, Cornell Clayton, Sue Davis, Charles Epp, Lee Epstein, Howard Gillman, Melinda Gann Hall, Ronald Kahn, Jack Knight, Forrest Maltzman, David O'Brien, Jeffrey Segal, Charles Sheldon, James Spriggs II, and Paul Wahlbeck.

While many disciplines contribute to environmental conservation, there is little successful integration of science and social values. Arguing that the central problem in conservation is a lack of effective communication, Bryan Norton shows in Sustainability how current linguistic resources discourage any shared, multidisciplinary public deliberation over environmental goals and policy. In response, Norton develops a new, interdisciplinary approach to defining sustainability—the cornerstone of environmental policy—using philosophical and linguistic analyses to create a nonideological vocabulary that can accommodate scientific and evaluative environmental discourse.

Emphasizing cooperation and adaptation through social learning, Norton provides a practical framework that encourages an experimental approach to language clarification and problem formulation, as well as an interdisciplinary approach to creating solutions. By moving beyond the scientific arena to acknowledge the importance of public discourse, Sustainability offers an entirely novel approach to environmentalism.

Sustainability is a nearly ubiquitous concept today, but can we ever imagine what it would be like for humans to live sustainably on the earth? No, says Bryan G. Norton in Sustainable Values, Sustainable Change. One of the most trafficked terms in the press, on university campuses, and in the corridors of government, sustainability has risen to prominence as a buzzword before the many parties laying claim to it have come close to agreeing how to define it. But the term’s political currency urgently demands that we develop an understanding of this elusive concept.

While economists, philosophers, and ecologists argue about what in nature is valuable, and why, Norton here offers an action-oriented, pragmatic response to the disconnect between public and academic discourse around sustainability. Looking to the arenas in which decisions are made—and the problems that are driving these decisions—Norton reveals that the path to sustainability cannot be guided by fixed, utopian objectives projected into the future; sustainability will instead be achieved through experimentation, incremental learning, and adaptive management. Drawing inspiration from Aldo Leopold’s famed metaphor of “thinking like a mountain” for a spatially explicit, pluralistic approach to evaluating environmental change, Norton replaces theory-dependent definitions with a new decision-making process guided by deliberation and negotiation across science and philosophy, encompassing all stakeholders and activists and seeking to protect as many values as possible. Looking across scales to today’s global problems, Norton urges us to learn to think like a planet.

The revolution in social scientific theory and practice known as nonlinear dynamics, chaos, or complexity, derived from recent advances in the physical, biological, and cognitive sciences, is now culminating with the widespread use of tools and concepts such as praxis, fuzzy logic, artificial intelligence, and parallel processing. By tracing a number of conceptual threads from mathematics, economics, cybernetics, and various other applied systems theoretics, this book offers a historical framework for how these ideas are transforming the social sciences. Daneke goes on to address a variety of persistent philosophical issues surrounding this paradigm shift, ranging from the nature of human rationality to free will. Finally, he describes this shift as a path for revitalizing the social sciences just when they will be most needed to address the human condition in the new millennium.

Systemic Choices describes how praxis and other complex systems tools can be applied to a number of pressing policy and management problems. For example, simulations can be used to grow a number of robust hybrid industrial and/or technological strategies between cooperation and competition. Likewise, elements of international agreements could be tested for sustainability under adaptively evolving institutional designs. Other concrete applications include strategic management, total quality management, and operational analyses.

This exploration of a wide range of technical tools and concepts will interest economists, political scientists, sociologists, psychologists, and those in the management disciplines such as strategy, organizational behavior, finance, and operations.

Gregory A. Daneke is Professor of Technology Management, Arizona State University, and of Human and Organization Development, The Fielding Institute.