Patricia M. Baranek – författare

Is there a crisis in Canadian health care? While the establishment of the Canadian health care system is widely considered a triumph of citizenship, after four decades the national program is in a fragile state marked by declining public confidence. In First Do No Harm, Sullivan and Baranek provide a concise introduction to the fundamentals of health care in Canada and examine various ideas for reforming the system sensibly. Arguing that administrators and policymakers should follow Hippocrates' dictum "first do no harm" when evaluating and reforming the Canadian health care system, the authors discuss health care financing, popular Canadian health care myths, waiting lists and emergency room overcrowding, and home- and community-based health care. This book is an invaluable invitation to Canadians to think carefully and creatively about the present and future of our health care system.

From the point of his arrest through to the final disposition of his case, the authors follow the accused as he proceeds through the criminal control system. They draw a picture of one who is dependent upon the orders and decisions of the police, crown attorney, defence lawyer, and judge and not a defendant with significant autonomy. Substudies conducted under a program of the Centre of Criminology provide empirical material on patrol police, detectives, crown attorneys and defence lawyers and are complemented by the authors’ own interviews of accused persons. They produce a unique picture of the person who stands accused: unlike the official agents who are regular and experienced participants in the criminal process, the accused is a ‘one-shot’ player. As a dependant he is subject to the orders and decisions of the official criminal control agents; he fails to exercise what appear externally as his formal rights because the apparent costs exceed the advantages. He complies with police searches, fails to remain silent, fails to call a third party, gives a statement, often does not obtain a lawyer, routinely accepts his lawyer’s advice, rarely demands a trial, often remains silent in court, and very rarely considers an appeal. The ordering which the accused meets out of court is reproduced in the public forum of the court. Through the display of formal legal rationality there and in the belief that matters ‘could have been a lot worse,’ he experiences the ‘majesty, justice, and mercy’ of the criminal process and, in turn, accords legitimacy to the actions taken against him. The authors discuss prospects for changing the criminal process and conclude that the range of reforms that have been advocated, and sometimes implemented, does not lead to an alteration of the accused’s position within the ordering of justice because the system is not truly adversarial. Rather, it serves the interests of the state in ordering the population as well as professional interests of those who man the system.

Almost Home is a rich and comprehensive study of the policy questions underlying the shift in medical care from hospitals to homes and communities, a change that is reshaping Canadian health care policy and politics. Using document analysis, and interviews with government officials and other key stakeholders in the policy community, the authors analyze the policy content and process of five different attempts to reform home and community care in Ontario between 1985 and 1996, as introduced by governments from three different political parties.As this study demonstrates, the ongoing shift from the Medicare 'mainstream' of physician and hospital care to the Medicare 'margins,' entails not only a shift in the site of care but an erosion of the post-war state's role in health care. While Medicare continues to resist political and ideological forces aimed at shrinking the state's role, cost constraints, demographic pressures and technological advancements are increasing pressure on home and community care.The authors have made a significant contribution to research on policy development and change. Their rigorously analytical approach fills a major gap in book-length literature on long-term health care in Canada.

From the point of his arrest through to the final disposition of his case, the authors follow the accused as he proceeds through the criminal control system. They draw a picture of one who is dependent upon the orders and decisions of the police, crown attorney, defence lawyer, and judge and not a defendant with significant autonomy. Substudies conducted under a program of the Centre of Criminology provide empirical material on patrol police, detectives, crown attorneys and defence lawyers and are complemented by the authors’ own interviews of accused persons. They produce a unique picture of the person who stands accused: unlike the official agents who are regular and experienced participants in the criminal process, the accused is a ‘one-shot’ player. As a dependant he is subject to the orders and decisions of the official criminal control agents; he fails to exercise what appear externally as his formal rights because the apparent costs exceed the advantages. He complies with police searches, fails to remain silent, fails to call a third party, gives a statement, often does not obtain a lawyer, routinely accepts his lawyer’s advice, rarely demands a trial, often remains silent in court, and very rarely considers an appeal. The ordering which the accused meets out of court is reproduced in the public forum of the court. Through the display of formal legal rationality there and in the belief that matters ‘could have been a lot worse,’ he experiences the ‘majesty, justice, and mercy’ of the criminal process and, in turn, accords legitimacy to the actions taken against him. The authors discuss prospects for changing the criminal process and conclude that the range of reforms that have been advocated, and sometimes implemented, does not lead to an alteration of the accused’s position within the ordering of justice because the system is not truly adversarial. Rather, it serves the interests of the state in ordering the population as well as professional interests of those who man the system.

Almost Home is a rich and comprehensive study of the policy questions underlying the shift in medical care from hospitals to homes and communities, a change that is reshaping Canadian health care policy and politics. Using document analysis, and interviews with government officials and other key stakeholders in the policy community, the authors analyze the policy content and process of five different attempts to reform home and community care in Ontario between 1985 and 1996, as introduced by governments from three different political parties.As this study demonstrates, the ongoing shift from the Medicare 'mainstream' of physician and hospital care to the Medicare 'margins,' entails not only a shift in the site of care but an erosion of the post-war state's role in health care. While Medicare continues to resist political and ideological forces aimed at shrinking the state's role, cost constraints, demographic pressures and technological advancements are increasing pressure on home and community care.The authors have made a significant contribution to research on policy development and change. Their rigorously analytical approach fills a major gap in book-length literature on long-term health care in Canada.