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Begin New Search Topic Procurement Political Geography North America

1. Revising Organ Procurement Organization Guidelines to Obtaining Family Consent for Deceased Donation: An Anthropologically Informed Policy Proposal

Author:
Gillian Tisdale
Publication Date:
04-2024
Content Type:
Journal Article
Journal:
Journal of Public and International Affairs (JPIA)
Institution:
School of Public and International Affairs (SPIA), Princeton University
Abstract:
Organ transplantation has become a widespread medical practice with public policy designed to increase rates of deceased donation. When individuals have not registered as organ donors, next-of-kin are called on to make donation decisions—requiring families to grapple with the often-confusing concept of ‘brain death’ and parse their understanding of what the deceased would have wanted. Current public policy is explicitly designed to promote high donation rates without clear regard to the experiences of donor-families; at best, these policies prime donation conversations to involve unethical practices, while at worst, the disregard of kin’s experiences may also diminish deceased donation rates. Anthropological literature has documented the often aggressive tactics used by transplant organizations that demonstrate a disregard for the emotional experiences of kin. In 2023, Congress passed the Securing the U.S. Organ Procurement and Transplantation Network Act, prompting the United States Department of Health and Human Services (HHS) to reevaluate organ donation policies and solicit requests for proposal for a new federal contractor to take over the network responsible for overseeing all organ sharing. This article leverages the relevant anthropological literature to provide guiding principles and proposed language amending the Centers for Medicare & Medicaid Services (CMS) Interpretive Guidance that HHS could implement as part of its modernization initiative. These principles aim to improve experiences for kin without lowering donation rates. The article recommends that HHS and its contractors collect metrics to measure the quality of Organ Procurement Organization (OPO) interactions, counterbalancing current benchmarks focused on procurement rates. It also recommends improved protocols to empathically and systematically support kin’s understanding of brain death.
Topic:
Legislation, Public Policy, Procurement, and Organ Transplants
Political Geography:
North America and United States of America

2. Toward Agile Procurement for National Defence: Matching the Pace of Technological Change

Author:
William Richardson, Kalen Bennett, Douglas Dempster, Philippe Dumas, Caroline Leprince, Kim Richard Nossal, David Perry, Elinor Sloan, and J. Craig Stone
Publication Date:
06-2020
Content Type:
Working Paper
Institution:
Canadian Global Affairs Institute (CGAI)
Abstract:
In the fall of 2019, the procurement theme of the Canadian Defence and Security Network (CDSN) convened a workshop on the challenges facing high technology defence acquisitions. The workshop brought together practitioners from the Department of National Defence and Canadian Armed Forces and researchers from universities and think tanks, including graduate students. The aim of this workshop was to give these researchers a chance to understand how those working in defence procurement are tackling the problem of acquiring high technological capabilities that are not obsolete before they are even delivered. The researchers, in turn, have prepared this report, in collaboration with the Canadian Global Affairs Institute (CGAI), on bringing greater agility to defence procurement in Canada. As the authors note, this should be a key part of the defence procurement debate in Canada once Canada and the world emerge from COVID-19 emergency.
Topic:
Defense Policy, Science and Technology, Armed Forces, and Procurement
Political Geography:
Canada and North America

3. Canadian Defence Commitments: Overview and Status of Selected Acquistions and Initatives

Author:
Elinor Sloan
Publication Date:
12-2013
Content Type:
Policy Brief
Institution:
Canadian Global Affairs Institute (CGAI)
Abstract:
For years, successive Canadian governments have been overpromising and under-delivering on defence procurement. Timetables have slipped even as repair and maintenance costs for aging equipment have soared, while elaborate rules have obscured the acquisition process in a bureaucratic fog. This paper assembles information from a wide range of official sources and cuts through the confusion. It surveys 15 Canadian defence acquisitions and initiatives, each anticipated to cost more than $100 million, to account for the delays. Final replacements for the ancient Sea King helicopters are no closer to arriving — after almost 30 years — because the DND failed to recognize that it asked for technology that is still in development. The Joint Support Ship project is years behind schedule because, as originally conceived, it sought to integrate so many capabilities that it was unbuildable. The Integrated Soldier System Project is almost as far behind because Ottawa’s procurement rules are so complex and niggling that no bidder could fulfill every single one. Canada faces evolving threats, but efforts to equip the Canadian Forces to meet them have been marked by a long litany of failures — failures of communication, of organization and of vision. This paper sets out the military procurement process, and concisely explains the most egregious flaws, making it essential reading for anyone interested in the future of Canada’s military.
Topic:
Defense Policy, Procurement, and Military
Political Geography:
Canada and North America