Certificate of Need Project - Free Essay Example

Sample details Pages: 4 Words: 1183 Downloads: 7 Date added: 2017/06/26 Category Medicine Essay Type Narrative essay Level High school Did you like this example? Certificate of Need Project The Certificate of Need (CON) program is a mechanism used by some states to restrain or control health care facility costs and to allow for the coordinated planning of new services and construction. The CON program was created by the National Health Planning and Resource Development Act (à ¢Ã¢â€š ¬Ã…“NHPRDAà ¢Ã¢â€š ¬Ã‚ ) in 1974. After the passage of NHPRDA states not having a CON process begin establishing rules for the CON process at the state level. In 1986 the Federal CON mandate was repealed, allowing states to determine its own CON process, if any at all. This paper will discuss Floridaà ¢Ã¢â€š ¬Ã¢â€ž ¢s CON process to include facilities requiring CON, steps in the CON process, appeals process, and exempt geographic locations. The CON program began in Florida in the year of 1973 with a primary reason for establishment being the promotion of cost containment by controlling unnecessary duplication of health care services and facilities. Floridaà ¢Ã¢â€š ¬Ã¢â€ž ¢s CON regulatory process is governed by the Florida Statutes sections 408.031 through 408.045 and the Florida Administrative Code Chapter 59C-1. Since 1992 Floridaà ¢Ã¢â€š ¬Ã¢â€ž ¢s CON program has been administered by the Agency for Health Care Administration (AHCA). Floridaà ¢Ã¢â€š ¬Ã¢â€ž ¢s CON regulatory process requires certain health care providers to obtain state approval before offering new or modified services. Facilities that require a CON (FS 408.036) Currently Floridaà ¢Ã¢â€š ¬Ã¢â€ž ¢s CON program regulates acute care hospitals, long-term care facilities, nursing homes, hospices, intermediate care facilities; services include neo-natal intensive care services, organ transplant services, open heart surgery, substance/drug abuse services, and psychiatric servicesà ¢Ã¢â€š ¬Ã¢â‚¬ requiring these healthcare facilities and service areas to go through the CON process. Florida Statutes section 408.036 identifies the following heal thcare related projects subject to CON review by way of an application with AHCA: (1) addition of beds in community nursing homes or intermediate care facilities for the developmentally disabled by new construction or alteration; (2) new construction or establishment of additional health care facilities, including a replacement health care facility when the proposed project site is not located on the same site as or within 1 mile of the existing health care facility, if the number of beds in each licensed bed category will not increase; (3) conversion from one type of health care facility to another, including the conversion from a general hospital, a specialty hospital, or a long-term care hospital; (4) establishment of a hospice or hospice inpatient facility; (5) increase in the number of beds for comprehensive rehabilitation; and (6) establishment of tertiary health services, including inpatient comprehensive rehabilitation services. Steps in Floridaà ¢Ã¢â€š ¬Ã¢â€ž ¢s CON pro cess (FS 408.039) The CON application steps are inclusive of a letter of intent, application review, and staff recommendation and decision from AHCA. The CON review process is funded through the collection of fees assessed to the CON applicantà ¢Ã¢â€š ¬Ã¢â‚¬ minimum base fee of $10,000 and an additional 0.015 of each dollar of proposed expenditure with the total fee not exceed $50,000. A letter of intent is to be filed at least 30 days prior to the published application deadline due date for the particular batching cycle. The letter of intent must contain a description of the proposed project; specify the number of beds sought, if any; identify the services to be provided; the location; and identify the applicant. Within 21 days after the letter of intent is received, AHCA publishes notice of letters of intent filed in the Florida Administrative Register. Following the letter of intent, the applicant has to file an application to the agency along with the $10,000 fee. Wit hin 15 days after the application filing deadline, AHCA has to determine if the application is complete. If the application is incomplete, AHCA can provide a one-time written response to the applicant indicating the section(s) of the application that are incomplete and request specific information from the applicant that would be necessary to complete the application. AHCAà ¢Ã¢â€š ¬Ã¢â€ž ¢s requested information has to be filed within 21 days after the applicantà ¢Ã¢â€š ¬Ã¢â€ž ¢s receipt of the request. Requested information not timely received, the application will be deemed incomplete and deemed withdrawn from consideration. Fourteen days after the notice of application has been filed, the applicant or a substantially affected person can request a public hearing which may be held at the agencyà ¢Ã¢â€š ¬Ã¢â€ž ¢s discretion. Twenty one days after the application is deemed complete, a local-level public hearing has to be held. A public hearing allows all parties to present their p ositions and any rebuttal information. The public hearing has to have a verbatim record of the hearing. Within 60 days after all the applications in the batching cycle are deemed complete, AHCA will issue a State Agency Action Report and Notice of Intent to (1) grant a CON in its entirety, (2) grant a CON for identifiable portions of the project, or (3) deny the CON. AHCA shall publish its proposed decision within 14 days after the Notice of Intent is issued. If an administrative hearing is not requested, the State Agency Action Report and the Notice of Intent will become the agencyà ¢Ã¢â€š ¬Ã¢â€ž ¢s final order with a copy provided to the appropriate local health council. Appeal process once the CON is granted (FS 408.039) The administrative appeals process ensures that all applicants are entitled to challenge the initial decision of the Agency through the administrative hearing process. Any party requesting an administrative hearing must do so within 21 days after AHCAà ¢Ã¢â€š ¬Ã¢â€ž ¢s Notice of Intent is published in the Florida Administrative Register. Hearings shall be held in Tallahassee unless the administrative law judge (ALJ) determines that changing the location will facilitate the proceedings. Unless an ALJ issues a continuance, hearings will be held within 60 days of the ALJ being assigned to the case. A recommended order will be issued by the judge. After the recommended order is issued, AHCA must issue its final order within 45 days. Any party to an administrative hearing has the right to seek a judicial review from the District Court of Appeals within 30 days of the date of the final order. AHCA is party to all such proceedings. During the review, the court will affirm the final order unless it is arbitrary, capricious or not in compliance with applicable Statutes. Geographic location exempt from CON (FS 408.036) With the exception of eligible rural geographic locations, the Florida Statues did not address locations exempt from CON process. When exemptions are allowed, AHCA has the authority to exempt eligible services from the CON project review process. Exemptions includes hospice services or swing beds in a rural hospital when one-half of its licensed beds is not exceeded and also conversion of licensed acute care hospital beds to Medicare and Medicaid certified skilled nursing beds in a rural hospital when construction of new facility is not involved and/or the total number of skilled nursing beds do not exceed one-half of the total number of licensed beds in the rural hospital. Other services exempt from CON process includes inmate health care facilities built by or for the exclusive use of the Department of Corrections and also state veteransà ¢Ã¢â€š ¬Ã¢â€ž ¢ nursing homes operated by or on behalf of the Florida Department of Veteransà ¢Ã¢â€š ¬Ã¢â€ž ¢ Affairs. Resource: The 2014 Florida Statutes, sections 408.031 through 408.045. Retrieved October 22, 2014 from https://www.leg.state.fl.us /Statutes/index.cfm?App_mode=Display_StatuteURL=0400- 0499/0408/0408.html Don’t waste time! Our writers will create an original "Certificate of Need Project" essay for you Create order

The Government And Government Of Public Finance - 1622 Words

Introduction The branch in which we read thoroughly the contribution of the government in money related matters is known as public finance. In this branch we analyze the government and government expenditure of public authorities with the help of these we tries to achieve useful effects discarding harmful effects. The initial point for accessing the public finance is the proper role of finance. Actually during special conditions private markets will distribute goods and services among people in a effective way. We want to achieve such conditions so that no waste occurs we get what suits with our economy productive abilities in a special condition when private markets were able to provide good results and the division of money was socially desirable, in such case there would be no scope for the government. In most of the cases the rules for private markets efficiency are discarded for e.g. In a special condition when many people want same good at the same time .in this special case the private m oney market supply become too less to handle. The example non-rival consumption is National defiance. When private market does not distribute goods services efficiently then there is market failure. The market failure gives collective or governmental provisions of goods and services, which is based on efficiency rational. The causes of market failures are public goods, informational advantages strong economies of scale and network effects. Government failure is term used forShow MoreRelatedFinancial Audit Report On The Decision Making Process855 Words   |  4 PagesAccountability on the other hand helps avoid the pointing of fingers. 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Literature review of Leadership Practices at Successful Organizations

Question: Discuss about the Literature Review of Leadership Practices at Successful Organizations. Answer: Introduction Leadership literature disclose that the practices of leadership have been customized and advanced with the course of time and each and e very practice is relevant in its own way. The relevance of leadership practices relies upon the context or situation in which they have been applied. The kind of leadership practices implemented in areas where there presents a high degree of sensitivity, conflicts, confidence level and precision may be different than the practices incorporated at areas where there presents simple management case. There are number of things which impacts the type of leadership practices to be incorporated such as psycho-social developments, organizational complexities, information overload, regulations and laws, working environment, culture contexts and situations. For any organization to become successful there are various elements which support the growth. Out of all those, one major and significant part is the leadership practices applied in the organization (Nort hhouse, 2015). The literature will throw light on several leadership practices of some renowned and successful organization and will also discuss and analyze various other practices which the organization can adopt to have further development. Literature review For understanding what leadership practices are, there is a need to first comprehend what is leadership. There are number of definitions associated with leadership, but to conclude all we can say leadership starts with individuals in the positions of leadership but this is not its end. The competence of any organization to attain its objectives and goals not only relies completely on the power of will of a single leader or on the effectiveness of the chain of command of an organization. The practices are significant but then also few organizations fail and few succeed (Yukl, 2002). Its not merely the number of excellent leaders which an organization have on which the success depends but the actual practices which have been implement ted at the grass-root level of an organization and the ability of both the informal and formal leaders to integrate the needs of the employees with the goals of an organization. There presents leadership practices of various organizations and the reasons how these practices turned out to be beneficial for those organization to become successful (Ireland and Hitt, 1999). Leadership practices at successful organizations Leadership practices adopted at McDonalds includes building of outlets that are considered as amusing places to work at. The leaders there promote accountability and comprehend the culture of social responsibility as well as implement these practices in their businesses. The leaders at McDonalds possess articulating visions, role relationships, influential power to impact the behavior of subordinates and also the embodying values. These traits of leaders influence the employees to accomplish the organizational goals and work liberally. The model of leadership which enforced at McDonalds is Adair model and which is an action-centered leadership. As per this model, the higher authorities inspire and influence the employees through their self-commitment, enthusiasm and their skill to communicated passion to other individuals (Carter, Ulrich and Goldsmith, 2012). The tasks are accomplished by developing different teams and so the team work practice is generally adopted at the workplace. The leadership practices and the Adair model incorporated by McDonalds majorly focuses over three main things which comprises of firstly the accomplishment of the work assigned or the task, secondly, maintaining and continuing with the team and lastly meeting the personal and individual requirements of the members of the team. Other leadership practices adopted at McDonalds comprises of that they perform with the maximum level of integrity and authenticity through building an association of trust with the team members, leaders remain fully committed towards the development and growth of the individuals and the tem, they practice efficient skills of listening as feedbacks are taken from the employees regarding policies, work culture, environment etc., they share their view points, perceptions openly with employees and also give the opportunity to work in an independent and self-organized way (Weinstein, 2012). The span of control is squat at McDonalds and it offers several advantages such as effective control over the subordinates is maintained, evaluation process becomes effective, increased co-ordination as well as there are opportunities for the subordinates to learn more and develop. Another organization which possesses few best leadership practices is Google. There are various practices and lessons which can be learn through the leadership style of Google. The leaders communicate the vision and provide employees with the autonomy to incorporate it; this is one of the leadership practices of Google of its people management system. Another practice relates with offering the employees with an environment which is hassle-free so that the people can perform well and have complete concentration on their work (Henson, 2016). The objective or aim of the company is to strip away all the things which come in the way of their employees. Google offers a customary package of advantages and remunerations to its employees which it clips up with an apparently continuous and extremely desirable the array of perquisites which includes excellent facilities of dining and that too with unrestrained and free supply of nutritious food, services for dry cleaning, car washes, haircuttin g salons, massage rooms, laundry rooms, gyms, in various segments of workplace there are snack stations, commuting buses, access to internet, leather seats as well as the company provides facility for carrying the pets onboard and related to anything which a reliable and hardworking employee require to be concerned for at the time she or he is working (Leithwood, 2005). Even though the workforces are also not required to get worried about the dress code to follow as Google incorporate and implement axioms in its vision which means that a person can be serious for his work even if he or she is in informal and not wearing suit. The leadership practice of facilitating and empowering the work of the employees is one of the major reasons behind the innovations of Google and as a result the company experienced explosive growth (Yalimaki and Jacobson, 2013). The company focuses on various approaches and practices of leadership such as knowing the employees through conversing with them on a n individual basis, developing innovative ways through which the high-performing and hard-working employees can get promoted and rewarded, the company let the workforces own the issues which they want them to answer which means Google provides the autonomy to its employees to achieve the goal of the company according to them and in their own way. Another practice is that the company provides the facility to its employees to work outside the hierarchy of the organization which comprises of freedom to select their own teams and the projects as well as one of the most preferred leadership practice of Google was giving the liberty and choice to its employees to select their the reviewer among all the professionals and experts whom they consider as impartial and respects their judgment and objectivity (Manimala and Wasdani, 2013). Another organization which possesses finest leadership practices is AstraZeneca. The leadership abilities of AstraZeneca were identified in 1999 just after the merger (Hyde and Paterson, 2001). The capabilities of leadership of the company are used in the management planning, development planning and performance management across the worldwide company. It is the core and essential element of the programme of leadership development and also a tool which provides 360 degree feedback has also been industrialized for supporting their functions. The behavior of leadership offers an association among the priorities of business and the AZ values of high ethical standards, integrity, support and trust for others, openness, respect for diversity, respect for individual and leadership over all levels. There are few practices which have implemented at AstraZeneca and are linked with the leadership behaviors. It comprises of practices regarding building of self-awareness, express individual conv iction, development of people, building of associations, emphasis on delivery, and safeguard the commitment and practice regarding proving of clarity related to the strategic direction (Storey, 2004). General Electric Company is another successful organization which has strong and powerful pillars of leadership practices implementing at its workplace. There are number of approaches and practices which have been incorporated by GE which includes firstly the leader at every level inspire and encourage the individuals to show a concern and apprehension for the necessities and requirements of other people. Next the leaders emphasis on achieving cooperation among each other so that the work can be accomplished in teams, instead of individual concern or just as per the requirements of higher authorities, GE do not function, it takes along the shared benefits in which each and every individual remain cherished. GE allow employees to provide their innovative ideas so that the employees consider themselves as the part of the organization but simultaneously it necessitates that the employees are required to follow the orders even though if they have a better plan, the respect for the higher authorities need to be maintained (Henderson and Evans, 2000). Another leadership practice of GE focus on making the employees work in such a way that they consider their job as a contest so that they strive hard for it and achieve the desired goals with much effectiveness and zeal. Few more practices of GE are the improved connectivity among the employees, increased integrity which requires the employees to be committed, passionate, curios and energized for performing the work. The leaders at GE incorporated a change acceleration programme as its leadership practice and it was initialized with the top senior managers and later on continued by other managers, the agenda behind this programme was to accelerate change within the organization and that too at the uppermost level so that the employees also get inspired by the higher authorities and became ready to adjust with the change (Lakshman, 205). This practice e signifies that how the behavior and traits of the leaders impacts th e understanding and behavior of the subordinates. These practices make the organization successful and open the doors for future development. Starbucks is another successful organization which is highly recognized for its leadership practices. Starbucks is famous for practicing servant leadership. Servant leadership generally focused on providing increased services to the individuals. It is a holistic approach towards the job and empowers a feeling of community and in the process of decision making the powers is shared. Starbucks highly emphasize on practicing this kind of leadership in its business and at the workplace (Sipe and Frick, 2015). There are various characters or elements of servant leadership which are incorporated in the working culture of Starbuck by their leaders. Leaders at Starbucks adopt the practice of listening, as a servant leader the mangers at Starbucks listen intentionally with a deep commitment to others. The will of the employees are identified and they are worked as per their will (Hamilton, Spears and Lawrence 2005). Another element practiced by Starbucks is that the leaders of Starbucks try to empathies with others in which the employees are recognized and been accepted for their individual and special spirits they possess. Employees are not to force to change themselves; they have appointed those tasks which they can serve better (Autry, 2007). As practicing servant leadership, the employees always been provided a healing hand at the time of any non-happening event occurred with them whether formal or informal. Leaders listen to them and try to solve their issues and make them comfortable at their work. The employees are persuaded and convinced rather than pressurized to follow a change or decision. As per the practice of servant leadership, they decisions are not just imposed coercively on the employees but they are convinced by various means and make them persuade for that work so that there sustain a sense of willingness and liberty to work independently (Trompenaars and Voerman, 2009). The leaders at Starbucks are committed to the development and growth of the emplo yees as they believe there always remains some intrinsic value beyond the work performing as employees. So to fulfil and develop the spiritual, professional and personal growth of the employees the leaders perform actions which support this such as availability of funds, encouraging involvement of the employees, taking up suggestions from them etc. These leadership practices of Starbucks enhance the involvement of employees and also empower them to grow and as its outcome the organization achieve huge success (Jones, 2012). Conclusion Leadership practices are the shared, combined and observable deeds which outline as well as define the culture of leadership. A leadership practice supports the successful incorporation of the other leadership strategies of any business. Without the right leadership practice, the other organizational strategies will be just like ink on paper which has no meaning and involvement of it in achieving success by an organization. With the appropriate leadership practices in place, the correctly designed leadership process for development and the suitable strategies for talent sustainability and talent acquisition, there presents extreme chances that the organization will accomplish growth and success in implementing its leadership strategies. One major thing to be focused for is, there is need to understand that just by speeches or verbal communication the leaders cannot determine that in what way employees have taken it so there is a high requirement to implement the leadership practices at workplace for influencing the employees. The leadership policies and leadership practices implemented in an organization are the best way to understand the needs of the employees and to make them comprehend the culture of the organization (Chhokar, Brodbeck and House, 2013). Leadership practices have a direct association of cause and effect on the business organization and its success. Through leadership practices, the leaders recognize the employee motivation, tolerance towards change, culture and values. They help in outlining the strategies comprising their execution and efficacy. Leadership practices could implement at any level of an organization and are not only meant for the employees or the grass-root levels. From the literature review we can conclude one major thing that all the successful organizations have one thing in common, they implement leadership practices at their workplace to reap utmost benefit from its resources comprising the most valuable and expensive reso urce i.e. its people. Recommendations There are number of effective and successful leadership practices which can be adopted by the organization to achieve success. It includes practices like 360 degree feedback which focus on ratings to be given on various performances, through it there is development of behavioral change and self knowledge. Another practice could be coaching which is a practical form of practice that included one-to-one learning; it has benefits like career development, personalized viewpoint etc. Another strategy could be mentoring which includes learning and advising from much more senior managers, the employee and the mangers share a development relationship, it has various benefits associated with it such as broader sense of understanding, avoiding of mistakes, lessons are learned as well as building of a strong personal bond (Orazi, et al., 2014). There are other various practices which the leaders and the organizations of can implement to have successful future but there should always maintain a balance between the needs of the employees and the organizational goals. References Autry, J.A., 2007.The Servant Leader: How to Build a Creative Team, Develop Great Morale, and Improve Bottom-Line Perf ormance. Crown Business. Carter, L., Ulrich, D. and Goldsmith, M. eds., 2012.Best practices in leadership development and organization change: how the best companies ensure meaningful change and sustainable leadership(Vol. 18). John Wiley Sons. Chhokar, J.S., Brodbeck, F.C. and House, R.J. eds., 2013.Culture and leadership across the world: The GLOBE book of in-depth studies of 25 societies. Routledge. Hamilton, F., Spears, L. and Lawrence, M., 2005. Practicing servant-leadership: Succeeding through trust, bravery, and forgiveness. Henderson, K.M. and Evans, J.R., 2000. Successful implementation of six sigma: benchmarking General Electric Company.Benchmarking: An International Journal,7(4), pp.260-282. Henson, R., 2016. The Road Ahead: The Future of Global Leadership and Implications for Research and Practice. InSuccessful Global Leadership(pp. 285-301). Palgrave Macmillan US. Hyde, A. and Paterson, J., 2001. Leadership development as a vehicle for change during merger.Journal of Change Management,2(3), pp.266-271. Ireland, R.D. and Hitt, M.A., 1999. Achieving and maintaining strategic competitiveness in the 21st century: The role of strategic leadership.The Academy of Management Executive,13(1), pp.43-57. Jones, D., 2012. Does servant leadership lead to greater customer focus and employee satisfaction.Business Studies Journal,4(2), pp.21-35. Lakshman, C., 2005. Top executive knowledge leadership: managing knowledge to lead change at General Electric.Journal of Change Management,5(4), pp.429-446. Leithwood, K., 2005. Understanding successful principal leadership: progress on a broken front.Journal of Educational Administration,43(6), pp.619-629. Manimala, M.J., Wasdani, K.P., 2013. Distributed leadership at Google: Lessons from the billion-dollar bran, Ivey Business Journal. Northouse, P.G., 2015.Leadership: Theory and practice. Sage publications. Orazi, D., Good, L., Robin M., Wanrooy, B.V., Butar, I.B., Olsen, J. and Gahan, P., 2014. Workplace leadership: A Review of Prior Research. Australia. Sipe, J.W. and Frick, D.M., 2015.Seven pillars of servant leadership: Practicing the wisdom of leading by serving. Paulist Press. Storey, J., 2004.Leadership in organizations: Current issues and key trends. Psychology Press. Trompenaars, F. and Voerman, E., 2009.Servant Leadership Across Cultures: Harnessing the Strength of the World's Most Powerful Leadership Philosophy. Infinite Ideas. Weinstein, M., 2012. McDonald's Recipe for Success.Training,49(1), pp.60-63. Ylimaki, R. and Jacobson, S., 2013. School leadership practice and preparation: Comparative perspectives on organizational learning (OL), instructional leadership (IL) and culturally responsive practices (CRP).Journal of Educational Administration,51(1), pp.6-23. Yukl, G.A., 2002. Leadership in organizations

On Human Sexuality an Example by

On Human Sexuality By definition, what constitutes sexual deviance and what constitutes sexual perversion relate to larger categories of social practice than those that are specifically sexual. This leads us to a useful distinction between sexual deviance and sexual perversion. Sexual deviance might be defined as the inappropriate or flawed performance of conventionally understood sexual practices. Need essay sample on "On Human Sexuality" topic? We will write a custom essay sample specifically for you Proceed Rape, for example, is an act of sexual deviance that is rarely defined as an act of perversion. Rape becomes perverse only when performed on an inpidual whose inclusion in a sexual act goes beyond the limits of generally conceivable sexual practice or is performed in ways that go beyond the limits of generally conceivable sexual practice. Though we may deplore the behavior, it is possible to comprehend, and even empathically reconstruct, the experience of the rapist or his victim. In the language of the pathologists, such behaviors can be termed a disease of control. As the character of sexual practice changes over time, so do the boundaries of the definitions of deviance. An excellent case in point is the increasing incorporation of oral sex in the scripting of conventional sexual scenarios. Although the behavior as a matter of organs and orifices remains unaltered, its collective meanings and uses for specific inpiduals demonstrably have been undergoing profound change (Irvine 1995, p. 314). Perversions, in contrast, tend to be forms of desire too mysterious and sometimes too threatening to the most elementary definitions of desire and satisfaction to be tolerated. Perversion can be thought of as a disease of desire, not only in the sense that it appears to violate the sexual practices of a time and place, but also because it constitutes a violation of common understandings that render current sexual practice plausible. The behavior of the pervert is disturbing because, at the level of folk psychology, we have difficulty understanding why someone might want to do something like that. Consistent with this approach was Krafft-Ebings use of the term perversion as cited by Davidson (1987). In Krafft-Ebings Psychopathia Sexualis (1876) there is a discussion of anomalies of appetite such as hyperorexia (increases), anorexia (lessening) and of perversions such as a true impulse to eat spiders, toads, worms, human blood, etc. Perversions of appetite thus involve not only the desire to eat the unthinkable, but also the desire to eat for unthinkable reasons. The same might be said of perversions of the sexual (Irvine, 2002, p. 430-31). As in the case of deviance, what is considered a perversion is also subject to revision as what constitutes the thinkable changes. Many forms of what for the contemporary world constitute acts of sexual deviance tend not to occur in other social settings not because they are repressed, but merely because they are literally unthinkable. Moreover, the processes through which behavior becomes thinkable for a collectivity are not identical to the processes through which behavior becomes thinkable to the inpidual. The logic at essay that links motive and behavior is the complex, almost magical logic of representation, a logic of metaphor and metonymy that meshes personal history with social history. Concerns for the role of the symbolic in the interaction of inpiduals often obscure the importance of the interaction between, and even within, symbols (Irvine 1995, p. 317). Homogeneity of sexual preferences inevitably masks heterogeneity of desired emotional productions, and this perhaps is the level at which, to some extent, we may all be perverts, as even the most conventional may find their sources of sexual excitement fueled by the slightest whiff of the unthinkable. Theories that describe the causes of behavior already presuppose the problematizing of that behavior. It is not theory that renders social practice problematic, but the emergence of the problematic in experience that gives rise to the requirement for theory, as well as the potential for its ability to find a responsive audience. In other words, theories of behavior are themselves behavior and, as such, have essentially the same basic requirements: first, they must be thinkable; second they must be plausible, that is, made either legitimate or explainable in terms of what is held to be legitimizing. In this sense I agree with Canguilhem (1989) when he notes: [I] t is not paradoxical to say that the abnormal, while logically second, is existentially first. One might argue (and many have) that nonprocreative sexincluding, but not limited to, masturbation, oral sex, and sex between persons of the same gender is evolutionary maladaptive because it does nothing to further the lineage of the inpiduals involved and, in many cases, wastes energy and precious resources such as sperm. Men, for example, have been admonished against spilling their seed by authorities ranging from the Christian Church to such vocal inpiduals as singer/ reactionary/ orange-juice-peddler Anita Bryant. Incidentally, the widely cited biblical reference to the spilling of seed (Genesis 38: 9) does not refer to masturbation, but instead to the practice of coitus interruptus. The verse in question reads: And Onan knew that the seed should not be his; and it came to pass, when he went unto his brother's wife, that he spilled it on the ground, lest that he should give seed to his brother. In this verse, Onan breaks the Hebrew law of the levirate by intentionally spilling his seed rather than impregnating the wife of his deceased brother. However, the fact that this is but an unfortunate misreading of Genesis has done nothing to stop the onslaught of admonitions against masturbation, or onanism as it is sometimes called. Nor has it prevented the introduction of singularly bizarre remedies for preventing autoerotic stimulation. In 1870, for example, the prestigious British medical journal The Lancet advised guarding the penis for a time against improper manipulation by keeping up slight soreness of the body of the organ . . . sufficient to render erection painful. Presumably, this was necessary to avoid the insanity inevitably produced by excessive manipulation of this popular body part. Masturbation was also believed to diminish the sexual incentive for men (and women) to marry; the desire for marital sex presumably being lost when by this means they appease their lustful appetites (Hunt 1998). Moreover, the pleasure that accompanies the ejection of semen was itself considered an abomination: The intrinsic malice of pollution [meaning self-induced orgasm of any kind] consists most probably in the intense sexual enjoyment and satiation of pleasure, occurring outside the legitimate bond of matrimony, which the effusion of seed produces and not only nor principally in the voluntary frustration of the seed itself. One of the most persistent rationales for the condemnation of masturbation is a misguided belief in the omnipotence of sperm, for sturdy manhood . . . loses its energy and bends under too frequent expenditure of this important secretion. An especially novel means of conserving this important secretion was practiced by male members of the become pregnant from playing basketball, attending the opera, or dancing, yet seldom are these activities proscribed for that reason alone, at least in modern times (Hunt 1998). (Throughout its history the Christian Church has periodically attempted to ban all pleasurable activities, including dancing and attending the theater. Perhaps in doing so the Church merely sought to err on the side of caution by eliminating all activities that could reasonably precede sex. Taken too literally, this often prompted some rather absurd prohibitionson baths, wine, and so forth.) Why, then, is nonprocreative sex held to a different standard than other reproductively safe activities, such as skiing, movie going, or swimming in public? We have already dismissed the argument that views nonreproductive sex as wasting a limited natural resource. Provided that pregnancy is a possible outcome of at least some sexual encounters (and even with modern contraceptive methods, many such opportunities continue to exist), procreation will occasionally occur. We have also argued, based on evidence garnered from observations of one of humankinds closest relatives on the evolutionary tree, that nonprocreative sex cannot properly be considered unnatural if natural is accorded its customary meaning (Hunt 1998). Of course, according to Church teachings, people should be able to rise above such bestial instincts in pursuit of loftier spiritual ideals. Perhaps nonprocreative sex is taboo because the behaviors themselves are perversions of the natural function of the sexual apparatus (which, of course, is implicitly construed as reproduction). This view was succinctly expressed by Dr. Lyttleton (a headmaster at Eton, a prestigious English boys school), who said: All exercise of a bodily faculty for the sake of pleasure and except for the purpose for which the faculty was given is wrong. Notice that the fault here lies not with the pleasure one feels, but with the reason one feels it. It is all right to enjoy coitus (sans contraceptives, of course), but only if ones purpose is to create another young lad to bolster Etons rolls, or a lass to rule the Commonwealth. Similar application of this principle to other bodily functions would condemn kissing (which is a perversion of the natural gustatory function of the oral cavity) and simple caressing (since this pleasure is certainly a violation of the proper function of the touch receptors of the skin, whatever that function might be). The absurdity of this position should be clear. Furthermore, if as claimed here, the elicitation of pleasure is a main function of human sexuality, then the preceding argument is effectively disarmed. That is, perhaps pleasure is itself [a] purpose for which the faculty was given. Reference: Hunt, A. "The Great Masturbation Panic and Discourses of Moral Regulation." The Journal of the History of Sexuality (1998). Irvine, J. "Regulated Passion." In Deviant Bodies: Critical Perspectives on Difference in Science and Popular, edited by Jennifer Terry and Jacqueline Urla: Bloomington and Indianapolis: Indiana University Press, 1995. "Reinventing Perversion: Sex Addiction and Cultural Anxieties " The Journal of the History of Sexuality (2002).