Methods Examination of historical materials, supplemented by personal interviews. The role that science played in the process of policy making was scrutinized with particular reference to the Garbage Can model.

Results

From the vantage of history, science remained instrumental in all period in the sense that it was not the primary objective for which policy change was discussed or intended, nor was it the principal driving force for policy change. When the argument arose, scientific arguments were employed to justify the patient isolation policy. However, in the early post-WWII period, issues were foregrounded and agendas were set as the inadvertent result of administrative reforms. Subsequently, scientific developments were more or less ignored due to concern about adverse policy outcomes. Finally, in the 1980s and 1990s, scientific arguments were used instrumentally to argue against isolation and for the termination of residential care.

Conclusion

Contrary to public expectations, health policy is not always rational and scientifically justified. In the process of policy making, the role of science can be limited and instrumental. Policy change may require the opening of policy windows, as a result of convergence of the problem, policy, and political streams, by effective exercise of leadership. Scientists and policymakers should be attentive enough to the political context of policies.'/>

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Termination of the leprosy isolation policy in the US and Japan : Science, policy changes, and the garbage can model

BMC International Health and Human Rights20055:3

DOI: 10.1186/1472-698X-5-3

Received: 31 December 2004

Accepted: 16 March 2005

Published: 16 March 2005

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31 Dec 2004 Submitted Original manuscript
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16 Mar 2005 Editorially accepted
16 Mar 2005 Article published 10.1186/1472-698X-5-3

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Authors’ Affiliations

(1)
Department of Public Health, Graduate School of Medicine, the University of Tokyo
(2)
Department of Political Science, the University of Louisiana at Lafayette

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