Conflicts of interest are rampant in the American medical community. Today it is not uncommon for doctors to refer patients to clinics or labs in which they have a financial interest (40% of physicians in Florida invest in medical centers); for hospitals to offer incentives to physicians who refer patients (a practice that can lead to unnecessary hospitalization); or for drug companies to provide lucrative give-aways to entice doctors to use their "brand name" drugs (which are much more expensive than (...) generic drugs). In Medicine, Money and Morals, Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change. (shrink)

This long-awaited book sets out the implications of Habermas's theory of communicative action for moral theory. "Discourse ethics" attempts to reconstruct a moral point of view from which normative claims can be impartially judged. The theory of justice it develops replaces Kant's categorical imperative with a procedure of justification based on reasoned agreement among participants in practical discourse.Habermas connects communicative ethics to the theory of social action via an examination of research in the social psychology of moral and interpersonal development. (...) He aims to show that our basic moral intuitions spring from something deeper and more universal than contingent features of our tradition, namely from normative presuppositions of social interaction that belong to the repertoire of competent agents in any society. Jürgen Habermas is Professor of Philosophy at the University of Frankfurt. (shrink)

In this paper, I have tried to develop a critique of committee procedures and conflict of interest within research advisory committees and ethical review committees (ERCs). There are specific features of conflict of interest in medical research. Scientists, communities and the subjects of research all have legitimate stakeholdings. The interests of medical scientists are particularly complex, since they are justified by the moral and physical welfare of their research subjects, while the reputations and incomes of scientists depend on the success (...) of their science. Tensions of this kind must at times produce conflict of interest. It is important to recognise that conflicts of interest may unwittingly lead to manipulation of research subjects and their lay representatives on research committees. It is equally important to recognise distinctions between the legal and moral aspects of conflict of interest. Some practical suggestions are made which may go some way towards resolving these difficulties. They indicate what might be needed to ensure the validity of ethical discourse, and to reduce the risks associated with conflict of interest. (shrink)

This book focuses on experimentation that is carried out on human beings, including medical research, drug research and research undertaken in the social sciences. It discusses the ethics of such experimentation and asks the question: who defends the interests of these human subjects and ensures that they are not harmed? The author finds that ethical research depends on the adequacy of review by committee. Indeed most countries now rely on research ethics committees for the protection of the interests of the (...) human participants in research. Dr McNeill analyses how successful these committees are in balancing the interests of science with the interests of human subjects. (shrink)

Fully revised and updated, Law for the Medical Profession in Australia is an important handbook for medical professionals in Australia as now, more than ever, legal and ethical duties associated with medical practice come under scrutiny. The second edition of this successful text demands no prior legal knowledge, and its easy-to-read format incorporates the latest changes in legislation. Authoritatively written by four respected medical law experts, this book is an invaluable reference for all medical practitioners, nurses, allied health professionals, paramedics, (...) students of medicine and law, and all legal professionals. (shrink)

"[Goodbye, Descartes] is certain to attract attention and controversy..a fascinating journey to the edges of logical thinking and beyond." -Publishers Weekly Critical Acclaim for Keith Devlin's Previous Book Mathematics: The Science of Patterns "A book such as this belongs in the personal library of everyone interested in learning about some of the most subtle and profound works of the human spirit." -American Scientist "Devlin's very attractive book is a well-written attempt to explain mathematics to educated nonmathematicians. the basic ideas are (...) presented in a clear, concise, and easily understood manner. Highly recommended." -Choice "[Devlin] has found an interesting way of exhibiting how mathematics is unified. the author's presentation is a tour de force." -Mathematical Reviews A Selection of the Newbridge Library of Science and Reader's Subscription. (shrink)

A multidisciplinary study of trust. The papers in this publication address the question of what generates, maintains, substitutes or collapses trusting relations.

In this remarkable book Michel Foucault, one of the most influential thinkers of recent times, calls us to look critically at specific historical events in order to uncover new layers of significance.

As each week beings more stories of doctors, lawyers and other professionals abusing their powers, while clients demand extra services as at a time of shrinking resources; it is imperative that all practising professionals have an understanding of professional ethics. In _The Ground of Profesional Ethics_, Daryl Koehn discusses the practical issues in depth, such as the level of service clients can justifiably expect from professionals, when service to a client may be legitimately terminated and circumstances in which client confidences (...) can be broken. She argues that, while clients may legitimately expect professionals to promote their interests, professionals are not morally bound to do whatever a client wants. _The Ground of Professional Ethics_ is important reading for all practising professionals, as well as those who study or have an interest in the subject of professional ethics. (shrink)