Este estudio tiene como propósito explicar la relatividad del secreto médico y la actuación del médico perito. El secreto profesional médico es un derecho a la intimidad y constituye obligación ineludible para el personal de la salud, los pacientes y peritados, de ahí que todo lo que revelen deba ser guardado para evitar daños a la vida privada de los individuos. Desde el punto de vista ético el secreto médico profesional obliga al perito a no revelar más de lo necesario (...) para el peritaje, así como a no divulgar dicho informe, limitándose a entregarlo solamente a quienes tuvieran derecho a él. This study aims at explaining the relativity of medical secrecy and the performance of the medical expert. The medical professional secrecy is a right to privacy and it is an unavoidable obligation for the health staff, and assessed patients, hence everything they reveal must be stored to prevent damage to the private life of individuals. From the ethical point of view medical confidentiality forces the expert not to disclose more than necessary for the expertise, as well as not to disclose such report, just limited to be delivered to those who had right to it. (shrink)

Think of a secret that you're keeping from others. It shouldn't take long; behavioral scientist Michael Slepian finds that on average, we are keeping as many as thirteen secrets at any given time. His research involving more than 50,000 participants from around the globe shows that the most common secrets include: lies we've told, addiction or mental health challenges, a hidden relationship, financial struggles, and more. Our secrets can weigh heavily upon us. Yet the burden of secrecy, Slepian argues, (...) rarely stems from the work it takes to keep a secret hidden. Rather, secrets are something we must "carry" because we do so alone, without the support of others. Whether we are motivated to protect our reputation, a relationship, or a loved one's feelings, or are pursuing some personal or professional goal, one thing is clear: holding back some part of our inner world is often lonely and isolating. But it doesn't have to be. Filled with fresh insight into one of the most universal-yet least understood-aspects of human behavior, The Secret Life of Secrets sheds a fascinating new light on questions like: At what age do children develop the cognitive capacity for secrecy? Do all secrets come with the same mental load? How can we reconcile our secrets with the human desire to relate, connect, and be known? When should we confess our secrets? Who makes for the ideal confidant? And can certain types of secrets actually enhance our well-being? (shrink)

Think of a secret that you're keeping from others. It shouldn't take long; behavioral scientist Michael Slepian finds that on average, we are keeping as many as thirteen secrets at any given time. His research involving more than 50,000 participants from around the globe shows that the most common secrets include: lies we've told, addiction or mental health challenges, a hidden relationship, financial struggles, and more. Our secrets can weigh heavily upon us. Yet the burden of secrecy, Slepian argues, (...) rarely stems from the work it takes to keep a secret hidden. Rather, secrets are something we must "carry" because we do so alone, without the support of others. Whether we are motivated to protect our reputation, a relationship, or a loved one's feelings, or are pursuing some personal or professional goal, one thing is clear: holding back some part of our inner world is often lonely and isolating. But it doesn't have to be. Filled with fresh insight into one of the most universal-yet least understood-aspects of human behavior, The Secret Life of Secrets sheds a fascinating new light on questions like: At what age do children develop the cognitive capacity for secrecy? Do all secrets come with the same mental load? How can we reconcile our secrets with the human desire to relate, connect, and be known? When should we confess our secrets? Who makes for the ideal confidant? And can certain types of secrets actually enhance our well-being? (shrink)

Events in teaching often bubble up and demand attention because they stay with us long after the moment has passed, causing us to revisit and recreate them, perhaps to ask ourselves whether we might have responded differently. Deeper reflection and wider social enquiry become possible when incidents are recorded over time. Themes are identified and form the basis of theorizing and alternative action. Themes tend to emerge from awareness of our emotional responses to events and through an investigation of the (...) values and beliefs that have informed our reactions to them. Since I am aiming to encourage and strengthen children’s participation in the community of enquiry, a major theme in my own practice is locating barriers to my listening, obstacles that inhibit children’s involvement in philosophical dialogue, whose advocates have emphasized its democratic nature and transformative educational potential. This paper describes an experience of teaching which led me to explore taboos surrounding certain topics in primary schools. In the case reported, I suggest that the subject of ‘secrets’ alludes to wider insecurities in the social construction of intimacy in child and adult relations. These difficulties inhibit the educational process and obscure the voice of the child, even in the context of philosophical dialogue, which aims to increase children’s participation. I consider the moral panic in the UK about the safety of children and the effect on interactions in the ambiguous context of primary schools. I examine the exercise of professional judgement in respect of boundaries of private and public. Conscious of a missed opportunity, I explore secrecy, hiding, concealing and revealing and the part that these play in relationships and in the making of individual identity and the sense of self. Throughout the enquiry I seek to identify obstacles to listening that limit the potential for mutual education. (shrink)

Toxoplasma gondii is a highly successful parasite capable of infecting virtually all warm-blooded animals by actively invading nucleated host cells and forming a modified compartment where it replicates within the cytosol. The parasite-containing vacuole provides a safe haven, even in professional phagocytes such as macrophages, which normally destroy foreign microbes. In an effort to eliminate the parasite, the host up-regulates a family of immunity-related p47 GTPases (IRGs), which are recruited to the parasite-containing vacuole, resulting in membrane rupture and digestion (...) of the parasite. To avoid this fate, highly virulent strains of Toxoplasma coat the external surface of their vacuole with a secretory serine/threonine kinase, known as ROP18. At this host-pathogen interface, ROP18 phosphorylates and inactivates IRGs, thereby protecting the parasite from killing. These findings reveal a novel molecular mechanism by which the parasite disarms host innate immunity. (shrink)

Gestational surrogacy relies on a legal agreement between the surrogate and the intended parents to define the roles and responsibilities of the parties, including explicit consent by the surrogate to allow the physician to release all pregnancy-related medical information to the intended parents. In the event of surrogate misconduct, however, physicians may feel conflicted if the surrogate asks the physician to withhold information about potentially dangerous behaviour in pregnancy from the intended parents. While the American Society for Reproductive Medicine guidelines (...) may support disclosure over the objections of the surrogate, the authors argue that such disclosure is a violation of the surrogate’s rights and the physician’s ethical and professional duties. A surrogate’s confidentiality must be maintained as it is an essential element of the physician–patient relationship. (shrink)

Gestational surrogacy relies on a legal agreement between the surrogate and the intended parents to define the roles and responsibilities of the parties, including explicit consent by the surrogate to allow the physician to release all pregnancy-related medical information to the intended parents. In the event of surrogate misconduct, however, physicians may feel conflicted if the surrogate asks the physician to withhold information about potentially dangerous behaviour in pregnancy from the intended parents. While the American Society for Reproductive Medicine guidelines (...) may support disclosure over the objections of the surrogate, the authors argue that such disclosure is a violation of the surrogate’s rights and the physician’s ethical and professional duties. A surrogate’s confidentiality must be maintained as it is an essential element of the physician–patient relationship. (shrink)

This article explores the social frameworks guiding expert and nonexpert perspectives on medicines safety in the U.K. Scientific experts from the Committee on the Safety of Medicines and the Medicines Commission were interviewed, and three nonexpertgroups, including patients and health professionals, were studied by the administration of questionnaires and focused group discussions. The research examined to what extent these groups subscribed to technocratic or democratic approaches to medicines regula tion and how this might be related to values toward technological risk. (...) The results reveal that there is substantial divergence between expert and nonexpert perspectives on medicines regulation, and that this derives as much from value differences as from any informational deficits. However, there seems to be some scope for shared values between some experts and some nonexperts, especially as regards state secrecy. The article concludes by discussing how those values could be used to foster a new "social contract of expertise" in which scientists are more democratically accountable and patients take more responsibility in governing medical risks. (shrink)

The case and commentaries below were developed as part of a project, Graduate Research Ethics Education, undertaken by the Association for Practical and Professional Ethics with funding from the National Science Foundation (NSF Grant No. SBR 9421897 and NSF Grant No. 9817880). The project aims at training graduate students in research ethics and building a community of scientists and engineers who are interested in and capable of teaching research ethics. As part of the project, each graduate student participant develops (...) a case for use in teaching and writes a commentary to go with the case, and then a staff member is asked to write additional commentary on the case. The case below was written in the second year of the project and was published in Research Ethics: Cases and Commentaries edited by B. Schrag, Association for Practical and Professional Ethics, Bloomington, Indiana, Vol. II (1998). Publication of these cases and commentaries will be a recurring feature of Science and Engineering Ethics. (shrink)

This article delves into Captain Samuel Alfred Warner’s dogged campaign to sell two inventions – his submersible mine and “long range” missile – to the British government in the 1840s and 1850s. Departing from a historiography that dismisses Warner as a fraudster, it clarifies how he managed to generate widespread interest in his weapons technologies for nearly twenty years. I therefore analyze three key elements of his self-promotion: his personal branding, his pitch, and his simultaneous embrace and rejection of publicity. (...) Neither elite nor highly educated, Warner ran up against a culture of “polite science” that distinguished disinterested practitioners from profit-minded schemers. To establish his credentials, he emphasized his practical maritime experience and represented himself as a martyr willing to bear the scorn of a disbelieving establishment. In pitching his devices, Warner capitalized on alarmism over border security and the integrity of the empire; he declared that they could hobble France’s modernizing navy and quickly end colonial conflicts. When skeptics began to fret over the proliferation of his destructive weapons, Warner flipped the script and lauded the threat of mutual annihilation as a deterrent to needless warfare. The issue of publicity, however, would ultimately be Warner’s professional undoing. Despite successful demonstrations, his clashes with official investigators and his refusal to disclose his chemical secrets led critics to dispute the originality of his discoveries. An examination of Warner’s self-promotional strategies, his fraught interactions with the British state, and the ambivalent public reaction to his contraptions provides insight into how scientific authority was acquired and lost in this period. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Artist as Professional in JapanKazuyo Nakamura and Akio OkazakiThe Artist as Professional in Japan, edited by Melinda Takeuchi. Stanford, Calif.: Stanford University Press, 2004, 262pp., $45.00 cloth.With the increase of cross-cultural academic exchange in our time, more accurate information on art from other cultures has become more easily available, and curriculum development of art education directed toward multiculturalism has been brought to realization. There is (...) need emerging among art educators for academic resources for teaching cross-cultural subject matters, and The Artist as Professional in Japan provides historical information helpful in gaining a critical understanding of the nature of Japanese art discourse. The volume is edited from a fresh sociocultural perspective by Melinda Takeuchi, professor of Japanese art at Stanford University.Takeuchi, noticing that few scholarly books on the profession of Japanese artists are available to students of art history in the United States, set about the volume in concerted efforts with her colleagues. The volume consists of individual case studies on different Japanese artists; they are well-known sculptors, painters, potters, printmakers, and architects and are recognized in Japan as representative in different eras from the seventh to the twentieth century. Running through the individual studies, there is a concern for political forces that shaped art discourse and the identity of the Japanese artist. The following questions are asked: What degree of control did the artists exercise over their métier? What were some of the dynamics operating in the production, consummation, and evaluation of art and artist? How was the image of the artist formed during various periods? Working with these questions, seven case studies address issues of canon formation of art by looking into the terrain of the meaning of a critical word, Shoku-nin; it literally means people (nin) with an occupation (shoku) and denotes the collective artisan class.Different art historians and art theorists take a unique approach for developing each case study in the volume. Donald F. McCallum's study in chapter 2 is on the Buddhist Icons of the Shaka Triad during the Asuka Period (ca.590-ca.650), and it is asked what were the political forces working on the production of the [End Page 118] icons. In contrary to orthodox view, it is argued that the icons were produced not by an individual sculptor named Tori-busshi but by the guilds of which the supervisor was Tori. Also, it is argued that the icons were produced with the patronage of soga clan, the dominant political force of the time, not by the imperial family, including Shotoku Taishi.Karen L. Brock in chapter 3 examines the case of E'nichibo Jonin (active ca.1211-ca.1243), the painter of Saint Myoe. The case shows that the ateliers of temples, such as Kozanji in Kyoto, played a central role in producing and distributing sacred images. This study makes clear that few individual painters, such as those named ebusshi, participated in the formation of the canon of Japanese painting, but collective political forces, such as Kozanji ateliers, exercised power in bringing out sacred objects.In chapter 4 Melinda Takeuchi takes up the case of Tosa Mitsunobu (1434-ca.1523), an artisan painter active in Kyoto court circles. It shows a historical fact particular to Japanese art discourse—that later artists manipulated the names of earlier ones for professional or cultural merits. Taking notice of the fact that Mitsunobu's name late became synonymous with a production unit that shares secret techniques of products, Takeuchi concludes, "In the end, the name of an artist transcends time, space, materiality, and ultimately discourse itself" (101).The study of Louise Allison Cort in chapter 5 is on the case of Morita Kyuemon in the seventeenth century, a warrior trained as a potter and running the Odo pottery in the Tosa domain. By exploring the motivations of the Tosa domain in trying to transform local products into refined and stylish pottery worthy of formal presentation to other domain rulers (daimyo), to government officials, and to the shogun in Edo, this chapter demonstrates how both the potter and the ruler actively sought to join the aesthetic mainstream of their own day.In... (shrink)

A study of how Derrida's acts of eulogy articulate the Levinasian ethical demand with a psychoanalytic account of ghosts.

Economist-philosopher Amartya Sen's writings on social and political issues have attracted wide audiences. Section 2 introduces his contributions on: how people reason as agents within society; social determinants of people's (lack of) access to goods and of the effective freedoms and agency they enjoy or lack; and associated advocacy of self-specification of identity and high expectations for ‘voice’ and reasoning democracy. Section 3 considers his relation to social theory, his tools for theorizing action in society, and his limited degree of (...) attention to work by sociologists and to capitalism and power structures. Section 4 characterizes a style marked by conceptual refinement, emphases on complexity and individuality, including personal individuality, and reformist optimism. Section 5 shows the features from Sections 3 and 4 at work in his conception of personhood that advocates freedom to make a reasoned composition of personal identity. Similarly, Section 6 addresses his conception of public reasoning and neglect of the sociology of democracy. It contrasts the ideal of a reasoning polity with features in many countries. Sen's programmes for critical autonomy in personhood and for reasoned politics play, nevertheless, a normic role, while his analytical formats help investigation of obstacles to more widespread agency, voice, and democratic participation. (shrink)

The fundamental rules which should be followed by Notary Public are: honesty, reliability, detachment and impartiality, as well as keeping the professional secret. As a crucial participant in creating and carrying into effect legal structures of free market, Notary Public performs public functions. Therefore, he or she is authorized to give an official character to declarations of persons being their clients. In view of the foregoing, the notary should secure such documents in trading abiding by the rules and (...) regulations of the governing law and ethics. With a view to a special role of the profession in question in economic trade, The National Notary Board passed a Notary Public Code of Professional Ethics, by virtue whereof a Notary shall with their attitude and actions give a good character to their profession and mind its dignity and honor. Any breach of the above – mentioned rules results in the Notary’s liability. Notary Public, as a person whose functions play a crucial role in legal trade and who is trusted by the parties, is responsible for correctness and precision of their activities. Their liability as clients’ confidant may result in civil, legal, disciplinary and tax liability. (shrink)

In an era of fake news, alternative truths and leaked secrets making constant headlines, we are telling stories about ourselves all the time, and we are telling them in so many different ways. From vlogs and blogs to tweets and posts, from photos and gifs to live streams. From instant updates that disappear to rash words that last for ever and data trails that chart every step we take. While people around her shake their heads and mutter bad things about (...) the new levels of day-to-day deceit, Kathleen Wyatt is busy marvelling at how society manages it. How do we do this extraordinary thing - often under the most ordinary of circumstances? How do we convince each other to suspend disbelief? And why do we do it? In this brilliant, wide-ranging study of lies and lying, Wyatt introduces us to a cast of professionals and professional liars - from scientists to investigators, from double agents to journalists, from toddler specialists to a fallen titan of industry - all to help her prove a remarkable thesis: lies hold us together as much as they push us apart and may be vital in a healthy society"--Publisher's description. (shrink)

Health professionals, by agreeing to provide care, accept a fiduciary role that entails an obligation to preserve trust. We trust health professionals to be competent, to promote patient interests, and to properly utilize their discretionary power. While some health professionals argue that such activities as secretly screening for drugs or sexually transmitted diseases are necessary to fulfill their fiduciary obligations, these may actually constitute a breach of trust. In this paper, I argue that, in the specific case of Munchausen’s Syndrome (...) by Proxy, covert surveillance is ethically justifiable and does not constitute a breach of trust and an abuse of the fiduciary relationship. (shrink)

From the secrets of the universe to the healing powers of music, this book draws on the passions of eight professionals who explore the "power" behind their own particular fields of interest, from the arts and humanities to the natural sciences. Their essays span the fascinating world of microscopic biochemical machines; the power of the cinema screen; democracy; mathematical knot theory; innovative new ways of producing energy to meet increasing world demands as well as the power of life and death.

The secret worlds of life experience, culture, sexuality and emotions are often expressed through physical “symptoms”. The lived body becomes the entry point for professionals to enter the world of the patient. This article, arising out of a study of the experiences of Greek women at menopause, discusses the story of one woman and interprets the cultural and emotional inscriptions that are carried into the clinical setting. It illustrates the multiple layers of corporeal meaning engendered by menopause and the (...) clinical interactions surrounding it. It argues that the bodies that present themselves for consultation and examination are phenomenological memoirs of suffering, struggle and illness. Even in its most technical aspects medical practice cannot ignore the philosophies, values, goals and cultural experiences of those who seek its assistance. (shrink)

Peter Byrne tells the story of Hugh Everett III (1930-1982), whose "many worlds" theory of multiple universes has had a profound impact on physics and philosophy. Using Everett's unpublished papers (recently discovered in his son's basement) and dozens of interviews with his friends, colleagues, and surviving family members, Byrne paints, for the general reader, a detailed portrait of the genius who invented an astonishing way of describing our complex universe from the inside. Everett's mathematical model (called the "universal wave function") (...) treats all possible events as "equally real", and concludes that countless copies of every person and thing exist in all possible configurations spread over an infinity of universes: many worlds. Afflicted by depression and addictions, Everett strove to bring rational order to the professional realms in which he played historically significant roles. In addition to his famous interpretation of quantum mechanics, Everett wrote a classic paper in game theory; created computer algorithms that revolutionized military operations research; and performed pioneering work in artificial intelligence for top secret government projects. He wrote the original software for targeting cities in a nuclear hot war; and he was one of the first scientists to recognize the danger of nuclear winter. As a Cold Warrior, he designed logical systems that modeled "rational" human and machine behaviors, and yet he was largely oblivious to the emotional damage his irrational personal behavior inflicted upon his family, lovers, and business partners. He died young, but left behind a fascinating record of his life, including correspondence with such philosophically inclined physicists as Niels Bohr, Norbert Wiener, and John Wheeler. These remarkable letters illuminate the long and often bitter struggle to explain the paradox of measurement at the heart of quantum physics. In recent years, Everett's solution to this mysterious problem - the existence of a universe of universes - has gained considerable traction in scientific circles, not as science fiction, but as an explanation of physical reality. (shrink)

Liberal-Democratic changes in the Russian Society have brought a number of acute problems threatening national security and leading to converting Russia into a peripheral socio-cultural system («national self-identification crisis»). Scientific research shows that the main indicator of the said crisis is not only the critical economic differentiation of people into the «poor» and «rich» Russia (with the different ways of life, needs, mentality) but also spiritual degradation, spread of aggressive – depressive syndrome (growth of hatred, feeling of injustice, loss of (...) meaning of the life, anger, melancholy, hopelessness, loneliness etc.). Twothirds of the citizens (74.9%) interviewed in 2006 think that their social status does not correspond to their personal achievements in education and professional abilities. One of the main reasons of their distrust towards the government bodies is insufficient professional and cultural level, absence of unity of a word and business. It is worth mentioning that books and articles of scientists and ideologists who resist Western liberalism are freely published, but you can hardly see these people close to the President. Russians are openly and secretly under pressure of ideas propagandizing negative past which undermine national self-identification, national pride for the great history of their country. The original sphere of influence of Russian language and Russian culture is shortening under the press of mass-culture. Meanwhile, 67% of Russians expressed their negative attitude towards massive Western cultural expansion. The Futureof Russia is in safeguarding national intellectual and spiritual values, Science, education and in supporting the person of work and creativity. (shrink)

After revelations of participation by psychiatrists and psychologists in interrogation of prisoners at Guantánamo Bay and Central Intelligence Agency secret detention centers, the American Psychiatric Association and the American Psychological Association adopted Position Statements absolutely prohibiting their members from participating in torture under any and all circumstances, and, to a limited degree, forbidding involvement in interrogations. Some interrogations utilize very aggressive techniques determined to be torture by many nations and organizations throughout the world. This paper explains why psychiatrists and (...) psychologists involved in coercive interrogations violate the Geneva Conventions and the laws of the United States. Whether done with ignorance of professional ethical obligations or not, these psychiatrists and psychologists have crossed an ethical barrier that may best be averted from re-occurring by teaching medical students and residents in all medical specialties about the ethics principles stemming from the 1946–1947 Nuremberg trials and the Geneva Conventions, together with the Ethics Codes of the World Medical Association and the American Medical Association; and, with regard to psychiatric residents and psychological trainees, by the teaching about The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry and the Ethical Principles of Psychologists and Code of Conduct, respectively. In this way, all physicians and psychologists will clearly understand that they have an absolute moral obligation to "First, do no harm" to the human beings they professionally encounter. (shrink)

In 2005, Ethiopia changed its abortion law to curb its high maternal mortality. This has led to a considerable reduction in deaths from unsafe abortions. Abortion is now legal if the woman’s pregnancy is a result of rape or incest, if her health is endangered, if the fetus has a serious deformity, if she suffers from a physical or mental deficiency, or if she is under 18 years of age. The word of the woman, if in compliance with the law, (...) is sufficient to qualify for an abortion. In this context, where the law makes the door slightly open, health workers become important in deciding who gets access to safe services and who doesn’t, thus creating considerable ethical dilemmas. The objective of this study was to explore abortion service providers’ personal experiences and reflections, perceptions of the abortion law, and ethical and dilemmas that arise. Data collection took place from March to May 2016 in Addis Ababa, at different health clinics providing abortion services. Thirty in-depth interviews and three focus group discussions were conducted with 41 abortion service providers at governmental and non-governmental clinics. Content analysis was drawn upon in the interpretation of the findings. When working in a context where the law has slightly opened the door for abortion seeking women, the health workers describe conflicting concerns, burdensome responsibilities, and ambiguity concerning how to interpret and implement the law. They describe efforts to balance their religious faith and values against their professional obligations and concern for women’s health and well-being. This negotiation is particularly evident in the care of women who fall outside the law’s indications. They usually handle ethical dilemmas and decision-making alone without guidance. Moreover, many health workers face a stigma from fellow colleagues not performing abortions and therefore keep their job a secret from family and friends. Health workers in Ethiopia experience ethical dilemmas trying to maneuver between the abortion law, their personal values, and their genuine concern for the health of women. More research is needed to further explore this. (shrink)

Background: The introduction of healthcare AI to society as well as the clinical setting will improve individual health statuses and increase the possible medical choices. AI can be, however, regarded as a double-edged sword that might cause medically and socially undesirable situations. In this paper, we attempt to predict several negative situations that may be faced by healthcare professionals, patients and citizens in the healthcare setting, and our society as a whole. Discussion: We would argue that physicians abuse healthcare AI (...) through their excessive and dependent use of it, and they will focus only on the AI services in their office and patient medical data and information, and forget to observe the patient in their clinical encounters. In the era of AI introduction, data from the wearable terminal or AI advice will become the primary target of the physician’s interest, and could be regarded as a patient surrogate. Paternalism would be paradoxically resurrected by the introduction of state-of-the-art AI. A physician’s conflict of interest related to AI as a commercial product could strongly influence his or her actions in clinical settings. We also worry that the general public will become uneasy and hypersensitive slaves to information, compulsively and uninterruptedly requesting healthcare information concerning their own health and advice from AI. An AI system capable of expressing proper and timely empathy to suffering patients could deprive healthcare professionals of their roles in terms of hospitality and emotional exchange. Finally, entire societies would soon share and consolidate healthcare sensitive information from all in the general public as part of a totalitarian healthcontrolled society where individual privacy and personal secrets could be neglected. The advent of the healthcontrolled society could lead to the metamorphosis of the concept of privacy itself into something completely different. Conclusion: Although AI which surpasses human healthcare professionals may never appear, hoping for the best and preparing for the worst is the best approach to take. To this end, we present some potential countermeasures including conducting clinical research and social investigations concerning problems surrounding the introduction of AI and developing guidelines for its appropriate use. (shrink)

The best studies on the relationship between pharmaceutical corporations and medicine have recognized that it is an ambiguous one. Yet most scholarship has pursued a simpler, more saleable narrative in which pharma is a scheming villain and medicine its maidenly victim. In this article, I argue that such crude moral framing blunts understanding of the murky realities of medicine's relationship with pharma and, in consequence, holds back reform. My goal is to put matters right in respect to one critical area (...) of scholarly interest, the medical journal publication.Pharma relies on peer advocacy to sell its wares to prescribing doctors. This is an arrangement in which clinicians’ qualified colleagues, including “key opinion leaders,” are recruited by pharmaceutical corporations and marketing agencies to deliver commercially expedient content to their professional fellows. Precisely how this practice works in the setting of publications is not well understood because ethicists studying the problem have made too much of the narrative of corporate villainy and medical victimhood. Accordingly, criticism of industry publications has been preoccupied with the crudely dishonest practices of ghostwriting, ghost authorship, and “ghost management,” vices condemned as “dirty little secrets” perpetrated from “behind the scenes” with the connivance of academic “shills” or “guest authors,” in contempt of standards set by the International Committee of Medical Journal Editors. This account is appealing, and yet it is wrong or, at the very least, seriously incomplete, with only limited relevance to the actualities of contemporary industry practices. In truth, many commercial publications are not developed in secret but fashioned within a culture of open collaboration, where academic authors make substantial, independent contributions; pharmaceutical companies are showcased rather than hidden; and medicine's editorial standards assist rather than impede the workings of commerce. (shrink)

Viewing animals as a disposable resource is by no means novel, but does milking the cow for all its worth now represent a previously unimaginable level of exploitation? New technology has intensified milk production fourfold over the last 50 years, rendering the cow vulnerable to various and frequent clinical interventions deemed necessary to meet the demands for dairy products. A major question is whether or not the veterinary code of practice fits, or is in ethical tension, with the administration of (...) ‘efficient’ techniques, such as artificial insemination, to enhance reproduction levels among cattle? Vets perform these interventions and their ‘success’ is measured by the maximisation of milk production, requiring perpetually pregnant cows. Our empirical research on 33 farm vets explores how their professional ethical code promising to protect the welfare of the animal ‘above all else’, is increasingly in conflict with, and subordinate to, the financial demands of clients. Since vets cannot stand outside of the productive power–knowledge relations that have intensified the consumption of animal bodily parts and secretions, we argue that a process of adiaphorization’ occurs, whereby humans become morally indifferent to cruel practices deemed necessary to our consumerist ways of life. However, this indifference reflects and reinforces a taken-for-granted anthropocentrism among vets, animal owners and the population generally. We suggest that posthumanist ideas may offer new insights for the study of human–animal relations in organisations that transcend the coercive and negative impact of discourses that deny any alternative to prevailing farm/veterinary practices. Our study has major implications in relation to climate warming and zoonotic diseases, both partly derived from our unethical relationship to animals, that are increasingly threatening our, and their, lives. (shrink)

Drawing on research data from a recent project, this paper reveals how cultural, organizational, professional and personal dimensions of time affect nurses’ availability to care and patients’ experiences of being cared for. Here, I will philosophize these dimensions of time through both the philosophical stance of the research methodology used in the study – phenomenological hermeneutics – and by engaging in philosophical theory that explores and challenges nurse and patient talk during interview. Patients’ experiences of time tend to be (...) embodied, whereas nurses choose between a disembodied structure of linear clock time or an embodied more spiritual experienced sense of time. To capture differences and their significance to caring, this paper first explores the way cursive time shapes and controls caring encounters. Following this, research data will be explored to demonstrate how an expanded notion of time as both cursive and circular enables nurses to sense patients’ illness patterns and to move with the ebb and flow of patients’ life/illness experiences. Next, the moment or the act of caring is explored as a presence, as a moral stance or presencing of the nurse for the patient. Finally, the notion of timelessness or what Kristéva calls ‘monumental time’ is explored in the context of the nurse/patient giving and gifting relationship, particularly their giving/gifting of voice and words to each other. Sensual, cultural and historical appreciation of these time dimensions is invited through the use of visual imagery. Exposure of the limitations, locations and dislocations of language reveals the therapeutic power of silence, quiet and stillness. Consequently, poetry will be used to expand the visual imagery and engage the reader in the silence from which words emerge, and the silence that lives between and within words, the silence of timelessness. O O’Donohue says ‘When we forget or neglect this silence we empty our world of its secret and subtle presences’. (shrink)

"Younker delves into and illustrates every aspect of Putman's life: how he works, what he does to relax, how he interacts with family and friends. He shows how Putman fished, divulging some of the secrets of the professional fisherman. Examining this fisherman's life - as well as the lives of his relatives and friends - Younker demonstrates Putman's skill as colorful storyteller with a rich vocabulary. Putman proved forthright when expressing his views about life, river lore, and the changing (...) ecology."--Jacket. (shrink)

The UN Convention against Torture defines torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person” by someone acting in an official capacity for purposes such as obtaining a confession or punishing or intimidating that person.1 It is unethical for healthcare professionals to participate in torture, including any use of medical knowledge or skill to facilitate torture or allow it to continue, or to be present during torture.2-7 Yet medical participation (...) in torture has taken place throughout the world and was a prominent feature of the US interrogation practice in military and Central Intelligence Agency (CIA) detention facilities in the years after the attacks of 11 September 2001.8-11 Little attention has been paid, however, to how a regime of torture affects the ability of health professionals to meet their obligations regarding routine clinical care for detainees. -/- The 2016 release of previously classified portions of guideline from the CIA regarding medical practice in its secret detention facilities sheds light on that question. These show that the CIA instructed healthcare professions to subordinate their fundamental ethical obligations regarding professional standards of care to further the objectives of the torturers. (shrink)

A compact, full-color companion guide to photographing San Francisco! Whether using a full-featured compact camera or a high-end dSLR, this companion guide provides you with detailed information for taking stunning shots of beautiful San Francisco. Whether you aim to capture breathtaking photos of the majestic Golden Gate Bridge, crooked Lombard Street, infamous Alcatraz, or unique Victorian homes, this portable resource goes where you go and walks you through valuable tips and techniques for taking the best shot possible. You'll discover suggested (...) locations for taking photos, recommended equipment, what camera settings to use, best times of day to photograph specific attractions, how to handle weather challenges, and more. In addition, lovely images of San Francisco's most breathtaking attractions and recognizable landmarks serve to both inspire and assist you as you embark on an amazing photographic adventure! Elevates your photography skills to a new level with photography secrets from professional photographer Bruce Sawle Presents clear, understandable tips and techniques that span all skill levels, using all types of digital cameras, from compacts to high end DSLRs Features San Fransisco's main attractions in alphabetical order as well as thumb tabs on the pages so you can quickly and easily access the information you are looking for Shares detailed information and insight on critical topics, such as ideal locations to photograph from, the best time of day to shoot, camera equipment to have handy, weather conditions, and optimal camera settings to consider Whether you're a local familiar with the territory or a visitor seeing San Francisco for the first time, this handy guide will help you capture fantastic photos! (shrink)

Create family portraits to cherish for a lifetime Family photographs are a staple of both amateur and professionalphotography. While always in demand, they also pose a unique set ofchallenges. In this book, Canon Explorer of Light Michele Celentanoguides beginning- to intermediate-level photographers around thecommon pitfalls and helps them learn how to get top-quality shotsevery time. From getting families organized and directing theposing to managing large groups and impatient kids, this bookreveals the secrets and helps you capture the shot without relyingon (...) post-production to achieve perfection. Whether you're a professional seeking to advance your knowledgeor the family's designated picture-taker, you'll benefit from theseprofessional tips. You'll learn camera techniques that can takepounds and years off your subjects and create images that stand thetest of time. Family pictures are a photographic staple with their own set ofchallenges; this book offers tried-and-true advice for bothhobbyists and professionals Veteran photographer and Canon Explorer of Light MicheleCelentano guides you through getting families prepared for a photosession, directing the poses, handling challenging personalities,and creating memorable settings Helps you capture the perfect shot in the camera withoutrelying on post-production to make it right Reveals secrets that can help your subjects shed pounds andyears Packed with advice to help you keep your photos from showing upon awkwardfamilyphotos.com Photographing Families: Tips for Capturing TimelessImages is loaded with insider tips to help you make familyportraits the treasure they should be. (shrink)