A general practice research project on ethics is underway at the University of New South Wales, funded by GPEP. Ethical issues, as defined and explored by general practitioners and consumers, are being examined across four areas of Sydney.So far, telephone interviews have been conducted with a random sample of general practitioners. Face-to-face interviews have been conducted with 107 consumers, randomly sampled using ABS collection district information. Focus groups have been formed to discuss acceptable solutions to GP and consumer identified ethical (...) issues. This report will report on some preliminary findings to date and will explore professional and consumer roles in the formation of ethical solutions. (shrink)

A general practice research project on ethics is underway at the University of New South Wales, funded by GPEP (General Practice Evaluation Program, Commonwealth Department of Human Services and Health, GPEP 386). Ethical issues, as defined and explored by general practitioners and consumers, are being examined across four areas of Sydney.So far, telephone interviews have been conducted (64% response rate) with a random sample of general practitioners (GPs). Face-to-face interviews have been conducted with 107 consumers, randomly sampled using ABS collection (...) district information. Focus groups have been formed to discuss acceptable solutions to GP and consumer identified ethical issues. This report will report on some preliminary findings to date and will explore professional and consumer roles in the formation of ethical solutions. (shrink)

OBJECTIVES: In treating critically ill neonates, situations occasionally arise in which aggressive medical treatment prolongs the inevitable death rather than prolonging life. Decisions as to limitation of neonatal medical intervention remain controversial and the primary responsibility of the generally unprepared family. This research was designed to study response patterns of expectant mothers towards treatment of critically ill and/or malformed infants. DESIGN/SETTING: Attitudes were studied via comprehensive questionnaires divided into three sections: 1-Sociodemographic data and prior personal experience with perinatal problems; 2-Theoretical (...) philosophical principles used in making medical ethical decisions; and 3-Hypothetical case scenarios with choices of treatment options. SUBJECTS AND RESULTS: Six hundred and fifty pregnant women were studied. Maternal birthplace (p = 0.005) and level of religious observance (p = 0.02) were strongly associated with the desire for maximally aggressive medical intervention in the hypothetical case scenario. Specific personal experiences such as infertility problems, previous children with serious mental or physical problems were not correlated with the selection of different treatment choices. Of the theoretical principles studied, only the desire to preserve life at all costs was significantly associated with the choice for maximal medical treatment (p = 0.003). CONCLUSIONS: Maternal ethnocultural background and philosophical principles more profoundly influenced medical ethical decision-making than did specific personal life experiences. (shrink)

A frequently recounted episode in early modern medicine concerns the physician Helvetius's introduction of ipecacuanha to French medical practice after curing Louis XIV's son of dysentery using this medicinal drug. To this day, the Helvetius story remains riven with contradictions, obscurity, and confusion, even down to the nature of the drug involved. This article, challenging histories of “information” as homogeneous and neutral, explores how Helvetius's reputation as a physician and pharmaceutical entrepreneur was crafted through print and correspondence. Rather than seeking (...) to establish a definitive account of “what actually happened,” it addresses the ways in which different media shaped and mediated the politics of knowledge surrounding Helvetius and his drug. Considerations of intellectual and commercial property inflected medical knowledge in different ways, producing distinct strategies of publicity. While Helvetius capitalized on courtly connections to promote himself and his drug, rivals eyed the Republic of Letters as an alternate route for establishing natural knowledge-claims. Yet the arch-newsmonger of the Republic of Letters, Leibniz, elected to preserve the connection between Helvetius and ipecacuanha in print. I argue that Leibniz's actions stemmed from a view of the public domain that downplayed discovery and emphasized disclosure of medical secrets in the public interest. (shrink)

The origin of marine invertebrate larvae has been an area of controversy in developmental evolution for over a century. Here, we address the question of whether a pelagic “larval” or benthic “adult” morphology originated first in metazoan lineages by testing the hypothesis that particular gene co-option patterns will be associated with the origin of feeding, indirect developing larval forms. Empirical evidence bearing on this hypothesis is derivable from gene expression studies of the sea urchin larval gut of two closely related (...) but differently developing congenerics, Heliocidaris tuberculata (feeding indirect-developing larva) and H. erythrogramma (nonfeeding direct developer), given two subsidiary hypotheses. (1) If larval gut gene expression in H. tuberculata was co-opted from an ancestral adult expression pattern, then the gut expression pattern will remain in adult H. erythrogramma despite its direct development. (2) Genes expressed in the larval gut of H. tuberculata will not have a coordinated expression pattern in H. erythrogramma larvae due to loss of a functional gut. Five structural genes expressed in the invaginating archenteron of H. tuberculata during gastrulation exhibit substantially different expression patterns in H. erythrogramma with only one remaining endoderm specific. Expression of these genes in the adult of H. erythrogramma and larval gut of H. tuberculata, but not in H. erythrogramma larval endoderm, supports the hypothesis that they first played roles in the formation of adult structures and were subsequently recruited into larval ontogeny during the origin and evolution of feeding planktotrophic deuterostome larvae. (shrink)