Over the past 35 years, patients have suffered from a largely hidden epidemic of side effects from drugs that usually have few offsetting benefits. The pharmaceutical industry has corrupted the practice of medicine through its influence over what drugs are developed, how they are tested, and how medical knowledge is created. Since 1906, heavy commercial influence has compromised congressional legislation to protect the public from unsafe drugs. The authorization of user fees in 1992 has turned drug companies into the FDA's (...) prime clients, deepening the regulatory and cultural capture of the agency. Industry has demanded shorter average review times and, with less time to thoroughly review evidence, increased hospitalizations and deaths have resulted. Meeting the needs of the drug companies has taken priority over meeting the needs of patients. Unless this corruption of regulatory intent is reversed, the situation will continue to deteriorate. We offer practical suggestions including: separating the funding of clinical trials from their conduct, analysis, and publication; independent FDA leadership; full public funding for all FDA activities; measures to discourage R&D on drugs with few, if any, new clinical benefits; and the creation of a National Drug Safety Board. (shrink)
Institutional corruption is a normative concept of growing importance that embodies the systemic dependencies and informal practices that distort an institution’s societal mission. An extensive range of studies and lawsuits already documents strategies by which pharmaceutical companies hide, ignore, or misrepresent evidence about new drugs; distort the medical literature; and misrepresent products to prescribing physicians. We focus on the consequences for patients: millions of adverse reactions. After defining institutional corruption, we focus on evidence that it lies behind the epidemic of (...) harms and the paucity of benefits. (shrink)
Discrimination against women and other vulnerable groups prevailed throughout the twentieth century; it persists today. This historical case study analyzes the life and times of “Typhoid Mary,” an unmarried, Irish Catholic, immigrant woman who was persecuted as an intransigent carrier of a deadly infectious disease. Being a Mexican immigrant, Muslim, or unattractive woman could condemn someone for similar mistreatment today. The failure to overcome prejudice impedes the effectiveness of public health to protect infected patients and susceptible persons from harm and (...) to interrupt disease transmission in communities; it jeopardizes the realization of social quality. Social justice, solidarity, equal valuation, and human dignity will be achieved through resistance to the human rights violations of the Trump administration and the resilience of strong women like Mary Mallon. (shrink)
Preparing the Next Generation of Oral Historians is an invaluable resource to educators seeking to bring history alive for students at all levels. Filled with insightful reflections on teaching oral history, it offers practical suggestions for educators seeking to create curricula, engage students, gather community support, and meet educational standards. By the close of the book, readers will be able to successfully incorporate oral history projects in their own classrooms.
“Punishment,” writes J. E. McTaggart, “ is pain and to inflict pain on any person obviously [requires] justification.” But if the need to justify punishment is obvious, the manner of doing so is not. Philosophers have developed an array of diverse, often conflicting arguments to justify punitive institutions. Gertrude Ezorsky introduces this source book of significant historical and contemporary philosophical writings on problems of punishment with her own article, “The Ethics of Punishment.” She brings together systematically the important papers and (...) relevant studies from psychology, law, and literature, and organizes them under five subtopics: concepts of punishment, the justification of punishment, strict liability, the death penalty, and alternatives to punishment. Under these general headings forty-two papers are presented to give philosophical perspectives on punishment. Included are many not generally available. This book brings together in a single volume the views of such diverse writers as Plato, St. Thomas Aquinas, Samuel Butler, Karl Marx, and Lady Barbara Wooten. Others are J. Andenaes, K. G. Armstrong, John Austin, Kurt Baier, Jeremy Bentham, F. H. Bradley, Richard Brandt, Clarence Darrow, A. C. Ewing, Joel Feinberg, “The Hon. Mr. Gilpin,” H. L. A. Hart, G. W. F. Hegel, Thomas Hobbs, Immanuel Kant, J. D. Mabbott, H. J. McCloskey, J. E. McTaggart, R. Martinson, G. E. Moore, Herbert Morris, Anthony Quinton, D. Daiches Raphael, H. Rashdall, John Rawls, W. D. Ross, Royal Commission on Capital Punishment Report 1949–53, George Bernard Shaw, T. L. S. Sprigge, and R. Wasserstrom. (shrink)
Social media and Internet technologies present several emerging and ill-explored issues for a modern healthcare workforce. One issue is patient-targeted Googling, which involves a healthcare professional using a social networking site or publicly available search engine to find patient information online. The study’s aim was to address a deficit in data and knowledge regarding PTG, and to investigate medical student use of SNSs due to a close association with PTG. The authors surveyed final year medical students at the Otago Medical (...) School, University of Otago in January 2016. A subset completed focus groups that were analysed using thematic analysis to identify key themes relating to students’ attitudes towards PTG, and reasons why they might engage in PTG. Fifty-four students completed the survey, which showed that PTG was uncommon. Attitudes were varied and context dependent. Most participants saw problems with PTG and favoured more explicit guidance on the issue. SNS usage was high ; participants were concerned by the content of their SNS profiles and who they were connecting with online. Participants showing high SNS use were 1.83 times more likely to have conducted PTG than lower use groups. The diverse attitudes uncovered in this study indicated that teaching or guidelines could be useful to healthcare professionals considering PTG. Though ethically problematic, PTG may be important to patient care and safety. The decision to conduct PTG should be made with consideration of ethical principles and the intended use of the information. (shrink)
Proposed here is that an overriding principle of nature governs all population behavior; that a single tenet drives the many regimes observed in nature—exponential-like growth, saturated growth, population decline, population extinction, and oscillatory behavior. The signature of such an all embracing principle is a differential equation which, in a single statement, embraces the entire panoply of observations. In current orthodox theory, this diverse range of population behaviors is described by many different equations—each with its own specific justification. Here, a single (...) equation governing all the regimes is proposed together with the principle from which it derives. The principle is: The effect on the environment of a population’s success is to alter that environment in a way that opposes the success. Experiments are suggested which could validate or refute the theory. Predictions are made about population behaviors. (shrink)
Background Social media and Internet technologies present several emerging and ill-explored issues for a modern healthcare workforce. One issue is patient-targeted Googling, which involves a healthcare professional using a social networking site or publicly available search engine to find patient information online. The study’s aim was to address a deficit in data and knowledge regarding PTG, and to investigate medical student use of SNSs due to a close association with PTG. Method The authors surveyed final year medical students at the (...) Otago Medical School, University of Otago in January 2016. A subset completed focus groups that were analysed using thematic analysis to identify key themes relating to students’ attitudes towards PTG, and reasons why they might engage in PTG. Results Fifty-four students completed the survey, which showed that PTG was uncommon. Attitudes were varied and context dependent. Most participants saw problems with PTG and favoured more explicit guidance on the issue. SNS usage was high ; participants were concerned by the content of their SNS profiles and who they were connecting with online. Participants showing high SNS use were 1.83 times more likely to have conducted PTG than lower use groups. Conclusions The diverse attitudes uncovered in this study indicated that teaching or guidelines could be useful to healthcare professionals considering PTG. Though ethically problematic, PTG may be important to patient care and safety. The decision to conduct PTG should be made with consideration of ethical principles and the intended use of the information. (shrink)
This year marks the 80 th anniversary of Clarence Darrow’s brilliant and passionate defense of Nathan Leopold and Richard Loeb, two wealthy teenagers who pled guilty to the kidnapping and murder of 14 year old Bobby Franks. On August 22, 1924 Darrow gave his famous twelve hour closing statement, bringing tears to the eyes of the presiding judge and saving his clients from the death penalty. Here are two excerpts from the summation.
Burns, C. R. Introduction.--Antiquity: Margalith, D. The ideal doctor as depicted in ancient Hebrew writings. Edelstein, L. The Hippocratic oath. Edelstein, L. The professional ethics of the Greek physician. Michler, M. Medical ethics in Hippocratic bone surgery. Maas, P. L., Oliver, J. H. An ancient poem on the duties of a physician.--The medieval era: Levey, M. Medical deontology in ninth century Islam. Bar-Sela, A., Hoff, H. E. Isaac Israeli's fifty admonitions of the physicians. Rosner, F. The physician's prayer attributed to (...) Moses Maimonides. MacKinney, L. C. Medical ethics and etiquette in the early middle ages, the persistence of Hippocratic ideals. Welborn, M. C. The long tradition, a study in fourteenth-century medical deontology.--The modern period: Larkey, S. V. The Hippocratic oath in Elizabethan England. Pleadwell, F. L. Samuel Sorbiere and his Advice to a young physician. Clark, G. Bernard Mandeville, M.D., and eighteenth-century ethics. Burns, C. R. Thomas Percival, medical ethics or medical jurisprudence? Burns, C. R. Reciprocity in the development of Anglo-American medical ethics, 1765-1865. Williams, T. F. Cabot, Peabody, and the care of the patient. (shrink)
This article sets out to show that it is more precise to speak of different liberal traditions than it is to speak of liberalism in general. The argument is pursued by showing how contrary to French liberalism, which has a strong republican element, and in contrast with English and Scottish liberalism, which reserve an important place for political economy, there is also a central European liberalism with a marked philosophical dimension. This particular form of liberalism is analysed by examining the (...) writings of Kant, Simmel and Freud. It is stated at the outset that critiques of liberalism often fail to appreciate the richness and diversity of liberal thinking, and that this depth must be borne in mind in any effective critique. It is explained that there are indeed grounds to critique liberal thought and practice, but that these grounds are obscured by lumping distinct and heterogeneous traditions together as if they all suffered from the same defects. (shrink)
This paper looks at key points of convergence and divergence in Hegel and Adorno on the question of the dialectics of humanity and nature as these unfold in institutions. Bearing in mind the distinct historical periods in which they worked, particular attention is paid to the ways in which their respective epistemologies deliver very different assessments of social and political life in modern societies. This is illustrated by contrasting Hegel's notion of recognition with the utopian dimension of Adorno's ideas on (...) non-identity and mimetic reconciliation. It is shown that in opposition to those who regard Adorno exclusively as a philosopher and aesthetic theorist, his ideas have social and juridical relevance, as well as continuing resonance in the history of political thought. (shrink)