From the title, Deadly Medicines and Organised Crime: How Big Pharma has Corrupted Healthcare, Peter Gøtzsche makes the thesis of his book very clear. Not only does the pharmaceutical industry contribute to detrimental health outcomes through biased research, deceptive marketing, and disease mongering, but the industry’s business model meets the criteria of an organized criminal operation. Gøtzsche argues for this in two parts. First, he defines organized crime by drawing upon the United States Organized Crime Control Act of 1970, (...) the centerpiece of which is the Racketeer Influenced and Corrupt Organizations Act. RICO prohibits deriving income from a pattern of racketeering... (shrink)
Now in its fourth edition, Rational Diagnosis and Treatment: Evidence-Based Clinical Decision - Making is a unique book to look at evidence-based medicine and the difficulty of applying evidence from group studies to individual patients._ The book analyses the successive stages of the decision process and deals with topics such as the examination of the patient,_the reliability of clinical data, the logic of diagnosis, the fallacies of uncontrolled therapeutic experience and the need for randomised clinical trials and meta-analyses. It is (...) the main theme of the book that, whenever possible, clinical decisions must be based on the evidence from clinical research, but the authors also explain the pitfalls of such research and the problems involved in applying evidence from groups of patients to the individual patient._ For this new edition, the sections on placebo and meta-analysis and on alternative medicine have been thoroughly updated, and there is more focus on insufficient reporting of harms of interventions. The sections on different research designs describe advantages and limitations, and the increased medicalisation and the effects of cancer screening on health people are noted. A section on academic freedom when clinicians collaborate with industry and ghost authors is added._ This essential reference work integrates the science and statistical approach of evidence-based medicine with the art and humanism of medical practice; distinguishing between data, sets of data, knowledge and wisdom, and their application. Such an intellectually challenging book is ideal for both medical students and doctors who require theoretical and practical clinical skills to help ensure that they apply theory in practice. (shrink)
BackgroundHealthcare professionals are exposed to advertisements for prescription drugs in medical journals. Such advertisements may increase prescriptions of new drugs at the expense of older treatments even when they have no added benefits, are more harmful, and are more expensive. The publication of medical advertisements therefore raises ethical questions related to editorial integrity.MethodsWe conducted a descriptive cross-sectional study of all medical advertisements published in the Journal of the Danish Medical Association in 2015. Drugs advertised 6 times or more were compared (...) with older comparators: comparative evidence of added benefit; Defined Daily Dose cost; regulatory safety announcements; and completed and ongoing post-marketing studies 3 years after advertising.ResultsWe found 158 medical advertisements for 35 prescription drugs published in 24 issues during 2015, with a median of 7 advertisements per issue. Four drug groups and 5 single drugs were advertised 6 times or more, for a total of 10 indications, and we made 14 comparisons with older treatments. We found: ‘no added benefit’ in 4 of 14 comparisons, ‘uncertain benefits’ in 7, and ‘no evidence’ in 3 comparisons. In no comparison did we find evidence of ‘substantial added benefit’ for the new drug; advertised drugs were 2 to 196 times more expensive per Defined Daily Dose; 11 safety announcements for five advertised drugs were issued compared to one announcement for one comparator drug; 20 post-marketing studies were requested for the advertised drugs versus 10 studies for the comparator drugs, and 7 studies assessed both an advertised and a comparator drug at 3 year follow-up.Conclusions and relevanceIn this cross-sectional study of medical advertisements published in the Journal of the Danish Medical Association during 2015, the most advertised drugs did not have documented substantial added benefits over older treatments, whereas they were substantially more expensive. From January 2021, the Journal of the Danish Medical Association no longer publishes medical advertisements. (shrink)
ObjectivesTo determine to which degree industry partners in randomised clinical trials own the data and can constrain publication rights of academic investigators.MethodsCohort study of trial protocols, publication agreements and other documents obtained through Freedom of Information requests, for a sample of 42 trials with industry involvement approved by ethics committees in Denmark. The main outcome measures used were: proportion of trials where data was owned by the industry partner, where the investigators right to publish were constrained and if this was (...) mentioned in informed consent documents, and where the industry partner could review data while the trial was ongoing and stop the trial early.ResultsThe industry partner owned all data in 20 trials and in 16 trials it was unclear. Publication constraints were described for 30 trials and this was not communicated to trial participants in informed consent documents in any of the trials. In eight trials the industry partner could review data during the trial, for 20 trials it was unclear. The industry partner could stop the trial early without any specific reason in 23 trials.ConclusionsPublication constraints are common, and data is often owned by industry partners. This is rarely communicated to trial participants. Such constraints might contribute to problems with selective outcome reporting. Patients should be fully informed about these aspects of trial conduct. (shrink)
Conflicts of interest affect recommendations in clinical guidelines and disclosure of such conflicts is important. However, not all conflicts of interest are disclosed. Using a public available disclosure list we determined the prevalence and underreporting of conflicts of interest among authors of clinical guidelines on drug treatments.
Contention in the form of protests, riots, and direct action is a central political practice in contemporary democracies. It is also a staple of sociological analysis, after slowly crystallizing as a distinct object of analysis from the 1970s onward. Lately, however, it has become unclear what this distinctiveness consists of and how it may help guide studies of contention: What distinguishes contention from other practices? I argue that contention can be seen as an ontologically distinctive experience. What sets this experience (...) apart is that it expresses a potential for conflict that underlies all social formations. We can take these expressions of conflict as objects of analysis. This means asking how the conflict expressed in contentious practices is ascribed meaning. I develop this perspective theoretically and show how it may facilitate new empirical analyses of contention’s boundaries, its relation to truth, and ethical relations in contention. (shrink)
Background: In this study, we aimed to investigate the effects of a mindfulness program including Mindfulness-Based Stress Reduction on the mental health of student teachers when offered at their educational institution in a real-life context.Methods: A parallel randomized controlled trial was conducted among self-selected student teachers at a Danish undergraduate program for teacher education in the autumns of 2019 and 2020. Participation was not recommended in case of clinical depression or a diagnosis of psychosis or schizophrenia, abuse of alcohol, drugs, (...) and/or medicine. Randomization was performed by a Statistician who was blinded to the identity of the students. Data was collected using self-reported questionnaires. The primary outcome was a change in perceived stress 3 months from baseline. Secondary outcome measures were symptoms of anxiety and depression, well-being, resilience, mindfulness, and thoughts and feelings during rest. The effects were analyzed according to the intention-to-treat principle using mixed-effect linear regression models. Mediating effects of mindfulness skills on the mental health outcomes were explored using structural equation modeling.Results: The study group included 67 student teachers with 34 allocated to the intervention group ; and 33 students allocated to a waiting list control group. At baseline, mean Perceived Stress Scale scores were 18.88 in the intervention group and 17.91 in the waiting list control group. A total of 56 students completed the questionnaire at a 3-month follow-up. Statistically significant effects of the intervention were found on perceived stress, symptoms of anxiety and depression, well-being, and on three of seven resting-state dimensions. No effects were found on resilience or mindfulness. Statistically significant mediated effects via resting-state dimensions were found.Conclusion The findings suggested that offering a mindfulness program at an undergraduate program for teacher education could significantly improve the mental health among self-selected students within 3 months. Results of mediation analysis supported the hypothesis that some of the effects might be explained by reduced distracting thoughts.Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT04558099]. (shrink)
Woolcock, Peter G A topic much exercising the minds of religious believers at the moment is whether or not science and religion are natural enemies. The Religion and Ethics program on the ABC's Radio National, for example, has recently provided access on its website to a series of articles on the topic, with titles such as Science or Naturalism? The Contradictions of Richard Dawkins; Christianity and the Rise of Western Science; Did Darwin Defeat God?; Does Science Make Belief in (...) God Obsolete?; Does Science Preclude Belief in Science; Genesis Created Science; Lawrence Krauss's Deficiencies; Theology Must Save Science from Naturalism, just to mention a few. As these titles suggest, the Religion and Ethics program is clearly on a mission to defend religion against the onslaught of philosophical materialism, presenting (as it does) only articles that argue either for the compatibility of science and religion or for the dependence of science on religion. My aim here is to redress the balance. Yes, science and religion are best understood as natural enemies. (shrink)
In this important book Peter G. Brown seeks to chart a new future for the species that share the earth. He offers an innovative, yet historically grounded, argument for human rights to bodily integrity; to moral, religious, and political choice; and to subsistence that all persons owe each other irrespective of nationality. He also argues that we have direct moral obligations to non-humans - he calls this 'respect for the commonwealth of life'. Honouring these obligations requires a thorough regrounding (...) of human institutions. Through a series of careful arguments the reader is shown: *How we could reconceptualise economics from a growth orientation to an economics of stewardship as a moral end.*How governments could be thought of as trustees to protect human rights and commonwealth of life.*How civil society could be organised and property rights reconceptualised in service of these objectives.The book concludes with the argument that traditional prerogatives of nation states need to be transparent to enforceable international standards concerning human rights and the commonwealth of life, and offers a practical agenda for beginning this fundamental reorientation. (shrink)
Peter G. Brown and Jeremy J. Smith (eds): Water Ethics: Foundational Readings for Students and Professionals Content Type Journal Article Pages 1-3 DOI 10.1007/s10806-011-9310-x Authors Neelke Doorn, Department of Technology Policy and Management, Section of Philosophy, 3TU. Centre of Ethics and Technology/Delft University of Technology, PO Box 5015, 2600 GA Delft, The Netherlands Journal Journal of Agricultural and Environmental Ethics Online ISSN 1573-322X Print ISSN 1187-7863.
More than thirty-five years ago, a longitudinal study was established to research the health and well-being of older people living in an English city. Self and Meaning in the Lives of Older People provides a unique set of portraits of forty members of this group who were interviewed in depth from their later seventies onwards. Focusing on sense of self-esteem and, especially, of continued meaning in life following the loss of a spouse and onset of frailty, this book sensitively illustrates (...) these persons' efforts to maintain independence, to continue to have a sense of belonging and to contribute to the lives of others. It examines both the psychological and the social resources needed to flourish in later life and draws attention to this generation's ability to benefit from strong family support and from belonging to a faith community. In conclusion, it questions whether future generations will be as resilient. (shrink)
A selective view of the relationship of censorship and free speech to the individual and society. The author does not take for granted that censorship is wrong, but equally what he has written is in no way an apology for censorship. He offers no solution to the problem of the proper extent of censorship in a society. Instead, he hopes to show that censorship, and more widely, other restrictions on freedom, cannot be considered in a self-contained way but have implications (...) of which the advocate of unrestricted freedom for the individual in matters of opinion seems surprisingly unaware. (shrink)
There is a widespread view that Buddhist philosophy embodies logical contradictions such that there would be 'true' contradictions, This article explains that this is not the case and that Buddhist philosophy, more generally the Perennial philosophy, denies all contradictions for the sake of a doctrine of Unity.
The difficulty of philosophy reflects the nature of Reality. Here it is proposed that the inability of determinedly scholastic philosophers to solve philosophical problems is a clear indication that neither philosophy nor Reality is as complicated as they believe and that its conceptual simplification cannot be achieved when we reject nondualism and endorse extreme and partial world-theories.
The view that metaphysics is a waste of time appears to be gaining in popularity with every passing day. It is held openly by many scientists and even by many philosophers. I argue here that this is a consequence of the way metaphysics is often done, the futility of a certain approach to it, and not a reason to suppose that there is no useful knowledge to be acquired in metaphysics.
Mysticism claims of its logical scheme that it is Euclidean, that from its first axiom or principle the remainder of its doctrine follows, but it makes this claim in so many languages and in such a variety of obscure and self-contradictory ways that it is difficult to discern how this could be possible, and it is rarely considered a plausible claim in metaphysics. I believe it is plausible, and in this essay I try to explain why. -/- .
We should cherish metaphysics for its power to overcome false views and yet we admonish it for its ongoing failure. Is it possible that this is for the embarrassingly simple reason that we usually ignore Aristotle’s definition for a legitimate contradictory pair?
This essay proposes that metaphysics is best done as lazily as possible, and that a lazy approach, which some would call 'high level', is effective where it means that issues are simplified and unpleasant facts are faced with no wriggling on the hook. It sketches out the solution proposed by Buddhism or more generally mysticism. It suggest that the principle obstacle to a solution for metaphysics is Russell's Paradox, and that it can be overcome.
The idea that explaining consciousness is a problem is questioned. Where a problem seems to arise it is accounted for as an artefact of a failure to take account of the results of metaphysical analysis or to study the Perennial philosophy.
The relationship between the Russell's 'Western' philosophy, which remains for the most part the philosophy of the modern university department, and the 'Perennial' or 'non-dual' philosophy of Plotinus, the Buddha and Lao Tsu is not widely understood. We examine this relationship by reference to the Noble Nagarjuna and his explanation of the antinomies of metaphysics. We suggest that in respect of logical analysis the relationship is a simple one since all clear-thinking philosophers must converge on the same results.
Some time ago, in an article for the Journal of Consciousness Studies, David Chalmers challenged his peers to identify the ingredient missing from our current theories of consciousness, the absence of which prevents us from solving the 'hard' problem and forces us to make do with nonreductive theories. Here I respond to this challenge. I suggest that consciousness is a metaphysical problem and as such can be solved only within a global metaphysical theory. Such a theory would look very like (...) the information theory proposed by Chalmers, but with the addition of an extra phenomenon that would allow it to become fundamental. (shrink)
A tongue-in-cheek marketing review of university philosophy prompted by a slow-down in sales and mounting criticism of the product. These problems are diagnosed as the consequence of an inward-looking culture that encourages a narrow and fixed focus on selling the traditional product while discouraging examination of its competitors.
This innovative volume brings together specialists in international relations to tackle a set of difficult questions about what it means to live in a globalized world where the purpose and direction of world politics are no longer clear-cut. What emerges from these essays is a very clear sense that while we may be living in an era that lacks a single, universal purpose, ours is still a world replete with meaning. The authors in this volume stress the need for a (...) pluralistic conception of meaning in a globalized world and demonstrate how increased communication and interaction in transnational spaces work to produce complex tapestries of culture and politics. Meaning and International Relations also makes an original and convincing case for the relevance of hermeneutic approaches to understanding contemporary international relations. (shrink)
This volume contains 17 articles on various aspects of Islamic thought in the Middle East and in Southeast Asia. The first 9 articles concentrate especially on the Qur’ān and its exegesis, _Kalām_ and Sufism; the second 8 articles deal with Javanese Islam, and with Islam and modernity in Southeast Asia.
Desire-based accounts of practical argument about incompatible ends seem limited either to advice about means or to coercive threats. This paper argues that this can be avoided if the parties to the dispute desire its resolution by means other than force more than they desire the satisfaction of any particular ends. In effect, this means they must argue as if in a position of equal power. This leads to an explanation of the apparent objectivity of moral claims and of why (...) moral reasons appear to be categorical and external. It also explains how notions such as reciprocal altruism and TIT-FOR-TAT can play a role in an evolutionary account of morality. The paper concludes with an argument to the effect that a desire-based metaethic must accept the is-ought gap and explains why there may appear to be no is-ought gap from within a given normative perspective. (shrink)