Context Physicians are regularly confronted with research that is funded or presented by industry. Objective To assess whether physicians discount for conflicts of interest when weighing evidence for prescribing a new drug. Design and setting Participants were presented with an abstract from a single clinical trial finding positive results for a fictitious new drug. Physicians were randomly assigned one version of a hypothetical scenario, which varied on conflict of interest: ‘presenter conflict’, ‘researcher conflict’ and ‘no conflict’. Participants 515 randomly selected (...) Fellows in the American College of Obstetricians and Gynecologists' Collaborative Ambulatory Research Network; 253 surveys (49%) were returned. Main object measures The self-reported likelihood that physicians would prescribe the new drug as a first-line therapy. Results Physicians do not significantly discount for conflicts of interest in their self-reported likelihood of prescribing the new drug after reading the single abstract and scenario. However, when asked explicitly to compare conflict and no conflict, 69% report that they would discount for researcher conflict and 57% report that they would discount for presenter conflict. When asked to guess how favourable the results of this study were towards the new drug, compared with the other trials published so far, their perceptions were not significantly influenced by conflict of interest information. Conclusion While physicians believe that they should discount the value of information from conflicted sources, they did not do so in the absence of a direct comparison between two studies. This brings into question the effectiveness of merely disclosing the funding sources of published studies. (shrink)

This study is based on the 1983 Rural Health Survey of Ethiopia. Patterns and levels of child morbidity by age, sex, geographic region, and sanitary facilities are examined. Morbidity levels peak in the second year of life. Diarrhoeal diseases are of major importance, especially among infants and toddlers. Parasitic diseases, and respiratory diseases other than pneumonia, become increasingly important with age.There are no significant sex differentials in morbidity except for higher rates of diarrhoeal diseases among female children. Geographic differentials are (...) quite marked with particularly high morbidity levels from all disease types in the western mountainous regions of Ethiopia. Access to high quality drinking water, a latrine, and garbage disposal, are strongly related to reduced overall morbidity levels, though not necessarily to reduced diarrhoeal disease levels. (shrink)

BackgroundThe expectation of pandemic-induced severe resource shortages has prompted authorities to draft and update frameworks to guide clinical decision-making and patient triage. While these documents differ in scope, they share a utilitarian focus on the maximization of benefit. This utilitarian view necessarily marginalizes certain groups, in particular individuals with increased medical needs.Main bodyHere, we posit that engagement with the disability critique demands that we broaden our understandings of justice and fairness in clinical decision-making and patient triage. We propose the capabilities (...) theory, which recognizes that justice requires a range of positive capabilities/freedoms conducive to the achievement of meaningful life goals, as a means to do so. Informed by a disability rights critique of the clinical response to the pandemic, we offer direction for the construction of future clinical triage protocols which will avoid ableist biases by incorporating a broader apprehension of what it means to be human.ConclusionThe clinical pandemic response, codified across triage protocols, should embrace a form of justice which incorporates a vision of pluralistic human capabilities and a valuing of positive freedoms. (shrink)

A study was undertaken of the views of users of two genitourinary medicine (GUM) clinics in England on unlinked anonymous testing (UAT) for HIV. The UAT programme measures the prevalence of HIV in the population, including undiagnosed prevalence, by testing residual blood (from samples taken for clinical purposes) which is anonymised and irreversibly unlinked from the source. 424 clinic users completed an anonymous questionnaire about their knowledge of, and attitudes towards, UAT. Only 1/7 (14%) were aware that blood left over (...) from clinical testing may be tested anonymously for HIV. A large majority (89%) said they would agree to their blood being tested, although 74% wanted the opportunity to consent. These findings indicate broad support for UAT of blood in a group of patients whose samples are included in the HIV surveillance programme. The findings suggest the need for greater attention to be given to the provision of information and, if replicated in a larger survey, may justify a reappraisal of UK policy on UAT. (shrink)

In his talk about G.K.'s Weekly to the 1986 Toronto Conference, Father Brocard Sewell, O. Carm., spoke about Chesterton's tribute to Alderman Cedric Chivers. This tribute was written at the time of Cedric Chivers's death and was published in G.K.'s Weekly . Cedric Chivers was, for many years, the Major of Bath, a bookbinder, and one of the Directors of G.K.'s Weekly. He was one of Chesterton's close friends.

In this article I intend to describe an issue of the Dutch euthanasia practice that is not common knowledge. After some general introductory descriptions, by way of formulating a frame of reference, I shall describe the effects of this practice on patients, physicians and families, followed by a more philosophical reflection on the significance of these effects for the assessment of the authenticity of a request and the nature of unbearable suffering, two key concepts in the procedure towards euthanasia or (...) physician-assisted suicide. This article does not focus on the arguments for or against euthanasia and the ethical justification of physician-assisted dying. These arguments have been described extensively in Kimsma and Van Leeuwen (Asking to die. Inside the Dutch debate about euthanasia, Kluwer Academic Publishers, Dordrecht, 1998). (shrink)

Two major functions of the visual system are discussed and contrasted. One function of vision is the creation of an internal model or percept of the external world. Most research in object perception has concentrated on this aspect of vision. Vision also guides the control of object-directed action. In the latter case, vision directs our actions with respect to the world by transforming visual inputs into appropriate motor outputs. We argue that separate, but interactive, visual systems have evolved for the (...) perception of objects on the one hand and the control of actions directed at those objects on the other. This 'duplex' approach to high-level vision suggests that Marrian or 'reconstructive' approaches and Gibsonian or 'purposive-animate-behaviorist' approaches need not be seen as mutually exclusive, but rather as complementary in their emphases on different aspects of visual function. (shrink)

Feminist Care Ethics has much to offer in an analysis of the international migration of care workers. This paper argues, however, that Joan Tronto’s analysis of this international care regime is incomplete insofar as it overlooks the ways in which the current global care market is progressive for the workers and the significant harms this market is inflicting on care receivers in source countries. In order for Feminist Care Ethics to fulfill its potential, it must be developed beyond a visionary (...) tool for revaluing care—it must also produce analytic tools for evaluating real alternatives under pressing, real-time constraints. (shrink)

First published in 1985. Routledge is an imprint of Taylor & Francis, an informa company.

In the debates surrounding the ethical dimensions of interventions in the human genome, much attention is paid to determining whether—and if so, how—market access to these technologies ought to be managed in order to maximize social benefit. There are those who advocate a “laissez-faire” free-market approach to the development and use of genetic and genomic interventions. We are sympathetic to this view insofar as we understand the workings of the market stimulus effect. We use the term “market stimulus effect” to (...) refer to the outcome of a set of mechanisms whereby early adoption of a new technology by wealthy consumers promotes the development of versions of this product that are cheaper to produce, or are simply .. (shrink)

2011 Reprint of 1943 Edition. Full facsimile of the original edition, not reproduced with Optical Recognition Software. "St. Thomas Aquinas" is enriched by the author's unique ability to see the world through the saint's eyes, a fresh and animated view that shows us Aquinas as no other biography has. Acclaimed as the best book ever written on Aquinas by such outstanding Thomists as Jacques Maritain, Etienne Gilson, and Anton Pegis, this brilliant biography will completely capture the reader and leave him (...) desirous of reading Aquinas' own monumental work. (shrink)

Drawing on conceptual tools from philosophical bioethics, economics, and materialist feminism, we advocate viewing transnational commercial surrogacy as labor and consider what it means to compensate women for this work. We find two distinct but interrelated concerns emerge in our discussion of wages for surrogates: how to value and compensate for social reproduction, and how to establish a fair wage for surrogates. We explore limitations of minimum wage policy in addressing the undervaluation of biological and emotional labor in the transnational (...) commercial surrogacy industry. We argue that subsidization is a superior method of addressing at least one cause of undervaluation. (shrink)