Rereading Renée C. Fox's “A Sociological Perspective on Organ Transplantation and Hemodialysis,” published in 1970, one is likely to be struck more by continuity than by change. The most pressing of the social, policy, and ethical concerns that Fox raised remain problematic fifty years later. We still struggle with scientific and clinical uncertainty, with the boundary between experimentation and therapy, and with the cost of organ replacement therapies and disparities in how they are allocated. We still have an imperfect understanding (...) of transplant immune responses. We still debate when a potential donor “actually” dies, and we still seem to think better empirical criteria could harmonize the diverse religious, cultural, and socioeconomic values of patients, providers, third‐party payers, and policy‐makers. Organ transplantation was for Fox both a particular case unfolding in time and an entryway for discussing the difficult moral questions presented by many new medical technologies in a context of high demand and limited resources. (shrink)

Objective: To examine current research payment practices and to inform development of clearer guidelines for researchers and ethics committees.Design: Exploratory email based questionnaire study of current research participant reimbursement practices. A diverse sample of organisations and individuals were targeted.Setting: Australia.Participants: Contacts in 84 key research organisations and select electronic listservers across Australia. A total of 100 completed questionnaires were received with representations from a variety of research areas .Main measurements: Open-ended and fixed alternative questions about type of research agency; type (...) of research; type of population under study; whether payment is standard; amounts and mechanisms of payment; factors taken into account when deciding on payment practices; and whether payment policies exist.Results: Reimbursement practice is highly variable. Where it occurs it is largely monetary and is for time and out-of-pocket expenses. Ethics committees were reported to be often involved in decision making around reimbursement.Conclusions: Research subject payment practices vary in Australia. Researchers who do provide payments to research participants generally do so without written policy and procedures. Ethics committees have an important role in developing guidelines in this area. Specific guidelines are needed considering existing local policies and procedures; payment models and their application in diverse settings; case study examples of types and levels of reimbursement; applied definitions of incentive and inducement; and the rationale for diverse payment practices in different settings. (shrink)

The legal requirements and justifications for collecting patient-identifiable data without patient consent were examined. The impetus for this arose from legal and ethical issues raised during the development of a population-based disease register. Numerous commentaries and case studies have been discussing the impact of the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. But uncertainty still remains about the legal requirements for processing patient-identifiable data without patient consent for research purposes. This is (...) largely owing to ignorance, or misunderstandings of the implications of the common law duty of confidentiality and section 60 of the Health and Social Care Act 2001. The common law duty of confidentiality states that patient-identifiable data should not be provided to third parties, regardless of compliance with the DPA1998. It is an obligation derived from case law, and is open to interpretation. Compliance with section 60 ensures that collection of patient-identifiable data without patient consent is lawful despite the duty of confidentiality. Fears regarding the duty of confidentiality have resulted in a common misconception that section 60 must be complied with. Although this is not the case, section 60 support does provide the most secure basis in law for collecting such data. Using our own experience in developing a disease register as a backdrop, this article will clarify the procedures, risks and potential costs of applying for section 60 support. (shrink)

What ecological advantages do animals gain by being able to detect, extract and exploit wavelength information? What are the advantages of representing that information as hue qualities? The benefits of adding chromatic to achromatic vision, marginal in object detection, become apparent in object recognition and receiving biological signals. It is argued that this improved performance is a direct consequence of the fact that many animals' visual systems reduce wavelength information to combinations of four basic hues. This engenders a simple categorical (...) scheme that permits a rich amount of sensory information to be rapidly and efficiently employed by cognitive machinery of limited capacity. (shrink)

On October 31, 1994, it was announced that a confidential settlement had been reached in Doe v. Kohn, Nast & Graf, P.C., et al., 862F. Supp. 1310 ). The settlement in ths widely publicized AIDS discrimination case came three weeks after the trial began in the District Court for the Eastern District of Pennsylvania, Nov. 2, 1994, at 10).Plaintiff Doe, an associate employed at Kohn, Nast & Graf, a prominent law firm in Philadelphia, filed an AIDS discrimination case under the (...) Americans with Disabilities Act against his employer claiming that the firm fired him in March 1993 because he was HIV-positive. Doe's complaint also cited claims under ERISA and other Pennsylvania employment laws. (shrink)

One dark and rainy night, Yuso sexually assaults and tortures Zelan. In escaping from the scene of his crime, he falls heavily and becomes an impotent paraplegic. Instead of treating his fate as divine retribution for his wicked acts, Yuso sees it as sheer bad luck. He shows no remorse for what he has done, and vainly hopes that he will recover his powers, which he now treats as involuntarily hoarded resources to be used on less rainy days. In the (...) presence of others, he pretends that he has turned over a new leaf. He asks for religious and educational books, hoping to make up for his poor education and deprived social background. But he immediately discards them when he is alone in favor of the pornographic magazines which he has bribed a nurse to smuggle in for him. His deception and various obscene acts committed in the hospital are exposed; by the time he comes up for trial, everyone knows that he is still a lustful, sadistic, and unrepentant man. Most retributivists have a sufficient justification for punishing Yuso independently of the social consequences of his punishment. Two features of the case might cause some difficulties. First, Yuso has already experienced considerable suffering and deprivation both before and after his crime, and retributivists might disagree about the relevance of the suffering to his punishment. Secondly, Yuso is unrepentant, and it is unlikely that punishment will change him. This might, as we shall see, create a problem for those who think that the justifying aim of punishment is the moral reform of the offender. (shrink)

In this article C. L. Tsou, of the Institute of Biophysics, Beijing, criticizes the use of the expression I50, the inhibitor concentration to produce 50% inhibition of a particular enzyme as a ‘most unfortunate’ parameter, when screening enzyme inhibitors designed as drugs. Comments on Dr Tsou's point of view will be welcomed from readers.

Plants are considered as archetypes of the ramification phenomenon but numerous elementary processes occur in the elaboration of the shaping of each species. This paper aims to identify the part ascribed to different mechanisms in the morphogenesis of a Thallophyte, the red alga Antihamnion plumula.Agonistic-antagonistic models (Bernard-Weil, 1988) can be applied to this alga whose thallus includes two different kinds of whorls, pleuridian and cladomian. In each whorl the agonistic and antagonistic effects are expressed by the full development (S) of (...) the two branches and by their symmetry rate (R) respectively. Variations in S and R show the existence of particular pleuridian whorls having an intermediary dissymmetry and a rhythmic arrangement similarly to that of the cladomian whorls. A unilateral change of the system (removal of a lateral cladome) induces a transitory destabilisation mainly manifested by the stimulating ascendant flow throughout the thallus. (shrink)

John Braithwaite and Philip Pettit, Not Just Deserts: A Republican Theory of Criminal Justice, Oxford Clarendon Press, 1990, vii + 229 pp.

This paper discusses the nature of liberty from the point of view of value. Liberty is the highest value for liberals. The root of this liberal view is their particular conception of self. Rawls says 'the self is prior to the ends which are affirmed by it.' This is also the Kantian view of the self: the self is prior to its socially given roles and relationships. Therefore, no end is exempt from possible revision by the self. There is nothing (...) wrong with this basic idea. In fact, all theories agree on free choice of life plan or self-determination. But they disagree about what package of rights and resources best enables people to pursue their own conceptions of the good. However, the liberal view of liberty is based on a metaphysically reasoned idealism. This results in a conception of liberty that is absolute, supreme, and has infinite value compared with other things. Communitarians have several arguments against the liberal view. I consider the following two points to be of utmost import: The liberal view of the self is empty; The liberal view ignores our embeddedness in communal practices. My reasoning is not exactly that of the communitarians. I view 'emptiness' as freedom associated with the substance of an action, which has a value that does not lie in itself. (shrink)

This detailed and sympathetic, but not uncritical, study of On Liberty' argues for the general consistency and coherence of Mill's defence of individual liberty, but maintains that there are significant non-utilitarian elements in his arguments.