By Janet D. Stemwedel | October 14, 2013
The Scientific American Blog
@docfreeride
Here is an excerpt:
Ethically speaking, mistakes are a problem because they cause harm, or because they result from a lapse in an obligation we ought to be honoring, or both. Thus, an ethical response to messing up ought to involving addressing that harm and/or getting back on track with the obligation we fell down on. What does this look like?
1. Acknowledge the harm. This needs to be the very first thing you do. To admit you messed up, you have to recognize the mess, with no qualifications. There it is.
2. Acknowledge the experiential report of the people you have harmed. If you’re serious about sharing a world (which is what ethics is all about), you need to take seriously what the people with whom your sharing that world tell you about how they feel. They have privileged access to their own lived experiences; you need to rely on their testimony of those lived experiences.
The entire article is here.
Thursday, October 31, 2013
Report: NSA collecting millions of contact lists
Phys.org
Originally published October 15, 2013
The National Security Agency has been sifting through millions of contact lists from personal email and instant messaging accounts around the world—including those of Americans—in its effort to find possible links to terrorism or other criminal activity, according to a published report.
The Washington Post reported late Monday that the spy agency intercepts hundreds of thousands of email address books every day from private accounts on Yahoo, Gmail, Facebook and Hotmail that move though global data links. The NSA also collects about a half million buddy lists from live chat services and email accounts.
The entire story is here.
Originally published October 15, 2013
The National Security Agency has been sifting through millions of contact lists from personal email and instant messaging accounts around the world—including those of Americans—in its effort to find possible links to terrorism or other criminal activity, according to a published report.
The Washington Post reported late Monday that the spy agency intercepts hundreds of thousands of email address books every day from private accounts on Yahoo, Gmail, Facebook and Hotmail that move though global data links. The NSA also collects about a half million buddy lists from live chat services and email accounts.
The entire story is here.
Wednesday, October 30, 2013
The potential benefit of the placebo effect in sham-controlled trials: implications for risk-benefit assessments and informed consent
By Remy L Brim and Franklin G Miller
J Med Ethics 2013; 39:703-707 doi:10.1136/medethics-2012-101045
Abstract
There has been considerable debate surrounding the ethics of sham-controlled trials of procedures and interventions. Critics argue that these trials are unethical because participants assigned to the control group have no prospect of benefit from the trial, yet they are exposed to all the risks of the sham intervention. However, the placebo effect associated with sham procedures can often be substantial and has been well documented in the scientific literature. We argue that, in light of the scientific evidence supporting the benefits of sham interventions for pain and Parkinson's disease that stem from the placebo effect, these sham-controlled trials should be considered as offering potential direct benefit to participants. If scientific evidence demonstrates the positive effect of placebo from sham interventions on other conditions, sham-controlled trials of interventions for the treatment of these conditions should be considered to have prospects of benefit as well. This potential benefit should be taken into account by research ethics committees in risk-benefit analyses, and be included in informed consent documents.
The article is here.
J Med Ethics 2013; 39:703-707 doi:10.1136/medethics-2012-101045
Abstract
There has been considerable debate surrounding the ethics of sham-controlled trials of procedures and interventions. Critics argue that these trials are unethical because participants assigned to the control group have no prospect of benefit from the trial, yet they are exposed to all the risks of the sham intervention. However, the placebo effect associated with sham procedures can often be substantial and has been well documented in the scientific literature. We argue that, in light of the scientific evidence supporting the benefits of sham interventions for pain and Parkinson's disease that stem from the placebo effect, these sham-controlled trials should be considered as offering potential direct benefit to participants. If scientific evidence demonstrates the positive effect of placebo from sham interventions on other conditions, sham-controlled trials of interventions for the treatment of these conditions should be considered to have prospects of benefit as well. This potential benefit should be taken into account by research ethics committees in risk-benefit analyses, and be included in informed consent documents.
The article is here.
Pharmaceutical firms paid to attend meetings of panel that advises FDA
By Peter Whoriskey
The Washington Post
Originally published October 8, 2013
A scientific panel that shaped the federal government’s policy for testing the safety and effectiveness of painkillers was funded by major pharmaceutical companies that paid hundreds of thousands of dollars for the chance to affect the thinking of the Food and Drug Administration, according to hundreds of e-mails obtained by a public records request.
The e-mails show that the companies paid as much as $25,000 to attend any given meeting of the panel, which had been set up by two academics to provide advice to the FDA on how to weigh the evidence from clinical trials. A leading FDA official later called the group “an essential collaborative effort.”
Patient advocacy groups said the electronic communications suggest that the regulators had become too close to the companies trying to crack into the $9 billion painkiller market in the United States.
The entire article is here.
The Washington Post
Originally published October 8, 2013
A scientific panel that shaped the federal government’s policy for testing the safety and effectiveness of painkillers was funded by major pharmaceutical companies that paid hundreds of thousands of dollars for the chance to affect the thinking of the Food and Drug Administration, according to hundreds of e-mails obtained by a public records request.
The e-mails show that the companies paid as much as $25,000 to attend any given meeting of the panel, which had been set up by two academics to provide advice to the FDA on how to weigh the evidence from clinical trials. A leading FDA official later called the group “an essential collaborative effort.”
Patient advocacy groups said the electronic communications suggest that the regulators had become too close to the companies trying to crack into the $9 billion painkiller market in the United States.
The entire article is here.
Tuesday, October 29, 2013
Moral responsibility for (un)healthy behaviour
Rebecca C H Brown
Journal of Medical Ethics
J Med Ethics 2013;39:695-698 doi:10.1136/medethics-2012-100774
Abstract
Combating chronic, lifestyle-related disease has become a healthcare priority in the developed world. The role personal responsibility should play in healthcare provision has growing pertinence given the growing significance of individual lifestyle choices for health. Media reporting focussing on the ‘bad behaviour’ of individuals suffering lifestyle-related disease, and policies aimed at encouraging ‘responsibilisation’ in healthcare highlight the importance of understanding the scope of responsibility ascriptions in this context. Research into the social determinants of health and psychological mechanisms of health behaviour could undermine some commonly held and tacit assumptions about the moral responsibility of agents for the sorts of lifestyles they adopt. I use Philip Petit's conception of freedom as ‘fitness to be held responsible’ to consider the significance of some of this evidence for assessing the moral responsibility of agents. I propose that, in some cases, factors outside the agent's control may influence behaviour in such a way as to undermine her freedom along the three dimensions described by Pettit: freedom of action; a sense of identification with one's actions; and whether one's social position renders one vulnerable to pressure from more powerful others.
The entire article is here.
Journal of Medical Ethics
J Med Ethics 2013;39:695-698 doi:10.1136/medethics-2012-100774
Abstract
Combating chronic, lifestyle-related disease has become a healthcare priority in the developed world. The role personal responsibility should play in healthcare provision has growing pertinence given the growing significance of individual lifestyle choices for health. Media reporting focussing on the ‘bad behaviour’ of individuals suffering lifestyle-related disease, and policies aimed at encouraging ‘responsibilisation’ in healthcare highlight the importance of understanding the scope of responsibility ascriptions in this context. Research into the social determinants of health and psychological mechanisms of health behaviour could undermine some commonly held and tacit assumptions about the moral responsibility of agents for the sorts of lifestyles they adopt. I use Philip Petit's conception of freedom as ‘fitness to be held responsible’ to consider the significance of some of this evidence for assessing the moral responsibility of agents. I propose that, in some cases, factors outside the agent's control may influence behaviour in such a way as to undermine her freedom along the three dimensions described by Pettit: freedom of action; a sense of identification with one's actions; and whether one's social position renders one vulnerable to pressure from more powerful others.
The entire article is here.
Preventing Weight Bias: A Toolkit for Professionals in Clinical Practice
Yale Rudd Center
Resource for Clinicians
Weight bias jeopardizes patients' emotional and physical health. As the majority of Americans are now overweight or obese, this is an important clinical concern, one that no provider can afford to ignore.
This toolkit is designed to help clinicians across a variety of practice settings with easy-to-implement solutions and resources to improve delivery of care for overweight and obese patients. The resources are designed for busy professionals and customized for various practice settings. They range from simple strategies to improve provider-patient communication and ways to make positive changes in the office environment , to profound ones, including self-examination of personal biases.
The entire 8 Module Toolkit is here.
Resource for Clinicians
Weight bias jeopardizes patients' emotional and physical health. As the majority of Americans are now overweight or obese, this is an important clinical concern, one that no provider can afford to ignore.
This toolkit is designed to help clinicians across a variety of practice settings with easy-to-implement solutions and resources to improve delivery of care for overweight and obese patients. The resources are designed for busy professionals and customized for various practice settings. They range from simple strategies to improve provider-patient communication and ways to make positive changes in the office environment , to profound ones, including self-examination of personal biases.
The entire 8 Module Toolkit is here.
Monday, October 28, 2013
The Dangers of Pseudoscience
By MASSIMO PIGLIUCCI and MAARTEN BOUDRY
The New York Times - Opinionator
Originally published October 10, 2013
Philosophers of science have been preoccupied for a while with what they call the “demarcation problem,” the issue of what separates good science from bad science and pseudoscience (and everything in between). The problem is relevant for at least three reasons.
The first is philosophical: Demarcation is crucial to our pursuit of knowledge; its issues go to the core of debates on epistemology and of the nature of truth and discovery. The second reason is civic: our society spends billions of tax dollars on scientific research, so it is important that we also have a good grasp of what constitutes money well spent in this regard. Should the National Institutes of Health finance research on “alternative medicine”? Should the Department of Defense fund studies on telepathy? Third, as an ethical matter, pseudoscience is not — contrary to popular belief — merely a harmless pastime of the gullible; it often threatens people’s welfare, sometimes fatally so. For instance, millions of people worldwide have died of AIDS because they (or, in some cases, their governments) refuse to accept basic scientific findings about the disease, entrusting their fates to folk remedies and “snake oil” therapies.
The entire article is here.
The New York Times - Opinionator
Originally published October 10, 2013
Philosophers of science have been preoccupied for a while with what they call the “demarcation problem,” the issue of what separates good science from bad science and pseudoscience (and everything in between). The problem is relevant for at least three reasons.
The first is philosophical: Demarcation is crucial to our pursuit of knowledge; its issues go to the core of debates on epistemology and of the nature of truth and discovery. The second reason is civic: our society spends billions of tax dollars on scientific research, so it is important that we also have a good grasp of what constitutes money well spent in this regard. Should the National Institutes of Health finance research on “alternative medicine”? Should the Department of Defense fund studies on telepathy? Third, as an ethical matter, pseudoscience is not — contrary to popular belief — merely a harmless pastime of the gullible; it often threatens people’s welfare, sometimes fatally so. For instance, millions of people worldwide have died of AIDS because they (or, in some cases, their governments) refuse to accept basic scientific findings about the disease, entrusting their fates to folk remedies and “snake oil” therapies.
The entire article is here.
Suit Could Determine Protections for Police Department Whistle-Blowers
By JOSEPH GOLDSTEIN
The New York Times
Published: October 13, 2013
When Officer Craig Matthews complained to his precinct commander about a quota system that he believed was resulting in illegal street stops and arrests, it did not take long, he said, for him to see a response: he was given undesirable assignments, a mediocre performance review and the cold shoulder from his immediate supervisors.
So Officer Matthews filed a federal lawsuit, seeking protection from retaliation by invoking the First Amendment — a standard strategy for whistle-blowers who believe they have been punished for coming forward.
But because Officer Matthews, 40, is with the New York Police Department, his rights are less assured.
The city has taken the position that because officers are expected to report misconduct, those who come forward as whistle-blowers are simply fulfilling their duty established by the patrol guide, a voluminous book of police procedures.
The entire story is here.
The New York Times
Published: October 13, 2013
When Officer Craig Matthews complained to his precinct commander about a quota system that he believed was resulting in illegal street stops and arrests, it did not take long, he said, for him to see a response: he was given undesirable assignments, a mediocre performance review and the cold shoulder from his immediate supervisors.
So Officer Matthews filed a federal lawsuit, seeking protection from retaliation by invoking the First Amendment — a standard strategy for whistle-blowers who believe they have been punished for coming forward.
But because Officer Matthews, 40, is with the New York Police Department, his rights are less assured.
The city has taken the position that because officers are expected to report misconduct, those who come forward as whistle-blowers are simply fulfilling their duty established by the patrol guide, a voluminous book of police procedures.
The entire story is here.
Sunday, October 27, 2013
Drug discovery: A jump-start for electroceuticals
Kristoffer Famm, Brian Litt, Kevin J. Tracey, Edward S. Boyden & Moncef Slaoui
Nature 496, 159–161 (11 April 2013) doi:10.1038/496159a
Here are some excerpts:
Imagine a day when electrical impulses are a mainstay of medical treatment. Your clinician will administer 'electroceuticals' that target individual nerve fibres or specific brain circuits to treat an array of conditions. These treatments will modulate the neural impulses controlling the body, repair lost function and restore health. They could, for example, coax insulin from cells to treat diabetes, regulate food intake to treat obesity and correct balances in smooth-muscle tone to treat hypertension and pulmonary diseases.
(cut)
Critics will argue that we underestimate the complexity of the nervous system; the challenges in reliably, durably and non-disruptively manipulating groups of individual neurons and the sheer volume of neural information flowing through these circuits. We would argue that miniaturization and big-data handling have been among the most rapidly advancing areas of scientific research in the past decade. Starting off with peripheral intervention points and simpler circuits should also help.
The entire story is here, hiding behind a paywall.
Nature 496, 159–161 (11 April 2013) doi:10.1038/496159a
Here are some excerpts:
Imagine a day when electrical impulses are a mainstay of medical treatment. Your clinician will administer 'electroceuticals' that target individual nerve fibres or specific brain circuits to treat an array of conditions. These treatments will modulate the neural impulses controlling the body, repair lost function and restore health. They could, for example, coax insulin from cells to treat diabetes, regulate food intake to treat obesity and correct balances in smooth-muscle tone to treat hypertension and pulmonary diseases.
(cut)
Critics will argue that we underestimate the complexity of the nervous system; the challenges in reliably, durably and non-disruptively manipulating groups of individual neurons and the sheer volume of neural information flowing through these circuits. We would argue that miniaturization and big-data handling have been among the most rapidly advancing areas of scientific research in the past decade. Starting off with peripheral intervention points and simpler circuits should also help.
The entire story is here, hiding behind a paywall.
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