By Beryl Benderly
Science Careers Blog
Originally published July 14, 2013
Difficult ethical issues can present significant challenges to graduate students and early-career scientists, but few receive adequate training and guidance in dealing with these problems, agreed a panel of experts at the Euroscience Open Forum (ESOF) 2012 in Dublin. Formal training in ethics was unknown in science before 1990, when it became a requirement in the United States, said Nicholas Steneck of the University of Michigan, who is a consultant to the Federal Office of Research Integrity. In recent years, he continued, interest has increased in other countries as well. Concepts of ethics and responsible research vary among countries and disciplines, however, the speakers agreed, and there is no uniformity in the content of training even within countries. And, although various initiatives are underway in a variety of nations, nowhere is training sufficient to the needs of young researchers, the panelists said.
The competitive pressures that young scientists face today are much more severe than in the past and can make ethical problems more acute, said Maria Leptin of the European Molecular Biology Organization (EMBO) in Germany and the Initiative for Science in Europe. Today's intense competition greatly increases incentive to produce the maximum number of publications and to have one's name on as many papers as possible.
The entire story is here.
Saturday, March 9, 2013
Ethics of 2 cancer studies questioned
India studies funded by Gates Foundation, National Cancer Institute draw scrutiny
By Bob Ortega
The Republic
Originally posted February 15, 2013
For more than 12 years, as part of two massive U.S-funded studies in India, researchers tracked a large group of women for cervical cancer but didn’t screen them, instead monitoring them as their cancers progressed. At least 79 of the women died.
One study, funded by the National Cancer Institute, did not adequately inform more than 76,000 women taking part about their alternatives for getting cervical-cancer screening; and those women did not give adequate informed consent, according to the Office of Human Research Protection, part of the U.S. Department of Health and Human Services.
The other study, funded by the Gates Foundation, is under review by the Food and Drug Administration, according to Kristina Borror, the OHRP’s director of compliance oversight. That study has raised similar concerns regarding 31,000 women who were tracked but not routinely screened or treated for cervical cancer.
Both studies continue today, though researchers for both told The Arizona Republic they have begun to offer screening to the women.
While the two studies differ in important respects, both included large numbers of women placed in “control groups” who were offered free visits with health-care workers, but who, until recently,were not screened for cervical cancer. Instead, researchers met with and tracked these women to monitor how many would develop cervical cancer and die, so their death rates could be compared with those of women who were being screened and treated for free.
The entire story is here.
By Bob Ortega
The Republic
Originally posted February 15, 2013
For more than 12 years, as part of two massive U.S-funded studies in India, researchers tracked a large group of women for cervical cancer but didn’t screen them, instead monitoring them as their cancers progressed. At least 79 of the women died.
One study, funded by the National Cancer Institute, did not adequately inform more than 76,000 women taking part about their alternatives for getting cervical-cancer screening; and those women did not give adequate informed consent, according to the Office of Human Research Protection, part of the U.S. Department of Health and Human Services.
The other study, funded by the Gates Foundation, is under review by the Food and Drug Administration, according to Kristina Borror, the OHRP’s director of compliance oversight. That study has raised similar concerns regarding 31,000 women who were tracked but not routinely screened or treated for cervical cancer.
Both studies continue today, though researchers for both told The Arizona Republic they have begun to offer screening to the women.
While the two studies differ in important respects, both included large numbers of women placed in “control groups” who were offered free visits with health-care workers, but who, until recently,were not screened for cervical cancer. Instead, researchers met with and tracked these women to monitor how many would develop cervical cancer and die, so their death rates could be compared with those of women who were being screened and treated for free.
The entire story is here.
Friday, March 8, 2013
Evaluations of Dangerousness among those Adjudicated Not Guilty by Reason of Insanity
Edited by Christina M. Finello, JD, PhD
American Psychology Law Society
Winter 2013 News
In many states, following an indeterminate period of hospitalization, individuals adjudicated Not Guilty by Reason of Insanity (hereafter called “acquittees” despite different international legal terminology) are typically discharged under conditional release with provisions for ongoing monitoring and recommitment (Packer & Grisso, 2011). Studies have identified factors associated with conditional release, recommitment, and reoffending in this population. However, few studies have evaluated whether risk assessment measures could assist in predicting recommitment to forensic hospitals.
A number of static factors may be associated with decisions to retain or conditionally release acquittees. For example, Callahan and Silver (1998) found that female acquittees, those with diagnoses other than Schizophrenia and those who committed non-violent offenses, were released most often. Additionally, low psychopathy and older age during one’s first criminal offense increased the likelihood of release (Manguno-Mire, Thompson, BertmanPate, Burnett, & Thompson, 2007). Dynamic and protective variables also influence decisions of retention versus release. For example, researchers identified that acquittees’ treatment compliance and responsiveness, substance use, risk of violence, and availability of structured activities in the community are relevant to release decisions (McDermott, Edens, Quanbeck, Busse, & Scott, 2008; Stredny, Parker, & Dibble, 2012).
Decisions regarding release versus retention involve determinations of future dangerousness (Jones v. United States, 1983), highlighting the relevance of violence risk assessment measures. However, available data do not indicate a strong relationship between scores on risk assessment measures and dispositional decisions. For example, McKee, Harris, and Rice (2007) observed that scores on the Violence Risk Appraisal Guide (VRAG; Quinsey, Harris, Rice, & Cormier, 1998) predicted clinicians’ recommendations for retention versus transfer from a maximum security facility, but did not predict the ultimate decisions. Côté, Crocker, Nicholls, and Seto (2012) reported that, with the exception of previous violence, presence of major mental illness, substance use problems, active symptoms of major mental illness, and unresponsiveness to treatment - the factors of the Historical, Clinical, Risk Management-20 (HCR-20; Webster, Douglas, Eaves, & Hart, 1997) identified by researchers - corresponded poorly (if at all) with those raised by evaluators in review hearings.
The entire article can be found here.
American Psychology Law Society
Winter 2013 News
In many states, following an indeterminate period of hospitalization, individuals adjudicated Not Guilty by Reason of Insanity (hereafter called “acquittees” despite different international legal terminology) are typically discharged under conditional release with provisions for ongoing monitoring and recommitment (Packer & Grisso, 2011). Studies have identified factors associated with conditional release, recommitment, and reoffending in this population. However, few studies have evaluated whether risk assessment measures could assist in predicting recommitment to forensic hospitals.
A number of static factors may be associated with decisions to retain or conditionally release acquittees. For example, Callahan and Silver (1998) found that female acquittees, those with diagnoses other than Schizophrenia and those who committed non-violent offenses, were released most often. Additionally, low psychopathy and older age during one’s first criminal offense increased the likelihood of release (Manguno-Mire, Thompson, BertmanPate, Burnett, & Thompson, 2007). Dynamic and protective variables also influence decisions of retention versus release. For example, researchers identified that acquittees’ treatment compliance and responsiveness, substance use, risk of violence, and availability of structured activities in the community are relevant to release decisions (McDermott, Edens, Quanbeck, Busse, & Scott, 2008; Stredny, Parker, & Dibble, 2012).
Decisions regarding release versus retention involve determinations of future dangerousness (Jones v. United States, 1983), highlighting the relevance of violence risk assessment measures. However, available data do not indicate a strong relationship between scores on risk assessment measures and dispositional decisions. For example, McKee, Harris, and Rice (2007) observed that scores on the Violence Risk Appraisal Guide (VRAG; Quinsey, Harris, Rice, & Cormier, 1998) predicted clinicians’ recommendations for retention versus transfer from a maximum security facility, but did not predict the ultimate decisions. Côté, Crocker, Nicholls, and Seto (2012) reported that, with the exception of previous violence, presence of major mental illness, substance use problems, active symptoms of major mental illness, and unresponsiveness to treatment - the factors of the Historical, Clinical, Risk Management-20 (HCR-20; Webster, Douglas, Eaves, & Hart, 1997) identified by researchers - corresponded poorly (if at all) with those raised by evaluators in review hearings.
The entire article can be found here.
Why the Ethics of Parsimonious Medicine Is Not the Ethics of Rationing
By Jon C. Tilburt and Christine Cassel
JAMA. 2013;309(8):773-774. doi:10.1001/jama.2013.368.
The ethics of rationing health care resources has been debated for decades. Opponents of rationing are concerned that societal interests will supplant respect for individual patient choice and professional judgment. Advocates argue that injustices in the current system necessitate that physicians use resources prudently on behalf of society, even in their daily work with individual patients. The debate is important, potentially divisive, and unavoidable.
Various groups have championed the cause of medicine practiced leanly, consistent with the professional responsibility to use resources wisely. These initiatives, which champion “parsimonious medicine,” have highlighted the 20% of routine practices in US medicine that add no demonstrable value to health care but that persist in the inertia and rituals of clinical work. The specialty societies and the Choosing Wisely collaborative outline commonsense principles for avoiding unnecessary, wasteful care.
Recent calls for waste avoidance and parsimonious care are not just a clever way to help physicians ration health care. Despite the intuitive similarity between themes in rationing and waste avoidance, the ethical rationales underlying the two differ considerably.
The entire article is here.
JAMA. 2013;309(8):773-774. doi:10.1001/jama.2013.368.
The ethics of rationing health care resources has been debated for decades. Opponents of rationing are concerned that societal interests will supplant respect for individual patient choice and professional judgment. Advocates argue that injustices in the current system necessitate that physicians use resources prudently on behalf of society, even in their daily work with individual patients. The debate is important, potentially divisive, and unavoidable.
Various groups have championed the cause of medicine practiced leanly, consistent with the professional responsibility to use resources wisely. These initiatives, which champion “parsimonious medicine,” have highlighted the 20% of routine practices in US medicine that add no demonstrable value to health care but that persist in the inertia and rituals of clinical work. The specialty societies and the Choosing Wisely collaborative outline commonsense principles for avoiding unnecessary, wasteful care.
Recent calls for waste avoidance and parsimonious care are not just a clever way to help physicians ration health care. Despite the intuitive similarity between themes in rationing and waste avoidance, the ethical rationales underlying the two differ considerably.
The entire article is here.
Thursday, March 7, 2013
Hitler's Philosophers, By Yvonne Sherratt
This book tells the disturbing and important story of how major thinkers abetted genocide
By John Gray - Book Review
The Independent
Originally published February 23, 2013
The only German philosophy professor who actively resisted the Nazis is nowadays virtually unknown. Though one or two scholarly monographs have appeared on him, Kurt Huber will not be found on any university syllabus. The silence that has swallowed his name and his works is almost as complete as that which followed when, after being stripped of his university post and doctoral degree by a Nazi People's Court, he was executed by guillotine in July 1943 for writing a pamphlet against National Socialism as a member of the White Rose resistance group.
A conservative Catholic who produced a classic study of Leibniz and made important contributions to aesthetics and musicology, Huber is today not much more than a footnote in history. When Yvonne Sherratt writes, "Huber's intellectual prowess remains as quiet in the Western world as it was under Hitler", she hardly exaggerates.
In contrast, some active collaborators with the Nazis feature among the most celebrated names of post-war philosophy. Serving the Nazis for a time as a university rector, Martin Heidegger cut off relations with Edmund Husserl, the Jewish philosopher who had secured his professorship, removing the dedication to Husserl from Being and Time (Heidegger's principal work) and failing either to visit his mentor when he was dying or attend his funeral in 1938. As a result of the intellectual campaign waged by his former student and lover Hannah Arendt, and support form prominent figures such as Jean-Paul Sartre, Heidegger succeeded in becoming one of the most influential of late 20th-century philosophers.
The entire review is here.
By John Gray - Book Review
The Independent
Originally published February 23, 2013
The only German philosophy professor who actively resisted the Nazis is nowadays virtually unknown. Though one or two scholarly monographs have appeared on him, Kurt Huber will not be found on any university syllabus. The silence that has swallowed his name and his works is almost as complete as that which followed when, after being stripped of his university post and doctoral degree by a Nazi People's Court, he was executed by guillotine in July 1943 for writing a pamphlet against National Socialism as a member of the White Rose resistance group.
A conservative Catholic who produced a classic study of Leibniz and made important contributions to aesthetics and musicology, Huber is today not much more than a footnote in history. When Yvonne Sherratt writes, "Huber's intellectual prowess remains as quiet in the Western world as it was under Hitler", she hardly exaggerates.
In contrast, some active collaborators with the Nazis feature among the most celebrated names of post-war philosophy. Serving the Nazis for a time as a university rector, Martin Heidegger cut off relations with Edmund Husserl, the Jewish philosopher who had secured his professorship, removing the dedication to Husserl from Being and Time (Heidegger's principal work) and failing either to visit his mentor when he was dying or attend his funeral in 1938. As a result of the intellectual campaign waged by his former student and lover Hannah Arendt, and support form prominent figures such as Jean-Paul Sartre, Heidegger succeeded in becoming one of the most influential of late 20th-century philosophers.
The entire review is here.
Stanford experiment shows that virtual superpowers encourage real-world empathy
Giving test subjects Superman-like flight in a virtual reality simulator
makes them more likely to exhibit altruistic behavior in real life, Stanford
researchers find.
By Bjorn Carey
The Stanford Report
Originally published January 31, 2013
If you give people superpowers, will they use those abilities for good?
Researchers at Stanford recently investigated the subject by giving people the ability of Superman-like flight in the university's Virtual Human Interaction Laboratory (VHIL). While several studies have shown that playing violent videogames can encourage aggressive behavior, the new research suggests that games could be designed to train people to be more empathetic in the real world.
(cut)
"It's very clear that if you design games that are violent, peoples' aggressive behavior increases," Bailenson said. "If we can identify the mechanism that encourages empathy, then perhaps we can design technology and video games that people will enjoy and that will successfully promote altruistic behavior in the real world."
The entire article is here.
Thanks to Ed Zuckerman for a lead on this article.
By Bjorn Carey
The Stanford Report
Originally published January 31, 2013
If you give people superpowers, will they use those abilities for good?
Researchers at Stanford recently investigated the subject by giving people the ability of Superman-like flight in the university's Virtual Human Interaction Laboratory (VHIL). While several studies have shown that playing violent videogames can encourage aggressive behavior, the new research suggests that games could be designed to train people to be more empathetic in the real world.
(cut)
"It's very clear that if you design games that are violent, peoples' aggressive behavior increases," Bailenson said. "If we can identify the mechanism that encourages empathy, then perhaps we can design technology and video games that people will enjoy and that will successfully promote altruistic behavior in the real world."
The entire article is here.
Thanks to Ed Zuckerman for a lead on this article.
Wednesday, March 6, 2013
War zone killing: Vets feel 'alone' in their guilt
By PAULINE JELINEK
Associated Press
Originally published February 22, 2013
A veteran of the wars in Iraq and Afghanistan, former Marine Capt. Timothy Kudo thinks of himself as a killer — and he carries the guilt every day.
"I can't forgive myself," he says. "And the people who can forgive me are dead."
With American troops at war for more than a decade, there's been an unprecedented number of studies into war zone psychology and an evolving understanding of post-traumatic stress disorder. Clinicians suspect some troops are suffering from what they call "moral injuries" — wounds from having done something, or failed to stop something, that violates their moral code.
Though there may be some overlap in symptoms, moral injuries aren't what most people think of as PTSD, the nightmares and flashbacks of terrifying, life-threatening combat events. A moral injury tortures the conscience; symptoms include deep shame, guilt and rage. It's not a medical problem, and it's unclear how to treat it, says retired Col. Elspeth Ritchie, former psychiatry consultant to the Army surgeon general.
The entire story is here.
Associated Press
Originally published February 22, 2013
A veteran of the wars in Iraq and Afghanistan, former Marine Capt. Timothy Kudo thinks of himself as a killer — and he carries the guilt every day.
"I can't forgive myself," he says. "And the people who can forgive me are dead."
With American troops at war for more than a decade, there's been an unprecedented number of studies into war zone psychology and an evolving understanding of post-traumatic stress disorder. Clinicians suspect some troops are suffering from what they call "moral injuries" — wounds from having done something, or failed to stop something, that violates their moral code.
Though there may be some overlap in symptoms, moral injuries aren't what most people think of as PTSD, the nightmares and flashbacks of terrifying, life-threatening combat events. A moral injury tortures the conscience; symptoms include deep shame, guilt and rage. It's not a medical problem, and it's unclear how to treat it, says retired Col. Elspeth Ritchie, former psychiatry consultant to the Army surgeon general.
The entire story is here.
Perspectives on Suicide in the Army National Guard
By James Griffith & Mark Vaitkus
Armed Forces & Society published online 22 February 2013
Abstract
Suicides in the US military were observed rising in 2004, most notably in the Army and Marine Corps, and particularly, in the Army National Guard (ARNG). Alarmed, Army leaders and researchers have offered various explanations and prescriptions, often lacking any evidence. In the present study, three data sets were used to examine evidence for various perspectives on suicide—dispositional risk, social
cognitive, stressor-strain, and social cultural/institutional, each having different emphases on relevant explanatory variables and underlying mechanisms of suicide. Primary risk factors associated with having committed suicide among the 2007–2010 ARNG suicide cases were age (young), gender (male), and race (white), supporting the dispositional risk perspective on suicide. Some evidence supported the stressor-strain perspective in that postdeployment loss of a significant other and a
major life change showed statistically significant, yet weaker associations with increased suicide intentions. Implications of results are discussed for future research and preventive strategies.
Here is part of the discussion:
Military-related variables, including having been deployed and combat exposure, showed little relationship to suicide. These findings are consistent with analyses of the active component Army suicides. US Army Public Health Command has consistently reported suicide cases as occurring disproportionally among males, Caucasians, younger in age (eighteen to twenty-four years), and often having an untreated behavioral condition and/or substance abuse.
The entire journal article is here.
Armed Forces & Society published online 22 February 2013
Abstract
Suicides in the US military were observed rising in 2004, most notably in the Army and Marine Corps, and particularly, in the Army National Guard (ARNG). Alarmed, Army leaders and researchers have offered various explanations and prescriptions, often lacking any evidence. In the present study, three data sets were used to examine evidence for various perspectives on suicide—dispositional risk, social
cognitive, stressor-strain, and social cultural/institutional, each having different emphases on relevant explanatory variables and underlying mechanisms of suicide. Primary risk factors associated with having committed suicide among the 2007–2010 ARNG suicide cases were age (young), gender (male), and race (white), supporting the dispositional risk perspective on suicide. Some evidence supported the stressor-strain perspective in that postdeployment loss of a significant other and a
major life change showed statistically significant, yet weaker associations with increased suicide intentions. Implications of results are discussed for future research and preventive strategies.
Here is part of the discussion:
Military-related variables, including having been deployed and combat exposure, showed little relationship to suicide. These findings are consistent with analyses of the active component Army suicides. US Army Public Health Command has consistently reported suicide cases as occurring disproportionally among males, Caucasians, younger in age (eighteen to twenty-four years), and often having an untreated behavioral condition and/or substance abuse.
The entire journal article is here.
Tuesday, March 5, 2013
Bitter Pill: Why Medical Bills Are Killing Us
By Steven Brill
Time: Health & Fitness
Originally published February 20, 2013
Here are some excerpts:
I got the idea for this article when I was visiting Rice University last year. As I was leaving the campus, which is just outside the central business district of Houston, I noticed a group of glass skyscrapers about a mile away lighting up the evening sky. The scene looked like Dubai. I was looking at the Texas Medical Center, a nearly 1,300-acre, 280-building complex of hospitals and related medical facilities, of which MD Anderson is the lead brand name. Medicine had obviously become a huge business. In fact, of Houston’s top 10 employers, five are hospitals, including MD Anderson with 19,000 employees; three, led by ExxonMobil with 14,000 employees, are energy companies. How did that happen, I wondered. Where’s all that money coming from? And where is it going? I have spent the past seven months trying to find out by analyzing a variety of bills from hospitals like MD Anderson, doctors, drug companies and every other player in the American health care ecosystem.
When you look behind the bills that Sean Recchi and other patients receive, you see nothing rational — no rhyme or reason — about the costs they faced in a marketplace they enter through no choice of their own. The only constant is the sticker shock for the patients who are asked to pay.
Yet those who work in the health care industry and those who argue over health care policy seem inured to the shock. When we debate health care policy, we seem to jump right to the issue of who should pay the bills, blowing past what should be the first question: Why exactly are the bills so high?
What are the reasons, good or bad, that cancer means a half-million- or million-dollar tab? Why should a trip to the emergency room for chest pains that turn out to be indigestion bring a bill that can exceed the cost of a semester of college? What makes a single dose of even the most wonderful wonder drug cost thousands of dollars? Why does simple lab work done during a few days in a hospital cost more than a car? And what is so different about the medical ecosystem that causes technology advances to drive bills up instead of down?
The entire story is here.
Time: Health & Fitness
Originally published February 20, 2013
Here are some excerpts:
I got the idea for this article when I was visiting Rice University last year. As I was leaving the campus, which is just outside the central business district of Houston, I noticed a group of glass skyscrapers about a mile away lighting up the evening sky. The scene looked like Dubai. I was looking at the Texas Medical Center, a nearly 1,300-acre, 280-building complex of hospitals and related medical facilities, of which MD Anderson is the lead brand name. Medicine had obviously become a huge business. In fact, of Houston’s top 10 employers, five are hospitals, including MD Anderson with 19,000 employees; three, led by ExxonMobil with 14,000 employees, are energy companies. How did that happen, I wondered. Where’s all that money coming from? And where is it going? I have spent the past seven months trying to find out by analyzing a variety of bills from hospitals like MD Anderson, doctors, drug companies and every other player in the American health care ecosystem.
When you look behind the bills that Sean Recchi and other patients receive, you see nothing rational — no rhyme or reason — about the costs they faced in a marketplace they enter through no choice of their own. The only constant is the sticker shock for the patients who are asked to pay.
Yet those who work in the health care industry and those who argue over health care policy seem inured to the shock. When we debate health care policy, we seem to jump right to the issue of who should pay the bills, blowing past what should be the first question: Why exactly are the bills so high?
What are the reasons, good or bad, that cancer means a half-million- or million-dollar tab? Why should a trip to the emergency room for chest pains that turn out to be indigestion bring a bill that can exceed the cost of a semester of college? What makes a single dose of even the most wonderful wonder drug cost thousands of dollars? Why does simple lab work done during a few days in a hospital cost more than a car? And what is so different about the medical ecosystem that causes technology advances to drive bills up instead of down?
The entire story is here.
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