These teaching materials explore the specific powers of governments to implement control measures in response to communicable disease, in two different contexts:The first context concerns global pandemic diseases. Relevant legal authority includes international law, World Health Organization governance and the International Health Regulations, and regulatory authority of nations.The second context is centered on U.S. law and concerns control measures for drug-resistant disease, using tuberculosis as an example. In both contexts, international and domestic, the point is to understand legal authority to (...) address public health emergencies. (shrink)

Objectives - To explore the wvay ethical principles develop during a medical education course for three groups of medical students - in their first year, at the beginning of their penultimate (fifth) year and towards the end of their final (sixth) year. Design - Survey questionnaire administered to medical students in their first, fifth and final (sixth) year. Setting - A large medical school in Queensland, Australia. Survey sample - Approximately half the students in each of three years (first, fifth (...) and sixth) provided data on a voluntary basis, a total of 385 students. Results - At the point of entry, minor differences were found between medical students and first year law and psychology students. More striking were differences between male and female medical students, suggesting early socialization had a substantial impact here. Conclusions - Results indicate that substantial changes in attitude have developed by the beginning of fifth year with little change thereafter. Gender difference persisted. Some difference in ethical attitudes were found when groups of different ethnic backgrounds were compared. The impact of a move to a graduate medical course, which gives high priority to ethics within a professional development domain, can now be evaluated. (shrink)

It has been 35 years since the publicationMelzack and Wall's Gate Control Theory whichhypothesized that nociceptive information wassubject to dynamic regulation by mechanismslocated in the spinal cord dorsal horn thatcould ultimately lead to hyperalgesic orhypoalgesic states. This paper examines GateControl Theory in light of our currentunderstanding of the neuroanatomical,neurophysiological and neurochemical substratesof nociception and antinociception. Despiteits initial controversies, no one has proposeda more comprehensive overall theory of painmodulation or has successfully refuted most ofthe basic tenets of this theory.

The issue of directed donation of organs from deceased donors for transplantation has recently risen to the fore, given greater significance by the relatively stagnant rate of deceased donor donation in the UK. Although its status and legitimacy is explicitly recognized across the USA, elsewhere a more cautious, if not entirely negative, stance has been taken. In England, Wales and Northern Ireland, the Human Tissue Act 2004, and in Scotland the Human Tissue (Scotland) Act 2006, are both silent in this (...) regard. Although so-called conditional donation, donation to (or perhaps withheld from) a specific class, has been outlawed as a product of guidance issued by the Secretary of State for Health issued in the wake of the controversial incident occurring in the North of England in 1998, its intended application to ‘directed’ donation is less certain. Directed and conditional donations challenge the traditional construct of altruistic donation and impartial (equitable) allocation in a very immediate and striking fashion. They implicitly raise important questions as to whether the body or parts of the body are capable of being owned, and by whom. This paper attempts to explore the notion of donor ownership of body parts and its implications for both directed and conditional donation. (shrink)

Background:Homeless persons in the United States have disproportionately high rates of illness, injury, and mortality and tend to believe that the quality of their end-of-life care will be poor. No studies were found as to whether nurses or nursing students require moral courage to help homeless persons or members of any other demographic complete advance directives.Research hypothesis:We hypothesized that baccalaureate nursing students require moral courage to help homeless persons complete advance directives. Moral courage was defined as a trait of a (...) person or an action that overcomes fears or other challenges to achieve something of great moral worth.Research design:The hypothesis was investigated through a qualitative descriptive study. Aside from the pre-selection of a single variable to study (i.e. moral courage), our investigation was a naturalistic inquiry with narrative hues insofar as it attended to specific words and phrases in the data that were associated with that variable.Participants and research context:A total of 15 baccalaureate nursing students at a public university in the United States responded to questionnaires that sought to elicit fears and other challenges that they both expected to experience and actually experienced while helping homeless persons complete advance directives at a local, non-profit service agency.Ethical considerations:The study was approved by the Internal Review Board of the authors’ university, and each participant signed an informed consent form, which stated that the study involved no reasonably foreseeable risks and that participation was voluntary.Findings:Before meeting with homeless persons, participants reported that they expected to experience two fears and a challenge: fear of behaving in ways that a homeless person would deem inappropriate, fear of discussing a homeless person’s dying and death, and the challenge of adequately conveying the advance directive’s meaning and accurately recording a homeless person’s end-of-life wishes. In contrast, after their meetings with homeless persons, relatively few participants reported having encountered those obstacles. So, while participants required moral courage to assist homeless persons with advance directives, they required greater moral courage as they anticipated their meetings than during those meetings.Discussion:Our study breaks new ground at the intersection of nursing, moral courage, and advance directives. It might also have important implications for how to improve the training that US nursing students receive before they provide this service.Conclusion:Our results cannot be generalized, but portions of our approach are likely to be transferable to similar social contexts. For example, because homeless persons are misunderstood and marginalized throughout the United States, our design for training nursing students to provide this service is also likely to be useful across the United States. Internationally, however, it is not yet known whether our participants’ fears and the challenge they faced are also experienced by those who assist homeless persons or members of other vulnerable populations in documenting healthcare wishes. (shrink)

Understanding the nature of pain at least partly depends on recognizing its inherent first person epistemology and on using a first person experiential and third person experimental approach to study it. This approach may help to understand some of the neural mechanisms of pain and consciousness by integrating experiential–phenomenological methods with those of neuroscience. Examples that approximate this strategy include studies of second pain summation and its relationship to neural activities and brain imaging-psychophysical studies wherein sensory and affective qualities of (...) pain are correlated with cerebral cortical activity. The experiential paradigm of Price and Barrell offers the possibility of improved designs and methods for investigating neural mechanisms underlying pain and consciousness. (shrink)

Donald Price and James Barrell show how a science of human experience can be developed through a strategy that integrates experiential paradigms with methods from the natural sciences.

Examines modern science, looks at scientific literature, and discusses the growth of science, invisible colleges, and the process of discovery.

In this 2001 book Jonathan Price attempts to demonstrate that Thucydides consciously viewed and presented the Peloponnesian War in terms of a condition of civil strife - stasis, in Greek. Thucydides defines stasis as a set of symptoms indicating an internal disturbance in both individuals and states. This diagnostic method, in contrast to all other approaches in antiquity, allows an observer to identify stasis even when the combatants do not or cannot openly acknowledge the nature of their conflict. The (...) words and actions which Thucydides chooses for his narrative meet his criteria for stasis: the speeches in the History represent the breakdown of language and communication characteristic of internal conflict, and the zeal for victory led to acts of unusual brutality and cruelty, and overall disregard for genuinely Hellenic customs, codes of morality and civic loyalty. Viewing the Peloponnesian War as a destructive internal war had profound consequences for Thucydides' historical vision. (shrink)

A diagnosis of Fetal Alcohol Spectrum Disorder ascribes cause to developmental disability; however, there are logical issues in causation with ethical implications. This article focuses on the use of fallacious logic in FASD, focusing on the Canadian Guidelines for diagnosis, and knowledge translation issues from science to practice. The clinician’s logical fallacy is an ethical issue of veracity in the clinician–patient relationship; this then leads to issues of nonmaleficence, because the diagnosis in turn blames the mother for her child’s difficulties. (...) Suggestions for revised diagnostic practices that avoid allusions to causation and responsibility are discussed. (shrink)

This paper questions the dogmatic stance of the domestic courts toward mandatory orders for treatment, arguing that this has the potential to subjugate patients' interests to clinical discretion, and proposing a via media to accommodate the legitimate concerns of all parties.

There has been a renewed interest in psychology and anthropology in the idea of altered states of consciousness. This paper begins by examining the meaning of this term and the extent to which such experiences are reported globally. The topic of shamanism is then discussed, first with respect to its social functions, and then to what is known about its psychological aspects (which is little). Far more is known about altered states of consciousness (ASCs) as they are expressed in meditation, (...) trance and possession, and channeling, and a number of studies are reviewed, both of individuals and of groups, which illustrate the full extent of ASCs. The following section then goes more deeply into the stimulus situations that are associated with ASCs. This brings the discussion into drugs, attempts at altering the sensorium (music and imagery in particular) and recent technological innovations, peculiar to our time, which deliberately alter our usual state of awareness through feedback principles. In the final section, what is known about the physiology of ASCs is reviewed and also the extent to which these phenomena, including shamanism, are regarded as pathological. As a great number of people across the world utilize the healing aspects of trance, possession and shamanic practices, this aspect is discussed, and lastly the adaptive functions of ASCs are considered, with their context in the history of psychology. (shrink)

Understanding the nature of pain at least partly depends on recognizing its inherent first person epistemology and on using a first person experiential and third person experimental approach to study it. This approach may help to understand some of the neural mechanisms of pain and consciousness by integrating experiential–phenomenological methods with those of neuroscience. Examples that approximate this strategy include studies of second pain summation and its relationship to neural activities and brain imaging-psychophysical studies wherein sensory and affective qualities of (...) pain are correlated with cerebral cortical activity. The experiential paradigm of Price and Barrell offers the possibility of improved designs and methods for investigating neural mechanisms underlying pain and consciousness. (shrink)

This essay examines the doctrine of divine omnipresence. I begin by presenting three desiderata for an adequate account of omnipresence. Four accounts are analyzed in light of these desiderata, two in the tradition and two in contemporary philosophical theology. I argue that none succeed in providing an adequate account of divine omnipresence. As an alternative, I offer a paradoxical account of omnipresence, arguing that one can be rational in affirming that what appears to be a doctrine afflicted by apparent contradiction (...) is in fact merely a paradox. I explain what makes affirmations of paradoxical doctrines rational, why omnipresence should be understood as a paradox, and discuss a similar account of omnipresence in the writings of Pseudo-Dionysius the Areopagite. (shrink)