Background Financial relationships between physicians and industry are extensive and public reporting of industry payments to physicians is now occurring. Our objectives were to describe physician recipients of large total payments from these seven companies, and to examine discrepancies between these payments and conflict of interest (COI) disclosures in authors’ concurrent publications. Methods The investigative journalism organization, ProPublica, compiled the Dollars for Docs database of payments to individuals from publically available data from seven US pharmaceutical companies during the period 2009 (...) to 2010. We examined the cohort of 373 physicians in this database who each received USD $100,000 or more in the reporting period 2009 to 2010. Results These physicians received a total of $52,600,624 during this period (mean payment per physician $141,020). The predominant specialties were internal medicine and psychiatry. 147 of these physicians authored a total of 134 publications in the first quarter of 2011 and 77% (103) of these publications provided a COI disclosure. 69% of the 103 publications did not contain disclosures of the payment listed in the Dollars for Docs database. Conclusions With increased public reporting of industry payments to physicians, it is apparent that large sums are being paid for services such as consulting and peer education. In over two-thirds of publications where COI disclosures were provided, the disclosures by physician authors did not include industry payments that were documented in the Dollars for Docs database. (shrink)

Researchers from diverse disciplines, including organismal and cellular physiology, sports science, human nutrition, evolution and ecology, have sought to understand the causes and consequences of the surprising variation in metabolic rate found among and within individual animals of the same species. Research in this area has been hampered by differences in approach, terminology and methodology, and the context in which measurements are made. Recent advances provide important opportunities to identify and address the key questions in the field. By bringing together (...) researchers from different areas of biology and biomedicine, we describe and evaluate these developments and the insights they could yield, highlighting the need for more standardisation across disciplines. We conclude with a list of important questions that can now be addressed by developing a common conceptual and methodological toolkit for studies on metabolic variation in animals. (shrink)

The United States Government does not mandate that US based firms follow US social and environmental law in foreign markets. However, because many developing countries do not have strong human rights, labor, and environmental laws, many multinationals have adopted voluntary corporate responsibility initiatives to self-regulate their overseas social and environmental practices. This article argues that voluntary actions, while important, are insufficient to address the magnitude of problems companies confront as they operate in developing countries where governance is often inadequate. The (...) United States can do more to ensure that its multinationals act responsibly everywhere they operate. First, policymakers should define the social and environmental responsibilities of global companies. They must consistently make their expectations for global business clear – and underscore that this objective can often be accomplished without mandates. Second, the US should closely examine the policies that undermine global Corporate Social Responsibility (CSR) and address the many conflicting signals sent by policymakers. Third, the President should make the US government a CSR model by examining how to use its purchasing power to promote human rights. Finally, the US government should require pension funds to report on the social and environmental consequences of their investments. In these ways, Americans can mind our business – and thus make sure that US based firms do not undermine social and environmental progress when they operate in the developing world. (shrink)

Unpublished counts of larceny arrests and census data for five of the largest cities in the United States are used to examine the contribution of white and nonwhite men and women in specific age groups to increases in larceny arrests from 1960 to 1980. The results suggest that nonwhite women and white men now have similar larceny arrest rates and that 77 percent of the total increase in the arrest of women for larceny from 1960 to 1980 was the result (...) of increased arrests of nonwhite women. Although 18 percent of this increase can be explained by increased numbers of nonwhite women in specific age groups in the population, the worsening economic situation of young black women in older U.S. central cities is suggested as the most plausible explanation for these trends. Implications of the findings for other theories of women's criminality are examined. (shrink)

Public bioethics bodies are used internationally as institutions with the declared aims of facilitating societal debate and providing policy advice in certain areas of scientific inquiry raising questions of values and legitimate science. In the United States, bioethical experts in these institutions use the language of consensus building to justify and define the outcome of the enterprise. However, the implications of public bioethics at science-policy boundaries are underexamined. Political interest in such bodies continues while their influence on societal consensus, public (...) debate, and science policy remains ambiguous. This article presents a theoretical discussion of public bioethics bodies as boundary organizations and examines them in terms of relationship to the moral and cognitive authority of science and other forms of expertise, mechanisms for public participation in controversial science policy, and the deployment of consensus models. The theoretical discussion is examined in the case of the U.S. Human Embryo Research Panel. (shrink)

In an analysis of 47 U.S. journalism ethics codes, we found that although most consider images, only 9 address a gripping issue: how to treat images of tragedy and violence, such as those produced on the battlefields of Iraq, during the 2005 London bombings, and after Hurricane Katrina. Among codes that consider violent and tragic images, there is agreement on what images are problematic and a move toward green-light considerations of ethical responsibilities. However, the special problems of violence and truth (...) telling in wartime and issues of how to handle graphic images across media platforms receive virtually no attention. (shrink)

"No person who is diseased, maimed, or deformed so as to be an unsightly or disgusting object shall expose himself to public view." My research on this municipal ordinance , a nineteenth-century statute adopted in many U.S. cities, showed me the extent to which U.S. immigration law has been ugly law writ large. The body politic of American democratic citizenry binds itself together through an internal logic that, even as it attempts to manage the incorporation of disabled subjects, drives disability (...) down or assumes it away. But it has never done so decisively, and never without contradiction. Native American history gives us an especially valuable frame for thinking through questions of American citizenship and the ways in which it intertwines with disability, since it reveals so clearly the dizzying array of contestations and confusions about who "has" citizenship and what responsibilities the state has to those who do not. This essay centers on a Yavapai man who lived in the late nineteenth/early twentieth century in a vortex of conflict about citizenship: Carlos Montezuma, physician and a prominent Native American intellectual, cofounder of the National Society of American Indians, and radical critic of the Bureau of Indian Affairs. I explore some of the ways in which Montezuma developed not only theories of citizenship but also theories of disability based on what he called "the standpoint of actual circumstance," ideas that speak to our understandings of the body of the citizen today. (shrink)

A critical difference between 1978, the first time the U.S. Supreme Court heard on its merits a case involving affirmative action policies (AAPs), and its 2003 revisiting of the issue was that the context for hearing the issue had significantly changed from that of medical education to that of undergraduate and law school programs. This shift in context mattered. I argue here that medicine has particular interests and insights into the problem of race, and in this, its participation in the (...) debate is critical not only for medical education and practice but for the development of sound judicial approaches to AAPs. (shrink)

A critical difference between 1978, the first time the U.S. Supreme Court heard on its merits a case involving affirmative action policies (AAPs), and its 2003 revisiting of the issue was that the context for hearing the issue had significantly changed from that of medical education to that of undergraduate and law school programs. This shift in context mattered. I argue here that medicine has particular interests and insights into the problem of race, and in this, its participation in the (...) debate is critical not only for medical education and practice but for the development of sound judicial approaches to AAPs. (shrink)

Using the infamous research studies in Tuskegee and Guatemala, the article examines the difference between victims and bystanders. The victims can include families, sexual partners, and children not just the participants. There are also the bystanders in the populations who are affected, even vaguely, decades after the initial studies took place. Differing reparations for victims and bystanders through lawsuits and historical acknowledgments has to be part of broader discussions of historical justice, and the weighing of the impact of racism and (...) imperial research endeavors. (shrink)

In the last five years, a number of U.S. companies have either moved their locus of incorporation to countries with more favorable tax laws, or announced such moves. Given this trend toward “inversions”, and the polemics that have accompanied it, we offer two ways in which the ethics of such a move can be evaluated. We provide multinational executives with two applications of ethics to inversion: Kant’s deontological theory and the consequentialist perspective of utilitarianism.

In 1880, when Oliver Wendell Holmes (later to be a Justice of the U.S. Supreme Court) criticized the logical theology of law articulated by Christopher Columbus Langdell (the first Dean of Harvard Law School), neither Holmes nor Langdell was aware of the revolution in logic that had begun, the year before, with Frege's Begriffsschrift. But there is an important element of truth in Holmes's insistence that a legal system cannot be adequately understood as a system of axioms and corollaries; and (...) this element of truth is not obviated by the more powerful logical techniques that are now available. (shrink)

Bringing Human Rights Education to US Classrooms presents ten research-based human rights projects powerfully implemented in a range of U.S. classrooms, from elementary school through community college and university. In these classrooms, the students--primarily young people of color who have experienced or witnessed human rights abuses such as discrimination and poverty--are exposed for the first time to thinking about their own lives and the world through an empowering human rights lens. Unique in integrating theory and classroom practice, and in addressing (...) human rights issues with special relevance for communities of color in the US, Katz and Spero provide indispensable guidance for those studying and teaching human rights. (shrink)

First published in 1985, the _Handbook for Achieving Gender Equity Through Education_ quickly established itself as the essential reference work concerning gender equity in education. This new, expanded edition provides a 20-year retrospective of the field, one that has the great advantage of documenting U.S. national data on the gains and losses in the efforts to advance gender equality through policies such as Title IX, the landmark federal law prohibiting sex discrimination in education, equity programs and research. Key features include:_ (...) Expertise_ – Like its predecessor, over 200 expert authors and reviewers provide accurate, consensus, research-based information on the nature of gender equity challenges and what is needed to meet them at all levels of education._ Content Area Focus_ – The analysis of gender equity within specific curriculum areas has been expanded from 6 to 10 chapters including mathematics, science, and engineering._ Global/Diversity Focus_ – Global gender equity is addressed in a separate chapter as well as in numerous other chapters. The expanded section on gender equity strategies for diverse populations contains seven chapters on African Americans, Latina/os, Asian and Pacific Island Americans, American Indians, gifted students, students with disabilities, and lesbian, gay, bisexual, and transgender students. _ Action Oriented_ – All chapters contain practical recommendations for making education activities and outcomes more gender equitable. A final chapter consolidates individual chapter recommendations for educators, policymakers, and researchers to achieve gender equity in and through education._ New Material_ – Expanded from 25 to 31 chapters, this new edition includes: *more emphasis on male gender equity and on sexuality issues; *special within population gender equity challenges ; *coeducation and single sex education; *increased use of rigorous research strategies such as meta-analysis showing more sex similarities and fewer sex differences and of evaluations of implementation programs; *technology and gender equity is now treated in three chapters; *women’s and gender studies; *communication skills relating to English, bilingual, and foreign language learning; and *history and implementation of Title IX and other federal and state policies. Since there is so much misleading information about gender equity and education, this _Handbook_ will be essential for anyone who wants accurate, research-based information on controversial gender equity issues—journalists, policy makers, teachers, Title IX coordinators, equity trainers, women’s and gender study faculty, students, and parents. (shrink)

The first section of this paper explains why assessing the worth of expert testimony poses special epistemological difficulties. The second traces the history of the various rules and procedures by means of which the U.S. legal system has tried to ensure, or at least control, the quality of the expert testimony on which it so often relies—from the Frye Rule, the Federal Rules of Evidence, and the Daubert trilogy to recent constitutional cases regarding the appearance of forensic witnesses in court (...) and experiments with court-appointed experts and scientific education for judges. The third and final section suggests some lessons to be learned from the limited success of these efforts, and explores what might be better strategies going forward. (shrink)

The emergence of nanotechnology, and specifically nanobiotechnology, raises major oversight challenges. In the United States, government, industry, and researchers are debating what oversight approaches are most appropriate. Among the federal agencies already embroiled in discussion of oversight approaches are the Food and Drug Administration , Environmental Protection Agency , Department of Agriculture , Occupational Safety and Health Administration , and National Institutes of Health . All can learn from assessment of the successes and failures of past oversight efforts aimed at (...) emerging technologies. This article reports on work funded by the National Science Foundation aimed at learning the lessons of past oversight efforts. The article offers insights that emerge from comparing five oversight case studies that examine oversight of genetically engineered organisms in the food supply, pharmaceuticals, medical devices, chemicals in the workplace, and gene therapy. Using quantitative and qualitative analysis, the authors present a new way of evaluating oversight. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 15.2 (2005) 211-218 [Access article in PDF] Bioethics, Biolaw, and Western Legal Heritage Susan Cartier Poland Bioethics and biolaw are two philosophical approaches that address social tension and conflict caused by emerging bioscientific and biomedical research and application. Both reflect their respective, yet different, heritages in Western law. Bioethics can be defined as "the research and practice, generally interdisciplinary in nature, which aims (...) to clarify or resolve ethical questions raised by the advances and application of biomedical and biological sciences" (II, Miller 2000, p. 246). Biolaw, on the other hand, is a legal philosophical concept that can be defined as "the taking of agreed upon principles and practices of bioethics into law with the sanctions that law engenders" (p. 246). Some see biolaw as hierarchical, either evolving from or devolving into bioethics (p. 245), while others think of bioethics and biolaw as a continuum or gradation (p. 246). Whichever view one takes, bioethics and biolaw are, at the least, intertwined (II, Loureiro 2000, p. 71).Although bioethics came out of the U.S. in the 1970s, the field is now considered Anglo-American (II, Kemp 2000a, p. 67). Biolaw emerged in the 1990s from the French biodroit and has become associated with continental Europe (p. 68). These distinctions, however, are based on geopolitical entities. Another way to distinguish bioethics from biolaw is to look at their legal heritage and understand the differences between the common law and the civil law.Bioethics and biolaw share a Western legal heritage, specifically roots in Roman law. When the Roman empire in the West fell to Germanic tribes in 476 A.D., the Romans had developed a sophisticated system of law that included flexible standards and abstract, rather than concrete, modes of thought. In 528, Justinian, emperor of the surviving Roman empire in the East at Constantinople, ordered a compilation and consolidation of Roman law. Despite the rise of seventh century Islam, the split of the Christian church into eastern and western branches in 1054, and the Norman conquest of England in 1066, Roman law survived through the courts of canon law and was revived later in the twelfth century at the University of Bologna in Italy. By 1500, what would later become France and Germany had [End Page 211] "received" or recognized Roman law, albeit in varying degrees. Not a single event, the Reception, or "direct acceptance of Roman law as a principal source of law," is the definitive turning point in Western legal history that eventually produced the common law and civil law strands (I, Von Mehren 1957, p. 10).England, however, did not participate in the Reception, although its influence was felt at Oxford University, where Vacarious taught its precepts in 1151, and in the courts of canon law (I, Von Mehren 1957, p. 10). William the Conqueror already essentially had established the common law tradition when he merged Anglo-Saxon law with Norman law and created a centralized system of justice administration for the single fiefdom known as England.Aside from historical development, the common law and the civil law differ from other legal families in terms of their modes of thought, institutions, sources, and ideology (I, Zweigert and Kotz 1977, p. 62). In the common law, Roman legal concepts were shaped by Christian ethics through the canon law courts. In the civil law, Roman law became the basis for a legal science centered in the universities and interpreted by various schools, such as the commentators, the glossators, and the humanists. The civil law uses a central text as the starting point for legal reasoning and analysis. The common law develops over time through case law, that is, by judges applying principles from preceding cases to resolve the issue at hand. One writer describes the common law as "anything that is not prohibited is permitted" and the civil law as "anything that is not permitted is prohibited" (I, Karambelas 2005, p. 28).The common law and the civil law are only two of the three traditions in Western law. The third is socialist law. All three are... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics Commissions: Town Meetings with a “Blue, Blue Ribbon”Susan Cartier Poland (bio)Town meetings are characteristic of New England. In theory, a quorum of registered voters in a small municipality meets annually to decide local public policy. In fact, special interests and the town bureaucracy control the meeting.Like a town meeting, a commission (or committee or council) comes into being, whether on an ad hoc or permanent basis, to (...) direct a government function. Bioethics commissions specialize in one area: the intersection of public policy with developments, either real or anticipated, in the basic and applied sciences.That specialization of commissions carries over into the selection of the members. More often than not commission members are appointed on the basis of expertise in a specific area. Although some commissions are still made up entirely of one kind of expert, usually medical, the majority of these government bodies seek breadth between the fields of law, religion, ethics, and science (including medicine and the social sciences).In the words of Mrs. Rigenbach, the law clerk to Chief Judge Carl B. Rubin of the United States District Court for the Southern District of Ohio, selection of persons “knowledgeable in the field” constitutes a “blue, blue ribbon” jury. In contrast, a “blue ribbon” jury is composed of those persons having “the greatest amount of formal education” (In re Richardson-Merrill, Inc. (Bendectin litigation), 624 Federal Supplement 1212 at 1217 (1985)). The problem with persons knowledgeable in the field is that their minds may have already been made up. For a jury, this is a disaster; for a bioethics commission, this directs and shapes the research, investigation, and discussion, or, in short, it makes for more efficient decision making.For this Scope Note, the definition of commission begins with the Bioethicsline description of its index term “advisory committees” as committees or commissions set up to advise government bodies on public policy. Furthermore, a commission [End Page 91] (or committee) receives government funding and support in exchange for its expertise in research, investigation, reporting, and recommendations.Six functions served by bioethics commissions have been clearly and succinctly described by LeRoy Walters (Commissions and Bioethics. Journal of Medicine and Philosophy 14 (4): 363–68, August 1989). The functions are: (1) to legitimize action; (2) to delay action or resolution; (3) to identify duplication; (4) to be representative; (5) to do research and find facts; and (6) to provide education and support (pp. 364–65). Since 1989, however, another government function has moved to the forefront. Instead of remaining within the legislative arena, government commissions serve the judiciary as well, in cases involving complex and technical questions. The now defunct Law Reform Commission of Canada recognized this use when it included in its annual reports a section on its “Influence on Law Reform through Judicial Decisions.”In mid-1997, the United States Supreme Court in its consolidated cases on assisted suicide used extensively the writings from a state commission, the New York State Task Force on Life and the Law, to support its rationale. Not only did the Court make use of the Task Force’s work, but in so doing the Court extended the efforts of the commission beyond its jurisdiction of New York into another jurisdiction on the opposite coast, Washington state. Furthermore, although the commission was chartered by one state, through the federal court system, its influence became national.Outside the U.S., the United Nations recently adopted its first bioethics text on the ethics of genetic research, and Canada is reworking its human research guidelines into a single set of guidelines that will apply to research in both the natural sciences and the social sciences.This Scope Note attempts to compile for the researcher and the reference librarian those commissions, existing and defunct, that have addressed bioethics issues. Only one other such attempt is known to the author, an Office of Technology Assessment [OTA] Background Paper, Biomedical Ethics in U.S. Public Policy (1993). Due to space limitations, not all publications could be listed; the selections included represent the range of topics from a particular group or the more frequently cited sources. Future updates of this compilation are planned, so please notify the... (shrink)

There is significant evidence that the health needs of women and minorities have been neglected by a medical research community whose agendas and protocols tend to focus on more advantaged segments of society. In response, the National Institutes of Health and Food and Drug Administration in the United States have recently issued new policies aimed at increasing the utilization of women in clinical studies. As well, the U.S. Congress passed the NIH Revitalization Act of 1993, which specifically mandates increased inclusion (...) of women and racial and ethnic groups in clinical studies. On the face of it, such gender and race-specific policies would appear to be morally problematic because traditionally ethics opposes the use of sex or race as legitimate criteria for distributions of benefits or burdens in social policies. Hence, these policies pose some significant moral questions. Feminist ethics provides us with a framework for evaluating such policies because of its readiness to recognize that socially and politically significant factors such as sex and race are morally relevant in setting public policy. Of course, feminist ethics does not simply endorse all appeals to sex and race but only the policies in which attention to such factors will contribute to social justice. In this essay, I Identify some of the Important ethical questions that a feminist ethics perspective raises about research policies devised to promote the Inclusion of women in clinical studies. (shrink)

Haack articulates something of what she takes the moral demands of academic life to be, calling for such virtues as industry, honesty, realism, patience, and consideration. She then explains why she believes the current academic environment is sapping the strength of character these virtues require, and why graduate students are caught in the middle. She writes primarily about philosophy, but much of what she has to say applies to other humanities disciplines and much of that to other disciplines as well---and (...) while she writes primarily about the U.S. situation, much of what she says applies elsewhere too. (shrink)

The work of bioethicists often involves identifying an ethical problem in health or medicine and proposing a policy to address it. But the path to policy is full of twists and turns, bumps and detours. Effecting policy may be the goal, but it is far from assured. One success story is discussed here. The U.S. Department of Health and Human Services issued a ruling in April 2024 that requires all teaching hospitals in the country to get written consent from patients (...) before they undergo intimate medical exams. The ruling was informed by an essay in the Hastings Center Report two years ago that revealed that millions of U.S. residents have received unconsented intimate exams and that this unethical practice occurs nearly four times as often in Black patients as White patients. (shrink)

There is tension between the adversarialism of the U.S. legal culture and the investigative procedures of the sciences, and between the law's concern for finality and the open‐ended fallibilism of science. A long history of attempts to domesticate scientific testimony by legal rules of admissibility has left federal judges with broad screening responsibilities; recent adaptations of adversarialism in the form of court‐appointed experts have been criticized as “inquisitorial,” even “undemocratic.” In exploring their benefits and disadvantages, it would make sense to (...) look to the experience of other legal systems. (shrink)

Modern secularity as a historically specific hegemonic social formation that prevailed in the U.S. in the mid-20th century depended on and was, in part, constituted by the exclusion of fundamentalists and their Bible-based moral rhetorics from public life. This essay argues that the movements for temperance, prohibition, and prohibition repeal were an important context in which the political and cultural predominance of white theologically conservative Protestants was made, unmade, and finally gave way to emerging secular voices that repudiated Protestant campaigns (...) to "legislate morality." Science, reason, and an etiquette of civility and ecumenicism came together in the prohibition repeal movement as integral elements of the nascent normative religiousity and public morality that we know retrospectively as modern secularity. (shrink)

In Über den Unterschied des Geistes u. des Buchstabens in der Philosophie, Fichte writes that man’s most fundamental tendency to philosophize is simply the drive to represent for the sake of representing—the same drive which is the ultimate basis of the fine arts. The process of representing for the sake of representing is grounded in “spirit”, which is nothing other than the power of the imagination to raise to consciousness images of das Urschöne. In this paper, I suggest that the (...) affinity between artistic activity and Fichte’s transcendental philosophy is closer than previously thought. I further suggest that for Fichte, transcendental philosophy is a performance and that such an interpretation of Fichte’s thought points to a way out of the circularity in his transcendental project. (shrink)

Appraising the worth of others’ testimony is always complex; appraising the worth of expert testimony is even harder; appraising the worth of expert testimony in a legal context is harder yet. Legal efforts to assess the reliability of expert testimony—I’ll focus on evolving U.S. law governing the admissibility of such testimony—seem far from adequate, offering little effective practical guidance. My purpose in this paper is to think through what might be done to offer courts more real, operational help. The first (...) step is to explain why the legal formulae that have evolved over the years may seem reassuring, but aren’t really of much practical use. The next is to suggest that we might do better not by amending evidentiary rules but by helping judges and attorneys understand what questions they should ask about expert evidence. I focus here on (i) epidemiological testimony, and (ii) the process of peer review. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Landmark Legal Cases in BioethicsSusan Cartier Poland (bio)Only a few decades old, the interdisciplinary field of bioethics has developed surrounded by centuries of legal tradition and moral philosophy. Bioethics and the law have weaved back and forth over time influencing each field. Sometimes ethics leads the debate on problematical issues; for example, the Recombinant DNA Advisory Committee at the National Institutes of Health established regulations prior to initiating human (...) gene therapy. At other times, law takes over; Roe v. Wade, for example, has polarized and closed public discussion on abortion. Most frequently, however, scientific developments initiate discussion in both fields, as when the announcement of the birth of Dolly—the first cloned mammal—sparked President Clinton to ask the National Bioethics Advisory Commission for a report on cloning.A back-and-forth pattern also exists within the law itself, this time between legislator and judge. Legislators enact statutes, which apply universally to regulate conduct in society. Judges, on the other hand, interpret statutes and apply them to particular cases to resolve disputes between parties. Case law, as judge-made law is called, that grows in the absence of legislation becomes the common law. Legislatures can change the course of common law development by enacting more law, usually as amendments, but sometimes as repeals. A judge who sees the facts of a case or the law differently may also change the common law. And so the counterpoint between legislator and judge goes.A legal case becomes a landmark in bioethics because of its historical or precedential value to the field. Historical cases reflect judicial reasoning or rationalization that lays the conceptual foundation for a bioethical principle. Perhaps the best known example of this is the focus on the right to self-determination in Schloendorff that led to the development of informed consent. The principle of autonomy in bioethics derives its legal impetus from this line of cases.A case that acquires landmark status because of its precedential value does so for one of two reasons based on legal precedents. First, the case may be one of “first impression.” In the legal sense, that means that the particular case with its [End Page 191] facts or issues is the first one that a particular court has confronted within that court’s jurisdiction or area of decision-making authority. To be a landmark in bioethics, however, the ordinary sense of “first impression” applies. The first time that a particular bioethical topic has appeared in court for legal resolution makes a case one of “first impression” for bioethics. The case of Baby M on surrogacy contracts illustrates this.The second way in which a case can achieve landmark status based on precedents involves legal precedent and the jurisdictional basis of the court system. Under the common law system, a preceding case that involves the same or similar facts or issues as a current case must be followed by lower—i.e., less authoritative—courts in the same jurisdiction. That judicial rule of decision making is called stare decisis. It creates an institution of continuity, yet allows for change due to differences in judicial interpretation of facts and issues, which is called distinguishing the case.All courts under United States jurisdiction must follow the U.S. Supreme Court. By its sheer power of authority, the Court issues opinions that, if they concern bioethical topics, make cases landmarks in bioethics. For example, Roe v. Wade made abortion legal and set off the debate between maternal and fetal rights. Casey later refined, or to some redefined with a discussion of stare decisis, the bioethical underpinnings of Roe by framing the debate as one between maternal rights and state interests.In law, precedents concern only appellate cases. Trial courts, like that in McFall v. Shimp, handle questions of both fact and law. Appellate courts, like that in Brotherton, hear appeals from the lower trial courts and address legal issues only. Trial judges apply the law to facts, and appellate judges reason about the trial judge’s legal interpretation.Appellate court decisions are the ones most frequently published, either in print or electronically online, for citation. Consequently they are the easiest to locate and retrieve. “Reporters” as... (shrink)

A natural language is an organic living thing; and meanings change as words take on new, and shed old, connotations. Recent philosophy of language has paid little attention to the growth of meaning; radical philosophers like Feyerabend and Rorty have suggested that meaning-change undermines the pretensions of science to be a rational enterprise. Thinkers in the classical pragmatist tradition, however -Peirce in philosophy of science and, more implicitly, Holmes in legal theory- both recognized the significance of growth of meaning, and (...) understood how it can contribute to the progress of science and to the adaptation of a legal system to changing circumstances. This paper develops these insights, and illustrates them by reference to the growth of meaning of "DNA" from the identification of "nuclein" to the discovery of mtDNA almost a century later, and the growth of meaning of "the establishment of religion" in the First Amendment to the U.S. Constitution from its ratification in 1791 to the present day. Arguing that the growth of meaning can indeed contribute to rationality, it also shows why narrowly formal models are inadequate both to science and to law. Un lenguaje natural es una cosa viviente orgánica, y los significados cambian a medida que las palabras adoptan nuevas connotaciones y abandonan viejas. La filosofía del lenguaje reciente ha prestado poca atención al desarrollo del significado; filósofos radicales, como Feyerabend y Rorty han sugerido que el cambio de significado socava las pretensiones de la ciencia de ser una empresa racional. Pensadores en la tradición pragmatista clásica, sin embargo -Peirce en la filosofía de la ciencia y, más implícitamente, Holmes en la teoría del Derecho- reconocieron la importancia del desarrollo del significado y comprendieron cómo éste puede contribuir al progreso de la ciencia y a la adaptabilidad de un sistema jurídico a las circunstancias cambiantes. Este trabajo desarrolla estas ideas, y las ilustra por medio de una referencia a el desarrollo del significado de "ADN" desde la identificación de la "nucleína" hasta el descubrimiento del ADN mitocondrial casi un siglo más tarde, y el desarrollo del significado de "el establecimiento de una religión" en la Primera Enmienda de la Constitución de los Estados Unidos desde su ratificación en 1791 hasta la actualidad. Argumentando que el desarrollo del significado puede contribuir mucho a la racionalidad, también muestra por qué los modelos estrechamente formales son inadecuados, tanto para la ciencia como para el Derecho. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 10.3 (2000) 265-281 [Access article in PDF] Scope Note 39 Genes, Patents, and Bioethics-Will History Repeat Itself? Susan Cartier Poland Gene patenting--the very notion sounds absurd! How can anyone claim to have invented the genes with which one is born? To make matters worse, genetic makeup precedes birth, meaning the existence of the invention predates the existence of the inventor. So, do we (...) really own our genes, or do they belong to our parents, or our governments, or a Supreme Being? Ownership is only one bioethical issue involved in gene patenting. But before looking at the issues, some essential and basic terms must be understood, namely genes and patents. Genes In his book On the Origin of Species, published in 1859, the biologist Charles Darwin proposed a theory called "natural selection," whereby living things changed over time or evolved through generations due to competition and variation. By experimenting with the garden pea in the 1860s, Gregor Mendel, a monk and accomplished horticulturalist, provided the mechanism of inheritance supporting the natural selection theory of his contemporary Darwin. That mechanism is the gene, or, as Mendel described it, a discrete "factor." The gene has also been defined as "the fundamental unit of heredity" (United States 1987, p. 157). Each individual has two copies of a gene, one from each parent, but that individual passes down to offspring only one of the two copies. Because of Mendel, the gene has become a scientific concept and the basis of a new scientific field: genetics.David C. Page (2000) of the Whitehead Institute for Biomedical Research at the Massachusetts Institute of Technology explained today's terms for genetics structures using an analogy taken from the home. In his view, the cell is a kitchen, the genome is a shelf in the kitchen, the chromosome is a cookbook on the shelf, the gene is a recipe in the cookbook, and a base-pair (either adenine with thymine or guanine with cytosine) is a single letter in the recipe. A protein, the [End Page 265] working molecule blueprinted by a gene, is a dish ready to eat, and an ingredient in the dish is an amino acid, which is a building block of the protein as specified by a string of base-pairs.Colin Tudge (1993), a British science journalist, would disagree with Page's description of the gene as a recipe. A recipe is like a blueprint: both are directions that precede the work. But a gene is not passive according to Tudge; it actively administers the cell's work, and it also responds to cellular events (Aldridge 1996).The current focus of scientific research and funding is on the gene and the completion of the sequencing of all the genes that comprise the human genome, portrayed in the press as a race between the U.S. government's Human Genome Project and the private corporation Celera Genomics. The real action, however, is at the protein level. The gene only holds the information to produce a protein; it is the three-dimensional shaped protein that does the work. In order to produce energy, eliminate waste, and perform other functions specific to a cell or tissue, proteins must bind, thus creating "biological pathways." Proteins bind (or not) and detach as a function of their shapes, which are determined by their precise chemical composition as spelled out in their genetic code. IBM will spend the next five years making one computer, Blue Gene, that will then take an entire year to come up with the chemical map for only one protein (Gillis 2000). It is estimated that there are about 40,000 proteins in the human body.Despite these overwhelming numbers, modern biology has been able to achieve significant results within the Human Genome Project's 15-year time frame, from 1990 to 2005. The genetic map was completed in 1993; the physical map was completed in 1995; and the genetic sequence is expected to be completed in 2002, with 97 to 99 percent completed as of 26 June 2000. This... (shrink)

Throughout the history ofthe U.S. national park system, park advocates and managers have changed both acquisition priorities and internal management policies. The park movement began with the establishment of large, spectacular natural areas, primarily in the West. As the movement developed there was more emphasis on the biological, on recreation, and on parks near population centers. GraduaIly, scenic wonders and uniqueness have become less necessary to designation and the types of sites eligible have diversified. Early managers treated the parks as (...) relatively unchanging, threatenedby little other than human vandalism. Initially managers removed “bad” animals, such as wolves, and suppressed disturbances, such as fire. Modem management values processes as weIl as objects and recognizes change and disturbance as integral to park maintanence. A conversion to an ecosystem mode of management does not answer all questions concerning values, however, and may present some disadvantages, such as a tendency to treat nature as aseries of functions and energy equations, thus weakening aesthetic values. (shrink)

Disease transmission is a fruitful domain in which to examine how scientific and folk theories interrelate, given laypeople’s access to multiple sources of information to explain events of personal significance. The current paper reports an in-depth survey of U.S. adults’ causal reasoning about two viral illnesses: a novel, deadly disease that has massively disrupted everyone’s lives, and a familiar, innocuous disease that has essentially no serious consequences. Participants received a series of closed-ended and open-ended questions probing their reasoning about disease (...) transmission, with a focus on causal mechanisms underlying disease contraction, transmission, treatment, and prevention; non-visible biological processes; and ontological frameworks regarding what kinds of entities viruses are. We also assessed participants’ attitudes, such as their trust in scientific experts and willingness to be vaccinated. Results indicated complexity in people’s reasoning, consistent with the co-existence of multiple explanatory frameworks. An understanding of viral transmission and viral replication existed alongside folk theories, placeholder beliefs, and lack of differentiation between viral and non-viral disease. For example, roughly 40% of participants who explained illness in terms of the transmission of viruses also endorsed a non-viral folk theory, such as exposure to cold weather or special foods as curative. Additionally, participants made use of competing modes of construal when explaining how viruses operate, such as framing the immune system response as cells trying to fight off the virus. Indeed, participants who displayed greater knowledge about viral transmission were significantly more likely to anthropomorphize bodily processes. Although comparisons of COVID-19 and the common cold revealed relatively few differences, the latter, more familiar disease elicited consistently lower levels of accuracy and greater reliance on folk theories. Moreover, for COVID-19 in particular, accuracy positively correlated with attitudes, self-protective behaviors, and willingness to be vaccinated. For both diseases, self-assessed knowledge about the disease negatively predicted accuracy. The results are discussed in relation to challenges for formal models of explanatory reasoning. (shrink)

This paper reviews 30 years of progress in U.S. cognitive science research related to education and training, as seen from the perspective of a research manager who was personally involved in many of these developments.

Almost 160 years after the American Civil War, where the Union defeated the Confederacy and ended slavery in the United States, approximately 1,910 tributes remain to Confederate military leaders located on public property in the 11 original Confederate states, particularly in cities with an exceptionally high density of Black residents. To Blacks, this iconography delivers a clear message of White supremacy. Six states have enacted laws to protect and preserve these memorials, making it almost impossible to use the court system (...) to move them to private property. This paper explores connections between support for a myth called the Lost Cause, which is a revisionist history intended to spread misinformation about the true cause of the American Civil War, and attitudes toward placement of Confederate symbols on public land. We show that there is significant belief in the Lost-Cause myth among many White U.S. Southerners. Furthermore, we find those who believe most in the myth are the least likely to want to move the monuments or end taxpayer support for their maintenance. (shrink)

Como se usa act ual ment e l a pal abr ainglesa “scientism”, es una verdad verbaltrivial que se debe evitar el cientismo –una actitud inapropiadamente deferentehaci a l a ci enci a. Pero const i t uye unacuestión sustancial determinar cuando,y por qué, la deferencia hacia las cienciases inapropiada o exagerada. Este artículot r a t a d e r e s p o n d e r a e s t a c u e s t i ó (...) narticulando “seis signos de cientismo”: eluso honorífico de “ciencia,” etc.; el empleode los símbolos de la ciencia de manerapuramente decorativa; la preocupaciónpor la demarcación; la preocupación porel “método científico”; la búsqueda derespuestas en las ciencias para preguntasque est án más al l á de su al cance; l anegación de la legitimidad o valor dela indagación no-científica o de actividades como escribirpoesía o producir arte.As t he Engl i s h wor d “ s c i e nt i s m” i sc ur r e nt l y us e d, i t i s a t r i vi al ve r baltruth that scientism-an inappropriatelydeferential attitude to science-should beavoided. But it is a substantial questionwhen, and why, deference to the sciencesis inappropriate or exaggerated. This papertries to answer that question by articulating“six signs of scientism”: the honorific useof “science,” etc.; using scientific trappingspur e l y de c o r a t i v e l y ; pr e o c c upa t i o nwith demarcation; preoccupation with“scientific method”; looking to the sciencesfor answers beyond their scope; denyingthe legitimacy or worth of non-scientific inquiry, or of writingpoetry or making art. (shrink)

Philosopher Christina Hoff Sommers's target inWho Stole Feminism? How Women Have Betrayed Womenis “gender feminism.” Her aim is to convince us that gender feminists are anti-intellectual opportunists who deliberately spread lies about the incidence of date rape (chap. 10), domestic battery (Preface, chap. 9) and about the general state of male-female relations in America (chaps. 1, 9 and 11), thereby generating fear and resentment of men (chap. 2), all so that they may secure vast amounts of government funding and high-paying (...) jobs in the academy (chaps. 4, 5 and 6). Because gender feminists are condescending to and contemptuous of the “average woman,” they lack a grass-roots constituency (p. 22). Nonetheless, they are powerful enough to be feared. Gender feminists have managed to dupe the U.S. Congress (chap. 8), and an otherwise sceptical press literally eats out of their hands (p. 15). Gender feminism is also a leading cause of the weakening of the American university (p. 52), and has “made the American campus a less happy place” (p. 112). (shrink)

In recent years the concept of parity democracy has rapidly risen up the European political agenda. Using a threefold typology of sex-quotas, this article undertakes a classification of the measures taken by the 15 old E.U. member states to improve the gender balance in representative assemblies. This is then used as the basis for an exploration of the advantages and disadvantages of the parity approach as a tool to promote gender equality, including the constitutional obstacles which stand in its way. (...) The article goes on to present a comparative study of several national systems in which attempts to achieve parity democracy have been pursued, concluding that, in order to maximise their effectiveness, parity measures must operate within a system of unbiased political structures and be properly adjusted to suit the particularities of individual national electoral regimes. (shrink)

This report explores the relationship between philosophy and medicine in the U.K. We note that medical training involves very little formal instruction in philosophy and ethics, and that, with few exceptions, philosophers in the U.K. do not contribute to the instruction of physicians or the philosophy of medicine. However, reviewing the problems arising out of recent developments within scientific medicine we find a pressing need for future philosophical analysis in the following areas: psychiatry, organ transplantation, abortion, euthanasia, experiments on living (...) subjects, consent, confidentiality, the relationship between medicine and political authority, and the provisions for social justice in medicine. (shrink)

New York University, USA In theoritical and political writings, multiculturalism is most frequently understood in the language of recognition. Multiculturalist initiatives responds to the demands of minority cultures for political and cultural recognition so long denied them with devastating effects. In this article, we argue that the politics of recognition may have implicit dangers. In so far as it is articulated as a demand placed upon a dominant group and integrally tied to the substantiation of pre-given or fixed identity, it (...) can easily mask or even reiterate cultural hierarchization associated with Eurocentrism. We argue that it is necessary to understand recognition in terms of equal dignity; at the core of our argument is the insistence that all of us must have our potential to shape our identifications recognized by the state, such that we - and not the state - are the source of the meaning that they have to us, as individuals and as members of groups. Key Words: multiculturalism • racism • recognition • U.S. politics and culture. (shrink)

This book details the underlining philosophical approaches to ethical theories and how these can be used to structure an approach to day-to-day ethical issues, and thereby resolve them. It provides an understanding of the ethical theories which underpin decisions in health care by first laying the foundation with a philosophical framework and then going on to develop this into an examination of contemporary health care dilemmas and professional issues. Not available in the U.S.

This study develops a scale to measure consumer sensitivity to corporate social performance (CSCSP) using the factor analysis procedure to generate a valid and reliable 11-item scale. Results from a U.S. sample of M.B.A. students suggest that women are more sensitive to CSP than men and that Democrats are more sensitive to CSP than Republicans. Future research can use this scale to measure the correlation between attitudes toward CSP and actual behavior.

Returning genetic research results to relatives raises complex issues. In order to inform the U.S. debate, this paper analyzes international law and policies governing the sharing of genetic research results with relatives and identifies key themes and lessons. The laws and policies from other countries demonstrate a range of approaches to balancing individual privacy and autonomy with family access for health benefit, offering important lessons for further development of approaches in the United States.

Preparing for and responding to public health emergencies involving medical countermeasures raise often complex legal challenges and questions among response stakeholders at the local, state, and federal levels. This includes concerns about emergency legal authorities, liability, emergency use of regulated medical products, and regulations that might enhance or hinder public health response goals. In this article, lawyers from the U.S. Department of Health and Human Services’ Office of the General Counsel , Centers for Disease Control and Prevention , and Food (...) and Drug Administration discuss federal legal tools that are critical to enhancing MCM legal preparedness for public health emergencies, with an emphasis on the legal mechanisms that can be used to facilitate the emergency use of countermeasures. Specifically, the authors describe the Public Readiness and Emergency Preparedness Act and Emergency Use Authorization authority, outlining the conditions under which these tools can be utilized and providing examples of how they have supported both pre-event and intra-event activities. (shrink)

The 1981 Uniform Determination of Death Act (UDDA) established the validity of both cardio-respiratory and neurological criteria of death. However, many religious traditions including most forms of Haredi Judaism (ultra-orthodox) and many varieties of Buddhism strongly disagree with death by neurological criteria (DNC). Only one state in the U.S., New Jersey, allows for both religious exemptions to DNC and provides continuation of health insurance coverage when an exception is invoked in its 1991 Declaration of Death Act (NJDDA). There is yet (...) no quantitative or qualitative data on the frequencies of religious exemptions in New Jersey. This study gathered information about the frequency of religious exemptions and policy in New Jersey that was created out of respect for religious beliefs. Literature and internet searches on topics related to religious objections to DNC were conducted. Fifty-three chaplains and heads of bioethics committees in New Jersey hospitals were contacted by phone or email requesting a research interview. Respondents answered a set of questions about religious exemptions to DNC at the hospital where they worked that explored the frequency of such religious exemptions in the past five years, the religious tradition indicated, and whether any request for a religious exemption had been denied. This study was approved by the Northeastern University Institutional Review Board (IRB #: 16–03-15). Eighteen chaplains and bioethics committee members participated in a full research interview. Of these, five reported instances of religious exemptions to DNC occurring at the hospital at which they worked for a total of approximately 30–36 known exemptions in the past five years. Families sought religious exemptions because of faith in an Orthodox Judaism tradition and nonreligious reasons. No failed attempts to obtain an exemption were reported. Religious exemptions to DNC in New Jersey do occur, although very infrequently. Prior to this study, there was no information on their frequency. Considering religious exemptions do occur, there is a need for national or state policies that addresses both religious objections to DNC and hospital resources. More information is needed to better understand the impact of granting religious exemptions before new policy can be established. (shrink)

This brief article introduces a special issue of Feminist Legal Studies addressing gender, sexuality and human rights, and comprising papers drawn from an E.S.R.C.-funded workshop held at the University of Kent in June 2004 on the theme of “Gender-Auditing the Human Rights Act”. The article begins by situating the themes of the special issue within the broader context of feminist engagement with rights discourse. It goes on to consider the introduction of the Human Rights Act 1998 into the U.K. with (...) a view to assessing its implications in terms of engendering a positive legal and political culture for equality-seeking initiatives. The article concludes with a survey of the contributions to the special issue, highlighting the possibilities for feminist theory and strategy posed by a wider intersectional engagement with rights issues. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Medical Tourism:Crossing Borders to Access Health CareHarriet Hutson Gray (bio) and Susan Cartier Poland (bio)Traveling abroad for one's health has a long history for the upper social classes who sought spas, mineral baths, innovative therapies, and the fair climate of the Mediterranean as destinations to improve their health. The newest trend in the first decade of the twenty-first century has the middle class traveling from developed countries to (...) those with emerging economies to avoid treatment delays, prohibitive costs for life-saving procedures, or simply high costs for elective surgery. Others leave to have access to assisted suicide in countries that have legalized it: Belgium, The Netherlands, and Switzerland. This new era of globalization in health care has arrived without the benefit of international standards, government oversight, or ethical and legal review.Howard Staab, a self-employed carpenter from North Carolina, flew to India for his medically necessary heart surgery, scheduled a side trip to the Taj Mahal, and returned home to work in North Carolina. He spent a total of less than $10,000, instead of the $200,000 required from the local hospital (I, Milstein and Smith 2006).At first blush, the outsourcing of medical care to India seems to be a particular solution for a particular problem. However, the particularity of Mr. Staab is not unique. His experience is emblematic of those patients in the United States with a medical need for major and elective procedures, but who also must bear the total cost of these procedures. These middle-class, under-insured Americans go abroad.In tandem with increasingly aggressive marketing campaigns, American hospitals and companies have begun to leverage their connections in Asia to grow the medical tourism business into a major economic force. What are the consequences of this?Several authors point to the effect on the host country's population, particularly the poor, to be pushed farther down the queue to receive adequate, affordable care. Resources are applied to the foreign trade instead of building the local [End Page 193] medical infrastructure. Another potential problem is the obligation of the home-country physician to provide follow-up care. What are the legal ramifications when the procedure was illegal to begin with? Are there opportunities for redress for medical errors?These factors may be converging into a "perfect storm" for health care in the U.S., in which the potential participation of the major insurance companies in promoting offshore care will be the tipping point in the precarious structure that represents the economic currents in health care. Third-party administrators and self-funded employers may be on the cutting edge in 2009 by providing incentives to employees to travel overseas for care.I. Economic ConsiderationsConnell, John. Medical Tourism: Sea, Sun, Sand and... Surgery. Tourism Management 27: 1093–1100, 2006.As evidence of the interest of traditional tour operators in this newer twist on the industry, the author explores medical tourism as an element of the growth of world tourism. In promoting medical tourism, he urges consideration of such issues as the privatization of health care, the foundational role of technology, and uneven access to health resources.Dunn, Philip. Medical Tourism Takes Flight. H and HN: Hospitals and Health Networks: 40–44, November 2007.Writing for U.S. health care executives, Dunn emphasizes that the reality of medical tourism competes with the local medical center for patients and their insurance dollars in a significant way. He examines the possibility that U.S. insurance plans soon may offer to pay for what is currently a cash only business and that the economic impact to the local medical center could be significant or even devastating.Frontiers of Health Services Management [Selected Articles] 24 (2), Winter 2007.In "Managing Healthcare Services in the Global Marketplace" (pp. 3–18), Bruce J. Fried and Dean M. Harris consider legal, ethical, and financial implications of the international workforce. In "Globalization of Health Care" (pp. 19–30), Lynn Schroth and Ruthy Khawahja point out that the transfer of comprehensive management expertise and intellectual property from U.S. medical centers to international sites is driving the success of collaboration between U.S. and foreign health care centers. In "Is... (shrink)