The PRIME Institute of the College of Pharmacy, University of Minnesota, recently released preliminary research findings indicating a trend of extraordinary pharmaceutical industry pricing of drug products in the United States (U.S.). According to researchers at the PRIME Institute, such extraordinary price increases are defined as any price increase that is equal to, or greater than, 100% at a single point in time. In some instances, PRIME Institute researchers found that drugs exhibiting extraordinary price increases are categorized as "orphan (...) drugs" (or blood-related biologic treatments) and often life-saving or life-sustaining for treating the cause or symptoms of diseases affecting fewer than 200,000 people in the U.S., or where there is prevalence of less than 5 per 10,000 people afflicted with a disease or symptoms in the community. Because of extraordinary price increases for orphan drugs — some exceeding 1000% at a single point in time -this article addresses two interrelated questions: Are extraordinary orphan drug price increases socially responsible behavior? If so, are the pharmaceutical industry's policies providing orphan drug access to American consumers in dire need of available life-sustaining and life-enhancing pharmaceuticals considered "socially responsible" behavior? The author concludes, after an interdisciplinary analysis of the legal, economic, sociopolitical, and ethical dimensions of orphan drug pricing, that they are not socially responsible – unless justified by cost and availability of health care marketplace/patient options. Furthermore, the author recommends a socially responsible industry strategic approach to insure that patients ultimately receive -regardless of cost -timely access to life-saving and life-sustaining orphan drugs. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 45, no. 1. © 2019 by Feminist Studies, Inc. 209 Trysh Travis Toward a Feminist History of the Drug-Using Woman— and Her Recovery In 1995, public health scholars Laura Schmidt and Constance Weisner published “The Emergence of Problem-Drinking Women as a Special Population in Need of Treatment.”1 The article, aimed at specialists in the growing field of behavioral sciences, explored the history of medpsych attitudes toward (...) women drinkers. That history had been characterized, until the 1970s, by ignorance and neglect, but it began to shift in the wake of Second Wave feminism and what Schmidt and Weisner called “the women’s alcoholism movement.”2 To be fair, attitudes toward male drinkers had also long been inchoate. But beginning in the 1940s, advocacy by a handful of scientific and legal professionals, as well as the mutual aid group Alcoholics Anonymous (founded in 1935) and the National Council on Alcoholism (founded in 1944), created a new vision, which went on to be underwritten by federal funding and private insurance.3 “Alcoholism is a disease 1. Laura Schmidt and Constance Weisner, “The Emergence of Problem-Drinking Women as a Special Population in Need of Treatment,” in Recent Developments in Alcoholism, Vol. 12: Women and Alcoholism, ed. Marc Galanter (New York: Plenum Press, 1995), 309–334. 2. Ibid., 310. 3. The organization was originally called the National Committee for Education on Alcoholism; it became the National Council on Alcoholism in 1950 and changed to the current National Council on Alcoholism and Drug Dependence in 1990. 210 Trysh Travis Books Discussed in This Essay Lady Lushes: Gender, Alcoholism, and Medicine in Modern America. By Michelle L. McClellan. New Brunswick, NJ: Rutgers University Press, 2017. The Recovery Revolution: The Battle over Addiction Treatment in the United States. By Claire D. Clark. New York: Columbia University Press, 2017. Addicted to Rehab: Race, Gender, and Drugs in the Era of Mass Incarceration. By Allison McKim. New Brunswick, NJ: Rutgers University Press, 2017. Through a Trauma Lens: Transforming Health and Behavioral Health Systems. By Vivian Barnett Brown. New York: Routledge, 2017. and the alcoholic a sick person,” argued National Council on Alcoholism founder Marty Mann in a host of magazine articles beginning in the late 1940s. From that assertion followed the beliefs that “the alcoholic can be helped and is worth helping” and that “alcoholism is a public health problem and therefore a public responsibility” (29).4 Behind Mann’s carefully gender-neutral language lay an image of the alcoholic as a white man from the respectable middle classes. The mid-century legitimation of that man’s problems, Schmidt and Weisner argue, paved the way for “problem-drinking women” to finally come into focus half a century later. Schmidt and Weisner’s article centers on the ways the Great Society funding streams that first steered funds to community-based alcohol and drug treatment changed during the 1980s. But along the way, they briefly explore organized feminism’s views of alcohol- and drug-using women. They note that Second Wave feminists had dealt aggressively with behavioral health issues such as domestic violence, child sexual 4. Marty Mann, “Can We Conquer Alcoholism?” Health (1947): 12–13, 29–30. Trysh Travis 211 abuse, and rape—all of which correlated closely with substance use and abuse. But they see no feminist activism around alcohol or drugs. Instead, “representatives from organizations in the broader feminist and women ’s health movements” were “conspicuously absent” from the women’s alcoholism movement, which consisted chiefly of activists motivated by alcohol issues, not gender.5 Interest in—and action on—women’s alcohol and other drug use consequently became the province chiefly of clinicians and policy makers, not movement women. Although many of those professionals saw substance-using women’s needs as important and worthy of services, few viewed them through the lenses of gender and power. The blind spot that Schmidt and Weisner observe among feminist activists is interesting not only for what it tells us about a conceptual boundary of Second Wave feminism (both liberal and radical) but also for the way it points to a gap in the feminist scholarship that is ostensibly a central legacy of the earlier movement. Like... (shrink)

In researching the biomedically-engineered drug Neulasta, a breast cancer patient becomes aware of the extent to which knowledge about the development and marketing of drugs influences her decisions with regard to treatment. Time spent on understanding the commercial interests of insurers and pharmaceutical companies initially thwarts but ultimately aids the healing process. This first-person narrative calls for physicians to recognize that the alignment of commercial interests transgresses the patient’s humanity.

In The Ethics of Universal Health Insurance, Alex Rajczi shows how defenders of universal health insurance can address the ethical issues raised by these objections and make the moral case for an American universal health insurance system that improves on the gains made in the Affordable Care Act.

In researching the biomedically-engineered drug Neulasta (filgrastim), a breast cancer patient becomes aware of the extent to which knowledge about the development and marketing of drugs influences her decisions with regard to treatment. Time spent on understanding the commercial interests of insurers and pharmaceutical companies initially thwarts but ultimately aids the healing process. This first-person narrative calls for physicians to recognize that the alignment of commercial interests transgresses the patient’s humanity.

The authors report the first Italian experience of a research ethics committee (REC) audit focused on the evaluation of the REC’s compliance with standard operating procedures, requirements in insurance coverage, informed consent, protection of privacy and confidentiality, predictable risks/harms, selection of subjects, withdrawal criteria and other issues, such as advertisement details and justification of placebo. The internal audit was conducted over a two-year period (March 2009–February 2011) divided into quarters to better value the influence of the new insurance (...) coverage regulation that came into effect in March 2010 (Ministerial Decree of 14 July, 2009) and expand the requirements to safeguard participants in clinical drug trials including other critical items as information and consent and the risks to benefits ratio. Out of a total of 639 REC’s opinions and research studies, 316 were reviewed. Regarding the insurance policy requirements, Auditor/REC non-compliance occurred only in one case. The highest number of Auditor/REC non-compliance was in regard to information and consent, which should have incurred a suspended decision rather than a favorable opinion. This internal audit shows the importance and the difficulty of the review process. For this reason, specific courses for members of the research ethics committee and for those who aspire to become auditors will be provided. There may also be efforts to improve the standard operating procedures already in place. (shrink)

Despite a consensus across the political spectrum that the problem of the chronically uninsured is in dire need of solution, little progress has been made. Public spending goes to topping up coverage for the elderly, already heavily subsidized under Medicare, or helping people temporarily without insurance because of international trade dislocations, so that it is clear that something is lacking in the case for significantly reducing the number of uninsured persons. In this paper I suggest that there have been (...) two missing ingredients: a strategy for breaking the political deadlock around this issue, and information about the benefits of coverage sufficient to persuade kindly but skeptical taxpayers that they should be willing to pay to help solve this problem. (shrink)

Despite a consensus across the political spectrum that the problem of the chronically uninsured is in dire need of solution, little progress has heen made. Public spending goes to topping up coverage for the elderly, already heavily subsidized under Medicare, or helping people temporarily without insurance because of international trade dislocations, so that it is clear that something is lacking in the case for significantly reducing the number of uninsured persons. In this paper I suggest that there have been (...) two missing ingredients: a strategy for breaking the political deadlock around this issue, and information about the benefits of coverage sufficient to persuade kindly but skeptical taxpayers that they should be willing to pay to help solve this problem.This article begins with a discussion of these two problems. It then outlines a strategy based on income-related or conditioned refundable tax credits for private and public insurance, coupled with a plan to assemble persuasive information that may move things forward. (shrink)

The overriding goal of health reform is to provide every American affordable access to adequate health care. Yet in every national effort to date, the focal means to this end has always been health insurance. Massachusetts is congratulated for having achieved nearly universal insurance coverage, and congressional Democrats are aiming for the same. But what if they don't succeed? Even in Massachusetts, 167,000 residents remain uninsured. Is it still possible to provide adequate access to medical care for (...) those without insurance? If so, shouldn't we reframe social goals to achieve universal access through any means possible, whether or not insurance is involved? (shrink)

Objectives: The aim of this study was to investigate the actual condition of the students of University of Rajshahi (RU) regarding drug abuse and addiction. Using case study method the research was conducted with four objectives: (a) to find out how respondents began drug abuse; (b) to discover the causes of their drug addiction; (c) to understand the process of their drug abuse; and (d) to find out the economic, social and health effects of drug (...) abuse. Methods: Case study method was used in this research. Through snowball sampling 18 drug- addicted students of RU were selected as respondents. In-depth interview with a schedule was used to collect data from the respondents in January 2019. Results: Findings of the study show that the causes of drug addiction included curiosity, frustration, friends’ request, neglect from family and friends etc. The drugs which they usually abused were Yaba, Phensydyle, Ganja (Weed), Chuani etc. Their average monthly expenditure for collecting drugs was in between Taka 8,000-10,000. They collected those drugs from rickshaw pullers at different points within the campus and from Mizaner Mor, Budhpara slum and other places outside the campus. The respondents opined that drugs were available if sufficient money could be spent. The respondents had senior and junior fellow students and local boys as companions while taking drugs. Most of them faced physical problems after taking drugs, and some of them tried to get rid of this curse of drug addiction. Conclusion: The findings of this research show that the rate of drug addiction among the students of RU was quite alarming. Therefore, all stakeholders including the students, guardians, teachers, university authority, the law makers and law enforcing agencies, researchers, civil society, NGO’s and the state must come forward together to combat this formidable foe. (shrink)

Access to students’ perspectives on substance abuse is essential for effective youth intervention projects development. This study aimed to explore students’ perspectives on abuse of drugs and alcohol with probable development of student-led intervention strategies. The study was conducted at public universities in Zambia. Student’s perspectives on drugs and alcohol abuse were documented using a mixed method design that employed purposive and snowball sampling to select 200 respondents to questionnaires and 10 to in-depth interviews. A humanistic theory approach was applied (...) in the interpretation and analysis of the data collected. The findings showed that cannabis (30%) and codeine contained in Benylin (17%) were commonly abused. Further findings showed that students’ academic pressure was the leading cause of substance abuse (27%), followed by peer pressure (20%). Students knew that abuse of drugs and alcohol led to low academic performance, violence and theft, risks of contracting sexually transmitted infections (STIs), and other social maladjustments. The study recommends that institutions of learning increase student-led awareness campaigns, security surveillance on campus, and collaboration with government drug enforcement agencies. Institutions of learning should involve students in the planning of programmes to deal with drug and alcohol abuse. Contribution: The study will inform amendment of drug and alcohol abuse policies in institutions of learning. The study will contribute towards the UNESCO O3 PLUS project goal of making campuses safe and inclusive, and overall, the Sustainable Development Goal 3 and 4. The study serves as basis for scholars in the field of biblical theology engaged with justice, health and human development. The article is a contribution to the research project Biblical Theology and Hermeneutics. The results of this research can especially be utilised by scholars in the field of psychology of religion, the sociology of religion and practical theologians focusing on youth ministry. (shrink)

Many countries have imposed strict regulations on the genetic information to which insurers have access. Commentators have warned against the emerging body of legislation for different reasons. This paper demonstrates that, when confronted with the argument that genetic information should be available to insurers for health insurance underwriting purposes, one should avoid appeals to rights of genetic privacy and genetic ignorance. The principle of equality of opportunity may nevertheless warrant restrictions. A choice-based account of this principle implies that it (...) is unfair to hold people responsible for the consequences of the genetic lottery, since we have no choice in selecting our genotype or the expression of it. However appealing, this view does not take us all the way to an adequate justification of inaccessibility of genetic information. A contractarian account, suggesting that health is a condition of opportunity and that healthcare is an essential good, seems more promising. I conclude that if or when predictive medical tests (such as genetic tests) are developed with significant actuarial value, individuals have less reason to accept as fair institutions that limit access to healthcare on the grounds of risk status. Given the assumption that a division of risk pools in accordance with a rough estimate of people's level of (genetic) risk will occur, fairness and justice favour universal health insurance based on solidarity. (shrink)

What level of government subsidy of higher education is justified, in what form, and for what reasons? We answer these questions by applying the hypothetical insurance approach, originally developed by Ronald Dworkin in his work on distributive justice. On this approach, when asking how to fund and deliver public services in a particular domain, we should seek to model what would be the outcome of a hypothetical insurance market: we stipulate that participants lack knowledge about their specific resources (...) and risks, and ask what insurance contracts they would take out to secure different types of benefit and protection in the domain in question. The great benefit of the hypothetical insurance approach is that it allows us to take apparently intractable questions about interpersonal distribution and transform them into questions about intrapersonal distributions: that is, questions about how an individual would choose to distribute risks and resources across the various lives that they might end up living, in light of their individual ambitions and preferences. Applying this approach to higher education, we argue that the UK model of higher education funding in which the costs of an individual's higher education are shared between general taxation and the individual herself, with the latter element to be paid retrospectively through an income-contingent state-backed loan, is vindicated as just. In particular, we argue that it is more just than alternatives such as a graduate tax, full funding through general taxation, and full privatisation. (shrink)

In the current era of the Sustainable Development Goals, many countries are attempting to strengthen their health system and achieving Universal Health Coverage. The Korean National Health Insurance system functions as a core element of health financing, contributing to achieving UHC by promoting public health and social security through insurance benefits for prevention, diagnosis, treatment, rehabilitation, childbirth, and health promotion. The Republic of Korea achieved 100% NHI coverage of the target population in 1989, 12 years after the (...) introduction of the social insurance system. However, poor coverage of health services and lack of financial protection are major obstacles to achieving UHC. Therefore, the Korean government announced and implemented ‘Moon Jae-in Care’ in August 2017 to enhance the coverage rate of NHI by 70%. First, this study reviews the existing health insurance system in Korea from the perspective of health financing and UHC. Second, it analyses ‘Moon Jae-in Care’, based on the main framework of UHC. Third, it considers the ethical implications of these developments, with focus on the principles of equity, fairness, autonomy, and solidarity. Although the NHI reform is expected to propel Korean health care closer to UHC, many ethical, social, and political issues remain. (shrink)

Ethical clinical practice requires cultural competency. In the United States, Hispanics report stronger attitudinal barriers to drug abuse treatment than any other racial/ethnic group. Hispanics report feeling that drug abuse treatment providers do not understand their unique cultural needs and are unfamiliar with their experiences of discrimination and immigration. Using this case study to explore broader ethical and policy issues, this study investigates the extent to which US universities train counselors to address the culturally specific needs of Hispanic (...) patients and how this is reflected in practice in Los Angeles County. Based on a content analysis of the required courses, syllabi, and course descriptions at 30 universities related to culture/race/racism/ethnicity/diversity at the undergraduate and graduate levels on the addiction therapist track, and thematic analysis of eight in-depth interviews with counselors working in outpatient rehabilitation centers in Los Angeles, I argue that cultural competency education for drug abuse counselors is too surface level and infrequent to adequately prepare students for a career in addiction counseling for Hispanic clients. Significant changes must be made to how cultural diversity is valued and prioritized in the field of psychology to provide better care for Hispanic people with a substance use disorder and fulfill the moral obligation to eliminate this health disparity. Although this study focuses on counselors in Los Angeles, these findings are relevant for professionals and healthcare systems across the United States and beyond who seek to provide equitable and effective care for Hispanic patients. (shrink)

This paper discusses the economic, legal, moral, and political difficulties in developing drugs for the developing world. It argues that large, global pharmaceutical companies have social responsibilities to the developing world, and that they may exercise these responsibilities by investing in research and development related to diseases that affect developing nations, offering discounts on drug prices, and initiating drug giveaways. However, these social responsibilities are not absolute requirements and may be balanced against other obligations and commitments in light (...) of economic, social, legal, political, and other conditions. How a company decides to exercise its social responsibilities to the developing world depends on the prospects for a reasonable profit and the prospects for a productive business environment. Developing nations can either help or hinder the pharmaceutical industry’s efforts to exercise social responsibility through various policies and practices. To insure that companies can make a reasonable profit, developing nations should honor pharmaceutical product patents and adhere to international intellectual property treaties, such as the Trade‐Related Aspects of Intellectual Property Rights agreement. To insure the companies have a good business environment, developing nations should try to promote the rule of law, ethical business practices, stable currencies, reliable banking systems, free and open markets, democracy, and other conditions conducive to business. Overall, this paper advocates for reciprocity and cooperation between pharmaceutical companies and developing nations to address the problem of developing drugs for the developing world. In pursuing this cooperative approach, developing nations may use a variety of other techniques to encourage pharmaceutical companies to act responsibly, such as subsidizing pharmaceutical research, helping to design and implement research protocols, providing a guaranteed market, and bulk buying. (shrink)

Arabian Drugs in Early Medieval Mediterranean Medicine. By Zohar Amar and Efraim Lev. Edinburgh Studies in Classical Islamic History and Culture. Edinburgh: Edinburgh University Press, 2017. Pp. xiv + 290, ills. $125, £80.

Despite some improvements in access to evidence-based medications for opioid use disorder, treatment rates remain low at under a quarter of those with need. High costs for brand name products in these medication markets have limited the volume of drugs purchased, particularly through public health insurance and grant programs. Brand firm anti-competitive practices around the leading buprenorphine product Suboxone — including product hops, citizen petitions and Risk Evaluation and Mitigation Strategy abuses — helped to maintain high prices by extending (...) brand exclusivity periods and hindering generic drug entry. Remedies to address costly anti-competitive activities include adoption of the proposed CREATES Act and modernization of the Hatch-Waxman Act by the Congress, and implementation of substantive modifications to the Food and Drug Administration citizen petition filing procedures. Given the persistence of these abuses, prescriptive changes are favorable to the procedural and clarifying steps thus far favored by the federal government. Extrapolating from the 37% price declines attributable to generic entry for buprenorphine tablets in 2011, our calculations suggest that implementing these remedies to facilitate generic competition with Suboxone film would have resulted in savings of approximately $703 million overall and $203 million to Medicaid in 2017. (shrink)

This compact and innovative book tackles one of the central issues in drug policy: the lack of a coherent conceptual structure for thinking about drugs. Drugs generally fall into one of seven categories: prescription, over the counter, alternative medicine, common-use drugs like alcohol, tobacco and caffeine; religious-use, sports enhancement; and of course illegal street drugs like cocaine and marijuana. Our thinking and policies varies wildly from one to the other, with inconsistencies that derive more from cultural and social values (...) than from medical or scientific facts. Penalties exist for steroid use, while herbal remedies or cold medication are legal. Native Americans may legally use peyote, but others may not. Penalties may vary for using different forms of the same drug, such as crack vs. powder cocaine. Herbal remedies are unregulated by the FDA; but medical marijuana is illegal in most states. Battin and her contributors lay a foundation for a wiser drug policy by promoting consistency and coherency in the discussion of drug issues and by encouraging a unique dialogue across disciplines. The contributors are an interdisciplinary group of scholars mostly based at the University of Utah, and include a pharmacologist, a psychiatrist, a toxicologist, a trial court judge, a law professor, an attorney, a diatary specialist, a physician, a health expert on substance abuse, and Battin herself who is a philosopher. They consider questions like the historical development of current policy and the rationales for it; scientific views on how drugs actually cause harm; how to define the key notions of harm and addiction; and ways in which drug policy can be made more consistent. They conclude with an examination of the implications of a consistent policy for various disciplines and society generally. The book is written accessibly with little need for expert knowledge, and will appeal to a diverse audience of philosophers, bioethicists, clinicians, policy makers, law enforcement, legal scholars and practitioners, social workers, and general readers, as well as to students in areas like pharmacy, medicine, law, nursing, sociology, social work, psychology, and bioethics. (shrink)

Step therapy is an insurance company policy whereby patients must try a less costly treatment and fail-first before the insurer will cover another, more costly treatment. This article argues that there are relevant and well-established principles of medical ethics—the duty to practice evidenced-based medicine and the duty to consider cost-effectiveness when treating patients—that constrain and guide physician behavior with respect to step therapy; clinical practice guidelines promulgated by authoritative physician groups attempt to incorporate and reconcile the competing demands of (...) evidenced-based and cost-effective medicine, although it is unclear whether they do so in a manner that appropriately considers all relevant ethical factors relating to cost-effectiveness; and despite the potential shortcomings of CPGs, the ethical principles guiding and constraining physician behavior can help demarcate the ethical boundaries for other actors in the drug prescribing and reimbursement matrix, including insurance companies and benefit managers. (shrink)

Future of Humanity Institute, James Martin 21st Century School, University of Oxford, Littlegate House, 16/17 St Ebbe's Street, Oxford OX1 1PT, UK; www.nickbostrom.com..

This research is part of the last study Drugs and School IX developed in the Basque Country (Spain) by the Instituto Deusto de Drogodependencias (Deusto Institute of Drug Addiction) of the University of Deusto and the data gathered by means of cluster sampling in two stages. The sample is made up of N= 6.007 girls and boys ranging from 12 to 22 years of age in Secondary Education and the aim is to answer the following new research questions based (...) on those parameters: (1) describe the reality of drug consumption and some psychosocial variables in this sample, as well as analyse several relations between variables; (2) analysing the role of school well-being, self-esteem and self-concept regarding consumption; (3) taking a close look at the moderating role of age and gender on the relationship of school well-being, self-concept and self-esteem with consumption; and (4) understand the existing interaction between all these variables, studying the moderating role of self-esteem and self-concept in the influence of school well-being on consumption. Using a correlation, hierarchical regression and mediation analysis with SPSS (v. 26) and Amos (v. 26) applications, three main conclusions were reached. Firstly, that educational and academic well-being, academic self-concept and self-esteem seem to play the role of protecting factors in adolescence, while assertiveness is linked to a higher consumption level. Secondly, that academic self-concept has a mediating effect between well-being and consumption. Some of these relations are moderated by the variables of gender and age. Thirdly, that age and gender are very relevant sociodemographic variables that must be taken into account in order to understand this phenomenon. Age has shown its covariant effect, which is especially relevant in the influence of academic well-being measured as being held back years. It has also proved to be important in order to understand its experiential or experimental and transitory character. Moreover, significant differences in consumptions have been found based on gender. (shrink)

The puzzling case of the broken arm -- Hernias, diets, and drugs -- Why physicians cannot know what will benefit patients -- Sacrificing patient benefit to protect patient rights -- Societal interests and duties to others -- The new, limited, twenty-first-century role for physicians as patient assistants -- Abandoning modern medical concepts: doctor's "orders" and hospital "discharge" -- Medicine can't "indicate": so why do we talk that way? --"Treatments of choice" and "medical necessity": who is fooling whom? -- Abandoning informed (...) consent -- Why physicians get it wrong and the alternatives to consent: patient choice and deep value pairing -- The end of prescribing: why prescription writing is irrational -- The alternatives to prescribing -- Are fat people overweight? -- Beyond prettiness: death, disease, and being fat -- Universal but varied health insurance: only separate is equal -- Health insurance: the case for multiple lists -- Why hospice care should not be a part of ideal health care I: the history of the hospice -- Why hospice care should not be a part of ideal health care II: hospice in a postmodern era -- Randomized human experimentation: the modern dilemma -- Randomized human experimentation: a proposal for the new medicine -- Clinical practice guidelines and why they are wrong -- Outcomes research and how values sneak into finding of fact -- The consensus of medical experts and why it is wrong so often. (shrink)

The past year in bioethics in Australia has been relatively predictable. We continue to struggle with rising healthcare costs, though thankfully not on par with numerous other countries due to a relatively positive economic outlook. We are still fighting difficulties associated with higher medical indemnity costs, which have again caused many physicians to leave private practice, particularly in high-risk and specialty practice areas. In response, the federal government delayed the imposition of the medical indemnity levy for physicians until mid 2005. (...) In May, the Australian Law Reform Commission and the Australian Health Ethics Commission issued their final joint report on genetic testing entitled “Essentially Yours” and endorsed use of genetic tests by insurance companies, despite the concerns of some geneticists and many members of the public about their scientific reliability. However, they also advocated the establishment of the Human Genetics Commission of Australia to oversee such uses of genetic tests in terms of both scientific and actuarial reliability, and debates continue over the implementation of this and a number of their other recommendations. And state governments continue to phase in smoking bans in public places, with most implementing full bans in enclosed restaurants and cafes and planning to require provision of nonsmoking areas in all pubs within the next year. a. (shrink)