Information is the fourth core element of public health legal preparedness and of legal preparedness for public health emergencies specifically. Clearly, the creation, transmittal, and application of information are vital to all public health endeavors. The critical significance of information grows exponentially as the complexity and scale of public threats increase.Only a small body of organized information on public health law existed before the 21st century: a series of landmark books published beginning in 1926 by Tobey, Grad, and Wing ; (...) model public health laws published as early as 1907; systematic reviews of original research studies published in the 1990s; and a small but growing number of articles published in public health journals and law reviews.With the new century came new public health law programs and activities at the Centers for Disease Control and Prevention, in public health professional associations, and in numerous non-profit and academic organizations. (shrink)

Information is the fourth core element of public health legal preparedness and of legal preparedness for public health emergencies specifically. Clearly, the creation, transmittal, and application of information are vital to all public health endeavors. The critical significance of information grows exponentially as the complexity and scale of public threats increase.Only a small body of organized information on public health law existed before the 21st century: a series of landmark books published beginning in 1926 by Tobey, Grad, and Wing ; (...) model public health laws published as early as 1907; systematic reviews of original research studies published in the 1990s; and a small but growing number of articles published in public health journals and law reviews.With the new century came new public health law programs and activities at the Centers for Disease Control and Prevention, in public health professional associations, and in numerous non-profit and academic organizations. (shrink)

This article introduces and clarifies a neglected sense of the word ἤ (‘or’) employed by Aristotle and other authors. In this sense, called ‘indifferent’, ἤ signifies ‘one or the other, regardless of which’. It is shown how attention to this use makes it possible to explain the source of the ambiguity of certain sentences, most obviously, though not exclusively, sentences that make a necessity claim about an embedded disjunction, for example ‘It is necessary that A or B’. Why this sense (...) cannot be explained, as some scholars have suggested, by the distinction between exclusive and inclusive ἤ is also discussed. Finally, it is shown how awareness of this sense might rescue Aristotle from a gross inconsistency. (shrink)

This is one of four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and nineteen multi-disciplinary partner organizations. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policymakers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.This paper focuses on the fourth core element: information that can be used in shaping and applying law as a public health tool, specifically in the context of public health emergencies. (shrink)

Whitehead's 1922 theory of gravitation continues to attract the attention of philosophers, despite evidence presented in 1971 that it violates experiment. We demonstrate that the theory strongly fails five quite different experimental tests, and conclude that, notwithstanding its meritorious philosophical underpinnings, Whitehead's theory is truly dead.

This is one of four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and nineteen multi-disciplinary partner organizations. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policymakers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.This paper focuses on the fourth core element: information that can be used in shaping and applying law as a public health tool, specifically in the context of public health emergencies. (shrink)

Somatic or inherited mutations in the adenomatous polyposis coli (APC) gene are a frequent cause of colorectal cancer in humans. APC protein has an important tumor suppression function to reduce cellular levels of the signaling protein β‐catenin and, thereby, inhibit β‐catenin and T‐cell‐factor‐mediated gene expression. In addition, APC protein binds to microtubules in vertebrate cells and localizes to actin‐rich adherens junctions in epithelial cells of the fruit fly Drosophila (Fig. 1). Very little is known, however, about the function of these (...) cytoskeletal associations. Recently, Hamada and Bienz have described a potential role for Drosophila E‐APC in cellular adhesion,1 which offers new clues to APC function in embryonic development, and potentially colorectal adenoma formation and tumor progression in humans. BioEssays 24:771–774, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

Clinical populations sometimes demonstrate difficulties forgetting stimuli related to their trauma-related disorder, perhaps because their intense personal connection to these stimuli produce deficits in the inhibitory control abilities necessary for forgetting. The present work examined this possibility for people who have high levels of traits implicated in borderline personality disorder (BPD). In two well-powered studies, we found no evidence for deficits in forgetting specific to BPD traits, even for people with clinically significant levels of the traits, contrary to previous studies. (...) The present experiments updated the designs from earlier experiments to employ the most contemporary methods to examine directed forgetting recommended by recent reviews. With these improved methods, Study 1 found that participants showed significant directed forgetting for BPD-related words independent of their level of BPD traits, perhaps because the BPD-related words were so strongly associated with one another. Study 2 found that when we removed the strong relatedness between the stimuli, forgetting of BPD-relevant words was significant and did not interact with BPD symptomology. We concluded that in contrast to people with PTSD who show specific inhibitory deficits for trauma-related works, people with BPD show normal, intact inhibitory control even for words that they should find threatening. (shrink)

The purpose of this study was to examine the impact of parenting and adolescent fearfulness on adolescents’ pro‐social values and pro‐social and antisocial behaviour. A total of 134 adolescents (M age = 16.22, 72 girls, 62 boys) responded to questions regarding their own fearfulness, pro‐social values and pro‐social and antisocial behaviour, as well as their perceptions of maternal attachment and maternal appropriateness. Results revealed few main‐effect findings, most notably a negative relation between attachment and antisocial behaviour. However, findings pointed to (...) several multiplicative relations as a function of parenting, adolescent fearfulness, and child gender, including: (1) maternal appropriateness was more important for boys than for girls, (2) maternal attachment was related to greater importance of pro‐social values and higher pro‐social behaviour for boys low on fear and (3) maternal appropriateness was related to lower antisocial behaviour for boys low on fear. The discussion focuses on the importance of examining the multiplicative relations between parenting and adolescent temperament and the implications of this for both educators and parents. (shrink)

How should clinical ethicists be trained? Scholars have stated that clinical ethics fellowships create well-trained, competent ethicists. While this appears intuitive, few features of fellowship programs have been publicly discussed, let alone debated. In this paper, we examine how fellowships can foster effective mentoring relationships. These relationships provide the foundation for the fellow’s transition from novice to competent professional. In this essay, we begin by discussing our pedagogical commitments. Next, we describe the structures our program has created to assist our (...) fellows in becoming competent ethicists. We then outline the kinds of knowledge, skills, and professional attributes mentors should possess. Following this, we focus on the knowledge, skills, and professional attributes that fellows develop as they co-create effective mentoring relationships. We will not prescribe a single approach to fellowship training; instead, our perspective will, we hope, become a catalyst for further conversation on training and mentoring clinical ethics fellows. (shrink)

Motorcycle helmet laws are perceived to infringe upon individual rights even though they reduce mortality and health care costs. We describe proposed helmet legislation that protects individual rights and provides incentives for helmet use through a differential motorcycle registration fee that requires higher fees for those who wish to ride without a helmet.

The harmful impact of an adverse event ripples beyond injured patients and their families to affect physicians, nurses, and other health care staff that are involved. These “Second Victims” may experience intense feelings of anxiety, guilt, and fear. They may doubt their clinical competence or ability to continue working at all. Some go on to suffer post-traumatic stress disorder and depression.Medical institutions long ignored this problem, preferring to believe that adverse events, or “errors,” occur due to incompetence — the unfortunate (...) work of a few “bad” practitioners who deserve, if anything, a reprimand for their negligence. Study after study has rejected this attribution and shown that adverse events in health care stem primarily from systemic flaws, not “bad apples.” Devastating errors, in other words, can, do, and always will happen in the care of competent, well-trained, and caring practitioners. (shrink)

Adverse events that harm patients can also have a harmful impact on health care workers. A few health care organizations have begun to provide psychological support to these Second Victims, but there is uncertainty over whether these discussions are admissible as evidence in malpractice litigation or disciplinary proceedings. We examined the laws governing the admissibility of these communications in 5 states, and address how the laws might affect participation in programs designed to support health care workers involved in adverse events. (...) We found that privilege is uneven from stateto- state, and also unclear. Ambiguity alone could have a chilling effect on Second Victim programs. We propose legislation to protect volunteer and health care worker communications provided by peer counselors, or failing this, updating of statutory provisions to explicitly include these communications within the ambit of existing protections. Enhancing protections could help to foster an environment of healing for both patients and caregivers. (shrink)

Video news releases (VNRs) have been criticized when they are used within a newscast without source disclosure because they violate ethical codes related to transparency and consumers' “right to be informed” by whom they are being persuaded. In an experiment, we show how increased persuasion knowledge about VNRs is positively related to beliefs in news commercialization, beliefs in VNR inappropriateness without disclosure, and support for disclosure of VNR material. We suggest that increased knowledge about VNRs without source disclosure measures might (...) harm messages that are not employing the tactic (“false positives”) and lead to a general distrust of all media. (shrink)

Neuroimaging offers great potential to clinicians and researchers for a host of mental and physical conditions. The use of imaging has been trumpeted for forensic psychiatric and psychological evaluations to allow greater insight into the relationship between the brain and behavior. The results of imaging certainly can be used to inform clinical diagnoses; however, there continue to be limitations in using neuroimaging for insanity cases due to limited scientific backing for how neuroimaging can inform retrospective evaluations of mental state. In (...) making this case, this paper reviews the history of the insanity defense and explains how the use of neuroimaging is not an effective way of improving the reliability of insanity defense evaluations. (shrink)

What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that require an institutional policy on limitation or (...) withdrawal of treatment to include a specified mechanism for resolving conflict. Unfortunately, despite these developments, prospective case consultation remains one of the most controversial and poorly understood aspects of IEC functions. Questions and concerns persist about the relation the IEC has and should have to actual decisions in specific cases.We briefly examine the clinical, organizational, and regulatory complexity of the NICU environment and suggest five potential sources of uncertainty, disagreement, and conflict among parent and NICU staff. (shrink)

Book reviewed in this article: Animal Experimentation: The Moral Issues. Edited by Robert M. Baird and Stuart E. Rosenbaum.

This paper examines the argument that scientific thinkers who embrace a religious tradition can promote intellectual integration between religion and science rather than fragmented discourse. It is argued that God’s Word as an event and the concept of structural directedness, an organized movement toward a future that does not demand a consciously intended end, may be helpful in understanding God’s actions in an indeterminant way.

BackgroundGenetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. A range of ethics and regulatory issues need to be addressed through comprehensive policy frameworks that integrate with local environments. While important efforts have been made to enhance understanding and awareness of ethical dimensions of GGR in Africa, including through the H3Africa initiative, there remains a need for in-depth policy review, at a country-level, to (...) inform and stimulate local policy development and revision on the continent.MethodsTo identify and characterize existing ethics-related guidelines and laws applicable to GGR across much of Africa, we conducted a scoping review of English language policy documents identified through databases, repositories, and web searches. Thirty-six documents were included and coded using a framework that contained a range of themes across five analytical categories: (1) respect, (2) beneficence, (3) justice, (4) independent oversight, and (5) bans and prohibitions. Data analysis software (NVivo 12) was used to organize, code, and tabulate information according to document characteristics and topics. Illustrative examples of policy requirements were selected for inclusion.ResultsDocuments that met inclusion criteria spanned 20 years; published between 1996 and 2018, with the majority (58%) published after 2009. About two-thirds were denoted as “guidelines,” and slightly more than half were non-exclusive to GGR. Very few (six) country-level documents identified were specific to GGR. Requirements related to the principle of “respect” appeared most often across all documents, relative to other principles and processes. The most commonly stated ban was on reproductive cloning. Other prohibitions applied to germline editing, undue inducements in research, sample use for commercial purposes, employee mandatory DNA testing, fetal sex selection, stem cell use, eugenics, and research without public health benefits.ConclusionsEnforceable policies that are indispensable to the ethical conduct and review of GGR are either deficient or missing in many African countries. Existing international, GGR-specific ethics guidelines can be used to inform GGR policy development at a country-level, in conjunction with insight from country specific ethics committees and other local stakeholders. (shrink)