This article unfolds in three stages. First, it locates the emergence of modern conceptions of social justice in industrializing Europe, and especially in the discovery of the “social,” which provided a particular idiom for the liberal democratic politics for most of the twentieth century. Second, the article links this particular conception of the social to the political rationalities of the postwar welfare state and the identity of the social citizen. Finally, the article discusses the myriad ways in which this legacy (...) of the social and social justice has been disrupted, although not yet fully displaced, by the economic orthodoxies and individualization that inform the contemporary neoliberal governing project in Canada. The result, the article concludes, has been the institutionalization of insecurity, which demands the renewal of a social way of seeing and a politics of social justice on local and global scales. (shrink)
Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)
Houston, Texas, is a major U.S. city with, like many, a growing aging population. The purpose of this study and ultimate book chapter is to explore the views and perceptions of long-term care (LTC) residents, family members and health care providers. Individuals primarily in independent living and group residential settings were interviewed and studied. Questions emphasized the concepts of personal autonomy, dignity, quality and location of care and decision making. Although a small sample of participants were involved, consistency was noted. (...) Keeping the elderly in caring and loving home situations (theirs or family) was most preferred. Personal choice and independence were emphasized by residents, but family members needed to act as advocates. We also noted that the legal system emphasizes family control over individual decision making as competency declines with aging. Optimal personal decision making in the residents' best interest also became more difficult with loss of individual mental capacity. (shrink)
This article examines the Canadian case, focusing on the ways in which the political rationalities that have informed the Canadian variants of post-war social liberalism and neoliberalism have opened and then closed spaces for the articulation and institutionalization of gender-based equality claims-making. The article recounts how the Canadian welfare state underwrote a unique gender equality infrastructure inside the state and a thick field of gender organizations in civil society and later how this potent political and symbolic node of social liberalism (...) became a critical field of contestation for those promoting neoliberal political rationalities. The article describes a protracted war of position in which the gendered politics and identities of the 20th century have been displaced and marginalized, but not fully consumed by neoliberal idioms, representations and policy interventions. (shrink)
There has been a growing concern over establishing norms that ensure the ethically acceptable and scientifically sound conduct of clinical trials. Among the leading norms internationally are the World Medical Association's Declaration of Helsinki, guidelines by the Council for International Organizations of Medical Sciences, the International Conference on Harmonization's standards for industry, and the CONSORT group's reporting norms, in addition to the influential U.S. Federal Common Rule, Food and Drug Administration's body of regulations, and information sheets by the Department of (...) Health and Human Services. There are also many norms published at more local levels by official agencies and professional groups.Any account of international standards should cover both scientific and ethical norms at once – the two are conceptually intertwined. Recent sources recognize that “[s]cientifically unsound research on human subjects is unethical in that it exposes research subjects to risks without possible benefit.”. (shrink)
This essay is composed of five stories written by practicing physicians about their patients. Each clinical story describes a challenging ethical condition–potential abuse of medical power, gravely ill and probably over-treated newborns, iatrogenic narcotic addiction, deceived dying people. Rather than singling out one ethical conflict to resolve or adjudicate, the authors attempt, through literary methods, to grasp the singular experiences of their patients and to act according to the deep structures of their patients' lives. Examining these five stories with simple (...) literary tools–attention to narrative frames, time, plot, and desire–reveals the mechanisms through which acts of writing and reading contribute to clinical clarity and ethical actions. (shrink)
Given a sequence {a n } in (0,1) converging to a rational, we examine the model theoretic properties of structures obtained as limits of Shelah-Spencer graphs G(m, m -αn ). We show that in most cases the model theory is either extremely well-behaved or extremely wild, and characterize when each occurs.
Originally published in 1948, this book contains an edited version of The Tree of Commonwealth, which was written by Edmund Dudley while imprisoned in the Tower of London in 1509 prior to his execution for treason the following year. Brodie notes any variations between manuscripts and provides a brief biography of Dudley and the impact of his famous text on later monarchs. This book will be of value to anyone with an interest in Tudor history or the history of (...) English statesmanship. (shrink)
Tversky and Koehler's support theory attempts to explain why probability judgments are affected by the manner in which formally similar events are described. Support theory suggests that as the explicitness of a description increases, an event will be judged to be more likely. In the present experiment, experienced decision-makers from large, international accounting firms were given case-specific information about an audit client and asked to provide a series of judgments regarding the perceived likelihood of events. Unpacking a hypothesis into four (...) formally equivalent hypotheses more than doubled its perceived likelihood. These results are largely consistent with support theory, extending its generalizability to applied contexts involving business professionals. Further, the paper finds that task-specific factors, a previously untested area, can also affect support theory interpretations. (shrink)
Ulf Schmidt, writing on “Medical Ethics and Nazism” in the recently published Cambridge World History of Medical Ethics, states:In 1920, the lawyer Karl Binding and the psychiatrist Alfred Hoche published their tract Permission for the Destruction of Life Unworthy of Life. … Their positivistic theory was a combination of legal norms and medical arguments that granted the state fundamental rights while overriding the rights of individuals. The traditional moral belief system that advocated care and compassion for the weak and unproductive (...) was radically called into question. The book was written in the wake of World War I; readers were asked to compare the “battlefields littered with.. (shrink)
BACKGROUND: Many published accounts of clinical trials report no differences between the treatment arms, while being underpowered to find differences. This study determined how the authors of these reports interpreted their findings. STUDY DESIGN: We examined 54 reports of surgical trials chosen randomly from a database of 110 influential trials conducted in 2008. Seven that reported having adequate statistical power were excluded from further analysis, as were the 32 that reported significant differences between the treatment arms. We examined the remaining (...) 15 to see whether the authors interpreted their negative findings appropriately. Appropriate interpretations discussed the lack of power and/or called for larger studies. RESULTS: Three of the 7 trials that did not report an a priori power calculation offered inappropriate interpretations, as did 3 of the 8 trials that reported an a priori power < 0.90. However, we examined only a modest number of trial reports from 1 year. CONCLUSIONS: Negative findings in underpowered trials were often interpreted as showing the equivalence of the treatment arms with no discussion of the issue of being underpowered. This may lead clinicians to accept new treatments that have not been validated. (shrink)
