Purpose: To determine the relative value that patients place on consent for procedures in the emergency department (ED) and to define a set of procedures that fall in the realm of implied consent. Methods: A questionnaire was administered to a convenience sample 134 of 174 patients who were seen in the ED of a Midwestern teaching hospital. The questionnaire asked how much time they believed was necessary to give consent for various procedures. Procedures ranged from simple (venipuncture) to complex (procedural (...) sedation). Results: Participants valued a simple blood draw at a low mean of 1.02 minutes of extra time and a lumbar puncture at a high mean of 7.78 minutes. Of all participants 52% and 48% noted a time-value of ?0? time on blood draw and intravenous line starts, respectively, indicating that they desire no additional consent for these procedures. Conclusion: Defining a set of ED procedures covered under implied consent will be difficult because many patients value formal consent for even the simplest procedure. (shrink)

The recent success of Foldit in determining the structure of the Mason-Pfizer monkey virus (M-PMV) retroviral protease is suggestive of the power-solving potential of internet-facilitated game-like crowdsourcing. This research model is highly novel, however, and thus, deserves careful consideration of potential ethical issues. In this paper, we will demonstrate that the crowdsourcing model of research has the potential to cause harm to participants, manipulates the participant into continued participation, and uses participants as experimental subjects. We conclude that protocols relying on (...) this model require institutional review board (IRB) scrutiny. (shrink)

Contemporary civil libertarians claim that their works preserve a worthy American tradition of defending free-speech rights dating back to the framing of the First Amendment. _Transforming Free Speech_ challenges the worthiness, and indeed the very existence of one uninterrupted libertarian tradition. Mark A. Graber asserts that in the past, broader political visions inspired libertarian interpretations of the First Amendment. In reexamining the philosophical and jurisprudential foundations of the defense of expression rights from the Civil War to the present, he exposes (...) the monolithic free-speech tradition as a myth. Instead of one conception of the system of free expression, two emerge: the conservative libertarian tradition that dominated discourse from the Civil War until World War I, and the civil libertarian tradition that dominates later twentieth-century argument. The essence of the current perception of the American free-speech tradition derives from the writings of Zechariah Chafee, Jr., the progressive jurist most responsible for the modern interpretation of the First Amendment. His interpretation, however, deliberately obscured earlier libertarian arguments linking liberty of speech with liberty of property. Moreover, Chafee stunted the development of a more radical interpretation of expression rights that would give citizens the resources and independence necessary for the effective exercise of free speech. Instead, Chafee maintained that the right to political and social commentary could be protected independent of material inequalities that might restrict access to the marketplace of ideas. His influence enfeebled expression rights in a world where their exercise depends increasingly on economic power. Untangling the libertarian legacy, Graber points out the disjunction in the libertarian tradition to show that free-speech rights, having once been transformed, can be transformed again. Well-conceived and original in perspective, _Transforming Free Speech_ will interest political theorists, students of government, and anyone interested in the origins of the free-speech tradition in the United States. (shrink)

Personal identity is critical to provider–patient interactions. Patients and doctors tend to self-select, ideally forming therapeutic units that maximise the patients' benefit. Recently, however, ‘reality’ has changed. The internet and virtual worlds such as Second Life allow models of identity and provider–patient interactions that go beyond the limits of mainstream personal identity. In this paper some of the ethical implications of virtual patient–provider interactions, especially those that have to do with personal identity, are explored.

Combines documents and analytical essays timed for the bicentennial in 2003. It explains the constitutional, political, philosophical background to judicial review, the historical record leading to this landmark case and the impact of the decision since 1803.

Purpose: To determine the relative value that patients place on consent for procedures in the emergency department and to define a set of procedures that fall in the realm of implied consent. Methods: A questionnaire was administered to a convenience sample 134 of 174 patients who were seen in the ED of a Midwestern teaching hospital. The questionnaire asked how much time they believed was necessary to give consent for various procedures. Procedures ranged from simple to complex. Results: Participants valued (...) a simple blood draw at a low mean of 1.02 minutes of extra time and a lumbar puncture at a high mean of 7.78 minutes. Of all participants 52% and 48% noted a time-value of “0” time on blood draw and intravenous line starts, respectively, indicating that they desire no additional consent for these procedures. Conclusion: Defining a set of ED procedures covered under implied consent will be difficult because many patients value formal consent for even the simplest procedure. (shrink)

Contemporary civil libertarians claim that their works preserve a worthy American tradition of defending free-speech rights dating back to the framing of the First Amendment. _Transforming Free Speech_ challenges the worthiness, and indeed the very existence of one uninterrupted libertarian tradition. Mark A. Graber asserts that in the past, broader political visions inspired libertarian interpretations of the First Amendment. In reexamining the philosophical and jurisprudential foundations of the defense of expression rights from the Civil War to the present, he exposes (...) the monolithic free-speech tradition as a myth. Instead of one conception of the system of free expression, two emerge: the conservative libertarian tradition that dominated discourse from the Civil War until World War I, and the civil libertarian tradition that dominates later twentieth-century argument. The essence of the current perception of the American free-speech tradition derives from the writings of Zechariah Chafee, Jr., the progressive jurist most responsible for the modern interpretation of the First Amendment. His interpretation, however, deliberately obscured earlier libertarian arguments linking liberty of speech with liberty of property. Moreover, Chafee stunted the development of a more radical interpretation of expression rights that would give citizens the resources and independence necessary for the effective exercise of free speech. Instead, Chafee maintained that the right to political and social commentary could be protected independent of material inequalities that might restrict access to the marketplace of ideas. His influence enfeebled expression rights in a world where their exercise depends increasingly on economic power. Untangling the libertarian legacy, Graber points out the disjunction in the libertarian tradition to show that free-speech rights, having once been transformed, can be transformed again. Well-conceived and original in perspective, _Transforming Free Speech_ will interest political theorists, students of government, and anyone interested in the origins of the free-speech tradition in the United States. (shrink)

It is almost universally accepted that traditional provider-patient relationships should be governed, at least in part, by the ethical principles set forth by Beauchamp and Childress. These principles include autonomy, beneficence, non-maleficence and justice. Recently, however, the nature of medial practice has changed. The pervasive presence of computer technology in medicine raises interesting ethical questions. In this paper we argue that some software designers should be considered health care providers and thus be subject the ethical principles incumbent upon “traditional” providers. (...) We argue that these ethical responsibilities should be applied explicitly rather than as a passive, implicit, set of guidelines. (shrink)