Background -- Overview of legal sources -- Summary of recent prosecutions and investigations -- Applications of law and professional and trade association standards to physician relationships with industry -- Legal and ethical aspects of specific physician's industry financial relationships -- Approaching and adopting effective compliance plans.

In recent years, several remarkable results have shown that certain theorems of finite combinatorics are unprovable in certain logical systems. These developments have been instrumental in stimulating research in both areas, with the interface between logic and combinatorics being especially important because of its relation to crucial issues in the foundations of mathematics which were raised by the work of Kurt Godel. Because of the diversity of the lines of research that have begun to shed light on these issues, there (...) was a need for a comprehensive overview which would tie the lines together. This volume fills that need by presenting a balanced mixture of high quality expository and research articles that were presented at the August 1985 AMS-IMS-SIAM Joint Summer Research Conference, held at Humboldt State University in Arcata, California.With an introductory survey to put the works into an appropriate context, the collection consists of papers dealing with various aspects of 'unprovable theorems and fast-growing functions'. Among the topics addressed are: ordinal notations, the dynamical systems approach to Ramsey theory, Hindman's finite sums theorem and related ultrafilters, well quasiordering theory, uncountable combinatorics, nonstandard models of set theory, and a length-of-proof analysis of Godel's incompleteness theorem. Many of the articles bring the reader to the frontiers of research in this area, and most assume familiarity with combinatorics and/or mathematical logic only at the senior undergraduate or first-year graduate level. (shrink)

This book examines how regulatory and liability mechanisms have impacted upon product safety decisions in the pharmaceutical and medical devices sectors in Europe, the USA and beyond since the 1950s. Thirty-five case studies illustrate the interplay between the regulatory regimes and litigation. Observations from medical practice have been the overwhelming means of identifying post-marketing safety issues. Drug and device safety decisions have increasingly been taken by public regulators and companies within the framework of the comprehensive regulatory structure that (...) has developed since the 1960s. In general product liability cases have not identified or defined safety issues, and function merely as compensation mechanisms. This is unsurprising as the thresholds for these two systems differ considerably; regulatory action can be triggered by the possibility a product is harmful, whereas establishing liability in litigation requires proving that the product was actually harmful.As litigation normally post-dates regulatory implementation, the 'private enforcement' of public law has generally not occurred in these sectors. This has profound implications for the design of sectoral regulatory and liability regimes, including associated features such as extended liability law, class actions and contingency fees. This book forms a major contribution to the academic debate on the comparative utility of regulatory and liability systems, on public versus private enforcement, and on mechanisms of behaviour control. (shrink)

William Scoresby Jnr spent the first years of his working life as a whaler, and then became an ordained minister of the Church of England. His early writings on the environment of the Greenland Sea gained him a reputation as an Arctic scientist. In the later part of his life he turned to the investigation of magnetism as it concerned the ship's compass, trying to find the best form of needle, and how the compass was affected by the magnetism of (...) the ship itself.Though he lived in various parts of the country, Scoresby kept his attachment to Whitby and bequeathed his papers, books and apparatus to its Literary and Philosophical Society. In this catalogue the apparatus and material relics are related to published accounts of his work.In the text, [S] numbers refer to Scoresby's publications and [C] numbers to the catalogue. (shrink)

Increasing pharmaceutical industry presence in health care research and practice has evoked critical social, political, economic, and ethical questions and concern among health care providers, ethicists, economists, and the general citizenry. The case example presented of the ‘marketization’ of nursing practice not only reveals the magnitude of the purview of the pharmaceutical industry, it demonstrates how that industry imparts effect upon the organization of nursing work, an area of health care professional practice where the ethical polemic of (...) pharmaceutical industry involvement and influence has been largely ignored, and the profession of nursing conspicuously silent. Drawing on a Foucauldian dispositive analysis that troubled the complex apparatus responsible for the production of knowledge and action in the neurology subspecialty of multiple sclerosis (MS), the case discloses how the pharmaceutical industry has created compliance and adherence as clinical imperatives in the practice of MS nursing. The case makes explicit the conscious transformative self‐action undertaken by MS nurses as a result of their subjectivation (marketization) and demonstrates how MS nurses have become pawns in pharmaceutical industry strategic games of power, truth, identity, and wealth creation by turning their clinical practice settings into heterodiscursive spaces of surveillance and persuasion. MS nurses have become instruments of the pharmaceutical industry, and their clinical practices ordered, organized, limited, constrained, and marketized as a result. (shrink)

The growing commercialization of research with its effect on the ethical conduct of researchers, and the advancement of scientific knowledge with its effect on the welfare or otherwise of patients, are areas of pressing concern today and need a serious, thorough study. Biomedical research, and its forward march, is becoming increasingly dependent on industry-academia proximity, both commercial and geographic. A realization of the commercial value of academic biomedical research coupled with its rapid and efficient utilization by industry is (...) the major propelling force here. A number of well-intentioned writers in the field look to the whole development with optimism. But this partnership is a double-edged sword, for it carries with it the potential of an exciting future as much as the prospect of misappropriation and malevolence. Moreover, such partnerships have sometimes eroded public trust in the research enterprise itself. Connected to the growing clout of industry in institutions is concern about the commercialization of research and resolving the 'patient or product' loyalty. There is ambivalence about industry funding and influence in academia, and a consequent 'approach-avoidance' conflict. If academia has to provide the patients and research talent, industry necessarily has to provide the finances and other facilities based on it. This is an invariable and essential agreement between the two parties that they can walk out of only at their own peril. The profound ethical concerns that industry funded research has brought center-stage need a close look, especially as they impact patients, research subjects, public trust, marketability of products, and research and professional credibility. How can the intermediate goal of industry serve the purpose of the final goal of academia is the basic struggle for conscientious research institutions /associations. And how best the goal of maximizing profits can be best served, albeit suitably camouflaged as patient welfare throughout, is the concern of the pharmaceutical industry. A very great potential conflict of interest lies in the fact that academia needs the sophisticated instruments that only big funding can provide, while at the same time resists the attempts of the fund provider to set the agenda of research, protocol, design, publication, the works. Conflicts arise at many steps and levels of functioning, and are related to the expectations, competing interests, and conflicting priorities of the different entities involved, whether they are the academic medical centers, the funding agencies, the patients and their families, or the investors and venture capitalists. The public expects access to new treatments. Its appetite for innovation has been bolstered by the constant attention given by the press to new treatments and by the implicit promise from researchers of continuing advances. Similarly, patients demand privacy and control over information about themselves. It makes greater sense for genuine researchers to associate with large long-term industry players who have a track record of genuine hard-core discoveries, even if the process is slow , and the funding less . The element of control venture capitalists exert over the pharmaceutical industry is an under researched area for obvious reasons. But it needs further probing, for that will lay bare the pulls and pressures under which industry works. It makes sense for ethically minded researchers and institutions not to fall in the trap of stocks and equity investments in industry, howsoever attractive they appear, and get rid of them as soon as possible if they have them. If at all they want, it makes more sense to own stocks of larger well established concerns, for the stock upheavals being less, the pressure of the market-place, and of venture sharks, is likely to be lower too. While active participation by the researcher in the commercialization process may be greatly desired by industry, ostensibly in the name of creating value, academia must realize it is a bait it might find hard to swallow in the long run. It makes more sense for the researcher and institution to forego such temptations and/or walk out of such investments as soon as possible. While mainstream medicine and research are booming, as is connected industry, concerns about professional commitment to patient welfare are growing too. Increasing corporate influence is challenging certain long held and fundamental values of patient care, which will have far reaching implications for biomedical care and the future progress of mainstream medicine. (shrink)

This book explores the controversial relationship between physicians and the pharmaceutical industry, identifies the ethical tensions and controversies, and proposes numerous reforms both for medicine's own professional integrity and for effective public regulation of the industry.

Unlike most of the literature on the contributions of refugees from Nazism to the contemporary intellectual and cultural life of the West, the role of the expatriates in creating today's large biomedical publishing industry has generally been neglected. In fact major scientific, technical and medical (STM) publishing came about via this route. In doing so, it was instrumental in changing the international language of pre-World War Two science from German to English. This remains true as the industry (...) evolves rapidly into new corporate and electronic modes. (shrink)

The complex history of pandemics has created a diversified array of anti-epidemic responses, which have allowed structures of authority to express their power in multiple ways. In this paper, by considering theories applicable to cases ranging from Europe to Asia, from the 11th to the 18th century, we conduct a comparative analysis capable of identifying common traits and radical differences, aiming to show how such deployment of power was not always commensurate with the medical theories of the age, and (...) with the gravity of the epidemiological situation. Specifically, we analyse how Western European States, in their process of formation, employed the concept of ‘public health’ to create the grounds for an unprecedented exercise of power over the private sphere. Furthermore, we compare this attitude with the discrimination of the minority known as burakumin in Japan, which was destined to undertake any ‘dirty’ or ‘impure’ occupation, to preserve the immunity of the community. In other words, we examine how structures of power have exploited states of exception to implement control measures beyond the needs of the situation through an increasingly hypertrophic apparatus of security; and ways in which political authorities have not aligned with medical or philosophical authorities of their times, for opportunistic reasons that benefited their own social, religious, or racial group. (shrink)

The paper aims at analyzing the production of creditworthiness within the context of commercial banking in international banks. Taking the interim financing in the Polish automobile sector as an example, the paper reconstructs the process between legal framing of the financial instrument, marketing, and risk management. Firstly, it shows that changes in the state vehicle registry function as a prerequisite upon which the bank uses the newly introduced vehicle registration document as a security. Secondly, it analyzes the change of perspectives (...) which takes place between the marketing of the product and the analysis of documents . Thirdly, it argues that creditworthiness cannot be deduced from the economic representation of the enterprise but is the very result of negotiations between the actors involved. (shrink)

A learning health system (LHS) seeks to establish a closer connection between clinical care and research and establishes new responsibilities for healthcare providers as well as patients. A new set of technological approaches in medication adherence monitoring can potentially yield valuable data within an LHS, and raises the question of the scope and limitations of patients’ responsibilities to use them. We argue here that, in principle, it is plausible to suggest that patients have a prima facie obligation to use novel (...) adherence monitors. However, the strength of the obligations depends considerably on the extent to which data that adherence monitors generate are, in fact, used to further the goals of LHSs. The way in which data ownership is structured in the USA poses a considerable challenge here, while the European Union framework offers a more promising alternative. (shrink)

During the first half of the twentieth century, the mining industry in Britain was subject to recurrent disputes about the risk to miners’ lungs from coal dust, moderated by governmental, industrial, medical and mining bodies. In this environment, precise measurements offered a way to present uncontested objective knowledge. By accessing primary source material from the National Archives, the South Wales Miners Library and the University of Bristol's Special Collections, I demonstrate the importance that the British Medical Research (...) Council (MRC) attached to standardized instrumental measures as proof of objectivity, and explore the conflict between objective and subjective measures of health. Examination of the MRC's use of spirometry in their investigation of pneumoconiosis (miner's lung) from 1936 to 1945 will shed light on this conflict and illuminate the politics inherent in attempts to quantify disability and categorize standards of health. (shrink)

Studies of drug development have described the role of clinical trials in the selection of drug profiles. This article presents a case study of the development of hormonal drugs in the 1920s and 1930s to illustrate that clinical trials have a more extensive role than is assumed. Clinical trials are instrumental in mediating the relationships between the pharmaceutical industry, the laboratory, and the clinic, resulting in a network of actors collectively creating medical knowledge, drugs, and markets for these (...) drugs. (shrink)

This paper begins with the lived accounts of emergency and critical care medical interventions in which an unhoused person is brought to the emergency department in cardiac arrest. The case is a dramatised representation of the extent to which biopolitical forces via reduction to bare life through biopolitical and necropolitical operations are prominent influences in nursing and medical care. This paper draws on the scholarship of Michel Foucault, Giorgio Agamben, and Achille Mbembe to offer a theoretical analysis of (...) the power dynamics that influence the health care and death care of patients who are caught in the auspices of a neoliberal capitalist healthcare apparatus. This paper offers analysis of the overt displays of biopower over those individuals cast aside as generally unworthy of access to healthcare in a postcolonial capitalist system, in addition to the ways in which humans are reduced to ‘bare life’ in their dying days. We analyse this case study through Agamben's description of thanatopolitics, a ‘regime of death’, and the technologies that accompany the dying process, particularly in that of the homo sacer. Additionally, this paper illustrates the ways in which necropolitics and biopower are integral to understanding how the most advanced and expensive medical interventions make visible the political values of the healthcare system and how nurses and healthcare functions in these deathworlds. The purpose of this paper is to develop a greater understanding of biopolitical and necropolitical operations in acute and critical care environments, and to offer guidance to nurses in these spaces as they work to uphold ethical duties in a system that increasingly dehumanises. (shrink)

Listening and responding to patients’ stories for over 20 years as an emergency physician has strengthened my appreciation for the many ways that the skills and principles drawn from writing fiction double as necessary clinical skills. The best medicine doesn’t work on the wrong story, and the stories patients tell sometimes feel like first drafts—vital and fragile works-in-progress. Increasingly complex health challenges compounded by social, financial, and psychological burdens make for stories that are difficult to articulate and comprehend. In this (...) essay, I argue that healthcare providers need to think like creative writers and the skills and sensitivities necessary to story construction deserve a vital space in medical education. A thorough understanding of story anatomy and the imaginative flexibility to work stories into open spaces serve as antidotes to the reductive nature of clinical decision making and have implications as patient safety and risk management strategies. The examples that I have selected demonstrate how thinking like a creative writer functions at the bedside, providing tools for clinical excellence and empathy. This approach asks that we re-imagine the importance of story in clinical care: from a vehicle to a diagnosis to its place as a critical destination. (shrink)

Medical research with children has been the subject of ongoing debate. The reason for controversy is clear. As with research on adults, one must strike a balance between two goals – promoting the health of children through advances in scientific knowledge and protecting child research subjects from exploitation and harm. However, because of their age and relative immaturity, children cannot protect their own interests as well as adult subjects can. Yet as they progress toward adulthood, increasing care must be (...) taken to involve children in decisions that affect them, even to the extent of allowing them to make choices that may have serious and long-term consequences. (shrink)

The world in which the Scottish Enlightenment took shape -- Archibald Campbell, 3rd Duke of Argyll (1682-1761) : patronage and the creation of the Scottish Enlightenment -- How many Scots were enlightened? -- What did eighteenth-century Scottish students read? -- Our excellent and never to be forgotten friend : David Hume (26 April 1711- 25 August 1776) -- Hume's intellectual development : part II, 1711-1762 -- Hume's histories -- Hume's economics -- Numbering the medics -- Numbers and money -- Who (...) were they? -- The émigrés as they appear in the American sample. (shrink)

As a regular reader of Science, Scientific American, Nature and The Eonomist, I could not miss how so many articles in these science-technology journals refer to micro-processing, which today dominates so much science-praxis. I have become aware that how science happens, changes primarily with a wide context of instrument changes. That is what this paper is about. Heidegger’s technologies were largely Industrial-Big, Machinic, and Mechanical. Science, today often a leader, is now operating by using micro-nano processes and has often shifted (...) to biological and medical sciences, marking a change in how science operates. This has significant consequences for how we should think about the “transcendental” and the “empirical” in philosophy of technology. (shrink)

Background: Expenditure on industry products (mostly drugs and devices) has spiraled over the last 15 years and accounts for substantial part of healthcare expenditure. The enormous financial interests involved in the development and marketing of drugs and devices may have given excessive power to these industries to influence medical research, policy, and practice.Material and methods: Review of the literature and analysis of the multiple pathways through which the industry has directly or indirectly infiltrated the broader healthcare systems. (...) We present the analysis of the industry influences at the following levels: (i) evidence base production, (ii) evidence synthesis, (iii) understanding of safety and harms issues, (iv) cost-effectiveness evaluation, (v) clinical practice guidelines formation, (vi) healthcare professional education, (vii) healthcare practice, (viii) healthcare consumer’s decisions.Results: We located abundance of consistent evidence demonstrating that the industry has created means to intervene in all steps of the processes that determine healthcare research, strategy, expenditure, practice and education. As a result of these interferences, the benefits of drugs and other products are often exaggerated and their potential harms are downplayed, and clinical guidelines, medical practice, and healthcare expenditure decisions are biased. Conclusion: To serve its interests, the industry masterfully influences evidence base production, evidence synthesis, understanding of harms issues, cost-effectiveness evaluations, clinical practice guidelines and Healthcare professional education and also exerts direct influences on professional decisions and health consumers. There is an urgent need for regulation and other action towards redefining the mission of medicine towards a more objective and patient-, population- and society-benefit direction that is free from conflict of interests. (shrink)

The emergence of instrument-making trades in early-modern England tested the power of established guilds. From the seventeenth century, instrument makers were able to exploit growing markets for scientific apparatus and attempted to exploit connections with the Royal Society. Given the growth in both local and international demand, and in new methods of manufacture, instrument makers were frequently able to evade the diminishing power of guilds to police the efforts of the makers.

The outsourcing of medical research has become a strategic imperative in the global pharmaceutical industry. Spurred by the challenges of competition, the need for speed in drug development, and increasing domestic costs, pharmaceutical companies across the globe continue to outsource critical parts of their value chain activities, namely contract clinical research and drug testing, to sponsors across the globe, typically into emerging markets. While it is clear that important ethical issues arise with this practice, unraveling moral responsibility and (...) the allocation of responsibility is not so clear, considering that contracts, by their very definition transfer responsibility from the principal to the agent. This research provides a framework for exploring some of the ethical issues, including attributions of moral responsibility associated with Contract Medical Research. Using a theory of strategic and moral behavior, the research shows that both clients and sponsors in contract research have individual and collective responsibility to ensure that due care and diligence is exercised in the performance of clinical research. The research suggests some guidelines for stakeholder action. (shrink)

This book analyses the concept of disease, as defined in the context of evolutionary medicine. Upon introducing the reader to evolutionary medicine in its current form and describing its approach to disease instances, the book leverages thoughts and instruments of knowledge of epistemology, social sciences, and ethics to answer the question: “How can we build a timely and appropriate concept of disease?” At first, it looks at the social concerns of medicalization, for example focusing on the suffering of people (...) who have not been diagnosed, or whose suffering is not caused by certain elements that falls under the definitions of disease. In turn, it merges different, both conceptual and empirical considerations in one comprehensive analysis, with the aim of fostering a multidisciplinary understanding of the phenomenon of disease. This book also highlights certain kinds of epistemic injustices that are taking place in the healthcare system, as this is currently conceived in post-industrial societies, thus offering a timely contribution to the current debate around social justice in healthcare. (shrink)

Historians have used university statutes and acts to reconstruct the official astrology curriculum for students in both the arts and medical faculties, including the books studied, their order, and their relation to other texts. Statutes and acts, however, cannot offer insight into what actually happened during lectures and in the classroom: in other words, how and why astrology was taught and learned in the medieval university. This paper assumes that the astrology curriculum is better understood as the set of (...) practices that constituted it and gave it meaning for both masters and students. It begins to reconstruct what occurred in the classroom by drawing on published and unpublished lecture notes. These offer insight into how masters presented the material as they did, and why. The paper argues three points: first, the teaching of astrology centered on demonstrations involving astrological instruments: specifically, various kinds of paper astrolabes. Second, the astrological instruction focused on conveying the pragmatics of astrology rather than esoteric, theoretical issues. Finally, astrology as it was taught in the arts curriculum was explicitly intended to provide a foundation for students who would advance to study medicine at the university. (shrink)

Hailed as the “foundation of the next industrial revolution,” nanotechnology is reshaping the landscape of technological innovation and creating hope around the world. Some believe that nanotechnology can address the critical needs of developing countries, but others are less optimistic. At one end of the spectrum, scientists predict that, among other accomplishments, nanotechnology can alleviate poverty, provide safe drinking water, and cure diseases. At the other end, skeptics warn that nanotechnology can further widen the gap between the rich and the (...) poor, contributing to an already imbalanced global landscape. What can nanotechnology bring to the 21st century? How and in what ways should it intersect with law, public policy, and the plight of the developing world?This article argues that the international community can harness nanotechnology to create sustainable development, particularly in the field of water remediation and treatment, but it must learn from its past missteps and adopt a strategy that combines two competing theories: instrumentalism and contextualism. Instrumentalism is the concept that technology is superb and stakeholders can easily transfer it from one application to another. In contrast, contextualism places technology in a socioeconomic context and conditions technological success on the stakeholders’ ability to meet local needs. (shrink)

Billions of people live in poverty, with no access to safe drinking water or solutions for other critical health and medical needs. Nanotechnology is poised to create workable solutions for large-scale public health needs in developing countries, including improving water quality and providing life-saving pharmaceuticals. There are two views on how emerging technologies such as nanotechnology can influence and affect developing countries. Instrumentalists believe that the international community can transfer nanotechnology from one context to another and use it to (...) assist the poor. Contextualists warn that nanotechnology can increase inequality in underdeveloped regions. Because of inadequacies in both positions, the international community must adopt a mixed strategy. This article argues that this mixed strategy should target the bottom of the pyramid, develop native capability, implement emergency protocols in projects, create accountability, and engage the public. Managed well, this strategy can propel developing countries toward sustainable development. (shrink)

Technologies of democracy are instruments based on material apparatus, social practices and expert knowledge that organize the participation of various publics in the definition and treatment of public problems. Using three examples related to the engagement of publics in nanotechnology in France (a citizen conference, a series of public meetings, and an industrial design process), the paper argues that Science and Technology Studies provide useful tools and methods for the analysis of technologies of democracy. Operations of experiments and (...) public demonstrations can be described, as well as controversies about technologies of democracy giving rise to counter-experiments and counter-demonstrations. The political value of the analysis of public engagement lies in the description of processes of stabilization of democratic orders and in the display of potential alternative political arrangements. (shrink)

This chapter discusses some strategies pharmaceutical companies employ to establish influence and even hegemony over domains of medical knowledge: marketing products via medical research and education. The chapter thus contributes to understanding the political economy of knowledge in this industry. As a counterpart to traditional epistemology, studying the political economy of knowledge shifts attention from individual claims and their justifications to some of the forces available to shape terrains on which claims are produced, distributed, and consumed.Of pharmaceutical (...) companies’ clinical research, 70–75% is performed by contract research organizations. CROs conduct trials with one eye to the drug approval process and the other to the marketing of products. On the basis of trial data, analyzed by pharmaceutical company statisticians and scientists, publication planners design suites of scientific manuscripts and hire ghostwriters to write them. These are then given to academic authors, who generally have had little prior connection to the research, analysis, or writing. The manuscripts are published in medical journals appropriate for the audiences the companies wish to reach.The doctors and researchers with whom companies engage most closely are generally termed key opinion leaders. In addition to authoring manuscripts, KOLs serve companies in a number of roles, but most prominently as speakers—at professional meetings, in after-dinner and similar settings arranged by sales representatives, and in continuing medical education courses, which doctors must take to keep their licenses. Research, education, and marketing, then, are often fused. (shrink)

BackgroundA different ethos with respect to the perception of medical ethics prevails in societies in transition such as those in the Arabian Peninsula, which makes it difficult to apply international principles of bioethics in medical practice. This study aimed to develop and psychometrically test an instrument that measures physicians’ awareness of bioethics and medical law and their attitudes towards the practice of medical ethics. Additionally, it examined physician correlates influencing the awareness of bioethics.MethodsFollowing a rigorous review (...) of relevant literature by a panel of experts, a 13-item instrument, the Omani physicians’ bioethics and medical law awareness (OBMLA) questionnaire was developed with the aim of assessing physicians’ awareness of bioethics and medical law. The study tool’s construct validity and internal consistency reliability were examined by exploratory factor analysis (EFA) and Cronbach’s alpha. In a cross-sectional study, the questionnaire was distributed among a random sample of 200 physicians at a tertiary hospital in Muscat, Oman. Participant characteristics that may influence awareness of bioethics and medical law were explored.ResultsThe EFA of the OBMLA questionnaire resulted in three well-loading factors: (1) Physicians’ bioethics practice subscale (2) incentive related bioethics subscale and (3) medical law awareness subscale. Internal consistency reliability ranged between Cronbach’s α: 0.73–0.8. Of the total 200 participants, 52% reported that teaching medical ethics during medical school was inadequate. The overall mean (standard deviation, SD) of the bioethics awareness score and Omani medical law awareness were 27.6 (3.5) and 10.1 (2.1) respectively. The majority of physicians (73%) reported that they frequently encountered ethical dilemmas in their practice and 24.5% endorsed the view that unethical decisions tended to occur in their practice.ConclusionThe study provides an insight into the practice of bioethics, and the awareness of bioethics and medical law among physicians in a teaching hospital in Oman. The OBMLA questionnaire appears to be a valid and reliable tool to assess a physician’s awareness of bioethics and medical law. In this preliminary study, it appears that participants have suboptimal scores on the indices which measure practice and awareness of bioethics and medical law. (shrink)

In the regime of Anglo-American tort law, every person has a responsibility to comport him- or herself with “due care” in going about day-to-day activities so as not to imperil the health, safety, or general welfare of others. The gold standard for determining what constitutes due care in any particular situation is what a reasonable person, similarly situated, would do. Determinations of due care are necessarily fact specific. Nevertheless, the general objective is to strike an appropriate balance between an unrealistically (...) high standard of caution and one that fails to take into account the known or foreseeable risks of any human endeavor. The same standard applies to individuals regardless of their age, gender, race, and level of education or economic status. The standard also applies to fictional “persons” such as corporations. The usual or prevailing custom and practice in an industry or occupation may provide relevant evidence of what constitutes “due care” in the activities common to it, but that evidence can be effectively overcome or rebutted by competent, credible evidence that the custom and practice either diverges from what it has been asserted to be or that the custom and practice is itself unsafe or otherwise poses an unreasonable risk of harm to others. Until quite recently, a singular exception to this general principle of tort law was made for the medical profession. We will consider this exception in the next section. (shrink)

There are deep structural conflicts between the mission of healthcare as cooperative care to the sick and injured and that of healthcare as a business whose mission is maximizing profits. These conflicts come to the fore in the medical pharmaceutical industry. I first set these out in a context that addresses the mission of healthcare, then examine the relative roles of competitive and cooperative systems of distributive justice, and then argue for the creation of nonprofit pharmaceutical companies and (...) the transformation of many for-profit companies into companies subject to public oversight and profit curbs. The recommendations are aspirational for the United States but it is meant to be action guiding for those industrialized countries wealthy enough to provide universal health coverage. (shrink)

Scientific instruments can help to shape and re-shape epistemic boundaries, especially those between communities of scienti?c researchers. But how do they function at boundaries between scienti?c communities and communities of non-experts? This paper examines the use of air monitoring instruments at the boundary between petrochemical facilities and nearby residential communities, asking whether a new generation of fenceline monitors shared by industry (and regulatory agency) experts and community members alter the epistemic boundary between the two groups. Arguing that (...) epistemic communities organized around instruments are characterized, in part, by a common understanding of the evidential contexts for instrumental data, the paper shows how the evidential contexts in which experts and residents interpret monitoring data diverge. Instead of the new, shared fenceline monitors helping to reconcile differences over evidential contexts, those pre-existing contexts shape the interpretation of data from the new instruments–perpetuating epistemic boundaries between industry experts and community members. (shrink)

Urban infrastructures serve as the backbone of modern economies, mediating global exchanges and responding to urban demands. Yet, our comprehension of these complex structures, particularly within diverse socio-political terrain, remains fragmented. In bridging this knowledge gap, this study delves into “boundary objects”—entities enabling diverse stakeholders to collaborate without a comprehensive consensus. Central to our investigation is the hypothesis that oceanic infrastructural developments are instrumental in molding the interface of urban, industrial, and energy sectors within marine contexts. Our lens is directed (...) at the Gulf of Mexico, which is distinguished by its industrial depth and expansive marine grid. We highlight the Gulf Intracoastal Waterway’s (GIWW) paramount role in regional movement and the ecological facets of practices such as dredging, which is vital for transport and coastal conservation. A striking revelation of our study is the transformation of offshore structures in the Gulf into vibrant marine habitats. Emphasizing the intertwined nature of marine infrastructures, we denote oceans as pivotal platforms for impending urban expansion, especially as land resources wane. Our research aspires to validate the role played by oceans as a nexus in the urban–industrial–energy fusion. (shrink)

This volume collects ten essays by the distinguished historian Roger L. Emerson. Many are augmented versions of public lectures or conference papers, and all advance Emerson’s career-long study of the Scottish Enlightenment, its social foundations, and its institutional embodiments. Emerson states his case and names his rivals in the anchor piece of the collection, “What is to be Done About the Scottish Enlightenment?” The Scottish Enlightenment, he argues, was a broad-based, indigenous movement of long standing, largely independent of English models. (...) He attacks the view, which he attributes to Nicholas Phillipson (with concurrence in varying degrees from J. G. A. Pocock, John Robertson, and Richard .. (shrink)

This superb account of the development of scientific research in the state of Baden places the growth of science in nineteenth century Germany within a broad social and economic context. The book analyses the progress of scientific research and its institutionalization in the state university system. Focusing on the experimental sciences, the book explores the introduction of the research ethic into the university medical curriculum, and the process by which laboratory science came to be an essential pedagogical tool in (...) the education of future citizens of the state. The social and economic changes that ultimately transformed Germany into a modern industrial state are also considered. It was within this setting that laboratory training, once considered inappropriate for university studies, grew in status, and that dissatisfaction with the overly theoretical education traditionally offered by the universities began to increase. Thus, much like computers today, the scientific method in the nineteenth century came to represent an instrument for teaching not only specific skills but also a particular way of approaching, analyzing, and solving the problems of an industrializing economy. This compelling volume will be of interest to historians of science, medicine, and European studies. (shrink)