The Physician Payments Sunshine Act requires health care product manufacturers to report to the federal government payments more than $10 to physicians. Bringing unprecedented transparency to medicine, PPSA holds great potential for enabling medical stakeholders to manage conflicts of interest and build patient trust—crucial responsibilities of medical professionalism. The authors conducted six focus groups with 42 physicians in Chicago, IL, San Francisco, CA, and Washington, DC, to explore attitudes and experiences around PPSA. Participants valued the concept of transparency but were (...) wary of the law's design and consequences. They downplayed PPSA's potential and felt it undermined public trust. Showing broad unawareness of COI, they dismissed the notion of industry influence and welcomed company “perks.” Misapprehensions may leave physicians unprepared to advance the opportunities PPSA holds for professionalism. The authors offer recommendations for government and medicine to improve physicians' and other stakeholders' understandings and use of the data. (shrink)

Addresses the issues at the heart of international medicine and social responsibility. A number of international declarations have proclaimed that health care is a fundamental human right. But if we accept this broad commitment, how should we concretely define the state’s responsibility for the health of its citizens? Although there is growing debate over this issue, there are few books for general readers that provide engaging accounts of critical incidents, practices, and ideas in the field of human rights, health care, (...) and medicine. Included in the book are case studies of such issues as AIDS among orphans in Romania, organ trafficking, prison conditions, health care rationing, medical research in the third world, and South Africa’s constitutionally guaranteed right of access to health care. It uses these topics to address themes of protection of vulnerable populations, equity and fairness in delivering competent medical care, informed consent and the free flow of information, and state responsibility for ensuring physical, mental, and social well-being. (shrink)

The most recent (Fifth) revision of the Declaration of Helsinki, adopted in October 2000 by the World Medical Association (WMA), reinforces the longstanding prohibition against offering placebo instead of effective therapy. The WMA left no doubt that if a beneficial treatment for a condition has already been recognised, it is unethical to offer placebo in place of such treatment to anyone in a study of the same condition. We have previously drawn attention to the discrepancy between the spirit of the (...) Declaration and the common practice of using placebo controls in randomised trials even if effective treatment exists. Despite the mandates of the Declaration of Helsinki and concern from ethicists and scientists, the US Food and Drug Administration (FDA) continues to demand and defend placebo‐controlled evidence of efficacy and safety for the development of many new pharmaceuticals, even if effective therapy exists. We suggest that the FDA's arguments defending their practice are insufficient to justify medical research that violates the Declaration of Helsinki. (shrink)

John Burdon Sanderson Haldane was a giant among men. He made major contributions to genetics, population biology, and evolutionary theory. He was at once comfortable in mathematics, chemistry, microbiology and animal physiology. But it was his belief in education that led to his preparing his popular essays for publication. In his own words: "Many scientific workers believe that they should confine their publications to learned journals. I think that the public has a right to know what is going on inside (...) the laboratories, for some of which it pays." So begins Haldane's collection of essays, perhaps the most public intellectual communicating science before the writings of Stephen Jay Gould. The first part of the volume emphasizes the important developments in biology and natural science in the first quarter of the century. As such, it provides a benchmark for studies of the next three quarters of the century. In an unusual introduction, Price takes the readers through their paces, discussing the situation then and now in vitamins, oxygen want, disease controls, and the rewards of science as such. This is followed by Haldane's views on society, art, religion and economy as seen through the eyes of a politically alert major scientist. The editor provides readers unfamiliar with Haldane with a carefully rendered chronology of a life that began in 1892 and that spanned much of the present century. Despite ideas on race, class and politics that have seen better times, Haldane was truly exceptional in translating the science of his time into ideas that "everyman" could readily grasp. His predictions on what science would achieve were on target far more often than not. But even his failed predictions are perhaps the most interesting of all. They throw into sharp relief the truly novel and revolutionary developments in science over the past 75 years. J.B.S. Haldane held many positions and received many honors during his lifetime. But for most of the period covered in this volume, he was the William Dunn Reader in Biochemistry at Cambridge University. He simultaneously served as Fellow of New College, in Oxford University's Horticultural Institute. Carl A. Price served until 1999 as professor IIof plant molecular biology in the Waksman Institute of Microbiology at Rutgers, the State University of New Jersey. He also served as the editor of Plant Molecular Biology Reporter from 1983 until 1997. This is the first volume in a new series on the history and theory of science. (shrink)

In a reflective and richly entertaining piece from 1979, Doug Hofstadter playfully imagined a conversation between ‘Achilles’ and an anthill (the eponymous ‘Aunt Hillary’), in which he famously explored many ideas and themes related to cognition and consciousness. For Hofstadter, the anthill is able to carry on a conversation because the ants that compose it play roughly the same role that neurons play in human languaging; unfortunately, Hofstadter’s work is notably short on detail suggesting how this magic might be achieved1. (...) Conversely in this paper - finally reifying Hofstadter’s imagination - we demonstrate how populations of simple ant-like creatures can be organised to solve complex problems; problems that involve the use of forward planning and strategy. Specifically we will demonstrate that populations of such creatures can be configured to play a strategically strong - though tactically weak - game of HeX (a complex strategic game).We subsequently demonstrate how tactical play can be improved by introducing a form of forward planning instantiated via multiple populations of agents; a technique that can be compared to the dynamics of interacting populations of social insects via the concept of meta-population. In this way although, pace Hofstadter, we do not establish that a meta-population of ants could actually hold a conversation with Achilles, we do successfully introduce Aunt Hillary to the complex, seductive charms of HeX. (shrink)

For a long time, researchers in the fields of psychology and neuroscience have been interested in discovering ways to boost productivity in traditionally "healthy," "clinical," and "military" populations. However, one of the biggest challenges in reaching this objective is developing personalised performance phenotypes that can be used to build interventions that are specifically catered to each individual's needs. Impact: Thanks to AI's recent advancements, we can now create individualised training, preparation, and recovery plans that are tailored to each person's unique (...) cognitive and biological profile. Concurrent AI advancements, especially in the psychological and neurological sciences, have demonstrated the importance of incorporating domain expertise and stakeholder inputs into the development of trustworthy AI. Value: This Patterns themed issue seeks original empirical work, literature reviews, and methodological papers that establish and validate precision artificial intelligence methods for human performance optimization, with a focus on modelling individual differences via state-of-the-art computational methods. (shrink)