POWER, INTEGRITY, AND TRUST IN THE MANAGED PRACTICE OF MEDICINE: LESSONS FROM THE HISTORY OF MEDICAL ETHICS

2002 ◽  
Vol 19 (2) ◽  
pp. 180-211 ◽  
Author(s):  
Laurence B. McCullough
Keyword(s):  
Human Subjects ◽  
Clinical Applications ◽  
Biomedical Science ◽  
Federal Regulations ◽  
Power Integrity ◽  
Research Subjects ◽  
Practice Of Medicine ◽  
History Of ◽  
The Moment ◽  
History Of Medical Ethics

Bioethics as a field began some years before it was finally named in the early 1970s. In many ways, bioethics originated in response to urgent matters of the moment, including the controversy over disconnecting Karen Quinlan's respirator, the egregious paternalism of Donald Cowart's doctors in the famous “Dax” case, the abuse of research subjects in the notorious Tuskegee Syphilis Study, and the need to devise an intellectual framework for the development of federal regulations to protect human subjects of research. The phrase “new and unprecedented” became a common description of the topics and issues to which people who later came to be called “bioethicists” responded. It should come as no surprise that bioethics and its practitioners soon came to the self-understanding that their work was new and unprecedented, much as the innovations of biomedical science and their clinical applications were thought to be.

It-Narrative and the Book as Agent

2012 ◽  
Author(s):  
Leah Price
Keyword(s):  
Human Subjects ◽  
Life Writing ◽  
Building Blocks ◽  
History Of The Book ◽  
Common Interest ◽  
Recent Book ◽  
Historical Scholarship ◽  
Shared Attention ◽  
History Of ◽  
The Moment

This chapter argues that the most productive overlap between recent book-historical scholarship and the longer tradition of bibliographically themed life writing lies not in their common interest in human subjects, but rather in their shared attention to the circulation of things. Analytical bibliographers have shown that books accrue meaning not just at the moment of manufacture, but through their subsequent uses: buying and selling, lending and borrowing, preserving and destroying. A history of the book that took that whole range of transactions as building blocks could usefully borrow its formal conventions from the “it-narrative”: a fictional autobiography in which a thing traces its travels among a series of richer and poorer owners.

IRB Creep: Federal Regulations Protecting Human Research Subjects and Increasing Instructors' Responsibilities

2009 ◽  
Vol 24 (1) ◽  
pp. 31-43 ◽  
Author(s):  
Diane A. Riordan ◽  
Michael P. Riordan
Keyword(s):  
Review Process ◽  
Human Subjects ◽  
Institutional Review Boards ◽  
Federal Regulations ◽  
Federally Funded ◽  
Research Subjects ◽  
Accounting Faculty ◽  
Institutional Review ◽  
Human Research Subjects ◽  
Review Boards

ABSTRACT: Federal regulations require oversight of federally sponsored research involving human subjects. Universities have responded by forming Institutional Review Boards (IRBs). Although these regulations only apply to federally funded projects, universities have extended the oversight to include all projects involving human subjects. From our own experience, we observe that not all accounting faculty are aware of their responsibilities to their local boards. The sanctions for failing to follow required procedures depend on the infraction, and range from an order to cease work on the project to termination of university service for the faculty member and expulsion for the student. This report helps accounting faculty understand how the review process may affect their role as instructors and serves as encouragement to them to become familiar with the requirements of local review boards.

The Role of the Institutional Review Board in Research Involving Human Subjects

1983 ◽  
Vol 17 (11) ◽  
pp. 828-834 ◽  
Author(s):  
John A. Bosso
Keyword(s):  
Experimental Research ◽  
Human Subjects ◽  
Institutional Review Board ◽  
Institutional Review Boards ◽  
Federal Regulations ◽  
Research Subjects ◽  
Basic Composition ◽  
Institutional Review ◽  
Policies And Procedures

Concern with the rights and welfare of human experimental research subjects has given rise to the evolution of institutional review boards. This article describes the basic composition and purposes of these boards, as well as the federal regulations by which they are governed. Since many of these regulations are open to interpretation, the policies and procedures of one such board are included to represent an example of how these regulations are interpreted and applied.

Ethical Issues in Treating Pain and Addiction (DRAFT)

2018 ◽  
Author(s):  
Christopher J. Spevak
Keyword(s):  
Ethical Decision Making ◽  
Ethical Issues ◽  
Human Subjects ◽  
Clinical Care ◽  
Hippocratic Oath ◽  
Treatment Programs ◽  
Ethical Challenges ◽  
Faith Based ◽  
History Of ◽  
History Of Medical Ethics

In addressing the ethical issues that arise in treating both pain and addiction, the author of this chapter has organized his presentation around: the history of medical ethics; theories and definitions; and the ethical challenges to providing clinical care. The theoretical underpinnings to ethical decision-making are important to providing the best possible outcome, and their evolution is described, from the Hippocratic Oath to current human subjects’ protection rules for clinical trials. The tension between patient autonomy and the physician’s obligation to protect is as high as that seen in parenthood, but commonly with even less control of the individuals involved. A framework is provided for examining clinical cases that aids in addressing such topics as treatment disagreement, confidentiality, informed consent, abandonment, pregnancy, and biases that may be seen with categorical treatment programs (e.g., abstinence-based, faith-based). A text box is added giving additional resources on the topics discussed.

The Invisible Vulnerable: The Economically and Educationally Disadvantaged Subjects of Clinical Research

2003 ◽  
Vol 31 (1) ◽  
pp. 149-153 ◽  
Author(s):  
T. Howard Stone
Keyword(s):  
Human Subjects ◽  
Disabled Persons ◽  
Federal Regulations ◽  
Research Subjects ◽  
Undue Influence ◽  
Common Rule ◽  
Educationally Disadvantaged ◽  
Mentally Disabled ◽  
The Common ◽  
Protection Of Human Subjects

U.S. Department of Health and Human Services (HHS) federal regulations pertaining to the protection of human subjects at Title 45 of the Code of Federal Regulations, Part 46, Subpart A (“the Common Rule”), refer to the need for special precautions when persons characterized as vulnerable are used as human research subjects. Under the Common Rule, persons considered “vulnerablae” are those who are likely to be susceptible to coercive or undue influence; the term “vulnerable” includes “children, prisoners, pregnant women, mentally disabled persons,” or those who are “economically or educationally disadvantaged.” The need for special precautions with some of these vulnerable persons in the context of research has long been addressed by both mandatory additional protections found in Subparts B through D of 45 C.F.R. pt. 46 (that are not, coincidentally, part of the Common Rule) and additional detailed guidance documents provided by HHS or its components to investigators and their respective institutions.

A Living Wage for Research Subjects

2011 ◽  
Vol 39 (2) ◽  
pp. 243-253 ◽  
Author(s):  
Trisha B. Phillips
Keyword(s):  
Human Subjects ◽  
Crowding Out ◽  
Living Wage ◽  
Research Subject ◽  
Federal Regulations ◽  
Research Subjects ◽  
Wage Payment ◽  
Study Results ◽  
Undue Inducement ◽  
Protection Of Human Subjects

Offering cash payments to research subjects is a common recruiting method, but this practice continues to be controversial because of its potential to compromise the protection of human subjects. Some critics question whether researchers should be allowed to offer money at all, citing concerns about commodification of the research subject, invalidation of study results, and increased risks to subjects. Other critics are comfortable with the idea of monetary payments but question how much researchers can pay their subjects, citing concerns about undue inducement, crowding out, and monetary exploitation. Focusing only on the amount researchers can pay their subjects, this paper argues that the federal regulations and guidelines should implement a standard payment formula. It argues for a wage payment model, and critically examines three candidates for a base wage: the nonfarm production wage, the FLSA minimum wage, and a living wage.

Evaluation of concomitant gynecological pathology in group of patients of reproductive age with tumors and tumor formations

2020 ◽  
pp. 10-14
Author(s):  
N. V. Spiridonova ◽  
A. A. Demura ◽  
V. Yu. Schukin
Keyword(s):  
Diagnostic Errors ◽  
Ovarian Tumors ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Predisposing Factor ◽  
Ovarian Tumours ◽  
Preoperative Diagnostic ◽  
Neoplastic Process ◽  
History Of ◽  
The Moment

According to modern literature, the frequency of preoperative diagnostic errors for tumour-like formations is 30.9–45.6%, for malignant ovarian tumors is 25.0–51.0%. The complexity of this situation is asymptomatic tumor in the ovaries and failure to identify a neoplastic process, which is especially important for young women, as well as ease the transition of tumors from one category to another (evolution of the tumor) and the source of the aggressive behavior of the tumor. The purpose of our study was to evaluate the history of concomitant gynecological pathology in a group of patients of reproductive age with ovarian tumors and tumoroid formations, as a predisposing factor for the development of neoplastic process in the ovaries. In our work, we collected and processed complaints and data of obstetric and gynecological anamnesis of 168 patients of reproductive age (18–40 years), operated on the basis of the Department of oncogynecology for tumors and ovarian tumours in the Samara Regional Clinical Oncology Dispensary from 2012 to 2015. We can conclude that since the prognosis of neoplastic process in the ovaries is generally good with timely detection and this disease occurs mainly in women of reproductive age, doctors need to know that when assessing the parity and the presence of gynecological pathology at the moment or in anamnesis, it is not possible to identify alarming risk factors for the development of cancer in the ovaries.

The Goal of the Moment (Summary of the Lecture Delivered by Ivan Ilyin in May 1917)

2019 ◽  
Vol 60 ◽  
pp. 424-428
Author(s):  
Alexandra I. Vakulinskaya
Keyword(s):  
The State ◽  
October Revolution ◽  
Legal Consciousness ◽  
New Order ◽  
History Of ◽  
The Moment

This publication is devoted to one of the episodes of I. A. Ilyin’s activity in the period “between two revolutions”. Before the October revolution, the young philosopher was inspired by the events of February 1917 and devoted a lot of time to speeches and publications on the possibility of building a new order in the state. The published archive text indicates that the development of Ilyin’s doctrine “on legal consciousness” falls precisely at this tragic moment in the history of Russia.

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