Ethical Issues in Prospective Studies in Children: The many Shades of Gray

2012 ◽  
Vol 46 (3) ◽  
pp. 126-128
Author(s):  
Meenu Singh ◽  
Madhusudan LNU

ABSTRACT Children being a vulnerable, unique, yet heterogenous population, pose varied ethical questions in clinical research. These need to be actively recognized and addressed in order to strike the right balance between ‘individual’ good and 'societal’ good. Certain general principles which can be streamlined into guidelines specific for each population and study is the need of the hour. How to cite this article Singh M, Madhusudan. Ethical Issues in Prospective Studies in Children: The many Shades of Gray. J Postgrad Med Edu Res 2012;46(3):126-128.

1942 ◽  
Vol 36 (5) ◽  
pp. 837-849 ◽  
Author(s):  
Byron Price

To a free people, the very word “censorship” always has been distasteful. In its theory, it runs counter to all democratic principles; in practice, it can never be made popular, can never please anyone.Everything the censor does is contrary to all that we have been taught to believe is right and proper. The Post Office Department, for example, has two proud mottoes: “The mail must go through,” and “The privacy of the mail must be protected at all hazards.” But censorship stops the mail, it invades the privacy of the mail, it disposes of the mail as may seem best. The same thing holds true in the publishing business. Censorship limits the lively competition and free enterprise of reporters. It relegates many a scoop to the waste basket. It wields a blue pencil—both theoretical and actual—on news stories, magazine articles, advertisements, and photographs. Censorship also enters the radio industry, where it may edit scripts and in some cases stop entire programs.Yet even the most vociferous critics of the principle of censorship agree that in war-time some form and amount of censorship is a necessity. It then becomes not merely a curtailment of individual liberty, but a matter of national security. It is one of the many restrictions that must be imposed on people fighting for the right to throw off those restrictions when peace returns.


1997 ◽  
Vol 21 (1) ◽  
pp. 71-99 ◽  
Author(s):  
Richard C. Morey ◽  
David A. Dittman

The “go/no-go” decision for a candidate property, i.e., whether or not to actually acquire the site, choose the brand (flag), build and operate the hotel, requires the explicit consideration of the interconnectedness of the many myriad elements affecting the property's potential profits. The many facility design decisions (number and mix of rooms, capacity for F&B operations etc.) as well as other strategic choices (e.g., size of marketing program, level of service aimed for) must recognize the site's competitive features and interactions with the above. Also, the particular design and operational features for a given property will affect its different revenue streams, fixed and variable costs, efficiency and profits. The authors consider developers contemplating acquiring a given site, choosing a brand, building and operating a new hotel. They offer a normative approach for this type of decision which arrives endogenously at possibly attractive options for the brand, design and strategic choices for the site. The final decision as to which option to actually use, if any, should be based on subjecting the above identified scenarios, as well as others, to traditional feasibility analyses where judgment and expert opinion are applied. The authors' implementable approach integrates a “best practices” benchmarking methodology with regression analysis to yield a mathematical programming optimization model. A key advantage of this approach lies in its contrast to conventional approaches for site selection which often ignore the more detailed design and strategic choices. The approach deals explicitly with the complex interfaces between marketing and operations management as the endogenous site and competitive environmental factors interact with the endogenous brand and facility design choices. By identifying attractive options to be further explored (that might otherwise be overlooked), several types of errors are avoided: i) an incorrect “go/no go” decision could be recommended for the site in question; ii) even if the right decision to proceed is made, the forecasted level of annualized profits could be in error, leading to an incorrect priority for the activity; iii) the incorrect brand and facility design choices could be made for the site. Other key advantages of the suggested approach are that 1) various substitution possibilities (between more or less capital, labor, materials etc.) are considered; 2) not only is the best brand and configuration identified, but also a ranking of other brands is available if the “best” brand is not available; 3) the “best practices” at other specific sites (which serve as the basis for the recommendations) are identified, thereby enabling management (possibly through site visits) to isolate the actual cultures, processes and procedures to be transported and emulated at the candidate site. This paper illustrates the approach for two different sites.


Fascism ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Roger Griffin

In the entry on ‘Fascism’ published in 1932 in the Enciclopedia Italiana, Benito Mussolini made a prediction. There were, he claimed, good reasons to think that the twentieth century would be a century of ‘authority’, the ‘right’: a fascist century (un secolo fascista). However, after 1945 the many attempts by fascists to perpetuate the dreams of the 1930s have come to naught. Whatever impact they have had at a local level, and however profound the delusion that fascists form a world-wide community of like-minded ultranationalists and racists revolutionaries on the brink of ‘breaking through’, as a factor in the shaping of the modern world, their fascism is clearly a spent force. But history is a kaleidoscope of perspectives that dynamically shift as major new developments force us to rewrite the narrative we impose on it. What if we take Mussolini’s secolo to mean not the twentieth century, but the ‘hundred years since the foundation of Fascism’? Then the story we are telling ourselves changes radically.


1998 ◽  
pp. 203-226 ◽  
Author(s):  
Patricia A. Marshall ◽  
Barbara A. Koenig ◽  
Paul Grifhorst ◽  
Mirjam van Ewijk

2017 ◽  
Vol 2 (Suppl. 1) ◽  
pp. 1-10
Author(s):  
Denis Horgan

In the fast-moving arena of modern healthcare with its cutting-edge science it is already, and will become more, vital that stakeholders collaborate openly and effectively. Transparency, especially on drug pricing, is of paramount importance. There is also a need to ensure that regulations and legislation covering, for example the new, smaller clinical trials required to make personalised medicine work effectively, and the huge practical and ethical issues surrounding Big Data and data protection, are common, understood and enforced across the EU. With more integration, collaboration, dialogue and increased trust among each and every one in the field, stakeholders can help mould the right frameworks, in the right place, at the right time. Once achieved, this will allow us all to work more quickly and more effectively towards creating a healthier - and thus wealthier - European Union.


2018 ◽  
Vol 37 (03) ◽  
pp. 263-266
Author(s):  
Lucas Meguins ◽  
Linoel Valsechi ◽  
Ronaldo Fernandes ◽  
Dionei Morais ◽  
Antonio Spotti

Introduction Pericallosal artery (PA) aneurysms represent 2 to 9% of all intracranial aneurysms, and their management remains difficult. Objective The aim of the present study is to describe the case of an adult woman with subarachnoid hemorrhage and bilateral PA aneurysm in mirror position. Case Report A 46-year-old woman was referred to our institution 20 days after a sudden severe headache. She informed that she was treating her arterial hypertension irregularly, and consumed ∼ 20 cigarettes/day. The patient was neurologically intact at admission. A non-contrast computed tomography (CT) on the first day of the onset of the symptoms revealed hydrocephaly and subarachnoid hemorrhage (Fisher III). An angio-CT/digital subtraction arteriography showed bilateral PA aneurysms in mirror position. The patient was successfully treated with surgery via the right interhemispheric approach (because the surgeon is right-handed); the surgeon performed the proximal control with temporary clipping, and introduced an external ventricular drain at the end of the surgery. The patient was discharged on the fourth postoperative day without any additional neurological deficits or ventricular shunts. Conclusion Ruptured PA aneurysm is a surgically challenging aneurysm due to the many anatomical nuances and risk of rebleeding. However, the operative management of ruptured bilateral PA aneurysms is feasible and effective.


2015 ◽  
Vol 96 (3) ◽  
pp. 471-477
Author(s):  
N N Blokhina

The article describes the activities of the Pokrovsky monastery-hospital in Kiev, created by the efforts of the Grand Duchess Alexandra Petrovna (1838-1900), who took the monastic vows in 1889 under the name Anastasia. The monastery became widely known in the late XIX - early XX century for the highly skilled medical aid provided to the population since its inception up to the events of 1917. It was a unique complex of medical settings located in the same area and equipped with modern medical equipment comparable with the many World’s clinics of that time. In this monastery-hospital, pilgrims with different diseases who came at Pokrovsky monastery in Kiev were provided the required qualified, affordable medical care. Thanks to the Grand Duchess Alexandra Petrovna, her attentive attitude to all the latest innovations, novel treatment methods were developed and introduced to the work of monastery medical settings. In addition, she was able to create a special atmosphere and goodwill towards the sick. But, being engaged in devising new methods of providing medical care to patients, she was able to create a special and inviting atmosphere with respect to the patient. With the ever-increasing circle of her organizational and economic activities, being in charge of the monastery-hospital problems of great importance, Grand Duchess reserved the right to nurse her patients. She worked by vocation, at the behest of the soul. Her example of selfless labor in the monastery medical settings where monastic sisters held the medical staff responsibilities for the patients care was important for all of the staff. Her assistants - Sisters of Charity - she fostered by her own example of selfless aid to a sick person. This favorable work atmosphere was very effective helping cure the sick.


2010 ◽  
Vol 4;13 (4;7) ◽  
pp. 305-315 ◽  
Author(s):  
James Giordano

The pain clinician is confronted with the formidable task of objectifying the subjective phenomenon of pain so as to determine the right treatments for both the pain syndrome and the patient in whom the pathology is expressed. However, the experience of pain — and its expression — remains enigmatic. Can currently available evaluative tools, questionnaires, and scales actually provide adequately objective information about the experiential dimensions of pain? Can, or will, current and future iterations of biotechnology — whether used singularly or in combination (with other technologies as well as observational-behavioral methods) — afford objective validation of pain? And what of the clinical, ethical, legal and social issues that arise in and from the use — and potential misuse — of these approaches? Subsequent trajectories of clinical care depend upon the findings gained through the use of these techniques and their inappropriate employment – or misinterpretation of the results they provide — can lead to misdiagnoses and incorrect treatment. This essay is the first of a two-part series that explicates how the intellectual tasks of knowing about pain and the assessment of its experience and expression in the pain patient are constituent to the moral responsibility of pain medicine. Herein, we discuss the problem of pain and its expression, and those methods, techniques, and technologies available to bridge the gap between subjective experience and objective evaluation. We address how these assessment approaches are fundamental to apprehend both pain as an objective, neurological event, and its impact upon the subjective experience, existence, and expectations of the person in pain. In this way, we argue that the right use of technology — together with inter-subjectivity, compassion, and insight — can sustain the good of pain care as both a therapeutic and moral enterprise. Key words: pain, assessment, neurotechnology, biotechnology, neuroethics, medicine


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