This article addresses a set of exploratory questions related to emergency contraception and the right to refuse to dispense such drugs. The paper first address the roles of the pharmacist in American society, i.e., as professional, employee, and business owner, and the pharmacists's identity and belief system; second, the paper reviews the status of state law and proposed legislation concerning patient/consumer access to emergency contraceptives; third, it offers an in-depth stakeholder analysis of the ethical and legal responsibilities of pharmacies to (...) stakeholders; and fourth, the paper provides overview of the salient ethical and legal issues concerning patient/customer access to emergency contraceptives relevant to management. The conclusions discuss questions for further research as well as strategic/human policy recommendations that balances the economic, legal, and ethical concerns of all primary stakeholders of the company/business, such as designing a management system which refers customers in a timely fashion; recognizing "conscience clauses," while ensuring that pharmacists "do no harm" to the consumer; and disseminating management "best practices" on "conscience clauses" through joint professional/industry sponsorship. (shrink)

This dissertation reassesses the chemical revolution that occurred in eighteenth-century France from the pharmacists' perspective. I use French pharmacy to place the event in historical context, understanding this revolution as constituted by more than simply a change in theory. The consolidation of a new scientific community of chemists, professing an importantly changed science of chemistry, is elucidated by examining the changing relationship between the communities of pharmacists and chemists across the eighteenth century. This entails an understanding of the chemical (...) revolution that takes into account social and institutional transformations as well as theoretical change, and hence incorporates the reforms brought about during and after the French Revolution. First, I examine the social rise of philosophical chemistry as a scientific pursuit increasingly independent of its practical applications, including pharmacy, and then relate this to the theoretical change brought about by Lavoisier and his oxygenic system of chemistry. Then, I consider the institutional reforms that placed Lavoisier's chemistry in French higher education. ;During the seventeenth century, chemistry was intimately entwined with pharmacy, and chemical manipulations were primarily intended to enhance the medicinal properties of a substance. An independent philosophical chemistry gained ground during the eighteenth century, and this development culminated in the work of Lavoisier who cast pharmacy out of his chemistry altogether. Fourcroy, one of Lavoisier's disciples, brought the new chemistry to the pharmacists in both his textbooks and his legislation. Under Napoleon, Fourcroy instituted a new system of education for pharmacists that placed a premium on formal scientific education. Fourcroy's successors, Vauquelin and Bouillon-Lagrange, taught the new chemistry to the elite pharmacists in the School of Pharmacy in Paris. These pharmacists also developed new analytical techniques that combined the aims of the new chemistry with traditional pharmaceutical extractive practices. The scientific pharmacist was created, who, although a respected member of the community of pharmacists, helped to define the new chemistry precisely by not being a true chemist. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Contradiction and Legislation Regarding the Right to LifeKevin L. Flannery, S.J.Unborn Human Life and Fundamental Rights: Leading Constitutional Cases under Scrutiny. Edited by Pilar Zambrano and William Saunders, with concluding reflections by John Finnis. Berlin: Peter Lang, 2019.The most fundamental principle of law is the principle of non-contradiction. This is Thomas Aquinas's position in the seminal article on the natural law, Summa theologiae I-II, question 94, article 2, where, (...) citing Aristotle, he formulates the principle as, "One should not simultaneously affirm and negate." Lafter in the same article, Thomas offers a practical formulation of the same principle, "Good is to be done and pursued and evil avoided"; but in law, since it is contained in propositions (airmations and negations) as distinct from ideas regarding the pursuit of goods, the prior formulation is the more immediately relevant of the two.The book under review is important in that, by going through the legal history regarding abortion and related issues in a number of different countries—the United States, Canada, Italy, Spain, Poland, Ireland (Eire), Costa Rica, Argentina, Chile, Mexico, and Peru—it causes to emerge any number of times the realization that legislation and judicial decisions in favor of abortion "rights" invariably infect a legal system with contradictions and inconsistencies of various sorts. The present essay is, therefore, not your typical book review. Its objective is simply to list some of the legal contradictions and inconsistencies identified by the book's various authors as they describe the legal status of the unborn in their respective nations. [End Page 1323]William Saunders's very clear and comprehensive first chapter is entitled, "Judicial Interference in the Protection of Human Life in the United States: Actions and Consequences." In it, he describes, among other things, the Human Cloning Prohibition Act passed by the U.S. House of Representatives in 2003, which prohibited "any person or entity, public or private" from performing human cloning (23). He speaks also of a bill proposed in the U.S. Senate once the Human Cloning Prohibition Act had passed in the House of Representatives. This Senate bill (which was entitle, "The Human Cloning Ban and Stem Cell Research Protection Act") would have prohibited "any person or other legal entity" from conducting human cloning, even while allowing nuclear transplantation, which it defines as "transferring the nucleus of a human somatic cell into an oocyte from which the nucleus... ha[s] been... removed or rendered inert." The problem here, as Saunders explains, is that this latter definition "is the very definition of cloning" (25). In other words, in the same year, two pieces of legislation were considered in the Congress of the United States, both purporting to ban human cloning, one of which would have permitted what the other described (correctly) as human cloning and so prohibited.In the second chapter, "Whither United States Abortion Law?" by Gerard V. Bradley, discussed, among other things, is the inconsistency between the United States Supreme Court's pro-abortion decision Roe v. Wade and various laws, both state and federal, prohibiting feticide. Bradley says of the 2004 federal Unborn Victims of Violence Act that, "in pertinent part it says that 'whoever' 'causes the death of or bodily injury to,' a 'child who is in utero' is guilty of an offense apart from any accompanying offense against the woman carrying the child." The penalty for such an act is the same as would be imposed if the act were inflicted upon the unborn child's mother: if, for instance, the mother was killed. "A child in utero," reports Bradley, "is defined as a member of the species homo sapiens, at any stage of development, who is carried in the womb'" (37).The problem here is that prosecutable under this law are acts identical with those performed legally by abortionists. Bradley mentions two cases in which a woman's male partner—in one case the woman's husband—effected by stealth the abortion of her child. In one case, the male purchased abortion pills and affixed to their container a pharmacy label indicating that it contained a common antibiotic; in the other, the husband obtained the same type of... (shrink)

Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary (...) to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care. (shrink)

Up to the present, there have not been any specific norms regarding medically assisted human reproduction in Romanian legislation. Due to this situation the general legislation regarding medical assistance, the Penal and Civil law and the provisions of the Code of Deontology of the Romanian College of Physicians are applied to the field of medically assisted human reproduction. By analysing the ethical and legal conflicts regarding medically assisted human reproduction in Romania, some characteristics cannot be set apart because they derive (...) from religious, cultural and socio-economic aspects. In this article the authors identify the development stages of medically assisted human reproduction in Romania, beginning from these characteristics and insisting upon the failure of the legal system in this specific field. The authors consider that the law regarding medically assisted human reproduction cannot be effective because it did not take into account the ethical and cultural aspects that might appear. Furthermore, in this framework of the legal process, no public debate involving the representatives of civil society was undertaken although the Council of Europe Oviedo Convention approved by our country according to law no. 17/2001 stipulated exactly this working method. Content Type Journal Article Pages 4-13 Authors Beatrice Ioan, PHD, MD, MA IN BIOETHICS, University of Medicine and Pharmacy, Iasi, Romania Vasile Astarastoae, PHD, MD, JD, University of Medicine and Pharmacy, Iasi, Romania Journal Human Reproduction & Genetic Ethics Online ISSN 2043-0469 Print ISSN 1028-7825 Journal Volume Volume 14 Journal Issue Volume 14, Number 2 / 2008. (shrink)

Opioid litigation continues a growing public health litigation trend in which governments seek to hold companies responsible for population harms related to their products. The litigation can serve to address gaps in regulatory and legislative policymaking and in market self-regulation pervasive in the prescription opioid domain. Moreover, prior opioid settlements have satisfied civil tort litigation objectives of obtaining compensation for injured parties, deterring harmful behavior, and holding certain opioid manufacturers, distributors and pharmacies accountable for their actions. In this way, opioid (...) litigation represents progress over prior public health litigation campaigns involving tobacco, lead paint, and asbestos, which had more limited tort litigation effects. Although opioid litigation is not a comprehensive solution to the opioid crisis, it can complement other strategies and infuse much needed money, behavior changes, and public accountability for prescription opioid and related harms. (shrink)

Abstract: To improve the countries’ pharmaceutical situation and to monitor the progress, the World Health Organization (WHO) and member states developed a system of indicators to measure the respective important aspects as a prerequisite step. Level I indicators to assess the country’s pharmaceutical situation include the national drug policy; legislation and regulations; drug accessibility and affordability; essential drug list; quality control; pharmacovigilance; storage and distribution; information and rational use. This study is aimed to document the professional opinion of 20 (...) class='Hi'>pharmacy practice professionals on Libya’s current pharmaceutical situation, utilizing WHO indicator-based approach. The core indicators measure the most important information needed to understand the pharmaceutical situation in a country. A closed-end questionnaire was distributed to ten practicing pharmacists and ten pharmacy teaching staff members who practice pharmacy. The questionnaires were handed over personally and collected on the same day. The responses were analyzed using simple statistics. The results were argued in the light of the first author’s observation and view, being expert in this field, with reference to the other experts’ views, relevant publications’ findings and WHO reports’ conclusions on these indicators. Suggestions and recommendations for a proper situation assessment, planning and action taking are presented. Primarily, government’s commitment towards appropriate restructuring, management and monitoring of the pharmaceutical sector is crucial. That is to enhance the country’s pharmaceutical situation, to provide and sustain efficient pharmaceutical services and to improve the overall health care system’s performance. (shrink)

KEY POINTS In Canada, commercial data brokers collect deidentified patient data from pharmacies, private drug insurers, the federal government and medical clinics without patient consent. Although pharmaceutical companies are the data brokers’ primary customers, academics and nonprofit and public entities also use commercial data sets, given the absence of a coordinated public approach to collecting these data across Canada. Risks of commercialized patient data include loss of anonymity, surveillance and marketing, discrimination and violation of Indigenous data sovereignty. Coordinated infrastructure for (...) the collection and coordination of health data across Canada and updated privacy legislation would protect individuals and communities and enable appropriate data uses. (shrink)

This article illustrates how a traditional U.S. pharmaceutical industry supply chain operates, beginning with pharmaceutical compounds and ending at patient‐dispensing hospitals or pharmacies. Furthermore, to place the problem of U.S. drug shortages in historical perspective, a review of the annual volume of such shortages over the last decade is undertaken. Following this review of recent drug shortages is an analysis of the market forces and business decisions that drive the creation of a pharmaceutical gray market, its attendant “price gouging” and (...) product integrity issues, and the alterations in the traditional pharmaceutical industry supply chain model. In response to persistent drug shortages, the U.S. Food and Drug Administration (FDA) has recently been empowered by the executive and legislative branches of the U.S. government to actively address this issue. To reflect these FDA challenges, a thorough review of these new agency charges and responsibilities is undertaken. Lastly, an analysis of the results of recent FDA public policy actions on mitigating drug shortages, as well as recommendations tor market‐based solutions to the gray market problem that pharmaceutical manufacturers, hospitals and pharmacies could institute as industry‐wide standards of business practice, are discussed in the conclusion. (shrink)

Medicine regulation demands the application of sound medical, scientific, and technical knowledge and skills, and operates within a legal framework. Regulatory functions involve interactions with various stakeholders (e.g., manufacturers, traders, consumers, health professionals, researchers, and governments) whose economic, social, and political motives may differ, making implementation of regulation both politically and technically challenging. This book discusses regulatory landscape globally and the current global regulatory scenario of medicinal products and food products comprehensively.

In this book J. Allan Hobson offers a new understanding of altered states of consciousness based on knowledge of how our brain chemistry is balanced when we are...

My office is in a medical building in suburban Washington, D.C. —in Bethesda, named for the Biblical healing pool. All of the offices of my building are occupied by medical specialists, representing the most sophisticated training in the application of the scientific method. Downstairs and of service to all of us is a pharmacy, looking for all the world like a research laboratory with its gleaming surface, meticulous cleanliness, micro-balances, records, reference books, and cash register. It is neatly stocked (...) with modern, physiologically-defined preparations of active, predictable drugs. Among the enzymes, hormones, antibiotics, and chemo therapeutics for neoplasm, are a few newly hatched, unfledged remedies, but most are dependable and thoroughly assayed. The intently busy, white-coated, unsentimental pharmacists serve a hard-headed group of practitioners and a neighborhood of upper-class, well-educated patients. It is disconcerting, then, to see the undersurface of this sophistication, the irrational shadows beneath the science. On the front counter of the pharmacy are displayed attractive colored advertisements and pleasantly seductive inducements to self-improvement through diet cults and foods, tranquilizers, energizers, protein supplements, happiness promisers, preparations to enhance sexuality, vitamins artfully combined, and many packeted stuffs of no rational or pretended use whatsoever. “Why,” I ask the gimlet-eyed pharmacist, “do you have this large display of ‘Il Wah Genuine Chinese Ginseng, the Miraculous Herb of Life’? Doesn't it violate your university training? Your integrity as a modernist?” “Oh,” says he, “ginseng makes you feel better! You have more energy. You can do more! Lots of athletes use it, and people who work too hard and feel exhausted. It's only $3.45 a package. The prescriptions you give me once in a while yield no profit, but I sell a lot of ginseng. I use it myself!” Bemused, I walk back to my office, wondering about the easy abandonment of rationality, and pull down a box of medicinals collected the year before at an open-air pharmacy in the riverside markets of Brazil. The box gives forth deliciously rich forest smells. The packets within contain barks, roots, seeds, all of purported medical value. Other packets have amulets, charms, and protectives. The colorful labels on some of the patent medicines invoke ancient saints and healers, and promise happiness, health, prosperity and power. The essential rationale for their use in indigenous medicine was illusive to me despite many conversations with indigenous healers, and many times I have gone through the hundreds of items trying to find the key to what Brazilian and North American people fundamentally want from a pharmacy. In both cultures, where does magic stop and science begin? Do shops in both countries vend talismans in the search for the enhanced life, and fetishes against death? How much of all drug use is ritual and inchoate expectation? How can we reduce the mystification and incrementally increase the rationality of our pharmacopeia? (shrink)

Pharmacy Ethics: A Foundation for Professional Practice provides a model for examining and resolving ethical dilemmas, thereby helping student pharmacists understand the ethical decision-making process in professional practice.

: This paper examines the obligations of pharmacy licensees and pharmacists in the context of conscience-based objections to filling lawful prescriptions for certain types of medications—e.g., standard and emergency contraceptives. Claims of conscience are analyzed as means to preserve or maintain an individual's moral integrity. It is argued that pharmacy licensees have an obligation to dispense prescription medications that satisfy the health needs of the populations they serve, and this obligation can override claims of conscience. Although efforts should (...) be made to respect the moral integrity of pharmacists and accommodate their claims of conscience, it is argued that the health needs of patients and the professional obligations of pharmacists limit the extent to which pharmacists may refuse to assist patients who have lawful prescriptions for medically indicated drugs. (shrink)

Bentham's best-known book stands as a classic of both philosophy and jurisprudence. The 1789 work articulates an important statement of the foundations of utilitarian philosophy — it also represents a pioneering study of crime and punishment. Bentham's reasoning remains central to contemporary debates in moral and political philosophy, economics, and legal theory.

Background There is a need for clearer guidance for pharmacists regarding their responsibilities when selling complementary medicines. A recently published ethical framework provides guidance regarding the specific responsibilities that pharmacists need to meet in order to fulfil their professional obligations and make a positive contribution to health outcomes when selling complementary medicines. Objective Evaluate the acceptability and feasibility of a new ethical framework for the sale of complementary medicines in community pharmacy. Methods Australian community pharmacists were invited to participate (...) in online focus groups and interviews. Participants were recruited via multiple methods, including social media and the professional networks of pharmacy groups. Participants were provided the ethical framework prior to the discussion. Discussions were transcribed verbatim and analysed using thematic analysis. Results Seventeen community pharmacists participated in the study. There was good representation among participants in terms of gender, years of practice, pharmacy location and script volume. Participants differed in how proactive they were in relation to selling and providing advice on complementary medicines, how they interpreted evidence in relation to complementary medicines, and how they navigated their practice within the retail environment of community pharmacy. The majority of participants found the framework was acceptable for practice and was feasible for implementation with targeted support. Participants identified two important areas for targeted support in implementing the framework: improved access to evidence-based information resources on complementary medicines and independent evidence-based education and training on complementary medicine for pharmacists and pharmacy support staff. Conclusion The ethical framework addresses an important gap in providing specific professional guidance to pharmacists when selling complementary medicines. The results of the study suggest that the framework may be acceptable to community pharmacists and be feasible to implement with targeted support. (shrink)

This article continues the themes developed in a previous paper looking at reparations for past wrongs in post-colonial Australia. It narrows the focus to examine the scope of the law of tort to provide reparations suffered as a result of colonisation and dispossession, with particular emphasis on the assimilation policies whose legacy is now known emphatically, although it ought not be exclusively, as the Stolen Generations. The search for more than just words is particularly topical in light of the Australian (...) Prime Minister's formal apology in early 2008. This highly symbolic step must not lose momentum. That momentum could be both political and legal. In the latter context, we explore here the concept of alien tort, in the light of current Australian tort jurisprudence, which has thus far proved inadequate to achieve compensation for the harms suffered. Taking a comparative approach, procedural and substantive developments are to better deliver justice consistent with community values. In particular, the greater acceptance of psychological harm as actionable tortious conduct in Canada and the United States is examined. The article further examines the scope for stolen children to bring suit under the US Alien Tort Claims Act 1789. While the Australian government enjoys sovereign immunity in the courts of the United States, non-state organisations such as churches that were complicit in the forcible removals may be subject to United States jurisdiction wherever they have a presence in that country. The procedural and substantive elements of such a claim are discussed. In particular, the relevant cause of action, the issue of forum non conveniens and the statute of limitations will be analysed to map out whether a claim could be developed and successfully prosecuted. © Springer Science + Business Media B.V. 2009. (shrink)

Educational Legislation and Administration of the Colonial Governments is an unchanged, high-quality reprint of the original edition of 1899. Hansebooks is editor of the literature on different topic areas such as research and science, travel and expeditions, cooking and nutrition, medicine, and other genres. As a publisher we focus on the preservation of historical literature. Many works of historical writers and scientists are available today as antiques only. Hansebooks newly publishes these books and contributes to the preservation of literature which (...) has become rare and historical knowledge for the future. (shrink)

'J'en suis encore à attendre la venue d'un philosophe médecin' espérait Nietzsche en préambule de son Gai Savoir. Historiquement, la relation à la médecine a été entretenue par la philosophie dès ses premiers pas, comme une nécessité de penser et de panser. Ayant la quête de la sagesse en ligne de mire, les philosophes avaient pour vocation d'en finir avec les troubles de l'âme, à l'image des médecins et des douleurs du corps. Dès lors, que signifie guérir, soigner, prescrire ou (...) diagnostiquer lorsqu'il s'agit de la philosophie? Comment cette dimension pratique de la philosophie trouve-t-elle sa place dans cette discipline prétendument destinée à l'esprit pur? C'est dans l'oeuvre de Nietzsche que nous trouvons sans doute les élaborations les plus abouties de cette problématique, aux implications extraphilosophiques. En substituant les notions de vérité, de morale ou de consolation, Nietzsche va composer une nouvelle conceptualité philosophique, dont les outils seront la valeur, la joie ou encore la santé. Cet ouvrage se propose de remonter aux origines de la philosophie comme médecine jusqu'à Nietzsche, afin de trouver, dans sa pharmacie, les traitements et les remèdes à notre nature humaine, trop humaine"--Page 4 of cover. (shrink)

This study was conducted in 1985 in Asuncion, Paraguay, 6 years after the closure of the state supported family planning services. Data from national surveys in 1977 and 1987 permit a comparison of sources of contraceptive supplies before and after the elimination of government support for family planning. The purchase of pseudo-abortifacients from private pharmacies was used as an indication of induced abortion. After the loss of government clinics, it is suggested that some women turned to pharmacists to obtain pseudo-abortifacients (...) when faced with unwanted pregnancy. There is an indication of increased pseudo-abortifacient use, particularly among unmarried women and those from poorer neighbourhoods. (shrink)

Every pharmacist, aware or not, is constantly making ethical choices. Sometimes these choices are dramatic, life-and-death decisions, but often they will be more subtle, less conspicuous choices that are nonetheless important. Assisted suicide, conscientious refusal, pain management, equitable and efficacious distribution of drug resources within institutions and managed care plans, confidentiality, and alternative and non-traditional therapies are among the issues that are of unique concern to pharmacists. One way of seeing the implications of such issues and the moral choices they (...) pose is to look at the experiences of practitioners and the kinds of choices they have had to make in situations typically faced by pharmacists. This book is a collection of those situations based on the real experiences of practicing pharmacists. The use of case studies in health care ethics is not new, but in pharmacy it is. This text is an important teaching tool that will help pharmacy students and pharmacists address the increasing number of ethical problems arising in their profession. It is not merely a compilation of cases, but rather is organized for the systematic study of applied ethics. Part I shows how to distinguish ethical problems from other kinds of evaluative judgments and examines the sources of values in pharmacy, posing basic questions about the meaning and justification of ethical claims. Part II explores the basic principles of ethics as they have an impact on pharmacy. Specific cases from clinical settings present in a systematic way the various questions raised by each of the major ethical principles -- benefiting the patient, distributing resources justly, respecting autonomy, dealing honestly with patients, keeping promises of confidentiality, and avoiding harm. Part II examines some of the special problems of contemporary pharmacy such as the linkages between pharmaceutical care and professional practice, human experimentation, reproductive issues, genetic technology, death and dying, and mental health. (shrink)

With a view to consolidating the existing theory development and stimulating new conceptual thinking, this paper explores the implications of culture, religion, and the legal framework on women’s employment and their limited advancement in the hospitality industry, one of the important elements of the economy in Jordan. A related aim is to contrast the egalitarian Islamic approach to gender equality with gender discriminatory tribal traditions that restrict women’s employment and progression. Guided by religion, culture, and gender literature, this study uses (...) a qualitative, content-based analysis. Drawing on open-ended questionnaires distributed to a diverse workforce across four tourist locations in Jordan, the results portray how tribalism and Bedouin customs embedded in the participants’ interpretation and practices of their religion are maintaining gender gaps in employment and positions of power. The results also reveal that despite the Islamic guidelines towards fairness and justice in employment, the tribal and Bedouin traditions restrict women’s employment through patriarchal interpretations of Islam. Thus, the salient novelty and significance of this study were achieved through contributing to the theory development of the interrelations between religion, culture, and gender equality. (shrink)

Patient-centered pharmacy practice involves increased pharmacist engagement in patient care. This increased involvement can sometimes require diverse decision-making when handling various situations, ranging from simple matters to major ethical dilemmas. There is literature about pharmacy ethics in developed Western countries. However, little is known about pharmacists’ practices in many developing countries. For example, there is a paucity of research conducted in the area of pharmacy ethics in Jordan. This study aimed to explore the manner in which ethical (...) dilemmas were handled by Jordanian pharmacists, the resources used and their attitudes towards them. Semi-structured, face to face interviews were carried out with 30 Jordanian registered pharmacists. The transcribed interviews were thematically analysed for emerging themes. Four major themes were identified: legal practice; familiarity with the code of ethics; personal judgement, cultural and religious values; and Experience. Findings showed that ethical decision-making in pharmacy practice in Jordan was decisively influenced by pharmacists’ personal moral values, legal requirements and managed by exercising common sense and experience. This pointed to gaps in Jordanian pharmacists’ understanding and application of basic principles of pharmacy ethics and highlighted the need for professional ethics training, incorporating pharmacy ethics courses in pharmacy undergraduate curricula, as well as professional development courses. This study highlighted that paternalism, personal values and legal obligations were major drivers influencing decision-making processes of Jordanian pharmacists. Findings also highlighted an inclination towards lack of respect for patient autonomy. This illuminated the need for increasing pharmacists’ literacy in professional ethics. (shrink)

Pharmacy Benefit Managers (PBM) induce drug manufacturers to offer rebates to insurers and employers by denying coverage through formulary exclusions, impeding physician prescription through prior authorization, and reducing patient drug use through cost sharing. As they tighten these access obstacles, PBMs reduce the net prices received by the manufacturers.

Value claims about ecological entities, their functionality, and properties take center stage in so-called “ecological” ethical and aesthetic theories. For example, the claim that the biodiversity in an old-growth forest imbues it with “value in and for itself” is an explicit value claim about an ecological property. And the claim that one can study “the aesthetics of nature, including natural objects...such as ecosystems” presupposes that natural instances of a type of ecological entity exist and can be regarded as more or (...) less aesthetically valuable. My discussion below will bear wide implications for how claims like... (shrink)

Industry analysts estimate that Internet pharmacies will generate $1.4 billion in prescription drug sales by 2001 and over $15 billion by 2004. The recent rush by traditional brick and mortar pharmacies either to partner with existing Internet pharmacies or to create their own web counterparts illustrates the increasing importance of business on the Internet. Last summer, retail pharmacy giant CVS acquired the Internet pharmacy soma.com and changed its name to reflect the new ownership. Early this year, in another (...) key industry move, Walgreen's launched an upgraded, full-service Internet pharmacy in order to compete more successfully in the pharmacy industry. (shrink)

Concerns have been raised around the alleged commercialisation of South African genetic material by various research institutes nationally and abroad. We consider whether the Protection of Personal Information Act in South Africa will conflict with or complement existing protections in health law and research ethics. The Act is not applicable to de‐identified samples that cannot be re‐identified but we question whether genetic samples can ever be truly de‐identified. The research participants in this matter provided consent for use of their samples (...) for research but did not consent to commercialisation by global research institutions, and neither did the researchers. We suggest that consent models incorporating broad consent as an option should include explicit discussions around benefit sharing and commercialisation. Mistrust between researchers and participants impedes scientific research and can harm relationships built up over the years between South African researchers and local communities. (shrink)

Representatives from eight European countries compared the legal, ethical and professional settings within which decision making for neonates takes place. When it comes to limiting treatment there is general agreement across all countries that overly aggressive treatment is to be discouraged. Nevertheless, strong emphasis has been placed on the need for compassionate care even where cure is not possible. Where a child will die irrespective of medical intervention, there is widespread acceptance of the practice of limiting aggressive treatment or alleviating (...) suffering even if death may be hastened as a result. Where the infant could be saved but the future outlook is bleak there is more debate, but only two countries have tested the courts with such cases. When it comes to the active intentional ending of life, the legal position is standard across Europe; it is prohibited. However, recognising those intractable situations where death may be lingering and unpleasant, Dutch paediatricians have reported that they do sometimes assist babies to die with parental consent. Two cases have been tried through the courts and recent official recommendations have set out standards by which such actions may be assessed. (shrink)

In recent years, Oregon and Washington have enacted so-called Death with Dignity (DWD) statutes that permit patients whose doctors certify that they have less than six months to live to commit suicide with the aid of a physician.1 The laws allow a doctor, upon the patient’s request, to prescribe a lethal dosage of drugs, which the patient then self-administers.2 Oregon’s law went into effect in 1997, and over five hundred terminal patients have ended their lives pursuant to it since then (...) (Oregon Public Health Division 2011).3 Washington’s law took effect in March of 2009, and by the end of 2010, some 87 terminally ill citizens of that state had brought their lives to a close with the permission of the law .. (shrink)

Abortion is forbidden under normal circumstances by nearly all the major world religions. Traditionally, abortion was not deemed permissible by Muslim scholars. Shiite scholars considered it forbidden after implantation of the fertilised ovum. However, Sunni scholars have held various opinions on the matter, but all agreed that after 4 months gestation abortion was not permitted. In addition, classical Islamic scholarship had only considered threats to maternal health as a reason for therapeutic abortion. Recently, scholars have begun to consider the effect (...) of severe fetal deformities on the mother, the families and society. This has led some scholars to reconsider the prohibition on abortion in limited circumstances. This article reviews the Islamic basis for the prohibition of abortion and the reasons for its justification. Contemporary rulings from leading Shiite scholars and from the Sunni school of thought are presented and reviewed. The status of abortion in Muslim countries is reviewed, with special emphasis on the therapeutic abortion law passed by the Iranian Parliament in 2003. This law approved therapeutic abortion before 16 weeks of gestation under limited circumstances, including medical conditions related to fetal and maternal health. Recent measures in Iran provide an opportunity for the Muslim scholars in other countries to review their traditional stance on abortion. (shrink)

A recently widely accepted view has it that the nature-spirit distinction in Hegel is to be understood as a distinction between a space or realm that is not normative or does not involve norms, and one that is or does. Notwithstanding the merits of this view, it has tended to create a separation between nature and spirit which is both philosophically troubling and difficult to reconcile with the picture of Hegel as the arch enemy of abstract or unreconciled dualisms. In (...) this paper I aim to show that the defining phenomenon for this view—collective self-government by norms—is on Hegel’s account both dependent on living nature that involves normativity broadly conceived all the way down and also subject to the normative or evaluative super-principle of Hegel’s Philosophy of Spirit—concrete freedom—the essence of spirit according to him. This is to say that for Hegel the normativity of collectively administered norms is neither the most basic nor the highest form of normativity. -/- Published online first 27 January 2021. (shrink)

This article explores the gender dynamics of ‘causing or allowing a child to die’, contrary to the Domestic Violence, Crime and Victims Act 2004, section 5. This offence was intended to allow for prosecution where a child had been killed and it was uncertain who had killed him/her, but also to allow for prosecution of non-violent defendants who failed to protect him/her. More women than men have been charged and convicted of this offence signifying a reversal of usual patterns of (...) prosecution and conviction. This analysis interrogates how section 5 criminalises women who have experienced domestic abuse. Drawing on a case observation, reported cases and media reports of cases, I suggest this offence derives from and perpetuates patriarchal constructs of motherhood. Grounded in a feminist approach building on women’s concrete experiences of law, I conclude that section 5 should be amended so that it is only used where it cannot be ascertained which defendant actively harmed a child. (shrink)

Name der Zeitschrift: Kant-Studien Jahrgang: 105 Heft: 4 Seiten: 509-530.

Jessica Flanigan argues that individuals have the right to self-medicate. Flanigan presents two arguments in defense of this right. The first she calls the epistemic argument and the second she calls the rights-based argument. I argue that the right to self-medicate hangs and falls on the rights-based argument. This is because for the epistemic argument to be sound agents must be assumed to be epistemically competent. But, Flanigan’s argument for a constitutionally mandated right to self-medicate models agents as epistemically incompetent. (...) For Flanigan, agents are different at the pharmacy than they are at the polls. I identify this behavioral asymmetry and advocate a symmetric and realistic behavioral postulate for both arguments. The result, however, is that the success of the epistemic argument becomes contingent which fails to justify a constitutionally mandated right. I proceed to raise skepticism about the rights-based argument as well. I conclude that there is reason to be skeptical that these arguments can justify a constitutionally mandated right to self-medicate. Ultimately, a bottom-up approach to pharmaceutical ethics is preferable. (shrink)

Biobanks are important resources for improving public health and individual care. Some legal frameworks can be more or less conducive to advancing the potential benefits of biobanks. The purpose of this article is to assess biobanking legislation and practices in Spain to determine how well they fare in such a regard. We focus here on some of the primary ethical values that ground relevant legislation and that we believe are consistent with promoting biobanking benefits: the value of scientific research; efficient (...) use of scarce resources; and respect for the dignity of donors. We argue that although Spanish regulations advance these values in important ways, they also have provisions that undermine them and thus risk limiting the potential benefits of biobanks. We offer some suggestions for improvement. (shrink)

Their important exegetical and philosophical disagreements notwithstanding, Pauline Kleingeld and Marcus Willaschek, on the one hand, and Alyssa Bernstein, on the other, seem to agree that Kant’s Categorical Imperative transcends the contemporary dichotomy between moral realism and ethical constructivism. My contribution is an attempt to further elaborate on the third, unique, conceptual option that they have identified. I employ the notion of an “enabling condition,” introduced in epistemology and action theory by Jonathan Dancy, in order to show that the Categorical (...) Imperative enables action and is enabled by action. The Categorical Imperative (as distinct from specific categorical imperatives and moral laws) is discussed as a structural, but still normative, coherence and consistence norm of practical reasoning. As such it is two things at the same time, namely, first, the most fundamental normative background condition of practical deliberation, choice, and action. Second, however, the mutual enabler-enablee-relationship between action and Categorical Imperative points in the other – “not-so-Kantian” – direction as well: individual practical deliberation, understood as the mundane phenomenon that penetrates the lives of agents, is the (existence) condition that enables the Categorical Imperative in normatively-structured action. (shrink)