Drug recalls and lawsuits against pharmaceutical manufacturers are accompanied by announcements emphasizing harmful drug side-effects. Those with elevated health anxiety may be more reactive to such announcements. We evaluated whether health anxiety and financial incentives affect subjective symptom endorsement, and objective outcomes of cognitive and physiological functioning during a mock drug recall. Hundred and sixty-one participants reported use of over-the-counter pain medications and presented with a fictitious medication recall via a mock Food and Drug Administration website. The opportunity to join (...) a class-action lawsuit was manipulated. We assessed health anxiety, recalled drug usage, blood pressure, heart rate, and performance on a computerized Trail Making Test. Symptom endorsement was strongly predicted by health anxiety. When combined, three health anxiety measures explained 28.5% variance. These effects remain strong after controlling for depression and anxiety. Litigation condition did not predict symptom endorsement. Blood pressure and heart rate were modestly predicted by health anxiety, but not by litigation condition. TMT performance was consistently predicted by health anxiety, with higher scores associated with poorer performance. Although there were no main effects for litigation, interactions consistently emerged for the TMT, with generally poorer performance for those with higher health anxiety in the non-litigation condition; whereas health anxiety was unrelated to performance for the litigation condition. All but one participant joined the litigation when given the opportunity, despite a healthy sample and minimal use of pain medication. Subsequent data from 67 individuals with no mention of the FDA scenario or litigation showed that health anxiety still significantly predicts symptom endorsement, but the explained variance is less than half that obtained in the FDA scenario. The findings suggest that health anxiety plays a significant role in adverse symptom reporting, beyond anxiety or depression, and this effect is independent of the presence of the FDA recall. The lack of differences for health anxiety and symptom endorsement between litigation and non-litigation conditions rules out malingering. Although it is general practice in drug recalls to list potential adverse side effects caused by medications, this may elicit unintended symptom experiences and health anxious individuals may be more susceptible. (shrink)

Many pharmaceuticals are available to patients only with a physician’s prescription. Although it is often not recognized as such, this is a classic example of paternalism in public policy. Pharmaceuticals are often perceived as carrying dangerous side effects. Access is restricted to protect patients from their own bad decisions. This chapter explores the moral justification for such paternalism and finds it wanting. It raises the question of whether there is adequate justification for this restriction. Consistency requires that pharmaceuticals posing dangers (...) primarily to the individual be available to competent consumers and that even moderate risks to third parties be tolerated. The chapter begins by arguing that all drug usage involves evaluative judgments about the relative benefits and harms of the agents and that physicians must make value judgments in deciding whether to prescribe. (shrink)

Comparing and contrasting nonreligious and religious perspectives on ethics and morals has perhaps attracted the greatest attention of any secular study area. There are indeed negative preconceptions about seculars that express worries about how morality can be preserved without the influence of religion. The research begins with definitions and categories of morality, along with current views on how they came to be and how to evaluate them. Examined are secular attitudes and actions in areas including prosociality, violence, criminal activity, drug (...) usage, sexual orientation, helping, and altruism. Secular morality is showing a trend in many sectors towards prioritizing individuals above group affiliation. General morality among secular people favors moral consequentialism over deontology and reasoning over intuition. Religious ethics explain that society can only be improved if human beings have a pure soul. So, we can say that religious Ethics have a main focus on the improvement of spirituality and the soul of human beings for a peaceful society. So, this is also a point of divergence between secular Morality and Religious Ethics. (shrink)

In ordinary usage, the term miracle is employed very broadly in modern times. It often refers to a highly improbable or extraordinary event with welcome consequences or an outstanding example of something, such as a miracle drug or an economic miracle. In my study of Chinese Buddhist stories relating marvelous and wondrous events, much of the modern conception of miracle is certainly not applicable. Indeed, the modern Chinese term qiji 奇蹟, a translation of miracle, has never been used to (...) refer to wondrous events in Buddhist literature. Nevertheless, wondrous events recounted in Indian and Chinese Buddhist works are referred to by modern scholars of Asian studies as "miracle tales,"... (shrink)

In the article ‘Testimonial injustice in medical machine learning’, Pozzi argues that the prescription drug monitoring programme (PDMP) leads to testimonial injustice as physicians are more inclined to trust the PDMP’s risk scores over the patient’s own account of their medication history.1 Pozzi further develops this argument by discussing how credibility shifts from patients to machine learning (ML) systems that are supposedly neutral. As a result, a sense of distrust is now formed between patients and physicians. While there are merits (...) to Pozzi’s main argument of epistemic injustice caused by PDMPs, Pozzi mentions but ultimately glosses over the problem of automation bias. In this commentary, I will discuss automation bias and the affect it has on clinical decision making as well as a technical problem exacerbated by the usage of PDMPs that can potentially cause physical harms. It is reiterated in the article that the confidence physicians have in the PDMP’s risk scores over the patient’s testimony leads to misplaced trust in the ML systems. What Pozzi describes here is known as automation bias, which occurs when there is an over-reliance on ML systems. …. (shrink)

BackgroundDepressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen. Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects (...) in patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.DiscussionThe use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.ConclusionWe urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine. (shrink)

Animal models play a crucial role in fundamental and medical research. Progress in the fields of drug discovery, regenerative medicine and cancer research among others are heavily dependent on in vivo models to validate in vitro observations, and develop new therapeutic approaches. However, conventional rodent and large animal experiments face ethical, practical and technical issues that limit their usage. The chick embryo represents an accessible and economical in vivo model, which has long been used in developmental biology, gene expression (...) analysis and loss/gain of function experiments. It is also an established model for tissue/cell transplantation, and because of its lack of immune system in early development, the chick embryo is increasingly recognised as a model of choice for mammalian biology with new applications for stem cell and cancer research. Here, we review novel applications of the chick embryo model, and discuss future developments of this in vivo model for biomedical research. (shrink)

Knowledge on regulatory relations, in for example regulatory pathways in biology, is used widely in experiment design by biomedical researchers and in systems biology. The knowledge has typically either been represented through simple graphs or through very expressive differential equation simulations of smaller sections of a pathway. As an alternative, in this work we suggest a knowledge representation of the most basic relations in regulatory processes regulates, positively regulates and negatively regulates in logics based on a semantic analysis. We discuss (...) the usage of these relations in biology and in artificial intelligence for hypothesis development in drug discovery. (shrink)

Les philosophes écrivent avec une aisance surprenante, presque sans retenue pourrait-on dire. Par ailleurs, ils semblent faire usage d’une force d’affirmation qui peut paraître énigmatique. Ils sont ainsi portés à soutenir des choses qui vont contre le sens commun, qui sont même manifestement fausses, mais jouissent malgré tout de prestige et de légitimité. On ajoutera que peu d’entre eux sont enclins à s’expliquer clairement sur ce qui les fait philosopher. Eh bien, entrons dans l’ambiance, dans l’état psychologique et intime (...) où se forge une philosophie. On y découvrira peut-être l’une des plus anciennes formes d’addiction psychique. Quelle est alors la drogue philosophique ? Plus précisément, en quelle manière la philosophie peut-elle relever d’une ivresse, d’un vertige comparable à un état narcotique ? Bien entendu, il faut s’empresser de relever la part d’humour de cette approche. Elle n’en est pas moins utile, car elle aide à s’approprier le geste philosophique. La philosophie pourrait ainsi se défaire de son visage d’aristocratie intellectuelle. (shrink)

ABSTRACT A key selling point of pharmacogenetics is the genetic stratification of either patients or diseases in order to target the prescribing of medicine. The hope is that genetically ‘tailored’ medicines will replace the current ‘one‐size‐fits‐all’ paradigm of drug development and usage. This paper is concerned with the relationship between difference and justice in the use of pharmacogenetics. This new technology, which facilitates the identification and use of difference, has, we shall argue, the potential to lead to injustice either (...) by the inappropriate use of difference or through the inappropriate failure to use difference. We build on empirical data from a detailed study of the range of options for the development of pharmacogenetics to present a consideration of the ethical issues that surround patient and disease stratification. In it we explore the ways in which the use of pharmacogenetics may lead to the creation of new, genetically stratified, forms of difference and new forms of injustice based on these divisions. We also examine the ways in which existing forms of difference and social stratification may interact with the use of pharmacogenetics. In conclusion, we suggest how an understanding of these ethical issues could usefully inform future policy discussions. (shrink)

After the post-electoral crisis of 2010-2011, prostitution on social networks developed in Abidjan. Faced with the complexity of this new form of prostitution, actors have developed coping strategies, such as taking drugs and using food and body supplements. This study aims to analyze the perceptions surrounding the use of doping products and body supplements among prostitutes. The survey took place in Abidjan and involved 122 prostitutes. The data was collected from the non-directive interview. The results show that prostitutes associate multiple (...) meanings to their practices which constitute not only a last resort to alleviate the difficulties related to prostitution, but also a means to meet beauty criteria and increase visibility on dating sites. (shrink)

Alcoholism is endemic in Nigeria’s traditional religion and society. This abuse is especially common at New Yam festivals, Ekpe, Ekpo and Nmanwu masquerades festivals, burial rituals, birth, marriage and naming ceremonies. Some claim that this is driven by specific beliefs and activities in African culture, such as beliefs in ancestors, libation, hospitality and entertaining guests and strangers and the desire to maintain the cultural traditions of the ancestors. Alcohol abuse has generated major health and social issues for abusers, their families (...) and society, plunging families, towns and tribes into crises and conflicts that bring economic and political retrogression. This research studied how the African traditional religion encourages alcohol misuse and how to decrease it for national development. This study was on Nigeria’s South-South region. The study uses qualitative and ethnographic research methodologies, including key informants, in-depth and focus group interviews and the reward deficiency syndrome as a theoretical framework. Although African Traditional Religion (ATR) supports alcohol usage, greed, a lack of self-control, peer pressure, indiscipline and lack of moral upbringing led to alcohol misuse, which harms the person, family, community and country as a whole. Education and enlightenment are a remedy to free alcoholics and utilise them for national integration and development.Contribution: Some say Africans drink a lot because their religious heritage promotes drinking, leading to abuse. However, peer pressure, selfishness, a lack of self-control, bad parenting and not religion push persons with reward deficiency syndrome into alcoholism, according to this research. (shrink)

In The Ethics of Food, Gregory E. Pence brings together a collection of voices who share the view that the ethics of genetically modified food is among the most pressing societal questions of our time. This comprehensive collection addresses a broad range of subjects, including the meaning of food, moral analyses of vegetarianism and starvation, the safety and environmental risks of genetically modified food, issues of global food politics and the food industry, and the relationships among food, evolution, and human (...) history. (shrink)

Before sailing past the sirens' “flowery meadow,” Ulysses instructed his sailors to lash him to the mast so that he would not succumb to the siren's singing. His advance directive demonstrated that he valued his dispositional or long-term autonomy over his unquestioned right to make decisions. He also indicated to his oarsmen that he understood the nature of temptation and his inability to resist it. Ideas of autonomy and sexual choice are central to this discussion of new AIDS treatments, especially (...) the trials of preventative vaccines. Questions arise over the rights of individuals and the extent that these should be limited by concerns of the gay community. Should the gay community intervene in the risky decisions of individuals if no explicit advance directive exists? If so, how do they justify their paternalism? Could their aims not be better served through strengthening the individual dispositional autonomy of trial participants rather than making specific claims about the common good? (shrink)

The American Journal of Bioethics, Volume 12, Issue 1, Page 16-18, January 2012.

The micro blogging platform Twitter is actively used by millions of people. By using the geo tags of the messages sent a virtual landscape of online activity at a certain place is generated to visualize the interface between the real-world location and the virtual activity. These New City Landscapes (NCL) visualize the amount of activity as density surfaces with hills, peaks and valleys. Across a set of different cities from around the world the resulting landscape morphologies are compared and characterized (...) as types. This article focuses on temporal narratives and how they travel through the urban fabric via the virtual landscape in different cities around the world. The findings are discussed as cross comparisons according to activity in time and space. (shrink)

Zusammenfassung Doping taucht im öffentlichen Diskurs meist als Problem des Hochleistungssports auf. Diese Aufmerksamkeitsfokussierung wird - angesichts der Dopingpraktiken hunderttausender Breiten- und Freizeitsportler - der Komplexität und Diversität des realen Dopingausmaßes nicht gerecht. Im Schatten des im Mittelpunkt der Aufmerksamkeit stehenden Hochleistungssports und der dort vorfindbaren Dopingpraktiken hat sich insbesondere in Fitness-Studios seit Jahrzehnten ein Milieu etabliert, in dem Medikamente missbräuchlich und ohne Skrupel eingesetzt werden, um den als „defizitär“ wahrgenommenen Körper zu überarbeiten und in eine hypermuskulöse Gestalt zu transformieren. (...) Der vorliegende Artikel verfolgt die Zielsetzung, die nach außen weitgehend intransparente Lebenswelt gedopter Kraftsportler und Bodybuilder im Sinne einer verstehenden Soziologie zu durchleuchten und zu erhellen. Die hierbei dargestellten Kenntnisse über die Einstellungen und biographischen Verlaufsfiguren der Dopingnutzer sowie über bestehende Netzwerke, konspirative Praktiken und eskalatorische Suchtspiralen sind frappierend und erschreckend zugleich. Sie zeigen, wie sehr Techniken der medikamentösen Körpermodellierung unter Ignorierung von Gesundheitsschäden und Nebenwirkungen bereits im modernen Alltag angekommen sind. (shrink)

Tieu, Matthew The main results of the reports published on the efficacy and achievements of the Medically Supervised Injecting Centre in Kings Cross over the last decade of its operations are discussed. The reports do not provide any substantive evidence that the MSIC has achieved its objectives.