In recent years there has been an increase in research conducted in the Middle East, with a corresponding increase in the challenges faced by members of the Research Ethics Committees. This study compares the structures of Omani and Jordanian RECs and investigates the perceptions of the challenges affecting the work of the REC members in Oman and Jordan. A convenience sample of 34 Omani and 66 Jordanian participants from 21 universities was recruited in this cross-sectional study. Almost 70% disagreed that (...) the members of RECs are unqualified, providing comments without justification; half believed that members have limited experience in research, and almost three-quarters that they have different opinions regarding some ethical issues. No significant differences were found between Omani and Jordanian REC members regarding their perception of the challenges, except for the perception that reviewing proposals is a time-consuming task and that multi-REC centres are less available. The regression model showed that there were significantly more male members of Jordanian RECs, and that Jordanian members were less likely to receive formal training. In conclusion, the current structure of RECs and the challenges faced by members need to be re-evaluated by decision makers to improve the overall quality of research activities, and to ensure that current REC members’ practices adhere to international standards. (shrink)

Volume 24, Issue 12, December 2024, Page 6-7.

Very few data exist in France on: (1) nurses’ knowledge and behaviour concerning ethical decisions in clinical practice; and (2) their knowledge of ethical rules in clinical research. This questionnaire-based audit tried mainly to assess these questions in a large French university teaching hospital. Of the 257 questionnaires distributed to nurses in 23 clinical units of the hospital, 206 were returned (80% response rate). When responding to the vignette describing a clinical situation requiring an ethical decision to be made, (...) most nurses acted as the patient’s advocate although they have had no formal training in ethics. Indeed, 66% of nurses responding considered that the patients themselves should be the primary decision makers in situations that relate to their health and medical care. For children or comatose patients, the decision should be left to the relatives according to 72% of the responses. The results indicated that the role of health care professionals in ethical decisions made for a given patient should be marginal. Nurses’ knowledge concerning research protocols, particularly their ethical requirements and consequences, is poor at present and information from and communication with doctors should be improved. (shrink)

Despite exponential growth in the past decades, most aspects of the assisted reproductive technology industry remain largely unregulated; recently, pressure has been mounting for coordinated study and regulation of this developing industry. On March 28, 2008, lawyers, health care professionals, representatives from sperm banks, consumers of ART services, and other stakeholders in ART industry gathered at DePaul University College of Law for its Health Law Institute’s symposium titled “Tracking Change: The Feasibility of a Voluntary Gamete Donor Registry (...) in the United States.” The implementation of a registry would mark the first effort in the United States to centralize, maintain, and disseminate information about gamete donors by collecting and storing genetic and identifying information about egg and sperm donors. Establishing a registry requires balancing the interests of donor-conceived individuals, their parents, gamete donors, health care professionals, and society as a whole, as well as ensuring the privacy and safety of all involved. (shrink)

The PRIME Institute of the College of Pharmacy, University of Minnesota, recently released preliminary research findings indicating a trend of extraordinary pharmaceutical industry pricing of drug products in the United States (U.S.). According to researchers at the PRIME Institute, such extraordinary price increases are defined as any price increase that is equal to, or greater than, 100% at a single point in time. In some instances, PRIME Institute researchers found that drugs exhibiting extraordinary price increases are categorized as "orphan (...) drugs" (or blood-related biologic treatments) and often life-saving or life-sustaining for treating the cause or symptoms of diseases affecting fewer than 200,000 people in the U.S., or where there is prevalence of less than 5 per 10,000 people afflicted with a disease or symptoms in the community. Because of extraordinary price increases for orphan drugs — some exceeding 1000% at a single point in time -this article addresses two interrelated questions: Are extraordinary orphan drug price increases socially responsible behavior? If so, are the pharmaceutical industry's policies providing orphan drug access to American consumers in dire need of available life-sustaining and life-enhancing pharmaceuticals considered "socially responsible" behavior? The author concludes, after an interdisciplinary analysis of the legal, economic, sociopolitical, and ethical dimensions of orphan drug pricing, that they are not socially responsible – unless justified by cost and availability of health care marketplace/patient options. Furthermore, the author recommends a socially responsible industry strategic approach to insure that patients ultimately receive -regardless of cost -timely access to life-saving and life-sustaining orphan drugs. (shrink)

South Africa currently has a pluralistic health care system with separate public and private sectors. It is, however, moving towards a socialised model with the introduction of National Health Insurance. The South African legislative environment has changed recently with the promulgation of the Consumer Protection Act and proposed amendments to the National Health Act. Patients can now be viewed as consumers from a legal perspective. This has various implications for health care systems, health care (...) providers and the doctor-patient relationship. (shrink)

OBJECTIVES: To compare the practices of local research ethics committees and the time they take to obtain ethical approval for a multi-centre study. DESIGN: A retrospective analysis of outcome of applications for a multi-centre study to local research ethics committees. SETTING: Thirty-six local research ethics committees covering 38 district health authorities in England. MAIN MEASURES: Response of chairmen and women, the time required to obtain approval, and questions asked in application forms. RESULTS: We received replies from all 36 chairmen (...) contacted: four (11%) granted their approval, and 32 (89%) required our proposal to be considered by their local research ethics committee. Three committees asked us to attend their meetings. The application was approved by all 36 local research ethics committees but the time to obtain ethical approval varied between six to 208 days. One third of the committees did not approve the project within three months, and three took longer than six months. There was considerable variation in the issues raised by local research ethics committees and none conformed exactly to the Royal College of Physicians' guidelines. CONCLUSION: Obtaining ethical approval for a multi-centre study is time-consuming. There is much diversity in the practice of local research ethics committees. Our data support the recommendation for a central or regional review body of multi-centre studies which will be acceptable to all local research ethics committees. (shrink)

Gamma radioactivity produced by human technology is the most dangerous industrial product to life. Two recent global catastrophic events in which nuclear plants were involved, separated only by 25 years, have confirmed that, independently of the usage of nuclear weapons, achieving the 100% of security in the nuclear energy management was and still is a complete unrealistic idea. Although the guarantee of offering information of food and drink products quality concerning the date of expiry or the ingredients content is nowadays (...) stipulated in laws around many countries, this is not the case of the radiation safety. An important investment to offer information concerning gamma radiation safety conditions in food and drink products offered by markets, which also could help to localize quickly, possible radioactive slight incidents, is here discussed. The implementation of a previous consumer-behaviour experiment in markets is also suggested. (shrink)

This paper draws on nearly two decades of research on health consumer and patients’ organizations in the United Kingdom. In particular, it addresses questions of representation and legitimacy in the health policy process. HCPOs claim to represent the collective interests of patients and others such as relatives and carers. At times they also make claims to represent the wider public interest. Employing Pitkin’s classic typology of formalistic, descriptive, symbolic, and substantive representation, the paper explores how and in (...) what sense HCPOs represent their constituencies. We found that policymakers themselves are less concerned with formal mechanisms adopted by groups and are more concerned with credibility, in particular whether HCPOs carry the confidence of their constituents. While some concerns about legitimacy remain, particularly in relation to funding from commercial interests, we argue that HCPOs bring a unique perspective to the policy process and to focus purely on formalistic representation provides only a partial understanding of their representative role and a constrained view of their collective moral claims. (shrink)

Edited by four leading members of the new generation of medical and healthcare ethicists working in the UK, respected worldwide for their work in medical ethics, Principles of Health Care Ethics, Second Edition_is a standard resource for students, professionals, and academics wishing to understand current and future issues in healthcare ethics. With a distinguished international panel of contributors working at the leading edge of academia, this volume presents a comprehensive guide to the field, with state of the art introductions (...) to the wide range of topics in modern healthcare ethics, from consent to human rights, from utilitarianism to feminism, from the doctor-patient relationship to xenotransplantation. This volume is the Second Edition of the highly successful work edited by Professor Raanan Gillon, Emeritus Professor of Medical Ethics at Imperial College London and former editor of the Journal of Medical Ethics, the leading journal in this field. Developments from the First Edition include:_ The focus on ‘Four Principles Method’ is relaxed to cover more different methods in health care ethics. More material on new medical technologies is included, the coverage of issues on the doctor/patient relationship is expanded, and material on ethics and public health is brought together into a new section. (shrink)

IntroductionThose in mental health-related consumer movements have made clear their demands for humane treatment and basic civil rights, an end to stigma and discrimination, and a chance to participate in their own recovery. But theorizing about the politics of recognition, 'recognition rights' and epistemic justice, suggests that they also have a stake in the broad cultural meanings associated with conceptions of mental health and illness.ResultsFirst person accounts of psychiatric diagnosis and mental health care (shown here to (...) represent 'counter stories' to the powerful 'master narrative' of biomedical psychiatry), offer indications about how experiences of mental disorder might be reframed and redefined as part of efforts to acknowledge and honor recognition rights and epistemic justice. However, the task of cultural semantics is one for the entire culture, not merely consumers. These new meanings must be negotiated. When they are not the result of negotiation, group-wrought definitions risk imposing a revision no less constraining than the mis-recognizing one it aims to replace. Contested realities make this a challenging task when it comes to cultural meanings about mental disorder. Examples from mental illness memoirs about two contested realities related to psychosis are examined here: the meaninglessness of symptoms, and the role of insight into illness. They show the magnitude of the challenge involved - for consumers, practitioners, and the general public - in the reconstruction of these new meanings and realities.ConclusionTo honor recognition rights and epistemic justice acknowledgement must be made of the heterogeneity of the effects of, and of responses to, psychiatric diagnosis and care, and the extent of the challenge of the reconstructive cultural semantics involved. (shrink)

The unfortunately vast history of paternalism in both medicine and clinical research has resulted in perpetually increasing respect for patient autonomy and free choice in Western health care systems. Beginning with the negative right to informed consent, the principle of respect for autonomy has for many patients evolved into a positive right to request treatments and expect accommodation. This evolution of patient autonomy has mirrored a more general social attitude of market liberalism where increasing numbers of patients have come (...) to embody the role of the “consumer.” This paper explores this transformation and critiques the current way in which respect for patient autonomy is put into practice. Ultimately, this paper concludes that the consumer view of patient autonomy is dysfunctional. Moreover, this paper argues that, based on the inherent goals of medicine, some form of paternalism is required in any meaningfully therapeutic relationship. (shrink)

PurposeThe purpose of this study is to identify the major factors influencing the adoption of health-care wearables in generation Z (Gen Z) customers in India. A conceptual framework using push pull and mooring (PPM) adoption theory was developed.Design/methodology/approachData was collected from 208 Gen Z customers based on 5 constructs related to the adoption of health-care wearables. Confirmatory factor analysis and structural equation modelling was used to analyse the responses. The mediation paths were analysed using bootstrapping method and examination (...) of the standardized direct and indirect effects in the model.FindingsThe study results indicated that the antecedent factors consisted of push (real-time health information availability), pull (normative environment) and mooring (decision self-efficacy) factors. The mooring factor (MOOR) was related to the push factor but not the pull factor. The MOOR, in turn, was related to the switching intention of Gen Z customers for health wearables adoption.Research limitations/implicationsThe research study extended the literature related to the PPM theory in the context of the adoption of health wearables among Gen Z customers in India.Practical implicationsThe study outcome would enable managers working in health wearable organizations to understand consumer behaviour towards health wearables.Social implicationsThe use of health wearables among Gen Z individuals would lead to future generations adopting a healthy lifestyle resulting in an effective workforce and better economy.Originality/valueThis was one of the few studies which have explored the PPM theory to explore the factors for the adoption of health wearables among Gen Z customers in India. (shrink)

Epidemiology is a core science of public health, focusing on research related to the distribution and determinants of both positive and adverse health states and events and on application of knowledge gained to improve public health. The American College of Epidemiology (ACE) is a professional organization devoted to the professional practice of epidemiology. As part of that commitment, and in response to concerns for more explicit attention to core values and duties of epidemiologists in light of (...) emerging issues and increased scrutiny of epidemiology, the College developed, adopted, and published a set of Ethics Guidelines. The structure of the ACE ethics guidelines is in four parts: (1) a brief statement of core values and duties of epidemiologists, coupled with the virtues important to professional practice; (2) concise statements of key duties and obligations; (3) exposition of the duties and obligations with more applications; and (4) a brief summary and conclusion. The Guidelines have been published on the ACE website and in the official College journal Annals of Epidemiology. The guidelines contain (and maintain) core elements that define the discipline of epidemiology and its fundamental duties, but they are also intended to be dynamic and evolving, responsive to a changing professional and social environment. (shrink)

Consumer-operated services organizations (COSOs) are independent, non-profit organizations that provide peer support and other non-clinical services to seriously mentally ill people. Mental health consumers provide many of these services and make up at least a majority of the organization’s leadership. Although the dominant conception of the COSO is as an adjunct to clinical care in the public mental health system, this paper reconceives the organization as a civic association and thereby a locus of citizenship. Drawing on empirical (...) research on COSOs in one state and the citizenship and civic democracy literatures, COSOs are analyzed here as membership organizations with democratic norms and strong ties to local communities. The suggestion is made that by embracing and enhancing their status as civic associations, COSOs may advance the goals of the social movement that spawned them and avoid predictable obstacles to further growth and development. (shrink)

Monetary compensation for human eggs used in research is a controversial issue and raises major concerns about women’s health and rights, including the potential of exploitation and undue inducement. Human eggs are needed for various types of studies and without payment, it would be impossible to procure sufficient eggs for vital research. Therefore, a solution seems necessary to prevent exploitation and resolve other ethical concerns while ensuring sufficient supplies of human eggs for research. A brief review of legislation in (...) different countries shows the existing diversity and controversy over compensating human egg donation for research purposes. While in more economically developed countries procreative liberty and consumer orientation seem to be defensible, in some developing countries, where concerns about exploitation exist, adopting a more regulated approach to assisted reproduction is more prudent and wise. Egg sharing is a program that has been proposed to solve both the ethical problems of purchasing eggs and the shortage of human egg supply for research. In developing countries, however, regardless of whether the egg sharing or the monetary compensation model is adopted, some steps should be taken to guarantee the ethical nature of this practice. These steps include ensuring the existence of independent institutional review boards, confirming the validity of all steps in the process of obtaining informed consent, and ensuring the existence and viability of independent supervising and auditing bodies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction: Conflicting Interest in Medicine: Stories by Physicians on How Financing Affects Their WorkJames M. DuBois, Symposium EditorPhysicians frequently enter into special relationships that establish personal financial interests that could conflict with their patients’ best interests. Examples include receiving gifts from drug companies, sharing a patent on a medical device, or accepting funding from industry to conduct a drug study. In recent years, such “conflicts of interests” in medicine (...) have received growing attention from medical associations (Association of American Medical Colleges, 2008, 2010), policy bodies (Institute of Medicine, 2009), industry (Pharmaceutical Research and Manufacturers of America, 2008), journalists (Caputo, 2009; Nguyen, Ornstein, & Weber, 2010), and even Congress, which included in the 2010 Patient Protection Affordable Care Act a Physician Payment Sunshine provision requiring industry to report a wide variety of ties to physicians. All of these efforts appear motivated by a similar assumption: Gifts and financially beneficial relationships can unconsciously motivate physicians to prioritize their own or industry’s interests over patients’ interests when providing care, conducting medical research, or educating physicians (American Association of Medical Colleges, 2008; Dana & Loewenstein, 2003).The call for stories produced for this narrative symposium provided the following request:We are interested in hearing about positive and negative experiences associated with a variety of financial relationships. The stories should give readers a sense of what it is like to be a physician in the midst of complex relationships to industry, physician practices, and third–party payers—relationships that go beyond ordinary reimbursement for care or research expenses.Obtaining stories proved more challenging than anticipated for reasons related to our theme. Precisely because access to physicians is considered valuable, it is highly restricted. Listservs and blogs that serve physicians typically prohibit postings from anyone except physician members, and even they are sometimes not allowed to post messages freely. While at least one listserv circulated our call to members (at the request of a member), others rejected our request, and one blog offered to post our call as a 1–month ad for $20,000. This contrasts radically with the relatively easy access we have had to other groups, including mental health consumers and living organ donors, who have broad grass root communication systems, and bioethicists, who have several listservs and blogs that readily share news about relevant scholarly opportunities.The collection of stories obtained resulted from extensive personal networking and a small amount of arm twisting. The collection was not what we expected to obtain, but is in many ways even more interesting. One story (Hodges) explicitly addresses the impact that pharmaceutical representatives can have on prescribing patterns—the classic, voluntary, conflicted relationship, insofar as sales reps are [End Page 65] welcomed in facilities, often bearing free samples, free lunches, and glossy articles on their products, all in the hopes of influencing prescribing patterns. But most stories do not fit the typical mold found in discussions of conflicts of interest. Among those expressing concerns about the impact of financial factors on medical practice, one focuses on the insufficient management of bias within the Food and Drug Administration (Perlmutter); three focus on the bias that is introduced through our current fee–for–service reimbursement system (Mikulec, Nagaldine, and Zientek)—of these, two illustrate ways that third parties seek to manipulate physician practices to maximize profits; one notes how any kind of clinical trial—whether government or industry sponsored—may affect patient care decisions (Cruz); while two argue that worries over industry sponsorship of research are disproportionate (Bierut and Sofair), and two address widespread concerns about industry sponsorship of educational activities, with one illustrating how bias might be reduced (Seitz & Diao), and another illustrating the potential harms of prohibiting educational sponsorship (Peppin).To be clear, all of these narratives are responsive to our call for stories that “describe positive and negative experiences associated with a variety of financial relationships.” Yet they are not classic conflict of interest stories; rather, they represent the conflicting interests that concern physicians today—conflicts that are often intrinsic to our current healthcare and research systems rather than special relationships courted by physicians.While making no pretense of representativeness or comprehensiveness, these stories provide fertile ground for reflection, as seen in our... (shrink)

In __Unearthed: The Economic Roots of Our Environmental Crisis_, _Kenneth M. Sayre argues that the only way to resolve our current environmental crisis is to reduce our energy consumption to a level where the entropy produced by that consumption no longer exceeds the biosphere’s ability to dispose of it. Tangible illustrations of this entropy buildup include global warming, ozone depletion, loss of species diversity, and unmanageable amounts of nonbiodegradable waste._ Degradation of the biosphere is tied directly to human energy use, (...) which has been increasing exponentially since the Industrial Revolution. Energy use, in turn, is directly correlated with economic production. Sayre shows how these three factors are invariably bound together. The unavoidable conclusion is that the only way to resolve our environmental crisis is to reverse the present pattern of growth in the world economy. Economic growth is motivated by social values. Key among them are the desire for wealth and consumer values including gratification, convenience, and acquisition of goods. Sayre maintains that economic growth can be reversed only by eliminating these social values in favor of others more conducive to environmental health. Eliminating these values will involve major changes in lifestyle within industrial societies generally. Only with such changes in lifestyle, he argues, does human society as we know it have a chance of survival. Clearly written and thoroughly documented, this book provides a comprehensive overview of our complex environmental predicament. "With unerring logic and science, Kenneth Sayre dissects the origins of the ecological crisis and points to the necessary recalibration of industrial societies with the laws of thermodynamics and ecology. It is a radical book in that he gets to the heart of what ails us, and it charts a course toward a future grounded in authentic hope." — David W. Orr, Oberlin College__ “Sayre’s assessment forces all seeking a sustainable future to reexamine the preeminence accorded to clean energy. _ Unearthed __uniquely combines thermodynamics and ethics to challenge and broaden readers’ understandings of the systemic issues we face. Assembled and presented with piercing clarity, __Unearthed __constructs a brilliant framework for making sense of our quiet, but growing crises.” —_Felipe Witchger, IHS Cambridge Energy Research Associates__ “Kenneth M. Sayre’s _ Unearthed: The Economic Roots of Our Environmental Crisis__ constitutes a major and significant contribution to our understanding of the grave ecological crisis facing humanity. It covers the complete picture, from the basic physical causes of the destruction of our environment to the sociological or anthropological forces that condition our self-destructive actions. The work not only is a brilliant and mind-sweeping piece of diagnosis and prognosis, but it goes all the way to point towards possible solutions.” —_Fernando del Río Haza, Laboratorio de Termodinámica, Universidad Autónoma Metropolitana, Iztapalapa, Mexico_. (shrink)

In order to improve education and teaching methods and meet the “heart” needs of college students in the era of big data, this paper analyzes the application of data mining technology in college mental health education, and introduces database technology and decision tree algorithm to support college mental health work. This process verifies the feasibility of this kind of system with the help of an example. Using the test standards outlined in this document, 1.5 previous (...) test tasks were completed within the timeframe. During the system test, the error rate was 14% and the number of tests was 7%.However, the error rate in the development stage is 11%, which is lower than 19% of the old version. The error rate in the acceptance stage is 14%, which is lower than 5% of the old version. That is to say, most of the errors were found in time in the system analysis and design stage. 14% of the problems found in the development stage are basically small problems in the interface display, which do not need major changes. However, the old version also includes design defects found in the development stage, and only large-scale rewriting of the involved modules. In the research process, the work of mental health in Colleges and universities has been promoted. At this time, the law of psychological changes of college students has been summarized. Therefore, the support of data mining technology can better meet the needs of mental health education in Colleges and universities. (shrink)

In his State of the Union address on January 31, 2006, President George W. Bush asserted: “for all Americans, we must confront the rising cost of care, strengthen the doctor-patient relationship, and help people afford the insurance coverage they need.” Soon thereafter, the White House National Economic Council released a summary of President Bush's plans for health care reform. The Bush plan argues that increased consumer control over health care purchasing decisions will go a long way to (...) solving America's health care woes. By making patients more value-conscious consumers, the Bush Administration hopes to reduce costs, improve quality and increase competition within the health care sector.The problem of rising health care costs is not new. In fact, President Bush's statement could have come from any American President in the last fifty years. (shrink)

Since the 1970s, the United States has adopted a trade policy agenda that has forced countries to trade away flexible patent provisions for access to US markets. While pharmaceutical companies have argued that the recognition of patent rights is essential for recovering investments in research and development of pharmaceuticals and incentivizing future innovation, the lack of competition has had damaging consequences for public health, as companies tend to set the prices of treatments beyond the reach of consumers and government (...) programs. Thailand and Brazil are bound by law to provide universal access to anti-retroviral treatment (ART) to People Living with HIV/AIDS (PLWHA). This has been made possible in part due to the universal health care systems in each country and the countries' local technical and industrial capacities that provide the government with affordable generic medicines. The introduction of stronger intellectual property protection laws however, has limited possibilities for procuring generic medicines and inflated the cost of treatment. Between 2006–2008, Thailand and Brazil used compulsory licensing to authorize generic competition against the consent of the pharmaceutical companies in order to guarantee the right to health and ensure the viability of government health budgets. This paper will demonstrate how the interaction between individual / collective action and structural and institutional elements in Thailand and Brazil produced propitious conditions for each country to assert the primacy of health over patent rights. (shrink)

Purpose This paper explores and identifies customer-value-related sacrifices that consumers attach to interactive health/life insurance. This paper aims to increase understanding of why individual consumers are not willing to embrace behaviour-tracking-based insurance applications. Design/methodology/approach The authors analysed data from a qualitative survey of Finnish insurance consumers who were not keen on adopting interactive insurance products. Findings Developed through thematic analysis, the framework presented in this paper illustrates consumers’ value sacrifices on four dimensions: economic, functional, emotional and symbolic value. Research (...) limitations/implications The framework and insights emerging in the study hold several implications related to increased understanding of consumers’ perceptions of insurance and to developing interactive insurance services. In addition, this work provides a promising foundation and avenues for further considerations related to digital ethics in insurance. Originality/value To the best of the authors’ knowledge, this paper is the first piece applying a value sacrifice perspective in studying consumers’ unwillingness to adopt interactive insurance products. (shrink)

The marketing of unproven direct-to-consumer stem cell interventions is becoming widespread in Canada. There is little evidence supporting their use and they have been associated with a range of harms. Canada has been slower to act against clinics offering these interventions than other jurisdictions, including the United States. Here, we outline the regulatory and policy tools available in Canada to address this growing problem. Health Canada’s regulations governing cell therapies are complex, but recent statements make it clear that (...) Health Canada believes it has jurisdiction over many of the currently marketed stem cell interventions. Still, further regulatory clarity is needed from Health Canada, as are increased directed enforcement efforts on interventions that fall within their scope. The Competition Bureau, via the Competition Act, prohibits advertisers from making materially false or misleading promotional representations. The Competition Bureau could collaborate with the scientific community to analyze the claims of existing clinics in Canada, and impose sanctions upon those who breach the established standard. Professional regulators, including provincial colleges of physicians and surgeons, have considerable power over what products and services their members can offer. Every college of physicians in Canada requires, via policy and codes of ethics, that doctors maintain evidence-based practices. This requirement is incompatible with offering many unproven stem cell interventions. Litigation may be another tool, including the use of fraud, misrepresentation and/or negligence claims for failing to meet the required standard of care. Finally, political pressure on federal and provincial lawmakers could encourage changes to marketing, cell therapy and professional regulations that would allow a more comprehensive response. In sum, there are many existing tools that can be used to protect the public from unproven stem cell interventions. Increased bureaucratic will and grassroots efforts are needed in order to effect a positive policy response. (shrink)

ObjectiveTo investigate the effects of cell phone dependence on mental health among undergraduates during the COVID-19 pandemic and further identify the determinants that may affect their mental health in China.MethodsThe data were collected from 602 students at a medical school in Shanghai via an online survey conducted from December 2021 to February 2022. The Mobile Phone Addiction Index and Depression Anxiety Stress Scale were applied to evaluate CPD and mental health, respectively. Independent sample t-test and one-way analysis (...) of variance were employed to compare the means of continuous variables among categorical groups. Correlations between continuous variables were detected using Pearson's correlation analysis. Univariable and multivariable logistic regressions were employed to identify the determinants of mental health.ResultsAmong the 402 eligible students, 73.88% were women with an average age of 20.19 ± 2.36 years. On average, the DASS score was 32.20 ± 11.07, the CPD score was 36.23 ± 11.89, and the cell phone use duration was 7.67 ± 3.61 h/day. CPD was found to have a negative effect on mental health among college students in Shanghai. Additionally, cell phone use duration, age, being senior students, faculty-student relationship, insomnia, tobacco use, obesity, and life satisfaction were clarified as contributing factors to mental health among college students.ConclusionHigh degree of CPD could have a negative effect on college students' mental health, which might lead to some psychological problems. Appropriate actions and effective interventions are highly needed to prevent severe psychological injuries among college students in China. (shrink)

The unprecedented outbreak of the novel coronavirus has led to a great shift toward online retailing and accelerated the need for contactless delivery. This study investigates how technological and health belief factors influence consumer acceptance of autonomous delivery robots. Anchored in four behavioral theories [i.e., technology acceptance model, health belief model, perceived value theory and trust theory], a synthesized model is developed. A total of 500 valid responses were collected through an online questionnaire in Singapore, and structural (...) equation modeling was conducted to examine the responses. The results revealed that perceived ease of use, perceived usefulness, perceived susceptibility, perceived severity, self-efficacy and cues to action have a positive and significant influence on consumers’ perceptions of the value of ADRs. The total effect analysis also showed that perceived VAL strongly affects consumer acceptance of ADRs. Academically, this study introduces both technological and health belief factors to explain consumer acceptance of ADRs. It also provides recommendations for policymakers and autonomous delivery robot developers on policy formulation, public communication, product design and infrastructure development. (shrink)

This paper argues that the Food and Drug Administration’s (FDA) policy for health and wellness apps is ethically problematic. Currently, the FDA does not regulate health and wellness apps that are not intended for medical use. As a result of this hands‐off policy, preventing harm to consumers is left primarily to developers and app marketplaces. We argue that the FDA’s duties to prevent harm and maintain accountability to the American public require that they play a much stronger role. (...) We also discuss concerns about efficiency and fostering innovation, and argue that while they should help shape FDA regulation of health and wellness apps, they do not justify complete absence of FDA involvement. -/- . (shrink)

ABSTRACT In recent years, the medical establishment has been speaking in favor of women's autonomy in childbirth by advocating cesarean delivery on maternal request (CDMR). This paper offers to look at the ethical dimension of CDMR through a feminist critique of the medicalization of childbirth and its influence on present‐day medical ethics. I claim that the medicalization of childbirth reflects a sexist bias with regard to conceptions of the body and needs to be used with caution when applied to women's (...) reproductive health. I then use this perspective to critically analyze the position of the American College of Obstetricians and Gynecologists (ACOG) on the ethics of decision‐making in patient‐choice surgery. I claim that informed consent cannot be meaningfully exercised unless women are made aware of the sexist underpinnings of the medical model of childbirth and its influence on the ethical reasoning of the American College of Obstetricians and Gynecologists. I also express concern about the effects of normalizing patient‐choice cesarean sections on the choices available to pregnant women using as examples the institutional rules on mandatory cesarean sections for women with a previous cesarean delivery or breech presentation. I conclude with a call for more research into the real cost of convenience in CDMR, particularly as our increasingly strained publicly funded healthcare system would greatly benefit from the de‐medicalization of normal body functions rather than an increased dependence on costly surgical technology. (shrink)

Critics of mass culture often identify 1950s-style status competition as one of the central forces driving consumerism. Thomas Frank has challenged this view, arguing that countercultural rebellion now provides the primary source of consumerism in our society, and that ‘cool’ has become its central ideological expression. This paper provides a rearticulation and defense of Frank's thesis, first identifying consumerism as a type of collective action problem, then showing how the ‘hip consumer’ is one who adopts a free-rider strategy in (...) this context. (shrink)

Since the establishment of the modern prison system in the early nineteenth century, prisons and prisoners have been construed as sites of moral, social, and biological contagion. Historic and contemporary studies show that most prisoners experience severe health inequalities, higher rates of addiction and mental health issues, and lower life expectancy than the rest of the population. They also come from deprived social strata. Yet, these aspects of Irish penal history have been largely neglected in academia and popular (...) histories. Our article discusses two public history projects—an art installation, _The Trial_, and a museum exhibition, _Living Inside_—that engaged different publics with the long history of health and welfare in Irish prisons. Developed by the research team on the Wellcome Trust Investigator Award “Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000,” based at University College Dublin, the projects adopted different methodologies to engage their audiences and explore the experience and management of health and welfare in nineteenth- and twentieth-century Irish prisons. We further examine the different methodological approaches of each project, their varied aims and audiences, and the impacts reported by audiences and participants. The article also considers some of the challenges of doing this kind of public history, both in terms of working with marginalized communities and presenting research about difficult subjects to various audiences. (shrink)

This essay argues that medical innovation proceeds most efficiently and effectively within a free market economy. Medical innovation is an expression of the technological project: the program through which we seek to control nature, to improve the quality and quantity of life. The Technological Project proceeds most efficiently with a free market economy because such a market both promotes competition and encourages innovation. As I argue, the market is a discovery process in which alternatives are tried, tested, and selected by (...) consumer's choices. The alternatives to a free market - primarily central planning and a heavily regulated market - fail adequately to encourage medical innovation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Growing Up With Autism: Challenges and Opportunities of Parenting Young Adult Children with Autism Spectrum DisordersKayhan Parsi and Nanette ElsterAs the parent and stepparent of a child with autism, we witness a world that is quite different from parents with only neurotypical children. Tantrums don’t vanish after the age of three. Aggression is a way of life. Simple communication is a constant challenge. And dreams of a child’s future (...) have to be altered and adapted. In the narratives that accompany this commentary, we see that the challenges of raising a child with autism do not necessarily diminish with age; they may, however, change because children with autism become adults with autism and this presents a new set of both challenges and opportunities.The current epidemic of young children with autism is giving rise to yet another epidemic—the rising number of young adults who are autistic. As one of the authors here mentioned, “the system is in for a tsunami of new individuals needing medical care of all types, needing continued supports for housing and vocational training, communication, occupational and physical therapy” (Cornell). According to a recent study published in Pediatrics, “[y]outh with an ASD have poor postsecondary employment and education outcomes, especially in the first 2 years after high school” (Shattuck, 2012). With the rising number of children being diagnosed with autism, this employment disparity is likely to be exacerbated until or unless the workforce adapts to and accommodates the needs and skills of persons with autism.The needs of young adults with autism are only recently beginning to receive more attention from the media. But for these children’s parents, this issue has always been personal. The emotions on display in these narratives are heartfelt—even raw at times—and seem to swell like the wave of a tsunami itself as parents are now confronting what should be the independence of adulthood. With barriers to employment, health care and housing, young adults with autism remain largely dependent upon their parents. While the topic of transition to adulthood for those with autism is a vast one, implicating the need for wide scale policy change, certain themes emerge in these personal narratives that we wish to focus on here, which may well serve as a guide for that change.The Advocate MotherThe Advocate Mother is a common theme in many narratives of autism and the ones presented here are not different. In fact, nearly all of the narratives presented are written by mothers. Mothers in these narratives exemplify sacrifice, dashed hopes, and even heartbreak. Although there is steely determination in many of these narratives, there is also [End Page 207] self–doubt, anxiety and guilt. As Laura Shumaker recounts the story of taking her adult son to Washington, DC, she experiences great anxiety when her son is mocked. She speaks of “the heavy feeling in [her] chest that mothers get when people laugh at their children.”The advocate mother can easily become the overly consumed mother. Take, for example, the powerful narrative of Nancy Coughlin. She confesses that her daughter’s autism took over her life and the life of her family: “my own mental health was disintegrating, as was my marriage, and in our family’s last–ditch effort to ease the burden we bought a second home; a cheap little place just a few blocks down the road from where we lived. We called it our ‘respite house’.”Others confess that raising a child with autism becomes a “full time job.” (Van der Poel). And the demands of this job do not diminish simply because the child reaches adulthood; it may, in fact, become not only a personal job for some parents but their vocation as well. For instance, Anonymous Four states, “I felt so strongly that parents and young adults needed to know about CIP [College Internship Program], that I applied for a part time job there where I could utilize my background in marketing to help parents like me find the services their son or daughter may desperately need.”While the inability to express appropriate emotions is a hallmark feature of autism, it seems that mothers in particular compensate by... (shrink)

The formation and research of Constructivism theory is another understanding in developing educational psychology. Many problems exist in English vocabulary teaching and learning, which are too common to be noticed, negatively and implicitly impacting Students’ English Vocabulary Memorization. In order to solve these problems, this work studies college Students’ EVM from the perspective of Constructivism. Firstly, the literature review and observation method understand the Students’ EVM performance and teaching behavior. Secondly, it analyzes the current situation, problems, and reasons for (...) Students’ poor EVM abilities. Finally, combined with relevant theories, a college Students’ EVM-oriented teaching model is proposed, whose effectiveness is verified by teaching experiments. The experiment recruits100 freshmen, including 60 boys and 40 girls, and lasts half a semester. The average score of the final exam in the experimental group is more than 90, which is better than that in the control group. Then, the SPSS21.0 is used in the independent-samples t-test, finding no significant difference. Thus, the experimental group’s comprehensive English Proficiency Level has not been negatively affected. The proposed teaching model can improve Students’ EVM efficiency and consolidate their memory. The proposal has important guiding significance for stimulating Students’ interest in English vocabulary learning and the quality of vocabulary teaching. (shrink)

This article addresses the data protection and product safety regulatory models currently applied to consumer-facing health technologies. It explains how the design and structures of existing data protection and safety regulation in the U.S. have resulted in exceptionally thin protection for the users of consumer-facing devices and products that rely on or that facilitate consumer collection or aggregation of health and wellness data. It also examines some appealing legislative alternatives to the current thin model used (...) in the U.S. and suggests a framework for prioritizing ameliorative regulation. To better understand existing regulatory models, their deficiencies, and how they should be reformed, the article employs an analytical model describing these regulatory systems across two axes. The vertical axis describes the quantity or depth of regulation, such as, for example, the strictness of the rules imposed by the regulatory model. The horizontal axis describes the reach of the regulation, the behaviors, products, or industries to which the regulation applies. (shrink)

Some health-care institutions have ethics committees. The experience of the Ethical Issues Committee at the Royal College of Physicians is described. Ethics committees in institutions may be reactive or creative, must determine an agenda and must deal with dissent.

This article investigates the scope and effects of enhanced consumer choice in health insurance that is presented as a cornerstone of the new health insurance legislation in the Netherlands that will come into effect in 2006. The choice for choice marks the current libertarian trend in Dutch health care policymaking. One of our conclusions is that the scope of enhanced choice should not be overstated due to many legal and non-legal restrictions to it. The consumer (...) choice advocates have great expectations of the impact of enhanced choice. A critical analysis of its impact demonstrates that these expectations may not become true and that enhanced consumer choice should not be perceived as the ‘magic bullet’ for many problems in health care. (shrink)