bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bioethics Testimony: Untangling the Strands and Testing Their Reliability
Authors: Spielman Bethany J. 
Published: January 2007

InThe Abuse of CasuistryJonsen and Toulmin describe one view of moral reasoning as follows:Those who take a rhetorical view of moral reasoning… do not assume that moral reasoning relies for its force on single chains of unbreakable deductions which link present cases back to some common starting point. Rather (they believe), this strength comes from accumulating many parallel, complementary considerations, which have to do with the current circumstances of the human individuals and communities involved and lend strength to our conclusions, not like links to a chain but like strands to a rope or roots to a tree.Whether or not all moral reasoning resembles “strands to a rope,” bioethics testimony certainly does. Bioethics testimony is eclectic, a composite of many loosely woven strands. Rarely, if ever, is bioethics testimony “a chain of unbreakable deductions.” Rarely is it “pure” ethics, much less pure normative ethics.
Is there any Indication for Ethics Evidence? An Argument for the Admissibility of some Expert Bioethics Testimony
Authors: Nelson Lawrence J. 
Published: January 2007

Professor Imwinkelried is surely right: the propriety of bioethicists serving as expert witnesses in litigation is problematic, and, I would add, it should remain problematic. Such testimony most certainly does not belong everywhere it will be offered by lawyers and litigants in an effort to advance their interests. Yet in contrast to some commentators, Imwinkelried and I both see a place for bioethicists serving as expert witnesses, although we differ significantly on how to understand and justify this place. In any event, serious questions regarding the proper place for expert bioethicist testimony in the courtroom do exist, not only for law but also bioethics as well.The threshold question regarding the prospect of bioethicists serving as expert witnesses would seemingly have to be: “could a bioethicist qualify as an expert witness under the controlling rules of evidence?” Imwinkelried, however, does not perceive any need to even entertain this question as he claims that “technical evidentiary standards are inapplicable when information is presented to a judge to permit the judge to perform… a legislative or law-making function.”
Ethics Expertise in Civil Litigation
Authors: Kipnis Kenneth 
Published: January 2007

I am an academically trained philosopher who has taught and written about medical ethics for three decades, who has done extra-mural ethics consultation in clinical and other settings for two decades, and who has served as an expert ethics witness in the courts for more than ten years. Trained as a traditional academic, none of these three pursuits have come easily. Like most philosophers, my education did not prepare me for such responsibilities. Indeed, regardless of a bioethicist's initial background - i.e., health care, law, theology or philosophy - it is invariably necessary to build upon foundational knowledges and abilities in gearing up for work as a health care ethics consultant.Edward J. Imwinkelreid has prepared a remarkable overview of the work of the expert ethics witness from the point of view of the law of evidence. My perspective as a philosopher, an ethicist, and an expert witness, stands in contrast with his.
California's Proposition 69: A Dangerous Precedent for Criminal DNA Databases
Authors: Simoncelli Tania , Steinhardt Barry 
Published: January 2007

On November 2, 2004, California voters approved Proposition 69, “The DNA Fingerprint, Unsolved Crime, and Innocence Protection Act” by a margin of approximately 60 to 40 percent. Given the limited amount of information provided to voters during the initiative process, it is unclear how many of the yea-sayers were apprised of the full implications of this measure. Indeed, by voting “yes” on Proposition 69, California has elected to house the most radical and costly state criminal DNA database in the country. This dangerous expansion of California's database poses tremendous threats to civil liberties and social justice while offering little, if anything, by way of increasing the safety of its citizens.Prior to November 2, California law required the permanent retention of DNA samples from felons convicted of serious, violent crimes. The new law expands the database to include DNA samples from all felons and individuals with past felony convictions - including juveniles - and, beginning in five years, all adults arrested for any felony offense.
A Multidisciplinary Approach to an Ethic of Biodefense and Bioterrorism
Authors: Sutton Victoria 
Published: January 2007

The normative approach to defining an ethic of a field, which focuses on one disciplinary field, requires modification in the consideration of a biodefense ethic to include not one discipline, but many. The consideration of an ethic in biodefense must capture issues in a multidisciplinary scope, including the ethical studies in the disciplines of medicine, sciences, technology, law, international relations, public health, environment, and war, each having their unique framework of ethical constructs.An ethic of bioterrorism and biodefense raises issues which can be examined utilizing multidisciplinary ethical considerations. The disciplines of medicine, sciences, technology, law, international relations, public health, environment, and war each have a framework of ethical principles which are essential in the scope of ethics which are incident to bioterrorism and biodefense; the absence of any one of which would create a void in our understanding of the complexity of this subject.
Quarantines and Distributive Justice
Authors: Markovits Daniel 
Published: January 2007

Medical quarantines often threaten the civil rights of the persons whom they confine. This might happen in two ways. First, quarantines might inflict harsh conditions on their occupants; and, second, quarantines might be imposed in an arbitrary or indeed discriminatory manner. These concerns, moreover, are anything but fantastic. Infectious diseases, particularly in epidemic forms, commonly trigger retributive and discriminatory instincts, so that actual quarantines often impose inhumane, stigmatizing, or even penal treatment upon persons who are confined based on caprice or even prejudice.But quarantines that impose no gratuitous hardships and that are applied pursuant to orderly and non-discriminatory procedures are theoretically possible and also practically available. And such well-run quarantines, especially when they are employed to combat epidemic diseases, cannot plausibly be said to violate the civil rights of the quarantined. Even the staunchest civil libertarian must accept that one person's liberty may be restricted when this is necessary for preventing harm to another.
Off with their Heads: The Need to Criminalize some forms of Scientific Misconduct
Authors: Redman Barbara K. , Caplan Arthur L. 
Published: January 2007

An increasingly long line of high-profile scientific misconduct cases raises the question of whether regulatory policy ought to incorporate more rigorous sanctions for investigators and their institutions. Broad and Wade graphically describe these cases through the early 1980s. They continue to recent times with the cases of Evan Dreyer, Kimon Angelides and Robert Liburdy, Justin Radolf, and others. In addition, recent Congressional investigation into conflict of interest concerns surrounding consulting by National Institutes of Health scientists has raised further questions about ethical standards. The record of continuing scandal suggests that current policy may not be optimal for controlling scientific misconduct. Would an alternative policy better minimize its incidence and associated costs?What should we expect of public policy governing misconduct by American scientists? Surely the public has a right to presume that its tax money is being spent wisely and that any economic rewards from taxpayer funded research are used prudently and in the public interest.
Currents in Contemporary Ethics
Authors: Doukas David John , Rothstein Mark A. 
Published: January 2007

In the fifteen-year-long public saga of the Terri Schiavo case, one oftcited regrettable aspect of her health care noted in the media was her lack of advance care planning. The withdrawal of her gastrostomy tube was per the consent of her husband, Michael Schiavo, based on the substituted judgment of what she would have desired in a persistent vegetative state (PVS). Her parents, the Schindlers, attempted to assert that ending treatment in her state (which they disputed as not being PVS violated her religious convictions.Many people were upset by the protracted public scrutiny of this private matter - citing the Schindler's public angst, the indignity of Ms. Schiavo's protracted treatment, the interference of politicians, and the financial injustice of devoting so much time and money to this case. All these points are less meritorious than this simple fact: an incapacitated patient had a substituted judgment rendered by her spouse (who was not found to have a conflict of interest),with corroboration by other witnesses for this refusal, and without any compelling contradictory evidence from the once-competent patient.
Physician Responses to the Malpractice Crisis: From Defense to Offense
Authors: Kachalia Allen , Choudhry Niteesh K. , Studdert David M. 
Published: January 2007

Medical science brings innovations in patient care at an astounding pace today - new chemotherapeutic agents, coated stents, and minimally invasive surgery are just few recent examples. For physicians, though, the specter of malpractice liability can overshadow the marvel of practicing in this era. Many physicians are working in a volatile liability environment; they face spiraling costs for malpractice insurance, have difficulties purchasing liability coverage at any price, and see record payouts in a growing number of claims against their colleagues. The American Medical Association (AMA) has declared that at least 20 states are currently in a malpractice “crisis,” with another 24 states showing early signs of an impending crisis.There have been two comparable periods of instability in the last thirty years, but these predecessor crises differ from the current one in important ways. First, while physicians mainly experienced dwindling options for obtaining coverage in the mid-1970s (i.e., availability) and exorbitant prices in the mid-1980s (i.e., affordability), the current crisis appears to have elements of both availability and affordability.
Medical Indemnity Reform in Australia: “First Do No Harm”
Authors: Wheatland Fiona Tito 
Published: January 2007

Medical indemnity is not usually the stuff of high political and social drama in Australia. When the biggest medical defense organization went into voluntary liquidation in 2002, this all changed. Newspapers carried stories on an almost daily basis about the actual or possible negative impact of the “crisis” on doctors, hospitals, and communities. Doctors became increasingly vocal in their criticisms and expansive in their claims. Their political organization, the Australian Medical Association, lobbied powerfully and successfully for government intervention to address the problem of dramatically escalating premiums for some doctors. This, combined with a broader public relations campaign about public liability insurance, resulted in significant changes in the law at both the federal and state level - not just in the area of medical negligence but in relation to most personal injury litigation.The genesis of and reasons for current medical indemnity problems in Australia have been the subject of much speculation and little rigorous analysis.
Reconsidering the Harvard Medical Practice Study Conclusions about the Validity of Medical Malpractice Claims
Authors: Baker Tom 
Published: January 2007

Over fifteen years after first reporting to the State of New York, the Harvard Medical Practice Study (HMPS) continues to have a significant impact in medical malpractice policy debates. In those debates the HMPS has come to stand for four main propositions. First, “medical injury… accounts for more deaths than all other kinds of accidents combined” and “more than a quarter of those were caused by substandard care.” Second, the vast majority of people who are injured as result of substandard care do not file a claim. Third, “a substantial majority of malpractice claims filed are not based on provider carelessness or even iatrogenic injury.” Fourth, “whether negligence or a medical injury had occurred… bore little relation to the outcome of the claims.”Medical malpractice researchers have long known that the HMPS provides far stronger support for the first two of these propositions than for the last two; the HMPS was not designed or powered to reach strong conclusions about the validity of medical malpractice claims.
Are Medical Malpractice Damages Caps Constitutional? An Overview of State Litigation
Authors: Kelly Carly N. , Mello Michelle M. 
Published: January 2007

The United States is in its fifth year of what is now widely referred to as “the new medical malpractice crisis.” Although some professional liability insurers have begun to report improvements in their overall financial margins, there are few signs that the trend toward higher costs is reversing itself - particularly for doctors and hospitals. In 2003-2004, the presidential election and tort reform proposals in Congress brought heightened public attention to the need for some type of policy intervention to ease the effects of the crisis.The darling of tort reformers at both the federal and state levels has been legislation to limit, or “cap,” damages awarded to plaintiffs in malpractice cases. Health care provider groups, liability insurers, and the Bush Administration have all seized on the example of California's MICRA law, which since 1975 has capped noneconomic damages in malpractice cases at a flat $250,000, as the path to financial recovery.
Inclusiveness, Effectiveness and Intrusiveness: Issues in the Developing Uses of DNA Profiling in Support of Criminal Investigations
Authors: Williams Robin , Johnson Paul 
Published: January 2007

Current methods of forensic DNA profiling (known also as DNA fingerprinting and DNA typing), based on Polymerase Chain Reaction (PCR) amplifications of a varying number of Short Tandem Repeat (STR) loci found at different locations on the human genome, are regularly described as constituting the “gold standard for identification” in contemporary society. At a time when criminal justice systems in Europe and North America increasingly seek to utilise the epistemic authority of a variety of sciences in support of the apprehension and prosecution of suspects and offenders, genetic science and recombinant DNA technology are often singled out for particular approbation. Indeed, the development and application of DNA profiling has been widely described as the “greatest breakthrough in forensic science since fingerprinting.”Prior to the implementation of PCR based extraction and amplification methods in the 1990's, the initial uses of DNA fingerprinting (based on Multiple and Single Locus Probes) were largely confined to reactive forensic casework.
Away from Exploitation and towards Engagement: An Ethical Compass for Medical Researchers Working in Resource-Poor Countries
Authors: Fitzgerald Daniel W. , Wasunna Angela 
Published: January 2007

In this era of globalization, as the health problems of poor countries and rich countries become increasingly intertwined, medical research is being conducted at the international level. For example, a research study may be sponsored by a developed country and conducted in a resource-poor country to address health problems faced by both nations. The globalization of medical research is, in effect, quickly outpacing the development of internationally accepted ethical guidelines for the conduct of research. For many medical researchers working in resource-poor countries, ethical decision-making is like sailing in the days before modern navigation; one is never quite sure where one is, or in what direction one is headed. Our aim in this article is to fix a few navigational points on an ethical compass to guide biomedical researchers from developed countries working in resource-poor countries.Just as one of the principles underlying the Hippocratic Oath is “First, do no harm,” a principle underlying medical research ethics may be “First, do not exploit.”
Rights to Specialized Health Care in Norway: A Normative Perspective
Authors: Norheim Ole Frithjof 
Published: January 2007

Is it possible to use the courts - or rights instruments - to advance fair access to health care? This article examines this question within the context of the Norwegian public health care system - one special example of the Scandinavian welfare system. In particular, it asks four basic questions: What are the normative justifications for rights to health care? What were the political processes and concerns leading up to the current Patients Rights Act in Norway? What kind of legal status do these rights have? How can rights to access be implemented?Patient rights do not only concern the right to access to health care; they also include the right to information, the right to participate in decision-making, and informed consent. This article examines only the former aspect, the use of the legal system to secure access to prioritized specialized health care services.
Joe Public v. The General Public: The Role of the Courts in Israeli Health Care Policy
Authors: Shalev Carmel , Chinitz David 
Published: January 2007

“One man’s ceiling is another man’s floor”Paul SimonThe words of Paul Simon capture the essence of what the courts are called upon to deal with when adjudicating matters of health. Wealthier and healthier neighbors living in the upstairs apartment are, all things being equal, not overly interested in raising the floor of their apartment in order to create more space for those in the apartment below. The floor is tangible, measurable and movable, and thus a subject where science can contribute much. However, where to locate the floor is a matter of values and thus largely in the realm of politics.Resorting to the courts in matters of public policy can be seen as the residual of the inability of the remaining two branches of government, the legislature and the executive, to succeed in allocating resources and regulating the system. When the combination of science (bureaucracy) and politics (legislation) falters, enter the judiciary.
Access to Health Care in the Netherlands: The Influence of (European) Treaty Law
Authors: den Exter André 
Published: January 2007

In the Netherlands, access to healthcare has been guaranteed by social health insurance legislation. But since the introduction of the Health Insurance Act (“Zikenfondswet”) in the 1960s, the health insurance system has been in a state of flux. Numerous reforms have changed the system gradually, of which the latest is the introduction of a competitive health insurance scheme for the entire population.Cutting across the various reforms has, however, been the goal of access to healthcare services as defined by international treaty law, including European Union law. In particular the leverage of Community law in strengthening the patient’s right to healthcare is remarkable. Since the European Court of Justice (ECJ) has accepted that healthcare should be considered as a service in terms of the EC Treaty, rights to healthcare have become inextricably linked with the free movement principles and are no longer restricted to the jurisdiction of the country of origin.
Health Law 2005: An Agenda
Authors: Jacobson Peter D. 
Published: January 2007

In 2004, the journalHealth Matrixpublished a very interesting symposium volume titled “The Field of Health Law: Its Past and Future. As the title implies, the various commentators took both a retrospective and a prospective look at past trends and future prospects in health law. Some, including Clark Havighurst, Skip Rosoff and Walter Wadlington, wrote thoughtful essays on the development of health law over time and the implications of those trends. Others, including Rob Schwartz, Jim Blumstein, Rand Rosenblatt, and Mark Hall and Carl Schneider, wrote equally thoughtful essays that reflected on the past but focused more on future directions and prospects. And one, Kep Wing, wrote a semi-dyspeptic essay debunking the entire field of health law.Taken together, these essays present a comprehensive view of how health law has developed so far and where its future might lie. Four themes emerge from the collected writings. First, there is considerable agreement on how and why health law has developed, but little agreement on where it is headed.
The Social, Professional, and Legal Framework for the Problem of Pain Management in Emergency Medicine
Authors: Johnson Sandra H. 
Published: January 2007

The problem of harmful, unnecessary and neglected pain has been studied extensively in many health care settings over the past decade. Research has documented the incidence of untreated pain, and scholars and advocates have given the problem several names: “public health crisis,” “oligoanalgesia, and “moral failing,” among them. Articles have identified a litany of now familiar “obstacles” or “barriers” to effective pain relief. Each of these individual obstacles or barriers has been the subject of targeted remedial action in at least some context.The checklist approach to improving care for patients in pain, however, is likely to have only limited effect. What really appears to be operating is a complex ecosystem that supports ambivalence, denial, and even suspicion of the circumstance of patients in pain and efforts to treat them. Pain relief in emergency medicine, a relatively new setting for the study of challenges to treating pain, provides a revealing context for viewing discrete obstacles to effective pain management in medicine as part of an integrated environment into which patients with pain enter for treatment.
Discourse on Embryo Science and Human Cloning in the United States and Great Britain: 1984–2002
Authors: Weed Matthew 
Published: January 2007

There is a stark difference between American and British policy on embryo science and research cloning. The following survey of the discourse offered both in support of and in opposition to research cloning and embryo science in the United States and Great Britain will show that the same arguments were made in both countries. The fact that similar ethical argumentation occurred in environments where different policy was set is an indicator that current frames for ethical discourse on embryonic stem cell research and human cloning do not effectively capture the debate in the form that politicians and possible consumers of services to be derived from embryo science face.The ethics surrounding embryo research and human cloning have been presented from virtually every possible viewpoint in all forms of medium. It is impossible to reprise every argument made on embryo science and research cloning; therefore, this survey will focus on some of the arguments made during the time leading up to the enactment of Great Britain's Human Fertilisation and Embryology Act of 1990 and the Human Fertilisation and Embryology regulations added to it in 2001.