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Full-Text Articles in Arts and Humanities
Ethics Of Surgical Training In Developing Countries, Kevin Ramsey, Charles Weijer
Ethics Of Surgical Training In Developing Countries, Kevin Ramsey, Charles Weijer
Charles Weijer
The practice of surgical trainees operating in developing countries is gaining interest in the medical community. Although there has been little analysis about the ethical impact of these electives, there has been some concerns raised over the possible exploitation of trainees and their patients. An ethical review of this practice shows that care needs to be taken to prevent harm. Inexperienced surgeons learning surgical skills in developing countries engender greater risk of violating basic ethical principles. Advanced surgical trainees who have already achieved surgical competence are best qualified to satisfy these ethical issues. All training programs need to develop a …
A Death In The Family: Reflections On The Terri Schiavo Case, Charles Weijer
A Death In The Family: Reflections On The Terri Schiavo Case, Charles Weijer
Charles Weijer
No abstract provided.
Will The Real Charles Fried Please Stand Up?, Paul Miller, Charles Weijer
Will The Real Charles Fried Please Stand Up?, Paul Miller, Charles Weijer
Charles Weijer
In response to the preceding commentary by Jerry Menikoff in this issue of the Journal, the authors argue that Fried's central concern is not that randomized clinical trials (RCTs) are conducted without consent, but rather that various aspects of the design and conduct of RCTs are in tension with physicians' duties of personal care to their patients. Although Fried does argue that the existence of equipoise cannot justify failure to obtain consent from research subjects, informed consent by itself does not supplant ill subjects' rights to personalized judgment and care embodied in Fried's equipoise.
The Ethics Of Placebo-Controlled Trials, Charles Weijer, Kathleen Glass
The Ethics Of Placebo-Controlled Trials, Charles Weijer, Kathleen Glass
Charles Weijer
No abstract provided.
Minimal Risk And Its Implications, Charles Weijer
Minimal Risk And Its Implications, Charles Weijer
Charles Weijer
No abstract provided.
Benefit-Sharing And Other Protections For Communities In Genetic Research, Charles Weijer
Benefit-Sharing And Other Protections For Communities In Genetic Research, Charles Weijer
Charles Weijer
No abstract provided.
Clinical Equipoise And Not The Uncertainty Principle Is The Moral Underpinning Of The Randomised Controlled Trial, Charles Weijer, Stanley Shapiro, Kathleen Glass
Clinical Equipoise And Not The Uncertainty Principle Is The Moral Underpinning Of The Randomised Controlled Trial, Charles Weijer, Stanley Shapiro, Kathleen Glass
Charles Weijer
No abstract provided.
Reporting The Study Populations Of Clinical Trials. Clear Transmission Or Static On The Line?, Stanley Shapiro, Charles Weijer, Benjamin Freedman
Reporting The Study Populations Of Clinical Trials. Clear Transmission Or Static On The Line?, Stanley Shapiro, Charles Weijer, Benjamin Freedman
Charles Weijer
In contrast to attempts that have been made to measure the clarity of reporting of the methods of clinical trials in journal articles, we report here an attempt to measure the accuracy of methods reporting. We focus in this article on eligibility criteria as a test case for the reporting of clinical trial methods. We examined the reporting of eligibility criteria in the protocol, methods paper (if applicable), journal article, and Clinical Alert for articles appearing in print between January 1988 and September 1994 for which a Clinical Alert had been issued. Eligibility criteria were further classified into five categories …
What's The Price Of A Research Subject?, Charles Weijer
What's The Price Of A Research Subject?, Charles Weijer
Charles Weijer
No abstract provided.
Protecting Communities In Research: Philosophical And Pragmatic Challenges, Charles Weijer
Protecting Communities In Research: Philosophical And Pragmatic Challenges, Charles Weijer
Charles Weijer
The issue of the protection of communities in clinical research first arose 10 years ago in studies conducted in technologically developing countries by scientists from technologically developed nations. The question was, which ethical standards ought to apply, those of the Western investigators or local standards?
Voting Ourselves Rights: A Critique Of The Canadian Medical Association Charter For Physicians, Nuala Kenny, Charles Weijer, Francoise Baylis
Voting Ourselves Rights: A Critique Of The Canadian Medical Association Charter For Physicians, Nuala Kenny, Charles Weijer, Francoise Baylis
Charles Weijer
No abstract provided.
Another Tuskegee?, Charles Weijer
Placebo-Controlled Studies In Schizophrenia: Ethical And Scientific Perspectives. Panel Discussion, T. Lemmens, P. Appelbaum, W. Carpenter, C. Mccarthy, C. Peterson, D. Streiner, Charles Weijer
Placebo-Controlled Studies In Schizophrenia: Ethical And Scientific Perspectives. Panel Discussion, T. Lemmens, P. Appelbaum, W. Carpenter, C. Mccarthy, C. Peterson, D. Streiner, Charles Weijer
Charles Weijer
No abstract provided.
Placebo-Controlled Trials In Schizophrenia: Are They Ethical? Are They Necessary?, Charles Weijer
Placebo-Controlled Trials In Schizophrenia: Are They Ethical? Are They Necessary?, Charles Weijer
Charles Weijer
The current controversy as to the proper role of the placebo control in the evaluation of new treatments for schizophrenia requires an analysis that is sensitive to both ethical and scientific issues. Clinical equipoise, widely regarded as the moral foundation of the randomized controlled trial (RCT), requires the use of best available treatment as the control in RCT. Scientific criticisms of the use of an active control are examined and none present an insuperable barrier to the use of an active control. Indeed, scrutiny of the most recent argument for the use of placebo controls, 'assay sensitivity', suggests that the …
Bioethics For Clinicians: 16. Dealing With Demands For Inappropriate Treatment, Charles Weijer, Peter Singer, Bernard Dickens, Stephen Workman
Bioethics For Clinicians: 16. Dealing With Demands For Inappropriate Treatment, Charles Weijer, Peter Singer, Bernard Dickens, Stephen Workman
Charles Weijer
Demands by Patients or their Families for treatment thought to be inappropriate by health care providers constitute an important set of moral problems in clinical practice. A variety of approaches to such cases have been described in the literature, including medical futility, standard of care and negotiation. Medical futility fails because it confounds morally distinct cases: demand for an ineffective treatment and demand for an effective treatment that supports a controversial end (e.g., permanent unconsciousness). Medical futility is not necessary in the first case and is harmful in the second. Ineffective treatment falls outside the standard of care, and thus …
Self Interest Is Not The Sole Legitimate Basis For Making Decisions, Charles Weijer
Self Interest Is Not The Sole Legitimate Basis For Making Decisions, Charles Weijer
Charles Weijer
No abstract provided.
Cardiopulmonary Resuscitation For Patients In A Persistent Vegetative State: Futile Or Acceptable?, Charles Weijer
Cardiopulmonary Resuscitation For Patients In A Persistent Vegetative State: Futile Or Acceptable?, Charles Weijer
Charles Weijer
No abstract provided.
A Study In Contrasts: Eligibility Criteria In A Twenty-Year Sample Of Nsabp And Pog Clinical Trials, Abraham Fuks, Charles Weijer, Benjamin Freedman, Stanley Shapiro, Myriam Skrutkowska, Amina Riaz
A Study In Contrasts: Eligibility Criteria In A Twenty-Year Sample Of Nsabp And Pog Clinical Trials, Abraham Fuks, Charles Weijer, Benjamin Freedman, Stanley Shapiro, Myriam Skrutkowska, Amina Riaz
Charles Weijer
We studied changes in eligibility criteria--the largest impediment to patient accrual--in two samples of clinical trials. Trials from the NSABP (National Surgical Adjuvant Breast and Bowel Program) and POG (Pediatric Oncology Group) were analyzed. After eliminating duplications, the criteria in each protocol were enumerated and classified according to a novel schema. NSABP trials contained significantly more criteria than POG trials, and added precision criteria (making study populations homogeneous) at a faster rate than POG studies. The difference between NSABP studies (explanatory trials) and POG studies (pragmatic trials) suggest that large numbers of eligibility criteria are not necessary for quality studies. …
Ccnp Position Paper On The Use Of Placebos In Psychiatry, William Friend, Charles Weijer
Ccnp Position Paper On The Use Of Placebos In Psychiatry, William Friend, Charles Weijer
Charles Weijer
No abstract provided.
Evolving Ethical Issues In Selection Of Subjects For Clinical Research, Charles Weijer
Evolving Ethical Issues In Selection Of Subjects For Clinical Research, Charles Weijer
Charles Weijer
Wittgenstein, in his famous critique of philosophy, noted that the influence of an idea can be such that it alters the way that we see the world. “It is like a pair of glasses on our nose through which we see whatever we look at,” he said. “It never occurs to us to take them off.” This view of the power of an idea suggests that the interpretation of an event, and what response this event calls for, can depend upon the view one has of the world. A person who is naive about medical facts may, for example, interpret …
Placebo Orthodoxy In Clinical Research I: Empirical And Methodological Myths, Benjamin Freedman, Charles Weijer, Kathleen Glass
Placebo Orthodoxy In Clinical Research I: Empirical And Methodological Myths, Benjamin Freedman, Charles Weijer, Kathleen Glass
Charles Weijer
No abstract provided.
Placebo Orthodoxy In Clinical Research Ii: Ethical, Legal, And Regulatory Myths, Benjamin Freedman, Kathleen Glass, Charles Weijer
Placebo Orthodoxy In Clinical Research Ii: Ethical, Legal, And Regulatory Myths, Benjamin Freedman, Kathleen Glass, Charles Weijer
Charles Weijer
No abstract provided.
The Breast Cancer Research Scandal: Addressing The Issues, Charles Weijer
The Breast Cancer Research Scandal: Addressing The Issues, Charles Weijer
Charles Weijer
The three claims put forward by Dr. Roger Poisson to rationalize his enrollment of ineligible subjects in clinical trials do not justify research fraud. None the less, certain lessons for the conduct of clinical research can be learned from the affair: experimental therapies should be made available to technically ineligible subjects when no effective therapy exists for their disease; further research must investigate the possible benefits of clinical-trial participation; broadly based, pragmatic trials must be regarded as the ideal model; and each eligibility criterion in a clinical-trial protocol should be justified.
The Duty To Exclude: Excluding People At Undue Risk From Research, Charles Weijer, Abraham Fuks
The Duty To Exclude: Excluding People At Undue Risk From Research, Charles Weijer, Abraham Fuks
Charles Weijer
The clinical trial is the major investigational tool of clinical medicine. Two recent reports highlight the fact that the most often quoted mechanisms for the protection of research subjects, viz., research ethics board review and eligibility criteria, are insufficient to achieve this end. In this paper, we argue that the prime mechanism for the protection of persons in clinical trials should be the clinical judgement of the physician-investigator. The clinical investigator has a duty to protect subjects from both harm and undue risk. It is argued that the clinical investigator has a duty to screen for, and exclude, potential research …
Case Notes And Carting Of Bioethical Case Consultations, Benjamin Freedman, Charles Weijer, Eugene Bereza
Case Notes And Carting Of Bioethical Case Consultations, Benjamin Freedman, Charles Weijer, Eugene Bereza
Charles Weijer
In summary, the usual elements of a typical health care ethics consultation note might reasonably accommodate the needs and expectations of relevant parties, and would therefore include: 1. identification of the relevant ethical issues, questions, or dilemmas; 2. reference to any relevant facts--medical, nursing, social, psychological, spiritual, legal, political, etc.; 3. a prioritized list of recommendations to improve coordinated care; 4. a clear and concise articulation of relevant arguments, wtih specific reference to the list of recommendations as well as to the institution's overall ethos; 5. a contextual statement, identifying the perceived degree of consensus or support for the recommendations …
In Loco Parentis: Minimal Risk As An Ethical Threshold For Research Upon Children, Benjamin Freedman, Abraham Fuks, Charles Weijer
In Loco Parentis: Minimal Risk As An Ethical Threshold For Research Upon Children, Benjamin Freedman, Abraham Fuks, Charles Weijer
Charles Weijer
No abstract provided.