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Sample records for evidence-based ethical policies

  1. Developing evidence-based ethical policies on the migration of health workers: conceptual and practical challenges.

    PubMed

    Stilwell, Barbara; Diallo, Khassoum; Zurn, Pascal; Dal Poz, Mario R; Adams, Orvill; Buchan, James

    2003-10-28

    It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995. As the global labour market strengthens, it is increasingly highly skilled professionals who are migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers who migrate, but the loss of health human resources for developing countries can mean that the capacity of the health system to deliver health care equitably is compromised. However, data to support claims on both the extent and the impact of migration in developing countries is patchy and often anecdotal, based on limited databases with highly inconsistent categories of education and skills.The aim of this paper is to examine some key issues related to the international migration of health workers in order to better understand its impact and to find entry points to developing policy options with which migration can be managed.The paper is divided into six sections. In the first, the different types of migration are reviewed. Some global trends are depicted in the second section. Scarcity of data on health worker migration is one major challenge and this is addressed in section three, which reviews and discusses different data sources. The consequences of health worker migration and the financial flows associated with it are presented in section four and five, respectively. To illustrate the main issues addressed in the previous sections, a case study based mainly on the United Kingdom is presented in section six. This section includes a discussion on policies and ends by addressing the policy options from a broader perspective. PMID:14613524

  2. Developing evidence-based ethical policies on the migration of health workers: conceptual and practical challenges

    PubMed Central

    Stilwell, Barbara; Diallo, Khassoum; Zurn, Pascal; Dal Poz, Mario R; Adams, Orvill; Buchan, James

    2003-01-01

    It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995. As the global labour market strengthens, it is increasingly highly skilled professionals who are migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers who migrate, but the loss of health human resources for developing countries can mean that the capacity of the health system to deliver health care equitably is compromised. However, data to support claims on both the extent and the impact of migration in developing countries is patchy and often anecdotal, based on limited databases with highly inconsistent categories of education and skills. The aim of this paper is to examine some key issues related to the international migration of health workers in order to better understand its impact and to find entry points to developing policy options with which migration can be managed. The paper is divided into six sections. In the first, the different types of migration are reviewed. Some global trends are depicted in the second section. Scarcity of data on health worker migration is one major challenge and this is addressed in section three, which reviews and discusses different data sources. The consequences of health worker migration and the financial flows associated with it are presented in section four and five, respectively. To illustrate the main issues addressed in the previous sections, a case study based mainly on the United Kingdom is presented in section six. This section includes a discussion on policies and ends by addressing the policy options from a broader perspective. PMID:14613524

  3. Evidence-based ethics? On evidence-based practice and the "empirical turn" from normative bioethics

    PubMed Central

    Goldenberg, Maya J

    2005-01-01

    Background The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics. Discussion The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating the demands of moral pluralism. Rather than appealing to explicit values that are likely not shared by all, "the evidence" is proposed to adjudicate between competing claims. Quantified measures are notably more "neutral" and democratic than liberal markers like "species normal functioning". Yet the positivist notion that claims stand or fall in light of the evidence is untenable; furthermore, the legacy of positivism entails the quieting of empirically non-verifiable (or at least non-falsifiable) considerations like moral claims and judgments. As a result, evidence-based ethics proposes to operate with the implicit normativity that accompanies the production and presentation of all biomedical and scientific facts unchecked. Summary The "empirical turn" in bioethics signals a need for

  4. Evidence-Based Health Policy: A Preliminary Systematic Review

    ERIC Educational Resources Information Center

    Morgan, Gareth

    2010-01-01

    Objective: The development of evidence-based health policy is challenging. This study has attempted to identify some of the underpinning factors that promote the development of evidence based health policy. Methods: A preliminary systematic literature review of published reviews with "evidence based health policy" in their title was conducted…

  5. Ethics in Distance Education: Developing Ethical Policies.

    ERIC Educational Resources Information Center

    Gearhart, Deb

    2001-01-01

    Examines the changing world of education through distance education and discusses the need for ethics in distance education. Explains how to ethically develop policy for distance education, including Internet ethics, good practices guidelines, and involving faculty. (LRW)

  6. [Health economics, medical ethics, and evidence-based medicine].

    PubMed

    Stelmach, Włodzimierz; Bryła, Marek; Stelmach, Iwona; Denys, Andrzej

    2002-12-01

    The paper is based on the assumption that the management on different levels of decision-making requires not only strictly medical knowledge, but also the competence to make use of the acquisitions of health economics as well as certain knowledge of the principles of medical ethics and research methods applied in the evidence-based medicine. So far the relevant scientific literature lacks any attempts to analyse the common and separate features of the three fields mentioned above. Therefore, this paper aims at filling this gap. The objective is going to be met by acquainting the reader with the historical development of the three disciplines. Emphasis will be put on the existing definitions and scope of the health economics, medical ethics and evidence-based medicine. The concluding remarks contain the authors' conviction that this paper will contribute to make the medical environment more interested in the presented issues and thus constitute the first step to work out solutions which could be applied in clinical practice in the future. PMID:12666439

  7. An evidence-based guide for ethics instruction.

    PubMed

    Bebeau, Muriel J

    2014-12-01

    Drawing from multiple sources of evidence, this paper updates previous descriptions (IOM, 2002) of measurement strategies and teaching techniques to promote four theoretically derived abilities thought to be necessary conditions for the responsible conduct of research. Data from three samples (exemplary professionals, professionals disciplined by a licensing board, and graduates who completed an ethics program designed to promote the four interrelated abilities) suggest that development of a moral identity that is consistent with the norms and values of a profession is the driving force that gives rise to ethical sensitivity, ethical reasoning, and ethical implementation. Evidence from the cited studies supports the usefulness of the theoretical model to (a) deconstruct summary judgments about character and see them as abilities that can be assessed and developed; (b) guide the design assessments that are sensitive to the effects of interventions; and (c) augment previous IOM recommendations for the development of meaningful learning activities. PMID:25574261

  8. An Evidence-Based Guide for Ethics Instruction†

    PubMed Central

    Bebeau, Muriel J.

    2014-01-01

    Drawing from multiple sources of evidence, this paper updates previous descriptions (IOM, 2002) of measurement strategies and teaching techniques to promote four theoretically derived abilities thought to be necessary conditions for the responsible conduct of research. Data from three samples (exemplary professionals, professionals disciplined by a licensing board, and graduates who completed an ethics program designed to promote the four interrelated abilities) suggest that development of a moral identity that is consistent with the norms and values of a profession is the driving force that gives rise to ethical sensitivity, ethical reasoning, and ethical implementation. Evidence from the cited studies supports the usefulness of the theoretical model to (a) deconstruct summary judgments about character and see them as abilities that can be assessed and developed; (b) guide the design assessments that are sensitive to the effects of interventions; and (c) augment previous IOM recommendations for the development of meaningful learning activities. PMID:25574261

  9. [Ethics and health policies].

    PubMed

    De los Santos-Briones, Saúl; Cruz-Lavadores, Dulce María

    2005-01-01

    The aim of this essay is highlight the need to establish an ethical frame of reference to formulate public health interventions. Politics and public health programs are viewed as an interaction between people where their own beliefs, moral values and expectations come together. One of the main reasons for the failure of public health interventions is that often they do not focus on the impact they will have in people's belief system and moral values. Aside from economic and epidemiological considerations, public health interventions must take into account essential human principles as self-determination, autonomy, justice, beneficence and non maleficence, social inclusion, equity, co-responsibility, citizenship, pluralism, solidarity, the right to information, privacy, confidentiality and fair treatment among others. International experiences in the establishment of ethical principles that regulate the medical profession constitute a good starting point to show that is possible to achieve a consensus for an ethical frame of reference to formulate public health policies; furthermore the accomplishment of this ethical framework will make public health more humane and dignified PMID:16025995

  10. Social construction and the evidence-based drug policy endeavour.

    PubMed

    Lancaster, Kari

    2014-09-01

    'Evidence-based policy' has become the catch-cry of the drug policy field. A growing literature has been dedicated to better realising the goal of evidence-based drug policy: to maximise the use of the best quality research to inform policy decision-making and help answer the question of 'what works'. Alternative accounts in the policy processes literature conceptualise policy activity as an ambiguous and contested process, and the role of evidence as being only marginally influential. Multiple participants jostle for influence and seek to define what may be regarded as a policy problem, how it may be appropriately addressed, which participants may speak authoritatively, and what knowledge(s) may be brought to bear. The question posited in this article is whether the conceptual shift offered by thinking about policy activity as a process of social construction may be valuable for beginning to explore different perspectives of the evidence-based drug policy endeavour. Within a constructionist account of policy, what counts as valid 'evidence' will always be a constructed notion within a dynamic system, based on the privileging and silencing of participants and discourse, and the contestation of those many positions and perspectives. The social construction account shifts our focus from the inherent value of 'evidence' for addressing 'problems' to the ways in which policy knowledge is made valid, by whom and in what contexts. As such, social construction provides a framework for critically analysing the ways in which 'policy-relevant knowledge' may not be a stable concept but rather one which is constructed through the policy process, and, through a process of validation, is rendered useful. We have limited knowledge in the drug policy field about how this happens; how ambiguity about the problems to be addressed, which voices should be heard, and what activities may be appropriate is contested and managed. By unpicking the values and assumptions which underlie drug

  11. Opportunities and Challenges in Evidence-Based Social Policy. Social Policy Report. Volume 28, Number 4

    ERIC Educational Resources Information Center

    Supplee, Lauren H.; Metz, Allison

    2014-01-01

    Despite a robust body of evidence of effectiveness of social programs, few evidence-based programs have been scaled for population-level improvement in social problems. Since 2010 the federal government has invested in evidence-based social policy by supporting a number of new evidence-based programs and grant initiatives. These initiatives…

  12. Health and Wellness Policy Ethics

    PubMed Central

    Cavico, Frank J.; Mujtaba, Bahaudin G.

    2013-01-01

    This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace. PMID:24596847

  13. Health and wellness policy ethics.

    PubMed

    Cavico, Frank J; Mujtaba, Bahaudin G

    2013-08-01

    This perspective is an ethical brief overview and examination of "wellness" policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a "healthy" lifestyle. The authors address how these policies could adversely affect "non-healthy" employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace. PMID:24596847

  14. Code of Ethics for Rehabilitation Educators and Counselors: A Call for Evidence-Based Practice

    ERIC Educational Resources Information Center

    Burker, Eileen J.; Kazukauskas, Kelly A.

    2010-01-01

    Given the emphasis on evidence-based practice (EBP) in the 2010 Code of Professional Ethics for Rehabilitation Counselors, it has become even more critical for rehabilitation educators and rehabilitation counselors to understand EBP, how to implement it in teaching and in practice, and how to access available EBP resources. This paper defines and…

  15. The Impact of Research on Education Policy in an Era of Evidence-Based Policy

    ERIC Educational Resources Information Center

    Lingard, Bob

    2013-01-01

    Currently, when there is a lot of political talk about the need for "evidence-based policy", and when public policy seeks to calibrate research quality and impact, there is a pressing need to reconsider the relationships between education/al research and education policy. This article seeks to do this, beginning with considerations of the…

  16. Implementing evidence-based policy in a network setting: road safety policy in the Netherlands.

    PubMed

    Bax, Charlotte; de Jong, Martin; Koppenjan, Joop

    2010-01-01

    In the early 1990s, in order to improve road safety in The Netherlands, the Institute for Road Safety Research (SWOV) developed an evidence-based "Sustainable Safety" concept. Based on this concept, Dutch road safety policy, was seen as successful and as a best practice in Europe. In The Netherlands, the policy context has now changed from a sectoral policy setting towards a fragmented network in which safety is a facet of other transport-related policies. In this contribution, it is argued that the implementation strategy underlying Sustainable Safety should be aligned with the changed context. In order to explore the adjustments needed, two perspectives of policy implementation are discussed: (1) national evidence-based policies with sectoral implementation; and (2) decentralized negotiation on transport policy in which road safety is but one aspect. We argue that the latter approach matches the characteristics of the newly evolved policy context best, and conclude with recommendations for reformulating the implementation strategy. PMID:20925155

  17. Ethical practice of evidence-based medicine: A review for plastic surgeons

    PubMed Central

    Ahuja, Rajeev B.

    2013-01-01

    Last decade has witnessed a spurt in articles focused on the topic of evidence-based medicine (EBM) and medical ethics. These articles are not only educative, but draw attention to the changing scenario of medical practice. Surgeons seem a bit less attentive to practice of EBM, more so in the developing world. The theme is now percolating in our realm for demonstrable incorporation of EBM in our practice, which is allegorical of a good physician and is also likely to become demanding legally. In practicing EBM, several conflicts may arise with the ethical vows of medicine. However, majority of these conflicting issues have germinated from a capitalistic approach to medical practice, where the fear of extraneous compulsions dictating prescriptions and procedures in the garb of ‘evidence-based practice’ conflicts ethical behaviour. This review shall appraise the reader with important definitions of medical ethics, EBM and how to incorporate best evidence into ones practice. While, EBM brings objectivity to treatment to derive measurable outcomes it should not become regimented or metamorphose as a pseudonym for defensive medicine to escalate treatment costs. EBM also has several limitations one of which is to place the onus on the practicing physician to search for the best evidence and the other is the resource constraint of practice in the developing world. How a plastic surgery practice could be made to conform to evidence based (EB) procedures is proposed as insufficient surgical skills can pose a serious threat to not only the practice of EB procedures, but to ethical responsibilities as well. In conclusion, it is necessary to incorporate ethical temperance into EB procedures to withstand societal, peer and legal pressures of current times. PMID:23960301

  18. A code of ethics for evidence-based research with ancient human remains.

    PubMed

    Kreissl Lonfat, Bettina M; Kaufmann, Ina Maria; Rühli, Frank

    2015-06-01

    As clinical research constantly advances and the concept of evolution becomes a strong and influential part of basic medical research, the absence of a discourse that deals with the use of ancient human remains in evidence-based research is becoming unbearable. While topics such as exhibition and excavation of human remains are established ethical fields of discourse, when faced with instrumentalization of ancient human remains for research (i.e., ancient DNA extractions for disease marker analyses) the answers from traditional ethics or even more practical fields of bio-ethics or more specific biomedical ethics are rare to non-existent. The Centre for Evolutionary Medicine at the University of Zurich solved their needs for discursive action through the writing of a self-given code of ethics which was written in dialogue with the researchers at the Institute and was published online in Sept. 2011: http://evolutionäremedizin.ch/coe/. The philosophico-ethical basis for this a code of conduct and ethics and the methods are published in this article. PMID:25998650

  19. When Ethics and Policy Collide

    ERIC Educational Resources Information Center

    Hightower, Bynum Blake; Klinker, JoAnn Franklin

    2012-01-01

    This case study explores an ethical dilemma faced by a new junior high school principal. It is appropriate for use in all preparation course work, including the internship. Studies show that novice principal decision making differs from that of experienced principals in moral dilemmas, including following policy versus best interests of the…

  20. Decolonizing the Evidence-Based Education and Policy Movement: Revealing the Colonial Vestiges in Educational Policy, Research, and Neoliberal Reform

    ERIC Educational Resources Information Center

    Shahjahan, Riyad Ahmed

    2011-01-01

    There is a growing body of literature discussing evidence-based education, practice, policy, and decision-making from a critical perspective. In this article, drawing on the literature and policy documents related to evidence-based education in the USA, Britain, and Canada, I join this critique and offer an anticolonial perspective. I argue that…

  1. The curious case of Housing First: the limits of evidence based policy.

    PubMed

    Stanhope, Victoria; Dunn, Kerry

    2011-01-01

    Evidence Based Policy has been articulated and practiced in Europe, particularly under the 'New Labour' policies of the former Labour government in the United Kingdom. In the United States, the impact of research on policy has been inconsistent due to differing relationships between researchers and policy makers. This paper gives an overview of evidence based policy and presents critiques based on its reliance on positivist methods and technical approach to policy making. Using these critiques as a framework, the paper discusses the case of Housing First, a policy adopted by the Bush Administration in order to address the problem of chronic homelessness. The case is an example of research driven policy making but also resulted in a progressive policy being promoted by a conservative administration. In discussing the case, the paper elaborates on the relationship between evidence and policy, arguing that evidence based policy fails to integrate evidence and values into policy deliberations. The paper concludes with alternative models of policy decision making and their implications for research. PMID:21807412

  2. A Critical Assessment of Evidence-Based Policy and Practice in Social Work.

    PubMed

    Diaz, Clive; Drewery, Sian

    2016-01-01

    In this article the authors consider how effective social work has been in terms of evidence-based policies and practice. They consider the role that "evidence" plays in policy making both in the wider context and, in particular, in relation to social work. The authors argue that there are numerous voices in the policy-making process and evidence only plays a minor role in terms of policy development and practice in social work. PMID:27082052

  3. Tobacco plain packaging: Evidence based policy or public health advocacy?

    PubMed

    McKeganey, Neil; Russell, Christopher

    2015-06-01

    In December 2012, Australia became the first country to require all tobacco products be sold solely in standardised or 'plain' packaging, bereft of the manufacturers' trademarked branding and colours, although retaining large graphic and text health warnings. Following the publication of Sir Cyril Chantler's review of the evidence on the effects of plain tobacco packaging, the Ministers of the United Kingdom Parliament voted in March 2015 to implement similar legislation. Support for plain packaging derives from the belief that tobacco products sold in plain packs have reduced appeal and so are more likely to deter young people and non-smokers from starting tobacco use, and more likely to motivate smokers to quit and stay quit. This article considers why support for the plain packaging policy has grown among tobacco control researchers, public health advocates and government ministers, and reviews Australian survey data that speak to the possible introductory effect of plain packaging on smoking prevalence within Australia. The article concludes by emphasising the need for more detailed research to be undertaken before judging the capacity of the plain packaging policy to deliver the multitude of positive effects that have been claimed by its most ardent supporters. PMID:26041731

  4. Views of Evidence-Based Practice: Social Workers' Code of Ethics and Accreditation Standards as Guides for Choice

    ERIC Educational Resources Information Center

    Gambrill, Eileen

    2007-01-01

    Different views of evidence-based practice (EBP) include defining it as the use of empirically-validated treatments and practice guidelines (i.e., the EBPs approach) in contrast to the broad philosophy and related evolving process described by the originators. Social workers can draw on their code of ethics and accreditation standards both to…

  5. Translating evidence-based practices into policy: a case study in Texas.

    PubMed

    Cochran, Gerald; Montgomery, Katherine L; Bell, Holly

    2012-01-01

    Screening and brief intervention (SBI) in health care settings is an evidence-based practice for substance misuse. The Uniform Accident and Sickness Policy Provision Law (UPPL) discourages providers from carrying out SBI by allowing insurers in 26 states to refuse coverage for injuries resulting from intoxication. This project used a qualitative case study methodology to understand how policy-advocacy communication may have impacted the success of UPPL repeal efforts in Texas. Results showed bill progress could have been impeded due to less-effective communication from advocates. These findings suggest the quality of communication may influence the success of evidence-based policy-advocacy for UPPL repeal. PMID:22583026

  6. Stating the Obvious: The European Qualifications Framework is "Not" a Neutral Evidence-Based Policy Tool

    ERIC Educational Resources Information Center

    Cort, Pia

    2010-01-01

    In European Union policy documents, the European Qualifications Framework (EQF) is described as a neutral tool embedded in an evidence-based policy process. Its purpose is to improve the transparency, comparability and portability of qualifications in the European Union. The aim of this article is to denaturalise the EQF discourse through a…

  7. "Perform, Measure Accurately, Optimise": On the Constitution of (Evidence-Based) Education Policy

    ERIC Educational Resources Information Center

    Decuypere, Mathias; Simons, Maarten; Masschelein, Jan

    2011-01-01

    This article takes its point of departure in the current tendency of education policy to become more and more evidence-based. The use of statistics and numbers seems to be a prerequisite for conducting a policy that is both efficient and effective. The kind of knowledge thus produced is regarded as factual and scientific. This article tries to get…

  8. Rationality versus reality: the challenges of evidence-based decision making for health policy makers

    PubMed Central

    2010-01-01

    Background Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the

  9. Economics, ethics, and climate policy

    SciTech Connect

    Howarth, R.B.; Monahan, P.A.

    1992-11-01

    Are the costs of greenhouse gas emissions abatement justified by the perceived benefits of sustained climate stability? Do people of the present generation have a moral right to impose climate risks on their descendants in generations to come? This report examines these questions in light of the emergent facts of climate science and their socioeconomic implications. We consider alternative normative criteria for social decision-making with particular emphasis on cost-benefit analysis and the principle of sustainable development. While each framework yields important insights, we argue that the gross uncertainties associated with climate change and the distribution of impacts between present and future generations constrain the usefulness of cost-benefit criteria in evaluating climate policy. If one accepts the ethical proposition that it is morally wrong to impose catastrophic risks on unborn generations when reducing those risks would not noticeably diminish the quality of life of existing persons, a case can be made for concerted policy action to reduce greenhouse gas emissions.

  10. Economics, ethics, and climate policy

    SciTech Connect

    Howarth, R.B.; Monahan, P.A.

    1992-11-01

    Are the costs of greenhouse gas emissions abatement justified by the perceived benefits of sustained climate stability Do people of the present generation have a moral right to impose climate risks on their descendants in generations to come This report examines these questions in light of the emergent facts of climate science and their socioeconomic implications. We consider alternative normative criteria for social decision-making with particular emphasis on cost-benefit analysis and the principle of sustainable development. While each framework yields important insights, we argue that the gross uncertainties associated with climate change and the distribution of impacts between present and future generations constrain the usefulness of cost-benefit criteria in evaluating climate policy. If one accepts the ethical proposition that it is morally wrong to impose catastrophic risks on unborn generations when reducing those risks would not noticeably diminish the quality of life of existing persons, a case can be made for concerted policy action to reduce greenhouse gas emissions.

  11. Evaluating the evidence base: policies and interventions to address socioeconomic status gradients in health.

    PubMed

    Dow, William H; Schoeni, Robert F; Adler, Nancy E; Stewart, Judith

    2010-02-01

    This chapter discusses the current evidence base for policies that could address socioeconomic status (SES) health gradients in the United States. The present volume has documented an enormous amount of research on the linkages between SES and health, but there are still relatively few studies that rigorously establish the effectiveness of particular policies or interventions in reducing those gradients. Given the difficulty in developing randomized evidence for many types of interventions related to social determinants of health, we argue for conducting policy analysis from a Bayesian perspective. This Bayesian approach combines information on best available theory and evidence regarding probable health benefits and costs of an intervention, providing a framework that also incorporates the probable costs of inaction. The second half of the chapter adopts a ladder metaphor to classify policies and interventions that could reduce SES gradients in population health. Using this framework, we consider the evidence base for various types of policies, focusing primarily on the social determinants of health, under the rubric that "all policy is health policy." We conclude by discussing promising strategies for future strengthening of the evidence base for policy, including the role of health impact assessment. PMID:20201876

  12. Migration, Race and Education: Evidence-Based Policy or Institutional Racism?

    ERIC Educational Resources Information Center

    Warren, Simon

    2007-01-01

    The promise of evidence-based policy is that social scientific research can lead to rational planning that will lead to improved outcomes and life chances for people across the whole spectrum of social provision. This article argues that evidence is politically mobilised to legitimise the reproduction of racial and social advantage and construct…

  13. Ethics in American Health 1: Ethical Approaches to Health Policy

    PubMed Central

    2008-01-01

    I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy. PMID:18703449

  14. Ethics in American health 1: ethical approaches to health policy.

    PubMed

    Ruger, Jennifer Prah

    2008-10-01

    I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy. PMID:18703449

  15. Policy to implementation: evidence-based practice in community mental health – study protocol

    PubMed Central

    2013-01-01

    Background Evidence-based treatments (EBTs) are not widely available in community mental health settings. In response to the call for implementation of evidence-based treatments in the United States, states and counties have mandated behavioral health reform through policies and other initiatives. Evaluations of the impact of these policies on implementation are rare. A systems transformation about to occur in Philadelphia, Pennsylvania, offers an important opportunity to prospectively study implementation in response to a policy mandate. Methods/design Using a prospective sequential mixed-methods design, with observations at multiple points in time, we will investigate the responses of staff from 30 community mental health clinics to a policy from the Department of Behavioral Health encouraging and incentivizing providers to implement evidence-based treatments to treat youth with mental health problems. Study participants will be 30 executive directors, 30 clinical directors, and 240 therapists. Data will be collected prior to the policy implementation, and then at two and four years following policy implementation. Quantitative data will include measures of intervention implementation and potential moderators of implementation (i.e., organizational- and leader-level variables) and will be collected from executive directors, clinical directors, and therapists. Measures include self-reported therapist fidelity to evidence-based treatment techniques as measured by the Therapist Procedures Checklist-Revised, organizational variables as measured by the Organizational Social Context Measurement System and the Implementation Climate Assessment, leader variables as measured by the Multifactor Leadership Questionnaire, attitudes towards EBTs as measured by the Evidence-Based Practice Attitude Scale, and knowledge of EBTs as measured by the Knowledge of Evidence- Based Services Questionnaire. Qualitative data will include semi-structured interviews with a subset of the

  16. Exploring the evidence base for national and regional policy interventions to combat resistance.

    PubMed

    Dar, Osman A; Hasan, Rumina; Schlundt, Jørgen; Harbarth, Stephan; Caleo, Grazia; Dar, Fazal K; Littmann, Jasper; Rweyemamu, Mark; Buckley, Emmeline J; Shahid, Mohammed; Kock, Richard; Li, Henry Lishi; Giha, Haydar; Khan, Mishal; So, Anthony D; Bindayna, Khalid M; Kessel, Anthony; Pedersen, Hanne Bak; Permanand, Govin; Zumla, Alimuddin; Røttingen, John-Arne; Heymann, David L

    2016-01-16

    The effectiveness of existing policies to control antimicrobial resistance is not yet fully understood. A strengthened evidence base is needed to inform effective policy interventions across countries with different income levels and the human health and animal sectors. We examine three policy domains-responsible use, surveillance, and infection prevention and control-and consider which will be the most effective at national and regional levels. Many complexities exist in the implementation of such policies across sectors and in varying political and regulatory environments. Therefore, we make recommendations for policy action, calling for comprehensive policy assessments, using standardised frameworks, of cost-effectiveness and generalisability. Such assessments are especially important in low-income and middle-income countries, and in the animal and environmental sectors. We also advocate a One Health approach that will enable the development of sensitive policies, accommodating the needs of each sector involved, and addressing concerns of specific countries and regions. PMID:26603921

  17. How Evidence Can Be Used to Inform Policy: A Case Study of Early Childhood Evidence-Based Policy Development

    ERIC Educational Resources Information Center

    Britto, Pia Rebello; Cerezo, Adrian; Ogbunugafor, C. Brandon

    2008-01-01

    Albeit science is clear in its support for early childhood, the developmental outcomes for young children, globally, are poor. It is hypothesized that evidence-based policies may be a potential mediator of the application of science to improve the lives and well-being of young children. However, the question arises--at what stage of policy…

  18. Evidence-Based Programming in the Context of Practice and Policy. Social Policy Report. Volume XXIII, Number III

    ERIC Educational Resources Information Center

    McCall, Robert B.

    2009-01-01

    Scholars, practice professionals, and policymakers should welcome the new era of evidence-based programming and policies, but these constituencies need to be realistic about the complexities, uncertainties, and limitations that lie beneath what could easily become a simplistic process. This paper discusses some of the requirements for the…

  19. Evidence-Based Practices in Addiction Treatment: Review and Recommendations for Public Policy

    PubMed Central

    Glasner-Edwards, Suzette; Rawson, Richard

    2010-01-01

    The movement in recent years towards evidence-based practice (EBP) in health care systems and policy has permeated the substance abuse treatment system, leading to a growing number of federal and statewide initiatives to mandate EBP implementation. Nevertheless, due to a lack of consensus in the addiction field regarding procedures or criteria to identify EBPs, the optimal processes for disseminating empirically based interventions into real-world clinical settings have not been identified. Although working lists of interventions considered to be evidence-based have been developed by a number of constituencies advocating for EBP dissemination in addiction treatment settings, the use of EBP lists to form policy-driven mandates has been controversial. This article examines the concept of EBP, critically reviews criteria used to evaluate the evidence basis of interventions, and highlights the manner in which such criteria have been applied in the addictions field. Controversies regarding EBP implementation policies and practices in addiction treatment are described, and suggestions are made to shift the focus of dissemination efforts from manualized psychosocial interventions to specific skill sets that are broadly applicable and easily learned by clinicians. Organizational and workforce barriers to EBP implementation are delineated, with corresponding recommendations to facilitate successful dissemination of evidence-based skills. PMID:20557970

  20. The safety at home study: an evidence base for policy and practice change.

    PubMed

    Doran, Diane; Blais, Régis; Baker, G Ross; Harrison, Margaret B; Lang, Ariella; Macdonald, Marilyn; McShane, Julie; Killackey, Tieghan

    2014-01-01

    This paper explores the policies and practices that are needed to improve the safety of home care in light of the most recent evidence about home care safety in Canada. Four areas for policy and practice change are addressed: 1) the promotion of effective communication processes in home care through cross-sector collaboration, case management and technology innovations; 2) screening for safety risk factors; 3) standardizing care processes, packaging and equipment; and 4) supporting family/caregivers and strengthening clients' ability to engage in therapeutic self-care. Evidence-based strategies for change are presented within the context of the evidence about home care safety issues. PMID:25591609

  1. Informing evidence-based policies for ageing and health in Ghana

    PubMed Central

    Byles, Julie; Aquah, Charles; Amofah, George; Biritwum, Richard; Panisset, Ulysses; Goodwin, James; Beard, John

    2015-01-01

    Abstract Problem Ghana’s population is ageing. In 2011, the Government of Ghana requested technical support from the World Health Organization (WHO) to help revise national policies on ageing and health. Approach We applied WHO’s knowledge translation framework on ageing and health to assist evidence based policy-making in Ghana. First, we defined priority problems and health system responses by performing a country assessment of epidemiologic data, policy review, site visits and interviews of key informants. Second, we gathered evidence on effective health systems interventions in low- middle- and high-income countries. Third, key stakeholders were engaged in a policy dialogue. Fourth, policy briefs were developed and presented to the Ghana Health Services. Local setting Ghana has a well-structured health system that can adapt to meet the health care needs of older people. Relevant changes Six problems were selected as priorities, however after the policy dialogue, only five were agreed as priorities by the stakeholders. The key stakeholders drafted evidence-based policy recommendations that were used to develop policy briefs. The briefs were presented to the Ghana Health Service in 2014. Lessons learnt The framework can be used to build local capacity on evidence-informed policy-making. However, knowledge translation tools need further development to be used in low-income countries and in the field of ageing. The terms and language of the tools need to be adapted to local contexts. Evidence for health system interventions on ageing populations is very limited, particularly for low- and middle-income settings. PMID:25558107

  2. Using knowledge brokering to promote evidence-based policy-making: The need for support structures.

    PubMed Central

    van Kammen, Jessika; de Savigny, Don; Sewankambo, Nelson

    2006-01-01

    Knowledge brokering is a promising strategy to close the "know-do gap" and foster greater use of research findings and evidence in policy-making. It focuses on organizing the interactive process between the producers and users of knowledge so that they can co-produce feasible and research-informed policy options. We describe a recent successful experience with this novel approach in the Netherlands and discuss the requirements for effective institutionalization of knowledge brokering. We also discuss the potential of this approach to assist health policy development in low-income countries based on the experience of developing the Regional East-African Health (REACH)-Policy Initiative. We believe that intermediary organizations, such as regional networks, dedicated institutional mechanisms and funding agencies, can play key roles in supporting knowledge brokering. We recommend the need to support and learn from the brokerage approach to strengthen the relationship between the research and policy communities and hence move towards a stronger culture of evidence-based policy and policy-relevant research. PMID:16917647

  3. Development of evidence-based remote telemetry policy guidelines for a multifacility hospital system.

    PubMed

    George, Karen J; Walsh-Irwin, Colleen; Queen, Caleb; Heuvel, Kimberly Vander; Hawkins, Carrie; Roberts, Susan

    2015-01-01

    Over 10 years ago, the standards for cardiac monitoring were set forth by the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young. The standards were endorsed by the International Society of Computerized Electrocardiology and the American Association of Critical-Care Nurses. The American Heart Association printed the standards as an American Heart Association Scientific Statement. The standards provided direction related to remote telemetry monitoring to acute care hospitals. Since the standards were published, remote monitoring of cardiac patients has increased dramatically prompting research and literature related to appropriate utilization. Appropriate and safe telemetry monitoring requires clearly written evidence-based facility policies. This article describes the process whereby a team of Veterans Hospital Administration nurses from across the country reviewed 70 remote telemetry policies representing 75 Veterans Hospital Administration hospitals for clarity, consistency, and congruency to existing levels of evidence found in the literature. This article describes the processes, successes, and challenges of compiling an evidence-based remote telemetry policy guideline. PMID:25470261

  4. Fetal therapy, ethics and public policies.

    PubMed

    Fletcher, J C

    1992-01-01

    This article reviews the evolution of ethical problems in the first generation of experimental fetal therapy and the prevailing approaches to them. The problems include: review of risks/benefits, case selection, informed consent, twin pregnancies, and refusal of proven fetal therapy. The article further discusses ethical and public policy issues in the lack of U.S. federal support for fetal diagnosis, fetal therapy, and human embryo research. An argument is made for such support, beginning with experimental gene therapy in the fetus. Ethical principles are identified that support an obligation to learn to relieve and treat such human suffering at the earliest time. Contradictions of these principles are also identified in terms of research not now supported. PMID:1503651

  5. The Quality Improvement Demonstration Study: An example of evidence-based policy-making in practice

    PubMed Central

    Shimkhada, Riti; Peabody, John W; Quimbo, Stella A; Solon, Orville

    2008-01-01

    unanticipated findings; introducing sustainable policy interventions based on the reform agenda; and providing results in real-time to policy makers through a combination of venues. Conclusion QIDS demonstrates that a large, prospective, randomized controlled policy experiment can be successfully implemented at a national level as part of sectoral reform. While we believe policy experiments should be used to generate evidence-based health policy, to do this requires opportunity and trust, strong collaborative relationships, and timing. This study nurtures the growing attitude that translation of scientific findings from the bedside to the community can be done successfully and that we should raise the bar on project evaluation and the policy-making process. PMID:18364050

  6. Evidence-based alcohol policy in the Americas: strengths, weaknesses, and future challenges.

    PubMed

    Babor, Thomas F; Caetano, Raul

    2005-01-01

    The objectives of this article are to describe the evidence base for alcohol policy in the Americas, to evaluate the extent to which national policies are likely to have an impact on public health, and to identify areas where alcohol policies could be improved. The paper begins with a brief review of epidemiological surveys of the prevalence of alcohol problems in the Americas. This is followed by an analysis of 32 prevention strategies and interventions in terms of the evidence for their effectiveness, amount of research support, cost to implement, and other feasibility issues. Overall, the strategies and interventions with the greatest amount of empirical support are low blood alcohol concentration levels for driving while intoxicated, controls on alcohol availability, age limits on alcohol purchases, and relatively high alcohol prices. The implications of the evidence are next discussed in relation to alcohol policy initiatives in the Americas, based on an analysis of the extent to which strategies and interventions currently used in 25 countries of the Americas are likely to have a public health impact on alcohol-related problems. The countries that have adopted the policies with the highest expected impact overall are Colombia, Costa Rica, Venezuela, and El Salvador. Nevertheless, the analysis indicates that almost all the countries of the Americas could improve the likelihood of preventing alcohol-related problems. Policy efforts in the developing countries of Latin America should focus on improving countermeasures against driving while intoxicated, measures that alter the drinking context, and limits on physical availability. For the developed, high-income countries of North America the goal should be to prevent deterioration of current drinking patterns and to reduce the overall volume of drinking. Given the low to moderate cost of many of the policies reviewed in this article, it now seems possible for communities and nations to substantially reduce the

  7. New directions in evidence-based policy research: a critical analysis of the literature.

    PubMed

    Oliver, Kathryn; Lorenc, Theo; Innvær, Simon

    2014-01-01

    Despite 40 years of research into evidence-based policy (EBP) and a continued drive from both policymakers and researchers to increase research uptake in policy, barriers to the use of evidence are persistently identified in the literature. However, it is not clear what explains this persistence - whether they represent real factors, or if they are artefacts of approaches used to study EBP. Based on an updated review, this paper analyses this literature to explain persistent barriers and facilitators. We critically describe the literature in terms of its theoretical underpinnings, definitions of 'evidence', methods, and underlying assumptions of research in the field, and aim to illuminate the EBP discourse by comparison with approaches from other fields. Much of the research in this area is theoretically naive, focusing primarily on the uptake of research evidence as opposed to evidence defined more broadly, and privileging academics' research priorities over those of policymakers. Little empirical data analysing the processes or impact of evidence use in policy is available to inform researchers or decision-makers. EBP research often assumes that policymakers do not use evidence and that more evidence - meaning research evidence - use would benefit policymakers and populations. We argue that these assumptions are unsupported, biasing much of EBP research. The agenda of 'getting evidence into policy' has side-lined the empirical description and analysis of how research and policy actually interact in vivo. Rather than asking how research evidence can be made more influential, academics should aim to understand what influences and constitutes policy, and produce more critically and theoretically informed studies of decision-making. We question the main assumptions made by EBP researchers, explore the implications of doing so, and propose new directions for EBP research, and health policy. PMID:25023520

  8. Databases as policy instruments. About extending networks as evidence-based policy

    PubMed Central

    de Bont, Antoinette; Stoevelaar, Herman; Bal, Roland

    2007-01-01

    Background This article seeks to identify the role of databases in health policy. Access to information and communication technologies has changed traditional relationships between the state and professionals, creating new systems of surveillance and control. As a result, databases may have a profound effect on controlling clinical practice. Methods We conducted three case studies to reconstruct the development and use of databases as policy instruments. Each database was intended to be employed to control the use of one particular pharmaceutical in the Netherlands (growth hormone, antiretroviral drugs for HIV and Taxol, respectively). We studied the archives of the Dutch Health Insurance Board, conducted in-depth interviews with key informants and organized two focus groups, all focused on the use of databases both in policy circles and in clinical practice. Results Our results demonstrate that policy makers hardly used the databases, neither for cost control nor for quality assurance. Further analysis revealed that these databases facilitated self-regulation and quality assurance by (national) bodies of professionals, resulting in restrictive prescription behavior amongst physicians. Conclusion The databases fulfill control functions that were formerly located within the policy realm. The databases facilitate collaboration between policy makers and physicians, since they enable quality assurance by professionals. Delegating regulatory authority downwards into a network of physicians who control the use of pharmaceuticals seems to be a good alternative for centralized control on the basis of monitoring data. PMID:18062824

  9. Strengthening vaccination policies in Latin America: an evidence-based approach.

    PubMed

    Tapia-Conyer, Roberto; Betancourt-Cravioto, Miguel; Saucedo-Martínez, Rodrigo; Motta-Murguía, Lourdes; Gallardo-Rincón, Héctor

    2013-08-20

    Despite many successes in the region, Latin American vaccination policies have significant shortcomings, and further work is needed to maintain progress and prepare for the introduction of newly available vaccines. In order to address the challenges facing Latin America, the Commission for the Future of Vaccines in Latin America (COFVAL) has made recommendations for strengthening evidence-based policy-making and reducing regional inequalities in immunisation. We have conducted a comprehensive literature review to assess the feasibility of these recommendations. Standardisation of performance indicators for disease burden, vaccine coverage, epidemiological surveillance and national health resourcing can ensure comparability of the data used to assess vaccination programmes, allowing deeper analysis of how best to provide services. Regional vaccination reference schemes, as used in Europe, can be used to develop best practice models for vaccine introduction and scheduling. Successful models exist for the continuous training of vaccination providers and decision-makers, with a new Latin American diploma aiming to contribute to the successful implementation of vaccination programmes. Permanent, independent vaccine advisory committees, based on the US Advisory Committee on Immunization Practices (ACIP), could facilitate the uptake of new vaccines and support evidence-based decision-making in the administration of national immunisation programmes. Innovative financing mechanisms for the purchase of new vaccines, such as advance market commitments and cost front-loading, have shown potential for improving vaccine coverage. A common regulatory framework for vaccine approval is needed to accelerate delivery and pool human, technological and scientific resources in the region. Finally, public-private partnerships between industry, government, academia and non-profit sectors could provide new investment to stimulate vaccine development in the region, reducing prices in the

  10. Internet Research Ethics and the Policy Gap for Ethical Practice in Online Research Settings

    ERIC Educational Resources Information Center

    Warrell, Jacqueline G.; Jacobsen, Michele

    2014-01-01

    A growing number of education and social science researchers design and conduct online research. In this review, the Internet Research Ethics (IRE) policy gap in Canada is identified along with the range of stakeholders and groups that either have a role or have attempted to play a role in forming better ethics policy. Ethical issues that current…

  11. New directions in evidence-based policy research: a critical analysis of the literature

    PubMed Central

    2014-01-01

    Despite 40 years of research into evidence-based policy (EBP) and a continued drive from both policymakers and researchers to increase research uptake in policy, barriers to the use of evidence are persistently identified in the literature. However, it is not clear what explains this persistence – whether they represent real factors, or if they are artefacts of approaches used to study EBP. Based on an updated review, this paper analyses this literature to explain persistent barriers and facilitators. We critically describe the literature in terms of its theoretical underpinnings, definitions of ‘evidence’, methods, and underlying assumptions of research in the field, and aim to illuminate the EBP discourse by comparison with approaches from other fields. Much of the research in this area is theoretically naive, focusing primarily on the uptake of research evidence as opposed to evidence defined more broadly, and privileging academics’ research priorities over those of policymakers. Little empirical data analysing the processes or impact of evidence use in policy is available to inform researchers or decision-makers. EBP research often assumes that policymakers do not use evidence and that more evidence – meaning research evidence – use would benefit policymakers and populations. We argue that these assumptions are unsupported, biasing much of EBP research. The agenda of ‘getting evidence into policy’ has side-lined the empirical description and analysis of how research and policy actually interact in vivo. Rather than asking how research evidence can be made more influential, academics should aim to understand what influences and constitutes policy, and produce more critically and theoretically informed studies of decision-making. We question the main assumptions made by EBP researchers, explore the implications of doing so, and propose new directions for EBP research, and health policy. PMID:25023520

  12. Scaling up Evidence-based Practices for Children and Families in New York State: Towards Evidence-based Policies on Implementation for State Mental Health Systems

    PubMed Central

    Hoagwood, Kimberly Eaton; Olin, S. Serene; Horwitz, Sarah; McKay, Mary; Cleek, Andrew; Gleacher, Alissa; Lewandowski, Eric; Nadeem, Erum; Acri, Mary; Chor, Ka Ho Brian; Kuppinger, Anne; Burton, Geraldine; Weiss, Dara; Frank, Samantha; Finnerty, Molly; Bradbury, Donna M.; Woodlock, Kristin M.; Hogan, Michael

    2014-01-01

    Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling-out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policy-makers, providers and family support specialists have worked in partnership since 2002 to redesign and evaluate the children’s mental health system. Five system strategies driven by empirically-based practices and organized within a state-supported infrastructure have been used in the child and family service system with over 2,000 providers: (a) business practices; (b) use of health information technologies in quality improvement; (c) specific clinical interventions targeted at common childhood disorders; (d) parent activation; and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems. PMID:24460518

  13. Research-Based Knowledge: Researchers' Contribution to Evidence-Based Practice and Policy Making in Career Guidance

    ERIC Educational Resources Information Center

    Haug, Erik Hagaseth; Plant, Peter

    2016-01-01

    To present evidence for the outcomes of career guidance is increasingly seen as pivotal for a further professionalization of policy making and service provision. This paper puts an emphasis on researchers' contribution to evidence-based practice and policy making in career guidance. We argue for a broader and more pluralistic research strategy to…

  14. Neoliberal Common Sense and Race-Neutral Discourses: A Critique of "Evidence-Based" Policy-Making in School Policing

    ERIC Educational Resources Information Center

    Nolan, Kathleen

    2015-01-01

    The author of this paper uses critical discourse analysis and draws on critical social theory and policy studies to analyze the interdiscursivity between neoliberal common sense discourses around crime and safety and race-neutral discourses, "evidence-based" policy, and the research that supports school policing programs. The author…

  15. Economic Ethics and Industrial Policy: The Analysis of Ethical Standardization

    ERIC Educational Resources Information Center

    Arnal, Juliette

    2008-01-01

    Beyond the presupposed cleavage between economics and ethics, the institutional dimension of economic ethics needs to be emphasized. The firm can use a large scope of instruments in order to formalize economic ethics. The asset of ethical standards is that they represent a specific way of coordination. They engender positive effects such as the…

  16. To what extent are Canadian second language policies evidence-based? Reflections on the intersections of research and policy

    PubMed Central

    Cummins, Jim

    2014-01-01

    The paper addresses the intersections between research findings and Canadian educational policies focusing on four major areas: (a) core and immersion programs for the teaching of French to Anglophone students, (b) policies concerning the learning of English and French by students from immigrant backgrounds, (c) heritage language teaching, and (d) the education of Deaf and hard-of hearing students. With respect to the teaching of French, policy-makers have largely ignored the fact that most core French programs produce meager results for the vast majority of students. Only a small proportion of students (<10%) attend more effective alternatives (e.g., French immersion and Intensive French programs). With respect to immigrant-background students, a large majority of teachers and administrators have not had opportunities to access the knowledge base regarding effective instruction for these students nor have they had opportunities for pre-service or in-service professional development regarding effective instructional practices. Educational policies in most jurisdictions have also treated the linguistic resources that children bring to school with, at best, benign neglect. In some cases (e.g., Ontario) school systems have been explicitly prohibited from instituting enrichment bilingual programs that would promote students’ bilingualism and biliteracy. Finally, with respect to Deaf students, policy-makers have ignored overwhelming research on the positive relationship between academic success and the development of proficiency in natural sign languages, preferring instead to leave uncorrected the proposition that acquisition of languages such as American Sign Language by young children (with or without cochlear implants) will impede children’s language and academic development. The paper reviews the kinds of policies, programs, and practices that could be implemented (at no additional cost) if policy-makers and educators pursued evidence-based educational policies

  17. To what extent are Canadian second language policies evidence-based? Reflections on the intersections of research and policy.

    PubMed

    Cummins, Jim

    2014-01-01

    THE PAPER ADDRESSES THE INTERSECTIONS BETWEEN RESEARCH FINDINGS AND CANADIAN EDUCATIONAL POLICIES FOCUSING ON FOUR MAJOR AREAS: (a) core and immersion programs for the teaching of French to Anglophone students, (b) policies concerning the learning of English and French by students from immigrant backgrounds, (c) heritage language teaching, and (d) the education of Deaf and hard-of hearing students. With respect to the teaching of French, policy-makers have largely ignored the fact that most core French programs produce meager results for the vast majority of students. Only a small proportion of students (<10%) attend more effective alternatives (e.g., French immersion and Intensive French programs). With respect to immigrant-background students, a large majority of teachers and administrators have not had opportunities to access the knowledge base regarding effective instruction for these students nor have they had opportunities for pre-service or in-service professional development regarding effective instructional practices. Educational policies in most jurisdictions have also treated the linguistic resources that children bring to school with, at best, benign neglect. In some cases (e.g., Ontario) school systems have been explicitly prohibited from instituting enrichment bilingual programs that would promote students' bilingualism and biliteracy. Finally, with respect to Deaf students, policy-makers have ignored overwhelming research on the positive relationship between academic success and the development of proficiency in natural sign languages, preferring instead to leave uncorrected the proposition that acquisition of languages such as American Sign Language by young children (with or without cochlear implants) will impede children's language and academic development. The paper reviews the kinds of policies, programs, and practices that could be implemented (at no additional cost) if policy-makers and educators pursued evidence-based educational policies

  18. Evidence-Based Practice in Group Care: The Effects of Policy, Research, and Organizational Practices

    ERIC Educational Resources Information Center

    Stuart, Carol; Sanders, Larry; Gurevich, Maria; Fulton, Robert

    2011-01-01

    This article describes the effect of a province-wide vision of evidence-based and outcome-based services for children and youth and the challenges of implementing evidence-based practice (EBP) and evidence-based treatment (EBT) approaches within group care settings. The paper is based on the results of a survey of group care settings in the…

  19. Improving community health and safety in Canada through evidence-based policies on illegal drugs

    PubMed Central

    Wood, Evan; McKinnon, Moira; Strang, Robert; Kendall, Perry R

    2012-01-01

    Illegal drug use remains a serious threat to community health in Canada, yet there has been a remarkable discordance between scientific evidence and policy in this area, with most resources going to drug use prevention and drug law enforcement activities that have proven ineffective. Conversely, evidence-based drug treatment programs have been chronically underfunded, despite their cost-effectiveness. Similarly, various harm reduction strategies, such as needle exchange, supervised injecting programs and opioid substitution therapy, have also proven effective at reducing drug-related harm but receive limited government support. Accordingly, Canadian society would greatly benefit from reorienting its drug policies on addiction, with consideration of addiction as a health issue, rather than primarily a criminal justice issue. In this context, and in light of the simple reality that drug prohibition has not effectively reduced the availability of most illegal drugs and has instead contributed to a vast criminal enterprise and related violence, among other harms, alternatives should be prioritized for evaluation. PMID:22567081

  20. Written institutional ethics policies on euthanasia: an empirical-based organizational-ethical framework.

    PubMed

    Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Schotsmans, Paul; Gastmans, Chris

    2014-05-01

    As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their institutional responsibility for dealing with euthanasia requests. By means of an interpretative analysis, we conducted a process of reinterpretation of results of former Belgian empirical studies on written institutional ethics policies on euthanasia in dialogue with the existing international literature. The study findings revealed that legal regulations, ethical and care-oriented aspects strongly affected the development, the content, and the impact of written institutional ethics policies on euthanasia. Hence, these three cornerstones-law, care and ethics-constituted the basis for the empirical-based organizational-ethical framework for written institutional ethics policies on euthanasia that is presented in this paper. However, having a euthanasia policy does not automatically lead to more legal transparency, or to a more professional and ethical care practice. The study findings suggest that the development and implementation of an ethics policy on euthanasia as an organizational-ethical instrument should be considered as a dynamic process. Administrators and ethics committees must take responsibility to actively create an ethical climate supporting care providers who have to deal with ethical dilemmas in their practice. PMID:24420744

  1. Scaling up evidence-based practices for children and families in New York State: toward evidence-based policies on implementation for state mental health systems.

    PubMed

    Hoagwood, Kimberly Eaton; Olin, S Serene; Horwitz, Sarah; McKay, Mary; Cleek, Andrew; Gleacher, Alissa; Lewandowski, Eric; Nadeem, Erum; Acri, Mary; Chor, Ka Ho Brian; Kuppinger, Anne; Burton, Geraldine; Weiss, Dara; Frank, Samantha; Finnerty, Molly; Bradbury, Donna M; Woodlock, Kristin M; Hogan, Michael

    2014-01-01

    Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policymakers, providers, and family support specialists have worked in partnership since 2002 to redesign and evaluate the children's mental health system. Five system strategies driven by empirically based practices and organized within a state-supported infrastructure have been used in the child and family service system with more than 2,000 providers: (a) business practices, (b) use of health information technologies in quality improvement, (c) specific clinical interventions targeted at common childhood disorders, (d) parent activation, and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems. PMID:24460518

  2. Biomedical Ethics Policy in Korea: Characteristics and Historical Development

    PubMed Central

    Hahm, Ki-Hyun

    2012-01-01

    Ethical consideration is an inseparable part of policy-making in modern society. Biomedical ethics is an interdisciplinary study of ethical issues that result from advances in medical practices and research. Because these issues often arise at the bedside, society must provide solutions or judgments that are effective and applicable. Thus, the development and progress of biomedical ethics has been made possible via the cooperation of experts from diverse backgrounds. The biomedical ethics discourse should not be seen as a conflict between values but as a collective activity for problem-solving. To support this perspective on ethics discourse, a historical perspective on biomedical ethics in Korea was given emphasis on the participants and their perspectives. Major cases and the changes resulting therefrom were discussed with the agenda proposed. The Korean situation with respect to ethics development shows the interactions between groups participating in policy development and its collaborative nature. PMID:22661876

  3. [Martin Heidegger, beneficence, health, and evidence based medicine--contemplations regarding ethics and complementary and alternative medicine].

    PubMed

    Oberbaum, Menachem; Gropp, Cornelius

    2015-03-01

    Beneficence is considered a core principle of medical ethics. Evidence Based Medicine (EBM) is used almost synonymously with beneficence and has become the gold standard of efficiency of conventional medicine. Conventional modern medicine and EBM in particular are based on what Heidegger called calculative thinking, whereas complementary medicine (CM) is often based on contemplative thinking according to Heidegger's distinction of different thinking processes. A central issue of beneficence is the striving for health and wellbeing. EBM is little concerned directly with wellbeing, though it does claim to aim at improving quality of life by correcting pathological processes and conditions like infectious diseases, ischemic heart disease but also hypertension and hyperlipidemia. On the other hand, wellbeing is central to therapeutic efforts of CM. Scientific methods to gauge results of EBM are quantitative and based on calculative thinking, while results of treatments with CM are expressed in a qualitative way and based on meditative thinking. In order to maximize beneficence it seems important and feasible to use both approaches, by combining EBM and CM in the best interest of the individual patient. PMID:25962251

  4. Ethical and public policy challenges for pharmacogenomics

    PubMed Central

    Gershon, Elliot S.; Alliey-Rodriguez, Ney; Grennan, Kay

    2014-01-01

    It is timely to consider the ethical and social questions raised by progress in pharmacogenomics, based on the current importance of pharmacogenomics for avoidance of predictable side effects of drugs, and for correct choice of medications in certain cancers. It has been proposed that the entire population be genotyped for drug-metabolizing enzyme polymorphisms, as a measure that would prevent many untoward and dangerous drug reactions. Pharmacologic treatment targeting based on genomics of disease can be expected to increase greatly in the coming years. Policy and ethical issues exist on consent for large-scale genomic pharmacogenomic data collection, public vs corporate ownership of genomic research results, testing efficacy and safety of drugs used for rare genomic indications, and accessibility of treatments based on costly research that is applicable to relatively few patients. In major psychiatric disorders and intellectual deficiency, rare and de novo deletion or duplication of chromosomal segments (copy number variation), in the aggregate, are common causes of increased risk. This implies that the policy problems of pharmacogenomics will be particularly important for the psychiatric disorders. PMID:25733960

  5. Framework of policy recommendations for implementation of evidence-based practice: a systematic scoping review

    PubMed Central

    Ubbink, Dirk T; Guyatt, Gordon H; Vermeulen, Hester

    2013-01-01

    Objectives Evidence-based practice (EBP) may help improve healthcare quality. However, not all healthcare professionals and managers use EBP in their daily practice. We systematically reviewed the literature to summarise self-reported appreciation of EBP and organisational infrastructure solutions proposed to promote EBP. Design Systematic review. Two investigators independently performed the systematic reviewing process. Information sources MEDLINE, EMBASE and Cochrane Library were searched for publications between 2000 and 2011. Eligibility criteria for included studies Reviews and surveys of EBP attitude, knowledge, awareness, skills, barriers and facilitators among managers, doctors and nurses in clinical settings. Results We found 31 surveys of fairly good quality. General attitude towards EBP was welcoming. Respondents perceived several barriers, but also many facilitators for EBP implementation. Solutions were proposed at various organisational levels, including (inter)national associations and hospital management promoting EBP, pregraduate and postgraduate education, as well as individual support by EBP mentors on the wards to move EBP from the classroom to the bedside. Conclusions More than 20 years after its introduction, the EBP paradigm has been embraced by healthcare professionals as an important means to improve quality of patient care, but its implementation is still deficient. Policy exerted at microlevel , middlelevel and macrolevel, and supported by professional, educational and managerial role models, may further facilitate EBP. PMID:23355664

  6. Evidence-Based Policy or Policy-Based Evidence? Higher Education Policies and Policymaking 1987-2012

    ERIC Educational Resources Information Center

    Brown, Roger

    2013-01-01

    The article discusses higher education policies and policy making during the period of the author's direct involvement between the mid-80s and the present. The author points to an increasingly ideological form of policy making which has emphasised the economic role of higher education and created a higher education "market". As the…

  7. Poverty Diagnostics Using Poor Data: Strengthening the Evidence Base for Pro-Poor Policy Making in Lesotho

    ERIC Educational Resources Information Center

    May, Julian; Roberts, Benjamin

    2005-01-01

    Increasingly national statistical agencies are being called upon to provide high quality data on a regular basis, to be used by governments for evidence-based policy development. Poverty Reduction Strategy Papers (PRSPs) give impetus to this, and bring a prerequisite for comprehensive "poverty diagnosis." Often the data that are required are not…

  8. The National Nursing Assistant Survey: Improving the Evidence Base for Policy Initiatives to Strengthen the Certified Nursing Assistant Workforce

    ERIC Educational Resources Information Center

    Squillace, Marie R.; Remsburg, Robin E.; Harris-Kojetin, Lauren D.; Bercovitz, Anita; Rosenoff, Emily; Han, Beth

    2009-01-01

    Purpose: This study introduces the first National Nursing Assistant Survey (NNAS), a major advance in the data available about certified nursing assistants (CNAs) and a rich resource for evidence-based policy, practice, and applied research initiatives. We highlight potential uses of this new survey using select population estimates as examples of…

  9. The Institute for the Advancement of Social Work Research: Working to Increase Our Practice and Policy Evidence Base

    ERIC Educational Resources Information Center

    Zlotnik, Joan Levy; Solt, Barbara E.

    2006-01-01

    This invitational update on the Institute for the Advancement of Social Work Research (IASWR) provides an overview of the work and progress toward strengthening the evidence base for social work practice and policy through research. The article includes information regarding IASWR work with its supporting social work organizations to provide a…

  10. The Ethics and Politics in Educational Policy Development and Practice

    ERIC Educational Resources Information Center

    Divala, Joseph Jinja

    2014-01-01

    Policy borrowing and policy travelling are words that are often used to mean the same process to different policy practitioners across the globe. Nevertheless, these ideas are also riddled with both ethical as well as political undertones, such that interchanging them becomes problematic. In reflecting on and responding to some of these debates,…

  11. Evidence-Based Fitness Promotion in an Afterschool Setting: Implementation Fidelity and Its Policy Implications

    ERIC Educational Resources Information Center

    Thaw, Jean M.; Villa, Manuela; Reitman, David; DeLucia, Christian; Gonzalez, Vanessa; Hanson, K. Lori

    2014-01-01

    Little is known about how the adoption of evidence-based physical activity (PA) curricula by out-of-school time (OST) programs affects children's physical fitness, and there are no clear guidelines of what constitutes reasonable gains given the types of PA instruction currently offered in these programs. Using a three-wave,…

  12. State Implementation of Evidence-Based Practice for Youths, Part II: Recommendations for Research and Policy

    ERIC Educational Resources Information Center

    Bruns, Eric J.; Hoagwood, Kimberly Eaton; Rivard, Jeanne C.; Wotring, Jim; Marsenich, Lynne; Carter, Bill

    2008-01-01

    The article surveys the various state-level evidence-based practice (EBP) implementation challenges and strategies adopted for children, youths, and families. The federal government also supports EBP through development and intervention research, training and technical assistance, and evaluation of different planning and implementation strategies.…

  13. Research Ethics Review: Identifying Public Policy and Program Gaps

    PubMed Central

    Strosberg, Martin A.; Gefenas, Eugenijus; Famenka, Andrei

    2014-01-01

    We present an analytical frame-work for use by fellows of the Fogarty International Center–sponsored Advanced Certificate Program in Research Ethics for Central and Eastern Europe to identify gaps in the public policies establishing research ethics review systems that impede them from doing their job of protecting human research subjects. The framework, illustrated by examples from post-Communist countries, employs a logic model based on the public policy and public management literature. This paper is part of a collection of papers analyzing the Fogarty International Center’s International Research Ethics Education and Curriculum program. PMID:24782068

  14. Childhood obesity: a framework for policy approaches and ethical considerations.

    PubMed

    Kersh, Rogan; Stroup, Donna F; Taylor, Wendell C

    2011-09-01

    Although obesity rates among US children have increased during the past 3 decades, effective public policies have been limited, and the quest for workable solutions raises ethical questions. To address these concerns, in 2010, the Robert Wood Johnson Foundation convened an expert panel to consider approaches to the ethics problems related to interventions for childhood obesity. On the basis of recommendations from the expert panel, we propose frameworks for policy approaches and ethical aspects of interventions and evaluation. We present these frameworks in the context of other papers in this collection and make recommendations for public health practice. PMID:21843423

  15. Evidence-Based Decision Making in School District Central Offices: Toward a Policy and Research Agenda

    ERIC Educational Resources Information Center

    Honig, Meredith I.; Coburn, Cynthia

    2008-01-01

    District central office administrators increasingly face policy demands to use "evidence" in their decision making. These demands up the ante on education policy researchers and policy makers to better understand what evidence use in district central offices entails and the conditions that may support it. To that end, the authors conducted a…

  16. Scenarios of London Local Authorities' Engagement with Evidence Bases for Education Policies

    ERIC Educational Resources Information Center

    Al Hallami, Mariam; Brown, Chris

    2014-01-01

    This paper examines the use of research and evidence in the formation of education policy within London local authorities. In particular it explores the policy processes in three local authorities, and observes the role of research and the interplay between research and policy within each. We begin the paper with a general overview of policy…

  17. Implementing Ethics Policies in Developing Countries: Ploughing on Parched Ground?

    ERIC Educational Resources Information Center

    Mazonde, Isaac N.; Jackson-Malete, Jose; Sugarman, Jeremy

    2007-01-01

    It is globally expected that universities will ensure that policies guiding researchers' conduct are in place and adhered to. This expectation is not waived in developing countries. Successful implementation of an ethics policy is facilitated by an appropriate national regulatory framework on which to base the argument for compliance. However, it…

  18. [Professional practice and ethics in the context of health policies].

    PubMed

    Mendes, H W; Caldas Júnior, A L

    2001-05-01

    This work addressed the professional practice in healthcare in the context of social policies in a municipality of São Paulo State, Brazil. It aimed at determining the influences of such policies on professional practices and on the observance of ethical principles and legal precepts established by the Unified Health System. Healthcare professionals responsible for the elaboration of health policies in the municipal district and for coordination of health institutions were interviewed. A fatalistic perception of the health system and a mechanicist vision of facts influenced by the liberal conception was verified. Thus, alternatives for solution of problems are looked at individually, not always in terms of law or ethics. PMID:12040787

  19. Diet Assessment Methods in the Nurses' Health Studies and Contribution to Evidence-Based Nutritional Policies and Guidelines

    PubMed Central

    Satija, Ambika; Rimm, Eric B.; Spiegelman, Donna; Sampson, Laura; Rosner, Bernard; Camargo, Carlos A.; Stampfer, Meir; Willett, Walter C.

    2016-01-01

    Objectives. To review the contribution of the Nurses’ Health Studies (NHSs) to diet assessment methods and evidence-based nutritional policies and guidelines. Methods. We performed a narrative review of the publications of the NHS and NHS II between 1976 and 2016. Results. Through periodic assessment of diet by validated dietary questionnaires over 40 years, the NHSs have identified dietary determinants of diseases such as breast and other cancers; obesity; type 2 diabetes; cardiovascular, respiratory, and eye diseases; and neurodegenerative and mental health disorders. Nutritional biomarkers were assessed using blood, urine, and toenail samples. Robust findings, from the NHSs, together with evidence from other large cohorts and randomized dietary intervention trials, have contributed to the evidence base for developing dietary guidelines and nutritional policies to reduce intakes of trans fat, saturated fat, sugar-sweetened beverages, red and processed meats, and refined carbohydrates while promoting higher intake of healthy fats and carbohydrates and overall healthful dietary patterns. Conclusions. The long-term, periodically collected dietary data in the NHSs, with documented reliability and validity, have contributed extensively to our understanding of the dietary determinants of various diseases, informing dietary guidelines and shaping nutritional policy. PMID:27459459

  20. Developing Science Education Policies: How Far Is It Evidence-Based?

    ERIC Educational Resources Information Center

    Oversby, John; McGregor, Deb

    2012-01-01

    Construction of science education policy is, for most practising educators, somewhat shrouded in mist. Policies are currently conveyed by the present Secretary of State with responsibility for education through presentations of governmental papers and curricular documents. While it may seem strange that a politician can be elected one day, and…

  1. Ethics and policy: dealing with public attitudes.

    PubMed

    Sheehan, M

    2008-01-01

    The current trend towards ethical scrutiny and oversight is very much a social trend. Many of the results of this trend are perfectly reasonable but some go harmfully too far. In this paper, caution is advocated about public attitudes and social trends. Although there is often a degree of truth in them, there is an inevitable simplification of the issues involved. The more specific danger for the professions is to think that public attitudes and social trends simply deliver 'the ethical'. In this context a more adequate account of ethics is considered--one that is relevant for professions like radiology confronting the demands of ethical scrutiny and oversight. The paper concludes with some suggestions about how to incorporate the important aspects of public attitudes and social trends without being subservient to them. PMID:18593686

  2. Fostering integrity in postgraduate research: an evidence-based policy and support framework.

    PubMed

    Mahmud, Saadia; Bretag, Tracey

    2014-01-01

    Postgraduate research students have a unique position in the debate on integrity in research as students and novice researchers. To assess how far policies for integrity in postgraduate research meet the needs of students as "research trainees," we reviewed online policies for integrity in postgraduate research at nine particular Australian universities against the Australian Code for Responsible Conduct of Research (the Code) and the five core elements of exemplary academic integrity policy identified by Bretag et al. (2011 ), i.e., access, approach, responsibility, detail, and support. We found inconsistency with the Code in the definition of research misconduct and a lack of adequate detail and support. Based on our analysis, previous research, and the literature, we propose a framework for policy and support for postgraduate research that encompasses a consistent and educative approach to integrity maintained across the university at all levels of scholarship and for all stakeholders. PMID:24228976

  3. Fighting Crime by Fighting Misconceptions and Blind Spots in Policy Theories: An Evidence-Based Evaluation of Interventions and Assumed Causal Mechanisms

    ERIC Educational Resources Information Center

    van Noije, Lonneke; Wittebrood, Karin

    2010-01-01

    How effective are policy interventions to fight crime and how valid is the policy theory that underlies them? This is the twofold research question addressed in this article, which presents an evidence-based evaluation of Dutch social safety policy. By bridging the gap between actual effects and assumed effects, this study seeks to make fuller use…

  4. Evidence-Based Reading Policy in the United States: How Scientific Research Informs Instructional Practices

    ERIC Educational Resources Information Center

    Lyon, G. Reid; Shaywitz, Sally E.; Shaywitz, Bennett A.; Chhabra, Vinita

    2005-01-01

    Representing a dramatic shift in education thinking, converging evidence now supports a reliance on findings from rigorous scientific research to guide education policy initiatives in the United States. Particularly for early reading instruction, scientific research has provided the framework for establishing the most effective measures for the…

  5. Richness or Rigour? A Discussion of Systematic Reviews and Evidence-Based Policy in Early Childhood

    ERIC Educational Resources Information Center

    Penn, Helen; Lloyd, Eva

    2007-01-01

    In this article, the authors report on the experiences of the Early Years Review Group, one of a number of education groups contracted to carry out systematic reviews for the Evidence for Policy and Practice Information and Coordinating (EPPI) Centre in the United Kingdom. The Early Years Review Group has carried out three systematic reviews: one…

  6. Coordinated and Evidence-Based Policy and Practice for Protecting Children outside of Family Care

    ERIC Educational Resources Information Center

    Boothby, Neil; Balster, Robert L.; Goldman, Philip; Wessells, Michael G.; Zeanah, Charles H.; Huebner, Gillian; Garbarino, James

    2012-01-01

    The 2011 U.S. Government Evidence Summit on Protecting Children Outside of Family Care brought together leading researchers and technical experts to assess the available evidence to inform policies, strategies, and programs relevant to protecting children outside of family care in lower and middle income countries. While child vulnerabilities are…

  7. Policies and Procedures That Facilitate Implementation of Evidence-Based Clinical Guidelines in U.S. Dental Schools.

    PubMed

    Polk, Deborah E; Nolan, Beth A D; Shah, Nilesh H; Weyant, Robert J

    2016-01-01

    The aim of this study was to determine the degree to which dental schools in the United States have policies and procedures in place that facilitate the implementation of evidence-based clinical guidelines. The authors sent surveys to all 65 U.S. dental schools in 2014; responses were obtained from 38 (58%). The results showed that, of the nine policies and procedures examined, only two were fully implemented by 50% or more of the responding schools: guidelines supported through clinical faculty education or available chairside (50%), and students informed of guidelines in both the classroom and clinic (65.8%). Although 92% of the respondents reported having an electronic health record, 80% of those were not using it to track compliance with guidelines. Five schools reported implementing more policies than the rest of the schools. The study found that the approach to implementing guidelines at most of the responding schools did not follow best practices although five schools had an exemplary set of policies and procedures to support guideline implementation. These results suggest that most dental schools are currently not implementing guidelines effectively and efficiently, but that the goal of schools' having a comprehensive implementation program for clinical guidelines is achievable since some are doing so. Future studies should determine whether interventions to improve implementation in dental schools are needed. PMID:26729681

  8. Lessons from Evidence-Based Operating Room Management in Balancing the Needs for Efficient, Effective and Ethical Healthcare

    PubMed Central

    Rosen, A.C.; Dexter, F.

    2009-01-01

    Foglia et al. (in press) describe tension in two veteran's hospitals among managers, clinicians, and patients over allocating appropriate resources to support care and inefficiencies in care delivery. Ultimately ethical healthcare in a system which is committed to caring for an entire population of patients must use its limited resources effectively while not compromising patient safety. This discussion gives examples from operating room management in which systematic analyses of existing data can guide more efficient care delivery. PMID:19326313

  9. Should policy ethics come in two colours: green or white?

    PubMed

    Oswald, Malcolm

    2013-05-01

    When writing about policy, do you think in green or white? If not, I recommend that you do. I suggest that writers and journal editors should explicitly label every policy ethics paper either 'green' or 'white'. A green paper is an unconstrained exploration of a policy question. The controversial 'After-birth abortion' paper is an example. Had it been labelled as 'green', readers could have understood what Giubilini and Minerva explained later: that it was a discussion of philosophical ideas, and not a policy proposal advocating infanticide. A serious policy proposal should be labelled by writer(s) and editor(s) as 'white'. Its purpose should be to influence policy. In order to influence policy, I suggest three essential, and two desirable, characteristics of any white paper. Most importantly, a white paper should be set in the context in which the policy is to be made and applied. PMID:23637437

  10. Ethics and Childhood Vaccination Policy in the United States.

    PubMed

    Hendrix, Kristin S; Sturm, Lynne A; Zimet, Gregory D; Meslin, Eric M

    2016-02-01

    Childhood immunization involves a balance between parents' autonomy in deciding whether to immunize their children and the benefits to public health from mandating vaccines. Ethical concerns about pediatric vaccination span several public health domains, including those of policymakers, clinicians, and other professionals. In light of ongoing developments and debates, we discuss several key ethical issues concerning childhood immunization in the United States and describe how they affect policy development and clinical practice. We focus on ethical considerations pertaining to herd immunity as a community good, vaccine communication, dismissal of vaccine-refusing families from practice, and vaccine mandates. Clinicians and policymakers need to consider the nature and timing of vaccine-related discussions and invoke deliberative approaches to policy-making. PMID:26691123

  11. Comparative Effectiveness Research and Evidence-Based Health Policy: Experience from Four Countries

    PubMed Central

    Chalkidou, Kalipso; Tunis, Sean; Lopert, Ruth; Rochaix, Lise; Sawicki, Peter T; Nasser, Mona; Xerri, Bertrand

    2009-01-01

    Context The discussion about improving the efficiency, quality, and long-term sustainability of the U.S. health care system is increasingly focusing on the need to provide better evidence for decision making through comparative effectiveness research (CER). In recent years, several other countries have established agencies to evaluate health technologies and broader management strategies to inform health care policy decisions. This article reviews experiences from Britain, France, Australia, and Germany. Methods This article draws on the experience of senior technical and administrative staff in setting up and running the CER entities studied. Besides reviewing the agencies' websites, legal framework documents, and informal interviews with key stakeholders, this analysis was informed by a workshop bringing together U.S. and international experts. Findings This article builds a matrix of features identified from the international models studied that offer insights into near-term decisions about the location, design, and function of a U.S.-based CER entity. While each country has developed a CER capacity unique to its health system, elements such as the inclusiveness of relevant stakeholders, transparency in operation, independence of the central government and other interests, and adaptability to a changing environment are prerequisites for these entities' successful operation. Conclusions While the CER entities evolved separately and have different responsibilities, they have adopted a set of core structural, technical, and procedural principles, including mechanisms for engaging with stakeholders, governance and oversight arrangements, and explicit methodologies for analyzing evidence, to ensure a high-quality product that is relevant to their system. PMID:19523121

  12. Ethics and policy of medical brain drain: a review.

    PubMed

    Kollar, Eszter; Buyx, Alena

    2013-01-01

    Health-worker migration, commonly called "medical brain drain", refers to the mass migration of trained and skilled health professionals (doctors, nurses, midwives) from low-income to high-income countries. This is currently leaving a significant number of poor countries, particularly in sub-Saharan Africa, with critical staff shortages in the healthcare sector. A broad consensus exists that, where medical brain drain exacerbates such shortages, it is unethical, and this review presents the main arguments underpinning this view. Notwithstanding the general agreement, which policies are justifiable on ethical grounds to tackle brain drain and how best to go about implementing them remains controversial. The review offers a discussion of the specific ethical issues that have to be taken into account when deciding which policy measures to prioritise and suggests a strategy of policy implementation to address medical brain drain as a matter of urgency. PMID:24163012

  13. Evidence-Based Health Care Policy in Reimbursement Decisions: Lessons from a Series of Six Equivocal Case-Studies

    PubMed Central

    Van Herck, Pieter; Annemans, Lieven; Sermeus, Walter; Ramaekers, Dirk

    2013-01-01

    Context Health care technological evolution through new drugs, implants and other interventions is a key driver of healthcare spending. Policy makers are currently challenged to strengthen the evidence for and cost-effectiveness of reimbursement decisions, while not reducing the capacity for real innovations. This article examines six cases of reimbursement decision making at the national health insurance authority in Belgium, with outcomes that were contested from an evidence-based perspective in scientific or public media. Methods In depth interviews with key stakeholders based on the adapted framework of Davies allowed us to identify the relative impact of clinical and health economic evidence; experience, expertise & judgment; financial impact & resources; values, ideology & political beliefs; habit & tradition; lobbyists & pressure groups; pragmatics & contingencies; media attention; and adoption from other payers & countries. Findings Evidence was not the sole criterion on which reimbursement decisions were based. Across six equivocal cases numerous other criteria were perceived to influence reimbursement policy. These included other considerations that stakeholders deemed crucial in this area, such as taking into account the cost to the patient, and managing crisis scenarios. However, negative impacts were also reported, in the form of bypassing regular procedures unnecessarily, dominance of an opinion leader, using information selectively, and influential conflicts of interest. Conclusions ‘Evidence’ and ‘negotiation’ are both essential inputs of reimbursement policy. Yet, purposely selected equivocal cases in Belgium provide a rich source to learn from and to improve the interaction between both. We formulated policy recommendations to reconcile the impact of all factors identified. A more systematic approach to reimburse new care may be one of many instruments to resolve the budgetary crisis in health care in other countries as well, by separating

  14. Food and beverage policies and public health ethics.

    PubMed

    Resnik, David B

    2015-06-01

    Government food and beverage policies can play an important role in promoting public health. Few people would question this assumption. Difficult questions can arise, however, when policymakers, public health officials, citizens, and businesses deliberate about food and beverage policies, because competing values may be at stake, such as public health, individual autonomy, personal responsibility, economic prosperity, and fairness. An ethically justified policy strikes a reasonable among competing values by meeting the following criteria: (1) the policy serves important social goal(s); (2) the policy is likely to be effective at achieving those goal(s); (3) less burdensome options are not likely to be effective at achieving the goals; (4) the policy is fair. PMID:24132618

  15. Reiki and related therapies in the dialysis ward: an evidence-based and ethical discussion to debate if these complementary and alternative medicines are welcomed or banned

    PubMed Central

    2013-01-01

    Background Complementary and Alternative Medicines (CAMs) are increasingly practiced in the general population; it is estimated that over 30% of patients with chronic diseases use CAMs on a regular basis. CAMs are also used in hospital settings, suggesting a growing interest in individualized therapies. One potential field of interest is pain, frequently reported by dialysis patients, and seldom sufficiently relieved by mainstream therapies. Gentle-touch therapies and Reiki (an energy based touch therapy) are widely used in the western population as pain relievers. By integrating evidence based approaches and providing ethical discussion, this debate discusses the pros and cons of CAMs in the dialysis ward, and whether such approaches should be welcomed or banned. Discussion In spite of the wide use of CAMs in the general population, few studies deal with the pros and cons of an integration of mainstream medicine and CAMs in dialysis patients; one paper only regarded the use of Reiki and related practices. Widening the search to chronic pain, Reiki and related practices, 419 articles were found on Medline and 6 were selected (1 Cochrane review and 5 RCTs updating the Cochrane review). According to the EBM approach, Reiki allows a statistically significant but very low-grade pain reduction without specific side effects. Gentle-touch therapy and Reiki are thus good examples of approaches in which controversial efficacy has to be balanced against no known side effect, frequent free availability (volunteer non-profit associations) and easy integration with any other pharmacological or non pharmacological therapy. While a classical evidence-based approach, showing low-grade efficacy, is likely to lead to a negative attitude towards the use of Reiki in the dialysis ward, the ethical discussion, analyzing beneficium (efficacy) together with non maleficium (side effects), justice (cost, availability and integration with mainstream therapies) and autonomy (patients

  16. Ebola Virus Disease: Ethics and Emergency Medical Response Policy.

    PubMed

    Jecker, Nancy S; Dudzinski, Denise M; Diekema, Douglas S; Tonelli, Mark

    2015-09-01

    Caring for patients affected with Ebola virus disease (EVD) while simultaneously preventing EVD transmission represents a central ethical challenge of the EVD epidemic. To address this challenge, we propose a model policy for resuscitation and emergent procedure policy of patients with EVD and set forth ethical principles that lend support to this policy. The policy and principles we propose bear relevance beyond the EVD epidemic, offering guidance for the care of patients with other highly contagious, virulent, and lethal diseases. The policy establishes (1) a limited code status for patients with confirmed or suspected EVD. Limited code status means that a code blue will not be called for patients with confirmed or suspected EVD at any stage of the disease; however, properly protected providers (those already in full protective equipment) may initiate resuscitative efforts if, in their clinical assessment, these efforts are likely to benefit the patient. The policy also requires that (2) resuscitation not be attempted for patients with advanced EVD, as resuscitation would be medically futile; (3) providers caring for or having contact with patients with confirmed or suspected EVD be properly protected and trained; (4) the treating team identify and treat in advance likely causes of cardiac and respiratory arrest to minimize the need for emergency response; (5) patients with EVD and their proxies be involved in care discussions; and (6) care team and provider discretion guide the care of patients with EVD. We discuss ethical issues involving medical futility and the duty to avoid harm and propose a utilitarian-based principle of triage to address resource scarcity in the emergency setting. PMID:25855946

  17. Pesticide testing in humans: ethics and public policy.

    PubMed Central

    Oleskey, Christopher; Fleischman, Alan; Goldman, Lynn; Hirschhorn, Kurt; Landrigan, Philip J; Lappé, Marc; Marshall, Mary Faith; Needleman, Herbert; Rhodes, Rosamond; McCally, Michael

    2004-01-01

    Pesticide manufacturers have tested pesticides increasingly in human volunteers over the past decade. The apparent goal of these human studies is to establish threshold levels for symptoms, termed "no observed effect levels." Data from these studies have been submitted to the U.S. Environmental Protection Agency (EPA) for consideration in standard setting. There are no required ethical guidelines for studies of pesticides toxicity conducted in humans, no governmental oversight is exercised, and no procedures have been put in place for the protection of human subjects. To examine ethical and policy issues involved in the testing of pesticides in humans and the use of human data in standard setting, in February 2002 the Center for Children's Health and the Environment of the Mount Sinai School of Medicine convened an expert workshop for ethicists, physicians, toxicologists, and policy analysts. After a peer consensus process, participants developed a number of ethical and public policy recommendations regarding the testing of pesticides in humans. Participants also strongly encouraged active biomonitoring of every pesticide currently in use to track human exposure, particularly in vulnerable populations, and to assess adverse effects on health. PMID:15175182

  18. Employing Policy and Purchasing Levers to Increase the Use of Evidence-Based Practices in Community-Based Substance Abuse Treatment Settings: Reports from Single State Authorities

    ERIC Educational Resources Information Center

    Rieckmann, Traci R.; Kovas, Anne E.; Cassidy, Elaine F.; McCarty, Dennis

    2011-01-01

    State public health authorities are critical to the successful implementation of science based addiction treatment practices by community-based providers. The literature to date, however, lacks examples of state level policy strategies that promote evidence-based practices (EBPs). This mixed-methods study documents changes in two critical…

  19. ETF Yearbook 2012: Evaluation and Monitoring of Vocational Education and Training Systems and the Role of Evidence-Based Policy in Their Reforms

    ERIC Educational Resources Information Center

    European Training Foundation, 2012

    2012-01-01

    The "ETF Yearbook 2012" continues the tradition of highlighting a thematic field of particular importance to the work of the European Training Foundation (ETF). The theme of this yearbook is evaluation and monitoring of vocational education and training (VET) systems and the role of evidence-based policy in VET reforms in ETF partner countries. As…

  20. Informatics, evidence-based care, and research; implications for national policy: a report of an American Medical Informatics Association health policy conference

    PubMed Central

    Detmer, Don E

    2010-01-01

    There is an increased level of activity in the biomedical and health informatics world (e-prescribing, electronic health records, personal health records) that, in the near future, will yield a wealth of available data that we can exploit meaningfully to strengthen knowledge building and evidence creation, and ultimately improve clinical and preventive care. The American Medical Informatics Association (AMIA) 2008 Health Policy Conference was convened to focus and propel discussions about informatics-enabled evidence-based care, clinical research, and knowledge management. Conference participants explored the potential of informatics tools and technologies to improve the evidence base on which providers and patients can draw to diagnose and treat health problems. The paper presents a model of an evidence continuum that is dynamic, collaborative, and powered by health informatics technologies. The conference's findings are described, and recommendations on terminology harmonization, facilitation of the evidence continuum in a “wired” world, development and dissemination of clinical practice guidelines and other knowledge support strategies, and the role of diverse stakeholders in the generation and adoption of evidence are presented. PMID:20190052

  1. Reconstructing data: evidence-based medicine and evidence-based public health in context.

    PubMed

    Nadav, Davidovitch; Dani, Filc

    2006-01-01

    The emergence of Evidence-Based Medicine (EBM) as the gold-standard practice in biomedicine and public health practices represents a significant epistemological turn in modern medicine. The development of Evidence-Based Public Health (EBPH) followed the emergence of Evidence-Based Medicine, as an attempt to ground health policies and interventions on "sound facts". The present paper analyzes the historical and sociological roots of this turn. We evaluate the ethical and social consequences of this transformation, both within the medical profession (the polarization between a medical elite which strengthened its professional status, and a rank and file which experienced a process of "de-professionalization") and in its relationship to the welfare state (the link between the medical elite, EBM, EBPH and the commodification of health care and public health). PMID:17214142

  2. A Proposal for a Policy on the Ethical Care and Use of Cadavers and Their Tissues

    ERIC Educational Resources Information Center

    Champney, Thomas H.

    2011-01-01

    Recent events have occurred that indicate the need for policies on the ethical care and use of cadavers and their tissues in the United States. At present, there are policies that address the procurement, handling and disposition of cadavers, but there are no national or society sponsored policies that clearly state the ethically appropriate use…

  3. Health policy, ethics, and the Kansas Legislative Health Academy.

    PubMed

    Blacksher, Erika; Maree, Gina; Schrandt, Suzanne; Soderquist, Chris; Steffensmeier, Tim; St Peter, Robert

    2015-03-01

    We describe a unique program, the Kansas Legislative Health Academy, that brings together state legislators from across the political spectrum to build their capacity in advancing policies that can improve the health of Kansans. To that end, the academy helps legislators develop new skills to deliberate the ethics of health policy, use systems thinking to understand the long- and short-term effects of policy action and inaction, and engage in acts of civic leadership. The academy also seeks to foster an environment of respectful open dialogue and to build new cross-chamber and cross-party relationships. Among the most important outcomes cited by program participants is the value of sustained, personal interaction and problem solving with individuals holding differing political views. PMID:25607945

  4. Biobanking human embryonic stem cell lines: policy, ethics and efficiency.

    PubMed

    Holm, Søren

    2015-12-01

    Stem cell banks curating and distributing human embryonic stem cells have been established in a number of countries and by a number of private institutions. This paper identifies and critically discusses a number of arguments that are used to justify the importance of such banks in policy discussions relating to their establishment or maintenance. It is argued (1) that 'ethical arguments' are often more important in the establishment phase and 'efficiency arguments' more important in the maintenance phase, and (2) that arguments relating to the interests of embryo and gamete donors are curiously absent from the particular stem cell banking policy discourse. This to some extent artificially isolates this discourse from the broader discussions about the flows of reproductive materials and tissues in modern society, and such isolation may lead to the interests of important actors being ignored in the policy making process. PMID:26758612

  5. New AGU scientific integrity and professional ethics policy available for review

    USGS Publications Warehouse

    Gundersen, Linda C.

    2012-01-01

    The AGU Task Force on Scientific Ethics welcomes your review and comments on AGU's new Scientific Integrity and Professional Ethics Policy. The policy has at its heart a code of conduct adopted from the internationally accepted "Singapore Statement," originally created by the Second World Conference on Research Integrity (http://www.singaporestatement.org/), held in 2010. The new policy also encompasses professional and publishing ethics, providing a single source of guidance to AGU members, officers, authors, and editors

  6. New AGU scientific integrity and professional ethics policy available for review

    NASA Astrophysics Data System (ADS)

    Gundersen, Linda

    2012-09-01

    The AGU Task Force on Scientific Ethics welcomes your review and comments on AGU's new Scientific Integrity and Professional Ethics Policy. The policy has at its heart a code of conduct adopted from the internationally accepted “Singapore Statement,” originally created by the Second World Conference on Research Integrity (http://www.singaporestatement.org/), held in 2010. The new policy also encompasses professional and publishing ethics, providing a single source of guidance to AGU members, officers, authors, and editors.

  7. Improving biomedical journals' ethical policies: the case of research misconduct.

    PubMed

    Bosch, Xavier

    2014-09-01

    Scientific journals may incur scientific error if articles are tainted by research misconduct. While some journals' ethical policies, especially those on conflicts of interest, have improved over recent years, with some adopting a uniform approach, only around half of biomedical journals, principally those with higher impact factors, currently have formal misconduct policies, mainly for handling allegations. Worryingly, since a response to allegations would reasonably require an a priori definition, far fewer journals have publicly available definitions of misconduct. While some journals and editors' associations have taken significant steps to prevent and detect misconduct and respond to allegations, the content, visibility of and access to these policies varies considerably. In addition, while the lack of misconduct policies may prompt and maintain a de novo approach for journals, potentially causing stress, publication delays and even legal disputes, the lack of uniformity may be a matter of contention for research stakeholders such as editors, authors and their institutions, and publishers. Although each case may need an individual approach, I argue that posting highly visible, readily accessible, comprehensive, consistent misconduct policies could prevent the publication of fraudulent papers, increase the number of retractions of already published papers and, perhaps, reduce research misconduct. Although legally problematic, a concerted approach, with sharing of information between editors, which is clearly explained in journal websites, could also help. Ideally, journals, editors' associations, and publishers should seek consistency and homogenise misconduct policies to maintain public confidence in the integrity of biomedical research publications. PMID:24505117

  8. Ethical, Legal, Social, and Policy Implications of Behavioral Genetics

    PubMed Central

    Berryessa, Colleen M.; Cho, Mildred K.

    2015-01-01

    The field of behavioral genetics has engendered a host of moral and social concerns virtually since its inception. The policy implications of a genetic basis for behaviors are widespread and extend beyond the clinic to the socially important realms of education, criminal justice, childbearing, and child rearing. The development of new techniques and analytic approaches, including whole-genome sequencing, noninvasive prenatal genetic testing, and optogenetics, has clearly changed the study of behavioral genetics. However, the social context of biomedical research has also changed profoundly over the past few decades, and in ways that are especially relevant to behavioral genetics. The ever-widening scope of behavioral genetics raises ethical, legal, social, and policy issues in the potential new applications to criminal justice, education, the military, and reproduction. These issues are especially critical to address because of their potentially disproportionate effects on vulnerable populations such as children, the unborn, and the incarcerated. PMID:23452225

  9. Uncommon Commonalities: Cosmopolitan Ethics as a Framework for Music Education Policy Analysis

    ERIC Educational Resources Information Center

    Richerme, Lauren Kapalka

    2016-01-01

    Contemporary American education policy rhetoric is problematic because its authors' assertions, particularly those about the goals of education, frequently conflict with their implied moral and/or ethical commitments. This philosophical policy analysis uses Appiah's cosmopolitan principles to examine the ethical implications of current education…

  10. 7 CFR 1486.511 - What is the general policy regarding ethical conduct?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false What is the general policy regarding ethical conduct? 1486.511 Section 1486.511 Agriculture Regulations of the Department of Agriculture (Continued..., Evaluation, and Compliance § 1486.511 What is the general policy regarding ethical conduct? (a) The...

  11. 7 CFR 1486.511 - What is the general policy regarding ethical conduct?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false What is the general policy regarding ethical conduct? 1486.511 Section 1486.511 Agriculture Regulations of the Department of Agriculture (Continued..., Evaluation, and Compliance § 1486.511 What is the general policy regarding ethical conduct? (a) The...

  12. 7 CFR 1486.511 - What is the general policy regarding ethical conduct?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false What is the general policy regarding ethical conduct? 1486.511 Section 1486.511 Agriculture Regulations of the Department of Agriculture (Continued..., Evaluation, and Compliance § 1486.511 What is the general policy regarding ethical conduct? (a) The...

  13. Is Social Work Evidence-Based? Does Saying So Make It So? Ongoing Challenges in Integrating Research, Practice and Policy

    ERIC Educational Resources Information Center

    Gambrill, Eileen

    2016-01-01

    The integration of research and practice is of concern in all helping professions. Has social work become an evidence-based profession as some claim? Characteristics of current-day social work are presented that dispute this view, related continuing concerns are suggested, and promising developments (mostly outside social work) are described that…

  14. Adapting Evidence-Based Pedagogy to Local Cultural Contexts: A Design Research Study of Policy Borrowing in Vietnam

    ERIC Educational Resources Information Center

    Pham, Thanh Thi Hong; Renshaw, Peter

    2015-01-01

    This study employs design-based research to investigate how university teachers and their students from Vietnam perceived and adapted an evidence-based pedagogy known as "student-teams achievement division" (STAD). Two hundred and twenty one students and their teachers from three classes at a Vietnamese university participated in this…

  15. Policy and Ethics In Agricultural and Ecological Water Uses.

    NASA Astrophysics Data System (ADS)

    Appelgren, Bo

    Agricultural water use accounts for about 70 percent of abstracted waters reaching 92 percent of the collective uses of all water resources when rain water is included. Agriculture is the traditional first sector and linked to a wide range of social, economic and cultural issues at local and global level that reach beyond the production of cheap food and industrial fibres. With the dominance in agricultural water uses and linkages with land use and soil conservation the sector is critical to the protection of global and local environmental values especially in sensitive dryland systems. Ethical principles related to development and nature conservation have traditionally been focused on sustainability imperatives building on precaution and preventive action or on indisputable natural systems values, but are by necessity turning more and more towards solidarity-based risk management approaches. Policy and management have in general failed to consider social dimensions with solidarity, consistency and realism for societal acceptance and practical application. As a consequence agriculture and water related land degradation is resulting in accelerated losses in land productivity and biodiversity in dryland and in humid eco- systems. Increasingly faced with the deer social consequences in the form of large man-made hydrological disasters and with pragmatic requirements driven by drastic increases in the related social cost the preferences are moving to short-term risk management approaches with civil protection objectives. Water scarcity assessment combined with crisis diagnoses and overriding statements on demographic growth, poverty and natural resources scarcity and deteriorating food security in developing countries have become common in the last decades. Such studies are increasingly questioned for purpose, ethical integrity and methodology and lack of consideration of interdependencies between society, economy and environment and of society's capacity to adapt to

  16. Evidence-based dentistry.

    PubMed

    Chambers, David W

    2010-01-01

    Both panegyric and criticism of evidence-based dentistry tend to be clumsy because the concept is poorly defined. This analysis identifies several contributions to the profession that have been made under the EBD banner. Although the concept of clinicians integrating clinical epidemiology, the wisdom of their practices, and patients' values is powerful, its implementation has been distorted by a too heavy emphasis of computerized searches for research findings that meet the standards of academics. Although EBD advocates enjoy sharing anecdotal accounts of mistakes others have made, faulting others is not proof that one's own position is correct. There is no systematic, high-quality evidence that EBD is effective. The metaphor of a three-legged stool (evidence, experience, values, and integration) is used as an organizing principle. "Best evidence" has become a preoccupation among EBD enthusiasts. That overlong but thinly developed leg of the stool is critiqued from the perspectives of the criteria for evidence, the difference between internal and external validity, the relationship between evidence and decision making, the ambiguous meaning of "best," and the role of reasonable doubt. The strongest leg of the stool is clinical experience. Although bias exists in all observations (including searches for evidence), there are simple procedures that can be employed in practice to increase useful and objective evidence there, and there are dangers in delegating policy regarding allowable treatments to external groups. Patient and practitioner values are the shortest leg of the stool. As they are so little recognized, their integration in EBD is problematic and ethical tensions exist where paternalism privileges science over patient's self-determined best interests. Four potential approaches to integration are suggested, recognizing that there is virtually no literature on how the "seat" of the three-legged stool works or should work. It is likely that most dentists

  17. Ethical principles as a guide in implementing policies for the management of food allergies in schools.

    PubMed

    Behrmann, Jason

    2010-06-01

    Food allergy in children is a growing public health problem that carries a significant risk of anaphylaxis such that schools and child care facilities have enacted emergency preparedness policies for anaphylaxis and methods to prevent the inadvertent consumption of allergens. However, studies indicate that many facilities are poorly prepared to handle the advent of anaphylaxis and policies for the prevention of allergen exposure are missing essential components. Furthermore, certain policies are inappropriate because they are blatantly discriminatory. This article aims to provide further guidance for school health officials involved in creating food allergy policies. By structuring policies around ethical principles of confidentiality and anonymity, fairness, avoiding stigmatization, and empowerment, policy makers gain another method to support better policy making. The main ethical principles discussed are adapted from key values in the bioethics and public health ethics literatures and will be framed within the specific context of food allergy policies for schools. PMID:20348215

  18. Elective ventilation for organ donation: law, policy and public ethics

    PubMed Central

    Coggon, John

    2013-01-01

    This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: ‘basic elective ventilation’; ‘epistemically complex elective ventilation’; ‘practically complex elective ventilation’; and ‘epistemically and practically complex elective ventilation’. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation. PMID:23222143

  19. Towards Evidence-Based Policy for Canadian Education = Vers des politiques candiennes d'education fondees sur la recherche.

    ERIC Educational Resources Information Center

    De Broucker, Patrice, Ed.; Sweetman, Arthur, Ed.

    This book is a collection of 19 essays that broadly treat the use of evidence in informing educational policy and practice in Canada: (1) "Knowledge and Action in Educational Policy and Politics" (Benjamin Levin); (2) "Data, Data Everywhere (and We Don't Know What to Do): Using Data for Wise Decisions in Schools" (Lorna M. Earl); (3) "Do Education…

  20. Using Evidence-Based Policy, Systems, and Environmental Strategies to Increase Access to Healthy Food and Opportunities for Physical Activity Among Asian Americans, Native Hawaiians, and Pacific Islanders

    PubMed Central

    Kwon, Simona; Arista, Pedro; Tepporn, Ed; Chung, Marianne; Ko Chin, Kathy; Rideout, Catlin; Islam, Nadia; Trinh-Shevrin, Chau

    2015-01-01

    Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities. PMID:25905839

  1. Using evidence-based policy, systems, and environmental strategies to increase access to healthy food and opportunities for physical activity among Asian Americans, Native Hawaiians, and Pacific Islanders.

    PubMed

    Patel, Shilpa; Kwon, Simona; Arista, Pedro; Tepporn, Ed; Chung, Marianne; Ko Chin, Kathy; Rideout, Catlin; Islam, Nadia; Trinh-Shevrin, Chau

    2015-07-01

    Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities. PMID:25905839

  2. Ethics policies on euthanasia in nursing homes: a survey in Flanders, Belgium.

    PubMed

    Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Verbeke, Geert; Van Craen, Katleen; Schotsmans, Paul; Gastmans, Chris

    2008-01-01

    In many European countries there is a public debate about the acceptability and regulation of euthanasia. In 2002, Belgium became the second country after the Netherlands to enact a law on euthanasia. Although euthanasia rarely occurs, the complexity of the clinical-ethical decision making surrounding euthanasia requests and the need for adequate support reported by caregivers, means that healthcare institutions increasingly need to consider how to responsibly handle euthanasia requests. The development of written ethics policies on euthanasia may be important to guarantee and maintain the quality of care for patients requesting euthanasia. The aim of this study was to determine the prevalence, development, position, and communication of written ethics policies on euthanasia in Flemish nursing homes. Data were obtained through a cross-sectional mail survey of general directors of all Catholic nursing homes in Flanders, Belgium. Of the 737 nursing homes invited to participate, 612 (83%) completed the questionnaire. Of these, only 15% had a written ethics policy on euthanasia. Presence of an ethics committee and membership of an umbrella organization were independent predictors of whether a nursing home had such a written ethics policy. The Act on Euthanasia and euthanasia guidelines advanced by professional organizations were the most frequent reasons (76% and 56%, respectively) and reference sources (92% and 64%, respectively) for developing ethics policies on euthanasia. Development of ethics policies occurred within a multidisciplinary context. In general, Flemish nursing homes applied the Act on Euthanasia restrictively by introducing palliative procedures in addition to legal due care criteria. The policy was communicated to the consulting general practitioner and nurses in 74% and 89% of nursing homes, respectively. Although the overall prevalence of ethics policies on euthanasia was low in Flemish nursing homes, institution administrators displayed growing

  3. Revitalising Evidence-based Policy for the Sendai Framework for Disaster Risk Reduction 2015-2030: Lessons from Existing International Science Partnerships

    PubMed Central

    Carabine, Elizabeth

    2015-01-01

    The convergence of agreements on disaster risk reduction (DRR), development finance, sustainable development and climate change in 2015 presents a unique opportunity for coherence across these inter-related policy areas. At the same time, demand is growing for a more prominent and effective role for science and technology in providing evidence for policy, with the international community recognising that successful disaster risk reduction (DRR) depends on it. Reflecting this ambition, science is included as a core aspect of the Sendai Framework for Disaster Risk Reduction 2015-2030, although the ways in which this will be implemented in practice is still unclear. This paper aims to inform the implementation of international science coordination for DRR by examining a number of existing international science partnerships used across other relevant areas of policy to understand best practice, options for coordination and lessons identified. In the field of DRR, the science-policy interface needs to be strengthened in line with the best practice described in this review. An enhanced UNISDR Scientific and Technical Advisory Group will be given the mandate for to enhance the evidence base for DRR and mobilise science and technical work in coordination with a broad range of stakeholders. The structure and function of an enhanced STAG must be as open, as inclusive and as participatory as possible in order to build trust in new and existing institutions at local, national, regional and global levels. The challenge for the international community is to facilitate evidence-based policy making by formally recognising the links between DRR, development finance, sustainable development and climate change in the upcoming post-2015 agreements. PMID:25969796

  4. Revitalising Evidence-based Policy for the Sendai Framework for Disaster Risk Reduction 2015-2030: Lessons from Existing International Science Partnerships.

    PubMed

    Carabine, Elizabeth

    2015-01-01

    The convergence of agreements on disaster risk reduction (DRR), development finance, sustainable development and climate change in 2015 presents a unique opportunity for coherence across these inter-related policy areas. At the same time, demand is growing for a more prominent and effective role for science and technology in providing evidence for policy, with the international community recognising that successful disaster risk reduction (DRR) depends on it. Reflecting this ambition, science is included as a core aspect of the Sendai Framework for Disaster Risk Reduction 2015-2030, although the ways in which this will be implemented in practice is still unclear. This paper aims to inform the implementation of international science coordination for DRR by examining a number of existing international science partnerships used across other relevant areas of policy to understand best practice, options for coordination and lessons identified. In the field of DRR, the science-policy interface needs to be strengthened in line with the best practice described in this review. An enhanced UNISDR Scientific and Technical Advisory Group will be given the mandate for to enhance the evidence base for DRR and mobilise science and technical work in coordination with a broad range of stakeholders. The structure and function of an enhanced STAG must be as open, as inclusive and as participatory as possible in order to build trust in new and existing institutions at local, national, regional and global levels. The challenge for the international community is to facilitate evidence-based policy making by formally recognising the links between DRR, development finance, sustainable development and climate change in the upcoming post-2015 agreements. PMID:25969796

  5. Evidence-based approach to HIV/AIDS policy and research prioritization in the Islamic Republic of Iran.

    PubMed

    Feizzadeh, A; Nedjat, S; Asghari, S; Keshtkar, A; Heshmat, R; Setayesh, H; Majdzadeh, R

    2010-03-01

    In formulating the second national strategic plan for prevention of HIV/AIDS in the Islamic Republic of Iran a more evidence-based approach was needed. This paper reports on a systematic review of the local evidence about the determinants of HIV/AIDS transmission in 3 categories: poor knowledge and negative attitudes about HIV transmission; injection drug use; and sexual promiscuity. Of 93 reports reviewed, 53 met the inclusion criteria. Information about the prevalence and magnitude of effect for the 3 risk determinants at the national and regional level was scarce. Heterogeneity between studies, even in the same sub-population, was significant. An improved research base and better sharing of information are needed within countries of the Eastern Mediterranean Region. PMID:20795438

  6. Resolving Ethical Dilemmas in Suicide Prevention: The Case of Telephone Helpline Rescue Policies

    ERIC Educational Resources Information Center

    Mishara, Brian L.; Weisstub, David N.

    2010-01-01

    The ethical basis of suicide prevention is illustrated by contrasting helpline emergency rescue policies of the Samaritans and the AAS and the U.S. National Suicide Prevention Lifeline network. We contrast moralist, relativist, and libertarian ethical premises and question whether suicide can be rational. Samaritans respect a caller's right to…

  7. 7 CFR 1486.511 - What is the general policy regarding ethical conduct?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false What is the general policy regarding ethical conduct? 1486.511 Section 1486.511 Agriculture Regulations of the Department of Agriculture (Continued... ethical conduct? (a) The Recipient shall maintain written standards of conduct governing the...

  8. 7 CFR 1486.511 - What is the general policy regarding ethical conduct?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false What is the general policy regarding ethical conduct? 1486.511 Section 1486.511 Agriculture Regulations of the Department of Agriculture (Continued... ethical conduct? (a) The Recipient shall maintain written standards of conduct governing the...

  9. AGU Launches Web Site for New Scientific Integrity and Professional Ethics Policy

    NASA Astrophysics Data System (ADS)

    Townsend, Randy

    2013-03-01

    AGU's Scientific Integrity and Professional Ethics policy, approved by the AGU Board of Directors and Council in December 2012, is now available online on a new Web site, http://ethics.agu.org. As the Web site states, the policy embodies a "set of guidelines for scientific integrity and professional ethics for the actions of the members and the governance of the Union in its internal activities; in its public persona; and most importantly, in the research and peer review processes of its scientific publications, its communications and outreach, and its scientific meetings."

  10. Ethics and the 7 `P`s` of computer use policies

    SciTech Connect

    Scott, T.J.; Voss, R.B.

    1994-12-31

    A Computer Use Policy (CUP) defines who can use the computer facilities for what. The CUP is the institution`s official position on the ethical use of computer facilities. The authors believe that writing a CUP provides an ideal platform to develop a group ethic for computer users. In prior research, the authors have developed a seven phase model for writing CUPs, entitled the 7 P`s of Computer Use Policies. The purpose of this paper is to present the model and discuss how the 7 P`s can be used to identify and communicate a group ethic for the institution`s computer users.

  11. Ethics in perioperative practice--values, integrity, and social policy.

    PubMed

    King, Cecil A; Broom, Catherine

    2002-12-01

    Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and should be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this final article of a nine-part series that is designed to help perioperative nurses relate the ANA code to their own area of practice, the author looks at the ninth provision, which emphasizes the responsibility of professional nursing associations to maintain the value and integrity of the profession. PMID:12528493

  12. The Role of Epidemiology in Evidence-based Policy Making: A Case Study of Tobacco Use in Youth

    PubMed Central

    Aldrich, Melinda C.; Hidalgo, Bertha; Widome, Rachel; Briss, Peter; Brownson, Ross C.; Teutsch, Steven M.

    2014-01-01

    Purpose Sound public health policy is based on relevant and timely information. A brief review of the history of youth tobacco control illustrates the central role of epidemiology to inform policy choices and evaluate their consequences. Methods A narrative review was conducted. Results Epidemiologic studies have shown that most smokers begin as adolescents or young adults and individuals who reach their mid-twenties as non-smokers are unlikely to ever become smokers. This key recognition made it clear that long-term tobacco control must prevent initiation of smoking among youth. Over time, tobacco use prevention interventions have evolved, increasing in reach and effectiveness as they moved from initially focusing on the individual to an approach that targets both populations and communities. Effective interventions for preventing youth smoking include raising tobacco prices, clean indoor air laws, and intensive mass media campaigns. Conclusions Great strides have been made in youth tobacco control but 18% of high school students continue to smoke. It is up to epidemiologists, fellow scientists, practitioners, and advocates to assure that strategies that are known to work are fully implemented as well as to continue to find more successful solutions that can further lower the incidence of youth smoking initiation and can address new tobacco products and changing contexts. PMID:24875267

  13. Reconnecting the Research-Policy-Practice Nexus in Higher Education: "Evidence-Based Policy" in Practice in National and International Contexts

    ERIC Educational Resources Information Center

    Locke, William

    2009-01-01

    It is often claimed that research on higher education has had little or no impact on HE policy-making, which is regarded as being largely driven by political ideology and the media and reinforced by little more than management consultancy. Recent higher education policy, it has been argued, is "a research-free zone" or at best "policy based…

  14. Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy.

    PubMed

    Shonkoff, Jack P; Fisher, Philip A

    2013-11-01

    Half a century of research and program evaluation has fueled a diverse landscape of early childhood policies and practices that produce a range of positive effects on the life prospects of children who face the burdens of significant adversity. Drawing on advances in neurobiology, developmental psychology, developmental psychopathology, and prevention science, this paper presents a framework for elucidating underlying causal mechanisms that explain differences in outcomes, formulating enhanced theories of change about how to shift developmental trajectories, designing creative interventions and rethinking the concept of a two-generation strategy to produce breakthrough impacts, and launching a new era of investment in young children and their families that will achieve greater reductions in intergenerational disparities in learning, behavior, and health than those produced by current best practices. Particular attention is focused on the hypothesis that substantially better outcomes for vulnerable, young children could be achieved by greater attention to strengthening the resources and capabilities of the adults who care for them rather than by continuing to focus primarily on the provision of child-focused enrichment, parenting education, and informal support. Central to achieving this goal is the need to establish an innovation-friendly environment that embraces fast-cycle sharing, supports risk taking, and celebrates learning from failure. PMID:24342860

  15. Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy

    PubMed Central

    Shonkoff, Jack P.; Fisher, Philip A.

    2016-01-01

    Half a century of research and program evaluation has fueled a diverse landscape of early childhood policies and practices that produce a range of positive effects on the life prospects of children who face the burdens of significant adversity. Drawing on advances in neurobiology, developmental psychology, developmental psychopathology, and prevention science, this paper presents a framework for elucidating underlying causal mechanisms that explain differences in outcomes, formulating enhanced theories of change about how to shift developmental trajectories, designing creative interventions and rethinking the concept of a two-generation strategy to produce breakthrough impacts, and launching a new era of investment in young children and their families that will achieve greater reductions in intergenerational disparities in learning, behavior, and health than those produced by current best practices. Particular attention is focused on the hypothesis that substantially better outcomes for vulnerable, young children could be achieved by greater attention to strengthening the resources and capabilities of the adults who care for them rather than by continuing to focus primarily on the provision of child-focused enrichment, parenting education, and informal support. Central to achieving this goal is the need to establish an innovation-friendly environment that embraces fast-cycle sharing, supports risk taking, and celebrates learning from failure. PMID:24342860

  16. Making longevity in an aging society: linking Medicare policy and the new ethical field.

    PubMed

    Kaufman, Sharon R

    2010-01-01

    Life-extending interventions for older persons are changing medical knowledge and societal expectations about longevity. Today's consciousness about growing older is partly shaped by a new form of ethics, constituted by and enabled through the routines and institutions that comprise ordinary clinical care. Unlike bioethics, whose emphasis is on clinical decision-making in individual situations, this new form of ethics is exceptionally diffuse and can be characterized as an ethical field. It is located in and shaped by health-care policies, standard technologies, and clinical evidence, and it emerges in what patients and families come to need and want. Three developments illustrate this ethical field at work: the changing nature of disease, especially the ascent of risk awareness and risk-based strategies for life extension; the role of technology in reshaping the ends of medicine; and the role of Medicare policy in creating need and ethical necessity. Medicare's expanding criteria for payment coverage of liver transplantation and implantable cardiac devices illustrate the pervasive logic of this new form of ethics. The powerful connection between the technological imperative and its ethical necessity is rarely mentioned in Medicare reform debates. PMID:20639608

  17. Policy and ethical issues in applying medical biotechnology in developing countries.

    PubMed

    Bhardwaj, Minakshi; Macer, Darryl R J

    2003-02-01

    A brief review of some of the key issues in policy relating to the ethical issues raised by medical biotechnology in developing countries is presented, using India as an example. A series of some key issues is discussed, including information obtained from interviewing Indian government policy makers. Some of the issues discussed include: Economic and social incentives to encourage biotechnology; Health policy and ethics review; Patents on drugs; Medical genetics; Relationship to traditional medical practices; Positive public attitudes to biotechnology; Limited public participation; Infrastructural hurdles; Indian progress in stem cell research; and dilemmas of expensive technologies. The results show that although the needs of developing countries are different to those of rich countries, government policy utilizing guidelines and ethics committees has evolved as mechanisms to aid ethical health care delivery in India. In all countries there may be some of these concerns that are raised here, however, the integration of traditional medicine and advanced medical technology, and access to medical services by people in need, are particularly important challenges in developing countries. Better public involvement in policy making will require education and infrastructural organization as well as mutual willingness on the part of policy makers and citizens. PMID:12601306

  18. Research Experience and Agreement with Selected Ethics Principles from Canada's "Tri-Council Policy Statement--Ethical Conduct for Research Involving Humans"

    ERIC Educational Resources Information Center

    Fahy, Pat; Spencer, Bob

    2004-01-01

    An online survey was conducted of students, instructors, and researchers in distance education regarding principles for the ethical treatment of human research subjects. The study used an online questionnaire based on principles drawn from Canada's "Tri-Council Policy Statement, Ethical Conduct for Research Involving Humans" (TCPS, 2003), which…

  19. Do Editorial Policies Support Ethical Research? A Thematic Text Analysis of Author Instructions in Psychiatry Journals

    PubMed Central

    Strech, Daniel; Metz, Courtney; Knüppel, Hannes

    2014-01-01

    Introduction According to the Declaration of Helsinki and other guidelines, clinical studies should be approved by a research ethics committee and seek valid informed consent from the participants. Editors of medical journals are encouraged by the ICMJE and COPE to include requirements for these principles in the journal’s instructions for authors. This study assessed the editorial policies of psychiatry journals regarding ethics review and informed consent. Methods and Findings The information given on ethics review and informed consent and the mentioning of the ICMJE and COPE recommendations were assessed within author’s instructions and online submission procedures of all 123 eligible psychiatry journals. While 54% and 58% of editorial policies required ethics review and informed consent, only 14% and 19% demanded the reporting of these issues in the manuscript. The TOP-10 psychiatry journals (ranked by impact factor) performed similarly in this regard. Conclusions Only every second psychiatry journal adheres to the ICMJE’s recommendation to inform authors about requirements for informed consent and ethics review. Furthermore, we argue that even the ICMJE’s recommendations in this regard are insufficient, at least for ethically challenging clinical trials. At the same time, ideal scientific design sometimes even needs to be compromised for ethical reasons. We suggest that features of clinical studies that make them morally controversial, but not necessarily unethical, are analogous to methodological limitations and should thus be reported explicitly. Editorial policies as well as reporting guidelines such as CONSORT should be extended to support a meaningful reporting of ethical research. PMID:24901366

  20. Undocumented Status: Implications for Child Development, Policy, and Ethical Research

    ERIC Educational Resources Information Center

    Suárez-Orozco, Carola; Yoshikawa, Hirokazu

    2013-01-01

    Nearly 5.5 million children in the United States grow up in the shadows of undocumented status. We review the ecological domains of influence in children's and adolescents' lives and briefly consider health, cognitive, socioemotional, educational, and labor market outcomes ripe for study. We also reflect upon the ethical policy…

  1. Current Practice in Research Ethics: Global Trends and New Opportunities for African Universities. Research and Innovation Policy Series. Number 1

    ERIC Educational Resources Information Center

    Roberts, Liam

    2007-01-01

    Research Ethics has emerged as one of the most well-developed policy areas within the sphere of Research and Innovation Management. As such, for African institutions looking to strengthen their policy frameworks, develop increased collaborations, and increase research outputs, a thorough understanding of global trends in Ethics will be vital.…

  2. Balance, Diversity and Ethics in Public Policy Education.

    ERIC Educational Resources Information Center

    Thompson, Paul B.

    Public policy for agriculture and natural resources must change as farming and the use of resources change, but policy also changes to reflect new understandings. The new understandings that will shape future agricultural policy may not come from food producers or agricultural scientists, and may not assume that expanding production is the primary…

  3. The ethics of interrogation and the American Psychological Association: a critique of policy and process.

    PubMed

    Olson, Brad; Soldz, Stephen; Davis, Martha

    2008-01-01

    The Psychological Ethics and National Security (PENS) task force was assembled by the American Psychological Association (APA) to guide policy on the role of psychologists in interrogations at foreign detention centers for the purpose of U.S. national security. The task force met briefly in 2005, and its report was quickly accepted by the APA Board of Directors and deemed consistent with the APA Ethics Code by the APA Ethics Committee. This rapid acceptance was unusual for a number of reasons but primarily because of the APA's long-standing tradition of taking great care in developing ethical policies that protected anyone who might be impacted by the work of psychologists. Many psychological and non-governmental organizations (NGOs), as well as reputable journalists, believed the risk of harm associated with psychologist participation in interrogations at these detention centers was not adequately addressed by the report. The present critique analyzes the assumptions of the PENS report and its interpretations of the APA Ethics Code. We demonstrate that it presents only one (and not particularly representative) side of a complex set of ethical issues. We conclude with a discussion of more appropriate psychological contributions to national security and world peace that better respect and preserve human rights. PMID:18230171

  4. The ethics of interrogation and the American Psychological Association: A critique of policy and process

    PubMed Central

    Olson, Brad; Soldz, Stephen; Davis, Martha

    2008-01-01

    The Psychological Ethics and National Security (PENS) task force was assembled by the American Psychological Association (APA) to guide policy on the role of psychologists in interrogations at foreign detention centers for the purpose of U.S. national security. The task force met briefly in 2005, and its report was quickly accepted by the APA Board of Directors and deemed consistent with the APA Ethics Code by the APA Ethics Committee. This rapid acceptance was unusual for a number of reasons but primarily because of the APA's long-standing tradition of taking great care in developing ethical policies that protected anyone who might be impacted by the work of psychologists. Many psychological and non-governmental organizations (NGOs), as well as reputable journalists, believed the risk of harm associated with psychologist participation in interrogations at these detention centers was not adequately addressed by the report. The present critique analyzes the assumptions of the PENS report and its interpretations of the APA Ethics Code. We demonstrate that it presents only one (and not particularly representative) side of a complex set of ethical issues. We conclude with a discussion of more appropriate psychological contributions to national security and world peace that better respect and preserve human rights. PMID:18230171

  5. Are the American Psychological Association’s Detainee Interrogation Policies Ethical and Effective?

    PubMed Central

    Pope, Kenneth S.

    2011-01-01

    After 9–11, the United States began interrogating detainees at settings such as Abu Ghraib, Bagram, and Guantanamo. The American Psychological Association (APA) supported psychologists’ involvement in interrogations, adopted formal policies, and made an array of public assurances. This article’s purpose is to highlight key APA decisions, policies, procedures, documents, and public statements in urgent need of rethinking and to suggest questions that may be useful in a serious assessment, such as, “However well intended, were APA’s interrogation policies ethically sound?”; “Were they valid, realistic, and able to achieve their purpose?”; “Were other approaches available that would address interrogation issues more directly, comprehensively, and actively, that were more ethically and scientifically based, and that would have had a greater likelihood of success?”; and “Should APA continue to endorse its post-9–11 detainee interrogation policies?” PMID:22096660

  6. Cosmopolitanism and foreign policy for health: ethics for and beyond the state

    PubMed Central

    2013-01-01

    Background Foreign policy holds great potential to improve the health of a global citizenship. Our contemporary political order is, in part, characterized by sovereign states acting either in opposition or cooperation with other sovereign states. This order is also characterized by transnational efforts to address transnational issues such as those featured so prominently in the area of global health, such as the spread of infectious disease, health worker migration and the movement of health-harming products. These two features of the current order understandably create tension for truly global initiatives. Discussion National security has become the dominant ethical frame underlying the health-based foreign policy of many states, despite the transnational nature of many contemporary health challenges. This ethical approach engages global health as a means to achieving national security objectives. Implicit in this ethical frame is the version of humanity that dichotomizes between “us” and “them”. What has been left out of this discourse, for the most part, is the role that foreign policy can play in extending the responsibility of states to protect and promote health of the other, for the sake of the other. Summary The principal purpose of this paper is to review arguments for a cosmopolitan ethics of health-based foreign policy. I will argue that health-based foreign policy that is motivated by security interests is lacking both morally and practically to further global health goals. In other words, a cosmopolitan ethic is not only intrinsically superior as a moral ideal, but also has potential to contribute to utilitarian ends. This paper draws on the cosmopolitanism literature to build robust support for foreign policies that contribute to sustainable systems of global health governance. PMID:23829176

  7. ICCE/ICCAI 2000 Full & Short Papers (Policies, Ethics, Standards, and Legal Issues).

    ERIC Educational Resources Information Center

    2000

    This document contains the following full and short papers on policies, ethics, standards, and legal issues from ICCE/ICCAI 2000 (International Conference on Computers in Education/International Conference on Computer-Assisted Instruction): (1) "A Study on the School Information Technology Pilot Scheme: Possibilities of Creative and Lifelong…

  8. The Potential of Applying Judeo-Christian Ethics to Tax Policy in Foreign Countries

    ERIC Educational Resources Information Center

    Hamill, Susan Pace

    2008-01-01

    This article extends the author's previous domestic analysis of tax policy and education finance under the moral principles of Judeo-Christian ethics to the international arena, beginning with an examination of the English-speaking OECD countries, which are the most economically and culturally similar to the United States. Although the tax and…

  9. Ethical Considerations in a Three-Tiered Approach to School Discipline Policy and Practice

    ERIC Educational Resources Information Center

    Mayworm, Ashley M.; Sharkey, Jill D.

    2014-01-01

    Research indicates that school discipline policies and practices have a significant influence on both student and school functioning. The purpose of this article is to uncover how the ethical standards guiding the field of school psychology inform school decisions about discipline in a three-tiered approach. Various discipline approaches,…

  10. Statement of Jon Baron, President, Coalition for Evidence-Based Policy. House Committee on Ways and Means, Subcommittee on Human Resources Hearing on the Maternal, Infant, and Early Childhood Home Visiting Program

    ERIC Educational Resources Information Center

    Coalition for Evidence-Based Policy, 2014

    2014-01-01

    In his testimony, Jon Baron, president of Coalition for Evidence-Based Policy, recommends reauthorization of the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) Program. He outlines three reasons that support his recommendation: (1) MIECHV represents an important, bipartisan departure from the usual approach to social…

  11. Educational Assessment Policy and Practice: A Matter of Ethics

    ERIC Educational Resources Information Center

    Elwood, Jannette

    2013-01-01

    Long-standing concerns within the field of educational assessment consider the impact of assessment policy and practice as matters of equity, inequality and social justice. Yet educational assessment policy and practice continues to have powerful social consequences for key users such as children and young people. This paper re-positions these…

  12. Policy, Performativity and Partnership: An Ethical Leadership Perspective

    ERIC Educational Resources Information Center

    Elliott, Geoffrey

    2012-01-01

    This paper identifies the need to think differently about educational partnerships in a changing and turbulent post-compulsory policy environment in England. The policy and institutional contexts in which universities and colleges currently operate seem to be fuelling performativity at the expense of educational values. There appears to be a sharp…

  13. Policy makers ignoring science and scientists ignoring policy: the medical ethical challenges of heroin treatment

    PubMed Central

    Small, Dan; Drucker, Ernest

    2006-01-01

    require patients who have been successfully treated with heroin in Canada, to be forced to move back to less effective treatments (treatments that failed to be efficacious in the past)? This essay discusses this dilemma and places it in the broader context of ethics, science, and health policy. It makes the case for continuation of the current successful patients in heroin treatment and the institution of heroin treatment to all Canadian patients living with active addictions who qualify. PMID:16670010

  14. [Shared governance and reasonableness as ethical contributions to health policy].

    PubMed

    Costa-Alcaraz, Ana M; Calvo-Rigual, Fernando; Siurana-Aparisi, Juan Carlos

    2013-01-01

    Health is one of the fundamental human rights. Recognizing it as a right means that the State has an obligation to ensure a minimum level of opportunities is maintained, and to restore it when lost. This minimum level may not be covered in periods of economic crisis, such as the one we are currently experiencing.Managed care, focused on economic questions, emerged after the crisis of 1973 in order to help make clinical decisions based on economic factors. In practice, the result of managed care was to turn economic cost control into an end in itself while forgetting about equity; something for which it has been challenged from an ethical perspective. Since then, many authors have attempted to reconcile efficiency and equity in health management, but the debate remains open.In this article, and basing our approach on the theories of P. Ruger and Norman Daniels, we argue that shared health governance and accountability for reasonableness can offer significant ethical contributions in the process of achieving an efficient and fair health system. In the model we propose, citizens, professionals and health institutions all play an active role in capacity building in the field of health. These capacities are related to healthy lifestyles, accessible and transparent information, the promotion of self-care, the acquisition of knowledge, skills and appropriate attitudes, leadership based on values and co-responsibility to achieve set goals in a reasonable way. If we develop these capacities, we will have used the current economic crisis as an opportunity for improving ethical practice in the field of health. PMID:23775103

  15. Ethics and policy in embryonic stem cell research.

    PubMed

    Robertson, John A

    1999-06-01

    Embryonic stem cells, which have the potential to save many lives, must be recovered from aborted fetuses or live embyros. Although tissue from aborted fetuses can be used without moral complicity in the underlying abortion, obtaining stem cells from embryos necessarily kills them, thus raising difficult questions about the use of embryonic human material to save others. This article draws on previous controversies over embryo research and distinctions between intrinsic and symbolic moral status to analyze these issues. It argues that stem cell research with spare embryos produced during infertility treatment, or even embryos created specifically for research or therapeutic purposes, is ethically acceptable and should receive federal funding. PMID:11660628

  16. Ethical Standards to Guide the Development of Obesity Policies and Programs Comment on “Ethical Agreement and Disagreement about Obesity Prevention Policy in the United States”

    PubMed Central

    Buchanan, David

    2013-01-01

    The recent report by Barnhill and King about obesity prevention policy raises important issues for discussion and analysis. In response, this article raises four points for further consideration. First, a distinction between equality and justice needs to be made and consistently maintained. Second, different theories of justice highlight one additional important source of disagreement about the ethical propriety of the proposed obesity prevention policies. Third, another point of contention arises with respect to different understandings of the principle of respect for autonomy due to its often-mistaken equation with simple, unfettered freedom. Finally, based on a more robust definition of autonomy, the key issues in obesity prevention policies can be suitably re-framed in terms of whether they advance just social conditions that enable people to realize human capabilities to the fullest extent possible. PMID:24596891

  17. Lessons from HeLa Cells: The Ethics and Policy of Biospecimens.

    PubMed

    Beskow, Laura M

    2016-08-31

    Human biospecimens have played a crucial role in scientific and medical advances. Although the ethical and policy issues associated with biospecimen research have long been the subject of scholarly debate, the story of Henrietta Lacks, her family, and the creation of HeLa cells captured the attention of a much broader audience. The story has been a catalyst for policy change, including major regulatory changes proposed in the United States surrounding informed consent. These proposals are premised in part on public opinion data, necessitating a closer look at what such data tell us. The development of biospecimen policy should be informed by many considerations-one of which is public input, robustly gathered, on acceptable approaches that optimize shared interests, including access for all to the benefits of research. There is a need for consent approaches that are guided by realistic aspirations and a balanced view of autonomy within an expanded ethical framework. PMID:26979405

  18. Confidentiality Limits with Clients Who Have HIV: A Review of Ethical and Legal Guidelines and Professional Policies.

    ERIC Educational Resources Information Center

    Harding, Anna K.; And Others

    1993-01-01

    Highlights barrage of ethical issues regarding human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Reviews ethical and legal guidelines pertaining to HIV and AIDS and confidentiality. Summarizes HIV and AIDS confidentiality policies of major helping professional organizations, articulates questions that contribute to…

  19. Ethical and Human Rights Foundations of Health Policy: Lessons from Comprehensive Reform in Mexico.

    PubMed

    Frenk, Julio; Gómez-Dantés, Octavio

    2015-01-01

    This paper discusses the use of an explicit ethical and human rights framework to guide a reform intended to provide universal and comprehensive social protection in health for all Mexicans, independently of their socio-economic status or labor market condition. This reform was designed, implemented, and evaluated by making use of what Michael Reich has identified as the three pillars of public policy: technical, political, and ethical. The use of evidence and political strategies in the design and negotiation of the Mexican health reform is briefly discussed in the first part of this paper. The second part examines the ethical component of the reform, including the guiding concept and values, as well as the specific entitlements that gave operational meaning to the right to health care that was enshrined in Mexico's 1983 Constitution. The impact of this rights-based health reform, measured through an external evaluation, is discussed in the final section. The main message of this paper is that a clear ethical framework, combined with technical excellence and political skill, can deliver major policy results. PMID:26766859

  20. The policies of ethics committees in the management of biobanks used for research: an Italian survey.

    PubMed

    Porteri, Corinna; Togni, Elena; Pasqualetti, Patrizio

    2014-02-01

    Gaps in regulations pertaining to the collection and storage of biological materials in a biobank, at least in the European context, have made the writing of local guidelines essential from an ethical point of view. Nevertheless, until recently, the elaboration of local guidelines for the collection, use and storage of biological materials in a biobank has been the exception in Italy and all European countries. In this context, it is of value to know the policies, even if they are unwritten, of local ethics committees (ECs) engaged in the evaluation of research protocols involving biobanks and biological materials. This paper presents the results of a survey carried out among local Italian ECs (229) to document their attitudes and policies regarding the management of the ethical issues related to biobanks and the use of biological materials. A questionnaire was developed to investigate the areas regarded as critical from an ethical-legal point of view: informed consent and information to the subjects; protection of confidentiality; communication of research results; access/transfer of biological materials and related data; ownership of samples and data and intellectual property rights; and subjects' remuneration and benefit sharing. Twenty-six ECs from the Italian Institutes for Research and Care (62%) and 26 other ECs (14%) participated in the survey. PMID:23695284

  1. Why should we care about ethical and policy challenges in congenital heart disease?

    PubMed

    Kirkpatrick, James N; Kaufman, Beth

    2013-01-01

    Congenital heart disease (CHD) affects 1% of infants worldwide, and approximately 90% of children with serious CHD who have access to surgery survive to adulthood. Particularly as this population ages, there are unique ethical and policy challenges pertaining to this diverse population of children and adults, which also serve as a paradigm for other chronic diseases. A unique forum to discuss these issues occurred at the University of Pennsylvania in Philadelphia on March 16 to 17, 2012, and was entitled "Ethics of the Heart: Ethical and Policy Challenges in Adult and Pediatric Congenital Heart Disease." The conference convened a multidisciplinary panel of nationally known experts in the fields of Pediatric Congenital Heart Disease, Adult Congenital Heart Disease, and Bioethics to identify and discuss the most important ethical issues in CHD through talks, panel discussions, and one-on-one interviews in six topic areas: genetic testing, transitions of care from pediatric to adult CHD, transplantation and mechanical circulatory support, research and development in CHD, the social and personal costs of success in treating CHD, and end-of-life considerations. This article is an introduction to the topics discussed. PMID:23799747

  2. The role of ethics in shale gas policies.

    PubMed

    de Melo-Martín, Inmaculada; Hays, Jake; Finkel, Madelon L

    2014-02-01

    The United States has experienced a boom in natural gas production due to recent technological innovations that have enabled natural gas to be produced from unconventional sources, such as shale. There has been much discussion about the costs and benefits of developing shale gas among scientists, policy makers, and the general public. The debate has typically revolved around potential gains in economics, employment, energy independence, and national security as well as potential harms to the environment, the climate, and public health. In the face of scientific uncertainty, national and international governments must make decisions on how to proceed. So far, the results have been varied, with some governments banning the process, others enacting moratoria until it is better understood, and others explicitly sanctioning shale gas development. These policies reflect legislature's preferences to avoid false negative errors or false positive ones. Here we argue that policy makers have a prima facie duty to minimize false negatives based on three considerations: (1) protection from serious harm generally takes precedence over the enhancement of welfare; (2) minimizing false negatives in this case is more respectful to people's autonomy; and (3) alternative solutions exist that may provide many of the same benefits while minimizing many of the harms. PMID:24246934

  3. Genomic research in Zambia: confronting the ethics, policy and regulatory frontiers in the 21st Century.

    PubMed

    Chanda-Kapata, Pascalina; Kapata, Nathan; Moraes, Albertina Ngomah; Chongwe, Gershom; Munthali, James

    2015-01-01

    Genomic research has the potential to increase knowledge in health sciences, but the process has to ensure the safety, integrity and well-being of research participants. A legal framework for the conduct of health research in Zambia is available. However, the ethical, policy and regulatory framework to operationalise genomic research requires a paradigm shift. This paper outlines the current legal and policy framework as well as the ethics environment, and suggests recommendations for Zambia to fully benefit from the opportunity that genomic research presents. This will entail creating national research interest, improving knowledge levels, and building community trust among researchers, policymakers, donors, regulators and, most importantly, patients and research participants. A real balancing act of the risk and benefits will need to be objectively undertaken. PMID:26510898

  4. [Social consensus on medical technology policy: ethical issues and citizen participation].

    PubMed

    Sato, Hajime

    2004-01-01

    Social consensus is considered to be a necessary condition for a policy to be introduced and implemented effectively. This is the case with the approval, regulation and prohibition of certain advanced medical research and technology, especially when they could invoke moral disputes in society. Public policies on organ transplantation, definition of death, euthanasia, genetic screening and diagnosis, and human stem cell research are recent examples. The concept of consensus, however, is elusive, along with the measures to secure it. Technocratic decision making, as a paternalistic activity frequently led by experts, sometimes poses a challenge to democratic decision making, supposedly based on a well-informed and rational public. It also remains to be proved whether public involvement in policymaking can be a solution to ethical value conflicts in society. From the perspective of policy sciences, this paper first introduces the concept of consensus, especially consensus on moral issues in pluralistic societies, and its implications to public policy, including citizen participation in decision making. Then, it briefly explains the historical background with which social consensus and public involvement have increasingly flourished in the field of technology assessments and technology policy making, including biomedical technology. Next, major institutions, governmental and nongovernmental, involved in the ethical aspects of medical research and technology, are presented along with their efforts for citizen participation. Finally, the paper discusses some of the future agendas on this issue. PMID:15007900

  5. Integrating ethics, health policy and health systems in low- and middle-income countries: case studies from Malaysia and Pakistan.

    PubMed

    Hyder, Adnan A; Merritt, Maria; Ali, Joseph; Tran, Nhan T; Subramaniam, Kulanthayan; Akhtar, Tasleem

    2008-08-01

    Scientific progress is a significant basis for change in public-health policy and practice, but the field also invests in value-laden concepts and responds daily to sociopolitical, cultural and evaluative concerns. The concepts that drive much of public-health practice are shaped by the collective and individual mores that define social systems. This paper seeks to describe the ethics processes in play when public-health mechanisms are established in low- and middle-income countries, by focusing on two cases where ethics played a crucial role in producing positive institutional change in public-health policy. First, we introduce an overview of the relationship between ethics and public health; second, we provide a conceptual framework for the ethical analysis of health system events, noting how this approach might enhance the power of existing frameworks; and third, we demonstrate the interplay of these frameworks through the analysis of a programme to enhance road safety in Malaysia and an initiative to establish a national ethics committee in Pakistan. We conclude that, while ethics are gradually being integrated into public-health policy decisions in many developing health systems, ethical analysis is often implicit and undervalued. This paper highlights the need to analyse public-health decision-making from an ethical perspective. PMID:18797618

  6. Redefining ecological ethics: science, policy, and philosophy at Cape Horn.

    PubMed

    Frodeman, Robert

    2008-12-01

    In the twentieth century, philosophy (especially within the United States) embraced the notion of disciplinary expertise: philosophical research consists of working with and writing for other philosophers. Projects that involve non-philosophers earn the deprecating title of "applied" philosophy. The University of North Texas (UNT) doctoral program in philosophy exemplifies the possibility of a new model for philosophy, where graduate students are trained in academic philosophy and in how to work with scientists, engineers, and policy makers. This "field" (rather than "applied") approach emphasizes the inter- and transdisciplinary nature of the philosophical enterprise where theory and practice dialectically inform one another. UNT's field station in philosophy at Cape Horn, Patagonia, Chile is one site for developing this ongoing experiment in the theory and practice of interdisciplinary philosophic research and education. PMID:18941926

  7. A review of management of infertility in Nigeria: framing the ethics of a national health policy

    PubMed Central

    Akinloye, Oluyemi; Truter, Ernest J

    2011-01-01

    Infertility has recently been construed to be a serious problem in sub-Saharan Africa. This problem seems to be viewed as of low priority with reference to the effective and efficient allocation of available health resources by national governments as well as by international donors sponsoring either research or service delivery in the public health sector. In this paper the problem of infertility in Nigeria is surveyed with a view to assessing the ethical dimension of proposals to manage infertility as a public sector priority in health care delivery. The population/individual and public/private distinction in the formulation of health policy has ethical implications that cannot simply be ignored and are therefore engaged in critically assessing the problem of infertility. Cost–utility analysis (such as Quality Adjusted Life-Year composite index) in the management of infertility in Nigeria entails the need for caution relevant to the country’s efforts to achieve Millennium Development Goals. This should remain the case whether the ethical evaluation appeals to utilitarian or contractarian (Rawlsian) principles. The “worst off ” category of Nigerians includes (1) underweight children less than 5 years of age, with special concern for infants (0–1 years of age) and (2) the proportion of the population below a minimum level of dietary consumption. The Rawlsian ethic implies that any Federal Ministry of Health policy aimed at establishing public programs for infertility management can be considered a “fair” allocation and expenditure if, and only if, the situation for these two cohorts is not thereby made worse. Nigerian health policy cannot assume this type of increased allocation of its resources to infertility care without it being hard pressed to warrant defensible moral or rational argument. PMID:21892337

  8. AIDS, policy and bioethics: ethical dilemmas facing China in HIV prevention: a report from China.

    PubMed

    Wang, Yan-Guang

    1997-01-01

    The present situation of the HIV/AIDS epidemic is very grim in China. The probability of China becoming a country with a high prevalence of HIV/AIDS cannot be excluded because there have been factors which promote the wide spread of HIV if we fail to take timely action to prevent it at the opportune moment. However, China's HIV prevention policy is inadequate. Health professionals and programmers believed that they could take a conventional public health approach to cope with the HIV epidemic. They simply ignored the fact that HIV infection is an epidemic so special that their approach is not effective to deter the epidemic. Many health professionals and programmers bypassed ethical issues that had emerged in the prevention of the HIV epidemic. Even some health educators, sexologists and officials believe that 'AIDS is the punishment for promiscuity', and this belief has led to discrimination and stigmatization of AIDS patients, HIV positive people, their family members and high risk groups. Although homosexuality is not illegal, the police can always find any reason to detain homosexuals. A difficult ethical issue is about the laws prohibiting prostitution and drug use in China which force prostitutes and intravenous drug users underground, giving them no chance to access information, education and the services needed to protect them. The dilemma facing China is whether to stay with a restrictive policy for the reason of ideology cleansing or to turn to a more supportive policy. It is necessary to have some change in the ethical framework to evaluate the action in HIV prevention. Tolerance should be the first ethical principle. PMID:11654786

  9. A review of management of infertility in Nigeria: framing the ethics of a national health policy.

    PubMed

    Akinloye, Oluyemi; Truter, Ernest J

    2011-01-01

    Infertility has recently been construed to be a serious problem in sub-Saharan Africa. This problem seems to be viewed as of low priority with reference to the effective and efficient allocation of available health resources by national governments as well as by international donors sponsoring either research or service delivery in the public health sector. In this paper the problem of infertility in Nigeria is surveyed with a view to assessing the ethical dimension of proposals to manage infertility as a public sector priority in health care delivery. The population/individual and public/private distinction in the formulation of health policy has ethical implications that cannot simply be ignored and are therefore engaged in critically assessing the problem of infertility. Cost-utility analysis (such as Quality Adjusted Life-Year composite index) in the management of infertility in Nigeria entails the need for caution relevant to the country's efforts to achieve Millennium Development Goals. This should remain the case whether the ethical evaluation appeals to utilitarian or contractarian (Rawlsian) principles. The "worst off " category of Nigerians includes (1) underweight children less than 5 years of age, with special concern for infants (0-1 years of age) and (2) the proportion of the population below a minimum level of dietary consumption. The Rawlsian ethic implies that any Federal Ministry of Health policy aimed at establishing public programs for infertility management can be considered a "fair" allocation and expenditure if, and only if, the situation for these two cohorts is not thereby made worse. Nigerian health policy cannot assume this type of increased allocation of its resources to infertility care without it being hard pressed to warrant defensible moral or rational argument. PMID:21892337

  10. Rationale for Computer Ethics Policies and a Model Policy for the North Carolina Community College System.

    ERIC Educational Resources Information Center

    DeLisse, Regina L.

    This study addresses new concerns of higher education organizational leaders as a result of the extended use of information technology on college campuses. Some of the most important and controversial issues include ethical and legal matters such as privacy, freedom of speech, intellectual property, and legislative attempts for Internet…

  11. From bench to bedside and to health policies: ethics in translational research.

    PubMed

    Petrini, C

    2011-01-01

    Translation of biomedical research knowledge to effective clinical treatment is essential to the public good. The first level of translation ("from bench to bedside") corresponds to efficacy studies under controlled conditions with careful attention to internal validity (clinical research). The second level is the translation of results from clinical studies into everyday clinical practice and health decision making. The article summarises the ethical issues involved in the translation of biomedical research advances to clinical applications and to clinical practice. In particular, the article synthesizes theory from clinical ethics, operational design, and philosophy to examine the unique bioethical issues raised by the recent focus on translational research. In this framework safety of study participants and balancing of risk due to treatment with the potential benefits of the research are crucial: in clinical research there is a danger that the emphasis on advancements in scientific knowledge might prevail over the protection of the people who participate in research. These issues involve basic scientists, clinicians and bioethicists because of their application to comparative effectiveness research, clinical trials and evidence-based medicine, as well basic biomedical research. PMID:21448547

  12. Use of the evidence base in substance abuse treatment programs for American Indians and Alaska natives: pursuing quality in the crucible of practice and policy

    PubMed Central

    2011-01-01

    Background A variety of forces are now shaping a passionate debate regarding the optimal approaches to improving the quality of substance abuse services for American Indian and Alaska Native communities. While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This longstanding tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions. Discussion We convened a panel of experts from American Indian and Alaska Native communities, substance abuse treatment programs serving these communities, and researchers to discuss and analyze these controversies in preparation for a national study of American Indian and Alaska Native substance abuse services. While the panel identified programs that are using evidence-based treatments, members still voiced concerns about the cultural appropriateness of many evidence-based treatments as well as the lack of guidance on how to adapt them for use with American Indians and Alaska Natives. The panel concluded that the efforts of federal and state policymakers to promote the use of evidence-based treatments are further complicating an already-contentious debate within American Indian and Alaska Native communities on how to provide effective substance abuse services. This external pressure to utilize evidence-based treatments is particularly problematic given American Indian and Alaska Native communities' concerns about protecting their sovereign status. Summary Broadening this conversation beyond its primary focus on the use of evidence-based

  13. An Evidence-Based Approach to Estimating the National and State Costs of PreK-3rd. FCD Policy Brief Advancing PK-3rd. No.10

    ERIC Educational Resources Information Center

    Picus, Lawrence O.; Odden, Allan; Goetz, Michael

    2009-01-01

    This study estimates the costs of providing a high-quality PreK-3rd education approach in all 50 states plus the District of Columbia. Relying on an Evidence-Based approach to school finance adequacy, it identifies the staffing resources needed to offer high-quality integrated PreK-3rd programs and then estimates the costs of those resources. By…

  14. Neuroscience research on the addictions: a prospectus for future ethical and policy analysis.

    PubMed

    Hall, Wayne; Carter, Lucy; Morley, Katherine I

    2004-09-01

    The increasing evidence that many addictive phenomena have a genetic and neurobiological basis promises improvements in societal responses to addiction that raise important ethical and social policy issues. One of the major potential benefits of such research is improved treatment of drug addiction, but in order to do the research required to realize this promise, it will be necessary to address ethical doubts raised about the capacity of addicted persons to give free and informed consent to participate in studies that involve the administration of drugs of dependence. Neuroscience research on addiction promises to transform the long running debate between moral and medical models of addiction by providing a detailed causal explanation of addiction in terms of brain processes. We must avoid causal models of addiction being misinterpreted as supporting simple-minded social policies, e.g., that we identify the minority of the community that is genetically and biologically vulnerable to addiction and hence can neglect social policy options for reducing addiction, including drug control policies. Causal accounts of addiction supplied by neuroscience and genetic research may also be seen to warrant the use of pharmacotherapies and drug vaccines under legal coercion. Neuroscientists also need to anticipate the ethical issues that may arise if the knowledge that they produce delivers interventions that enhance human cognitive and other capacities. Advances in neuroimaging that enable us to identify "addicts" or predict future risk of addiction will raise concerns about invasion of privacy, third-party use of neuroimaging data, the powers of courts to coerce defendants to undergo such tests, and consumer protection against the overinterpretation of test results. Given the strong public and media interest in the results of their research, neuroscientists and geneticists have a moral obligation, and a professional interest, to minimize popular misunderstandings of their work

  15. Integrating Values and Ethics into Wildlife Policy and Management—Lessons from North America

    PubMed Central

    Fox, Camilla H.; Bekoff, Marc

    2011-01-01

    Few animals provoke as wide a range of emotions as wolves. Some see wolves as icons of a lost wilderness; others see them as intruders. As the battle continues between wolf proponents and opponents, finding solutions that resolve conflicts while supporting the integrity of nature is challenging. In this essay we argue that we need to make room for wolves and other native carnivores who are re-colonizing areas from which they were extirpated. Strategies that foster coexistence are necessary and wildlife agencies must consider all stakeholders and invest adequate resources to inform the public about how to mitigate conflicts between people/domestic animals, and predators. Values and ethics must be woven into wildlife policy and management and we must be willing to ask difficult ethical questions and learn from past mistakes. PMID:26486219

  16. Regulatory policies in paediatric research: how harmonised are the ethical principles?

    PubMed

    Petrini, C

    2014-01-01

    Trials involving children generate considerable practical problems of a mainly ethical nature. While there is wide-ranging agreement on the basic ethical requisites for these trials, substantial--and even profound--differences remain between national and international regulatory policies. For the European Union Directive 2001/20/EC is the basic reference for national regulations regarding clinical trials. Article 4 of this Directive deals with trials on minors. The present article compares the regulations of this Article with four other documents regulating paediatric trials in Europe, the US and Japan. This comparison points to different approaches relating particularly to: risk acceptability, risk/benefit assessments, informed consent, assent of minors. PMID:24589964

  17. Imagined in Policy, Inscribed on Bodies: Defending an Ethic of Compassion in a Political Context

    PubMed Central

    Mercer, Dave

    2015-01-01

    In response to the International Journal of Health Policy and Management (IJHPM) editorial, this commentary adds to the debate about ethical dimensions of compassionate care in UK service provision. It acknowledges the importance of the original paper, and attempts to explore some of the issues that are raised in the context of nursing practice, research and education. It is argued that each of these fields of the profession are enacted in an escalating culture of corporatism, be that National Health Service (NHS) or university campus, and global neoliberalism. Post-structuralist ideas, notably those of Foucault, are borrowed to interrogate healthcare as discursive practice and disciplinary knowledge; where an understanding of the ways in which power and language operate is prominent. Historical and contemporary evidence of institutional and ideological degradation of sections of humanity, a ‘history of the present,’ serve as reminders of the import, and fragility, of ethical codes. PMID:26673179

  18. Unconsented HIV Testing in Cases of Occupational Exposure: Ethics, Law, and Policy

    PubMed Central

    Cowan, Ethan; Macklin, Ruth

    2012-01-01

    Post-exposure prophylaxis (PEP) has substantially reduced the risk of acquiring human immunodeficiency virus (HIV) after an occupational exposure; nevertheless, exposure to HIV remains a concern for emergency department providers. According to published guidelines, PEP should be taken only when source patients are HIV positive or have risk factors for HIV. Initiating PEP when source patients are uninfected puts exposed persons at risk from taking toxic drugs with no compensating benefit. Forgoing PEP if the source is infected results in increased risk of acquiring HIV. What should be done if source patients refuse HIV testing? Is it justifiable to test the blood of these patients over their autonomous objection? The authors review current law and policy and perform an ethical analysis to determine if laws permitting unconsented testing in cases of occupational exposure can be ethically justified. PMID:22994417

  19. Revisiting 'The clinic': ethical and policy challenges in U.S. community health centers.

    PubMed

    Berlinger, Nancy; Gusmano, Michael K; Turbiner, Eva

    2014-10-01

    Where do poor people in the United States (US) go when they get sick? Often, they go to Federally Qualified Health Centers (FQHCs) and hospital emergency departments. Even after the implementation of the Patient Protection and Affordable Care Act (ACA), these safety-net health care organizations will continue to play a crucial role in the US health care system. FQHCs have long grappled with some of the biggest questions facing the US health care system and their leaders and clinicians face ethical challenges in everyday practice. Ethical and policy challenges in the US health care safety-net are not usually 'tragic choices' involving the allocation of transplantable organs, or ventilators during a pandemic. They are everyday choices with a tragic dimension because, even with the adoption of the ACA, the US has not yet decided whether poor people deserve a 'home' or a 'net' when they are sick, and whether even a net should be in good repair. PMID:24845755

  20. Birth control policies in Iran: a public health and ethics perspective.

    PubMed

    Aloosh, Mehdi; Saghai, Yashar

    2016-06-01

    In less than one generation, a unique demographic transition has taken place in Iran. A population growth rate of 4.06% in 1984 fell to 1.15% in 1993 and a total fertility rate of 6.4 births per woman in 1984 declined to 1.9 in 2010. In 2012, Iranian policymakers shifted away from a birth control policy towards a pro-natalist policy. At first glance, this may seem reasonable since its goal is to avoid the consequences of an aging population. However, we argue that the policy package raises serious public health, socioeconomic, environmental and ethical concerns and is likely to fail on its own terms. PMID:26759127

  1. Ethical models in bioethics: theory and application in organ allocation policies.

    PubMed

    Petrini, C

    2010-12-01

    Policies for allocating organs to people awaiting a transplant constitute a major ethical challenge. First and foremost, they demand balance between the principles of beneficence and justice, but many other ethically relevant principles are also involved: autonomy, responsibility, equity, efficiency, utility, therapeutic outcome, medical urgency, and so forth. Various organ allocation models can be developed based on the hierarchical importance assigned to a given principle over the others, but none of the principles should be completely disregarded. An ethically acceptable organ allocation policy must therefore be in conformity, to a certain extent, with the requirements of all the principles. Many models for organ allocation can be derived. The utilitarian model aims to maximize benefits, which can be of various types on a social or individual level, such as the number of lives saved, prognosis, and so forth. The prioritarian model favours the neediest or those who suffer most. The egalitarian model privileges equity and justice, suggesting that all people should have an equal opportunity (casual allocation) or priority should be given to those who have been waiting longer. The personalist model focuses on each individual patient, attempting to mesh together all the various aspects affecting the person: therapeutic needs (urgency), fairness, clinical outcomes, respect for persons. In the individualistic model the main element is free choice and the system of opting-in is privileged. Contrary to the individualistic model, the communitarian model identities in the community the fundamental elements for the legitimacy of choices: therefore, the system of opting-out is privileged. This article does not aim at suggesting practical solutions. Rather, it furnishes to decision makers an overview on the possible ethical approach to this matter. PMID:21196904

  2. Ethics.

    PubMed

    Pellegrino, E D

    1989-05-19

    This article is from the 1989 CONTEMPO issue of the Journal of the American Medical Association, the purpose of which is to keep physicians informed of recent developments in different areas of medicine through brief overviews by specialists in each field. In his article on ethics, Pellegrino focuses on the issues of euthanasia and fetal research. The practice of active, voluntary euthanasia raises questions about the difference between killing a terminally ill patient and withholding or withdrawing life-prolonging treatment, the limits of patient autonomy, the compatibility of active euthanasia with professional ethics, and the social consequences of legalizing euthanasia. The debate over the use of fetal tissue for research and treatment centers on the issue of induced abortion. PMID:2709576

  3. The ABCs of Evidence-Based Practice for Teachers

    ERIC Educational Resources Information Center

    Kretlow, Allison G.; Blatz, Sharon L.

    2011-01-01

    It is critical teachers adhere to federal policies regarding evidence-based practices. Quickly identifying and effectively using evidence-based programs and practices is particularly important for special educators, because students in special education often already have academic or behavioral deficits. Using evidence-based practices with…

  4. How effective is an ethical international recruitment policy? Reflections on a decade of experience in England.

    PubMed

    Young, Ruth

    2013-07-01

    Using evidence from a 2006 postal survey of NHS organisations, plus eight case studies and source country interviews (India; Philippines; Zimbabwe; Poland; Spain) in 2007-2008, the paper explores the impacts of England's 'ethical' recruitment policy as it developed from the late 1990s onwards. It shows that a Code of Practice and bilateral agreements did positively influence the behaviour of NHS organisations and commercial agencies at the height of England's international recruitment drive from 2001 to 2006. However, such policies could only go so far; and other actions are needed to mitigate the downside effects of migration on source countries. One key step is an attitude change that sees countries like England receiving internationally mobile health professionals for the 'value added' that they bring--rather than regarding them primarily as a numerical addition or substitute for the domestically-trained workforce. Another is to plan and manage the domestic workforce in order to deliver on self-sufficiency ambitions. Finally, 'ethical' stances mean placing health professional recruitment/migration into wider development agendas--as a platform for training and skills development for the developing world. Overall, it was the winding down of England's active recruitment policy from 2006 together with subsequent general immigration and professional registration rule changes that had most influence on migration numbers. PMID:23602547

  5. Champions for social change: Photovoice ethics in practice and 'false hopes' for policy and social change.

    PubMed

    Johnston, Gloria

    2016-01-01

    Photovoice methodology is growing in popularity in the health, education and social sciences as a research tool based on the core values of community-based participatory research. Most photovoice projects state a claim to the third goal of photovoice: to reach policy-makers or effect policy change. This paper examines the concerns of raising false hopes or unrealistic expectations amongst the participants of photovoice projects as they are positioned to be the champions for social change in their communities. The impetus for social change seems to lie in the hands of those most affected by the issue. This drive behind collective social action forms, what could be termed, a micro-social movement or comparative interest group. Looking to the potential use of social movement theory and resource mobilisation concepts, this paper poses a series of unanswered questions about the ethics of photovoice projects. The ethical concern centres on the focus of policy change as a key initiative; yet, most projects remain vague about the implementation and outcomes of this focus. PMID:27132466

  6. The potential conflict between policy and ethics in caring for undocumented immigrants at academic health centers.

    PubMed

    Cacari Stone, Lisa; Steimel, Leah; Vasquez-Guzman, Estela; Kaufman, Arthur

    2014-04-01

    Academic health centers (AHCs) are at the forefront of delivering care to the diverse medically underserved and uninsured populations in the United States, as well as training the majority of the health care workforce, who are professionally obligated to serve all patients regardless of race or immigration status. Despite AHCs' central leadership role in these endeavors, few consolidated efforts have emerged to resolve potential conflicts between national, state, and local policies that exclude certain classifications of immigrants from receiving federal public assistance and health professionals' social missions and ethical oath to serve humanity. For instance, whereas the 2010 Patient Protection and Affordable Care Act provides a pathway to insurance coverage for more than 30 million Americans, undocumented immigrants and legally documented immigrants residing in the United States for less than five years are ineligible for Medicaid and excluded from purchasing any type of coverage through state exchanges. To inform this debate, the authors describe their experience at the University of New Mexico Hospital (UNMH) and discuss how the UNMH has responded to this challenge and overcome barriers. They offer three recommendations for aligning AHCs' social missions and professional ethics with organizational policies: (1) that AHCs determine eligibility for financial assistance based on residency rather than citizenship, (2) that models of medical education and health professions training provide students with service-learning opportunities and applied community experience, and (3) that frontline staff and health care professionals receive standardized training on eligibility policies to minimize discrimination towards immigrant patients. PMID:24556759

  7. Mapping and sequencing the human genome: Science, ethics, and public policy. Final report

    SciTech Connect

    McInerney, J.D.

    1993-03-31

    Development of Mapping and Sequencing the Human Genome: Science, Ethics, and Public Policy followed the standard process of curriculum development at the Biological Sciences Curriculum Study (BSCS), the process is described. The production of this module was a collaborative effort between BSCS and the American Medical Association (AMA). Appendix A contains a copy of the module. Copies of reports sent to the Department of Energy (DOE) during the development process are contained in Appendix B; all reports should be on file at DOE. Appendix B also contains copies of status reports submitted to the BSCS Board of Directors.

  8. Tightening Conflict-of-Interest Policies: The Impact of 2005 Ethics Rules at the NIH

    PubMed Central

    Zinner, Darren E.; DesRoches, Catherine M.; Bristol, Steffanie J.; Clarridge, Brian; Campbell, Eric G.

    2013-01-01

    Purpose To determine both the intended and unintended effects of the National Institutes of Health (NIH) 2005 ethics rules by examining changes in publishing rates and the frequency of external relationships among NIH scientists. Method After identifying eligible intramural scientists and administrators from institute’s web pages and central directories, a mailed survey was administered to 900 NIH research faculty between October 2008 and January 2009 (response rate 70.1%).A Results Eighty percent of respondents believed the NIH ethics rules were too restrictive. While nearly half (45%) of respondents believed the rules positively impacted the public’s trust in the NIH, over three-quarters (77%) believed the rules hindered the NIH’s ability to complete its mission. Implementation of the ethics rules significantly decreased self-reported GIRs among NIH faculty (from 51.8% to 33.2%, P<.01), including significant drops in consulting (33.1% to 7.8%, P<.01) and scientific advisory board membership (31.5% to 16.0%, P<.01). The policy had limited impact on NIH faculty participation in non-industrial professional service roles and had no detectable change in publishing behavior (5.29 articles per researcher per year from 2002–2005 vs. 5.26 from 2005–2008, P = .88). Conclusions The NIH ethics rules accomplished much of what they were intended to do, limiting relationships with industry while maintaining NIH researchers’ association with external scientific and professional organizations. However, the rules negatively affected personnel morale and the perceived progress of research. PMID:20852402

  9. Genetically modified animals from life-science, socio-economic and ethical perspectives: examining issues in an EU policy context.

    PubMed

    Frewer, L J; Kleter, G A; Brennan, M; Coles, D; Fischer, A R H; Houdebine, L M; Mora, C; Millar, K; Salter, B

    2013-06-25

    The interdisciplinary EC consortium (the PEGASUS project) aimed to examine the issues raised by the development, implementation and commercialisation of genetically modified (GM) animals, and derivative foods and pharmaceutical products. The results integrated existing social (including existing public perception) environmental and economic knowledge regarding GM animals to formulate policy recommendations relevant to new developments and applications. The use of GM in farmed animals (aquatic, terrestrial and pharmaceutical) was mapped and reviewed. A foresight exercise was conducted to identity future developments. Three case studies (aquatic, terrestrial and pharmaceutical) were applied to identify the issues raised, including the potential risks and benefits of GM animals from the perspectives of the production chain (economics and agri-food sector) and the life sciences (human and animal health, environmental impact, animal welfare and sustainable production). Ethical and policy concerns were examined through application of combined ethical matrix method and policy workshops. The case studies were also used to demonstrate the utility of public engagement in the policy process. The results suggest that public perceptions, ethical issues, the competitiveness of EU animal production and risk-benefit assessments that consider human and animal health, environmental impact and sustainable production need to be considered in EU policy development. Few issues were raised with application in the pharmaceutical sector, assuming ethical and economic issues were addressed in policy, but the introduction of agricultural GM animal applications should be considered on a case-by-case basis. PMID:23567982

  10. Ethics and policies in the face of research into extending human life.

    PubMed

    Bellver Capella, Vicente

    2014-01-01

    If the prediction of some scientists comes true, then we are only few years away from the appearance of the first generation of human beings who will be able to add one year to each remaining year of life expectancy. Faced with this possibility, it seems appropriate to give thought to the public policies that should be adopted. It is better to anticipate the various future scenarios than react to a reality which is a fait accompli. To date, the debate has mainly focused on the ethical question: is it good or bad for us humans to achieve immortal life? Until now, neither legal guidelines at State level nor those of international organisations which deal with bioethical issues have concerned themselves with this matter. But before discussing policies, two other matters should be addressed: first, to show how the prolongation of human life can be as much the unwanted outcome of legitimate efforts in search of healthy aging, as one of the aims of the post-humanist project; second, to present the most consistent and shared ethical reasons for rejecting the human immortality project. PMID:25684387

  11. Methods of legitimation: how ethics committees decide which reasons count in public policy decision-making.

    PubMed

    Edwards, Kyle T

    2014-07-01

    In recent years, liberal democratic societies have struggled with the question of how best to balance expertise and democratic participation in the regulation of emerging technologies. This study aims to explain how national deliberative ethics committees handle the practical tension between scientific expertise, ethical expertise, expert patient input, and lay public input by explaining two institutions' processes for determining the legitimacy or illegitimacy of reasons in public policy decision-making: that of the United Kingdom's Human Fertilisation and Embryology Authority (HFEA) and the United States' American Society for Reproductive Medicine (ASRM). The articulation of these 'methods of legitimation' draws on 13 in-depth interviews with HFEA and ASRM members and staff conducted in January and February 2012 in London and over Skype, as well as observation of an HFEA deliberation. This study finds that these two institutions employ different methods in rendering certain arguments legitimate and others illegitimate: while the HFEA attempts to 'balance' competing reasons but ultimately legitimizes arguments based on health and welfare concerns, the ASRM seeks to 'filter' out arguments that challenge reproductive autonomy. The notably different structures and missions of each institution may explain these divergent approaches, as may what Sheila Jasanoff (2005) terms the distinctive 'civic epistemologies' of the US and the UK. Significantly for policy makers designing such deliberative committees, each method differs substantially from that explicitly or implicitly endorsed by the institution. PMID:24833251

  12. Sicily statement on evidence-based practice

    PubMed Central

    Dawes, Martin; Summerskill, William; Glasziou, Paul; Cartabellotta, Antonino; Martin, Janet; Hopayian, Kevork; Porzsolt, Franz; Burls, Amanda; Osborne, James

    2005-01-01

    Background A variety of definitions of evidence-based practice (EBP) exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP) means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC"). Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP) requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'. PMID:15634359

  13. Evidence-based Science Communication

    NASA Astrophysics Data System (ADS)

    Kahan, D.

    2012-12-01

    This presentation will describe a concrete strategy for bridging the gap between the *science* of science communication and the practice of it. In recent years, social scientists have made substantial progress in identifying the psychological influences that shape public receptivity to scientific information relating to climate change and other public policy issues. That work, however, has consisted nearly entirely of laboratory experiments and public opinion surveys; these methods identify general mechanisms of information processing but do not yield concrete prescriptions for communication in field settings. In order to integrate the findings of the science of science communication with the practice of it, field communication must now be made into a meaningful site of science communication research. "Evidence-based science communication" will involve collaborative work between social scientists and practitioners aimed at formulating and testing scientifically informed communication strategies in real-world contexts.

  14. Evidence based vaccinology.

    PubMed

    Nalin, David R

    2002-02-22

    Evidence based vaccinology (EBV) is the identification and use of the best evidence in making and implementing decisions during all of the stages of the life of a vaccine, including pre-licensure vaccine development and post-licensure manufacture and research, and utilization of the vaccine for disease control. Vaccines, unlike most pharmaceuticals, are in a continuous process of development both before and after licensure. Changes in biologics manufacturing technology and changes that vaccines induce in population and disease biology lead to periodic review of regimens (and sometimes dosage) based on changing immunologic data or public perceptions relevant to vaccine safety and effectiveness. EBV includes the use of evidence based medicine (EBM) both in clinical trials and in national disease containment programs. The rationale for EBV is that the highest evidentiary standards are required to maintain a rigorous scientific basis of vaccine quality control in manufacture and to ensure valid determination of vaccine efficacy, field effectiveness and safety profiles (including post-licensure safety monitoring), cost-benefit analyses, and risk:benefit ratios. EBV is increasingly based on statistically validated, clearly defined laboratory, manufacturing, clinical and epidemiological research methods and procedures, codified as good laboratory practices (GLP), good manufacturing practices (GMP), good clinical research practices (GCRP) and in clinical and public health practice (good vaccination practices, GVP). Implementation demands many data-driven decisions made by a spectrum of specialists pre- and post-licensure, and is essential to maintaining public confidence in vaccines. PMID:11858871

  15. Evidence-based medicine.

    PubMed

    Sackett, D L

    1997-02-01

    Evidence-based medicine, whose philosophical origins extend back to mid-19th century Paris and earlier, is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. By individual clinical expertise we mean the proficiency and judgment that we individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care. By best available external clinical evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centered clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatment and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer. Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannized by external evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best external evidence, practice risks becoming rapidly out of date, to the detriment of patients. The practice of evidence-based medicine is a process of life-long, self-directed learning in which caring for our own patients creates the need for

  16. Enhancing Children against Unhealthy Behaviors—An Ethical and Policy Assessment of Using a Nicotine Vaccine

    PubMed Central

    Lev, Ori; Wilfond, Benjamin S.; McBride, Colleen M.

    2013-01-01

    Health behaviors such as tobacco use contribute significantly to poor health. It is widely recognized that efforts to prevent poor health outcomes should begin in early childhood. Biomedical enhancements, such as a nicotine vaccine, are now emerging and have potential to be used for primary prevention of common diseases. In anticipation of such enhancements, it is important that we begin to consider the ethical and policy appropriateness of their use with children. The main ethical concerns raised by enhancing children relate to their impact on children’s well-being and autonomy. These concerns are significant, however they do not appear to apply in the case of the nicotine vaccine; indeed the vaccine could even further these goals for children. Nevertheless, concerns about broadly applying this enhancement may be more challenging. The vaccine may be less cost-effective than alternative public efforts to prevent tobacco use, utilizing it could distract from addressing the foundational causes of smoking and it might not be publically acceptable. Empirical research about these concerns is needed to ascertain their likelihood and impact as well as how they could be minimized. This research could help determine whether behavior-related enhancements hold promise for improving children’s health. PMID:23864909

  17. Evidence-based management.

    PubMed

    Cohen, Frank

    2012-01-01

    It's OK to be lucky when you're lucky, but it's not OK when the issues are critical. Too often, we manage by anecdote, which is OK when you can afford to be wrong, but when finances are tight, or the market is overregulated, or a lot is at stake, making mistakes is not an option. Evidence-based management depends on attention to three components: analytics, decision making, and problem solving. These are skills that should be required of everyone who assumes a management position, no matter how high or low one is on the totem pole. Understanding basic analytical techniques, knowing how to apply these techniques to making good decisions, and learning how to become a skilled problem solver ensure that, when we manage our businesses, we minimize the risk of mistakes and maximize the potential for positive outcomes. PMID:22594062

  18. Recent trends in reproductive tourism and international surrogacy: ethical considerations and challenges for policy

    PubMed Central

    Deonandan, Raywat

    2015-01-01

    Reproductive tourism, or “cross-border reproductive care”, is the phenomenon of people crossing international borders to access reproductive technologies. One of the fastest-growing categories of cross-border reproductive care is international surrogacy, the act of infertile clients traveling internationally to engage the paid services of foreign surrogates to carry their babies to term. It is a multibillion-dollar global industry presenting unique legal, ethical, and risk-management challenges. Clients tend to be price-sensitive, middle-income individuals seeking services from surrogates who in the global market are thought to be of quite low socioeconomic status. Risks are experienced by all parties involved in the transaction, including the client’s countries of origin and destination. The risks to the surrogate evolve from the potential to exploit her economic vulnerability in order to encourage both consent and unfair pricing. Opportunities for policy development are explored. PMID:26316832

  19. Peter Bourne's drug policy and the perils of a public health ethic, 1976-1978.

    PubMed

    Clark, Claire D; Dufton, Emily

    2015-02-01

    As President Jimmy Carter's advisor for health issues, Peter Bourne promoted a rational and comprehensive drug strategy that combined new supply-side efforts to prevent drug use with previously established demand-side addiction treatment programs. Using a public health ethic that allowed the impact of substances on overall population health to guide drug control, Bourne advocated for marijuana decriminalization as well as increased regulations for barbiturates. A hostile political climate, a series of rumors, and pressure from both drug legalizers and prohibitionists caused Bourne to resign in disgrace in 1978. We argue that Bourne's critics used his own public health framework to challenge him, describe the health critiques that contributed to Bourne's resignation, and present the story of his departure as a cautionary tale for today's drug policy reformers. PMID:25521893

  20. Recent trends in reproductive tourism and international surrogacy: ethical considerations and challenges for policy.

    PubMed

    Deonandan, Raywat

    2015-01-01

    Reproductive tourism, or "cross-border reproductive care", is the phenomenon of people crossing international borders to access reproductive technologies. One of the fastest-growing categories of cross-border reproductive care is international surrogacy, the act of infertile clients traveling internationally to engage the paid services of foreign surrogates to carry their babies to term. It is a multibillion-dollar global industry presenting unique legal, ethical, and risk-management challenges. Clients tend to be price-sensitive, middle-income individuals seeking services from surrogates who in the global market are thought to be of quite low socioeconomic status. Risks are experienced by all parties involved in the transaction, including the client's countries of origin and destination. The risks to the surrogate evolve from the potential to exploit her economic vulnerability in order to encourage both consent and unfair pricing. Opportunities for policy development are explored. PMID:26316832

  1. Ethical and public health considerations in HIV counseling and testing: policy implications.

    PubMed

    Yeatman, Sara E

    2007-12-01

    HIV counseling and testing is broadly considered a critical component of HIV transmission-prevention and treatment efforts. Given the severity of the AIDS pandemic in sub-Saharan Africa, the potential societal benefit of testing is invoked to call for its massive expansion and to justify a shift from voluntary to routine testing. Surprisingly little evidence has demonstrated, however, that such a shift will result in the intended benefits to communities, particularly that of reducing the horizontal transmission of HIV. This analysis addresses and critiques the assumptions underlying a serostatus-based approach to behavior change and discusses the ethical consequences of transferring control of the decision to be tested from the individual to the provider. It concludes with a discussion of the implications for HIV counseling and testing policies and proposes alternatives to routine testing that have the potential to be effective while preserving the right to know one's HIV status. PMID:18284041

  2. Evidence-based equine dentistry: preventive medicine.

    PubMed

    Carmalt, James L

    2007-08-01

    Dental problems are some of the most common reasons for a horse to be presented to an equine veterinarian. Despite the importance of anecdotal evidence as a starting point, the science of equine dentistry (especially prophylactic dentistry) has remained poorly supported by evidence-based approaches to diagnosis and treatment. In the 21st century, veterinarians have an ethical responsibility to promote and use the results of evidence-based research and not propagate statements attesting to the purported benefits of intervention without supporting research. Consider also that society is becoming more litigious and therefore is basing treatment plans and advice on published research, which protects the profession from legal challenges concerning our professional conduct. This article reviews the current published evidence concerning the role of equine dentistry in feed digestibility and performance. PMID:17616326

  3. Evidence-based policymaking: a critique.

    PubMed

    Greenhalgh, Trisha; Russell, Jill

    2009-01-01

    The idea that policy should be based on best research evidence might appear to be self-evident. But a closer analysis reveals a number of problems and paradoxes inherent in the concept of "evidence-based policymaking." The current conflict over evidence-based policymaking parallels a long-standing "paradigm war" in social research between positivist, interpretivist, and critical approaches. This article draws from this debate in order to inform the discussions over the appropriateness of evidence- based policymaking and the related question of what is the nature of policymaking. The positivist, empiricist worldview that underpins the theory and practice of evidence-based medicine (EBM) fails to address key elements of the policymaking process. In particular, a narrowly "evidence-based" framing of policymaking is inherently unable to explore the complex, context-dependent, and value-laden way in which competing options are negotiated by individuals and interest groups. Sociolinguistic tools such as argumentation theory offer opportunities for developing richer theories about how policymaking happens. Such tools also have potential practical application in the policymaking process: by enhancing participants' awareness of their own values and those of others, the quality of the collective deliberation that lies at the heart of policymaking may itself improve. PMID:19395827

  4. The social and policy contexts of the New Brunswick Declaration on Research Ethics, Integrity, and Governance: a commentary.

    PubMed

    van den Hoonaard, Will C

    2013-04-01

    This paper explores the social and policy implications of the "New Brunswick Declaration on Research Ethics, Integrity, and Governance" developed at the Ethics Rupture Summit in Fredericton, N.B., Canada, October 2012. It discusses the Declaration and the Summit in relation to the usual criticism and analysis of research ethics regimes, and considers reasons why the immense prior literature has had little impact on regulatory bodies. Because the Declaration, like the Illinois White Paper, has quickly achieved considerable attention relative to most other such documents, and because much further deliberation has evolved since the Summit, we offer here a commentary on each of the eight principles contained in the Declaration in the hope of further stimulating discussion and consolidating the progress that now seems underway. PMID:23651934

  5. Evidence-based Nursing Practice: To Infinity and Beyond.

    ERIC Educational Resources Information Center

    Pape, Tess M.

    2003-01-01

    Provides an historical background for evidence-based practice and methods for assimilating research into practice. Information searching, systematic reviews, and other decision-making models are discussed using specific questions for establishing policy guidelines. Stresses the need for evidence-based practice implementing the best-known practices…

  6. Evidence-Based Language Practice

    ERIC Educational Resources Information Center

    Pollock, Eric J.

    2005-01-01

    The purpose of this paper was to examine evidence-based procedures in medicine and to demonstrate that the same protocols can be used in English language instruction. In the evidence-based methodology, studies are divided into those that address specific language problems. Integrated studies are presented as a systematic overview, meta-analysis,…

  7. Exploring the relationship between public environmental ethics and river flood policies in western Europe.

    PubMed

    de Groot, Mirjam

    2012-01-01

    Two styles of river flood management can be distinguished: dike reinforcement and the more sustainable 'Room for River' option. This paper investigates public adherences to these two management styles and whether their adherence correlates with their Visions of Nature. The focus is especially on people's image of the appropriate human/nature relationship, i.e. Mastery over nature, Stewardship of nature, Partnership of nature or Participation in nature. Other variables that are part of the analysis are the respondents' sense of place, safety perception and background variables. The results of a written survey among riverside residents in France, Germany and the Netherlands (N = 1811) show high adherences to the Room for River style and a rejection of dike reinforcement. A regression analysis shows that adherence to the Room for River style correlates with adherence to the image of Stewardship, while adherence to dike reinforcement is predicted by Mastery over nature. Thus, according to the public a policy shift from dike reinforcement to a more sustainable style is seen as a fundamental one, connected to a change in environmental ethics. PMID:22054565

  8. Responsibility, capability, and Active SETI: Policy, law, ethics, and communication with extraterrestrial intelligence

    NASA Astrophysics Data System (ADS)

    Vakoch, Douglas A.

    2011-02-01

    With recently growing interest in the Active Search for Extraterrestrial Intelligence (SETI), in which humankind would send intentional signals to extraterrestrial civilizations, there have been increased concerns about appropriate policy, as well as the role of space law and ethics in guiding such activities. Implicit in these discussions are notions of responsibility and capability that affect judgments about whether humans or other civilizations should initiate transmissions. Existing protocols that guide SETI research address transmissions from Earth, but there is debate over whether these guidelines should inform de novo transmissions as well. Relevant responsibilities to address include (1) looking out for the interests of humankind as a whole, (2) being truthful in interstellar messages, and (3) benefiting extraterrestrial civilizations. Our capabilities as a species and a civilization affect how well we can fulfill responsibilities, as seen when we consider whether we will be able to reach consensus about message contents (and whether that would be desirable), and whether we have the capacity to decode messages from beings that rely on different sensory modalities. The interplay of these responsibilities and capabilities suggests that humankind should place increased emphasis on Active SETI.

  9. Laypeople's ethical concerns about a New Israeli organ transplantation prioritization policy aimed to encourage organ donor registration among the public.

    PubMed

    Guttman, Nurit; Ashkenazi, Tamar; Gesser-Edelsburg, Anat; Seidmann, Vered

    2011-08-01

    A new policy recently enacted in Israel promises preferred status in receiving organs for transplantation to individuals who register to be organ donors and to their close family members. Proponents believe it will increase the supply of organs for transplantation from the deceased. Ethical issues were raised in government committees appointed to discuss the policy before its approval, but discussions among laypeople were not solicited. This study aimed to elicit laypeople's views about the policy by conducting thirteen group interviews and thirty-six individual interviews. Participants included religious and nonreligious people, immigrants, and Arabs. Some participants thought the law would contribute to fairness by prioritizing those willing to give, but others articulated ethical concerns that were not emphasized by scholars, in particular that the policy would add to the erosion of social solidarity, increase divisiveness, and enable people to abuse the system. Mistrust in the health care system emerged as a prominent reason for not registering as an organ donor. Implications about the importance of transparency in the organ transplantation system as a basis for an information campaign, social norms regarding organ donation, and the public's involvement in policy issues on organ donation are discussed. PMID:21940423

  10. Developing evidence-based immunization recommendations and GRADE.

    PubMed

    Duclos, P; Durrheim, D N; Reingold, A L; Bhutta, Z A; Vannice, K; Rees, H

    2012-12-17

    The Strategic Group of Advisory Experts (SAGE) on immunization is an independent advisory committee with a mandate to advise the World Health Organization (WHO) on the development of vaccine and immunization related policies. SAGE working groups are established on a time-limited basis to review and provide evidence-based recommendations, together with their implications, for open deliberation and decision-making by SAGE. In making its recommendations, SAGE takes into consideration: the epidemiologic and clinical characteristics of the disease; vaccine and immunization characteristics; economic analysis; health system considerations; the existence of and interaction with other intervention and control strategies; costing and social impacts; and legal and ethical concerns. Since 1998, WHO has produced evidence-based vaccine position papers for use primarily by national public health officials and immunization programme managers. Since April 2006 all new or updated position papers have been based on SAGE recommendations. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach has been adopted by WHO and, since 2008, GRADE tables that rate the quality of evidence have been produced in support of key recommendations. SAGE previously expressed concern that GRADE was not ideally suited to many immunization-specific issues such as the vaccine population level effect and the inclusion of surveillance system data, particularly for vaccine safety. Extensive productive interactions with various advisory groups including the US Advisory Committee on Immunization Practices, the European Centres for Disease Control, the German Standing Committee on Vaccination (STIKO), WHO's Global Advisory Committee on Vaccine Safety and the GRADE working group resulted in key enhancements to accommodate vaccine-relevant evidence. This facilitated integration and acceptability of the GRADE approach in the development of immunization related SAGE and WHO

  11. Ethical policies on animal experiments are not compromised by whether a journal is freely accessible or charges for publication.

    PubMed

    Rands, S A

    2009-11-01

    The advent of the open access (OA) movement in publishing has been instrumental in causing a shift in the accessibility of research findings published in academic journals. The adoption of OA and other online publication models means that the results of scientific research published in journals using a free access (FA) framework are now available, free of charge, to anyone with access to the Internet. FA journals typically require a payment from the authors of a manuscript, which has raised concerns about the quality of work published in them; accepting payment from an author may compromise a journal's acceptance criteria. This study addresses whether journal policy on the treatment of animals is influenced by whether a journal follows a FA publishing model, and whether a requirement to pay for publication has an influence. A random sample of 332 biomedical journals listed in the ISI Web of Knowledge and Directory of Open Access Journals databases were assessed for whether they had an ethical policy on publishing animal studies, and what form of publication framework they used (103 of the journals followed a FA framework; 101 charged in some way for publication). Only 135 (40.7%) of the journals surveyed demanded that submissions comply with a pre-defined ethical stance. FA journals are just as likely to have an ethical policy on the treatment and presentation of animal studies as 'traditional', non-FA journals (significance of there being a difference: P = 0.98), and there is no relationship between policy and whether an author is required to pay for publication (significance of there being a difference: P = 0.57). Older journals are more likely to have an ethical policy (P = 0.03). There is, therefore, no obvious compromise shown by FA journals in the explicit policies on reporting studies involving animals. However, since anyone can read published FA studies online, FA journals that do not have an explicit policy about publishing animal research are urged to

  12. Decoupling Policy and Practice: How Life Scientists Respond to Ethics Education

    ERIC Educational Resources Information Center

    Smith-Doerr, Laurel

    2008-01-01

    Many graduate programmes in science now require courses in ethics. However, little is known about their reception or use. Using websites and interviews, this essay examines ethics requirements in the field of biosciences in three countries (the United States of America, the United Kingdom, and Italy) between 2000 and 2005. Evidence suggests that…

  13. Speaking to the World: Four Protestant Perspectives. Ethics and Public Policy Essay 50.

    ERIC Educational Resources Information Center

    Neuhaus, Richard John

    This volume contains an address by Richard John Neuhaus entitled "Let the Church Be the Church" in which it is asserted that the crisis in Christian social ethics today is a crisis of faith which calls for spiritual, theological, and ethical renewal. The address is a retrospective look at the Vietnam-era debate between Neuhaus and Paul Ramsey,…

  14. Pain in Intellectually Disabled Children: Towards Evidence-Based Pharmacotherapy?

    PubMed

    Valkenburg, Abraham J; de Leeuw, Tom G; van Dijk, Monique; Tibboel, Dick

    2015-10-01

    This critical opinion article deals with the challenges of finding the most effective pharmacotherapeutic options for the management of pain in intellectually disabled children and provides recommendations for clinical practice and research. Intellectual disability can be caused by a wide variety of underlying diseases and may be associated with congenital anomalies such as cardiac defects, small-bowel obstructions or limb abnormalities as well as with comorbidities such as scoliosis, gastro-esophageal reflux disease, spasticity, and epilepsy. These conditions themselves or any necessary surgical interventions are sources of pain. Epilepsy often requires chronic pharmacological treatment with antiepileptic drugs. These antiepileptic drugs can potentially cause drug-drug interactions with analgesic drugs. It is unfortunate that children with intellectual disabilities often cannot communicate pain to caregivers. Although these children are at high risk of experiencing pain, researchers nevertheless often have to exclude them from trials on pain management because of ethical considerations. We therefore make a plea for prescribers, researchers, patient organizations, pharmaceutical companies, and policy makers to study evidence-based, safe and effective pharmacotherapy in these children through properly designed studies. In the meantime, parents and clinicians must resort to validated pain assessment tools such as the revised FLACC scale. PMID:26076801

  15. The gap between law and ethics in human embryonic stem cell research: overcoming the effect of U.S. federal policy on research advances and public benefit.

    PubMed

    Taylor, Patrick L

    2005-10-01

    Key ethical issues arise in association with the conduct of stem cell research by research institutions in the United States. These ethical issues, summarized in detail, receive no adequate translation into federal laws or regulations, also described in this article. U.S. Federal policy takes a passive approach to these ethical issues, translating them simply into limitations on taxpayer funding, and foregoes scientific and ethical leadership while protecting intellectual property interests through a laissez faire approach to stem cell patents and licenses. Those patents and licenses, far from being scientifically and ethically neutral in effect, virtually prohibit commercially sponsored research that could otherwise be a realistic alternative to the federal funding gap. The lack of federal funding and related data-sharing principles, combined with the effect of U.S. patent policy, the lack of key agency guidance, and the proliferation of divergent state laws arising from the lack of Federal leadership, significantly impede ethical stem cell research in the United States, without coherently supporting any consensus ethical vision. Research institutions must themselves implement steps, described in the article, to integrate addressing ethical review with the many legal compliance issues U.S. federal and state laws create. PMID:16279757

  16. Ethical Implications of Probabilistic Event Attribution for Policy Discussions about Loss and Damage

    NASA Astrophysics Data System (ADS)

    Otto, F. E. L.; Thompson, A.

    2014-12-01

    deaths in a heatwave to man-made climate change is from an ethical point of you very significant and we argue that this has widespread implications, e.g. for pending policy decisions concerning the Warsaw International Mechanism for Loss and Damage.

  17. Toward a just policy on healthcare rationing. Ethical principles must inform the debate concerning the distribution of services.

    PubMed

    Hofmann, P B

    1994-04-01

    Perceptions of inequity and excess have given rise to a debate over whether policymakers should consider some form of rationing as a means of achieving a more just healthcare system. Three factors will be critical in determining whether the policies ultimately developed will be just and equitable. First, participants must grasp relevant facts involving the current distribution of healthcare services in the United States. Second, the debate must be based on a clear understanding of who has ultimate responsibility for making decisions regarding healthcare rationing. Finally, those committed to implementing a just approach to the issue must ensure that ethical principles relevant to policy-making are clear to everyone and affect the debate's outcome. The controversy over whether to ration healthcare services obscures the fact that healthcare is, in reality if not in policy, rationed now. A key advantage of promoting formal public policy decisions about the provision and limitation of healthcare services is that it shifts responsibility for these decisions from providers to society. Applying four classic bioethical principles to the question of rationing can also help ensure implementation of an appropriate public policy on healthcare rationing. For the debate on rationing to be meaningful, it must be conducted in a way that respects and promotes participants' autonomy. Policymakers should also observe the principle of nonmaleficence, which dictates that their policies not harm those they affect. A proper rationing policy should also fulfill the criterion of beneficence (i.e., actively promote the good of others). Last, such a policy should conform to the principle of justice by being fair and impartial. PMID:10132880

  18. School Centered Evidence Based Accountability

    ERIC Educational Resources Information Center

    Milligan, Charles

    2015-01-01

    Achievement scores drive much of the effort in today's accountability system, however, there is much more that occurs in every school, every day. School Centered Evidence Based Accountability can be used from micro to macro giving School Boards and Administration a process for monitoring the results of the entire school operation effectively and…

  19. Future Public Policy and Ethical Issues Facing the Agricultural and Microbial Genomics Sectors of the Biotechnology Industry: A Roundtable Discussion

    SciTech Connect

    Diane E. Hoffmann

    2003-09-12

    On September 12, 2003, the University of Maryland School of Law's Intellectual Property and Law & Health Care Programs jointly sponsored and convened a roundtable discussion on the future public policy and ethical issues that will likely face the agricultural and microbial genomics sectors of the biotechnology industry. As this industry has developed over the last two decades, societal concerns have moved from what were often local issues, e.g., the safety of laboratories where scientists conducted recombinant DNA research on transgenic microbes, animals and crops, to more global issues. These newer issues include intellectual property, international trade, risks of genetically engineered foods and microbes, bioterrorism, and marketing and labeling of new products sold worldwide. The fast paced nature of the biotechnology industry and its new developments often mean that legislators, regulators and society, in general, must play ''catch up'' in their efforts to understand the issues, the risks, and even the benefits, that may result from the industry's new ways of conducting research, new products, and novel methods of product marketing and distribution. The goal of the roundtable was to develop a short list of the most significant public policy and ethical issues that will emerge as a result of advances in these sectors of the biotechnology industry over the next five to six years. More concretely, by ''most significant'' the conveners meant the types of issues that would come to the attention of members of Congress or state legislators during this time frame and for which they would be better prepared if they had well researched and timely background information. A concomitant goal was to provide a set of focused issues for academic debate and scholarship so that policy makers, industry leaders and regulators would have the intellectual resources they need to better understand the issues and concerns at stake. The goal was not to provide answers to any of the

  20. Mapping and Sequencing the Human Genome: Science, Ethics, and Public Policy.

    ERIC Educational Resources Information Center

    Cutter, Mary Ann G.; Drexler, Edward; McCullough, Laurence B.; McInerney, Joseph D.; Murray, Jeffrey C.; Rossiter, Belinda; Zola, John

    The human genome project started in 1989 with the collaboration of the National Institutes of Health (NIH) and the U.S. Department of Energy (DOE). This document aims to develop an understanding among students of the human genome project and relevant issues. Topics include the science and technology of the human genome project, and the ethical and…

  1. The ethics of policy writing: how should hospitals deal with moral disagreement about controversial medical practices?

    PubMed Central

    Winkler, E

    2005-01-01

    Every healthcare organisation (HCO) enacts a multitude of policies, but there has been no discussion as to what procedural and substantive requirements a policy writing process should meet in order to achieve good outcomes and to possess sufficient authority for those who are asked to follow it. Using, as an example, the controversy about patient's refusal of blood transfusions, I argue that a hospital wide policy is preferable to individual decision making, because it ensures autonomy, quality, fairness, and efficiency. Policy writing for morally controversial medical practices needs additional justification compared to policies on standard medical practices and secures legitimate authority for HCO members by meeting five requirements: all parties directed by the policy are represented; the deliberative process encompasses all of the HCO's obligations; the rationales for the policy are made available; there is a mechanism for criticising, and for evaluating the policy. PMID:16199594

  2. Aequilibrium prudentis: on the necessity for ethics and policy studies in the scientific and technological education of medical professionals

    PubMed Central

    2013-01-01

    Background The importance of strong science, technology, engineering, and mathematics education continues to grow as society, medicine, and the economy become increasingly focused and dependent upon bioscientific and technological innovation. New advances in frontier sciences (e.g., genetics, neuroscience, bio-engineering, nanoscience, cyberscience) generate ethical issues and questions regarding the use of novel technologies in medicine and public life. Discussion In light of current emphasis upon science, technology, engineering, and mathematics education (at the pre-collegiate, undergraduate, graduate, and professional levels), the pace and extent of advancements in science and biotechnology, the increasingly technological orientation and capabilities of medicine, and the ways that medicine – as profession and practice – can engage such scientific and technological power upon the multi-cultural world-stage to affect the human predicament, human condition, and perhaps nature of the human being, we argue that it is critical that science, technology, engineering, and mathematics education go beyond technical understanding and directly address ethical, legal, social, and public policy implications of new innovations. Toward this end, we propose a paradigm of integrative science, technology, ethics, and policy studies that meets these needs through early and continued educational exposure that expands extant curricula of science, technology, engineering, and mathematics programs from the high school through collegiate, graduate, medical, and post-graduate medical education. We posit a synthetic approach that elucidates the historical, current, and potential interaction of scientific and biotechnological development in addition to the ethico-legal and social issues that are important to educate and sustain the next generation of medical and biomedical professionals who can appreciate, articulate, and address the realities of scientific and biotechnological

  3. Evidence-based medicine: applications in dietetic practice.

    PubMed

    Gray, Gregory E; Gray, Lorraine K

    2002-09-01

    Evidence-based medicine has been defined as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients." Evidence-based practice requires the ability to apply knowledge of medical informatics (eg, efficiently searching the medical literature) and clinical epidemiology (eg, being able to critically appraise the literature) to the treatment of individual patients. Being able to apply the principles of evidence-based medicine in the dietetic practice adds to the credibility and value of dietetics professionals, is consistent with the dietetic code of ethics, and is empowering. This article provides an introduction to the history, philosophy, and methods of evidence-based medicine as applied to the dietetic practice. This article focuses on a 5-step process to finding the best evidence to answer clinical questions: (a) formulate the question, (b) search for answers, (c) appraise the evidence, (d) apply the results, and (e) assess the outcome. We describe the 4S methodology-a systematic approach to efficiently finding the best evidence to answer clinical questions involving the use of systems (comprehensive, evidence-based resources), synopses (compilations of structured abstracts of high-quality studies), syntheses (systematic reviews), and studies (original research articles). Particular emphasis is given to a method for critically appraising papers that emphasizes validity, importance, and clinical applicability. Resources (including Web sites) for further learning are provided. J Am Diet Assoc. 2002;102:1263-1272. PMID:12792624

  4. Putting Public Health Ethics into Practice: A Systematic Framework

    PubMed Central

    Marckmann, Georg; Schmidt, Harald; Sofaer, Neema; Strech, Daniel

    2015-01-01

    It is widely acknowledged that public health practice raises ethical issues that require a different approach than traditional biomedical ethics. Several frameworks for public health ethics (PHE) have been proposed; however, none of them provides a practice-oriented combination of the two necessary components: (1) a set of normative criteria based on an explicit ethical justification and (2) a structured methodological approach for applying the resulting normative criteria to concrete public health (PH) issues. Building on prior work in the field and integrating valuable elements of other approaches to PHE, we present a systematic ethical framework that shall guide professionals in planning, conducting, and evaluating PH interventions. Based on a coherentist model of ethical justification, the proposed framework contains (1) an explicit normative foundation with five substantive criteria and seven procedural conditions to guarantee a fair decision process, and (2) a six-step methodological approach for applying the criteria and conditions to the practice of PH and health policy. The framework explicitly ties together ethical analysis and empirical evidence, thus striving for evidence-based PHE. It can provide normative guidance to those who analyze the ethical implications of PH practice including academic ethicists, health policy makers, health technology assessment bodies, and PH professionals. It will enable those who implement a PH intervention and those affected by it (i.e., the target population) to critically assess whether and how the required ethical considerations have been taken into account. Thereby, the framework can contribute to assuring the quality of ethical analysis in PH. Whether the presented framework will be able to achieve its goals has to be determined by evaluating its practical application. PMID:25705615

  5. Putting public health ethics into practice: a systematic framework.

    PubMed

    Marckmann, Georg; Schmidt, Harald; Sofaer, Neema; Strech, Daniel

    2015-01-01

    It is widely acknowledged that public health practice raises ethical issues that require a different approach than traditional biomedical ethics. Several frameworks for public health ethics (PHE) have been proposed; however, none of them provides a practice-oriented combination of the two necessary components: (1) a set of normative criteria based on an explicit ethical justification and (2) a structured methodological approach for applying the resulting normative criteria to concrete public health (PH) issues. Building on prior work in the field and integrating valuable elements of other approaches to PHE, we present a systematic ethical framework that shall guide professionals in planning, conducting, and evaluating PH interventions. Based on a coherentist model of ethical justification, the proposed framework contains (1) an explicit normative foundation with five substantive criteria and seven procedural conditions to guarantee a fair decision process, and (2) a six-step methodological approach for applying the criteria and conditions to the practice of PH and health policy. The framework explicitly ties together ethical analysis and empirical evidence, thus striving for evidence-based PHE. It can provide normative guidance to those who analyze the ethical implications of PH practice including academic ethicists, health policy makers, health technology assessment bodies, and PH professionals. It will enable those who implement a PH intervention and those affected by it (i.e., the target population) to critically assess whether and how the required ethical considerations have been taken into account. Thereby, the framework can contribute to assuring the quality of ethical analysis in PH. Whether the presented framework will be able to achieve its goals has to be determined by evaluating its practical application. PMID:25705615

  6. Neonatal and Pediatric Organ Donation: Ethical Perspectives and Implications for Policy

    PubMed Central

    Sarnaik, Ajit A.

    2015-01-01

    The lifesaving processes of organ donation and transplantation in neonatology and pediatrics carry important ethical considerations. The medical community must balance the principles of autonomy, non-maleficence, beneficence, and justice to ensure the best interest of the potential donor and to provide equitable benefit to society. Accordingly, the US Organ Procurement and Transplantation Network (OPTN) has established procedures for the ethical allocation of organs depending on several donor-specific and recipient-specific factors. To maximize the availability of transplantable organs and opportunities for dying patients and families to donate, the US government has mandated that hospitals refer potential donors in a timely manner. Expedient investigation and diagnosis of brain death where applicable are also crucial, especially in neonates. Empowering trained individuals from organ procurement organizations to discuss organ donation with families has also increased rates of consent. Other efforts to increase organ supply include recovery from donors who die by circulatory criteria (DCDD) in addition to donation after brain death (DBD), and from neonates born with immediately lethal conditions such as anencephaly. Ethical considerations in DCDD compared to DBD include a potential conflict of interest between the dying patient and others who may benefit from the organs, and the precision of the declaration of death of the donor. Most clinicians and ethicists believe in the appropriateness of the Dead Donor Rule, which states that vital organs should only be recovered from people who have died. The medical community can maximize the interests of organ donors and recipients by observing the Dead Donor Rule and acknowledging the ethical considerations in organ donation. PMID:26636051

  7. Neonatal and Pediatric Organ Donation: Ethical Perspectives and Implications for Policy.

    PubMed

    Sarnaik, Ajit A

    2015-01-01

    The lifesaving processes of organ donation and transplantation in neonatology and pediatrics carry important ethical considerations. The medical community must balance the principles of autonomy, non-maleficence, beneficence, and justice to ensure the best interest of the potential donor and to provide equitable benefit to society. Accordingly, the US Organ Procurement and Transplantation Network (OPTN) has established procedures for the ethical allocation of organs depending on several donor-specific and recipient-specific factors. To maximize the availability of transplantable organs and opportunities for dying patients and families to donate, the US government has mandated that hospitals refer potential donors in a timely manner. Expedient investigation and diagnosis of brain death where applicable are also crucial, especially in neonates. Empowering trained individuals from organ procurement organizations to discuss organ donation with families has also increased rates of consent. Other efforts to increase organ supply include recovery from donors who die by circulatory criteria (DCDD) in addition to donation after brain death (DBD), and from neonates born with immediately lethal conditions such as anencephaly. Ethical considerations in DCDD compared to DBD include a potential conflict of interest between the dying patient and others who may benefit from the organs, and the precision of the declaration of death of the donor. Most clinicians and ethicists believe in the appropriateness of the Dead Donor Rule, which states that vital organs should only be recovered from people who have died. The medical community can maximize the interests of organ donors and recipients by observing the Dead Donor Rule and acknowledging the ethical considerations in organ donation. PMID:26636051

  8. A proposed non-consequentialist policy for the ethical distribution of scarce vaccination in the face of an influenza pandemic.

    PubMed

    McLachlan, Hugh V

    2012-05-01

    The current UK policy for the distribution of scarce vaccination in an influenza pandemic is ethically dubious. It is based on the planned outcome of the maximum health benefit in terms of the saving of lives and the reduction of illness. To that end, the population is classified in terms of particular priority groups. An alternative policy with a non-consequentialist rationale is proposed in the present work. The state should give the vaccination, in the first instance, to those who are at risk of catching the pandemic flu in the line of their duties of public employment. Thereafter, if there is not sufficient vaccine to give all citizens equally an effective dose, the state should give all citizens an equal chance of receiving an effective dose. This would be the just thing to do because the state has a duty to treat each and all of its citizens impartially and they have a corresponding right to such impartial treatment. Although this article specifically refers to the UK, it is considered that the suggested alternative policy would be applicable generally. The duty to act justly is not merely a local one. PMID:22411748

  9. Ethics review: Position papers and policies – are they really helpful to front-line ICU teams?

    PubMed Central

    Hawryluck, Laura

    2006-01-01

    During the past few years the ethics sections of critical care societies have proposed a number of policies describing the goals of intensive care unit (ICU) care and providing broad guidance on the diagnoses and physiological criteria that would mandate using the specialized skill and technologies of an ICU environment. Discussions on what constitutes appropriate use of such scarce resources, incorporating cultural and religious beliefs and exploring how they interact with these medical criteria, remain vague. To date, these policies do not provide any definitive guidance in the difficult decision making faced by clinicians. Some argue that they were never meant to do so and yet they have served to guide the development of local hospital policies. Many have explored how critical care services are allocated without achieving consensus on the best way to achieve fair and equitable access to life-sustaining interventions. A consensus is needed though, one that is reflective of both individual and societal values and goals. Otherwise, increasing pressure to provide treatments with marginal benefits at best will threaten the ability of others to access treatments that may offer them very real benefits. PMID:17164011

  10. Rethinking mandatory HIV testing during pregnancy in areas with high HIV prevalence rates: ethical and policy issues.

    PubMed

    Schuklenk, Udo; Kleinsmidt, Anita

    2007-07-01

    We analyzed the ethical and policy issues surrounding mandatory HIV testing of pregnant women in areas with high HIV prevalence rates. Through this analysis, we seek to demonstrate that a mandatory approach to testing and treatment has the potential to significantly reduce perinatal transmission of HIV and defend the view that mandatory testing is morally required if a number of conditions can be met. If such programs are to be introduced, continuing medical care, including highly active antiretroviral therapy, must be provided and pregnant women must have reasonable alternatives to compulsory testing and treatment. We propose that a liberal regime entailing abortion rights up to the point of fetal viability would satisfy these requirements. Pilot studies in the high-prevalence region of southern African countries should investigate the feasibility of this approach. PMID:17538051

  11. Does the Shoe Fit? Ethical, Legal, and Policy Considerations of Global Positioning System Shoes for Individuals with Alzheimer's Disease.

    PubMed

    Yang, Y Tony; Kels, Charles G

    2016-08-01

    As the overall incidence of Alzheimer's disease rises, the burden on caregivers and law enforcement institutions will increase to find individuals who wander. As such, technological innovations that could reduce this burden will become increasingly important. One such innovation is the GPS Shoe. As with any innovation involving the transfer of personal data to third parties, potential pitfalls with respect to loss of privacy and inadequate consent counterbalance the substantial promise of GPS shoes. To some extent, advance planning can mitigate these concerns, wherein individuals willingly elect to be monitored before their impairments progress to a stage that makes such authorization impractical. Nonetheless, tension may arise between the peace of mind of caregivers and family members and other important considerations at the intersection of autonomy, privacy, dignity, and consent. Ultimately, confronting ethical, legal, and policy considerations at the front end of product development and deployment will help ensure that new technologies are used wisely and that their lifesaving potential is realized. PMID:27394035

  12. Ethics in Practice

    ERIC Educational Resources Information Center

    Medlin, E. Lander

    2010-01-01

    Ethics is defined as a set of guidelines and/or rules for the conduct of individual behavior in an organization or civil society. This ethical code of conduct is intended to guide policies, practices, and decision-making for employees on behalf of the organization. This article explores the importance of ethics, the basis for making ethical…

  13. Sepsis management: An evidence-based approach.

    PubMed

    Baig, Muhammad Akbar; Shahzad, Hira; Jamil, Bushra; Hussain, Erfan

    2016-03-01

    The Surviving Sepsis Campaign (SSC) guidelines have outlined an early goal directed therapy (EGDT) which demonstrates a standardized approach to ensure prompt and effective management of sepsis. Having said that, there are barriers associated with the application of evidence-based practice, which often lead to an overall poorer adherence to guidelines. Considering the global burden of disease, data from low- to middle-income countries is scarce. Asia is the largest continent but most Asian countries do not have a well-developed healthcare system and compliance rates to resuscitation and management bundles are as low as 7.6% and 3.5%, respectively. Intensive care units are not adequately equipped and financial concerns limit implementation of expensive treatment strategies. Healthcare policy-makers should be notified in order to alleviate financial restrictions and ensure delivery of standard care to septic patients. PMID:26968289

  14. Ethical, Legal and Policy Issues in Management of Fetal Alcohol Spectrum Disorder

    PubMed Central

    Hackler, Chris

    2014-01-01

    Alcohol use during pregnancy may have severe and lasting effects on the developing fetus. Unfortunately it is often difficult to detect and address maternal drinking, as previous articles in this series have demonstrated. The difficulty is only compounded by a number of ethical quandaries and legal concerns. Underlying most of these concerns is a particularly agonizing conflict of obligations: to protect vulnerable, nascent human life on the one hand, and to preserve the privacy, dignity, and trust of one’s patient on the other. PMID:23252025

  15. Ethics and Policy Issues for Stem Cell Research and Pulmonary Medicine

    PubMed Central

    Lowenthal, Justin

    2015-01-01

    Stem cell research and related initiatives in regenerative medicine, cell-based therapy, and tissue engineering have generated considerable scientific and public interest. Researchers are applying stem cell technologies to chest medicine in a variety of ways: using stem cells as models for drug discovery, testing stem cell-based therapies for conditions as diverse as COPD and cystic fibrosis, and producing functional lung and tracheal tissue for physiologic modeling and potential transplantation. Although significant scientific obstacles remain, it is likely that stem cell-based regenerative medicine will have a significant clinical impact in chest medicine. However, stem cell research has also generated substantial controversy, posing a variety of ethical and regulatory challenges for research and clinical practice. Some of the most prominent ethical questions related to the use of stem cell technologies in chest medicine include (1) implications for donors, (2) scientific prerequisites for clinical testing and use, (3) stem cell tourism, (4) innovation and clinical use of emerging stem cell-based interventions, (5) responsible translation of stem cell-based therapies to clinical use, and (6) appropriate and equitable access to emerging therapies. Having a sense of these issues should help to put emerging scientific advances into appropriate context and to ensure the responsible clinical translation of promising therapeutics. PMID:25732448

  16. Involving citizens in the ethics of biobank research: informing institutional policy through structured public deliberation.

    PubMed

    O'Doherty, Kieran C; Hawkins, Alice K; Burgess, Michael M

    2012-11-01

    This paper reports on the design, implementation, and results of a structured public deliberation on human tissue biobanking conducted in Vancouver, Canada, in 2009. This study builds on previous work on the use of deliberative democratic principles and methods to engage publics on the social and ethical implications of human tissue biobanking. In a significant refinement of methods, we focus on providing public input to institutional practice and governance of biobanks using a tailored workbook structure to guide participants' discussion. Our focus is on the local context and practices of a particular institution, the BC BioLibrary. However, elements of both the methodological innovations and the ethical guidance implied by our findings are generalisable for biobanking internationally. Recommendations from the deliberative forum include issues of informed consent, privacy protections, collection of biospecimens, governance of biobanks, and how to manage the process of introduction between biobanks and potential donors. Notable findings include public support for research use of anonymised un-consented tissue samples when these come from archived collections, but lack of support when they are collected prospectively. PMID:22867865

  17. Ethics and policy issues for stem cell research and pulmonary medicine.

    PubMed

    Lowenthal, Justin; Sugarman, Jeremy

    2015-03-01

    Stem cell research and related initiatives in regenerative medicine, cell-based therapy, and tissue engineering have generated considerable scientific and public interest. Researchers are applying stem cell technologies to chest medicine in a variety of ways: using stem cells as models for drug discovery, testing stem cell-based therapies for conditions as diverse as COPD and cystic fibrosis, and producing functional lung and tracheal tissue for physiologic modeling and potential transplantation. Although significant scientific obstacles remain, it is likely that stem cell-based regenerative medicine will have a significant clinical impact in chest medicine. However, stem cell research has also generated substantial controversy, posing a variety of ethical and regulatory challenges for research and clinical practice. Some of the most prominent ethical questions related to the use of stem cell technologies in chest medicine include (1) implications for donors, (2) scientific prerequisites for clinical testing and use, (3) stem cell tourism, (4) innovation and clinical use of emerging stem cell-based interventions, (5) responsible translation of stem cell-based therapies to clinical use, and (6) appropriate and equitable access to emerging therapies. Having a sense of these issues should help to put emerging scientific advances into appropriate context and to ensure the responsible clinical translation of promising therapeutics. PMID:25732448

  18. The evidence-based paradox.

    PubMed

    Hinojosa, Jim

    2013-01-01

    Many occupational therapy practitioners consider evidence-based practice (EBP) to be the means by which occupational therapy can prove the validity of its services and thus support the legitimacy of our profession. The unquestioned acceptance of EBP as the way to establish credibility concerns me; unchallenged acceptance of any idea concerns me. Do practitioners accept EBP as the paradigm for guiding occupational therapy practice and research solely because it is presented as what we must do? I believe that practitioners must examine the implications for our profession of accepting EBP without question. In this article, I review EBP, present criticisms and concerns voiced by other professions and, finally, examine the implications of adopting an EBP perspective that replaces theory-directed practice. PMID:23433283

  19. Strategies for Teaching Internet Ethics.

    ERIC Educational Resources Information Center

    Rader, Martha H.

    2002-01-01

    Ten strategies for teaching Internet ethics are as follows: establish acceptable use policy; communicate ethical codes; model behaviors and values; encourage discussion of ethical issues; reinforce ethical conduct; monitor student behavior; secure systems and software; discourage surfing without supervision; monitor e-mail and websites; and…

  20. The challenge for NIH ethics policies: preserving public trust and biomedical progress.

    PubMed

    Bravo, Norka Ruiz

    2007-03-01

    Recently updated ethics rules for employees of the National Institutes of Health (NIH) aim to prevent inappropriate influences on research decisions while preserving employees' professional and scientific interactions. Specific provisions require NIH employees to report their financial holdings in "substantially affected organizations" and require senior employees to divest all holdings greater than $15,000 in any single such organization. Outside institutions that receive NIH grants are bound by separate disclosure requirements. Public-private partnerships have become more important to NIH efforts to advance biomedical research in light of flat NIH budgets in recent years. Such partnerships open the door, however, to financial conflicts that must be prevented or managed in order to maintain scientific integrity and public trust. PMID:17469471

  1. Evidence-based health information and risk competence

    PubMed Central

    Mühlhauser, Ingrid; Albrecht, Martina; Steckelberg, Anke

    2015-01-01

    Consumers and patients want to be included in decisions regarding their own health and have an ethically justified claim on informed decisions. Therefore, sound information is required, but health information is often misleading and based on different interests. The risks of disease and the benefits of medical interventions tend to be overestimated, whereas harm is often underestimated. Evidence-based health information has to fulfil certain criteria, for instance, it should be evidence-based, independent, complete, true as well as understandable. The aim of a medical intervention has to be explained. The different therapeutic options including the option not to intervene have to be delineated. The probabilities for success, lack of success and unwanted side effects have to be communicated in a numerical and understandable manner. Patients have the right to reject medical interventions without any sanctions. PMID:26195924

  2. History, Geography, and Citizenship: The Teacher's Role. Ethics and Public Policy Essay 64.

    ERIC Educational Resources Information Center

    Bennett, William J.; Kirkpatrick, Jeane

    One of a series of booklets designed to make available to a wide audience thoughtful perspectives on issues of domestic and foreign policy, this booklet contains two essays which provide a solid base for elementary and secondary teachers to communicate the nature of America's place in the world, its responsibilities, ideals, and traditions to…

  3. Integrating Ethical and Economic Interests. Suggested Policy and Practice for the Post-Industrial Society.

    ERIC Educational Resources Information Center

    Linnell, Robert H.

    Current academic policy and practice for supplemental income are analyzed in this speech. It is concluded that the traditional missions of an academic institution (e.g., teaching, scholarship and creative work, and public service) are lacking today. It is felt that commitment to income-producing sources may lead to unconscious compromise of…

  4. Sport Governance and Policy Development: An Ethical Approach to Managing Sport in the 21st Century

    ERIC Educational Resources Information Center

    Sawyer, Thomas H.; Bodey, Kimberly J.; Judge, Lawrence W.

    2008-01-01

    "Sport Governance and Policy Development" is written with the sport management student in mind. Designed to address the curriculum standards set by the National Association for Sport and Physical Education and the North American Society for Sport Management, this book provides information to meet core and related competency areas required for the…

  5. Advancing Democratic Principles: A European Examines a Neglected American Asset. Ethics and Public Policy Essay 49.

    ERIC Educational Resources Information Center

    Haseler, Stephen

    According to this essay by a visiting scholar from Great Britain, there will always be a debate in democratic societies, about the proper role of morality in fashioning and articulating foreign policy. This ambivalence has been reflected in the uneven approach to the problem exhibited by successive United States administrations. There are two…

  6. Ethical Principles as a Guide in Implementing Policies for the Management of Food Allergies in Schools

    ERIC Educational Resources Information Center

    Behrmann, Jason

    2010-01-01

    Food allergy in children is a growing public health problem that carries a significant risk of anaphylaxis such that schools and child care facilities have enacted emergency preparedness policies for anaphylaxis and methods to prevent the inadvertent consumption of allergens. However, studies indicate that many facilities are poorly prepared to…

  7. Street Children and The Work Ethic: New Policy for an Old Moral, Nairobi (Kenya)

    ERIC Educational Resources Information Center

    Droz, Yvan

    2006-01-01

    Kenyan policy-makers use the language of children's rights to legitimize, within the new global political order, an old colonial concern about controlling the urban marginal population. The local business community's worries about the safety of Nairobi's streets stand paramount, while the growing financial and political leverage of NGOs…

  8. The influence and ethics of interest groups on policy incentives for clean energy development

    NASA Astrophysics Data System (ADS)

    Maguire, Mariana C.

    The clean energy revolution in the United States is not going to happen until diverse stakeholders in the coalition of clean energy proponents strengthen their cohesion and influence—two critical tools for interest group's to be successful in driving the formulation of public policy. Currently, clean energy technology and resource development is supported by a highly diverse coalition of interest groups such as environmental groups, health organizations, industry, and the Defense Department, whose primary goals are often unrelated. Yet their objectives are increasingly well served by pursuing clean energy development by pushing lawmakers for supportive policies. However, characteristics of this ad hoc coalition can hinder its influence and cohesion. Whereas, fossil fuel interests—exemplified by the coalition of oil proponents—are highly cohesive and influential. This thesis will analyze whether there is a correlation between public policies on clean energy, and the strength of interest group influence over those policy decisions. It will begin with an analysis of interest group theories. Next it will analyze the histories of the oil industry as the model opponent of clean energy policies, and the biofuels, wind energy, and solar energy industries as the model proponents of clean energy policies. The composition of the respective coalitions will reveal if they are diverse or similar, with broad or narrow goals, and other important characteristics. Their respective policy positions and messages will show what values are important to them, and the presidential support each coalition has been achieved, or failed to achieve, will provide further insight into their effectiveness. This thesis will then apply interest group theories to the supporter and opponent coalitions. Results obtained indicate that the coalition of oil interests is large, yet very cohesive and influential, while the coalition for clean energy is large, generally diffuse but with some important

  9. Evidence-Based Integrative Dermatology

    PubMed Central

    Narahari, Saravu R; Prasanna, Kodimoole S; Sushma, Kandathu V

    2013-01-01

    American recognition for medical pluralism arrived in 1991. The National Center for Complementary and Alternative Medicine was established under the National Institutes of Health in 1998. Following this, patients and researchers began exploring use of integrative medicine. Terence Ryan with Gerry Bodeker in Europe, Brian Berman in America, and the Indian council of Medical Research advocated traditional medicine and integrative medicine. The Institute of Applied Dermatology (IAD), Kerala has developed integrated allopathic (biomedical) and ayurvedic therapies to treat Lymphatic Filariasis, Lichen planus, and Vitiligo. Studies conducted at the IAD have created a framework for evidence-based and integrative dermatology (ID). This paper gives an overview of advances in ID with an example of Lichen Planus, which was examined jointly by dermatologists and Ayurveda doctors. The clinical presentation in these patients was listed in a vikruthi table of comparable biomedical terms. A vikruthi table was used for drug selection in ayurvedic dermatology. A total of 19 patients were treated with ayurvedic prescriptions to normalize the vatha-kapha for 3 months. All patients responded and no side effects were recorded. In spite of advancing knowledge on ID, several challenges remain for its use on difficult to treat chronic skin diseases. The formation of new integrative groups and financial support are essential for the growth of ID in India. PMID:23716802

  10. Fundamental patterns of knowing in nursing: the challenge of evidence-based practice.

    PubMed

    Porter, Sam

    2010-01-01

    This article reconsiders the fundamental patterns of knowing in nursing in light of the challenge of narrow empirics in the form of evidence-based practice. Objections to the dominance of evidence-based practice are reviewed, and the reasons for it are examined. It is argued that it is partially the result of weaknesses in the alternative patterns of ethical, personal, and esthetic knowing, the ineffability of which compromises accountability. This ineffability can be countered only by introducing a wider form of empirics than countenanced by evidence-based practice into all patterns of knowing, to demonstrate their salience and to make their use in practice transparent. PMID:19996934