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Results for “Social Control, Formal”

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At least 847 records · Page 47Linked to original sources
PubMed2000

Teenage suicides in northern Sweden: an interview study of investigating police officers.

OBJECTIVE: To disclose recurrent, dynamic, and static factors in teenage suicide involving the suicidee, his/her family, and the community; and to investigate the feasibility of using police as informants for suicide studies. SUBJECTS: All deaths categorised as suicide 1993 through 1995 among teenagers in Northern Sweden (n=15). METHOD: Semiqualitative interviews with police officers, and, when applicable, general practitioners. Police reports, necropsy protocols, medical records, and conscription data were also analysed. RESULTS: Most suicides occurred in rural and depopulated areas. In contrast to males, females often had a history of overt psychiatric problems with suicide attempts. At least two thirds of the suicides were planned. CONCLUSION: Cultural and sociopolitical aspects are important in teenage suicide as well as gender differences. Police officers can provide essential information. Identifying teenagers at risk remains difficult, however, due to low baseline rates.

Adolescent↗
PubMed2005

Hormone replacement therapy, cancer, controversies, and women's health: historical, epidemiological, biological, clinical, and advocacy perspectives.

Routine acceptance of use of hormone replacement therapy (HRT) was shattered in 2002 when results of the largest HRT randomised clinical trial, the women's health initiative, indicated that long term use of oestrogen plus progestin HRT not only was associated with increased risk of cancer but, contrary to expectations, did not decrease, and may have increased, risk of cardiovascular disease. In June 2004 a group of historians, epidemiologists, biologists, clinicians, and women's health advocates met to discuss the scientific and social context of and response to these findings. It was found that understanding the evolving and contending knowledge on hormones and health requires: (1) considering its societal context, including the impact of the pharmaceutical industry, the biomedical emphasis on individualised risk and preventive medicine, and the gendering of hormones; and (2) asking why, for four decades, since the mid-1960s, were millions of women prescribed powerful pharmacological agents already demonstrated, three decades earlier, to be carcinogenic? Answering this question requires engaging with core issues of accountability, complexity, fear of mortality, and the conduct of socially responsible science.

Cardiovascular Diseases↗
PubMed1985

Heroin addiction, ethics and philosophy of medicine.

This article discusses various ethical and philosophical aspects of heroin addiction. It arose as a result of the plan by the Amsterdam city council to supply free heroin to drug addicts. The objective of treatment of heroin addicts is ambivalent because what is in fact a socio-cultural problem is transformed into a medical problem. The characteristics of this treatment are made explicit through a philosophical analysis which sees the medical intervention as part of a strategy aimed at achieving social normalisation. The reason why such a social control function is practised by physicians is discussed, as well as the reason why heroin users in particular are the object of such a process. In this paper, heroin addiction is considered primarily as a cultural problem. The consequences of this for treatment and ethics form the conclusion.

Behavior Control↗
PubMed1990

Let the patients smoke: a defence of a patient privilege.

I examine two kinds of arguments in favour of imposing restrictions on smoking by hospitalised psychiatric patients. First, I look at patient-centered arguments in favour of restrictions. These arguments focus on the benefits that patients will receive if their smoking is stopped or curtailed. Second, I examine arguments that seek to justify restrictions by citing the costs that smokers impose on others. Neither kind of argument justifies any meaningful restrictions on the smoking of hospitalised psychiatric patients.

Behavior Control↗
PubMed2004

Evolutionary ethics: can values change.

The hypothesis that values change and evolve is examined by this paper. The discussion is based on a series of examples where, over a period of a few decades, new ethical issues have arisen and values have changed. From this analysis it is suggested that there are a series of core values around which most people would agree. These are unlikely to change over long time periods. There are then a series of secondary or derived values around which there is much more controversy and within which differences of view occur. Such changes need to be documented if we are to understand the process involved in the evolution of differences in ethical views.

Attitude of Health Personnel↗
PubMed1996

Covert video surveillance continues to provoke debate.

When the editor invites comment on a response to an analysis of a criticism of a protocol already defended by the author in this journal, the issue is clearly contentious. I will comment briefly on Thomas's paper in this issue of the journal, and look at points of agreement as well as dissent.

Behavioral Research↗
PubMed1997

Compensation for subjects of medical research: the moral rights of patients and the power of research ethics committees.

Awareness of the morally significant distinction between research and innovative therapy reveals serious gaps in the legal provision for compensation in the UK for injured subjects of medical research. Major problems are limitations inherent in negligence actions and a culture that emphasises indemnifying researchers before compensating victims. Medical research morally requires compensation on a no-fault basis even where there is proper consent on the part of the research subject. In particular, for drug research, there is insufficient provision in the current patient guidelines of the Association of the British Pharmaceutical Industry, since they make "no legal commitment" to paying compensation for injury to patient subjects. There is a need for the provision of both adequate insurance and contractual arrangements for making payments. The solution is for Local Research Ethics Committees (LRECs) to make use of their power to withhold approval of medical research where compensation is not legally enforceable.

Clinical Trials as Topic↗
PubMed1999

Selecting subjects for participation in clinical research: one sphere of justice.

Recent guidelines from the US National Institutes of Health (NIH) mandate the inclusion of adequate numbers of women in clinical trials. Ought such standards to apply internationally? Walzer's theory of justice is brought to bear on the problem, the first use of the theory in research ethics, and it argues for broad application of the principle of adequate representation. A number of practical conclusions for research ethics committees (RECs) are outlined. Eligibility criteria in clinical trials ought to be justified by trial designers. Research ethics committees ought to question criteria that seem to exclude unnecessarily women from research participation. The issue of adequate representation should be construed broadly, so as to include consideration of the representation of the elderly, persons with HIV, mental illness and substance abuse disorders in clinical research.

Biomedical Research↗
PubMed1999

How physician executives and clinicians perceive ethical issues in Saudi Arabian hospitals.

OBJECTIVES: To compare the perceptions of physician executives and clinicians regarding ethical issues in Saudi Arabian hospitals and the attributes that might lead to the existence of these ethical issues. DESIGN: Self-completion questionnaire administered from February to July 1997. SETTING: Different health regions in the Kingdom of Saudi Arabia. PARTICIPANTS: Random sample of 457 physicians (317 clinicians and 140 physician executives) from several hospitals in various regions across the kingdom. RESULTS: There were statistically significant differences in the perceptions of physician executives and clinicians regarding the existence of various ethical issues in their hospitals. The vast majority of physician executives did not perceive that seven of the eight issues addressed by the study were ethical concerns in their hospitals. However, the majority of the clinicians perceived that six of the same eight issues were ethical considerations in their hospitals. Statistically significant differences in the perceptions of physician executives and clinicians were observed in only three out of eight attributes that might possibly lead to the existence of ethical issues. The most significant attribute that was perceived to result in ethical issues was that of hospitals having a multinational staff. CONCLUSION: The study calls for the formulation of a code of ethics that will address specifically the physicians who work in the kingdom of Saudi Arabia. As a more immediate initiative, it is recommended that seminars and workshops be conducted to provide physicians with an opportunity to discuss the ethical dilemmas they face in their medical practice.

Attitude of Health Personnel↗
PubMed2006

Are comprehensive environmental changes as effective as health education for smoking cessation?

OBJECTIVES: To compare the effectiveness of health education on smoking cessation for all smokers regardless of their willingness to quit smoking and cumulative environmental changes including designation of smoking places, legislation, and price rise. DESIGN: Comparison of smoking cessation rates over two time periods: the period of health education on smoking cessation (1997-1999), and the period of cumulative environmental changes (2002-2004). SETTING: An occupational setting in a radiator manufacturing factory in Japan. SUBJECTS: All habitual male smokers who remained in the worksite through the pertinent time period (n = 202 in the period of health education and n = 170 in the period of environmental changes). MAIN OUTCOME MEASUREMENTS: Smoking cessation rates at the end of each time period. RESULTS: The smoking cessation rates over the periods of health education and environmental changes were 8.9% and 7.1%, respectively. There was no difference between these two proportions in a chi2 test (p = 0.513). The age adjustment did not significantly alter the cessation rate. CONCLUSIONS: Cumulative environmental changes are fairly effective in promoting smoking cessation, and may yield similar smoking cessation rates as a health education intervention reaching all smokers regardless of their willingness to quit smoking.

Adolescent↗