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At least 109 records · Page 6Linked to original sources
PubMed1985

Politics and bioethical commissions: "muddling through" and the "slippery slope".

When they have addressed highly controversial subjects, the bioethical commissions of the last decade have tended to avoid explaining the ethical justifications for their recommendations. This omission is consistent with the typical preference of policymakers for "muddling through," because it is often possible to reach agreement on specific decisions even when disagreeing sharply on principles. In bioethical policy, this omission of reasons has some special consequences. It allows commission members to ignore "slippery slope" arguments, which are based on the claim that the logic of justification adopted to address the current problem will ultimately lead us to great harms. Case-by-case decision-making--along with the omission of reasons for decisions--will tend to highlight the benefits of innovation, and downplay possible long-term effects that might be ethically upsetting.

Advisory Committees↗
PubMed1990

Expanding health insurance coverage: who will pay?

Recent discussions on extending health insurance to the more than thirty million uninsured Americans have focused on two strategies: expanding the Medicaid program and mandating that employers sponsor coverage for their employees. This analysis, using a microsimulation model of the U.S. health care financing system, suggests that these two options would result in very different distributions of financial burden. Employer-sponsored coverage is financed in a highly regressive fashion, in contrast to the Medicaid program, which is proportional to income. Furthermore, the burden of paying for health care under Medicaid varies little among generations, whereas the cost of employer-sponsored care is lowest in households headed by persons over sixty-five years old. Low health status populations do not pay disproportionately higher taxes or premiums to finance either the Medicaid program or employer-sponsored coverage. Their incomes, however, are more effectively protected by Medicaid, because it offers more comprehensive benefits.

Costs and Cost Analysis↗
PubMed2001

Breast cancer policy as a paradigm for other health prevention issues: analysis of the Breast and Cervical Cancer Mortality Prevention Act of 1990.

The public policy response to breast cancer mortality is examined through an analysis of federal legislation. Departing from the federal government's traditional role in health policy, the legislation funds states to provide directly some health services related to breast and cervical cancer. The legislation establishing a national program for breast and cervical cancer screening is used as an analytic model for policy development for preventive services for other public health issues. Increased collaboration between the public health community and the social work profession is advocated.

Breast Neoplasms↗
PubMed1993

The cost of ethics legislation: a look at the Patient Self-Determination Act.

The Patient Self-Determination Act (PSDA) requires hospitals to ask patients upon admission whether they have an advance directive. Although the PSDA has received extensive criticism, little attention has been paid to the cost of the law, either during its legislative course or following its implementation. Nonetheless, several tangible and intangible costs are associated with the PSDA. Such costs may be incurred by different parties. This paper examines the costs and benefits of the PSDA and illustrates the extent of some of its tangible costs. The incremental start-up cost for one institution's response to the PSDA is estimated to be $49,304 ($1.31 per admission) and the total implementation cost of the program to be $114,528. In addition, the national incremental start-up cost for hospitals to implement the PSDA is estimated to be between $43,625,114 and $101,569,922. Finally, the potential implications of the PSDA for future governmental health care ethics regulation are discussed.

Advance Directives↗
PubMed1996

Disagreement, consensus, and moral integrity.

The Advisory Committee on Human Radiation Experiments experienced some disagreements among its members in the course of its work. An epistemological controversy over the nature and degree of evidence required to draw ethical conclusions pervaded the Committee's deliberations. Other disagreements involved the proper role of a governmental advisory committee and the question of when it is appropriate to notify people that they were unknowing subjects of radiation experiments. In the end, the Committee was able to reach consensus on almost all of its findings and recommendations through a process that preserved the integrity of its members.

Advisory Committees↗
PubMed1997

Deleterious consequences of Hsp70 overexpression in Drosophila melanogaster larvae.

We compared transgenic Drosophila larvae varying in hsp70 copy number to assess the consequences of Hsp70 overexpression for growth and development after heat shock. Exposure to a mildly elevated temperature (36 degrees C) induced expression of Hsp70 (and presumably other heat shock proteins) and improved tolerance of more severe heat stress, 38.5-39.5 degrees C. We examined this pattern in two independently derived pairs of extra-copy and excision strains that differed primarily in hsp70 copy number (with 22 and 10 copies, respectively). Extra-copy larvae produced more Hsp70 in response to high temperature than did excision larvae, but surpassed the excision strain in survival only immediately after thermal stress. Excision larvae survived to adulthood at higher proportions than did extra-copy larvae and grew more rapidly after thermal stress. Furthermore, multiple pretreatment reduced survival of 1st-instar extra-copy larvae, but did not affect the corresponding excision strain. While extra Hsp70 provides additional protection against the immediate damage from heat stress, abnormally high concentrations can decrease growth, development and survival to adulthood.

Analysis of Variance↗
PubMedDate not supplied

Optimal search strategy for clinical trials in the Latin American and Caribbean Health Science Literature Database (LILACS).

OBJECTIVE: To define and disseminate the optimal search strategy for clinical trials in the Latin American and Caribbean Health Science Literature (LILACS). This strategy was elaborated based on the optimal search strategy for MEDLINE recommended by Cochrane Collaboration for the identification of clinical trials in electronic databases. DESIGN: Technical information. SETTING: Clinical Trials and Meta-Analysis Unit, Federal University of São Paulo, in conjunction with the Brazilian Cochrane Center, São Paulo, Brazil. (http://www.epm.br/cochrane). DATA: LILACS/CD-ROM (Latin American and Caribbean Health Science Information Database), 27th edition, January 1997, edited by BIREME (Latin American and Caribbean Health Science Information Center). LILACS Indexes 670 journals in the region, with abstracts in English, Portuguese or Spanish; only 41 overlap in the MEDLINE-EMBASE. Of the 168,902 citations since 1982, 104,016 are in human trials, and 38,261 citations are potentiality clinical trials. Search strategy was elaborated combining headings with text word in three languages, adapting the interface of the LILACS. We will be working by locating clinical trials in LILACS for Cochrane Controlled Trials Database. This effort is being coordinated by the Brazilian Cochrane Center.

Caribbean Region↗
PubMed1993

Medical technology assessment and practice guidelines: their day in court.

There is the expectation that outcomes research and the promulgation of medical practice guidelines will be able to identify and hopefully reduce the amount of unnecessary or inappropriate medical care through a variety of methods, including utilization review. However, past efforts by public and private insurers to deny claims on the basis of formal technology assessments or practice guidelines have frequently been overturned by the courts for multifarious reasons. This paper examines the court's reluctance to accept a variety of technology assessment methods in coverage policy decisions. The paper reviews the options that have been proposed to restrict judicial involvement in the formulation of coverage policy and then proposes a new option that employs a more precise taxonomy of medical practice assessment.

Complementary Therapies↗
PubMed1995

Managed health care companies' lobbying frenzy.

The top dozen national managed health care companies and two industry trade groups spent at least $2,023,041 on lobbying expenses and campaign contributions to key lawmakers during last year's health care debate, according to an analysis of Federal Election Commission data and federal lobbying disclosure forms. Five of the top six spenders are large insurance companies that are rapidly transferring their business from traditional indemnity insurance to HMOs. Over half--52 percent--of campaign donations from the top managed care companies' and trade associations' PACs and employees went to members sitting on the five Congressional committees with jurisdiction over health care reform.

Financial Support↗
PubMed1994

The baby chase.

Explore the source record for details and available documents.

Ambulatory Care Facilities↗