Consent and Informed Consent: Their Ongoing Evolutions in Clinical Care and Research on Humans

The dual concepts of 'consent' and 'informed consent' continue to have three evolutions. The primary evolution of consent in the patient–physician relationship began in Great Britain in 1767 in the British case, Slater v. Baker and Stapleton , in the judge-made law of consent. The term 'informed consent' within the patient–physician relationship entered the judicial lexicon in the 1957 California appellate case, Salgo v. Leland Stanford Junior University . In its second evolution within research on humans following the Nuremberg trials that included experimental atrocities on humans, there is a key focus on clarifying the purpose of research and specifying the reasons for the need for an even more extensive risk disclosure to individuals considering volunteering for study participation. This second evolution continues with the further refinement of the Declaration of Helsinki and, within the USA, a focus on the Belmont Report . In its third evolution in research in the social science, there has been a recognition of problems with informed consent to questionnaire research. When questionnaires involve patients with moderate or severe posttraumatic stress disorder or abused individuals, there needs to be intense consideration focused on how to best protect the participants with these conditions during the questionnaire study.     

Social and demographic determinants of abortion in Poland

Summary Most abortions in Polish hospitals and clinics are performed on social indications. In the 22 administrative areas of Poland, the high rates of divorce and large proportions of total population employed in non-agricultural pursuits reflect the individualistic approach to family planning which is characteristic of present-day urban society. Industrialization is disruptive to the normal functioning of the country's traditionally large families. In addition, the gross reproduction rate increases directly with the proportion of the peasant population in 17 voivodships and five large cities of Poland, whereas in the urban sector the gross reproduction rate has fallen below replacement level in the past few years. Rural birth rates will continue to decline. In view of increasing needs for future manpower, population policy aimed at increasing births through incentives to prospective mothers may achieve a limited degree of success in cities only among the educated segments of the female population.     

Reconstruction of fertility trends for the female population of the U.S.S.R

Abstract The article describes fertility trends among Soviet women during the past 40 years as compared to American women during the same period of time. Period-specific fertility rates were arrived at by relating the annual total of live births to a pattern of age-specific fertility rates estimated for each year and also to the number of women for each single year of age. These rates were then appropriately re-arranged and compressed into five-year age groups to form a series of cohort-specific fertility rates. The findings rest on somewhat conjectural estimates of live births and numbers of women in the U.S.S.R., some of which were originally prepared before the 1959 Soviet census. The tentative evidence shows that changes in the period-specific fertility of Soviet women were far more irregular and dramatic in the past, than among American women. After World War II these rates dropped in the U.S.S.R. below those of the United States, except for women over 30 years of age. On the other hand, the cohort-specific rates of Soviet women, although declining from one cohort to the next, at present show their magnitude in the cumulative series for older ages to be marked by higher than among American women. This experimental investigation of fertility in the Soviet Union makes no claim to high standards of accuracy and validity. Its intended purpose is to stress the desirability of shifting emphasis from the temporal and prognostic type of study, characteristic of present-day demographic research about the U.S.S.R., to the generational and historical approach.     

Expectancy of life at birth in 36 nationalities of the Soviet Union: 1958-60

Abstract In the 36 nationalities of the Soviet Union the estimated expectancy of life at birth ranged from 50·0 years for Chechens to 71·1 years for Latvians with a median of about 67·5 years for Russians. In essence, the life table function e(0) was generated from the child-woman ratios with the use of intricate equations based on empirical data obtained from official Soviet publications. A modified version of Bourgeois-Pichat's model was used to estimate life expectancies at birth among the 36 nationalities on the basis of their crude death rates and the percentage of population aged 65 years and over. The 1959 U.S.S.R. Census of Population provided information pertaining to the older age groups. The crude death rates were estimated separately with the aid of second-degree polynomials fitted to the crude demographic measures for 109 administrative areas of the Soviet Union for 1960. Information about recent improvements in public health, as well as conjectural evaluations of economic advancement in recent years were examined and related to the past and present level of mortality among the Russian people and the remaining population of minorities.     

Redefining Success: A Qualitative Investigation of Therapeutic Outcomes for Noncompleting Drug Court Clients

ABSTRACT

Utilizing a convenience sample from a drug court program, the authors investigated the benefits of treatment for noncompleting drug court clients (n = 30). Using an as-treated design, the qualitative investigation assessed whether noncompleters received any benefit from their drug court experience. In-depth interviews were conducted to determine both benefits gained and reductions in harm that occurred as a result of drug court participation. Data analysis was guided by the grounded theory method. Outcomes of coding indicated that participants' motivation and self-efficacy were enhanced through the intervention. Further, participants reported that their relationships with family, therapists, or peers were improved as a result of their involvement with drug court. Individuals in the study sample reported abstinence or decreased substance use, as well as improvements in employment and/or educational attainment. Participants’ perceptions of barriers to program completion were also noted. Study outcomes suggest that expansion of a harm reduction approach in social service practice may have utility for drug-abusing populations. Limitations of the research, including lack of generalizability, are discussed. Further research of harm reduction effects with a larger, heterogeneous sample size is recommended.     

How Bad Can a Crisis Be If It Does Not Top the News?

Sudden onset of front-page news about the U.S. financial crisis, beginning September 6, 2008, may have exacerbated underlying financial problems and facilitated the spread of risk panic to other nations.