Group Benefit and Protection of Pediatric Research Subjects: Grimes v. Kennedy Krieger and the Lead Abatement Study

The Maryland Court of Appeals in Grimes v. Kennedy Krieger Institute was sharply critical of the lead abatement study conducted by this Institute, an affiliate of Johns Hopkins University. Grimes ruled that investigators might, given the facts of the case, have a special relationship with subjects, thereby creating a duty of care that could, if breached, give rise to an action in negligence. This ruling has implications for pediatric research practices and long-standing disputes among informed people of good will about what pediatric studies should be permitted.     

Competence and consent to research: A critique of the recommendations of the national bioethics advisory commission*

Concern about the participation of incompetent subjects in psychiatric research has grown in the last several years. In response, the National Bioethics Advisory Commission (NBAC) recommended in its recent report that all investigations involving persons with mental disorders that may be associated with cognitive impairment that may pose greater than minimal risk to subjects utilize independent assessors to verify the capacities of subjects prior to entry into the study. This recommendation poses several problems for the conduct of research and the protection of research subjects. First, it fails to target that group of subjects most likely to be at risk for incapacity. Second, it focuses on too broad a range of research projects, many of which pose little risk to participants. The substantial costs of this approach are therefore not likely to be outweighed by concomitant benefits. In place of the NBAC recommendation, the author proposes a more flexible system of capacity assessment, designed to balance the costs with a greater likelihood of achieving meaningful protection for research subjects with mental disorders.     

Does Drinking Alcohol Prior to Sexual Activity Influence College Students’ Consent?

Objectives: This study assessed the extent to which consuming alcohol prior to sexual activity influenced college students' verbal/behavior cues utilized to communicate consent (external consent) as well as their feelings associated with consent (internal consent). Methods: Data was collected via paper-and-pencil surveys administered to heterosexual college students (N = 794) in the United States. Results: After controlling for gender, relationship status, rape myth acceptance, and alcohol expectancies, findings indicated that alcohol consumption prior to sexual activity was associated with both internal and external consent. Conclusions: Current findings can help inform sexual assault prevention education programming given the high rates of sexual assault occurring on college campuses that involve alcohol consumption.     

知情选择对人工流产影响的验证

利用固定效应模型对1988—2001年全国计划生育／生殖健康调查数据进行了再次分析,以量化考察知情选择政策对中国已婚育龄妇女人工流产行为的影响。研究发现,知情选择与已婚育龄妇女人工流产可能性的降低之间呈现一定的因果关联。知情选择导致了育龄妇女人工流产的可能性降低,并在各个孩次上都有明显的体现。     

The Planets Aligned: Is Child Protection Policy Reform Good Luck or Good Management?

Abstract

Governments across Australia are struggling to address escalating child protection notifications, a marked increase in the number of children in State care, a decrease in the number of foster carers and chronic workforce shortages in child welfare services. This paper explores the reform process that culminated in the proclamation of the Victorian Children, Youth and Families Act, 2005 and represents an aspect of the response in Victoria to these wider issues. It explores the history of the reform from the perspective of key actors from government, non-government sectors and academics who participated in the process. The paper explores the “ingredients of social policy reform” and how the change process was managed in Victoria. It does not seek to evaluate the reform but rather to understand the complex processes through which a propitious moment for reform was both seized and constructed.     

宣州基层避孕方法知情选择工作浅析

基于对安徽省宣州市几个乡镇的走访调查 ,概述了当地避孕方法知情选择工作开展现状和取得的初步成效 ,简要分析了存在的问题并提出相应改进建议     

人身保险合同中的保险利益之我见

保险利益是保险合同的核心,缺乏保险利益的保险合同是无效的合同.本文对人身保险合同中有关保险利益的三个问题,即保险利益的主体、范围以及保险利益原则的存废进行了探讨.笔者认为,应增加受益人为保险利益的主体,同时对保险利益的范围应做扩大解释,并对保险利益原则予以保留.     

What influences respondents to behave consistently when asked to consent to health record linkage on repeat occasions?

This study constitutes the first longitudinal exploration of consent to link survey and administrative data. It examines variations in consent over time and explores the influence of the respondents’ characteristics (both observed and latent) and the impact of the interviewers on consent co-operation. Respondent inclination to consent is modelled as a latent construct. Most respondents behave consistently over time. However, this consistency is not driven by a strong inclination to consent but rather by the circumstances of the respondents at the time of the interview and by the impact of the interviewers themselves. The findings also show that the change in consent behaviour over time is a clear indication that consent should be treated as a dynamic phenomenon at the individual level.     

Refusal of recommended maternity care: Time to make a pact with women?

Background

The right to refuse medical treatment can be contentious in maternity care. Professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy, but there is little guidance available to clinicians about the appropriate clinical responses when women decline recommended care.