Thesis (L.L.M.)--York University, 2000. / "Graduate Programme in Law, Osgoode Hall Law School, York University." Includes bibliographical references. Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pMQ59546.

Research misconduct has been generally considered a limited issue, occurring in a small percentage of research studies. Studies of the number of article retractions use retraction percentages to perpetuate the idea that research misconduct is not a common event, and use information in the retraction notice to quantify types of research misconduct and types or research error. However, retractions appear to be the wrong variable with which to assess misconduct rates and characteristics. Using final misconduct findings in hard science research from the Office of Research Integrity (ORI) for investigations closed from 1993 through 2013, the number of publications and subsequent retractions or corrections per final ORI finding was analyzed. Out of 167 subjects who received ORI sanctions, 84 (50.3%) had no publications associated with their misconduct. Of the remaining 83 subjects, only 72 had at least one retraction associated with their misconduct, i.e., only 43.1% of the all study subjects sanctioned for misconduct had at least one retraction from misconduct. Of the 231 retractions and corrections arising from the sanctioned misconduct, only 94 notices (40.6%) gave research misconduct as a cause for the retraction or correction. Thus, the study demonstrates that research misconduct occurs at a greater rate than retractions for misconduct are published, and retraction and correction notices cannot be relied upon to convey the presence of fraudulent data within the publication.

A philosophical and scientific eclectic, Dr. Friedrich Hoffmann (1660-1742) brought together the wisdom of ancient writers with the new science and philosophy of his day. In the Medicus Politicus (The Politic Physician) (1738) he applied his concepts to medicine and medical ethics. The Medicus Politicus contains the lecture notes of Hoffmann as first professor of medicine at the University of Halle. The work is divided into three parts: the personal characteristics required by the new politic physician; the physician's relationship with other members of the medical community (often competitors); and the patient-physician relationship. This dissertation provides the first comprehensive English-language philosophical analysis and commentary on this work. It addresses two issues found in the Medicus Politicus: Hoffmann's model for the new physician and the medical ethics required in the patient-physician relationship. The political, intellectual and religious upheavals of the Long Eighteenth Century inform the work of Hoffmann. Physicians were not yet considered professionals and competed with the untrained. The new Hoffmannian physician would change that and would develop the personal qualities that were found in the professions of theology and law. Specifically, the Hoffmannian physician would be moral, rational and clinically competent. Hoffmann provided two independent but harmonious foundations to justify these requirements: one theological and one rational. Specifically, Hoffmann was an enthusiastic Pietist, a Natural Law theorist and an evidence-based scientist. His applied ethics is one of the most complete systems ever found in the medical clinical setting as it addresses each stage of the healing process. The focus of the patient-physician relationship is trust and trustworthiness. The physician is trustworthy when he is compassionate and competent. Patient and physician work together towards a mutual goal of the patient's healing. The judgments of both patient and physician are directed by prudence--seeking that which preserves society and individuals. This very mature concept of the ethics of the patient-physician relationship founded on trust and trustworthiness is the basis of modern concepts of patient, fiduciary trust, medical ethics and medicine as a profession. / text

<p> This study examined hospice physicians' understanding of and attitudes toward existential suffering and palliative sedation, including their understanding of existential suffering, their responses to existential suffering, their use of palliative sedation as a treatment for existential suffering, and the influences on physicians' attitudes and behaviors about palliative sedation. Data were collected through a semi-structured, one-on-one, in-person interview conducted with five physicians employed at one hospice. Each interview was audio-recorded and lasted approximately 60 minutes. The data were examined using thematic analysis. The physicians had consistent views regarding the complex nature of existential suffering and agreed that it is difficult to define and diagnose. They explained that they alleviate existential suffering by helping patients work through it through conversation over time (usually with other hospice team members). The physicians unanimously emphasized that palliative sedation should be a last resort&mdash;and typically given only for intractable physical suffering. Examination of the influences on physicians' decisions to administer palliative sedation revealed that their background, training, and experiences, as well as their personal values and beliefs, countertransference, their assessment of patient's actual need, and ethical concerns influenced their decisions about palliative sedation. Four recommendations are offered based on the study results: Increase physicians' comfort and competence with patients' existential suffering, incorporate training in the use of self for physicians, destigmatize the intervention of palliative sedation, and revisit the terminology of palliative sedation. Limitations affecting the study include small sample size as well as possible researcher bias due to her experience as a hospice social worker and views about palliative sedation. Continued qualitative research throughout the medical field is recommended to further build the body of knowledge about physicians' understanding of and response to patients' existential suffering.</p>

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The increasing impact of technology on health care has raised some important questions. This study is undertaken to examine how the predominance of a scientific approach to medicine and health care undermines other crucial aspects of the relationship between patients and care givers. / The role and function of language and its relationship to the ascription of human agency in the clinical setting is discussed. A patient's understanding and interpretation of the meaning of illness or disease requires a dialogue between patient and care giver such that the patient's agential horizons are incorporated into the decision-making process. A review is called for, therefore, of the dominance given to the technological over the human agential dimensions of decision-making in the health care environment.

This thesis considers the rationalization of health care in Canada. It focuses on the conflicting roles modern physicians play in our system, acting as both patient advocate and social agent. It begins by tracing the origin of both of these duties. It then examines the ethical, professional, and legal issues which arise in the limited circumstances where front-line physicians must participate in the rationing of health care. It offers a framework for resolving the double agent dilemma and states five interlocking recommendations which are the building blocks of the resolution.

Through a qualitative analysis of the use of intestinal parasites for treating immune system disorders, this research illustrates how contingency emerges in the context of the human relationship to hookworms. The affect of the human–nonhuman relationship is an important part of understanding the direction of evolutionary medicine today, and has implications for the politics of biological health innovations. The shift from the bad parasite to a parasite that at least sometimes heals, discursively and materially, has opened new spaces for patients to change the way they relate to medical knowledge, medical professionals, and pharmaceutical companies. Hookworms are banned by the FDA, which sets the scene for lively, but sometimes rebellious, hybridity between host and parasite. Underground and do-it-yourself hookworm therapy cultures have sprung up in around the site of the gut. I argue that not only is material hookworm affect as important as human discourses in negotiating the rapidly advancing field of biome reconstruction, but it also plays a role in how that biome reconstruction takes place, conventionally or otherwise.

<p> A Survey of Physical Therapists&rsquo; Perceptions of Workplace Ethics in the State of Georgia. Roberto Cantu, 2014: Applied Dissertation, Nova Southeastern University, Abraham S. Fischler School of Education. ERIC Descriptors: Physical Therapy, Ethics, Conflict of Interest, Ethical Instruction, Job Satisfaction. </p><p> This study examined how physical therapists in Georgia perceive ethical climates in their workplaces, based on the use of the Ethics Environment Questionnaire (EEQ), and how these perceptions may be different based on the type of workplace, financial status of their workplaces, their respective positions within their organizations, their age, gender, and years in the profession.</p><p> Questionnaires were sent to a random sample of 1200 physical therapists in Georgia; 340 surveys were completed and returned. The results suggested that, overall, physical therapists in Georgia are satisfied with the ethical environments of their workplaces. The average score was 3.8, higher than the 3.5 cutoff score that indicates an ethical environment. The only sub-group that scored below 3.5 on the EEQ were those who worked in skilled nursing/assisted living facilities (<i>M</i> = 3.35, <i>SD</i> = .67). There was a statistically significant difference in scores between therapists working in for-profit settings (<i>M</i> = 3.75, <i>SD</i> = .55) and therapists working in not-for-profit settings (<i>M</i> = 3.88, <i>SD</i> = .45; <i>t</i> (335) = -2.21, <i> p</i> = .027). Clinicians had the lowest perceptions of ethical climate (3.73), executives/owners the highest (4.29), with middle managers scoring in between the two groups. There were strong negative correlations between the perception of an ethical environment with burnout and intent to leave the place of employment (<i>r_s</i> = -.66, <i>p </i> &lt; .01; <i>r_s</i> = -.524, <i>p</i> &lt; .01).</p><p> Increased governmental/insurance regulation, increased paperwork, decreased reimbursement, and productivity issues were areas of most concern to therapists. Greater communication and dialogue between clinicians and managers was the dominant theme in the recommended solutions to these concerns.</p>

Paul Ramsey's medical ethics is built from a philosophical antinomy: Premise, the human being is a creature of will; Proposition, the human will is a free will; Contrary Proposition, the human will is a not-free will. General, exceptionless rules of conduct function in Ramsey's thought as moral restraint to human freedom. The moral agent ought always to act in accord with the demands of agape; and not only once but as often as the same features of a decision/action arise. General rules guide and restrain human free will in a necessary way to assure an ordered and moral society. This antinomy-interpretation helps locate Ramsey in the theatre of ethical debate; it also is the key to criticism of Ramsey's rigid rules in medical ethics.