Friday, January 31, 2020
Ethics and Placebo Trials Essay Example for Free
Ethics and Placebo Trials Essay Placebo trials are experimental trials that involve the administration of a substance that does not really have any effect on the individualââ¬â¢s system. This means that it is a neutral trial that will have neither positive nor negative effects on the physiology of the person it is administered on. Whatever positive benefits may be derived out of placebo trials are merely therapeutic and may arise from the potency of the power of suggestion. These trials are most often used in randomized control trials in investigating the effectiveness of a specific treatment. (Miller and Brody, 3) However, with the rise of the use of such trials, there have been many more questions raised. Are these placebo control trials indeed necessary? What ethical issues are raised with the implementation of placebo trials? The debates regarding the ethicality of placebo trials in investigative research continue to rage across the scientific community. The discussion has become so complex that the sides taken regarding the matter have evolved to more than just ââ¬Å"yesâ⬠or ââ¬Å"noâ⬠to the question of placebo ethicality. There have been numerous aspects of placebo trials that have undergone the scrutiny of those directly involved with fields utilizing these trials. The main aim of this paper is to understand the obligations of medical practitioners who are employing placebo trials in their own scientific investigations of the effectiveness of various treatments. What ethical standards should these individuals, physicians and the like, take into consideration when conducting investigative researches with placebo trials? Glass and Waring The main problem with a physicianââ¬â¢s utilization of placebo trials for investigative purposes is the fact that they are part of the profession that involves the assurance of optimal health for their patients. Some of the researchers and critics exploring the ethical holds on medical practitioners with regards to placebo trials have looked at it from a legal standpoint. Glass and Waring (582) indicate that they have foundââ¬Å"no legal precedent allowing physicians to ââ¬Ëopt outââ¬â¢ of their professional obligations because they are researchers in addition to being physiciansâ⬠. It is emphasized that the physician must do all in his power in order to insure that the client receives all possible modes of treatment that would maintain or enhance his or her health. As a researcher, the physician is viewed as a fiduciary, a person delegated with power that will be used for the benefit of another person and who is held legally against the highest standards of conduct. The physician-researcher as a fiduciary, then, has a moral ascendancy over his or her patient-subject. (Glass and Waring, 578) This means that a placebo trial that would involve having the physician-researcher observe the null effect on the health of a patient-subject and at the same time have knowledge of the betterment of the health status of patient-subjects in the other experimental trials. (Glass and Waring 579) Thus physicianââ¬â¢s are now ethically compromised and even legally liable for their utilization and continuation of the placebo trial. Knowing that there is a treatment that could improve the health of those in the placebo arm of the experiment but not applying that treatment on the participants in that arm indicates their sacrifice of the health of those participants for the scientific progress afforded by research data. The ethical responsibility of the physician-reseracher, therefore, is in the fact that clinical studies of treatment effectivity make use of participants who have been diagnosed with the specific medical condition hoped to be treated by the experimentââ¬â¢s procedure. Hawkins Hawkins (484) states that the true problem faced by physician-researchers is a moral one. The moral norms and societal dictates placed upon those in the medical profession involve the fact that they need to be able to give a sick person all the possible chances of being treated. However, Hawkins (484) points out that this moral responsibility is limited. She states clearly ââ¬Å"researchers do not owe effective treatment to everyone around them. â⬠(473) The obligations of a physician to his or her patient are enclosed within a given framework, that of the physician-patient relationship. In order for such a relationship to be established, the physician must come into agreement with the client that he or she will indeed act as one half of that relationship. The same agreement must be made on the part of the client. Although this agreement may not be explicit, it is nevertheless positively acknowledged by both parties. (Hawkins, 476) There is, according to Hawkins, no ethical dilemma in a physician-researcherââ¬â¢s use of placebo trials. Just because these researchers have had medical training and have taken a medical oath does not mean that they are always in the role of a physician. These are individuals that have many other different roles as fathers, mothers, non-practicing physicians, friends and the like. The role they take as a researcher, therefore, does not mean a continuation of their role as a physician. (Hawkins, 479) The obligations of an individual in the role of a researcher is separate from his or her role as a physician thus their obligation in placebo trials involves simple assurance that the participant will not be harmed by the procedure that will take place. Miller and Brody Some critics of placebo control trials state a weakness in therapeutic obligation of physician researchers as the main grounds of contestation of the ethical foundations of the said trials. Miller and Brody (8) state that even when based on the principles of clinical equipoise, an ethical basis of assigning participants in different experimental arms which involves disagreement among experts as to the effectiveness of either arm, therapeutic obligation is still a weak attack against the ethics of placebo trials. The individuals who knowingly participate in experiments with placebo arms are not exploited as long as no harm befalls them. Also, they are aware that they enter the experimental set-up as participants in a research and not as patients of the researchers who happen to also be physicians. (Miller and Brody, 5) Miller and Brody thus state that ââ¬Å"placebo trials are not unethical just because they withhold proven effective treatmentâ⬠. (6) It is thus seen that the responsibility and obligation of the researcher with regards to the ethicality of placebos is not in their therapeutic obligations as physicians. However, this does not mean that placebo trials are completely ethical. This also does not mean that researchers are devoid of ethical obligations to their participants assigned to placebo arms of the investigative experiments. The ethical obligation of the researcher in placebo trials is the same as that of researcher in any clinical trials. This involves the proper acquisition of informed consent from the participants. Also, researchers must be able to assure the fact that participants will not be exploited or put in harmful situations. Miller and Brody also insist that researchers must first establish that the investigation has scientific merit and that scientific merit is increased with the implementation of the placebo trial. (8) Analysis and Argument All three articles assessed above have merit and, at the same time, also have faults. Glass and Waring (582) stating that no legal precedents were found that indicated physicians were no longer tied to their professional obligations is faulty. In much the same way that a lawyer does not have to give counsel to every jaywalker he or she sees, the physician likewise does not have professional obligation over individualââ¬â¢s whose relationship to him is simply that which exists between researchers and participants. I also disagree with Hawkinsââ¬â¢ statement that morality is what binds the physician thus the use of placebo trials is not unethical. What is ethics but a concept in the realm of morality? Yes, there are standards and regulations with regards to ethical conduct. However, as a whole, ethics is based on morality thus a moral problem is, in fact, an ethical problem. The middle ground taken by Miller and Brody also seems to be misled. A placebo trial is not equivalent to other clinical trials. It involves factors that are not present in other trials, such as the exposure of the participants to neutral treatment. In other clinical trials, there is still exposure to some form of treatment thus there is an effort to aid the participant. I believe, however, that physician-researcherââ¬â¢s obligations to the patient-participant, is limited solely to the relationship of researcher and participant. The role taken by the individual is not that of a physician but that of a researcher. The participants are also aware that they enter into the experiment not as patients but as participants. Although they are not given the chance to undergo possibly effective treatment, it is not the moral obligation of the researcher to insure that they do. Even if, for example, a person persists to smoke, I am not morally or ethically obligated to make sure that he or she stop. Placebo trials are valid research designs and should not be stopped simply because of a feeling that it is unfair to those who, in the first place, willingly submitted themselves to the experimentââ¬â¢s conditions. Works Cited Glass, Kathleen G. , and Waring, Duff. ââ¬Å"The Physician/Investigatorââ¬â¢s Obligation to Patients Participating in Research: The Case of Placebo Controlled Trials. â⬠The Journal of Law, Medicine Ethics 33 (2005): 575-585 Hawkins, Jennifer S. ââ¬Å"Justice and Placebo Controls. â⬠Social Theory and Practice 32 (2006): 467- 496. Miller, Franklin G. , and Brody, Howard. ââ¬Å"What Makes Placebo-controlled Trials Unethical? â⬠The American Journal of Bioethics 2(2002): 3-9
Thursday, January 23, 2020
African And Native American Slavery Essays -- Slavery Essays
African and Native American Slavery The 1500's, a time of discovery, was when the Europeans came to dominate most of the New World. The Europeans traveled to Africa and captured Africans to help develop their land and satisfy their need for power. I feel that the treatment of the Indians and Africans by the Europeans was completely unjustifiable. While the Indians and Africans were less technologically advanced and the Europeans were uneducated, in this particular field, nothing can compensate for the actions of the Europeans. Ã Ã Ã Ã Ã As Europeans began to settle new lands they began their exploration of the foreign worlds. What they found was the opposite of what they expected. They found what they thought was a new breed of humans. In reality they were just Native Americans. These Indians were less technologically advanced than the Europeans. They also worshipped different and multiple gods and ate different foods. Europeans saw this as barbaric, so they treated them as barbarians. In the beginning Native Americans hadn't the faintest idea of what the Europeans had in mind when they said trade. They figured that when the White Man came and showed all that hospitality they meant it. Of course, they didn't, the Europeans captured the Indians to be used as slaves. They were also slaughtered and raped because of resistance to leave their land. If any Indians refused to leave their land they would be killed. The women were raped for...
Wednesday, January 15, 2020
Goldilocks Point of Sale
1. 3 Statement of the problem There are several problems in computing the sales using calculator that the owner sometimes encountered. 1. 3. 1 General Problem This study will aim to answer this General question: Will it be useful for the company to have a Point of Sale? 1. 3. 2 Specific Problem Specially, this study sougth to answer the following question * What is the existing system of the company? * What is the advantages and disadvantages of a point of Sale (POS)? Will the company be able to see pictures of their products in the proposed system? 1. 4 Objective of the study The main aim of this study is to design a point of Sale for Goldilocks Macabebe Branch. 1. 4. 1 General Objectvie This study will make a point of sale for Goldilocks Macabebe Branch. And the most common problem in the store is having their difficult time in keeping the sale of record using the manual record method. The researcher had decided to make a system Exclusively for Goldilocks Macabebe Branch.To make th eir work easier and faster so that they can lessen the time they used in keeping records. 1. 4. 2 Specific Objective The study is design to fulfill this intent: * To design and develop a Point of Sales System for Goldilocks Macabebe Branch. * To have a computerized system that will be able to save filefor their products. * To have an automatic calculations of their daily sales. * To reveal the advantages and disadvantages of having a Point of sale (POS). * To make their work easier and faster. 1. 5 Hypothesis of the Study.The proponents hypothesized that the proposed Goldilocks Macabebe Branch Point of Sale (POS) will let the Company their computerized records and pictures of their products and an automatic computation of their sales every day. Most of their problem are on manual process taking a long time of work to encode the cakes and pastries. The proponents added more options related on other system like processing to make the system better. They only have a manual process that work slowly, the proponents assumed that the program processes work quickly. 1. 6
Tuesday, January 7, 2020
The Revolution Of The 19th Century - 939 Words
As the United States entered the 19th century, a new era of development and evolution in its economy, population, and technology was ushered into American society. America s economic and industrial power grew as a result of the industrial revolution of the 1800 s. At this time, organizations known as political machines saw an opportunity and capitalized on the fears and desires of individuals who wanted to achieve the American dream but could not necessarily find the means to achieve those goals.These political machines took control over urban areas because they promised wealth and prosperity to those who were looking for it. For impoverished immigrants that were searching for any means to survive, these incentives created a false sense of hope for those who believed that political machines truly had their best interest at heart. Essentially, political machines were just another chance for someone to make money off of another person by taking advantage of their unfortunate circumstan ces and voting rights in order to control the politics of their cities. America was growing rapidly, but this came at a great cost. The late 19th century was coined by Mark Twain as the Gilded Age because everything in the United States seemed to be flourishing, the industrial age had created an illusion of prosperity due to underlying issues such as: poverty, crime, corruption, and over-crowding due to a large influx of immigrants from Europe. At this time, there was no possible way forShow MoreRelatedThe Revolution Of The 19th Century1609 Words à |à 7 PagesIn the early 19th century, Napoleon rose to power in Europe. In 1804, a young man, visited his empire. In 1808, he conquered Spain. 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