Interesting conflicts and conflicting interests.
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Most evolutionary analyses of animal communication suggest that low-cost signals can evolve only when both the signaller and the recipient rank outcomes in the same order. When there is a conflict of interest between sender and receiver, honest signals must be costly. However, recent work suggests that low-cost signals can be evolutionarily stable, even when the sender and the receiver rank outcomes in different orders, as long as the interest in achieving coordination is sufficiently great. In this paper, we extend this body of work by analysing a game theory model that shows that low-cost signals can evolve when there are conflicts of interest and no interest in coordination, as long as individuals interact repeatedly. We also present an empirical example indicating that female rhesus macaques, Macaca mulatta, use honest, low-cost, vocal signals to facilitate interactions when conflicts of interest exist. Copyright 2000 The Association for the Study of Animal Behaviour.
Conflicts of interest for the clinician(physician)-researcher are not limited only to direct and clear financial support by manufacturers of the pharmaceutical and medical device industry, but rather include delicate indirect monetary and research support. Today professionals face an inevitable choice between two opposing moral orders, one based in the primacy of ethical obligations to the sick, the other in the primacy of self-interest and the marketplace. Some medical ethicists urge, reshape ethical codes to conform to the ethos of the marketplace, which legitimates self-interest over beneficence and makes vices out of most of traditional virtues. Second opinion represents the ethicists who recommend a firm stand in belief that being a physician imposes certain specific obligations. Medicine is at heart a moral enterprise and those who practice it are de facto members of a moral community. The market introduces an alien-till this time unknown-set of economic values into an institution (medicine) whose inherent ends are altruistic, but in countries under health care reform it brings a complex of special ethical issues in connection with deficient legislation and not firm ethical rules adopted. (Ref. 17.)
This article looks at key changes impacting on private hospital care: the increasing corporate ownership of private hospitals; the Commonwealth Government's support for private health; the significant increase in health fund membership; and the contracting arrangements between health funds and private hospitals. The changes highlight the often conflicting interests of hospitals, doctors, Government, health funds and patients in the provision of private hospital care. These conflicts surfaced in the debate around allegations of 'cherry picking' by private hospitals of more profitable patients. This is also a good illustration of the increasing entanglement of the Government in the fortunes of the private health industry.
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In December 2000, the University of Toronto breached a contract it held with me, initiating a sequence of events that has led to a public letter to the University from a large number of senior figures in the psychopharmacology community, protesting against the infringement of academic freedom involved, and a first-ever legal action seeking redress for violation of academic freedom. This case has been intertwined from the start with a longer running debate about the possibility that the SSRI group of antidepressants may have the potential to trigger suicidality or other serious effects in a subgroup of takers. And this specific issue connects to concerns about conflict of interest in the domain of therapeutics, as well as in science in general, the ghostwriting of scientific articles, and a series of other hot-spots on the interface between academia and industry.
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Historically the primary role of the Institutional Review Board (IRB) has been "to assure, both in advance and by periodic review, that appropriate steps are taken to protect the rights and welfare of humans participating as subjects in research" (U.S. FDA, 1996). However, there is much to suggest that IRBs have been unable to fulfil this mandate, particularly in regard to the matter of informed consent. Part of the problem in this regard is that the competing interests of other stakeholders often undermine the IRB's capacity to serve the best interests of research subjects. This paper proposes an alternative view of the role of the IRB. It begins by treating the interests of other stakeholders as legitimate matters of concern for IRBs. Hence the process established to review and monitor human research should be treated as an exercise in social justice in which the interests of all legitimate stakeholders must be represented and considered. A variation of Rawls' (1971) heuristic "the veil of ignorance" is employed to explore the dynamic relationship between knowledge and interests that ensues when the role of the IRB is characterized in this manner. Inadequacies in the informed consent process are taken as illustrative of the inability of IRBs as they are presently construed to attend to the interests of research subjects. The major normative implication of the analysis offered here is that the role of the IRB must be expanded to include the granting of a provisional proxy consent on behalf of prospective research subjects. This provision is necessary, it is argued, if the interests of research subjects are to be fairly assessed by IRBs as a matter of social justice. It is necessary as well to ensure that an adequate standard of informed consent is attained. Somewhat paradoxically it is argued that the interests of research subjects are better served when treated as one among a number of competing sets of interests the IRB must serve, rather than as the primary concern of the IRB.
Nurses involved in organ transplantation often face divided loyalties between the organ donor's family and the recipient. In this article, an Israeli nurse describes how such decisions must be dealt with using an ethical approach which preserves patients' rights and dignity.
It is said that ethics comprise principles of good conduct or standards governing the conduct of the members of a profession. These standards are unbending and strict, yet the reality is that occupational health professionals are subject to many conflicting pressures. Most of these stresses arise from the fact that employers and insurance companies, not worker-patients, fund OH services, and these two entities have overlapping, yet distinct, interests. OH professionals must consider the health and safety of individual workers as their top priority, while also addressing myriad other concerns. This is the moral challenge confronting practitioners.
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