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Should We Charge Patients for Medical Research?

A FEW months ago, we got a call from a former oncology professor of ours. He had developed an experimental precision diagnostic test that he thought would be able to determine which chemotherapies would be most effective against a patient’s cancer. He wanted to conduct a research trial to evaluate the effectiveness…

Clinical research: Should patients pay to play?

Paying people for their participation in research has long engendered controversy. Payments, some argue, can be an undue inducement that exposes participants to unnecessary risks and undermines the voluntary nature of informed consent. Although some disagreement remains, these charges have now largely been refuted by both argument and data. But what…

A Professor Just Gave Us a Brutally Honest Assessment of Killer Robots

More than 1,000 of the world's top tech leaders and robotics experts are urging for a ban on offensive autonomous weapons before it leads to a future arms race with the potential production of cheap, killer robots. As technology develops, it is inevitable that people could develop robots to kill people,…

Casarett: What I Learned at the Weed Dispensary

The first time you meet Robin, it’s easy to be misled by her fragile appearance. She’s in her 40s and painfully thin, and she grips her aluminum walker with hands that have been twisted by rheumatoid arthritis. But she’s both tough and resourceful, and she doesn’t give up easily. I met…

Logic Models--Tools to Bridge the Theory-Research-Practice Divide

Clinical investigators must confront the challenge of developing interventions that are based on sound theory and can be implemented in real-world settings. In research, the standard tool to help address the sound theory component of this challenge is the conceptual model, which can be useful in relating broad theoretical constructs but…

Ethics of Development Assistance for Health

In the past three decades, levels of and contributors to global health aid have increased at an unprecedented pace. Development assistance for health—financial contributions from public and private institutions to low- and middle-income countries to help improve health and health systems—nearly quintupled from 1990 to 2012 (from $5.7 billion to $28.1…

Transplanting Hepatitis C-Positive Kidneys

The scarcity of kidneys for transplantation and high mortality among patients on the waiting list have led some patients to accept kidney transplants that carry elevated risks of transmitting infections or cancer. In certain cases, such as the transmission of cytomegalovirus, physicians can anticipate these events and institute preventive measures. But…
Tags: peter reese

Stoned: A Doctor's Case for Medical Marijuana

No substance on earth is as hotly debated as marijuana. Opponents claim it’s dangerous, addictive, carcinogenic, and a gateway to serious drug abuse. Fans claim it as a wonder drug, treating cancer, anorexia, AIDS, chronic pain, glaucoma, arthritis, migraines, PTSD, and insomnia. Patients suffering from these conditions need—and deserve—hard facts based on medical…

MBE Alum Emily Kramer-Golinkoff honored as White House Champion of Change

Emily Kramer-Golinkoff, manager of strategic initiatives and operations at the Penn Social Media and Health Innovation Lab and cofounder of Emily’s Entourage was honored by the White House as a Champion of Change for Precision Medicine on Wednesday, July 8. Learn More

Promoting Informed Decision Making for Comparative Effectiveness Randomized Trials

The US Code of Federal Regulations governing human participants research requires that investigators disclose reasonably foreseeable risks of a research study to prospective participants during the informed consent process. Although this mandate appears straightforward, controversy surrounds how investigators should define and describe risks of comparative effectiveness randomized clinical trials (CE-RCTs) that…

Public health, universal health coverage, and Sustainable Development Goals: can they coexist?

In her 2012 reconfirmation speech as WHO Director-General, Dr Margaret Chan asserted: “universal coverage is the single most powerful concept that public health has to offer. It is our ticket to greater efficiency and better quality. It is our saviour from the crushing weight of chronic noncommunicable diseases that now engulf…

US Congress moves to block human-embryo editing

The US House of Representatives is wading into the debate over whether human embryos should be modified to have heritable changes. Its fiscal year 2016 spending bill for the US Food and Drug Administration (FDA) would prohibit the agency from spending money to evaluate research or clinical applications for such products.…

The Elusive Right to Health Care Under U.S. Law

Is there a right to health care in the United States? No U.S. Supreme Court decision has ever interpreted the Constitution as guaranteeing a right to health care for all Americans. The Constitution does not contain the words “health,” “health care,” “medical care,” or “medicine.” But if we look deeper, a…

Penn's Emanuel on high priced drugs, high priced technology, including Penn's

Ezekiel Emanuel, chair of the department of medical ethics and health policy at the University of Pennsylvania, is not afraid of delivering difficult news. Speaking to biotech and health executives at an invitation-only event Monday in Philadelphia, he said he was invited as a counter balance to other speakers, whom he…

How national security gave birth to bioethics

Starting near the end of World War II and continuing until the 1970s, the US government sponsored radiation experiments on human subjects. Some of these experiments were conducted to understand the effects of radiation on atomic bomb workers. Others were to learn about the benefits of radiation for cancer patients. Many…

Responses to donor proliferation in Ghana's health sector: a qualitative case study

This article presents findings from a qualitative case study of the responses to a proliferation of donor aid to the health sector in Ghana. Between 1995 and 2010, Ghana gained 17 such donors – more than most other countries that received health-sector aid during this period. In adopting policies for donor…

Nurse Staffing and Patient Safety

To the Editor: Alexandra Robbins paints a morally distressing picture of the occupational oppression of nurses in some American hospitals. When nurses cannot advocate for the safety and well-being of their patients without fear of retaliation and threats to their job security for speaking out about perceived unsafe staffing conditions, nobody…

Women's political participation and health: a health capability study in rural India

Understanding the relationship between women's political participation and health has eluded researchers and cannot be adequately studied using traditional epidemiological or social scientific methodologies. We employed a health capability framework to understand dimensions of health agency to illuminate how local political economies affect health. Exploiting a cluster-randomized controlled trial of a…

Multigene Cancer-Susceptibility Tests Require New Approaches to Patient Counseling

Multigene panel (“multiplex”) gene tests for cancer susceptibility can save time compared to sequential targeted-gene tests, and are becoming more widely used. Many see them as an inevitable and important step toward genomics-based cancer prevention. But it is too soon for multiplex tests to be offered broadly as a routine part…

Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation

We randomly assigned CVS Caremark employees and their relatives and friends to one of four incentive programs or to usual care for smoking cessation. Two of the incentive programs targeted individuals, and two targeted groups of six participants. One of the individual-oriented programs and one of the group-oriented programs entailed rewards…