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Solving the climate crisis: lessons from ozone depletion and COVID-19
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- Mark P. Baldwin, Timothy M. Lenton
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- Journal:
- Global Sustainability / Volume 3 / 2020
- Published online by Cambridge University Press:
- 21 September 2020, e29
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The ‘climate crisis’ describes human-caused global warming and climate change and its consequences. It conveys the sense of urgency surrounding humanity's failure to take sufficient action to slow down, stop and reverse global warming. The leading direct cause of the climate crisis is carbon dioxide (CO2) released as a by-product of burning fossil fuels,i which supply ~87% of the world's energy. The second most important cause of the climate crisis is deforestation to create more land for crops and livestock. The solutions have been stated as simply ‘leave the fossil carbon in the ground’ and ‘end deforestation’. Rather than address fossil fuel supplies, climate policies focus almost exclusively on the demand side, blaming fossil fuel users for greenhouse gas emissions. The fundamental reason that we are not solving the climate crisis is not a lack of green energy solutions. It is that governments continue with energy strategies that prioritize fossil fuels. These entrenched energy policies subsidize the discovery, extraction, transport and sale of fossil fuels, with the aim of ensuring a cheap, plentiful, steady supply of fossil energy into the future. This paper compares the climate crisis to two other environmental crises: ozone depletion and the COVID-19 pandemic. Halting and reversing damage to the ozone layer is one of humanity's greatest environmental success stories. The world's response to COVID-19 demonstrates that it is possible for governments to take decisive action to avert an imminent crisis. The approach to solving both of these crises was the same: (1) identify the precise cause of the problem through expert scientific advice; (2) with support by the public, pass legislation focused on the cause of the problem; and (3) employ a robust feedback mechanism to assess progress and adjust the approach. This is not yet being done to solve the climate crisis, but working within the 2015 Paris Climate Agreement framework, it could be. Every nation can contribute to solving the climate crisis by: (1) changing their energy strategy to green energy sources instead of fossil fuels; and (2) critically reviewing every law, policy and trade agreement (including transport, food production, food sources and land use) that affects the climate crisis.
Rice (Oryza sativa) Response to Imazaquin Residues in a Soybean (Glycine max) and Rice Rotation
- Ronnie S. Helms, Timothy N. Tripp, Roy J. Smith, Jr., Ford L. Baldwin, Max Hackworth
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- Journal:
- Weed Technology / Volume 3 / Issue 3 / September 1989
- Published online by Cambridge University Press:
- 12 June 2017, pp. 513-517
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Nine field experiments were conducted from 1984 through 1988 to determine the effect on rice of imazaquin applied to soybeans the previous growing season. Imazaquin was applied preplant incorporated, preemergence, or postemergence at rates ranging from 70 to 560 g ai/ha. ‘Bond’, ‘Lemont’, ‘Mars', ‘Newbonnet’, and ‘Tebonnet’ rice were planted the following year. Across all locations, years, cultivars, soil series, methods of application, and imazaquin rates, rice injury symptoms were not observed, and rice grain yields were not reduced by imazaquin residues.
Can machine translation systems be evaluated by the crowd alone
- YVETTE GRAHAM, TIMOTHY BALDWIN, ALISTAIR MOFFAT, JUSTIN ZOBEL
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- Journal:
- Natural Language Engineering / Volume 23 / Issue 1 / January 2017
- Published online by Cambridge University Press:
- 16 September 2015, pp. 3-30
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Crowd-sourced assessments of machine translation quality allow evaluations to be carried out cheaply and on a large scale. It is essential, however, that the crowd's work be filtered to avoid contamination of results through the inclusion of false assessments. One method is to filter via agreement with experts, but even amongst experts agreement levels may not be high. In this paper, we present a new methodology for crowd-sourcing human assessments of translation quality, which allows individual workers to develop their own individual assessment strategy. Agreement with experts is no longer required, and a worker is deemed reliable if they are consistent relative to their own previous work. Individual translations are assessed in isolation from all others in the form of direct estimates of translation quality. This allows more meaningful statistics to be computed for systems and enables significance to be determined on smaller sets of assessments. We demonstrate the methodology's feasibility in large-scale human evaluation through replication of the human evaluation component of Workshop on Statistical Machine Translation shared translation task for two language pairs, Spanish-to-English and English-to-Spanish. Results for measurement based solely on crowd-sourced assessments show system rankings in line with those of the original evaluation. Comparison of results produced by the relative preference approach and the direct estimate method described here demonstrate that the direct estimate method has a substantially increased ability to identify significant differences between translation systems.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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A lexical semantic approach to interpreting and bracketing English noun compounds
- SU NAM KIM, TIMOTHY BALDWIN
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- Journal:
- Natural Language Engineering / Volume 19 / Issue 3 / July 2013
- Published online by Cambridge University Press:
- 30 May 2013, pp. 385-407
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This paper presents a study on the interpretation and bracketing of noun compounds (‘NCs’) based on lexical semantics. Our primary goal is to develop a method to automatically interpret NCs through the use of semantic relations. Our NC interpretation method is based on lexical similarity with tagged NCs, based on lexical similarity measures derived from WordNet. We apply the interpretation method to both two- and three-term NC interpretation based on semantic roles. Finally, we demonstrate that our NC interpretation method can boost the coverage and accuracy of NC bracketing.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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Contextual risk and resiliency during late adolescence
- Alfred L. Baldwin, Clara P. Baldwin, Timothy Kasser, Melvin Zax, Arnold Sameroff, Ronald Seifer
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- Development and Psychopathology / Volume 5 / Issue 4 / Fall 1993
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- 09 September 2009, pp. 741-761
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The factors contributing to the mental health of a sample of 18-year-olds were analyzed in a hierarchical multiple regression analysis. The contribution of proximal variables such as parenting behavior, intermediate variables such as other family factors, and the more distal variables such as social class and minority status were all highly significant. Child variables were also found to make significant contributions to understanding mental health. When the sample was divided into three subsamples, white advantaged, white disadvantaged, and African American (almost entirely disadvantaged), the mental health of the African American sample was higher than that of the white disadvantaged sample. The regression coefficients fit to the whole sample underestimated the mental health of the African Americans and overestimated the health of the white disadvantaged. The parenting of the African American sample was less approving and more critical and more controlling than that of the other two samples. To investigate the correlates of resilience, pairs of subjects were contrasted who had the same mental health but differed in whether they exceeded or were less than the mental health predicted for them. None of the variables in the study differentiated significantly between the two groups.
Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
- Stuart M. White, Timothy J. Baldwin
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- 18 August 2009
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- 09 December 2004
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Clinical decisions in modern medical practice are increasingly influenced by ethical and legal issues, but few doctors have been formally trained in medical law and ethics, and are unsure of potential sources of accessible information, which leaves them exposed to public criticism and the threat of legal action. Perioperative medicine and critical care are, by their very nature, subjects in which issues of autonomy, dignity, consent, confidentiality, medical research, life and death decision making, and the rationing of health care resources are ever-present. This book provides a straightforward but comprehensive one-stop reference and should be essential reading for all medical and allied health care professionals who encounter ethicolegal problems during their management of patients.
Index
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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- Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
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2 - An introduction to the UK legal system
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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- Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
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Summary
Similarly to the other professions, the legal profession has established its own hierarchy, language and code of practice, in order to manage the large number of people professing general and specialist legal knowledge. As a result, the workings of the legal profession can appear arcane to the outsider, even despite recent attempts to improve public accessibility to the law.
This chapter provides a short introduction to legal system in the UK, as well as listing a number of sources of information by which the lay person may further access legal information.
STRUCTURE OF THE UK LEGAL SYSTEM
The UK has three distinct legal jurisdictions: England and Wales, Scotland, and Northen Ireland. All of the jurisdictions are common law jurisdictions, but Scotland has a very distinct, separate and interesting legal system that incorporates aspects of the civilian system of law seen in continental Europe.
The legal profession in the UK is split into two branches, solicitors and barristers, whose training, practice and regulation are separate.
Solicitors are the legal equivalent of general practitioners, and are visited first by clients seeking legal advice. Solicitors instruct barristers to provide specialist legal advice and representation (if necessary) in court. Solicitors in England and Wales are regulated by The Law Society of England and Wales. In other countries of the UK they are regulated by the equivalent body.
Barristers play a similar role to that of hospital consultants, acting as a referral service for solicitors.
5 - Consent
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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- Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
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Summary
Obtaining consent from a patient is not the same as having the patient sign a consent form. Instead, consent should be viewed as a legal and ethical concept that reflects the respect given by a society towards the autonomy of its citizens.
In a medical setting, consent allows an autonomous patient (i.e. one who has the capacity to think, decide and act on the basis of such thought, independently and without hindrance) to define and protect his or her own interests and to control bodily privacy. In law, consent is a device that protects the autonomy of a patient from interference by another party. Any doctor, for example, may be liable in battery or assault if (s)he administers a treatment to a patient without obtaining valid consent from them. Legal sanctions, including awards of damages, injunctions and (in extreme cases) imprisonment are employed to ensure that patient autonomy is respected.
Recourse to the law, however, does not necessarily address the thornier moral problem of why doctors should respect their patients' autonomy, and why they should respect it in preference to other principles that influence the relationship (such as paternalism). Nevertheless, respect for autonomy has become a central pillar of contemporary medical law and ethics, and has resulted in a greater emphasis on patient-centred determination of treatment strategies.
ETHICS
Autonomy
Many authors have attempted to provide an all-encompassing definition of autonomy (Greek: autos – ‘self ’, nomos – ‘rule’).
13 - Resource allocation
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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- Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
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It is sometimes said that the entire gross domestic product (GDP) of the UK, or indeed any country, would be insufficient to pay for the healthcare of its citizens. In fact, only about 7% of the GDP of the UK is spent on healthcare, roughly equivalent to £1000 per person per annum (these figures are marginally lower than the equivalent values in Germany and France, and approximately half the equivalent values of the US).
With limited funds and increasing demand for ever more expensive therapies, it is inevitable that a degree of resource rationing occurs, rationing that undoubtedly leads to the problems of healthcare provision. Intensive care bed and staff availability, waiting lists, ‘postcode prescribing’ and hospital mergers are all examples of the consequences of rationed resource allocation.
Since the inception of the National Health Service (NHS) in 1948, successive governments have faced two politically contentious problems, namely:
how much of the GDP should be allocated to healthcare,
how this sum of money should be most effectively allocated.
On the whole, governments have responded in a utilitarian manner, by trying to treat as many people as possible, rather than affording high quality, expensive treatment for fewer patients.
Unfortunately, there is no single theory of health economics that adequately and effectively allocates resources. This chapter reviews the two main theories of resource allocation in healthcare (needs theory and cost-effectiveness), before outlining the development of the law in relation to resource allocation in the NHS.
9 - Products liability
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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- Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
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Summary
The field of products liability is a large and specialised area of legal practise. In the context of perioperative medicine, products liability is concerned with the following questions:
Who is liable when a faulty product is alleged to have caused harm to a patient?
Can a defendant in a case of negligence claim that faulty equipment contributed to the harm caused to a patient?
ETHICS
In spite of developments in the law to protect consumers against negligence, highly publicised cases arising from the use of defective products (e.g. silicon breast implants, Bjork–Shiley heart valves) have brought pressure on successive governments to reform the law concerning products liability.
A key turning point came with the Thalidomide tragedy of the late 1950s and early 1960s. Thalidomide was marketed as a treatment for morning sickness in pregnant women, but hundreds of babies worldwide were born with varying degrees of phocomelia or abnormally developed limbs, as an unforeseen side effect of the drug. As the tort of negligence relies on demonstrating fault and foreseeable harm, it was very difficult for claimants at the time to recover damages against manufacturers. Naturally, these events gave rise to considerable public concern. There was an understandable perception that a great injustice had been perpetrated in these circumstances, without any possibility of the injustice being righted or prevented by the law.
Contents
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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- Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
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7 - Confidentiality, and access to medical records
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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‘What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about’
– the Hippocratic Oath‘Patients have a right to expect that doctors will not disclose any personal information which they learn during the course of their professional duties, unless they give permission’
– General Medical Council (GMC), ‘Duties of a Doctor’Modern medical practice is founded on the concept of respecting patient autonomy, which in part includes respecting the right of an individual to determine what personal information may or may not be divulged to a third party. Unwarranted disclosure of a patient's medical treatment, advice or medical records is regarded as breach of their personal integrity. In essence, confidentiality protects the patient's informational autonomy.
The concepts of confidentiality and privacy are inter-related, but they are not identical. Privacy is generally viewed as an individual right, whereas confidentiality is considered an interest but not necessarily an individual right.
The major ethical theories accommodate the notion of confidentiality. Deontology envisages confidentiality as a moral duty, but accepts that breaching confidentiality may be ethically acceptable if there is a more pressing duty to disclose information. Utilitarianism supports confidentiality if it promotes the best consequences, but obviously allows for breaches of confidentiality if the greater good is best served by disclosure.
8 - Abortion
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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- Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
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‘I will not give to a woman an abortive remedy’
– Hippocratic OathThe termination of a pregnancy is potentially one of the most difficult and harrowing decisions a woman can make. This process of decision-making has a profound impact on the practice of medicine. Doctors have to be aware of their legal and ethical duties to the patient, even though these may be at odds with their own personal morals or beliefs, and without unnecessarily intruding on the privacy of the patient concerning their decision. In particular the doctor should pay consideration to the fact that it is the patient (and their family) who have to deal with the emotional and personal consequences of their decision.
In 2001, 186,274 terminations were carried out in the UK, 88% because it was considered a risk to the mother's mental or physical health. Eighty-three per cent of terminations were performed before 12 weeks gestational age.
ETHICS
Abortion has been a contentious issue for many centuries in the UK, although both the level of debate and the politicisation of abortion are not as comprehensive or polarising as in the USA, where potential presidential candidates are expected to make their sentiments known on the subject (and where doctors have been murdered for performing abortions), or in other countries around the world (notably, countries where Islam or Catholicism is the predominant religion).
The abortion issue encompasses a number of different views and value systems.
6 - Negligence
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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- Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
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‘Errare humanum est’
– attributed to Plutarch‘Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief …’
– Hippocratic OathOne of the most noticeable changes in medico-legal practice over the last 20 years has been the vast increase in the number of complaints from patients and their relatives. There may be a number of reasons for this, including:
clinicians may be making more errors;
patient expectations are higher;
patients are more likely to sue clinicians;
lawyers are more likely to pursue legal claims against clinicians;
significant financial payouts act as incentives to pursue legal claims.
The cost to the National Health Service (NHS) of settled and outstanding negligence claims is enormous. Various estimates have been made. Fenn et al. estimated that the rate of closed claims rose by 7% per annum throughout the 1990s, and cost the NHS between £48 million and £130 million in 1998 alone. By extrapolation, the liability for claims that are yet to be settled amounts to £1.8 billion.
The gradual realisation of the cost of negligence claims to the NHS has prompted the formation of a number of bodies, in order to try and improve the safety and quality of healthcare.
10 - Research
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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- Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
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‘Medical progress is based on research which ultimately must rest in part on experimentation involving human subjects.’
– Principle 4, Declaration of Helsinki (World Medical Association)All interventional medical treatment has resulted from research. Future cures or improvements in medical therapy rely on continued research, and this necessarily must include research performed on human beings. Observational research is without the remit of the law. Interventional research, however, is prescribed by rigid sets of ethical and practical guidelines (failure to comply with which is viewed poorly by the courts), and common law, particularly in relation to consent and medical negligence.
ETHICS
The quest for medical knowledge has not always been carried out in the most ethical of fashions. In the 1st century BC, for example, Cleopatra is reputed to have had a number of her handmaidens impregnated, and subsequently operated upon at certain times of gestation, in order to test the theory that it took 40 days for a male foetus to form, compared to 80 days for a female foetus. In 1796, Edward Jenner injected a healthy 8-year-old boy, James Phillips, with cowpox, then 3 months later with smallpox, in order to prove that the former provided defence against the latter. Between about 1850 and 1980, there are numerous documented reports of doctors in the US using soldiers, prisoners, orphans and others as subjects in research trials of dubious validity and value.
Appendix: Important legal cases
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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- Legal and Ethical Aspects of Anaesthesia, Critical Care and Perioperative Medicine
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4 - Rights, and the Human Rights Act, 1998
- Stuart M. White, University Hospital Trust, Sussex, Timothy J. Baldwin, King's College London
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The Human Rights Act, 1998 (HRA) came into force throughout UK on October 2nd, 2000. The HRA incorporated most of the Articles of the European Convention of Human Rights (ECHR) into domestic law. Until that time, both the state and the individual were notionally allowed to act with relative freedom in pursuit of their own interests, provided those actions were in accordance with statutory provisions and common law. The HRA introduced the principle that the action of the state and public bodies had to be justified in accordance with the limitations imposed by the ECHR. Moreover, the HRA introduced the concept of positive rights into UK legislation. The legal and moral position now is such that both the human rights of the UK citizen and the responsibilities of the UK state have become legally defined.
ETHICS
Human rights are considered practicable, inalienable, moral claims attributable to any human being (by reason alone of being human) that ought to be respected and enforced by all, in order to ensure the political and civil freedoms of individuals. In theory a right is to be morally respected even if it goes against the common good (e.g. parental refusal of vaccination for a child) or is at odds with a specific duty (e.g. refusal of treatment when a doctor thinks treatment is in the patient's best interest). To interfere with the exercise of a right requires a clear demonstration that another right will be unjustifiably interfered with, when exercising the first right.