DOCSLIB.ORG

Adopting the UNESCO Ethics Model to Critique Disease Mongering Barbara Postol

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Adopting the UNESCO Ethics Model to Critique Disease Mongering Barbara Postol Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Spring 1-1-2016 Adopting the UNESCO Ethics Model to Critique Disease Mongering Barbara Postol Follow this and additional works at: https://dsc.duq.edu/etd Recommended Citation Postol, B. (2016). Adopting the UNESCO Ethics Model to Critique Disease Mongering (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/1496 This One-year Embargo is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. ADOPTING THE UNESCO ETHICS MODEL TO CRITIQUE DISEASE MONGERING A Dissertation Submitted to the McAnulty College and Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Philosophy By Barbara A. Postol May 2016 Copyright by Barbara A. Postol 2016 ADOPTING THE UNESCO ETHICS MODEL TO CRITIQUE DISEASE MONGERING By Barbara A. Postol Approved April 5, 2016 ________________________________ ________________________________ Henk ten Have, MD, PhD Gerard Magill, PhD Director, Center for Healthcare Ethics Vernon F. Gallagher Chair for Professor of Healthcare Ethics Integration of Science, Theology, (Dissertation/Project Chair) Philosophy and Law Professor of Healthcare Ethics (Committee Member) ________________________________ ________________________________ Joris Gielen, PhD Henk ten Have, MD, PhD Assistant Professor of Healthcare Ethics Professor of Healthcare Ethics (Committee Member) (Center Director) ________________________________ James Swindal, PhD Dean, McAnulty College and Graduate School of Liberal Arts Professor and Dean of McAnulty College (Dean) iii ABSTRACT ADOPTING THE UNESCO ETHICS MODEL TO CRITIQUE DISEASE MONGERING By Barbara A. Postol May 2016 Dissertation supervised by Dr. Henk ten Have, MD, PhD The question this dissertation seeks to address is if the process of disease mongering can be ethically assessed. Chapter one provides a broad scope of the ethical challenge of disease mongering, UNESCO model framework, ADHD and PMDD. Chapter two examines disease mongering and its driving forces in detail. Chapter three provides an overview of the UNESCO model frameowork. Chapter four ethically examines disease mongering in conjunction with Attention Deficit Hyperactivity Disorder (ADHD). Chapter five examines disease mongering in association with Premenstrual Dysphoric Disorder (PMDD). Chapter six concludes that examined through the UNESCO model ethical framework disease mongering is occurring for both ADHD and PMDD, and provides remarks for the addressing this in the future. iv DEDICATION For you, Mom and in memory of you, Dad; thank you for everything. v ACKNOWLEDGEMENT Thank you to my dissertation director, Dr. Henk ten Have, for your invaluable guidance throughout the process of completing my dissertation, providing outstanding coursework, and for the opportunity to have worked as your Graduate Assistant. Thank you to Dr. Gerard Magill for both serving on my dissertation committee and for providing me with engaging coursework that challenged me throughout my doctoral program. Thank you to my committee member, Dr. Joris Gielen, for providing immediate oversight on my dissertation upon newly arriving at Duquesne. Last, but certainly not least, thank you to Ms. Glory Smith for her joyful spirit and for being my academic advisor, fellow Pittsburgher, and dear friend. Thank you all for helping me achieve success. vi TABLE OF CONTENTS Page Abstract .............................................................................................................................. iv Dedication ............................................................................................................................v Acknowledgement ............................................................................................................. vi Chapter One: Introduction 1.1 Background………………………………….………………………………………...1 1.2 Chapter 2………………………………………………………………………………4 1.3 Chapter 3………………………………………………………………………………6 1.4 Chapter 4………………………………………………………………………………8 1.5 Chapter 5…………………………………………………………………………...….9 1.6 Chapter 6…………………………………………………………………………..…10 Chapter Two: Disease mongering and the mechanisms that drive it 2.1 Disease Mongering………………………………………………………………..…13 2.2 Why disease mongering is problematic……………………………………………...19 2.3 Some examples of disease mongering………………………………………….……21 2.4 The impact of disease mongering on research and medicine………………………..26 2.4.1 Prescription Drug User Fee Act……………………………………………………27 2.4.2 The Bayh-Dole Act………………………………………………………………...28 2.4.3 Drug approval process………………………………………………………..……28 2.4.4 The case of VIOXX……………………………………………………………..…31 2.4.5 Sponsored research……………………………………………….………..………32 vii 2.4.6 The Physician Payment and Sunshine Act………………………………………...33 2.4.7 The value of drug patents…………………………………………………………..35 2.5 Mechanisms of disease mongering…………………………………………………..36 2.5.1 Expansion of disease and creation of disease criteria…………………………...…37 2.5.2 Off-label drug use……………………………………………………………….…40 2.5.3 Diagnostic criteria manipulation………………………………………………..…41 2.5.4 Normal conditions branded as disease………………………………………….…42 2.5.5 Ghostwriting…………………………………………………………………….…43 2.5.6 Lax definition of disease………………………………………………………...…46 2.5.7 Construction of disease……………………………………………………….……47 2.5.7.1 Effects of medicalization……………………………...…………………………51 2.5.8 Business marketing procedures……………………………………………….……52 2.5.8.1 Direct to consumer marketing……………………………………………………54 2.5.8.2 Direct to physician marketing……………………………………………………60 2.5.8.2.1 The role of drug representatives……………………………………………….60 2.5.8.2.2 Detailing and Sampling………………………………………………………...62 2.5.8.2.3 Incentives to physicians……………………………………………………..…63 2.5.8.3 Indirect to physician marketing………………………………………………….64 2.5.8.4 The marketing of self-diagnosis…………………………………………………65 2.5.8.5 Marketing patients as consumers………………………………………………...66 2.6 A global phenomenon……………………………………………………………..…68 2.6.1 Neglected disease………………………………………………………………..…68 2.6.2 US medical model’s global reach…………………………………………….……70 viii 2.6.3 Access to drugs limited by patents………………………………………………..71 2.7 Conclusion………………………………………………………………………..…73 Chapter 3: An ethical framework for assessing disease mongering: the UNESCO model 3.0 Western Bioethics……………………………………………………………………75 3.1 Principlism……………………………………………………………………….…..75 3.1.1 Respect for Autonomy…………………………………………………………..…77 3.1.2 Principle of Nonmaleficence…………………………………………………….…78 3.1.3 Principle of Beneficence………………………………………………………...…78 3.1.4 Principle of Justice……………………………………………………………....…79 3.2 Criticism of principlism……………………………………………………………...80 3.3 Bioethics……………………………………………………………………………..83 3.3.1 Van Rensselaer Potter……………………………………………………………..84 3.4 Global bioethics……………………………………………………………………..90 3.4.1 Why a global model.................................................................................................91 3.5 The UNESCO model……………………………………………………….……….95 3.5.1 Background of UNESCO………………………………………………………….95 3.5.2 The Declaration…………………………………………………………………....98 3.5.2.1 History of Declaration……………………………………………………………98 3.5.2.2 Function of the Declaration……………………………………………………..99 3.5.2.3 Scope of the Declaration………………………………………….……………100 3.5.2.3 Aims of the Declaration……………………………………………………...…101 3.5.3 The articles…………………………………………………………………….…102 3.5.4 The principles………………………………………………………………….…104 ix 3.5.4.1 Article 3: The principle of respect for human dignity…………………….……104 3.5.4.2 Article 4: Benefit and Harm…………………………………………………….106 3.5.4.3 Article 5: Autonomy and individual responsibility………………………….....109 3.5.4.4 Article 6: Consent………………………………………………………………115 3.5.4.5 Article 8: Respect for human vulnerability and personal integrity……………..122 3.5.4.6 Article 10: Equality, justice, and equity……………………………………...…127 3.5.4.7 Non-discrimination and non-stigmatization……………………………………130 3.5.4.8 Article 14 on social responsibility and health………………………………..…132 3.5.4.9 Article 15: sharing of benefits………………………………………………..…133 3.5.4.10 Article 16: Protecting future generations……………………………..…….…135 3.6 Conclusion………………………………………………………………………….135 Chapter 4: Ethically assessing ADHD in the UNESCO framework 4.1 History of ADHD…………………………………………………...………………138 4.2 Critique of DSM criteria……………………………………………………………143 4.2.1 Criticism of DSM-5………………………………………………………………144 4.3 DSM-IV criteria of ADHD criteria comparison……………………………………146 4.4 DSM-5: ADHD……………………………………………………………….…… 146 4.4.1 Overview of ADHD………………………………………………………………146 4.4.2 Criteria for diagnosis……………………………………………………………...147 4.4.2.1 Inattention ADHD………………………………………………………………147 4.4.2.2 Hyperactivity or impulsivity type ADHD………………………………………148 4.4.2.3 Diagnostic features……………………………………………………...………150 4.4.2.4 Associated feature of ADHD………………………………………………...…151 x 4.4.2.5 Risk factors……………………………………………………………………151 4.4.2.6 Culture related components of ADHD…………………………………………153 4.4.2.7 Gender and ADHD……………………………………………………………..153 4.4.2.8 Consequences of ADHD…………………………………………………….…153 4.4.2.9 Differential diagnosis………………………………………………………..…154 4.4.2.10 Comorbidity………………………………………………………………...…155 4.5 Factors involved in diagnosing ADHD…………………………………………..…156 4.5.1 Clinical judgment…………………………………………………………………156 4.5.2 Components of a psychiatric diagnosis………………………………………..…156 4.5.3 Organic nature
Load more

Recommended publications
  • Depression and Antidepressants in Australia and Beyond - a Critical Public Health Analysis Melissa Raven University of Wollongong
    University of Wollongong Research Online University of Wollongong Thesis Collection University of Wollongong Thesis Collections 2012 Depression and antidepressants in Australia and beyond - a critical public health analysis Melissa Raven University of Wollongong Recommended Citation Raven, Melissa, Depression and antidepressants in Australia and beyond - a critical public health analysis, Doctor of Philosophy thesis, Faculty of Arts, University of Wollongong, 2012. http://ro.uow.edu.au/theses/3686 Research Online is the open access institutional repository for the University of Wollongong. For further information contact the UOW Library: [email protected] Depression and antidepressants in Australia and beyond A critical public health analysis A thesis submitted in fulfilment of the requirements for the award of the degree Doctor of Philosophy from UNIVERSITY OF WOLLONGONG by Melissa Raven BA(Hons), MPsych(Clin), MMedSci(ClinEpid) Faculty of Arts 2012 ii Certification I, Melissa Raven, declare that this thesis, submitted in fulfilment of the requirements for the award of Doctor of Philosophy, in the Faculty of Arts, University of Wollongong, is wholly my own work unless otherwise referenced or acknowledged. The document has not been submitted for qualifications at any other academic institution. Melissa Raven 5 July 2012 iii iv Concise table of contents List of acronyms .................................................................................... xiii Abstract ..................................................................................................
    [Show full text]
  • Overdiagnosis and Overtreatment Over Time
    University of Massachusetts Medical School eScholarship@UMMS Family Medicine and Community Health Publications and Presentations Family Medicine and Community Health 2015-6 Overdiagnosis and overtreatment over time Stephen A. Martin University of Massachusetts Medical School Et al. Let us know how access to this document benefits ou.y Follow this and additional works at: https://escholarship.umassmed.edu/fmch_articles Part of the Community Health and Preventive Medicine Commons, Diagnosis Commons, Family Medicine Commons, Preventive Medicine Commons, and the Primary Care Commons Repository Citation Martin SA, Podolsky SH, Greene JA. (2015). Overdiagnosis and overtreatment over time. Family Medicine and Community Health Publications and Presentations. https://doi.org/10.1515/dx-2014-0072. Retrieved from https://escholarship.umassmed.edu/fmch_articles/318 Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in Family Medicine and Community Health Publications and Presentations by an authorized administrator of eScholarship@UMMS. For more information, please contact [email protected]. Diagnosis 2015; 2(2): 105–109 Opinion Paper Open Access Stephen A. Martin*, Scott H. Podolsky and Jeremy A. Greene Overdiagnosis and overtreatment over time Abstract: Overdiagnosis and overtreatment are often Introduction thought of as relatively recent phenomena, influenced by a contemporary combination of technology, speciali- In recent years, an increasing number of clinicians, jour- zation, payment models, marketing, and supply-related nalists, health service researchers, and policy-makers demand. Yet a quick glance at the historical record reveals have drawn attention to the problems of overdiagnosis that physicians and medical manufacturers have been and the overtreatment that it so often engenders [1, 2].
    [Show full text]
  • BOOKTIVISM: the Power of Words
    BOOKTIVISM: The Power of Words Book•ti•vi•sm(noun). 1. The mobilization of groups of concerned citizens produced by reading books offering powerful analyses of social or political issues. 2. A call to action based on the sharing of knowledge through books. 3. Books + activism = “booktivism.” 4. A term first used at the SellingSickness, 2013: People Before Profits conference in Washington, DC, see www.sellingsickness.com. Read. Discuss. Be thoughtful. Be committed. Here are some more suggestions to get you started: 1) Set up a reading group on disease-mongering among interested friends and colleagues. If you do The books included in BOOKTIVISM celebrate recent contributions to the broad topic of disease- not already have a group of interested readers, post a notice in your workplace, library, community mongering, especially as they examine the growing prevalence and consequences of overtreatment, center, apartment building, etc. Once you have a group, decide where to meet. Book clubs can overscreening, overmarketing, and overdiagnosis (see Lynn Payer’s 1992 classic, Disease-Mongers: How meet anywhere – at homes, in dorms, in pubs, in coffeehouses, at libraries, even online! Decide on Doctors, Drug Companies, and Insurers Are Making You Feel Sick, for an introduction to timing and format. Will you meet monthly/bimonthly? You’ll need time to prepare for the sessions, disease-mongering). but not so much time that you lose touch. Circulate the reading guide. It is usually best if one person leads each discussion, to have some questions at the ready and get things rolling. Although the challenge to disease-mongering is not unprecedented (the women’s health movement of the 1970s was another key historical moment), these books represent an impressive groundswell OR, maybe you’d like to of amazing, powerful, brilliant, and often deeply unsettling investigations by physicians, health scientists, 2) Set up a lecture/discussion group.
    [Show full text]
  • Greenshield.Ca MORE HEALTH CARE DOESN’T NECESSARILY MEAN BETTER HEALTH …But It Can Mean More Harm
    AUGUST/SEPTEMBER 2019 Don’t miss episode 19 of our podcast as we discuss better approaches to health care with Dr. Danielle Martin, family physician, author, chief medical executive at Women’s College Hospital, and YouTube star. CLICK HERE TO LISTEN WHAT’S INSIDE MORE HEALTH CARE DOESN’T NECESSARILY MEAN BETTER HEALTH Page 2 WHAT’S UP... Drug pricing in the news Message of health care survey: evolve with the times Page 12 greenshield.ca MORE HEALTH CARE DOESN’T NECESSARILY MEAN BETTER HEALTH …But it can mean more harm Turns out that 60 really is the new 40—and even 80 is the new 60—as people worldwide are living longer. In fact, we can expect to live more than twice as long as our ancestors.1 So why then, if we are healthier and more active than ever, are more people becoming patients? It’s because health care is no longer considered just for the sick, it has expanded into also focusing on the well. At first blush, this may sound like a good thing; it may sound like prevention. But if your plan members are healthy—in that they don’t have health problems that need solving— health services may actually create problems. Problems like overdiagnosis and in turn, overtreatment—including all the anxiety, energy, time commitment, potential costs, and even physical harm that can come along with it. The controversy surrounding the medicalization of healthy people raises awareness of the difference between what is truly prevention versus what is just early diagnosis that may—or may not—be a good thing.
    [Show full text]
  • Quine and Whitehead: Ontology and Methodology 3
    McHENRY I QUINE AND WHITEHEAD: ONTOLOGY AND METHODOLOGY 3 philosophical scene as of late (e.g., deconstructionism, postmodem relativism), the and Whitehead: Ontology and gulf that separates Whitehead and analytical philosophy is not as great as it used to Quine 'be.3 Before I begin to explore the affinities, as well as some contrasts, between Methodology . Quine and Whitehead, a word of caution is in order. It is well known that Quine wrote his doctoral dissertation, "The Logic of Sequences: A Generalization of LeemonMcHenry Principia Mathematica," under Whitehead's direction.4 Quine also took two of Whitehead's seminars at Harvard,"Science and the Modem World" and "Cosmol­ I LEEMON McHENRY reaches philosophy at Loyola Marymount University, Los ogies Ancient and Modem," but he says that he "responded little to these courses" Angeles, CA 90045, E-mail: [email protected] and "took refuge in his relatively mathematical material on 'extensive abstrac­ tion. "'s Despite Quine's statement that he "retained a vivid sense of being in the presence of the great," he does not acknowledge any philosophical influence from · Introduction . the ph!losoph!es o!'W.V . Qu�e an d Whitehead. Rather, Camap and Russell are cited as the inspirations of Quine's The very idea· of a basis for comparing . , mcluding Qume himself. early development. A.N. Whitehead may be surprising to most philosophe� . philosophy two completely Both produced systems of thought that have taken m When Quine overlapped with Whitehead at Harvard, Whitehead was deeply at the forefron: of c�ntemp�­ involved in working out the details of his metaphysics of process--a philosophic different directions.
    [Show full text]
  • JEMH Vol4 No1 Sept
    ARTICLE SPECIAL THEME ISSUE ARTICLE Privatization of Knowledge and the Creation of Biomedical Conflicts of Interest Leemon B. McHenry Department of Philosophy, California State University, Northridge Jon N. Jureidini Discipline of Psychiatry, University of Adelaide, South Australia rather than to what is meaningful, so that fi ndings that are Abstract likely to be clinical and meaningful are rejected because they fail to reach statistical signifi cance whereas others that appear Scientifi c and ethical misconduct have increased at an clinically trivial are accepted (Ziliak and McCloskey, 2007). Th e alarming rate as a result of the privatization of knowledge. disenchantment with the psychoanalytic paradigm of psychiatry What began as an eff ort to stimulate entrepreneurship led to a massive investment in psychopharmacology and other and increase discovery in biomedical research by physical interventions. A concession now to the limited benefi t strengthening the ties between industry and academics that psychopharmacology off ers would come at great cost to the has led to an erosion of confi dence in the reporting of profession. A vested interest in protecting the new paradigm of research results. Inherent tensions between profi t-directed neurological models of psychiatric disorders reaches beyond the inquiry and knowledge-directed inquiry are instantiated quest for a secure scientifi c foundation. in psychopharmacology, especially in the co-option of academic activity to corporate objectives. The eff ects of To the vulnerability created by personal bias and questionable these tensions are visible in research agendas, publication methodology we must add the dangers of pervasive fi nancial practices, postgraduate education, academic-industry confl icts of interest, of which we investigate the root cause in this partnerships and product promotion.
    [Show full text]
  • Drugs, Money and Misleading Evidence
    Books & arts tallying up the inequalities. She recruited colleagues to gather much more data. The culmination was a landmark 1999 study on gender bias in MIT’s school of science (see go.nature.com/2ngyiyd), which reverber- ated across US higher education and forced many administrators to confront entrenched discrimination. Yet Hopkins would rather have spent that time doing science, she relates. The third story comes from Jane Willenbring, a geoscientist who in 2016 filed a formal com- plaint accusing her PhD adviser, David March- ant, of routinely abusing her during fieldwork in Antarctica years before. Marchant, who has denied the allegations, was sacked from his post at Boston University in April 2019 after an inves- tigation. Picture a Scientist brings Willenbring together with Adam Lewis, who was also a grad- uate student during that Antarctic field season and witnessed many of the events. Their conver- sations are a stark reminder of how quickly and how shockingly the filters that should govern work interactions can drop off, especially in UPRISING, LLC Biologist Nancy Hopkins campaigned for equal treatment at work for female scientists. remote environments. Lewis tells Willenbring he didn’t realize at the time that she had been as they admit on camera. scientists. Its two other protagonists are white bothered, because she did not show it. “A ton The iceberg analogy for sexual harassment is women with their own compelling stories. of feathers is still a ton,” she says. apt. It holds that only a fraction of harassment — Biologist Nancy Hopkins was shocked In stark contrast, the film shows us obvious things such as sexual assault and sex- when Francis Crick once put his hands on Willenbring, now at the Scripps Institution of ual coercion — rises into public consciousness her breasts as she worked in the laboratory.
    [Show full text]
  • The American Philosophical Association EASTERN DIVISION ONE HUNDRED TENTH ANNUAL MEETING PROGRAM
    The American Philosophical Association EASTERN DIVISION ONE HUNDRED TENTH ANNUAL MEETING PROGRAM BALTIMORE MARRIOTT WATERFRONT BALTIMORE, MARYLAND DECEMBER 27 – 30, 2013 Important Notices for Meeting Attendees SESSION LOCATIONS Please note: the locations of all individual sessions will be included in the paper program that you will receive when you pick up your registration materials at the meeting. To save on printing costs, the program will be available only online prior to the meeting; with the exception of plenary sessions, the online version does not include session locations. In addition, locations for sessions on the first evening (December 27) will be posted in the registration area. IMPORTANT INFORMATION ABOUT REGISTRATION Please note: it costs $40 less to register in advance than to register at the meeting. The advance registration rates are the same as last year, but the additional cost of registering at the meeting has increased. Online advance registration at www.apaonline.org is available until December 26. 1 Friday Evening, December 27: 6:30–9:30 p.m. FRIDAY, DECEMBER 27 EXECUTIVE COMMITTEE MEETING 1:00–6:00 p.m. REGISTRATION 3:00–10:00 p.m., registration desk (third floor) PLACEMENT INFORMATION Interviewers and candidates: 3:00–10:00 p.m., Dover A and B (third floor) Interview tables: Harborside Ballroom, Salons A, B, and C (fourth floor) FRIDAY EVENING, 6:30–9:30 P.M. MAIN PROGRAM SESSIONS I-A. Symposium: Ancient and Medieval Philosophy of Language THIS SESSION HAS BEEN CANCELLED. I-B. Symposium: German Idealism: Recent Revivals and Contemporary Relevance Chair: Jamie Lindsay (City University of New York–Graduate Center) Speakers: Robert Brandom (University of Pittsburgh) Axel Honneth (Columbia University) Commentator: Sally Sedgwick (University of Illinois–Chicago) I-C.
    [Show full text]
  • Academic Publishing and Scientific Integrity: Case Studies of Editorial Interference by Taylor & Francis
    Kahr et al. Journal of Scientific Practice and Integrity. 1(1). DOI: 10.35122/jospi.2019.848394 Research Article | Commentary Academic Publishing and Scientific Integrity: Case Studies of Editorial Interference by Taylor & Francis Bart Kahr,i Leemon B. McHenry,ii Mark D. Hollingsworthiii Abstract Editorial independence is a bedrock principle of academic publishing. The growing domination of academic publishing by large, for-profit corporations threatens this independence. There is alarming evidence that large companies too often serve their own business interests and those of powerful clients rather than serving the scientific community and the general public. This evidence includes the publication of infelicitous commercial science and concealing scientific misconduct. We present two case studies in which the UK-based publisher Taylor & Francis interfered in the editorial process by blocking publication of legitimate criticism that had been reviewed and approved for publication by its specialized editors. The integrity of science depends in part on the transparency and intellectual honesty of all stakeholders. The widely- acknowledged inadequacies of English libel law are reviewed as context for some of Taylor & Francis’s fearful decisions. Introduction the editorial independence of the editor, and it should not interfere in the assessment, selection, or editing Editorial independence, the license of editors to approve of journal articles. The relationship between the a contribution for publication free from the influence of editor and the publisher, sponsoring society, or journal owners, advertisers, or media company directors, is a owner should be based on trust and respect.1 bedrock of journalism and academic publishing. This position has been adopted by COPE, the Committee Independence is intended to ensure public access to true on Publication Ethics, an advisory body for its member stories and investigations.
    [Show full text]
  • National Cancer Institute University of Oxford
    SEPTEMBER 1-3, 2015 CO-SPONSORED BY NATIONAL CANCER INSTITUTE Division of Cancer Prevention UNIVERSITY OF OXFORD Centre for Evidence-Based Medicine NATCHER CONFERENCE CENTER National Institutes of Health | Bethesda, Maryland USA NOTICE OF PHOTOGRAPHY & FILMING Preventing Overdiagnosis 2015 is being visually documented. By your attendance you acknowledge that you have been informed that you may be photographed and recorded during this event . Images taken will be treated as property of Preventing Overdiagnosis and may be used in the future for promotional purposes. These images may be used without limitation by any organisation approved by the Preventing Overdiagnosis scientific committee and edited prior to publication as seen fit for purpose. Images will be available on the Internet, accessible to Internet users throughout the world including countries that may have less extensive data protection laws than partnering organisation countries. All films will be securely stored on the University of Oxford servers. Please make your- self known at the registration desk if you wish to remain off camera. Thank you for your cooperation. CONFERENCE PARTNERS The Dartmouth Institute Bond University, Centre for Research in Evidence-Based Practice The BMJ Consumer Reports University of Oxford, Centre for Evidence-Based Medicine The views expressed in these materials or by presenters or participants at the event do not necessarily reflect the official policies of the U.S. Department of Health and Human Services, the National Institutes of Health, the National Cancer Institute, or any NIH component. TABLE OF CONTENTS WELCOME 2015 Scientific Committee 4 KEYNOTES BIOS 6 PROGRAMME 16 KEYNOTE ABSTRACTS 32 WORKSHOP ABSTRACTS 34 SEMINAR ABSTRACTS 48 PANEL SESSION ABSTRACTS 61 POSTERS 66 NOTES 67 MAPS WELCOME We are pleased to welcome you to the 3rd Preventing Overdiagnosis conference, held in Bethesda, Maryland on the campus of the US National Institutes of Health.
    [Show full text]
  • Whitehead's Panpsychism As the Subjectivity of Prehension
    Whitehead's Panpsychism as the Subjectivity of Prehension Leemon B. McHenry LEEMON B. McHENRY is Visiting Scholar in the Department of Philosophy, University of California, Los Angeles, CA 90024. 1. Introduction Whitehead's concept of prehension is undeniably the master principle of his process metaphysics. It is the central function of a creative universe whereby the many past occasions become a novel one. In my view, the concept of pre­ hension is Whitehead's most original and distinctive contribution to metaphy­ sics. It is also the very idea that prevents most contemporary philosophers from understanding or appreciating his thought. In this paper, I wish to explore the idealist context in which the concept of prehension becomes intelligible. While I do not deny that important influences from physics and biology helped Whitehead frame his idea, I contend that pre­ hension only makes sense as a concept of panpsychistic idealism. Here I use the term 'idealism' not in the sense of nature dependent on mind, but rather nature understood fun.damentally as sentient experience. 1 This appears to be White­ head's intention when, introducing the term 'prehension' for the first time in Science and the Modern World, he says: For Berkeley's mind, I substitute a process of prehensive unification. In order to make intelligible this concept of the progressive realization of natural occurrences, considerable' expansion is required, and confrontation with its actual implications in terms of concrete experience. (SMW 69) Whitehead also draws analogies with Leibniz's monads and Spinoza's modes in order to clarify how his novel idea of prehension squares with the notion of individual perspectives interlocked in a system of internal relations.
    [Show full text]
  • People Before Profits February 21 - 22, 2013
    Selling Sickness, 2013: People Before Profits February 21 - 22, 2013 bringing together ACADEMIC MEDICAL REFORMERS, CONSUMER ACTIVISTS, AND HEALTH JOURNALISTS to examine the current scope of disease mongering and to develop strategies and coalitions FOR CHANGE Hyatt Regency Washington on Capitol Hill Washington D.C. Floorplan REGENCY D REGENCY B REGENCY C GOOD NEWS EXHIBIT HALL Ballroom Level 2 Selling Sickness 2013: People Before Profits - Washington D.C. Table of Contents Conference Floorplan ............................................................................. 2 Welcome from Leonore and Kim ............................................................ 4 Special Thank Yous ............................................................................... 5 Disease-Mongering, defined.................................................................. 6 Call To Action On Disease Mongering ................................................... 7 Booktivism ............................................................................................. 9 Schedule-at-a-glance, Thursday, 2/21 ................................................... 10 Schedule-at-a-glance, Friday, 2/22 ........................................................ 11 Conference Program ............................................................................. 12 Wednesday, Registration, Social Hour .............................................. 12 Thursday morning sessions and break ............................................. 12 Thursday lunch .................................................................................
    [Show full text]