Dissertations / Theses on the topic 'Drugs Testing Moral and ethical aspects'

In 2005, the House of Commons (HoC) Health Committee produced a report on The Influence of the Pharmaceutical Industry – the first of its kind since 1914. The inquiry concluded that there were ‘over-riding concerns about the volume, extent and intensity of the industry’s influence, not only on clinical medicine and research but also on patients, regulators, the media, civil servants and politicians’, and stressed the need ‘to examine critically the industry’s impact on health to guard against excessive and damaging dependencies’ (HoC 2005, p. 97). It also noted that it is important to comprehensively analyse pharmaceutical regulation in order to ascertain whether there are systemic problems: In some circumstances, one particular item of influence may be of relatively little importance. Only when it is viewed as part of a larger package of influences is the true effect of the company’s activity recognised and the potential for distortion seen. The possibility that certain components of any such campaign are covert and their source undeclared is particularly worrying. (HoC 2005, p. 97) This study addresses this recommendation and was primarily conducted to examine whether recognised concerns are merely ad hoc or as a result of systemic flaws in the current system of pharmaceutical regulation. The work addresses a gap in the academic literature by drawing on the fragmented criticisms of the pharmaceutical industry in order to produce a model to illustrate how various stakeholders collaborate with drug companies to promote licensed products, and to explore the nature of the relationships between these elite stakeholders. The thesis begins with a literature review which determines who is involved in pharmaceutical regulation; how the regulatory system works; and explores the key role of communication in this process (Chapters 1 to 3). The recurrent theme is the neglect or exclusion of the patient/consumer, which leads to the development a model of intra-elite communication in drug regulation called Pharmaffiliation (Chapter 3). The thesis then looks for evidence to support or refute this model, using multiple methods (Chapter 4). Four case studies (with specific selection criteria) are chosen to test the model’s constructs and indicators (Chapters 5 to 8). The research uncovers systemic problems in the current system of pharmaceutical regulation which can ultimately harm the patient/consumer, and the implications of these findings are discussed (Chapter 9). Solutions on a micro-level include consumer involvement in decision making processes, which can be enhanced through public education and awareness campaigns and the instigation of public inquiries whenever drugs are withdrawn from the market (HoC 2005, p. 105). On a macro-level, however, this will involve critically exploring neoliberal capitalism and the empowerment of the citizenry (Street 2001).

Medicines play a pivotal role in the process of human development as their rational utilization can decrease morbidity and mortality as well as improve quality of life (Jamshed, Hassali, Ibrahim, Shafie, & Babar, 2010). Access to therapeutic drugs form an integral part of any successful healthcare system. The high cost of medicines, is a barrier to accessibility and improved health to the majority of the South African population (Bangalee, 2015). In developing countries with limited healthcare budgets, such as South Africa, generic drugs (medicines) can be a cost-saving treatment alternative, resulting in medical expenditure being reduced and access to scarce resources increased (Van der Westhuizen, Burger, Lubbe, Serfontein, 2010). There is very little knowledge on perception and attitude of South African citizens with regard to use of generic drugs (Bangalee, 2015). Consumer perception can have a large impact on the choice of medicines or drugs chosen. The study intended to find out what the current consumer beliefs, attitudes, behaviours and knowledge of generic drugs are. There was also intent to establish if lack of awareness or misconception about generic drugs influence consumer choice. The study consists of a literature review of the definition of generic drugs and original or branded drugs, their influence in the public and private health sector, factors that influence consumer behaviour, brand effect, brand trust, brand loyalty, and most importantly the South Africa acceptance of generic drugs. Primary data was collected, reported and analysed through the use of a questionnaire to determine the current consumers’ belief, attitude, behaviour and knowledge of generic drugs. The study results reveal that scepticism does exists, yet there was clear acceptance, but still lack of confidence in generic drugs. Consumer education and information is the key to increased generic drug acceptance.

Pharmaceutical advertising involves the advertising of medicines, medical devices, and healthcare services. A review of available international literature indicates the belief that pharmaceutical advertisements negatively affect healthcare decisions made by consumers. Very little research has been conducted to determine how consumers in South Africa (SA) are affected by pharmaceutical advertisements. This study aimed to determine how consumers in the Nelson Mandela Metropole (NMM) perceive pharmaceutical advertisements. More specific objectives included the investigation of legislation in SA employed in pharmaceutical advertisements, the interpretation and misinterpretation of the advertisements, and the identification of problematic areas in this form of advertising. South African legislation applied to pharmaceutical advertisements was investigated by means of a literature review. A qualitative research design was also used to achieve the aim and objectives. This included a focus group consisting of six randomly selected participants in the NMM. A consumer survey, consisting of a 100 consumers obtained from 10 randomly selected community pharmacies within the NMM, supported the findings of the qualitative techniques. The themes identified in the focus group were incorporated into a questionnaire used in the consumer survey. Three randomly selected pharmaceutical advertisements were also decoded to interpret the components employed in each. The results determined that pharmaceutical advertising is a marketing tool that incorporates various emotional and psychological techniques to persuade consumers. It was also evident that consumers can misinterpret pharmaceutical advertisements. Various legal and ethical problems were identified in pharmaceutical advertisements. These results showed that pharmaceutical advertisements have the possibility of negatively affecting consumers’ healthcare decisions and warrants further investigation.

This research examines the many different ethical issues that emerge in the health care setting with regards to prenatal diagnostic testing. Identifying the areas of clinical practice and religious counselling in need of improvements, particularly physician-client communication, is important to ensure that competent pregnant women make informed, considered choices about prenatal testing. This paper investigates the many factors that contribute to pregnant women's decision-making processes surrounding the acceptance or refusal of the maternal serum alpha-fetoprotein screen, ultrasonography, amniocentesis, chorionic villus sampling, and preimplantation diagnosis. Integrating scholarship in bioethics, religious studies, and the anthropological and sociological study of medicine, this dissertation offers a comparative analysis of religious attitudes toward prenatal diagnostic testing, describes the complexities of practical decision-making by pregnant women faced with genuine ethical dilemmas, and provides an analysis of ethical issues related to prenatal testing. This research will be of interest to scholars in religious studies and bioethics, prenatal genetic counsellors and obstetricians involved in the provision of prenatal diagnostic testing services, and specialists in women's health and reproductive decisionmaking.

Research consistently shows actuarial classification instruments have equal or higher predictive validity than clinical judgment and can lead to more ethical and fair treatment of incarcerated men and women (Austin, 1983, 1986; Bonta, 2002; Clements, 1981; Holsigner, Lowenkamp, & Latessa, 2006; Meehl, 1954; Salisbury, Van Voorhis, & Spiropoulos, 2009). Best correctional practice recommends all objective classification systems are tested for reliability and validity to ensure they are effective for the population they intend to serve (Austin, 1986; Holsinger et al., 2006; Salisbury et al., 2009). This study examined the reliability and validity of the classification and assessment instruments currently used by Golden Grove Adult Correctional Facility (Golden Grove), located on St. Croix in the United States Virgin Islands (USVI). Golden Grove is a mixed-gender, mixed-security status prison managed by the USVI territorial government, and is subject to United States Federal laws and mandates. Data from archival files were used to assess the internal reliability, construct validity, and predictive validity of the classification and assessment instruments used with incarcerated men and women at Golden Grove (N = 200). Primary objectives of this study were separated into four main categories: 1) examine the construct validity of Golden Grove's custody assessment tools; 2) investigate the predictive validity of Golden Grove's custody assessment tools across gender; 3) determine reliability and assess to what extent the primary classification officer's decisions have higher predictive validity than the actuarial tool; and 4) investigate the relationship between items on the needs assessment form and level of custody (minimum, medium, or maximum). Results were mixed but generally indicated weak reliability, construct validity, and predictive validity. Contrary to most research on gender and classification, a significant correlation between the initial custody score for incarcerated females and disciplinary reports (r = .26, n = 56, p < .05) indicated the initial custody tool predicted misconduct for maximum custody females better than for males. The mean number of disciplinary reports for maximum women (M = 1.12) was significantly higher compared to maximum men (M = .46). The classification officer overrode the instrument at a high rate for both the initial assessment instrument (44%) and the reassessment instrument (36.4%) rendering the objective assessment overly subjective. Overall, findings show the classification system at Golden Grove is not functioning as intended and improvements are recommended.

In the debate surrounding performance enhancing drugs (PEDs) in sport, academic investigation has focused mainly on why some individual athletes use PEDs while other actors refrain from doing so. In this thesis I adopt a broader social perspective and argue that the debate can be usefully reframed by considering how sports governing bodies (SGBs) maintain legitimacy and moral authority over their sporting communities. This highlights how various drug-related controversies and reports are associated with a crisis of legitimacy for SGBs. The thesis adopts a social constructionist perspective, using a modified'moral panic' framework based on the work of Goode and Ben-Yehuda. Situating legitimacy within this moral panic model reveals the'multifaceted' nature of legitimacy and the way doping debate reflects the interests of elite SGBs. At the same time, elite SGBs affected by the debate can use the media to resist other elite SGBs and impose their own interpretation of reality upon the situation. Using a grounded theoretical model, I examine whether the anti-doping debate is an example of a 'moral panic,' involving PED-using 'folk devils.' In the first part of this thesis I present a socio-historical examination of anti-doping policies and interactions between the International Olympic Committee (IOC), the World Anti-Doping Agency (WADA) and the Australian Football League (AFL). Multiple methods were used, including a review of media coverage, an online survey and follow-up interview with sporting participants. This multi-layered approach revealed how the creation of PED-using 'folk devils' challenges SGBs legitimacy, while also providing opportunities to restore perceptions of legitimacy. A quantitative e-Survey and follow-up interviews revealed that grassroots sporting participants in Australia accepted there was a crisis of legitimacy for SGBs, even if the perceived causes of this crisis varied. Using this multi-dimensional approach, I conclude that the debate surrounding PEDs provides an example of a moral panic engineered by elite SGBs, and particularly WADA, based on a concern with maintaining the moral authority and legitimacy to control the ever-widening global sporting community.

M.Comm.
A revolution in genetic research, known as the Human Genome Project (HGP), is taking place. This project, initiated in 1984, is a twenty-year, six billion-dollar science project designed to map the entire genetic structure (Genome) of the human species (Brockett and Tankersley, 1995). In 1998, the HGP leaders expected to complete the project by 2003 (Lowden, J. A., 1999:33). The Human Genome Project is designed to sequence the human genome (the blue print of genetic information) and to identify the estimated 100000 genesherein. This has added a new dimension to the technology available to underwriters in the life and health insurance industry for the selection of medical risks. Genetic testing can identify inherited diseases and predict illnesses that might not manifest for decades (Brackenridge & Elder, 1998:89). Genome research has opened up new opportunities for diagnosis and in some cases, early treatment of medical conditions. This new basis of knowledge is referred to as the advent of the molecular age in medicine. Medical journals, the mass media and genetic interest groups are treating human genetics and the opportunities it presents as a high-profile issue, with great attention being paid to the complex and emotive topics of life insurance and genetic testing (Regenauer & Schmidtke, 1998:5). The Insurance Industry can use genetic testing to identify high-risk applicants more accurately and price products accordingly, thereby improving risk assessment and profitability. These potential advantages, however, are counter-balanced by ethical considerations that are much more difficult to address (Lowden, J. A., 1999:33). Many consumers, ethicists and geneticists fear that insurers will use this data for unfair discriminatory purposes, identifying a genetic underclass of people who, although clinically well, will be uninsurable. Genetic testing could invade the privacy of applicants and their families. There are concerns about the confidential handling of genetic information as well as the accurate interpretation of genetic tests. The uncertainty about the predictive value of genetic tests, the shortage of trained geneticists and counsellors and the psychological impact of that knowledge of a predictable serious disease might have, have lead to much opposition to the use of genetic information by third parties. In the United States most Americans receive health insurance through their place of employment. There are fears that genetic testing will be used to discriminate against prospective employees and render many people unemployable and uninsurable (Council for responsible Genetics, 1997: http://www.gene-watch.org/genclisc htuil Consumer groups have lobbied effectively for the prohibition of testing or the use of testing by insurers in the United States and Europe and legislators aim to ban the use of genetic information on a broad basis. Insurers, on the other hand, are assuming that the new laws will cause untold damage to the fiscal stability of their companies (Lowden, J. A., 1999:33). However, it seems inevitable that genetic testing will affect risk classification sooner rather than later and to a greater extent than most believe (Chambers, 1997: http://www.Inrc.com/epirr/issues/143/143-4.htm).

M.A.
With the more popular practice of communication through emails, cellular phones, and instant online messaging, the pace at which organisations communicate and function has increased dramatically over the past decade, as information is speedily available. Organisations need to adapt to the latest technology applications in order to be more efficient and to increase productivity ...

This research evaluated the ethics competencies which were determined to be important to the curriculum of an ethics course for students studying Nondestructive Testing and Welding Inspection. Data were gathered from samples of American Society of Nondestructive Testing Nationally Certified Level III's (N = 268), American Welding Society Nationally Certified Welding Inspectors CWI's (N = 212) and American Welding Society Nationally Certified Associate Welding Inspectors - CAWI's (N = 101) who are currently licensed by their respective societies. The twenty-nine (29) item instrument utilized a six-point Likert type scale for the data collection. The scale, which was validated by consensus using a DELPHI panel procedure, utilized the Hoyt-Stunkard method for assessing reliability. The computed reliability for the instrument was determined to be +0.970. Analysis of variance tests were completed for each of the twenty-nine (29) competencies to ascertain differences between ASNT Level III's, AWS CWI's and AWS CAWI's samples. Factor analysis, using the R-mode, provided for the clustering of competencies and constituted the major analysis procedure for the study. The results of the study indicated the presence of three (3) clusters of content which were considered necessary to curriculum inclusion in an ethics course for nondestructive testing and welding inspection. The identified clusters include: I. Ethical issues and personal integrity (18 competencies), II. Ethics and the legal aspects of inspection (8 competencies), and III. Ethical theory and professional conduct (4 competencies). Overall competency means ranged from 3.929 to 5.594; significance tests showed only five (5) rejected hypotheses for the twent-ynine (29) primary competencies. Standard errors of the mean were found to be lower for the ASNT Level III's sample. The results of the study present a valid pattern for the development of objectives which should be included in an ethics curriculum for nondestructive testing personnel and welding inspectors.
Graduation date: 1993

Research report submitted in accordance for partial requirements for the degree of Masters in Interdisciplinary Global Change Studies in the Faculty of Science at the University of the Witwatersrand, 2018
The vision for this project is to aid in approaching climate change by providing an improved understanding of environmental concern. There are two missions. First, to develop heuristic models of environmental concern, and to utilize their constructs to assess environmental behaviour and environmental concern in a population. The model is intended to provide a depiction to aid in better understanding environmental concern and may aid in framing and developing intervention strategies to mitigate harmful effects of climate change. Broadly, assessments of environmental concern have been operationalized in two ways, as a unidimensional construct, ranging from high concern to low concern, or as multidimensional constructs demonstrating underlying reasons for environmental concern. Examining two multidimensional assessments reveals limitations of both and gaps between their underlying constructs. A reading of value-orientated theories from environmental ethics literature identifies six constructs for use in a multidimensional assessment of environmental concern. Utilizing equivalent constructs to the previous multidimensional assessments and expanding “nature” and natural entities into three separate categories results in six constructs intended to fill the gaps of the previous multidimensional assessments and may addresses some of their limitations. This reading also provides a theoretical foundation for designing items to relate to the six constructs. A theory map is presented which demonstrates constructs relating to an expanded narrative for use in multidimensional assessments. Climate change is a complex and often poorly understood phenomenon. Furthermore, it is clear that human behaviours are the underlying causes of climate change. Cross-disciplinary research and integration of several disciplines and fields of inquiry are necessary for developing sound approaches to climate change. Experimental philosophy and empirical ethics are discussed as guiding methodologies for this project. Meta-ethical fallacies and two considerations from the philosophy of science aid in contextualizing this research and provide epistemological limits for deriving ethical conclusions from facts about the world. A survey consisting of 11 sociodemographic items, the revised NEP scale’s 15 items, an existing 17 item environmental behaviour scale, and six 10 item original scales relating to six constructs based on value-orientated theories from environmental ethics and presented in the heuristic models, was drafted. An electronic version was designed and emailed to firstyear Life Science and Economics students. The environmental behaviour scale and the revised NEP scale are significant and correlate moderately positively, corroborating the hypothesis, that there is a relationship between environmental behaviour and environmental concern. While three of the six original scales (egocentrism, sociocentrism, and sentiocentrism) were unreliable, did not have many significant relationships with other variables, and require further development, the other three (nihilism, biocentrism, and ecocentrism) succeeded in corroborating the hypothesis, that there are underlying dimensions of environmental concern, and that they are significantly related to environmental behaviour. The project’s implications and recommendations discusses different intervention strategies in response to climate change as well as environmental communications and education, and how the heuristic models may aid in these topic’s endeavours. The project concludes by identifying a lack of environmental concern in two South African President’s State Of the Nation Addresses and stresses the need to improve environmental concern and increase the frequencies of people engaging in environmental behaviours. Key words: nature; natural entities; environment; environmental concern; environmental behaviour; value; environmental communication; environmental education; nihilism; anthropocentrism; egocentrism; sociocentrism; sentiocentrism; biocentrism; ecocentrism; experimental philosophy; empirical ethics; quantitative research.
XL2019

This dissertation has made an attempt at exploring the psychological factors that motivates individuals into opting for or against undertaking an HIV-test. The Health Belief Model is used to ascertain its predictive powers towards the motivation for undertaking such a test. Literature on HIV-testing indicates non-exploration of voluntary HIV-testing, as opposed to massive reporting on mandatory HIV-testing. Therefore, the focus of this dissertation is on voluntary HIV-testing. The sample used for the study. comprised of antenatal mothers who were offered HIV/Aids education and then presented with an option of either undertaking the HIV-test, or not. The results of the study indicate that the Health Belief Model has failed in its predictive powers towards motivations for or against HIV-testing. However, the study provided valuable psychological factors that are associated with the decision to undertake the HIV-test, which will be important for future research on HIV/Aids and on the control in the spread of the disease.
Thesis (M.A.)-University of Natal, Pietermaritzburg, 1999.

Thesis (M.A.)--Indiana University, 2007.
Department of Philosophy, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Jason T. Eberl, Peter H. Schwartz, William H. Schneider. Includes vitae. Includes bibliographical references (leaves 71-81).

The increasing transparence of the human genome has profound implications for how we understand health and illness and perceive our biological and social relatedness to others. Presymptomatic testing for adult onset conditions, in particular, creates the novel situation in which some individuals know in advance of impending illness while others learn that they have escaped such a fate. How families at risk for one adult onset condition — Huntington Disease (HD) — communicate about such information is the topic of this dissertation. HD is often described as a 'genetic time bomb'. It is an autosomal dominant neuropsychiatric disorder characterized by mid-life onset, involuntary movements, cognitive impairment, and depression. There is no effective prevention or cure but with the advent of predictive testing in 1987 it became possible for at risk individuals to learn if they had inherited the mutation associated with HL\ Empirical studies on predictive testing for HD focus primarily on the individual psychological impacts of the test; few studies consider how families understand and attempt to manage genetic information in their everyday lives. This dissertation begins to address these lacunae by examining the stories that test candidates and their families tell about hereditary risk and predictive testing. These stories derive from a prospectively designed study which includes 102 in-depth, at-home interviews conducted in the pre and post-results period with 16 test candidates and 33 family members. Focusing on three narrative 'moments', the dissertation explores how study participants storied their experiences of: 1) learning about the family history of HD, 2) deciding to request the predictive test and, 3) making sense of an informative result. Drawing upon a social constructionist approach, the analysis emphasizes the processual nature of predictive testing as well as the significance of interpersonal communication in producing and reproducing the social realities in which genetic information acquires a particular salience. Given the recent proliferation of genetic tests as well as the absence of an adequate popular discourse on embodied risk, the research underscores lay actors' abilities to reframe existing clinical schema in order to interpret and manage hereditary risk in an intersubjectively meaningful way.

The limited success of HIV-testing facilities in South Africa means that many people are not accessing necessary antiretroviral treatment services. This study investigates the practical implications of HIV exceptionalism inherent in Voluntary Counselling and Testing (VCT). A semi-structured interview schedule was used to survey participants for their perspectives on barriers to HIV-testing uptake as well as the effects of exceptionalist practices at VCT clinics. Responses showed marked perceptions of gender differences in people's willingness to test and several important barriers including problems of access to services. Significantly, exceptionalism displayed in certain clinic procedures was thought to contribute to stigma, and attempts to normalise HIV practice in order to combat the effects of stigma were being informally implemented. Participants' views on routine opt-out testing were explored. The researcher recommended further investigation on how HIV testing and treatment policies can be normalised so as to reduce stigma and increase testing uptake.
Social Work
M.A. Sociology (Social Behaviour Studies in HIV/AIDS)