Limning the Semantic Frontier of Informed Consent

It is the researcher’s responsibility to provide accurate, complete, and unbiased verbal and written information yet, as this essay discusses, challenges to meaningful research consent abound in the communication between researcher and subject. This discussion of these challenges is far from exhaustive, but it will flag some of the potholes that researchers must anticipate on the sometimes rocky road to eliciting meaningful consent. These hazards include unfamiliar scientific terms and connotations, divergent conceptions of medical history and science, the conscious and unconscious deploying of rosy adjectives with which scientists sometimes “sell” a study in lieu of describing it, semiotics that magnify the therapeutic illusion, and legal maneuvers that bypass consent altogether

Harriet A. Washington, Medical Ethicist and Author

Harriet Washington is an award-winning medical writer and editor, and the author of the best-selling book, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, and Deadly Monopolies: The Shocking Corporate Takeover of Life Itself. In her work, she focuses mainly upon bioethics, history of medicine, African American health issues and the intersection of medicine, ethics and culture. Medical Apartheid, the first social history of medical research with African Americans, was chosen as one of Publishers\u27 Weekly Best Books of 2006. The book also won the National Book Critics Circle Nonfiction Award, a PEN award, 2007 Gustavus Myers Award, and Nonfiction Award of the Black Caucus of the American Library Association. Experts have praised its scholarship, accuracy and insights. Her other books include, Parkinson\u27s Disease, a monograph published by Harvard Health Publications, Living Healthy with Hepatitis C and she is co-author of Health and Healing for African Americans. Ms. Washington has also worked as a laboratory technician, as a medical social worker, as the manager of a poison-control center/suicide hotline, and has performed as an oboist and as a classical-music announcer for WXXI-FM, a PBS affiliate in Rochester, N.Y. She lives in New York City with her husband Ron DeBose.https://thekeep.eiu.edu/humanitiescenter_transformations1213/1002/thumbnail.jp

The Well Curve

Pseudo-nitzschia and ATCV-1 join a panoply of microorganisms that have long been suspected, and sometimes known, to change how well we think. These newcomers are getting attention because they struck in the West, where a functional public health infrastructure allows for disease surveillance and the investigation of mysterious sources of disability. But pathogens that affect cognition have traditionally infected poor people of color in the developing world, so their ravages and long-term effects have been more likely to go unanalyzed and untreated

Harriet A. Washington, Medical Ethicist and Author

Harriet Washington is an award-winning medical writer and editor, and the author of the best-selling book, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, and Deadly Monopolies: The Shocking Corporate Takeover of Life Itself. In her work, she focuses mainly upon bioethics, history of medicine, African American health issues and the intersection of medicine, ethics and culture. Medical Apartheid, the first social history of medical research with African Americans, was chosen as one of Publishers\u27 Weekly Best Books of 2006. The book also won the National Book Critics Circle Nonfiction Award, a PEN award, 2007 Gustavus Myers Award, and Nonfiction Award of the Black Caucus of the American Library Association. Experts have praised its scholarship, accuracy and insights. Her other books include, Parkinson\u27s Disease, a monograph published by Harvard Health Publications, Living Healthy with Hepatitis C and she is co-author of Health and Healing for African Americans. Ms. Washington has also worked as a laboratory technician, as a medical social worker, as the manager of a poison-control center/suicide hotline, and has performed as an oboist and as a classical-music announcer for WXXI-FM, a PBS affiliate in Rochester, N.Y. She lives in New York City with her husband Ron DeBose.https://thekeep.eiu.edu/humanitiescenter_transformations1213/1002/thumbnail.jp

Flacking for Big Pharma

Drugmakers don’t just compromise doctors; they also undermine top medical journals and skew medical research

Targeting smoking cessation to high prevalence communities: outcomes from a pilot intervention for gay men

BACKGROUND: Cigarette smoking prevalence among gay men is twice that of population levels. A pilot community-level intervention was developed and evaluated aiming to meet UK Government cessation and cancer prevention targets. METHODS: Four 7-week withdrawal-oriented treatment groups combined nicotine replacement therapy with peer support. Self-report and carbon monoxide register data were collected at baseline and 7 weeks. N = 98 gay men were recruited through community newspapers and organisations in London UK. RESULTS: At 7 weeks, n = 44 (76%) were confirmed as quit using standard UK Government National Health Service monitoring forms. In multivariate analysis the single significant baseline variable associated with cessation was previous number of attempts at quitting (OR 1.48, p = 0.04). CONCLUSIONS: This tailored community-level intervention successfully recruited a high-prevalence group, and the outcome data compares very favourably to national monitoring data (which reports an average of 53% success). Implications for national targeted services are considered

“What if There's Something Wrong with Her?”‐How Biomedical Technologies Contribute to Epistemic Injustice in Healthcare

While there is a steadily growing literature on epistemic injustice in healthcare, there are few discussions of the role that biomedical technologies play in harming patients in their capacity as knowers. Through an analysis of newborn and pediatric genetic and genomic sequencing technologies (GSTs), I argue that biomedical technologies can lead to epistemic injustice through two primary pathways: epistemic capture and value partitioning. I close by discussing the larger ethical and political context of critical analyses of GSTs and their broader implications for just and equitable healthcare delivery

First M87 Event Horizon Telescope Results. IX. Detection of Near-horizon Circular Polarization

Event Horizon Telescope (EHT) observations have revealed a bright ring of emission around the supermassive black hole at the center of the M87 galaxy. EHT images in linear polarization have further identified a coherent spiral pattern around the black hole, produced from ordered magnetic fields threading the emitting plasma. Here we present the first analysis of circular polarization using EHT data, acquired in 2017, which can potentially provide additional insights into the magnetic fields and plasma composition near the black hole. Interferometric closure quantities provide convincing evidence for the presence of circularly polarized emission on event-horizon scales. We produce images of the circular polarization using both traditional and newly developed methods. All methods find a moderate level of resolved circular polarization across the image (〈∣v∣〉 < 3.7%), consistent with the low image-integrated circular polarization fraction measured by the Atacama Large Millimeter/submillimeter Array (∣v int∣ < 1%). Despite this broad agreement, the methods show substantial variation in the morphology of the circularly polarized emission, indicating that our conclusions are strongly dependent on the imaging assumptions because of the limited baseline coverage, uncertain telescope gain calibration, and weakly polarized signal. We include this upper limit in an updated comparison to general relativistic magnetohydrodynamic simulation models. This analysis reinforces the previously reported preference for magnetically arrested accretion flow models. We find that most simulations naturally produce a low level of circular polarization consistent with our upper limit and that Faraday conversion is likely the dominant production mechanism for circular polarization at 230 GHz in M87*

First Sagittarius A* Event Horizon Telescope Results. VII. Polarization of the Ring

The Event Horizon Telescope observed the horizon-scale synchrotron emission region around the Galactic center supermassive black hole, Sagittarius A* (Sgr A*), in 2017. These observations revealed a bright, thick ring morphology with a diameter of 51.8 ± 2.3 μas and modest azimuthal brightness asymmetry, consistent with the expected appearance of a black hole with mass M ≈ 4 × 106 M ⊙. From these observations, we present the first resolved linear and circular polarimetric images of Sgr A*. The linear polarization images demonstrate that the emission ring is highly polarized, exhibiting a prominent spiral electric vector polarization angle pattern with a peak fractional polarization of ∼40% in the western portion of the ring. The circular polarization images feature a modestly (∼5%–10%) polarized dipole structure along the emission ring, with negative circular polarization in the western region and positive circular polarization in the eastern region, although our methods exhibit stronger disagreement than for linear polarization. We analyze the data using multiple independent imaging and modeling methods, each of which is validated using a standardized suite of synthetic data sets. While the detailed spatial distribution of the linear polarization along the ring remains uncertain owing to the intrinsic variability of the source, the spiraling polarization structure is robust to methodological choices. The degree and orientation of the linear polarization provide stringent constraints for the black hole and its surrounding magnetic fields, which we discuss in an accompanying publication

Polarimetric Geometric Modeling for mm-VLBI Observations of Black Holes

The Event Horizon Telescope (EHT) is a millimeter very long baseline interferometry (VLBI) array that has imaged the apparent shadows of the supermassive black holes M87* and Sagittarius A*. Polarimetric data from these observations contain a wealth of information on the black hole and accretion flow properties. In this work, we develop polarimetric geometric modeling methods for mm-VLBI data, focusing on approaches that fit data products with differing degrees of invariance to broad classes of calibration errors. We establish a fitting procedure using a polarimetric “m-ring” model to approximate the image structure near a black hole. By fitting this model to synthetic EHT data from general relativistic magnetohydrodynamic models, we show that the linear and circular polarization structure can be successfully approximated with relatively few model parameters. We then fit this model to EHT observations of M87* taken in 2017. In total intensity and linear polarization, the m-ring fits are consistent with previous results from imaging methods. In circular polarization, the m-ring fits indicate the presence of event-horizon-scale circular polarization structure, with a persistent dipolar asymmetry and orientation across several days. The same structure was recovered independently of observing band, used data products, and model assumptions. Despite this broad agreement, imaging methods do not produce similarly consistent results. Our circular polarization results, which imposed additional assumptions on the source structure, should thus be interpreted with some caution. Polarimetric geometric modeling provides a useful and powerful method to constrain the properties of horizon-scale polarized emission, particularly for sparse arrays like the EHT