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Summary. Explores how liability concerns influence physicians to order tests that patients don’t need.
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Summary. An individual has a mind; a group does not. Yet humans routinely endow groups with mental states irreducible to any of their members (e.g., “scientists hope to understand every aspect of nature”). But are these mental states categorically similar to those we attribute to individuals? In two fMRI experiments, we tested this question against a set of brain regions that are consistently associated with social cognition—medial pFC, anterior temporal lobe, TPJ, and medial parietal cortex. Participants alternately answered questions about the mental states and physical attributes of individual people and groups. Regions previously associated with mentalizing about individuals were also robustly responsive to judgments of groups, suggesting that perceivers deploy the same social-cognitive processes when thinking about the mind of an individual and the “mind” of a group. However, multivariate searchlight analysis revealed that several of these regions showed distinct multivoxel patterns of response to groups and individual people, suggesting that perceivers maintain distinct representations of groups and individuals during mental state inferences. These findings suggest that perceivers mentalize about groups in a manner qualitatively similar to mentalizing about individual people, but that the brain nevertheless maintains important distinctions between the representations of such entities.
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Summary. This piece explores the similarities and differences between the ethical and regulatory issues raised by direct-to-consumer advertising of prescription drugs and those raised by the promotion of foods for their purported health-benefits.
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Summary. The general public is skeptical of our current system of campaign finance and feels that members of Congress are corrupt. Although the scholarly literature on campaign contribution influence is mixed, there is growing consensus that Political Action Committees (PACs) and interest groups do, indeed, have a powerful influence on policymaking in Congress. In this article, the author reviews this literature and discusses how influence occurs. Findings reveal that influence is only very rarely an explicit quid pro quo exchange. Instead, it is typically an ongoing, implicit, reciprocal exchange that impacts multiple stages of the legislative process and yields contributors many dividends, such as softer regulations, lower taxes, and lucrative contracts—none of which are explicitly promised (except in rare cases of full-blown bribery), but are, nonetheless, regularly granted. The social relationships between contributors and lawmakers are central to this process, as is the ability to get legislators to sway their colleagues.
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Summary. Physicians discriminate among trials of varying degrees of rigor, but industry sponsorship negatively influences their perception of methodologic quality and reduces their willingness to believe and act on trial findings, independently of the trial's quality. These effects may influence the translation of clinical research into practice.
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Summary. The dominant business model of the pharmaceutical sector is based on the massive promotion of drugs that often do not represent any significant therapeutic advance. Clinical research is therefore run like a promotional campaign. The data obtained from clinical research are primarily used to boost and support sales rather than to improve prescribing behaviour. Three common and widely used corporate strategies are used to this end: ghostwriters are employed to inflate the number of publications showing the drug in a positive light; results that would harm sales are not published (publication bias); and negative data are suppressed, sometimes going as far as to intimidate troublesome independent academics and whistle-blowers. The objective of these strategies is to enable the new drug to gain market share from its competitors. If medicine is to progress, research must be more independent and freed from the commercial imperatives of the pharmaceutical industry.
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Summary. This paper explores the empirical evidence regarding the impact financial relationships on the behavior of health care providers, specifically, physicians. We identify and synthesize peer-reviewed data addressing whether financial incentives are causally related to patient outcomes and health care costs. We cover three main areas where financial conflicts of interest arise and may have an observable relationship to health care practices: (1) physicians' roles as self-referrers, (2) insurance reimbursement schemes that create incentives for certain clinical choices over others, and (3) financial relationships between physicians and the drug and device industries. We found a well-developed scientific literature consisting of dozens of empirical studies, some that allow stronger causal inferences than others, but which altogether show that such financial conflicts of interests can, and sometimes do, impact physicians' clinical decisions. Further research is warranted to document the causal relationship of such changes on health outcomes and the cost of care, but the current base of evidence is sufficiently robust to motivate policy reform.
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Summary. This essay explores the ethical issues raised by the promotion of foods for their purported health benefits, and compares the U.S. and E.U. regulatory frameworks governing such claims.