A nation's genes for a cure to cancer: evolving ethical, social and legal issues regarding population genetic databases

The advent of the human genome sequence has focused research on understanding underlying genetic links to complex diseases such as cancer, asthma and heart disease. In the past few years, individual countries, such as Iceland, Estonia, Singapore and the United Kingdom, have created national databases of their citizens' DNA for comparative research. Most recently, an international consortium including Nigeria, Japan, China and the United States launched a $100 million project called the International HapMap to map the human genome according to haplotypes, blocks of DNA that contain genetic variation. Such population genetic databases present challenging ethical, social and legal issues, yet regulation of genetic information has developed sporadically, from region to region, without a consistent international standard. Without a clear understanding of the consequences of genetic research in terms of individual and community-wide discrimination and stigmatization, genetic databases raise concerns about the protection of genetic information. This Note provides a survey of the evolving landscape of population genetic databases as a legislative and public policy tool for national and international regulators. It compares different approaches to regulating the collection and use of population genetic databases in order to understand what areas of consensus are formulating a foundation for an international standard. As the first population genetics project that will span multiple countries for the collection of DNA, the International HapMap has the potential to become an influential standard for the protection of population genetic information. This Note highlights issues among the national databases and the HapMap project that raise ethical, social and legal concerns for the future and recommends further protections for both individual donors and community interests.     

The doctor-patient relationship as the business case for quality: doing well by doing right

The idea that healthcare quality in America has lagged behind optimal levels has been a central national policy issue since at least 1998. Reform efforts, however, have failed to acknowledge the critical and unique role physicians play in making quality initiatives real. This Article argues physicians are at the core of any effort to propel quality forward in a significant way and, therefore, must be taken into account directly and without apology. The Article examines the quality-accountability context present in this country. It addresses why the physician nexus on these issues is vital for real change to take place and sets forth a clear statement of what is essential to support the doctor-patient relationship in any quality agenda. Finally, it reiterates the author's previously proposed five principles for quality, as well as her unified field theory of quality, all of which are designed to advance quality in a very different way.     

Patterns of family interaction and adolescent sex role concepts

This study examined the relationship between patterns of family interaction and adolescent development of sex role concepts. Sixty-six families of high school seniors completed a measure of daily family activities and a Plan Something Together Task, used to measure individuation in family communication. Adolescents' responses on the sex roles section of the Ego Identity Interview were coded to reflect Block's theory of the stages of development of sex role concepts. Results indicated gender differences in the development of sex role concepts as related to distinctive patterns of family communication and daily activity with the adolescents' mothers and fathers.This work was supported by grants from the National Institute of Child Health and Human Development (HD-29819 and HD-17983), the Hogg Foundation for Mental Health, and the University Research Institute and Institute of Human Development and Family Studies of the University of Texas at Austin.Received degree from the University of Texas at Austin. Research interests in adolescent development, adolescent mental health, and adolescents in high-risk families. To whom reprint requests should be addressed at School of Social Work, Annex C, University of Maine, Orono, Maine 04469-0124.Received degree from the University of Minnesota. Research interests are in adolescent development within the context of the family and adoptive family relationships.Received degree from the University of Minnesota. Research interests are in the role of ethnicity in adolescent identity development and family relationships.     

The “Hired Gun” Effect: Assessing the Effect of Pay,Frequency of Testifying,and Credentials on the Perception of Expert Testimony

Three experiments addressed the proposition that jurors use short cuts in processing information when confronted with expert scientific testimony. The results of the first two studies demonstrated that experts who are highly paid for their testimony and who testify frequently are perceived as hired guns. They are neither liked nor believed. The results of the third experiment replicated the hired gun effect and showed that it is most likely to occur when the testimony is complex and cannot be easily processed. The results were discussed in terms of the theoretical differences between central and peripheral processing of persuasive messages in a legal context.