Just compensation: a no-fault proposal for research-related injuries

Biomedical research, no matter how well designed and ethically conducted, carries uncertainties and exposes participants to risk of injury. Research injuries can range from the relatively minor to those that result in hospitalization, permanent disability, or even death. Participants might also suffer a range of economic harms related to their injuries. Unlike the vast majority of developed countries, which have implemented no-fault compensation systems, the United States continues to rely on the tort system to compensate injured research participants—an approach that is no longer morally defensible. Despite decades of US advisory panels advocating for no-fault compensation, little progress has been made. Accordingly, this article proposes a novel and necessary no-fault compensation system, grounded in the ethical notion of compensatory justice. This first-of-its-kind concrete proposal aims to treat like cases alike, offer fair compensation, and disburse compensation with maximum efficiency and minimum administrative cost. It also harmonizes national and international approaches—an increasingly important goal as research becomes more globalized, multi-site trials grow in number, and institutions and sponsors in the United States move to single-IRB review.     

Perestroyka and the Slavic Regions

The paper examines the effects and significance of geographic position, cumulative advantages and disadvantages of past development, present investment cuts, political factors and links, and two recent decrees on enterprises, regional self-management, and the devolution of authority in selected Slavic regions. It argues that structural and spatial constraints and system-preserving controls on the reforms themselves have rendered perestroyka ineffectual and accentuated “center-periphery” tensions within the Slavic republics, Journal of Economic Literature, Classification Numbers: 052, 124, 940.     

Sudden Death by Occult Metastatic Carcinoma

A 33-year-old female collapsed and died suddenly after presenting with acute dyspnea and increasing cough over the preceding several months. Autopsy revealed poorly differentiated linitis plastica adenocarcinoma of the stomach. Microscopic examination of the lungs showed features consistent with pulmonary tumor thrombotic microangiopathy (PTTM). PTTM is a well-described complication in patients with adenocarcinoma. The typical presentation involves acute pulmonary hypertension, right-sided heart failure, and sudden death, often before the adenocarcinoma is discovered. The pathophysiology of PTTM remains elusive; it has been suggested that carcinoma cells may produce substances that influence pulmonary vasculature. Our patient had classic clinical and histologic features of PTTM in addition to prominent extravascular compression by intralymphatic tumor cells. These features undoubtedly caused her precipitous decline and lethal pulmonary hypertension, induced by underlying adenocarcinoma. This case demonstrates that sudden death can occur from pulmonary hypertension induced by metastatic carcinoma with remarkably little prior symptomatology.     

TENNESSEE'S ADOPTION LAW AND THE LIMITATIONS OF THE CONSTITUTIONAL ARGUMENTS REGARDING OPEN RECORDS

In 1995, Tennessee enacted a statute allowing adult adoptees access to information contained in their adoption records. Since then, debate has arisen concerning the constitutional rights of both the adoptive parents and the adoptees. A further dichotomy arose concerning the newly-created variation between adult and minor adoptees. While the debate continues, certain cases have begun to outline a judicial position on these matters, establishing predictors for the future application of the Tennessee law.     

Human rights at the “end of nature”

Nature has been employed as a moral concept across the millennia. Human rights are beholden to nature as a normative standard, as they developed within a tradition of natural law and natural rights. Should contemporary advocates of human rights continue to deploy the standard of nature at a time when both its physical and metaphysical statuses are increasingly challenged? I argue that the life sciences help us understand human rights in terms of the development of prosocial behavior in our species, and in this respect there remains an important role for nature to play in the advance of human rights. Attention to the status of nature in the modern world’s most important document of human rights, the 1948 Universal Declaration of Human Rights, illuminates the challenges associated with linking rights to the standard of nature.     

Implementing ILO Child Labour Convention 182: lessons from Honduras

This article explores the implementation of Convention 182 on the Worst Forms of Child Labour in Honduras. It highlights key lessons learned from a joint Save the Children Fund‐UK and Ministry of Labour project. These lessons are of relevance to similar projects addressing the application of child labour legislation and to projects focusing on institutional strengthening and children's participation. The article examines the centrality of partnership and ownership, and the value of child‐centred approaches. It also explores the capacity of NGOs to engage in national‐ and regional‐level government, and the importance of linking national‐, regional‐, and local‐level initiatives.