Warung Bebas

Rabu, 21 Maret 2012

Sejarah Surat Kabar / Koran

newspaper, Apa itu "news"?

Beberapa observasi yang tertuang atau diucapkan pada suatu media. Biasanya kita berpikir tentang berita sebagai semacam tertentu dari realitas sejarah, yang mungkin dapat digambarkan secara analitis. Itu adalah mistifikasi subjek. Jika wartawan yang ahli dalam sesuatu, audiens Anda, dan bukan aspek lain dari realitas. Dilihat dari "pheomenologically," adalah berita yang dilakukannya di koran hari ini atau siaran berita. Sekarang ada 188 negara, kemarin $ 5 juta, dan ribuan hal-hal yang "terjadi". Hanya mereka yang benar-benar melakukan pekerjaan menjadi berita. Besok akan memiliki berita sendiri, peristiwa sehingga ditolak tidak akan pernah menjadi berita. Tentu saja bisa menjadi bagian dari rekonstruksi sejarah kemudian waktu kita. Orang akan berpikir bahwa dalam kasus ini bahwa wartawan hanya menggagalkannya - jika Anda benar-benar percaya bahwa berita itu sifat yang sama seperti cerita. Tapi berita itu bukan tentang cerita, sebenarnya, namun manfaatnya, ketika editor berpikir jernih, dan penerbit surat kabar berpikir jelas sejak awal.

Definisi harus berasal dari pemakaian umum, dan ini adalah yang kita maksud dengan "berita" ketika bingung dengan pengertian seperti berita penting atau berita dilaporkan. Tidak ada hal seperti dilaporkan pers, karena berita itu tidak alami.

Mereka yang berharap bahwa berita itu akan membuat Anda informasi tentang kekuatan besar di dunia harus mempertimbangkan kemungkinan bahwa daya dapat didefinisikan sebagai kemampuan untuk disimpan dari berita. Selain itu, elit dapat didefinisikan sebagai kelompok yang mampu memonopoli jenis tertentu informasi, dan menjaganya dari sirkulasi. Bahkan untuk hari ini semua berita penting ditularkan secara lisan, dalam elite. Jika sebuah cerita besar adalah apa yang memberi seseorang keuntungan lebih dari orang lain, maka berikut bahwa berita berharga adalah sesuatu yang Anda harus membayar banyak untuk, salah satu cara atau yang lain. Yang tersisa diubah menjadi isi media.

Memang benar bahwa selama berabad-abad perhatian media telah membantu penduduk untuk memantau dan menantang elite. Seiring waktu, perhatian ini telah mengikis daya dari beberapa elit, tapi hanya jika pers itu sendiri menjadi bisnis besar, elit dengan rahasia mereka sendiri. Apa keseimbangan ditunjukkan dalam distribusi baru kekuasaan, dan jika publik memiliki hak untuk dimasukkan dalam struktur kekuasaan karena kesadarannya berita, harus mendapat perhatian lebih dari yang dimilikinya.

Asal-usul Pers

Sejarah surat kabar sering bab dramatis pengalaman manusia akan kembali beberapa lima abad. Dalam Renaisans Eropa surat kabar tulisan tangan beredar secara pribadi di antara pedagang, untuk informasi tentang segala sesuatu dari peperangan dan kondisi ekonomi untuk kebiasaan sosial dan karakteristik dari "human interest". Pelopor dicetak pertama koran muncul di Jerman pada tahun 1400-an dalam bentuk pamflet atau berita broadsides, sering sangat sensasional dalam konten. Beberapa yang paling terkenal dari laporan-laporan kekejaman melawan Jerman di Transylvania yang dilakukan oleh Drakul Tsepes sadis veovod disebut Vlad, yang menjadi Count Dracula kemudian dari cerita rakyat.

Di dunia berbahasa Inggris, nenek moyang awal dari surat kabar adalah corantos, pamflet berita diproduksi hanya kecil ketika peristiwa penting terjadi. Judul pertama dipublikasikan di The Newes Mingguan dari 1622. Hal ini diikuti tahun 1640 dan 1650 oleh sejumlah judul yang berbeda dalam Newsbook format yang sama. Surat kabar pertama benar dalam bahasa Inggris adalah Lembaran London 1666. Untuk generasi yang merupakan koran resmi hanya sanksi, meskipun judul berkala banyak di media adalah pada akhir abad ini.
Dimulai di Amerika Serikat

Di Amerika, surat kabar ( koran )pertama kali muncul di Boston pada tahun 1690, berjudul Kemunculan Publick. Diterbitkan tanpa otoritas, yang kemudian segera ditekan, penerbit ditangkap, dan semua salinan dihancurkan. Bahkan, itu terlupakan hingga 1845, ketika contoh yang masih hidup hanya dikenal ditemukan di Perpustakaan Inggris. Surat kabar itu adalah sukses pertama Berita Boston-Surat, dimulai oleh postmaster John Campbell pada 1704. Meskipun menerima subsidi besar dari pemerintah kolonial percobaan adalah kegagalan dalam jangka pendek, dengan sirkulasi sangat terbatas. Dua penelitian lain diperkenalkan pada 1720, di Philadelphia dan New York, dan kekuatan keempat secara bertahap didirikan di benua baru. Pada malam Perang Kemerdekaan, sekitar dua lusin dokumen diterbitkan di semua koloni, meskipun Massachusetts, New York, dan Pennsylvania akan tetap pusat pencetakan Amerika selama bertahun-tahun. Artikel di koran kolonial, cemerlang dikandung oleh propagandis revolusioner, adalah kekuatan utama yang mempengaruhi opini publik di Amerika Serikat rekonsiliasi dengan Inggris untuk kemerdekaan politik penuh.

Pada akhir perang pada tahun 1783 ada empat puluh tiga surat kabar di cetak. Pers memainkan peran penting dalam urusan negara baru, banyak surat kabar lebih banyak dimulai, mewakili seluruh nuansa pendapat politik. Dia tidak gaya prinsip jurnalisme dicegah sebagian besar memfitnah dengan standar modern, mencerminkan kehidupan politik kasar dan kacau republik sebagai faksi saingan mendorong untuk kekuasaan. Ratifikasi Bill of Rights tahun 1791 untuk menjamin kebebasan pers dan surat kabar AS mulai mengambil peran sentral dalam urusan nasional. Pertumbuhan terus berlanjut di semua negara. Pada tahun 1814 ada 346 surat kabar. Dalam Jackson populis, 1830, kemajuan dalam teknologi pencetakan dan kertas menyebabkan ledakan pertumbuhan harian, munculnya "Tekan Penny", tapi sekarang mungkin untuk memproduksi satu koran yang bisa dijual hanya sepeser pun per copy. Sebelumnya, surat kabar adalah provinsi dari sedikit kaya, membaca dan menulis. Harga berlangganan selama satu tahun, biasanya sekitar upah satu minggu dari buruh, harus dibayar penuh dan "selalu di muka." Ini ketersediaan mendadak dari bahan murah, bacaan menarik adalah stimulus penting untuk mencapai hampir universal melek begitu saja di Amerika.
Revolusi Industri

Revolusi industri seperti mengubah setiap aspek kehidupan dan masyarakat Amerika, surat kabar dramatis terpengaruh. Kedua jumlah dokumen dan sirkulasi mereka dibayar terus meningkat. Sensus 1850 tercatat 2.526 judul. Pada tahun 1850, kuat menekan raksasa muncul, mampu mencetak sepuluh ribu makalah lengkap per jam. Pada saat ini yang pertama "bergambar" surat kabar mingguan muncul, tapi ilustrasi acara besar pertama dalam berita, sebagai ukiran ukiran kayu dari sketsa para koresponden atau diambil dari penemuan baru fotografi. Selama Perang Sipil permintaan belum pernah terjadi sebelumnya untuk tepat waktu, berita yang akurat mengubah jurnalisme Amerika dalam dinamis, hardhitting dalam kehidupan nasional. Wartawan yang disebut "khusus", menjadi kesayangan publik dan berhala-berhala kaum muda di seluruh dunia. Banyak account pertempuran disampaikan oleh petualang pemberani berdiri hari ini sebagai sejarah definitif rakyatnya.

Berita itu tidak menghentikan pertumbuhan di tahun-tahun sesudah perang. Sebuah 11.314 mengejutkan item yang berbeda tercatat dalam sensus 1880. Dalam angka-angka sirkulasi 1890 dari satu juta eksemplar per edisi pertama dicatat (ironisnya, surat kabar ini sekarang sangat langka karena kualitas mengerikan kertas murah maka digunakan, dan kerugian besar dalam Perang Dunia Dunia kertas unit era II) Pada periode ini muncul fitur dari surat kabar modern, headline besar "banner", ekstensif menggunakan ilustrasi, "halaman lucu" serta cakupan diperluas acara olahraga yang terorganisir. Munculnya "jurnalisme kuning" juga menandai periode ini. Hearst benar-benar bisa membanggakan bahwa surat kabar itu diproduksi keributan publik untuk perang melawan Spanyol pada 1898. Ini juga merupakan usia konsolidasi dari media, surat kabar independen banyak yang ditelan menjadi kuat "rantai" dengan konsekuensi yang tidak menguntungkan untuk tekan sekali tak kenal takut dan tidak fana, banyak yang dikurangi menjadi kendaraan untuk distribusi pendapat terpisah dari pemiliknya, dan sebagainya tetap, tanpa bersaing kertas untuk menantang pandangan mereka. Pada 1910-an, semua fitur penting koran dikenali modern telah muncul. Pada zaman kita, radio dan televisi secara bertahap menggantikan surat kabar sebagai sumber informasi utama bangsa, sehingga dapat menjadi sulit pada awalnya untuk menghargai peran bahwa surat kabar telah memainkan dalam sejarah kami.

Challenge Accepted!

I have a post that I keep re-working addressing this whole "Antagonism against LC" whine from one Jimmy Moore. Perhaps I hit "Publish" in a day or so.  For my newer readers, a little background.  I basically came to the larger LC/paleo/ancestral community from the LLVLC forum where I was a rather prolific participant.  After losing roughly 100 lbs with an Atkins Induction-style pretty Primal friendly diet with planned cheats from 2007-2009 (most of it in the first 10 months), I plateaued out and looked for answers.  LLVLC was a good fit ... I went by Low Carb Cheater.  Shortly after I began following Jimmy's menus blog ... and I'm one with a good memory (something that drives even me crazy at times because I'll often remember exact wordings but not where exactly I read them ... part of the reason for starting this blog).  Because of our podcast but before that a few other times, Jimmy and I had corresponded via email.   I've been criticized for "bashing" Jimmy ... some of that may be fair criticism.  But let me be blunt:  I do not like the man based on our personal interactions.  I think he is a two-faced opportunist with a mean streak he manages to keep under wraps in his public "aw shucks" persona.  His part in the Taubes/FatHead/Moore "confused, stalking, mentally unstable, female" campaign and violation of email privacy over a critical issue can be forgiven but not forgotten.  And I'm human so I'm sure part of those personal feelings are bound to come through when I write posts like this one.  Still, most of the criticism befuddles me given that I'm only pointing out the obvious, that is at least part of what underlies the rift in the LC and Paleo communities.  Jimmy has staked his claim to his Livin La Vida Low Carb webpire, and although it's clearly not working for him anymore,  recent pictures are really worth more than 1000 words regarding part of the problem.  
This picture is from Ancestralize Me! blog.
Please go check out her blog and also check out her other pictures from Paleo FX  too!
She has extensive notes on her blog from the conference and links to FB where she's got much more.
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Selasa, 20 Maret 2012

An Example of How the Complex Takes Control - A Board Dominated by Hired Managers Levitates Its Hired CEO's Pay

The Indianapolis Star published the latest story about anti-gravity health care executive compensation.  The report emphasized how the largest hospital systems in the metropolitan area raised CEO pay faster than any reasonable metric:
CEO pay is up, sharply in some cases, at Indianapolis' four large hospital groups, as the systems have grown and dumped more responsibilities on their top leaders.

Total pay for those CEOs rose anywhere from 15 percent to 53 percent from 2008 to 2010. While experts say the pay is in line with executive compensation at other large hospital groups, the rate of the increases far outpaces the minimal wage gains that area health-care workers (1.7 percent) and hourly workers (3.1 percent) have seen over the same time.

The rising CEO pay comes at one of the shakiest financial periods ever for hospitals, as they struggle with cuts in reimbursements for care from federal Medicare and Medicaid programs and private insurers.

CEO Pay Up More than Revenue

Pay at specific health care systems also rose faster than revenue. At the Indiana University Health System:
At the top of the best-paid list: IU Health's President and Chief Executive Daniel F. Evans Jr., who pulled down $2.08 million in compensation in 2010, up 17 percent from 2008. Subtracting Evans' retirement payouts, which vary year to year, his base pay jumped 19 percent since 2008.

However,
From 2008 to 2010, IU Health has seen revenue grow 10 percent to $2.46 billion,...

At St Vincent Hospital and Health Care
Close behind comes Vincent Caponi, CEO of St. Vincent Hospital and Health Care Center, who took in $1.86 million in 2009-10, a two-year jump of 44 percent, or 64 percent when retirement is removed.

However,
Revenue over the two years rose 28 percent at St. Vincent,...

At Franciscan Alliance,
Robert Brody of Franciscan Alliance earned $1.27 million in 2010 (53 percent more than in 2008),...

However, over that period revenue only rose 17%.

At Community Health Network,
Bryan A. Mills, the relatively new CEO of Community Health Network, received $1.35 million, or 15 percent more than his predecessor, William Corley, collected in 2008. (Corley retired in 2009.)
while revenue only rose 4%.

The Usual Talking Points

At this point, it should come as no surprise that hospital leadership trotted out the same old talking points to account for the ever upward trajectory of CEO pay as used in other areas and to account for the pay of leaders of other kinds of health care organizations (look here). These included...

We Pay What Everyone Else Pays

It was easy to find a professional compensation consultant to repeat this one:
Jim Otto, senior principal in Atlanta for the Hay Group, a consultant on executive benefits, said pay to top hospital CEOs in Indianapolis appears in line with rising compensation, including retirement benefits and bonuses, being paid nationally to most large-system hospital executives.

CEOs Work Hard and Are Brilliant

So we read:
At IU Health, formerly Clarian Health Partners, where Evans has been CEO since 2002, 'The system's grown significantly. It makes us think twice about the difficulty of running such a system. We literally cover the entire state of Indiana. And much of that has been under Dan's oversight,' said Charles Golden, an IU Health board member and chair of its compensation committee.

Also,
Golden says Evans 'has done a really superb job. Almost everything favorable to our system has been positive in his time.'

Here is the version pertaining to St Vincent's
Caponi 'is on an airplane and out of town a good bit, running a much bigger area' for Ascension, said Bill Estes, chairman of St. Vincent's board. 'That's the way we justify (higher CEO pay) and feel comfortable with that.'

High Pay is Needed to Attract Competent, if not Brilliant People

From Mr Otto, the compensation consultant:
Large hospital groups make certain they pay similar to their peers to remain competitive.

One reason for rising pay, Otto says: 'These aren't easy jobs. They are not easy to fill. The candidate pool isn't terribly large.'

Furthermore, Mr Golden, from the IU Board, added,
'Unless you want to default to mediocrity, I suppose you can do that (cut CEO pay),' he said. 'But I don't think that's where we are going. I don't think these (hospital) systems will get any easier to manage.'

Talking Points Sans Justification

As in previous cases, no one that reporter Jeff Swiatek could find provided any specifics to back up these talking points. It is striking that those who stewarded all the major hospital systems in this one area
felt the need to raise executive pay substantially faster than the rate of rise of revenue, that is from 1.7 times to 3.75 times the rate of revenue rise.

Why Are Hospital Boards So Nice to CEOs?

In the interests of full disclosure, I noticed this article because reporter Jeff Swiatek chose yours truly, plus fellow blogger Dr Howard Brody (look here) to comment for it.
'Whenever the nonprofit sector starts acting more like the for-profit sector, I start to get worried,' said Dr. Howard Brody, director of the Institute for the Medical Humanities. 'It just becomes crony capitalism. If one executive gets paid $3 million instead of $1 million, then every executive wants $3 million. It just becomes a vicious cycle of inflation of CEO benefits.'

Also, I suggested:
Put more noncorporate members on hospital boards because they'd be less inclined to endorse large compensation packages that are more typical of for-profit companies.

'Boards are populated by wealthy executives, who themselves are getting increasing compensation, rather than by community representatives or patient representatives,' Poses said.
Could the Composition of the Board Explain Excess Deference to the CEO?

I made the above comments after hearing approximations of the compensation given out by the hospital systems, but without any knowledge of the composition of the boards that approved that compensation. I am guessing that Dr Brody also was not told anything about board composition when he suggested the possibility of crony capitalism.

However, now that the article is out, I think it makes sense to look at the composition of at least one of the boards involved. I chose IU Health, since it is the largest of the systems, paid the most to its CEO, and was kind enough to list board members' brief biographies on a web-page.  Here they are, listed with their primary affiliations, and some notable other affiliations.

- Judge Sarah Evans Barker, former federal district court judge.
- Dr D Craig Brater, "dean of the Indiana University School of Medicine and director of IU Medical Center." Also on  the Board of Advisors of Spring Mill Venture Partners, "an early stage venture capital firm focused on investing in high-growth information technology and life sciences companies;" recipient of consulting and travel money from Pfizer (per ProPublica); and who was listed as having "a financial interest/relationship or affiliation in the form of: Consultant for AstraZeneca Pharmaceuticals; BioGen, Inc.; Forest Laboratories; Merck & Co., Inc.; Pfizer Inc.; and Pharmacia and Upjohn Company" per CMECorner.
- William R Cast, "CEO of NoMore Clipboard, an online, patient-controlled personal health record management system."
- Thomas W Chapman, "president and CEO of The HSC Foundation in Washington, DC, the parent corporation for two subsidiaries, The HSC Pediatric Center and Health Services for Children with Special Needs. He was previously senior associate vice president for Network Development and Professor of Health Services Management and Policy at George Washington University Medical Center in Washington, DC."
- Bishop Michael J Coyner, "Bishop of the Indiana Area United Methodist Church"
- J Scott Davison, "chief financial officer for OneAmerica and its affiliated companies," and member of the board of directors for Indiana Bond Bank."
- Daniel F Evans Jr - CEO of IU Health, also member of the board of Lakeland Financial Corp, (per Bloomberg)
- Charles E Golden, "retired from Eli Lilly and Company in 2006 as executive vice president and CFO and a member of the board of directors. He was previously a corporate vice president of General Motors...." He is also currently on the boards of Unilever, which makes health care related products, and Hill-Rom, which makes medical devices and supplies.
- David W Goodrich, "retired in 2005 as president and CEO of Central Indiana Corporate Partnership, Inc."
- V William Hunt, "chairman of Hunt Capital Partners, LLC, a venture capital and consulting firm based in Indianapolis. Until August 2001, he was the vice chairman and president of ArvinMeritor Inc...."
- Dr James E Lingeman, "long-standing member of the IU Health Methodist Hospital medical staff," but also according to a 2009 American Urologic Association Education and Research paper, Consultant or Advisor to, and Meeting Participant or Lecturer for Boston Scientific Corp and Lumenis, scientific investigator for Boston Scientific and Olympus, investor in Beck Analytical Laboratories and Midstate Mobile Lithotripsy, and having "Other" financial relationships with Beck and Midstate.
- Angela Barron McBride, " distinguished professor and university dean emerita at Indiana University School of Nursing"
- Michael A McRobbie, "Indiana University President," also on the board of OneAmerica (look here).
- Anne Nobles, "senior vice president for Enterprise Risk Management and chief ethics and compliance officer for Eli Lilly and Company."

When considering the composition of this board, note that members of non-profit organizations' boards generally are said to have three duties, as per BoardSource:
- The Duty of Care: "a board member owes the duty to exercise reasonable care when he or she makes a decision as a steward of the organization."
- The Duty of Loyalty: "a board member must give undivided allegiance when making decisions affecting the organization. This means that a board member can never use information obtained as a member for personal gain, but must act in the best interests of the organization."
- The Duty of Obedience: "The duty of obedience requires board members to be faithful to the organization's mission. They are not permitted to act in a way that is inconsistent with the central goals of the organization."

The Duties of Care and Obedience require board members to exercise prudent and reasonable supervision over hired managers, and provide these managers reasonable pay and incentives.  However, boards dominated by hired managers may put the interests of such managers ahead of their organizations' missions. 

So of the 14 members of the IU Health board, 8 are current or retired top level corporate executives or corporate board members, 4 of which have such leadership positions at financial service companies, (two at OneAmerica). In addition, 5, including 4 apparently ex-officio members, had or have top leadership positions in academic institutions. The board also included one Methodist Bishop and one federal judge. All but two board members are thus current or former top level hired managers of for-profit corporations or non-profit organizations.

Thus this board is largely populated by executives who are likely to be wealthy. Thus it is similar to many other boards of health care corporations (e.g., look here and here) and non-profit organizations  (e.g., look here,  here, and here) which we have discussed.  It stands to reason that boards dominated by hired managers will feel comfortable with and look kindly on the hired managers whom they are supposed to supervise, and view their compensation sympathetically.  Thus such boards may not exercise the Duties of Care and Obedience.

Furthermore, the Duty of Loyalty requires boards not to be affected by conflicts of interest. 
 
However, many of the IU Health board members have financial relationships that could be considered conflicts of interest. Two have or had executive positions at the same pharmaceutical company, Eli Lilly, one of whom also was on the board of medical device and supply company. In addition, both of the doctors on the board have or had significant disclosed financial relationships with drug, device, or biotechnology firms.  Again, it is like other boards affected by such conflicts that we have discussed.  Again, such boards may not exercise the Duty of Loyalty.
 
Summary
 
Combined with other examples of the composition of boards of for-profit health care corporations, and non-profit health care organizations, the latest example suggests the complex has taken control.  Nearly every board we have scrutinized is dominated by hired managers of other companies, and salted with conflicts of interest.  It seems likely that such boards will put the interests of hired managers ahead of those of the shareholders of for-profit corporations, and ahead of the missions of non-profit organizations. 
 
The complex that has taken control looks like a confederation of hired managers.  In 2003, five years before the fall of Lehman Brothers ushered in the global financial collapse, John C Bogle warned of the "grotesque transformation" of capitalism into an oligarchy of hired managers:
The root causes of the disease in our system are deep, and the remedies that are required to cure it will not be easy to come by. For what we have witnessed in the failure of corporate governance in America has been, as journalist William Pfaff described it, 'a pathological mutation in capitalism.' He was right on the mark. The classic system—owners capitalism—had been based on a dedication to serving the interests of the corporation’s owners, maximizing the return on their capital investment. But a new system developed—managers capitalism—in which 'the corporation came to be run to profit its managers, in complicity if not conspiracy with accountants and the managers of other corporations.' Why did it happen? 'Because,' in Mr. Pfaff’s words, 'the markets had so diffused corporate ownership that no responsible owner exists. This is morally unacceptable, but also a corruption of capitalism itself.'
This plague of managers' capitalism seems not to have spared health care, and to have infected the non-profit as well as public for-profit sphere.

To stave off the coming dystopia, we must return the control of for-profit corporations, including health care corporations, to their owners, and stewardship of non-profit organizations to those who will put their missions ahead of self-interest.

Random thought on Sun, Tanning & Vitamin D

As I changed races in Me-hee-co last week something I read in Stephanie Seneff's blog post on VitD and sunscreens, etc.  that got me thinking about my negative vitamin D experience a few years back.  For those who haven't read me drop a comment on it, here's the Cliff's Notes version.  I rather foolishly decided to jump on the megadoses of VitD bandwagon a few years back and began taking somewhere in the 5000-10000 IU/day range.  I started getting weird "dizzy spells" but only when lying down and shifting positions (like rolling over).  I also had my first ever "high" BP reading at my "well woman" doc visit.  So I figured I should stop taking all supps and sort that out.  I've since added back in the other supps and identified it was the D.  I now only take 1000 IU and no more than 2000 IU, definitely not daily (currently I'm experimenting with whether the Estroven is doing anything at this point and it has D in it).  
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Human Subjects Experimentation Directives Ignored in the Grand Health IT Experiment?

The following represents some very inconvenient truths that have long been ignored.

Health IT is an experimental technology. The literature in 2012 remains conflicting on benefits and risks (the latter which is acknowledged, but whose magnitude is uncertain).

At NIH study sections, for example, research proposals that involve health IT (even modifications to existing applications) are subjected to far more scrutiny around human subjects protections, of both patients and investigators, than the typical wide-scale hospital implementation of enterprise health IT systems. The latter are validated and approved by - nobody.

How many of these directives are ignored in the Grand Health IT Experiment?

I've bolded the issues that I believe are ignored.

See "Reading list on health IT" for more information on conflicts in the literature:

---------------------------------------------

Directives for Human Experimentation

NUREMBERG CODE

  1. The voluntary consent of the human subject is absolutely essential. This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice [that is, to opt-out - ed.], without the intervention of any element of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision. This latter element requires that before the acceptance of an affirmative decision by the experimental subject there should be made known to him the nature, duration, and purpose of the experiment; the method and means by which it is to be conducted; all inconveniences and hazards reasonable to be expected; and the effects upon his health or person [information on HIT risk exists, such as on this blog - ed.] which may possibly come from his participation in the experiment. The duty and responsibility for ascertaining the quality of the consent rests upon each individual who initiates, directs or engages in the experiment. It is a personal duty and responsibility which may not be delegated to another with impunity.
  2. The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study [such as small scale controlled clinical trials with full informed consent and opt-out provisions- ed.], and not random and unnecessary in nature.
  3. The experiment should be so designed and based on the results of animal experimentation and a knowledge of the natural history of the disease or other problem under study that the anticipated results will justify the performance of the experiment.
  4. The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.
  5. No experiment should be conducted where there is an a priori reason to believe that death or disabling injury will occur; except, perhaps, in those experiments where the experimental physicians also serve as subjects.
  6. The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved by the experiment. [The magnitude of HIT risks are unknown - ed.]
  7. Proper preparations should be made and adequate facilities provided to protect the experimental subject against even remote possibilities of injury, disability, or death.
  8. The experiment should be conducted only by scientifically qualified persons. [Yet the HIT field is filled with amateurs - ed.] The highest degree of skill and care should be required through all stages of the experiment of those who conduct or engage in the experiment.
  9. During the course of the experiment the human subject should be at liberty to bring the experiment to an end [go back to paper - ed.] if he has reached the physical or mental state where continuation of the experiment seems to him to be impossible.
  10. During the course of the experiment the scientist in charge must be prepared to terminate the experiment at any stage [go back to paper - ed.], if he has probable cause to believe, in the exercise of the good faith, superior skill and careful judgment required of him that a continuation of the experiment is likely to result in injury, disability, or death to the experimental subject.

Reprinted from Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law No. 10, Vol. 2, pp. 181-182.. Washington, D.C.: U.S. Government Printing Office, 1949.

I'd thought these issues were settled after WW2, but apparently not.

-- SS

 

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