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Discourse regarding the legal position of osteopathic clinical educators is scarce. The educator-patient-student relationship is complex and if not managed well may compromise patient and student safety. This doctrinal research paper explores how Australian Civil Liability Legislation may be applied during clinical education. The paper constitutes a thought experiment and uses reasoning by analogy, applied to a hypothetical problem scenario, set during an osteopathic student's clinical practice event for the purpose of exploring the educator's duty relationships and to tease-out possible acts or omissions that could potentially be used in an argument designed to establish a clinical educators breach of duty. The deliberations presented here illuminate the complex relationships and highlight situations in which a reasonable person may consider the clinical educator has provided poor supervision of the student's work with patients. This concept paper signposts the potential vulnerability of the patient and the student if supervision standards are not maintained and if appropriate clinical standards are not applied. Possible lines of arguments a patient may raise or a student may raise in a negligence case as well as possible defences the clinical educator may offer are presented.

Cyberbullying has been defined as the “process of using the internet, cell phones or other devices to send or post text or images intended to hurt or embarrass another person.” The word “cyberbullying” is often used interchangeably with “cyber stalking” and in fact the Cybercrimes (Prohibition, Prevention, etc.) Act 2015 of Nigeria, uses the word “cyber stalking” which it defines as any course of conduct directed at a specific person that would cause a reasonable person to feel fear. By the provisions of the Act, the transmission of any communication through the means of a computer to bully, threaten or harass another person where such communication places another person in fear of death, violence or bodily harm amounts to cyber stalking. Cyberbullying is becoming a common phenomenon in Nigeria as more people engage in it especially on social media platforms. This is carried out in various ways and a common trend is posting indecent imagery of persons online such as naked pictures or videos of persons in order to humiliate them. When posted by a person, the communication is shared by others thereby causing circulation on social media. This act amounts to cyber stalking where the intention consists of those elements stated under the Cybercrimes Act. In other situations where it is shared without the aim of humiliating the victim, such act can still be incriminated under some other laws in Nigeria such as the Criminal Code Act and the Penal Code Act which for instance both criminalise obscene publications. It is worthy of note there have been reported cases where victims of cyberbullying have committed suicide as a result of fear or shame. A major observation is that cyberbullying has gained normalcy and many internet users engaged in it do not seem to be aware of the criminal connotation of their actions. This paper examines the effectiveness of legal responses to cyberbullying in Nigeria. It discusses the forms of cyberbullying commonly perpetrated in Nigeria by citing some real life instances that have happened in the past. The paper notes that most forms of cyberbullying can be prosecuted under the Cybercrimes Act, however, there has not been any notable enforcement of the law in terms of prosecution of cyberbullying cases. It appears that the lack of prosecution of offenders has fostered the act of cyberbullying especially under the present circumstances where there is widespread ignorance among internet users. The paper also notes that the absence of image rights is a precursor in many respects to some forms of cyberbullying especially when photographs and videos of victims are involved. The paper advocates the implementation and enforcement of the Cybercrimes Act as well as other laws relating to cyberbullying in Nigeria. The paper also posits that the protection of image rights will go a long way to assist in curbing the act of cyberbullying in Nigeria.

There is substantial published evidence showing that countless people enroll each year in ethically deficient clinical trials. Many of the trials are problematic because the quality of the science used to justify their launch may not be sufficiently vetted while many other trials may lack requisite social value. This poses the question: why do people volunteer for them? The answer resides in large part in the fact that informed consent practices have historically masked, rather than disclosed, the information that would alert research candidates to the ethically problematic nature of the trials. The “reasonable person” and “key information” provisions in the revised US Common Rule create the opportunity to correct this historical shortcoming. Two sources are employed to shed light on what the “key information” is that should be disclosed to a “reasonable person”: the original disclosure aims of the Nuremberg Code, as well as an extensive body of meta-research evidence. Those sources jointly support a range of new disclosures in the informed consent process that would unmask the heretofore undisclosed information. The resulting proposed new disclosures pertain to the overall success prospects of clinical trials, the quality of the prior research that both forms the basis of clinical trials and informs assessment of their risks and benefits, the potential social value of clinical trials, and the commercial purposes of clinical trials.

Banking solves the principal–agent problem with incentive contracts which assume a Homo Economicus representative agent. However, professions can solve the principal–agent problem by assuming a 'Reasonable Person' representative agent, from tort law, who reliably tells the truth about hidden action. We describe a non‐virtuous circle in finance, which is a negative feedback loop between motivation crowding out arising from incentive contracts, and the subsequent need to offer incentive contacts because agents change from the Reasonable Person to Homo Economicus. We prescribe less reliance on incentive contracts in the practice of finance, and on Homo Economicus in the theory of finance. [ABSTRACT FROM AUTHOR]

The adoption of director’s duty of care in the 2005 revision of the PRC Company Law made significant progress in holding directors accountable for their wrongdoings. However, certain defects still exist, most importantly the lack of a specific standard for the duty of care in the legislation. Therefore, this article adopts an empirical and comparative approach in reviewing Chinese duty of care cases in comparison with major jurisdictions such as the United Kingdom and the United States. The 86 sample cases hand-collected from the ten-year period from 2011 to 2020 reveal that the number of duty of care litigation in China is still far lower than other types of company disputes, despite an increasing trend. This article finds a divergence in judicial practice concerning at least two different standards of the duty of care, with an array of non-uniform factors considered in the judgments. Accordingly, this article adopts a selective approach concerning best practices in major jurisdictions globally and proposes several solutions specifically catered to China’s legal and commercial context, including the unified adoption of the objective reasonable person standard, the suggestion that a wholesale transplant of the business judgment rule is undesirable while some of its elements could be borrowed for reference, the shifting of evidentiary burden to the defendants and the promotion of director’s liability insurance. By incorporating these changes, China’s company law stands to benefit from striking an appropriate balance between director’s authority to manage the companies and shareholder’s right to hold them accountable.

Care of the preterm infant has improved tremendously over the last 60 years, with attendant improvement in outcomes. For the extremely preterm infant

In the field of Law and Literature studies, contributions on poetry are rare. This article focuses on a selection of contemporary poetic works: Cornelius Eady’s A Brutal Imagination (2001), Frédéric Boyer’s Le Goût du suicide lent (1999), Maurizio Cucchi’s Il disperso (1976) and Corrado Benigni’s Tribunale della mente (2012). Their lyrical shaping of law establishes a difference from the model of “forensic” poetry that can be found in Charles Reznikoff’s Testimony (1978–1979). Through them, this contribution shows how it is possible to challenge a reflection on the language of lyric poetry and that of law at the same time, if we interpret the lyric poetry as a non-narrative discourse., Law, Culture and the Humanities, vol. 18, no. 1, p. 229

The law of informed consent to medical treatment has recently been extensively overhauled in England. The 2015 Montgomery judgment has done away with the long-held position that the information to be disclosed by doctors when obtaining valid consent from patients should be determined on the basis of what a reasonable body of medical opinion agree ought to be disclosed in the circumstances. The UK Supreme Court concluded that the information that is material to a patient’s decision should instead be judged by reference to a new two-limbed test founded on the notions of the ‘reasonable person’ and the ‘particular patient’. The rationale outlined in Montgomery for this new test of materiality, and academic comment on the ruling’s significance, has focused on the central ethical importance that the law now (rightfully) accords to respect for patient autonomy in the process of obtaining consent from patients. In this paper, we dispute the claim that the new test of materiality articulated in Montgomery equates with respect for autonomy being given primacy in re-shaping the development of the law in this area. We also defend this position, arguing that our revised interpretation of Montgomery’s significance does not equate with a failure by the courts to give due legal consideration to what is owed to patients as autonomous decision-makers in the consent process. Instead, Montgomery correctly implies that doctors are ethically (and legally) obliged to attend to a number of relevant ethical considerations in framing decisions about consent to treatment, which include subtle interpretations of the values of autonomy and well-being. Doctors should give appropriate consideration to how these values are fleshed out and balanced in context in order to specify precisely what information ought to be disclosed to a patient as a requirement of obtaining consent, and as a core component of shared decision-making within medical encounters more generally.

One of the significant modifications to the Common Rule is the requirement that prospective participants are given information sufficient for a “reasonable person”. However, there is limited research on what types of information patients, caregivers, and providers consider “key information”. Although certain aspects of informed consent (IC) may be considered standard, considering individualized needs and preferences of patients is necessary for patient-centered consent. In the current study, we qualitatively examined the specific types of information that patients and caregivers involved in hematopoietic cell transplantation (HCT), as well as their providers, believe are important and necessary as part of the IC process in order to make a decision about participating in clinical research; and further, how these perspectives are aligned. Our findings suggest opportunities for improving the IC document and process by emphasizing information of importance to patients such as the benefits to others and contributions to science that are associated with participation in clinical research. Further, increasing patient engagement during the IC process may enable providers to streamline information that is aligned with patient information needs and preferences.

Sports law can be regarded as one of the latest developments in law. As applied to the school setting, and with special reference to sport coaching, this article deals with the five fundamental elements of the law of delict that influence and inform the execution of the duty of care of the educator-coach. This article pays special attention to the legal aspects related to the security, on the one hand, of the learners as participants, but also the educator-coach in his or her respective roles as coach, organiser of sport events, referee and sport official on the other. The basic research question is: To what extent can educator-coaches increase their own security by ensuring safer participation of learners? How can these educators prevent or minimise the occurrence of serious injuries during practices (as coaches) and during meetings, contests or matches (as officials, such as being referees)? A certain amount of risk is typical of and inherent to most types of sports, especially those that involve physical contact or in which potentially dangerous implements are used. In contrast, many learners are coached by educators that do not necessarily have enough experience, skills or knowledge regarding the more advanced techniques of the specific sports code. This contrast between the inherent risks and the lack of expertise of many educator-coaches creates an amount of insecurity for both the participants and the coaches. This article includes a discussion of the application of the five fundamental elements of the South African law of delict to school sports coaching. To illustrate the ways in which courts consider sports law issues, examples from court cases related to different types of sports are analysed, and, where applicable, cases from other countries and from outside the sphere of education are also included. This discussion is followed by an overview of those legal provisions that impact on sports participation at school. The legal duty of care of all educators stems from the special relationship between an educator and a learner. Not acting to ensure the safety of a participant constitutes wrongfulness on the side of the educator-coach, which may lead to being held liable for damage to the participant. This article specifically considers the higher standard of care expected from the educator-coach, as compared to the normal reasonable person, based on the former's specific training in working with learners. The acts or omissions of higher qualified and more experienced educator-coaches will also be measured against a higher standard. This article concludes with the recommendation that educator-coaches should not be overly reassured by section 60 of the South African Schools Act . Ensuring the safety and security of learners should still be the main priority for all educators. Educatorcoaches should remember that, true to their calling as educators, and consistent with section 28(2) of the Constitution, a child's best interests are of paramount importance in every matter concerning the child. KEYWORDS: Delictual liability; school sports coach; education law; educator liability

ObjectiveIn approximately half the states in the USA, and more recently in the UK, informed consent is legally defined as what a reasonable patient would wish to know. Our objective was to discern the information needs of a hospitalised, ‘reasonable patient’ during the informed-consent process.DesignWe performed a cross-sectional study to develop a survey instrument and better define ‘reasonable person’ in relation to informed consent in a hypothetical scenario where an invasive procedure may be an option.SettingA 10-question survey was administered from April 19 through 22 October 2018 to three groups: student nurses (n=76), health professions educators (n=63) and a US national population (n=1067).Primary and secondary outcome measuresThe primary outcome measure was the average intensity, on a 5-point scale, by which survey groups wished to have each of 10 questions answered. The secondary outcome was to discern relationships between survey demographics and the intensity by which participants wanted an answer.ResultsDespite substantial demographic differences in the nursing-student group and health-professions-educator group, the average intensity scores were within 0.2 units on nine of 10 questions. The national survey revealed a strong desire to have an answer to each question (range 3.98–4.60 units). It showed that women desired answers more than men and older adults desired answers more than younger adults.ConclusionsBased on responses to 10 survey questions regarding wishes of people in a situation where an invasive procedure may be necessary, the vast majority want an answer to each question. They wanted to know about all treatment options, risky drugs, decision aids, who will perform the procedure, and the cost. They wanted their advocate present, periodic review of their medical record, a full day to review documents and expected outcomes and restrictions after the procedure.

OBJECTIVE In this article, we evaluate and compare the frailties of two different standards of disclosure of information regarding the risks of medical procedures applied in recent judicial decisions in the United Kingdom. As an alternative, we present the tenets and philosophical grounds of an agency model of consent and a person-based standard of disclosure. METHODS Critical philosophical analysis of the background assumptions of two standards of disclosure and their relative "tests of negligence" applied in recent legal judgements in the United Kingdom. RESULTS Both standards, the "Professional Practice Standard" (the traditional standard employed in Sidaway versus Board of Governors of the Bethlem Royal Hospital, 1985) and the allegedly new "Reasonable Person Standard" (mentioned in Montgomery versus Lanarkshire Health Board, 2015), can lead to malpractice if the medical-patient relationship is not guided by attitudes of respectful care. The traditional standard is disrespectful as it does not take patients as full agents, presupposing that the patient's right is only a negative right to refuse what was deliberated only by the practitioner. The "new" standard can be disrespectful if the practitioner, concerned only with what a hypothetical reasonable individual would take as relevant for choosing between alternatives of treatment, does not know how to respect their real patient in a genuine shared decision-making process. CONCLUSION We conclude that in order to know how to obtain valid informed consent, doctors need to engage in real conversations with their patients, revealing as much information as they, taken as real persons, need to be part of a genuine shared and respectful decision-making process.

A recent District Court decision held that the Affordable Care Act (ACA), absent a tax penalty relating to the individual mandate, was unconstitutional. This follows on a Circuit Court decision that the ACA wellness provisions should be nullified. This editorial reviews the similarities and differences between the rulings and asks if a reasonable person would believe that offering financial incentives aimed at supporting a modicum of effort at self-care is rational. One survey of employers and health care consumers indicates 91 percent of those surveyed agree that wellness programs are a perk that helps employees improve health and, interestingly, the same percent agree these programs are sponsored by employers to cut costs. Where some may view the cost containment objectives of employee wellness as dubious, it's a minority view. Still, some minorities should and do carry inordinate sway in public health such as the small percent of those living with chronic conditions who are unwilling to participate in a healthy living program that is associated with their receiving full benefits. Are incentives a worthwhile strategy if they fail to motivate those who would benefit most from health improvement?

IT’S 2034. A drunken man walking along a sidewalk at night trips and falls directly in front of a driverless car, which strikes him square on, killing him instantly. Had a human been at the wheel, the death would have been considered an accident because the pedestrian was clearly at fault and no reasonable person could have swerved in time. But the "reasonable person" legal standard for driver negligence disappeared back in the 2020s, when the proliferation of driverless cars reduced crash rates by 90 percent. Now the standard is that of the reasonable robot. The victim's family sues the vehicle manufacturer on that ground, claiming that, although the car didn't have time to brake, it could have swerved around the pedestrian, crossing the double yellow line and colliding with the empty driverless vehicle in the next lane. A reconstruction of the crash using data from the vehicle's own sensors confirms this. The plaintiff's attorney, deposing the car's lead software designer, asks: "Why didn't the car swerve?"

This chapter consists of a brief discussion on some legal aspects concerning scientists’ responsibility in risk prevention processes. After proposing some introductory considerations on scientists’ responsibility as such, the author deals with the L’Aquila earthquake crisis of 2009, when a strong quake destroyed significant parts of L’Aquila (Italy) and surrounding villages, killing more than 300 people. The chapter focuses on the relations between scientific knowledge, normative expectations, decision-making and criminal negligence for ‘failed’ risk assessment and management, paying particular attention to the role of ‘regulatory science’ in constructing the ‘reasonable person’ normative standard of care in the theory of criminal negligence. This allows explaining why the first judgement in the L’Aquila trial (2012) is not convincing, having misunderstood how policy-relevant science should participate in prevention processes and the construction of normative standards. In his conclusions, the author suggests some reasons for the recent tendency to blame experts when natural or technological disasters occur.

In 2017, federal officials issued a revised version of the Common Rule, the federal regulations that govern much of the human subject research conducted in the United States. Two provisions on information disclosure have reportedly provoked confusion among researchers and people responsible for research oversight. These provisions incorporate the familiar and foundational legal concept known as the reasonable person standard, applying this to research disclosure. Although other, long-standing Common Rule provisions require reasonableness judgments, the new provisions differ in that they require reasonableness to be judged from the ordinary person's perspective instead of the perspective of scientists, clinicians, and other experts generally involved in designing and reviewing human studies.

Laura Odwazny and Benjamin Berkman have raised several challenges regarding the new reasonable person standard in the revised Common Rule, which states that informed consent requires potential research subjects be provided with information a reasonable person would want to know to make an informed decision on whether to participate in a study. Our aim is to offer a response to the challenges Odwazny and Berkman raise, which include the need for a reasonable person standard that can be applied consistently across institutional review boards and that does not stigmatize marginal groups. In response, we argue that the standard ought to be based in an ordinary rather than ideal person conception of reasonable person and that the standard ought to employ what we call a liberal constraint: the reasonability standard must be malleable enough such that a wide variety of individuals with different, unique value systems would endorse it. We conclude by suggesting some of the likely consequences our view would have, if adopted.

The phrase “standard of care” is primarily a legal term representing what procedure a reasonable person (i.e., health practitioner) would administer to patients across similar circumstances. One major concern for health practitioners is delivering and advocating for treatments not defined as a standard of care. While providing such treatments may meet certain ethical imperatives, doing so may unwittingly trigger medical malpractice litigation fears from practitioners. Apprehension to deviate, even slightly, from the standard of care may (seem to) put the practitioner at significant risk for litigation, which, in turn, may limit options for treatment and preventive measures recommended by the practitioner. Specific to testicular treatment, certain guidelines exist for cancer, torsion, vasectomy, and scrotal masses, among others. As it relates to screening, practitioner examination is expected for patients presenting with testicular abnormalities. Testicular self-examination (TSE) advocacy, however, is discouraged by the U.S. Preventive Services Task Force, which may prompt a general unwillingness among health practitioners to promote the behavior. Considering the benefits TSE has beyond cancer detection, and the historical support it has received among health practitioners, it is paramount to consider the ethical implications of its official “exclusion” from preventive health and clinical care recommendations (i.e., standard of care). Since good ethics should lead practitioner patient care guidelines, not fear of increased malpractice risks, we recommend the development of a standard of care for counseling males to perform TSE.

In March 2015, the Supreme Court published its decision in Montgomery v Lanarkshire Health Board, a case involving the failure to warn a pregnant diabetic woman of the risk of shoulder dystocia and the possibility of having a caesarean section to avoid this risk. The risk materialised and the baby suffered oxygen deprivation. The lower courts had applied the test for the standard of care that had been in place since 1985, which has been criticised for protecting doctors not patients. The Supreme Court has introduced a new, autonomy-based, patient-centred standard. This article examines the case and explains the importance of the change for future midwifery practice. When disclosing risks, midwives must identify what a reasonable person in the woman's position, with this woman's specific characteristics, would consider a significant risk. They could be held liable for non-disclosure even if the woman does not ask about specific risks.

The CAPM is about expected return. If you find a formula for expected returns that works well in the real markets, would you publish it? Before or after becoming a billionaire? The CAPM is an absurd 2 model because its assumptions and its predictions/conclusions have no basis in the real world. According to the dictionary, a theory is “an idea or set of ideas that is intended to explain facts or events”; and a model is “a set of ideas and numbers that describe the past, present, or future state of something”. With the vast amount of information and research that we have, it is quite clear that the CAPM does not “explain facts or events”, nor does it “describe the past, present, or future state of something”. The use of CAPM is also a source of litigation: many professors, lawyers... get nice fees because many professionals use CAPM instead of common sense to calculate the required return to equity. Users of the CAPM make many illogical errors valuing companies, accepting/rejecting investment projects, evaluating fund performance, pricing goods and services in regulated markets, calculating value creation... It is important to differentiate between a fact (something that truly exists or happens: something that has actual existence; a true piece of information) and an opinion (what someone thinks about a particular thing). We all should try to explain a portion of “the world as it is”, not of “the world as we model it”. Ricardo Yepes, professor of philosophy of my university, wrote: “Learning means being able to keep perceiving reality as it truly is: complex and not trying to fit every new experience into a closed and pre-conceived notion or overall scheme”. We may find out an investor’s expected return for IBM by asking him. However, it is impossible to determine the expected return for IBM of the market, because this parameter does not exist. Different investors have different cash flow expectations and different expected (and required) returns to equity. One could only talk of the expected return of the market if all investors had the same expectations. But investors do not have homogeneous expectations. Sections 11 and 12 show how to calculate required returns in a sensible way and how to use betas being a reasonable person (using common sense, experience and some finance knowledge). Valuation is about required return. There are persons, papers and books that mix (or assume that are equal) expected and required returns.

In any given context, negligence means that the defendant or the accused failed to foresee the possibility of harm (bodily/mental injury or death) occurring to another in circumstances where the reasonable person (diligens paterfamilias) in the defendant’s or accused position would have foreseen the possibility of harm occurring to another and would have taken steps to avoid or prevent it. The generic test for negligence is thus one of foreseeability and preventability. Although the test for negligence is fundamentally objective, it does contain subjective elements when the negligence of an expert is assessed. Where the defendant or accused is an expert, the standard of negligence is upgraded from the reasonable layperson to the reasonable expert. Where the expert is a medical practitioner, the standard is that of the reasonable medical practitioner in the same circumstances. It is to be noted that the standard of care and skill, in context of medical negligence, required of a general practitioner is to be distinguished from the standard and care and skill required of a medical specialist. Simply stated, if the physician is a general medical practitioner, the test is that of the reasonable general practitioner. If the physician is a specialist, the test is that of the reasonable specialist with reference to the specific field of medical specialisation. This principle is of particular significance as it has definite implications for the practice of medicine in a developing country as South Africa. Due to the shortages of medical services and qualified health care practitioners and/or compromised medical services, particularly in rural areas, health care practitioners (inclusive of doctors, nurses and paramedics) are often called upon to perform medical services for which they are, strictly speaking, not qualified to undertake – for example, a general practitioner in a small rural hospital may be required to administer anaesthesia to a patient despite not being a qualified anaesthetist; a nurse might be required to assist with the extraction of a tooth without being a dentist. The question arises, according to which yardstick they should be judged in instances of alleged negligence? The locality of practice and the imperitia culpae adnumeratur – rule are clearly also relevant factors in answering this question.In view of the aforesaid, it is the aim of this note to revisit the meaning and application of the maxim imperitia culpae adnumeratur and its possible link with conscious negligence (luxuria) in context of medical negligence. It is to be noted, for purposes of this discussion, that the test for medical negligence is exactly the same in civil law as it is in the criminal law – it makes no difference whether a medical practitioner is sued civilly for damages or by a patient who alleges that he has been negligently treated or is prosecuted by the state. The burden of proof in criminal cases though, is heavier than in civil cases since in the latter the plaintiff must only prove his case on a balance of probability, whereas in the former negligence must be proven beyond reasonable doubt.

The UK Supreme Court Montgomery judgment marks a decisive shift in the legal test of duty of care in the context of consent to treatment, from the perspective of the clinician (as represented by Bolam rules) to that of the patient. A majority of commentators on Montgomery have focused on the implications of the judgment for disclosure of risk. In this article, we set risk disclosure in context with three further elements of the judgment: benefits, options, and dialogue. These elements, we argue, taken together with risk disclosure, reflect the origins of the Montgomery ruling in a model of consent based on autonomy of patient choice through shared decision-making with their doctor. This model reflects recent developments in both law and medicine and is widely regarded (by the General Medical Council and others) as representing best practice in contemporary person-centred medicine. So understood, we suggest, the shift marked by Montgomery in the basis of duty of care is a shift in underpinning values: it is a shift from the clinician's interpretation about what would be best for patients to the values of (to what is significant or matters from the perspective of) the particular patient concerned in the decision in question. But the values of the particular patient do not thereby become paramount. The Montgomery test of duty of care requires the values of the particular patient to be balanced alongside the values of a reasonable person in the patient's position. We illustrate some of the practical challenges arising from the balance of considerations required by Montgomery with examples from surgical care. These examples show the extent to which Montgomery, in mirroring the realities of clinical decision-making, provides elbowroom for best practice in person-centred clinical care.

Defamation law offers a remedy when the plaintiff’s reputation is harmed by something the defendant publishes. At the heart of the action lies the question—what do the words complained about actually mean? The process of determining defamatory meaning depends heavily on what the court finds to be the imputations conveyed by the matter concerned to ‘ordinary, reasonable people’. The process relies on assumption and conjecture, rather than on evidence. This article examines how this process applied in the Hockey v Fairfax Media case brought by Australia’s former Federal Treasurer Joe Hockey against Fairfax Media, which presented a paradox—the court described the journalists’ articles concerned in glowing terms but still found for the plaintiff.

As addressed by Sugarman (2017), the additional informed consent requirements incorporated in the revised Common Rule present some of the most intriguing aspects of the updated regulatory scheme. T...

It is widely agreed that pharmaceutical research has serious problems, but there is no consensus on what to do about them. The first of these is concerned with issues of political morality, while the second focuses on scientific methodology, yet they turn out to be surprisingly related. The general idea is that everyone's medical needs are covered free of cost to the individual. On utilitarian grounds, socialized medicine does the most good for the least cost. Once aware of the issues involved in medical research, especially pharmaceutical, any reasonable person will be horrified and want to make changes. In his contribution to this volume Reiss argues for two important points. The first is to banish patents entirely, on the grounds that they do not promote innovation but rather stifle it. The second major suggestion Reiss makes is that randomized controlled trials are overrated when it comes to evidence in medical research.

In March 2014, the New South Wales Government dramatically increased penalty notice amounts for a number of summary offences. The fine increases were part of the Government's alcohol- and drug-fuelled violence initiatives, introduced in response to recent 'one-punch' homicides. This comment examines the use of penalty notices, or 'on-the-spot' fines, for the minor offences of offensive conduct, offensive language and the continuation of intoxicated and disorderly behaviour following a move-on direction. It considers the potential impact of these new fines on vulnerable and minority groups, particularly Aboriginal Australians. The comment questions whether police, as opposed to judicial officers, are the appropriate arbitrators for complex (albeit minor) offences that involve ill-defined elements such as offensiveness, community standards and the reasonable person test. It also asks whether these measures will be effective in fulfilling their stated aim to decrease alcohol-fuelled violence.

This is an opinion piece, of sorts. Opinion pieces usually are calls to action, focused on doing. In a sense, this piece intends to encourage readers to consider doing less. Specifically, this piece is directed at college counseling center professionals were now, or soon may become, a member of the campus threat assessment team. At this time, when mass violence has become commonplace in literally every region of the world, how could any reasonable person contend that we may be doing too much, in our efforts to stop horrific acts of violence? Could it be possible to be constructive to do any less than we do now, of any preventive measure? At the onset let me be clear: I am not necessarily suggesting eliminating campus threat assessment teams. Public funding does not seem adequate to differ this function to law enforcement, and so colleges and universities will likely need to address threats of on-campus violence. The question becomes one of composition, activities, and functions of these teams. Language: en

When I was asked to write this Perspective on the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines,1 I wondered why any reasonable person would agree to do so? It is nice to have your thoughts and opinions in a prestigious journal read by your closest peers, but could it be anything more than a lose-lose situation? I decided, therefore, to preface the perspective with several disclosures. First, I was a member of the original Adult Treatment Panel (ATP) guidelines committee—on the Drug Treatment Subcommittee.2 I was never again asked to be on the committee, but that rejection has had no effect on what I have written here. Second, I think that physician–scientists have the responsibility to integrate all available data, with appropriate priorities, and draw conclusions that can be offered to patients, clinicians, and the world-at-large. So let me state that, based on what I have integrated from a variety of sources for the past 40 years, I have concluded that lowering low-density lipoprotein cholesterol (LDL-C) reduces the risk for atherosclerotic cardiovascular disease (ASCVD), and that the level of LDL-C is important—lower is better. Third, as someone who led a major clinical trial—Action to Control Cardiovascular Risk in Diabetes Lipid3—I know that although randomized clinical trials (RCTs) provide the best evidence for the efficacy and safety of an intervention, each and every RCT has deficiencies. We must avoid, therefore, the tyranny of RCT evidence-based dogma. Fourth, at the end of this piece is my official Disclosure, a listing of my pharmaceutical company relationships. Suffice it to say that all of us who have such relationships must carefully look in the mirror when we evaluate guidelines. However, the same is true for our colleagues who avoid, as part of their career paths, all such …

The Patient Preference Predictor (PPP) is intended to improve treatment decision making for incapacitated patients. The PPP would collect information about the treatment preferences of people with different demographic and other characteristics. It could be used to indicate which treatment option an individual patient would be most likely to prefer, based on data about the preferences of people who resemble the patient. The PPP could be incorporated into existing US law governing treatment for incapacitated patients, although it is unclear whether it would be classified as evidence of a specific patient's preferences or those of a reasonable person sharing certain characteristics with the patient. Ethical concerns about the quality and significance of PPP choices could influence legal decision makers' views of the PPP.

The long-running litigation in the USA involving the meaning of a pari passu provision in the Republic of Argentina’s bonds has resulted in interpretations that many find surprising. The bonds in question were governed by New York law. But, as sovereign bonds are also issued under English law and many contain similar provisions, it is worth considering how an English court might approach the subject. The starting point is to look at the rules of interpretation that would be applied by an English court. These have changed considerably over the years, moving (broadly speaking) from a strict dictionary and syntactical interpretation of the words used in the contract alone, to a more flexible approach aimed at understanding what the parties to the contract must have intended, recognizing that human beings sometimes misuse words and fail to express themselves precisely. Having established these rules, the next stage is to apply them to the facts. As will be seen, this process involves looking not just at the words in isolation, but at whether a reasonable person would, knowing the consequences of an interpretation, have intended that interpretation.

Although a plethora of studies focus on jury decision making in sexual harassment cases, few studies examine damage award assessments in such suits, and even fewer explore the impact of psychological injury on jurors’ liability and damage award assessments. In the present study, 342 undergraduates read a hostile environment sexual harassment case that manipulated the plaintiff’s psychological injury level (severe vs. mild vs. control) to investigate whether males and females made different damage decisions. Males using a reasonable person standard found more liability as the severity of the plaintiff’s psychological injury increased. However, males using a reasonable woman standard found less liability with the addition of any psychological injury information. Similarly, for mild and severe injuries, males using the reasonable woman standard awarded lower damages than males using the reasonable person standard. Females tended to find more harassment than males, but psychological injury and legal standard had little impact on females’ legal decisions. We discuss these findings in light of the positive relationship often observed between the plaintiff’s injury severity level and pro-plaintiff verdicts.

The issue of medical negligence has been catching attention of many people nowadays. With advancement of technology in medical field, many incurable diseases of past time can now be managed well at the cost of burdening expenditure. This has resulted in obvious expectations to the patient and their families that any ailment can be cured from the medical procedures and therapies. When these expectations are not met in terms of complications or death of the near ones, people get frustrated and tend to allege health care providers against medically negligent.Negligence are of two types; civil negligence where the doctors are alleged to have lost simple degree of care and attention to the patients thereby causing damage whereas in criminal negligence, the doctors grossly deviate from the standard of care and competence or perform activities which are understood prima facie as a crime, for eg: performing criminal abortion, organ transplantation against the law etc.Whatever the type of negligence, there are legal measures to file complaint against the doctors who are alleged to have caused negligence. Gone are the days when people regarded doctors near to gods. Medical service also falls under the consumer protection act where the patients are the consumers and medical personnel, the service providers. The patients have rights to get quality medical service under this act. If the patients or their relatives are dissatisfied with the medical service rendered to them by the health care providers, they have the right to lodge complaint to the compensation committee of the district in which chief district officer (CDO) is the chairman in each district. If there is an issue of criminal negligence, the complaint can also be filed in the concerned court.In some circumstances, when the patient develops complications or dies, the attendants accuse the doctors for the failure in treatment and protest in the hospital premises rather than opting the legal way of charging them against negligence. The health professionals are at times threatened and forced to apologize in public. Most of the times, they demand for compensation and many direct benefits to the relatives of the deceased. The hospitals and the health professionals feel insecure and often they have agreed to the demands put forth to peacefully settle the issue and to get prevented from defamation. The government is also unable to provide security. Similar cases have been reported time and again in Nepal, creating a sense of lawlessness in the country.When deciding whether a doctor is held liable for negligence, the “standard of care” should be analysed. It means the practice should be an accepted one and standard, such that doctor of the similar filed and competence would have also opted the same procedure in given circumstances. Even when a doctor has duly acted opting standard procedure, still there can be chances that a patient can develop complications. Every human body cannot react exactly same to a medical intervention though that may be a scientifically proven one as there can be chances of medical misadventure. The doctors should have possessed reasonable degree of care and skill when he is attending the patient. According to Bolam’s test, a person is said to have inappropriate standard, and becomes negligent, if it is proven that he had failed to do what a reasonable person would do in the circumstances.1 The degree of care and skill should be comparable to an average doctor in similar settings. In order to analyse these issues, expert opinion from reputable and unbiased experts of the similar field of medicine should be taken. In case of death due to alleged medical negligence, the dead body should be autopsied by qualified experts in Forensic Medicine. This can explain so many facts about the deceased which can be helpful to decide whether negligence has factually taken. It highlights the need of taking opinion from the experts of the concerned field by the councils framed to settle the cases of medical negligence, especially the consumer protection council, Nepal Medical Council, etc.It is a high time for the government to play role to address to this sensitive and quai-legal issue. If this trend is not ended, the trust of patients towards the doctors may nullify. The doctors also cannot work effectively when there is no safe working environment and may begin to have tendency to abandon handling critical cases with a fear of vulnerability to defamation if not physical assault in worst case. The situation is ultimately disastrous to the entire health care system. The very sensitive issue of health care delivery cannot be compared to any other commercial issues. The proper mechanism of addressing the issue of medical negligence should be practiced alongside encouragement from governmental urge to come up with better medicolegal systems in this regard. This is highly essential for balancing expectations of the patients and performance of medical professionals.

The parties are free to make their contract with whom they want. But by the law of representation, in the cases, when an agent acts in the name of a principal, its acts bind the principal and the other party directly each other. The agent is not bind personally to the other party. But, the actor acts on instructions and on behalf of, but not in the name of, a principal, the other party neither knows nor could have known that the intermediary acts an agent, the intermediary and the other party may be bound to each other. Sometimes, an actor, in spite that he is the true beneficiary of the contract, may conclude a contract under the name of a principal, who has no intention of bounding any legal obligations. When the position of a lessor is becoming to success from an assignor (also lessor) to an assignee at the housing lease protection law, also the returning debt on assurance deposit justly becomes succession, in this case, it must interpret that a lessor have to stand on the position of guarantor, in case of returning assignee`s the debt on assurance deposit. This regulation is become to help a lessee who isn`t protected at the housing lease protection law in case of problem about the returning debt on assurance deposit also. Namely, this regulation will become to help in true feelings to the weak in our society, which stand on the position of a lessee with reason which assurance deposit is only cheap, though he will know or not know about that it cannot be guaranteed returning on assurance deposit from exchange value of the residence. The contents of contract are to be interpreted according to the common intention of the parties in spite of the literal meaning of the words. If an intention cannot be known, it is necessary to be interpreted according to the understanding that a reasonable person of the same kind as the other party would have had in the same circumstances. In determining the intention of a party or the understanding a resonable person would have had, due consideration to be given to all circumstances of the case including the characteristic of the contracts, the contents, the negotiations, an practices which the parties have established between themselves, and usages.

The post-9/11 global sensitivity to fear that "terrorism" from unreasoned radicals will come stalking in the dark of night has made finding a reasonable person who is unafraid of strangers hard to find. The elevated uses of language, rhetoric, and argument with very high vocabulary fog index, confronts any serious student of the literature, be it Christian-Muslim, capitalist-communist, or populist-elitist. The fear of terrorism penetrates much of political jawing. This type of rhetoric have produced cognitive debates that are shocking, if not terrifying, as average people try to find non-paranoid views of a decent and honorable life in a mostly safe world. As co-authors of the following conversation, we make transparent our belief in honoring the scholarship of adult educators who take a macro-political view of terrorism, and who consider the human dimensions of living day to day in an unsafe environment. Many adult education scholars are aware of the range of topics on the minds of adults who bring their hopes, fears, and experiences to graduate adult education study programs. American scholarship on adult education is replete with advocates who encourage, foster, and nurture learning climates that engage discussion, explore life's options, and an understanding of human desire to establish policies that promote and assure justice. But in the Arab Middle East, one is challenged to find such literature. We should know, since we are an Iraqi and an American engaged in dialogue about the significance of andragogy as a tool for rebuilding war-torn Iraq. We are Ghada and Larry. Ghada is an Iraqi doctoral candidate in adult and higher education and Larry is her doctoral advisor. We have been involved in intensive dialogue about how we see our cultures, how we perceive the conflict in the Middle East, and how andragogical theory offers hope for changing learning and teaching approaches that can influence political and social philosophies of leadership. Ghada believes that as a woman, wife and a mother of two boys from Baghdad, Iraq, and who experienced the bombings and terror, she has insights to bring to a mentoring relationship. Larry, as a senior professor in adult education, has made a lifetime study of Asia, but has found a certain value in learning and teaching with Ghada. Both have shared their perceptions of their cultures, including their concerns about potential conflicts from issues of oil, religion, governments, and families. This conversation is a reflection of our advocacy for andragogy as a tool for change and peace. We have written in a way that allow both of our voices to be heard; Ghada--from her experience as an Iraqi and as a U.S. doctoral student, and Larry--as a senior professor in adult education and educational administration. We talk about how an inclusive education can bridge two cultures, American and Arab together in meaningful ways. Following our conversations, our combined voices contemplate the following questions. What does Andragogy have to offer to people in cultures facing distress, conflict, and war? We poignantly ask ourselves, what is the relevance? And more importantly, why should we in the field of adult education care? An Iraqi Seeks Meaning in Adult Education Study Ghada: After struggling for two years to get the opportunity to go to the United States for doctoral studies, I did not know what to expect of American professors at the University of South Dakota. Would they be prejudiced toward my heritage? Would they be open to knowing me? Or, would they be dominating, self-important, or careless about morality as often portrayed in Western movies? Would I find new meaning in my studies? Would anyone care about me as a person? What I found was shocking. My professor turned out to be extraordinary. He was real, caring, and a good listener. He offered more than I expected, his ideas, empathy, and a willingness to share with me a deep concern for trying to make peace and meaning in the world. …

The difference between battery and negligence with regard to the effect of hypothetical consent and its justification by the different degrees to which the non-disclosure of information by the doctor violates the patient's autonomy is discussed. Four situations of medical non-disclosure are examined and show that hypothetical informed consent should continue to exclude liability in negligence, provided that the doctor rather than the patient bears the legal burden of proof as to causation and that causation is determined by asking what the particular claimant, not the reasonable person would have done.

Artificial intelligence is part of our daily lives. Whether working as taxi drivers, financial analysts, or airport security, computers are taking over a growing number of tasks once performed by people. As this occurs, computers will also cause the injuries inevitably associated with these activities. Accidents happen, and now computer-generated accidents happen. The recent fatality caused by Tesla’s autonomous driving software is just one example in a long series of “computer-generated torts.” Yet hysteria over such injuries is misplaced. In fact, machines are, or at least have the potential to be, substantially safer than people. Self-driving cars will cause accidents, but they will cause fewer accidents than human drivers. Because automation will result in substantial safety benefits, tort law should encourage its adoption as a means of accident prevention. Under current legal frameworks, manufacturers (and retailers) of computer tortfeasors are likely strictly responsible for their harms. This article argues that where a manufacturer can show that an autonomous computer, robot, or machine is safer than a reasonable person, the manufacturer should be liable in negligence rather than strict liability. The negligence test would focus on the computer’s act instead of its design, and in a sense, it would treat a computer tortfeasor as a person rather than a product. Negligence-based liability would create a powerful incentive to automate when doing so would reduce accidents, and it would continue to reward manufactures for improving safety. In fact, principles of harm avoidance suggest that once computers become safer than people, human tortfeasors should no longer be judged against the standard of the hypothetical reasonable person that has been employed for hundreds of years. Rather, individuals should be measured against computers. To appropriate the immortal words of Justice Holmes, we are all “hasty and awkward” compared to the reasonable computer.

Medical error is serious health problem among the healthcare organizations but major drawback is that errors are not disclosed, and remains hidden. It is necessary to maintain the standards of practice, information and error to be disclosed to reasonable person and if it is not so it is against the professional practice, and authority have to feel physician guilty for negligent disclosure. This commentary article is a scholarly examination of the ethical issue confronted in the health care setting, based on the case study of little girl who lost her life due to medical error but the parents were not informed about it and everyone did negligence, and case was not reported to higher authorities.

Humans are social creatures. Our actions and attitudes are dictated by our interactions with others and the influence of the wider environment and society. The culture of a nation or even an organisation, the attitude of the group and the actions of leaders shape our perceptions of right and wrong and of what is appropriate or permissible. They can even cause a person to act against their own belief system and to behave unethically or illegally. The influence of these societal and environmental factors is stronger in high-stress environments, and stress itself has a powerful effect on the human physiology, cognitive function and behaviour. The military and combat environments amplify and heighten these environmental factors and physiological processes. This means that the effects of culture, leaders, the group and stress on the soldier’s behaviour, perceptions and standards are much greater than the effects of these environmental factors and physiological processes on the civilian. Yet, the courts do not pay sufficient regard to these processes or their effects when determining whether the soldier acted ‘reasonably’. This means that the courts are implementing the law, and ascertaining the ‘reasonable person’ standard, without an in-depth understanding of the social, behavioural, psychological, biological and cultural effects generated by society and intensified in the military and combat environments.

We are all products of our environment. It shapes our perceptions and influences our behaviour (see, for example, Isen and Levin 1972; Darley and Batson 1973; Mathews and Cannon 1975; Haney et al. 1973; Overmier and Seligman 1967). Since the law is fundamentally a tool for the regulation of human behaviour, it is important that the law takes into account the individual’s environment. Yet, the legal standard set for soldiers that obey the illegal orders of their commanders is often implemented in isolation from or with a limited understanding of the soldier’s environment. Under the Rome Statute, soldiers are liable for obeying illegal orders if they knew the order was unlawful or the order was manifestly unlawful. In determining whether an order is manifestly unlawful, the courts can use the standard of whether a ‘reasonable person’ would have known that the order was manifestly unlawful. The ‘reasonable person’ is often ascertained without sufficient in-depth understanding of the social, behavioural, psychological, biological and cultural effects generated by the unique military and combat environment.

This paper examines ethical issues involved in the mass marketing of securities to individuals. The marketing of products deemed “socially questionable” or “sinful” (like tobacco and alcohol) has long been recognized as posing special ethical challenges (Kotler, P. and S. Levy: 1971, Harvard Business Review 49, 74–80; Davidson, D. K: 1996, Selling Sin: The Marketing of Socially Unacceptable Products (Quorum Press, Westport). We contend that marketers should consider securities (i.e. common stock, options) in a similar vein, as a potentially dangerous product. Given the inherent volatility of equity prices, responsible marketers need to exercise caution and restraint in promoting securities. We evaluate whether the NYSE’s current guidelines adequately encourage ethical marketing practices and deter unethical ones. Using recent examples of controversial brokerage advertisements, we expose weaknesses in the Exchange’s vague injunction that members not “mislead” reasonable people by making “exaggerated claims” in their communications. From a moral perspective, we find it troublesome that intentionality need not be present for a promotion to be considered misleading. Also problematic is the continued invocation of the reasonable person standard to judge the propriety of advertisements. We close with some thoughts on improving the quality of securities marketing. We suggest that the NYSE, in the interests of fostering higher ethical behavior among member marketers, may need to revive a marketing code of conduct prevalent on Wall Street in an earlier era.

Informed consent is a cornerstone of contemporary healthcare as well as of contemporary healthcare research. However, what counts as informed consent differs significantly from one setting to the other. This review begins with a brief discussion of the notion of informed consent itself and then applies it to the research setting. It gives a brief sketch of how the requirement for informed consent in research evolved from the Prussian Directive of 1900 to the current national and international guidelines and regulations, and outlines the various requirements that must be met for such consent to be valid. In research, the complete standard of disclosure is mandatory whereas in therapy an ‘objective reasonable person standard of disclosure’ is generally considered sufficient. In therapy, the discussion of expectations for a positive outcome and of hope for a cure form part of the consent process; in research, this must be handled differently so as to avoid unduly enticing potential research participants. For similar reasons, rewards for participating in the research must be kept to a minimum. Venue-shopping is also considered unethical. Since potential research participants who lack decision-making capacity cannot give consent, substitute decision-makers must take over the decision-making role. In considering whether to enrol incompetent persons in research, substitute decision-makers must follow either the previous competently expressed wishes of the now-incompetent persons or use what is known as the objective reasonable person standard. However, an incompetent person’s refusal to give assent is considered binding in nontherapeutic research and overrules even the duly empowered substitute decision-maker’s decision, and the wishes that have previously been expressed by the now-incompetent person in an advance directive are considered binding even if that may exclude the individual from participating in potentially life-saving trials. The article also distinguishes between deferred consent, presumed consent, prospective consent and substituted consent, and evaluates their acceptability in light of current ethical and legal considerations. The right of research participants to withdraw from any project is explained and the current standards for data management in the case of such a withdrawal are discussed. A separate section deals with consent to research in the emergency setting. It is shown why a signature on a consent form does not in itself mean that consent has been obtained, and why the concept of minimal risk that is used by some ethics committees is seriously flawed. Since legal standards of informed consent differ from jurisdiction to jurisdiction, the discussion highlights some of these differences and suggests ways to minimise any difficulties that might arise for multicentred trials involving distinct jurisdictions.

Without informed consent, any invasive procedure becomes an assault. The prevailing legal and ethical standard is that the physician has a fiduciary duty to give enough information to the patient so that a reasonable person can make an informed decision to accept or refuse the proposed treatment. The patient's frailty, delirium and/or dementia, and end-of-life concerns and expectations can make informed consent a difficult task. This review examines informed consent requirements for adults and provides communication tools to enable shared decision making while engendering patient-physician trust.

But it will take much more to change clinical practice The UK Supreme Court’s decision in the Montgomery case is a landmark judgment, establishing beyond doubt the court’s commitment to protecting patients’ right to self determination. 1 The judgment concerns Nadine Montgomery, a woman with diabetes whose son was born with serious and permanent disabilities after a shoulder dystocia during delivery. Montgomery’s obstetrician had not warned her of the risk of shoulder dystocia during vaginal delivery or discussed alternatives such as caesarean section. The court held that the doctor should have done both: doctors have a duty to ensure that each patient is aware of any material risks of any recommended treatment and of any reasonable alternative treatments. The test of materiality is whether a reasonable person in that particular patient’s position would be likely to attach importance to the risk, or whether the doctor is—or should reasonably be—aware that that particular patient would be likely to attach importance to it. The message for clinicians is: know your patient and provide tailored information. The patient must be given sufficient information, but what constitutes sufficient? Two standards of disclosure have been employed: the professional standard (the court relies on medical …

R ecent studies [7, 9] have conclusively demonstrated that hospital administrators and physicians in the United States often are flummoxed by a relatively simple question: ‘‘How much will my [insert name of procedure] cost?’’ Any reasonable person should be outraged, perplexed, and infuriated. Call your local Wal-Mart and ask them for the cost of any item. You will get answer within seconds. Go online and you can quickly find the cost of a roll of toilet paper, a new car, or a round-trip bus ticket to Peoria, IL, USA. Yet most of us are unable to provide our own patients with reasonable cost estimates for the tests, procedures, and products we prescribe every day. Akhavan et al. [1] used a rigorous accounting method (Time-driven Activity Based Costing [TDABC]) to examine the cost of TKA and THA procedures. The authors then compared the costs ascertained using TDABC with the traditional accounting method used by virtually all US hospitals. Not surprisingly, the authors found that methods matter. Specifically, the authors found that TDABC methods yielded ‘‘cost’’ estimates for TKA and THA that were approximately 45% lower than traditional accounting methods (USD 10,000 per case). These results have a number of important implications. First, the results provide an explanation for recent research studies that indicated hospitals were unable to provide credible estimates of prices for many of the most routine services that they provide [2, 12]. If hospitals’ internal accounting systems are fundamentally flawed and inaccurate as Akhavan and colleagues suggest, it is no wonder that hospitals are unable to provide accurate pricing data to consumers [5]. We cannot excuse our healthcare system for dysfunctional accounting systems and its inability to know costs and provide prices, but this does at least provide an explanation for the problem at hand. Second, the results have implications for hospital leadership when This CORR Insights is a commentary on the article ‘‘Time-drive Activity-based Costing More Accurately Reflects Costs in Arthroplasty Surgery’’ by Akhavan and colleagues available at: DOI: 10.1007/ s11999-015-4214-0. The author certifies that he, or any member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR or the Association of Bone and Joint Surgeons. This CORR Insights comment refers to the article available at DOI: 10.1007/s11999-0154214-0. PC is supported by a K24 award from NIAMS (AR062133). This work is also funded in-part by R01 AG033035 from NIA at the NIH. P. Cram MD, MBA (&) Division of General Internal Medicine, Toronto General Hospital, 200 Elizabeth Street, Eaton 14th Floor, Toronto, ON M5G 2C4, Canada e-mail: peter.cram@uhn.ca CORR Insights Published online: 27 May 2015 The Association of Bone and Joint Surgeons1 2015

The Internet presents opportunities for corporations to efficiently build their brands online and to enhance their global reach. But there are threats as well as opportunities, since anti-branding and free-riding activities are easier in cyberspace. One such threat is the unauthorized incorporation of a trademark into a domain name. This can lead to trademark dilution and cause consumer confusion. But some users claim a right to use these trademarks for the purpose of parody or criticism. Underlying these trademark conflicts is the familiar tension between property rights and free speech rights. While some trademark scholars are reluctant to consider a trademark as property, we find strong support for the property paradigm in Hegel’s philosophy. Assuming that a trademark is an earned property right, we propose that a trademark owner should be allowed to control the permutations of its trademark incorporated into domain names unless a reasonable person would not confuse that domain name with the company’s mark. But we also conclude that there must be latitude to employ a domain name for negative editorial comment, so long as the source and purpose of that domain name is plainly apparent.

Wording differs substantially between the various legislation with regard to with behaviours constitute stalking. Some legislation comprehensively describes which behaviours are punishable, whilst other legislation uses only broad terms, Differences also exist with regard to the number of occasions and the intent of the perpetrator necessary to constitute stalking. Moreover, legislative provisions usually require the victim to experience negative effects of the offender's behaviour, or require that a reasonable person would be likely to experience such negative effects in the same situation. This article discusses whether these legislative components for the definition of stalking are problematic or not, Past studies and a study among 234 victims in The Netherlands are discussed to illustrate difficulties in legislative provisions dealing with stalking. It is argued that legislation should refrain from descriptions of specific behaviours and negative effects for victims in the definition of what constitutes stalking and that it is advisable for provisions to adhere to a "reasonable-person-test".

In civilian life, an individual has the right to refuse medical treatment in almost any circumstance. While a patient who refuses treatment may face adverse consequences such as prolonged illness, our society recognizes the importance of individual choice in health matters. Members of the military, however, enjoy no such right. Service members are required to submit to certain medical treatments as a part of their employment contract. Refusing such treatments is disobeying an order, and the service member then faces the prospect of a dishonorable or "other than honorable" discharge, and even imprisonment.1 Disobeying an order to receive treatment can thus result in the equivalent of a felony conviction on the individual's employment history forever.2 The lack of a right to refuse treatment in the military has become public in recent years because of the anthrax vaccine controversy. In 1998, well before the recent civilian cases of anthrax, the Department of Defense (DOD or Pentagon) ordered that all 2.4 million active duty and reserve service members be vaccinated against anthrax.3 While the vaccine was approved by the National Institutes of Health (NIH) for general use in 1970,(4) concerns over potential side effects, primarily sterility, arose among the soldiers, and significant numbers of them began refusing the vaccine.5 Some soldiers recently may have eased their stance on the vaccine because of the new reality of the anthrax threat. However, the question of whether a member of the armed forces can decide which drugs and biological agents enter his body has not lost its significance. Service members argue that the right and the duty to refuse the vaccine arises IMAGE FORMULA79 from the armed forces' policy that service members must disobey "illegal or immoral orders."6 Air Force reservist Thomas Rempfer claims that "professional standards justify disobedience" when an order is "militarily absurd," and that the vaccine is such an order.7 Therefore, Rempfer asserts that punishment of such disobedience through courts-martial is inappropriate.8 To support this argument, members of the military claim that the vaccine is in fact an investigational drug.9 Even the military must obtain informed consent from research subjects. Therefore, if the vaccine is actually experimental, the DOD is violating not just its own regulations, but also international principles of human dignity.10 Several issues thus arise from the anthrax vaccine order.11 First, can the military require its forces to give up their right to refuse treatment? Is this a valid employment contract? The answer to both of these questions is most assuredly yes. Those joining the military voluntarily give up many of their freedoms and rights for the good of the country. Second, can members of the military succeed with the argument that the order to receive the anthrax vaccine is immoral or illegal because of the possible health risks, and thus that they have the right, and even the duty, to refuse the order? Because the reasons behind such refusal are based on personal fears and not on larger moral issues or goals, and because a reasonable person in the situation would not view this order as illegal, service members are unlikely to succeed with this argument. Finally, should the anthrax vaccine be considered experimental for the purpose of protecting combatants against germ warfare? If so, soldiers could refuse the vaccine as a violation of national and international law. While the vaccine is not approved for this very narrow purpose, a broad interpretation of its labeling will allow the vaccine to be legally used to protect susceptible populations from airborne anthrax. Thus, the military has the right to require that its service members receive the anthrax vaccine, and resignation from the service is the only recourse for a soldier who does not wish to take it. Part I of this Note will discuss the history of the anthrax vaccine and the concerns of the soldiers, which are based in rumors of side effects as well as distrust of the Pentagon's health-related decisions. …

H.L. Mencken wrote that ‘‘When somebody says it’s not about money. It’s about the money.’’ Once again, the issue is about the money. Five years ago, I founded the Association for Medical Ethics (AME), calling for full disclosure of all money paid to researchers by manufacturers. Over those past 5 years, I have often heard ‘‘It’s the principle, not the money,’’ from defensive clinical researchers and industry folks. Would any reasonable person believe what I write when my article is about a product whose manufacturer is paying me? Well, if it is a little money say for implant expenses for testing you will probably have more confidence than if it is millions of dollarsdwith large sum comes large doubts. In those cases, you will probably reserve judgment on using the product and first perform the necessary due diligence to confirm the findings independently. This scenario may be a big problem for industries with marginal products who have a low expectation that initial company data will stand up to independent surveillance and analysis. Conversely, companies with substantial confidence in product performance have little to fear if surgeons choose conservative ‘‘wait and see’’ attitudes and do not jump right in there using the new product. Most prudent doctors will ‘‘wait and see’’ when they detect the influence of something other than independent unbiased literature from a historically trusted source in medicine. ‘‘Wait and see’’ can be very bad for launching new products because as industry folks say, ‘‘what ruins all those good papers is follow-up.’’ Unless practice patterns have already been changed to adopt the product in the absence of independent data, if complications and bad results surface in articles with generalized use, the battle to launch a new product with efficacy or safety problems is lost. It should not be surprising then that the solution for some company executives to prevent hindering profit making is to sweep these problems (complications) under the rug

A valid consent for treatment must fulfill three basic requirements. First, consent must be given voluntarily without undue influence, coercion or misrepresentation. Second, the person giving consent must be competent and if the patient herself is not competent, the person giving consent in her place must have the legal authority to do so. Third, the consent must be specific to the treatment and those providing it. In addition to these requirements, consent must be informed, which means that the patient must have received sufficient information to make an informed decision. The paper discusses these requirements and how to determine what information must be provided to the patient to ensure that a fully informed decision can be made. All information that a reasonable person in the patient's circumstances would need to make a decision must be provided. This information includes the risks of the procedure, the consequences of declining treatment, alternatives, success and failure rates, recommendations, and any actual or potential conflicts of interest. A physician is responsible for ensuring that this information is provided, and that the patient understands the information. If a patient claims that she has not been properly informed, in a lawsuit she will have to show that a reasonable person in her position would have made a different decision if adequately informed, which is often difficult. However, the consent process is not just concerned with avoiding liability. The education process to inform the patient's choice regarding treatment is a key aspect of the relationship between physician and patient. It highlights the primary importance of good communication and respect for the patient's right to autonomy.

The purpose of this article is to clarify the decision points that are important to consider when evaluating the ethics of a placebo-controlled trial. The ethical requirements for research involving human subjects are reviewed, and the rationale for and potential problems with concomitant placebo control are explained. A series of case discussions are used to illustrate each decision point. The critical decision points in the evaluation of the ethics of a placebo-controlled trial are as follows: (i) Is placebo being used in place of standard therapy? (ii) Is standard therapy likely to be effective? (iii) Is the toxicity of standard therapy such that patients routinely refuse this treatment? (iv) Could the use of placebo result in severe suffering or irreversible harm? (v) Is the variability in the placebo response such that it is reasonable to consider other options for the control group? (vi) Would a reasonable person with an average degree of altruism and risk aversiveness agree to participate in this study? The algorithm presented in this article gives researchers and research monitors (such as Institutional Review Board members) the tools they need to evaluate the ethics of a study that uses concomitant placebo control.