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This article reviews adoption debates about the disclosure of children's medical history in the twentieth century, noting shifts in the prescription of how much and what to tell adoptive applicants. I look at how adoption professional debates throughout the twentieth century around the disclosure of a child's medical history reveal the ways in which these professionals tried to deal with issues of predictability, risk, adoptability, and acceptability when it came to the persistent question of disability in adoptive family making. I consider how this management is similar to and different from histories of reproduction. I argue that as child eligibility gradually expanded to include children labeled disabled, and as adoption moved from a being a parent-centered practice to a child-centered one, professionals more intensely negotiated the management and communication of disability risk as a way to both mitigate the possibility of a failed placement and to facilitate a successful one.

The United States and the United Kingdom ended outdoor biological warfare testing in populated areas nearly half a century ago. Yet, the conduct, health effects, and propriety of those tests remain controversial. The varied views reflect the limits of currently available test information and evolving societal values on research involving human subjects. Western political culture has changed since the early days of the American and British testing programs. People have become less reluctant to question authority, and institutional review boards must now pre-approve research involving human subjects. Further, the heightened stringency of laboratory containment has accentuated the safety gap between a confined test space and one without physical boundaries. All this makes it less likely that masses of people would again be unwittingly subjected to secret open-air biological warfare tests.

Purpose: Quality of care is strongly influenced by evidence-based medicine, a large part of which is based on results obtained from clinical trials. If trials are conducted in secret, patient safety is at risk. Several mandates-legal, editorial, financial, and ethical-have tried to influence the disclosure of clinical trials, first by encouraging registration in publicly accessible registers and, second, by calling for the publication of results. Not all these initiatives have reached high rates of compliance, but the succession of national and international events over a few years gave an important boost to information disclosure. This article provides a chronicle of the succession of the events, from the historical calls to the recent EMA policy and WHO statement, and public consultations requested by the NIH, and the HHS, which will inevitably change the international panorama. The path of these new policies is moving towards more supervised clinical research. Individual scientific institutions can also contribute, at the local level, to such an ethical endeavor as is improving research transparency, by disclosing information on the trials coordinated by their own researchers., Results: The way is long and complex, but, if everyone contributes there could be a prompt, worldwide diffusion of the findings of clinical trials, and therefore a more possible evidenced-based medicine.

This paper examines the representations and emotions associated with disclosure and stigma in Pietermaritzburg, KwaZulu-Natal, seven years after the start of the South African government's ARV roll-out programme on the basis of in-depth oral history interviews of HIV-positive support group members. It argues that the wider availability of ARV treatment, the ensuing reduced fatality rate and the increased number of people, including men, who receive counselling and testing, may mean that HIV/AIDS is less stigmatised and that disclosure has become easier. This does not mean that stigma has disappeared and that the confusion created by competing world-views and belief systems has dissipated. Yet the situation of extreme denial and ideological confusion observed, for example, by Deborah Posel and her colleagues in 2003 and 2004 in the Mpumalanga province seems to have lessened. The interviews hint at the possibility that people living with HIV may have, more than a decade before, a language to express the emotions and feelings associated with HIV/AIDS. They were also found to be more assertive in matters of gender relations. These new attitudes would make disclosure easier and stigma more likely to recede.

Traditional historiography of science has constructed secrecy in opposition to openness. In the first part of the paper, I will challenge this opposition. Openness and secrecy are often interlocked, impossible to take apart, and they might even reinforce each other. They should be understood as positive (instead of privative) categories that do not necessarily stand in opposition to each other. In the second part of this paper, I call for a historicization of the concepts of 'openness' and 'secrecy'. Focusing on the early modern period, I briefly introduce three kinds of secrecy that are difficult to analyse with a simple oppositional understanding of openness and secrecy. In particular, I focus on secrecy in relation to esoteric traditions, theatricality and allegory.

Freud's analogies were legion: hydraulic pipes, military recruitment, magic writing pads. These and some three hundred others took features of the mind and bound them to far-off scenes--the id only very partially resembles an uncontrollable horse, as Freud took pains to note. But there was one relation between psychic and public act that Freud did not delimit in this way: censorship, the process that checked memories and dreams on their way to the conscious. (Freud dubbed the relation between internal and external censorship a 'parallel' rather than a limited analogy.) At first, Freud likened this suppression to the blacking out of texts at the Russian frontier. During the First World War, he suffered, and spoke of suffering under, Viennese postal and newspaper censorship--Freud was forced to leave his envelopes unsealed, and to recode or delete content. Over and over, he registered the power of both internal and public censorship in shared form: distortion, anticipatory deletion, softenings, even revision to hide suppression. Political censorship left its mark as the conflict reshaped his view of the psyche into a society on a war footing, with homunculus-like border guards sifting messages as they made their way--or did not--across a topography of mind.

The Freedom of Information Act (FOIA) and state 'open-records' laws govern access to records in the possession of federal agencies and state entities, such as public universities. Although these laws are intended to promote 'open government' and to assure the existence of an informed citizenry capable of holding government officials accountable for their decisions, an inherent tension exists between the public's access to information and biomedical research institutions' need to ensure the confidentiality of proprietary records and to protect the personal safety of employees. Recognizing these and other conflicts, the federal FOIA and state public-disclosure laws contain express exemptions to protect sensitive information from disclosure. Although some state open-records laws are modeled after the federal FOIA, important differences exist based on the language used by the state law, court interpretations, and exemptions. Two specific types of exemptions are particularly relevant to research facilities: exemptions for research information and exemptions for personal information. Responding to FOIA and state open-records requests requires knowledge of relevant laws and the involvement of all interested parties to facilitate a coordinated and orderly response.

This article investigates the extent of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Disclosures (HIV/AIDSD) in online annual reports by 200 listed companies from 10 African countries for the year ending 2006. Descriptive statistics reveal a very low level of overall HIV/AIDSD practices with a mean of 6 per cent disclosure, with half (100 out of 200) of the African companies making no disclosures at all. Logistic regression analysis reveals that company size and country are highly significant predictors of any disclosure of HIV/AIDS in annual reports. Profitability is also statistically significantly associated with the extent of disclosure.

The descriptive “conventions” used on food labels are always evolving. Today, however, the changes are so complicated (partly driven by legislation requiring disclosures about environmental impacts, health issues, and geographical provenance) that these labels more often baffle buyers than enlighten them. In a light-handed manner, the article points to how sometimes reading label language can be like deciphering runes—and how if we are familiar with the technical terms, we can find a literal meaning, but still not see the implications. The article could be ten times longer because food labels vary according to cultures—but all food-exporting cultures now take advantage of our short attention-span when faced with these texts. The question is whether less is more—and if so, in this contest for our attention, what “contestant” is voted off.

During his first term as President of the United States, Dwight D. Eisenhower suffered several serious illnesses. Particularly important was the massive heart attack he experienced in the fall of 1955. Drawing on primary sources as well as prior scholarship, this article analyzes varying interpretations of Eisenhower's 1955 medical treatment in light of his previous illnesses and their management. It explores the handling of public disclosure by the White House, by Eisenhower himself, and by his medical team. And it reconsiders Republican strategists' efforts to allay public concerns about the President's health. Current understanding is called into question in several respects. Although it sharpened speculation about his fitness and willingness to run in the 1956 presidential campaign, the 1955 heart attack made Eisenhower more likely, rather than less likely, to run. Although often sick, and in several instances critically so, Eisenhower was clearly the dominant player--intentionally "behind the scenes"--both in the management of his illnesses and in the health-perceptual aspects of his drive toward a second term. These findings should lead us to a better reading of Eisenhower as a president and to a better appreciation of health's linkage to legacy in presidential politics.

Research on the history of medical ethics in Germany still regards the nineteenth century as the age of medical paternalism. The authoritarian manner of German physicians is particularly emphasised by assuming that patients were normally not involved in decisions about serious therapeutic measures. This paper will analyse if and how physicians dealt with the issues of medical disclosure and of patient consent concerning surgery and other painful interventions in the first half of the nineteenth century. Physicians rarely dealt with this problem in their articles on medical ethics but reflected, instead, on the issues of disclosure and consent in descriptions of risky therapeutic interventions. They devoted considerable attention to the description of the decision making process, particularly in medical case reports on life-threatening surgery. The benefits hoped for and the risks of the surgical intervention were frequently explained in detail. It was important for them not only to legitimise their adventurous course of action by obtaining patients' consent but also to demonstrate that the seriously ill patients in reality played the active, demanding part in the decision on life-threatening surgery. It is remarkable that, even where patients from lower social classes were concerned, physicians stressed the necessity of obtaining their consent for risky surgical interventions. However, it cannot be established with certainty if the patients were comprehensively informed by the physicians about the risks involved. Nevertheless, physicians' awareness of the necessity of such disclosure, as expressed by their rhetorical "self-fashioning" in the published case reports, is beyond doubt.

The 1972 U.S. surgeon general's report The Health Consequences of Smoking was the first to include a warning about exposure to second-hand smoke. Because the tobacco industry has a record of withholding the results of their research from the public, we searched the internal tobacco industry documents and compared internal industry research on second-hand smoke to what the industry published in the open scientific literature through 1972. We found chemical analyses, sensory evaluations, and discussions of sidestream cigarette smoke (the smoke emitted by the cigarette between puffs, the main component of second-hand smoke), beginning in 1929. American Tobacco Company research in the 1930s indicated that, compared with mainstream smoke, sidestream smoke was produced in larger quantities and contained, per cigarette, 2 times more nicotine and 12 times more ammonia. Research funded by the Tobacco Industry Research Committee in the 1950s revealed that sidestream smoke contained, per unit cigarette, higher concentrations of carcinogenic polycyclic aromatic hydrocarbons, per unit mass, including four times more 3,4 benzopyrene. In 1956 and 1957, respectively, Philip Morris and R. J. Reynolds also began to research sidestream smoke. In 1961, Philip Morris began to do sensory evaluation and modification of sidestream odor during product development. This sensory evaluation of sidestream smoke was the first biological testing of sidestream smoke by a tobacco company. Prior to the release of the 1972 U.S. surgeon general's report, the tobacco industry published the majority of its findings in the open scientific literature and does not appear to have perceived second-hand smoke as a threat to human health.

The amount of published literature on adverse drug reactions is overwhelming; for example, the serial publication Side Effects of Drugs Annual lists and critically discusses over 3000 references each year. As a group, pharmacotherapeutics journals publish more papers on adverse drug reactions than journals that cover other fields, but even so they publish a minority of the total number of papers, and no single journal or group of journals can be highlighted as being a frequent source of primary information. Non-specialists must therefore rely on secondary literature (reviews) and tertiary literature (critical summaries) for information. Most of the primary published literature is in the form of anecdotal reports (30%) and formal studies or randomized controlled trials (35%). The anecdotal reports vary in quality; a new serial publication devoted to this type of article would bring some of the literature together and would improve the quality of reporting. Although many of the randomized controlled trials are of good quality and large enough to reveal benefit, most are too small to provide robust information about adverse drug reactions. Systematic reviews are too few in number (only 1.25% of publications on adverse drug reactions cited in Side Effects of Drugs Annual); more are needed.