School of Historical and Philosophical Studies - Research Publications

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    Chinese health biotech and the billion-patient market
    Frew, SE ; Sammut, SM ; Shore, AF ; Ramjist, JK ; Al-Bader, S ; Rezaie, R ; Daar, AS ; Singer, PA (NATURE PUBLISHING GROUP, 2008-01)
    UNLABELLED: Chinese government support and 'sea turtles' are spurring the sector, but investors lack exits. SUPPLEMENTARY INFORMATION: The online version of this article (doi:10.1038/nbt0108-37) contains supplementary material, which is available to authorized users.
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    Science and society -: Genomic medicine and developing countries:: creating a room of their own
    Seguin, B ; Hardy, B-J ; Singer, PA ; Daar, AS (NATURE PUBLISHING GROUP, 2008-06)
    The notion that developing countries must wait for the developed world to make advances in science and technology that they later import at great cost is being challenged. We have previously argued that developing countries can harness human genetic variation to benefit their populations and economies. Based on our empirical studies of large-scale population genotyping projects in Mexico, India and Thailand, we describe how these resources are being adopted to improve public health and create knowledge-based economies. A significant additional benefit is building the capacity for scientific research and internalizing advances in technology, whatever their source.
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    1980-2005: bioethics then and now.
    Singer, P ; Kuhse, H (Springer Science and Business Media LLC, 2006-01)
    In this article we examine the role and ethics of communications in planning for an influenza pandemic. We argue that ethical communication must not only he effective, so that pandemic plans can be successfully implemented, communications should also take specific account of the needs of the disadvantaged, so that they are not further disenfranchised. This will require particular attention to the role of the mainstream media which may disadvantage the vulnerable through misrepresentation and exclusion.
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    Regenerative medicine and the developing world
    Greenwood, HL ; Singer, PA ; Downey, GP ; Martin, DK ; Thorsteinsdottir, H ; Daar, AS (PUBLIC LIBRARY SCIENCE, 2006-09)
    This is the first study to systematically identify and prioritize which applications of regenerative medicine are the most promising for improving health in developing countries.
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    The three main monotheistic religions and gm food technology: an overview of perspectives
    Omobowale, EB ; Singer, PA ; Daar, AS (BIOMED CENTRAL LTD, 2009)
    BACKGROUND: Public acceptance of genetically modified crops is partly rooted in religious views. However, the views of different religions and their potential influence on consumers' decisions have not been systematically examined and summarized in a brief overview. We review the positions of the Judaism, Islam and Christianity - the three major monotheistic religions to which more than 55% of humanity adheres to - on the controversies aroused by GM technology. DISCUSSION: The article establishes that there is no overarching consensus within the three religions. Overall, however, it appears that mainstream theology in all three religions increasingly tends towards acceptance of GM technology per se, on performing GM research, and on consumption of GM foods. These more liberal approaches, however, are predicated on there being rigorous scientific, ethical and regulatory scrutiny of research and development of such products, and that these products are properly labeled. SUMMARY: We conclude that there are several other interests competing with the influence exerted on consumers by religion. These include the media, environmental activists, scientists and the food industry, all of which function as sources of information and shapers of perception for consumers.
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    Priority setting: what constitutes success? A conceptual framework for successful priority setting
    Sibbald, SL ; Singer, PA ; Upshur, R ; Martin, DK (BMC, 2009-03-05)
    BACKGROUND: The sustainability of healthcare systems worldwide is threatened by a growing demand for services and expensive innovative technologies. Decision makers struggle in this environment to set priorities appropriately, particularly because they lack consensus about which values should guide their decisions. One way to approach this problem is to determine what all relevant stakeholders understand successful priority setting to mean. The goal of this research was to develop a conceptual framework for successful priority setting. METHODS: Three separate empirical studies were completed using qualitative data collection methods (one-on-one interviews with healthcare decision makers from across Canada; focus groups with representation of patients, caregivers and policy makers; and Delphi study including scholars and decision makers from five countries). RESULTS: This paper synthesizes the findings from three studies into a framework of ten separate but interconnected elements germane to successful priority setting: stakeholder understanding, shifted priorities/reallocation of resources, decision making quality, stakeholder acceptance and satisfaction, positive externalities, stakeholder engagement, use of explicit process, information management, consideration of values and context, and revision or appeals mechanism. CONCLUSION: The ten elements specify both quantitative and qualitative dimensions of priority setting and relate to both process and outcome components. To our knowledge, this is the first framework that describes successful priority setting. The ten elements identified in this research provide guidance for decision makers and a common language to discuss priority setting success and work toward improving priority setting efforts.
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    Just regionalisation: rehabilitating care for people with disabilities and chronic illnesses.
    Secker, B ; Goldenberg, MJ ; Gibson, BE ; Wagner, F ; Parke, B ; Breslin, J ; Thompson, A ; Lear, JR ; Singer, PA (Springer Science and Business Media LLC, 2006-08-29)
    BACKGROUND: Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. DISCUSSION: Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs - equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care - and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. SUMMARY: This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of - or revisions to - a regionalised health care strategy.
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    Grand challenges in global health: Community engagement in research in developing countries
    Tindana, PO ; Singh, JA ; Tracy, CS ; Upshur, REG ; Daar, AS ; Singer, PA ; Frohlich, J ; Lavery, JV (PUBLIC LIBRARY SCIENCE, 2007-09)
    The authors argue that there have been few systematic attempts to determine the effectiveness of community engagement in research.
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    Public engagement on global health challenges
    Cohen, ERM ; Masum, H ; Berndtson, K ; Saunders, V ; Hadfield, T ; Panjwani, D ; Persad, DL ; Minhas, GS ; Daar, AS ; Singh, JA ; Singer, PA (BMC, 2008-05-20)
    BACKGROUND: Experience with public engagement activities regarding the risks and benefits of science and technology (S&T) is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. METHODS: This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. RESULTS: The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. CONCLUSION: Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues.
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    Lessons on ethical decision making from the bioscience industry
    Mackie, JE ; Taylor, AD ; Finegold, DL ; Daar, AS ; Singer, PA (PUBLIC LIBRARY SCIENCE, 2006-05)
    Mackie and colleagues performed over 100 interviews with managers and executives at 13 bioscience companies to learn about bioindustry ethics from their perspective.