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Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.
Contents: (1) Intro.; (2) House and Senate Select Committees on Intelligence; (3) Joint Committee on Atomic Energy as a Model; (4) Proposed Joint Committee on Intelligence Characteristics: Methods of Establishment; Jurisdiction and Authority; Membership; Terms and Rotation; Leadership; Secrecy Controls; Pros and Cons; (5) Alternatives to a Joint Committee: Changing the Select Committees¿ Structure and Powers; Concerns about Restructuring the Intelligence Committees; Constraints on Coordination; Increasing the Use of Congressional Support Agencies; (6) Observations on Oversight of Intelligence: Obstacles to Oversight: Secrecy Constraints. This is a print on demand edition of an important, hard-to-find publication.
The Patient Protection and Affordable Care Act (PPACA) remains vulnerable to repeal, largely because Congress and the Supreme Court have granted each state the power to veto major provisions of the law before they take effect in 2014. The PPACA itself empowers states to block the employer mandate, to exempt many of their low- and middle-income taxpayers from the individual mandate, and to reduce federal deficit spending, simply by not establishing a health insurance "exchange." To date, 34 states have refused to create Exchanges and some 16 states have announced they would not expand their Medicaid programs. Yet the Obama administration is trying to coerce states into implementing parts of the expansion that the Court rendered optional. This special White Paper provides a comprehensive review of the process now occurring between states and the Obama Administration, underscoring how a critical mass of states exercising their vetoes over Exchanges and the Medicaid expansion can force Congress to reconsider, and hopefully repeal, the rest of the PPACA.
Congress has continued to debate the efficacy and constitutionality of federal regulation of firearms and ammunition, with strong advocates arguing for and against greater gun control. While several dozen gun control-related proposals have been introduced in recent Congresses, only a handful of those bills received significant legislative action. The 109th Congress, for example, passed two bills with firearmsrelated provisions that were enacted into law. P.L. 109-72 prohibits certain types of lawsuits against firearm manufacturers and dealers to recover damages related to the criminal or unlawful use of their products by other persons, and P.L. 109-295 includes a provision that prohibits federal officials from seizing any firearm from private persons during a major disaster or emergency, if possession of that firearm was not already prohibited under federal or state law. Nevertheless, the 110th Congress could possibly reconsider several gun control proposals that were considered as part of appropriations and crime legislation in the previous Congress. During the 109th Congress, the House amended the Children's Safety Act of 2005 (H.R. 3132) to prohibit the transfer or possession of a firearm to or by any person convicted of a sex offense against a minor. The House also amended Secure Access to Justice and Court Protection Act of 2005 (H.R. 1751) to authorize certain federal court judges and officials to carry firearms for personal protection. The Senate passed a different version of H.R. 1751 that included similar provisions, as well as provisions designed to clarify and expand the Law Enforcement Officers Safety Act (P.L. 108-277) -- a law that gives concealed carry privileges to qualified on-duty and retired law enforcement officers. None of those provisions were enacted into law, however. In addition, the House Judiciary considered four gun-related bills: the ATFE Modernization and Reform Act of 2006 (H.R. 5092), the Firearms Corrections and Improvement Act (H.R. 5005), the Firearm Commerce Modernization Act (H.R. 1384), and the NICS Improvement Act of 2005 (H.R. 1415). H.R. 5092 was passed by the House. The 109th Congress, moreover, maintained a fee prohibition for Brady background checks and other funding limitations and conditions related to gun enforcement in the FY2006 DOJ appropriations (P.L. 109-108). Those limitations and conditions have been continued into FY2007 under continuing resolutions. They are often referred to as the "Tiahrt amendment," for their sponsor in the FY2004 appropriations cycle, Representative Todd Tiahrt. Issues addressed in those bills, as well as the Tiahrt funding limitations and conditions, could be reconsidered in the 110th Congress. Senator Charles Schumer, for example, has introduced a bill (S. 77) that would repeal portions of the Tiahrt amendment that limit the sharing of firearm trace data. Other gun control-related issues that may reemerge in the 110th Congress include (1) retaining Brady background check records for approved transactions to enhance terrorist screening, (2) more strictly regulating certain long-range fifty caliber rifles, (3) further regulating certain firearms previously defined in statute as "assault weapons," and (4) requiring background checks for firearm transfers at gun shows. This report will updated to reflect legislative action.