Handling ethical problems in counterterrorism: An inventory of methods to support ethical decisionmaking
This document presents the findings of a study into methods that may help counterterrorism professionals make decisions about ethical problems. The study was commissioned by the Research and Documentation Centre (Wetenschappelijk Onderzoek- en Documentatiecentrum, WODC) of the Dutch Ministry of Security and Justice (Ministerie van Veiligheid en Justitie), on behalf of the National Coordinator for Counterterrorism and Security (Nationaal Coördinator Terrorismebestrijding en Veiligheid, NCTV). The study provides an inventory of methods to support ethical decision-making in counterterrorism, drawing on the experience of other public sectors — healthcare, social work, policing and intelligence — and multiple countries, primarily the Netherlands and United Kingdom.
The report introduces the field of applied ethics; identifies key characteristics of ethical decision-making in counterterrorism; and describes methods that may help counterterrorism professionals make decisions in these situations. Finally, it explores how methods used in other sectors may be applied to ethical decision-making in counterterrorism. It also describes the level of effectiveness that can be expected from the various methods. The report is based on a structured literature search and interviews with professionals and academics with expertise in applied ethics.
This report will be of interest to counterterrorism professionals who are responsible for strengthening ethical decision-making in their organisation. It may also provide insights for counterterrorism professionals who seek new methods to help them make ethical decisions. The findings may additionally be relevant for professionals in other sectors, if complemented with a review of decision-making characteristics in their sector of specialism.
Food Fraud and “Economically Motivated Adulteration” of Food and Food Ingredients (PDF)
Source: Congressional Research Service (via MSPB Watch)
Food fraud, or the act of defrauding buyers of food or ingredients for economic gain—whether they be consumers or food manufacturers, retailers, and importers—has vexed the food industry throughout history. Some of the earliest reported cases of food fraud, dating back thousands of years, involved olive oil, tea, wine, and spices. These products continue to be associated with fraud, along with some other foods. Although the vast majority of fraud incidents do not pose a public health risk, some cases have resulted in actual or potential public health risks. Perhaps the most high-profile case has involved the addition of melamine to high-protein feed and milk-based products to artificially inflate protein values in products that may have been diluted. In 2007, pet food adulterated with melamine reportedly killed a large number of dogs and cats in the United States, followed by reports that melamine-contaminated baby formula had sickened thousands of Chinese children. Fraud was also a motive behind Peanut Corporation of America’s actions in connection with the Salmonella outbreak in 2009, which killed 9 people and sickened 700. Reports also indicate that fish and seafood fraud is widespread, consisting mostly of a lowervalued species, which may be associated with some types of food poisoning or allergens, mislabeled as a higher-value species. Other types of foods associated with fraud include honey, meat and grain-based foods, fruit juices, organic foods, coffee, and some highly processed foods.
Views of internists towards uses of PGD
Source: Reproductive BioMedicine Online
Preimplantation genetic diagnosis (PGD) is increasingly available, but how physicians view it is unclear. Internists are gatekeepers and sources of information, often treating disorders for which PGD is possible. This quantitative study surveyed 220 US internists, who were found to be divided. Many would recommend PGD for cystic fibrosis (CF; 33.7%), breast cancer (BRCA; 23.4%), familial adenomatous polyposis (FAP; 20.6%) and familial hypertrophic cardiomyopathy (19.9%), but few for social sex selection (5.2%); however, in each case, >50% were unsure. Of those surveyed, 4.9% have suggested PGD to patients. Only 7.1% felt qualified to answer patient questions about it. Internists who would refer for PGD had completed medical training less recently and, for CF, were more likely to have privately insured patients (P < 0.033) and patients who reported genetic discrimination (P < 0.013). Physicians more likely to refer for BRCA and FAP were less likely to have patients ask about genetic testing. This study suggests that internists often feel they have insufficient knowledge about it and may refer for it based on limited understanding. They view possible uses of PGD differently, partly reflecting varying ages of onset and disease treatability. These data have critical implications for training, research and practice.
By the numbers: a 2013 money-in-politics index
Source: Center for Public Integrity
Number of bills passed by Congress this year that have been signed into law: 58
Number of bills passed in 1948, the year President Harry Truman* assailed the “Do-Nothing Congress”: 511
Number of minutes Sen. Ted Cruz, R-Texas, spent reading Dr. Seuss’s “Green Eggs and Ham” during a 21-hour talk-a-thon in September: 5 ½
Number of hours per day the Democratic Congressional Campaign Committee recommends embattled freshmen spend fundraising: 4
Amount of campaign cash all members of Congress have reported raising so far in 2013: $403,952,012
Medicare and State Health Care Programs: Fraud and Abuse; Electronic Health Records Safe Harbor Under the Anti-Kickback Statute
Medicare and State Health Care Programs: Fraud and Abuse; Electronic Health Records Safe Harbor Under the Anti-Kickback Statute (PDF)
Source: U.S. Department of Health and Human Services, Office of Inspector General
In this final rule, the Office of Inspector General (OIG) amends the safe harbor regulation concerning electronic health records items and services, which defines certain conduct that is protected from liability under the Federal anti-kickback statute, section 1128B(b) of the Social Security Act (the Act). Amendments include updating the provision under which electronic health records software is deemed interoperable; removing the electronic prescribing capability requirement; extending the sunset provision until December 31, 2021; limiting the scope of protected donors to exclude laboratory companies; and clarifying the condition that prohibits a donor from taking any action to limit or restrict the use, compatibility, or interoperability of the donated items or services.
Adequacy of U.S. Secret Service Efforts to Identify, Mitigate, and Address Instances of Misconduct and Inappropriate Behavior (Redacted)
Adequacy of USSS Efforts to Identify, Mitigate, and Address Instances of Misconduct and Inappropriate Behavior (Redacted) (PDF)
Source: U.S. Department of Homeland Security, Office of Inspector General
Although individual employees have engaged in misconduct or inappropriate behavior, we did not find evidence that misconduct is widespread in USSS. Furthermore, we did not find any evidence that USSS leadership has fostered an environment that tolerates inappropriate behavior. Of the 2,575 employees who responded to our electronic survey, 2,144 (83 percent) indicated they were not aware of USSS employees engaging in any of six behaviors that were displayed in Cartagena. Additionally, 61 percent of survey respondents believed management does not tolerate misconduct.
Political advertisers and TV stations ignore disclosure rules
Source: Sunlight Foundation
In a 2003 Supreme Court opinion on the biggest campaign reforms in a generation, Justice Stephen Breyer reflected on a little-known provision that required outside groups to disclose additional details about their political ad spending at local TV stations. “Recordkeeping can help both the regulatory agencies and the public evaluate broadcasting fairness,” Breyer wrote, “and determine the amount of money that individuals or groups, supporters or opponents, intend to spend to help elect a particular candidate.”
But a decade after the Supreme Court ruling, an extensive review of these documents by the Sunlight Foundation reveals that TV stations often fail to report even the most basic information about the political ads that outside groups buy on their airwaves. As a result, the records that Breyer said would facilitate public watchdogging are spotty or don’t exist. There’s no way to total reliably how much is being spent for or against a candidate, or, in some cases, who is doing the spending. A systematic review of 200 randomly-selected ad buys made by outside groups found that fewer than 1 in 6 ads targeting federal candidates disclosed the name of the candidate or election mentioned.
Such omissions deprive the voting public of important information. TV ad files have become an increasingly important tool for tracking otherwise undisclosed political spending by groups that run the gamut from well-known trade associations and unions to lesser-known operations whose anodyne names offer little information about the financial or political interests behind them: “Americans for Job Security,” for instance, or “Checks and Balances for Economic Growth.” In the wake of court decisions making it easier to route big money through outside groups, broadcast political TV ads jumped to an estimated $5.6 billion in 2012 — up 30% from 2008. Yet in spite of this massive payday, stations still find it hard to fill out paperwork about their benefactors.
More Settlements Reached in Foreign Bribery Cases, but Only 3% of Penalties Goes Back to Affected Countries
More Settlements Reached in Foreign Bribery Cases, but Only 3% of Penalties Goes Back to Affected Countries
Source: World Bank and United Nations Office on Drugs and Crime
A new report by the Stolen Asset Recovery Initiative (StAR) highlights the increase in enforcement actions to counter foreign bribery and the growing prevalence of settlements – that is, any resolution short of a full-scale trial – to conclude such cases and impose monetary sanctions.
The study, “Left out of the Bargain,” looks into the scope and value of settlements in 395 foreign bribery cases that took place between 1999 and mid-2012. StAR’s research examined cases in which the country where the legal settlements took place was different from the country where the bribery occurred.
The study illustrates how little money has been returned or ordered returned to the countries whose officials were alleged to have been bribed. According to the report, only 3 percent (US $197 million out of US $5.8 billion) was returned to those countries.
Robust action to counter foreign bribery is a key factor in the global fight against corruption. The return of stolen assets to their legitimate owners and the compensation to affected parties are vital components of that effort.
Business, Corruption and Crime in Bosnia and Herzegovina: The impact of bribery and other crime on private enterprise
Business, Corruption and Crime in Bosnia and Herzegovina: The impact of bribery and other crime on private enterprise (PDF)
Source: United Nations Office on Drugs and Crime
This survey of private businesses in Bosnia and Herzegovina reveals that corruption and other forms of crime are a great hindrance to private enterprise and have a negative effect on private investment. A significant percentage of businesses pay bribes to public officials repeatedly over the course of the year. Businesses in the Building and Construction sector are those most affected by bribery, followed by businesses in the Transportation and Storage sector. The public officials with the highest risk of bribery in interactions with businesses are health authorities, police officers, customs officers and judges/prosecutors.
Backgrounder — Governance in India: Corruption
Source: Council on Foreign Relations
With a booming economy throughout the 2000s, India was touted as one of the most promising major emerging markets. But that breakneck growth sputtered to a decade low in 2012, with many observers pointing to the corrosive effect of endemic corruption—including a spate of scandals under Prime Minister Manmohan Singh—as a culprit. Perhaps more than India’s weak currency and rising inflation, the graft problem has undermined institutions and thwarted efforts to reduce poverty and catalyze sustainable growth in the world’s largest democracy. Public revelations of corruption, including major scandals in the telecommunications and coal industry, have galvanized a rising middle class with increased demands for better governance. The tide has spurred new political movements, and forced Prime Minister Singh’s Congress Party to address transparency and marshal reforms. As the country enters a busy political season, culminating in the 2014 general elections, corruption is expected be a cornerstone issue—and one with big implications for India’s development.
Ethics Abandoned: Medical Professionalism and Detainee Abuse in the ‘War on Terror’ (PDF)
Source: Institute on Medicine as a Profession and Open Society Institute (via Harvard Law School)
the task Force has determined that actions taken by the U.s. government immediately following 9/11 included three key elements affecting the role of health professionals in detention centers:
1. The declaration that as part of a “war on terror,” individuals captured and detained in Afghanistan, Pakistan, and elsewhere were “unlawful combatants” who did not qualify as prisoners of war under the geneva conventions. Additionally, the U.S. Department of Justice approved of interrogation methods recognized domestically and internationally as constituting torture or cruel, inhuman, or degrading treatment.
2. The DoD and CIA’s development of internal mechanisms to direct the participation of military and intelligence-agency physicians and psychologists in abusive interrogation and breaking of hunger strikes. Although the involvement of health professionals in human rights violations against detainees progressed differently in the military and the CIA, both facilitated that involvement in similar ways, including undermining health professionals’ allegiances to established principles of professional ethics and conduct through reinterpretation of those principles.
3. The secrecy surrounding detention policies that prevailed until 2004– 2005, when leaked documents began to reveal those policies. secrecy allowed the unlawful and unethical interrogation and mistreatment of detainees to proceed unfettered by established ethical principles and standards of conduct as well as societal, professional, and nongovernmental commentary and legal review.
These key elements, as well as the task Force’s recommendations for remediating the participation of health professionals in detainee torture or cruel, inhuman, or degrading treatment, are summarized below and addressed in detail in the body of this report.
Culture, Compliance, and the C-Suite: How Executives, Boards, and Policymakers Can Better Safeguard Against Misconduct at the Top
On May 2, 2013, the RAND Corporation convened a symposium, “Culture, Compliance and the C-Suite: How Executives, Boards and Policy-Makers Can Better Safeguard Against Misconduct at the Top,” to stimulate a broad conversation about the challenges posed by executive misconduct (e.g., episodes of fraud, malfeasance, unethical behavior) at the level of the chief executive, financial, and other officers (sometimes called the C-suite). The symposium conversation also focused on the risk factors that contribute to executive misconduct and on practical steps that could be taken to strengthen compliance and ethical tone at the C-suite level and the unique roles of directors, top executives, chief ethics and compliance officers (CECOs), and government regulators and policymakers in pursuing those steps. Prior to the symposium, several of the invited participants were asked to prepare and present formal remarks on corporate culture, compliance, and the C-suite. Their white papers, distributed in advance of the event, represent varied perspectives on law enforcement, organizational behavior, and compliance activity, all relating to instances of C-suite misconduct. The speakers presented their remarks during the first session of the symposium. The second and third sessions engaged the symposium participants in interactive discussions, launching from the foundational remarks initially offered by the white-paper authors. These proceedings summarize the discussion and include the white papers.
Report on Government Information Requests (PDF)
We believe that our customers have a right to understand how their personal information is handled, and we consider it our responsibility to provide them with the best privacy protections available. Apple has prepared this report on the requests we receive from governments seeking information about individual users or devices in the interest of transparency for our customers around the world.
This report provides statistics on requests related to customer accounts as well as those related to specific devices. We have reported all the information we are legally allowed to share, and Apple will continue to advocate for greater transparency about the requests we receive.
Talking with Patients about Other Clinicians’ Errors
Source: New England Journal of Medicine
Although a consensus has been reached regarding the ethical duty to communicate openly with patients who have been harmed by medical errors, physicians struggle to fulfill this responsibility. One particular challenge is that although the literature assumes the physician providing the disclosure also committed the error, health care today is delivered by complex groups of clinicians across multiple care settings. In addition, safety experts emphasize the role that system breakdowns play in adverse events. Thus, many decisions about discussing errors with patients involve situations in which other clinicians were primarily responsible for the error.
Confronting the apparent error of a colleague raises challenging questions about whether an error occurred, how the error arose, which professionals carry what responsibilities, and how to talk with the patient about the event. Existing guidelines emphasize the overall importance of disclosing errors, but (with the exception of the case study of the American College of Physicians Ethics and Human Rights Committee)16 they offer little guidance on disclosing others’ mistakes; this lack of guidance heightens clinicians’ uncertainty about what to do. Consequently, patients may be told little about these events, and opportunities to build trust, ensure that learning occurs after errors, and avoid litigation may be lost.
We convened a working group of experts in patient safety, medical malpractice insurance and litigation, error disclosure, patient–provider communication, professionalism, bioethics, and health policy. After the meeting, a subgroup of attendees collaborated to refine these concepts and draft this manuscript. Below, we describe recommendations that extend existing guidelines for clinicians and institutions on communicating with patients about colleagues’ harmful errors.
Report: Veterans Affairs Spending Binge Fueled by Unethical Behavior and Irresponsible Leadership
Source: U.S. House of Representatives, Committee on Oversight & Government Reform
In conjunction with a full committee hearing, the House Oversight and Government Reform Committee today released a staff report entitled “U.S. Department of Veterans Affairs 2011 Human Resources Conferences: A Culture of Reckless Spending.” The report is a product of the Committee’s year-long investigation of two conferences held by the Department of Veterans Affairs in July 2011 and August 2011 in Orlando, Florida. These two conferences, which were purportedly organized to train human resources professionals, cost taxpayers approximately $6.1 million.
“The Committee’s investigation has revealed that this massive price tag was the direct result of spending mismanagement, unethical behavior by federal employees, and irresponsible leadership,” the report states.
Non-publication of large randomized clinical trials: cross sectional analysis
Source: British Medical Journal
To estimate the frequency with which results of large randomized clinical trials registered with ClinicalTrials.gov are not available to the public.
Cross sectional analysis
Trials with at least 500 participants that were prospectively registered with ClinicalTrials.gov and completed prior to January 2009.
PubMed, Google Scholar, and Embase were searched to identify published manuscripts containing trial results. The final literature search occurred in November 2012. Registry entries for unpublished trials were reviewed to determine whether results for these studies were available in the ClinicalTrials.gov results database.
Main outcome measures
The frequency of non-publication of trial results and, among unpublished studies, the frequency with which results are unavailable in the ClinicalTrials.gov database.
Of 585 registered trials, 171 (29%) remained unpublished. These 171 unpublished trials had an estimated total enrollment of 299 763 study participants. The median time between study completion and the final literature search was 60 months for unpublished trials. Non-publication was more common among trials that received industry funding (150/468, 32%) than those that did not (21/117, 18%), P=0.003. Of the 171 unpublished trials, 133 (78%) had no results available in ClinicalTrials.gov.
Among this group of large clinical trials, non-publication of results was common and the availability of results in the ClinicalTrials.gov database was limited. A substantial number of study participants were exposed to the risks of trial participation without the societal benefits that accompany the dissemination of trial results.