This resource is to complement your learning, and introduce you to other perspectives on the topics under discussion. Subjects were given varying doses of a placebo, consisting of decaffeinated coffee, with double-blind or deceptive instructions. Deceptive administration simulated clinical situations in that subjects were led to believe that they were receiving an active drug. In contrast, subjects in double-blind conditions were aware that they might receive a placebo. Double-blind and deceptive administration of the placebo produced different, and in some instances, opposite effects on pulse rate, systolic blood pressure, and subjective mood. Deceptive administration produced an increase in pulse rate, whereas double-blind administration did not. A theoretically predicted curvilinear effect on systolic blood pressure, alertness, tension, and certainty of having consumed caffeine was confirmed with deceptive administration, but not with double-blind administration. Double-blind administration produced curves in the opposite direction on each of these variables. The effects of the placebo on motor performance varied as a function of subjects' beliefs about the effects of caffeine. These data challenge the validity of double-blind experimental designs and suggest that this common method of drug assessment may lead to spurious conclusions. 

This resource is to complement your learning, and introduce you to other perspectives on the topics under discussion. The article discusses the issues facing the Paniya tribe of Wayanad, Kerala. They suffer from a range of health issues related to their experience of marginality. They have indigenous forms of healing; however, the use of biomedicine has increased. But, lack of time and resources means that the broader dimensions of health and well-being remain unaddressed. The socio-economic causes of illness are reconfigured into medical terms for management in the clinical setting. Ultimately, the struggles of the marginalized are rendered invisible, and primary medical aid has become a conduit through which ideology and modes of practice are transferred. However, the Paniya use biomedicine in an attempt to negotiate new forms of identity. Symbolic parallels between the ‘rituals’ of medicine and manthravady (black magic) facilitate movement between the two. However, specific practices within the manthravady ritual draw on deeply embedded cultural idioms that caution against the coercive influences of dominant groups and help the Paniya make sense of their place in the contemporary world.

This resource is to complement your learning, and introduce you to other perspectives on the topics under discussion. 'Binan Goonj: Bridging cultures in Aboriginal health is a comprehensive Indigenous health text which addresses key topics in a clear and accessible manner. It has been well documented that the health status of many Aboriginal people remains the poorest in Australia despite some many years of research, policies and interventions. The book explores the processes and practices which has created this situation and looks to provide practical strategies to work towards redressing it.

This article provides a new perspective with which to understand what for a half century has been known as the “placebo effect.” The authors argue that, as currently used, the concept includes much that has nothing to do with placebos, confusing the most interesting and important aspects of the phenomenon. They propose a new way to understand those aspects of medical care, plus a broad range of additional human experiences, by focusing on the idea of “meaning,” to which people, when they are sick, often respond. 

This Special Issue brings together five of the articles from this panel. It is international and cross-cultural in scope, including research undertaken in urban and rural Australia, Kenya and Denmark. 

Racial/ethnic disparities in health in the U.S. have been well described. The field of “cultural competence” has emerged as one strategy to address these disparities. Based on a review of the relevant literature, the authors develop a definition of cultural competence, identify key components for intervention, and describe a practical framework for implementation of measures to address racial/ethnic disparities in health and health care. Demographic changes anticipated over the next decade magnify the importance of addressing racial/ethnic disparities in health and health care. A framework of organizational, structural, and clinical cultural competence interventions can facilitate the elimination of these disparities and improve care for all Americans.

This brief document from The Australian Human Rights Commission provides insight and facts into Australia's cultural diversity.

This resource is to complement your learning, and introduce you to other perspectives on the topics under discussion. The purpose of this Report is to examine the ethical issues raised when research related to healthcare is carried out in developing countries and funded by sponsors from developed countries. Developing countries urgently need research to help to address the enormous burden of disease that they carry. The inequalities in resources between developed and developing countries pose a real risk of exploitation in the context of externally-sponsored research.

This resource is to complement your learning, and introduce you to other perspectives on the topics under discussion. This web link provides insight into WHO's ethical standards and procedures for research with human beings.

Many believe that informed consent makes clinical research ethical. However, informed consent is neither necessary nor sufficient for ethical clinical research. Drawing on the basic philosophies underlying major codes, declarations, and other documents relevant to research with human subjects, we propose 7 requirements that systematically elucidate a coherent framework for evaluating the ethics of clinical research studies: (1) value—enhancements of health or knowledge must be derived from the research; (2) scientific validity—the research must be methodologically rigorous; (3) fair subject selection—scientific objectives, not vulnerability or privilege, and the potential for and distribution of risks and benefits, should determine communities selected as study sites and the inclusion criteria for individual subjects; (4) favorable risk-benefit ratio—within the context of standard clinical practice and the research protocol, risks must be minimized, potential benefits enhanced, and the potential benefits to individuals and knowledge gained for society must outweigh the risks; (5) independent review—unaffiliated individuals must review the research and approve, amend, or terminate it; (6) informed consent—individuals should be informed about the research and provide their voluntary consent; and (7) respect for enrolled subjects—subjects should have their privacy protected, the opportunity to withdraw, and their well-being monitored. Fulfilling all 7 requirements is necessary and sufficient to make clinical research ethical.