Spectacular treatment disasters in recent years have made it clear that informal "let's-try-it-and-see" methods of testing new proposals are more risky now than ever before, and have led many to call for a halt to experimentation in clinical medicine. In this easy-tp-read, philosophical guide to human experimentation, William Silverman pleads for wider use of randomized clinical trials, citing many examples that show how careful trials can overturn preconceived or ill-conceived notions of a therapy's effectiveness and lead to a (...) clearer understanding of clinical anomalies. Because it gives careful guidance on setting up trials and avoiding conceptual pitfalls, this book will be of great interest to all epidemiologists and clinical statisticians, and to a wide varitey of clinicians, pharmacologists, and nurses. Since it requires no medical or statistical knowledge, it will also appeal to ethicists, lawyers, and the general public. (shrink)

Medicine is moving away from reliance on the proclamations of authorities to the use of numerical methods to estimate the size of effects of its interventions. But a rumbling note of uneasiness underlines present-day medical progress: the more we know, The more questions we encounter about what to do with the hard-won information. The essays in Where's the Evidence examine the dilemmas that have arisen as the result of medicine's unprecedented increase in technical powers. How do doctors draw the line (...) between "knowing" (the acquisition of new medical information) and doing" (the application of that new knowledge)? What are the long-term consequences of responding to the demand that physicians always do everything that can be done? Is medicine's primary aim to increase the length of life? Or is it to reduce the amount of pain and suffering? And who is empowered to choose when these ends are mutually exclusive? This engaging collection of essays will be of interest to professionals interested in the evidence-based medicine debate, including epidemiologists, neonatologists, those involved in clinical trials and health policy, medical ethicists, medical students, and trainees. (shrink)

Neonatal pediatrics has made stunning and completely unprecedented progress in recent years. Nonetheless, an increasing number of voices now ask, Where is this field of medicine going? Is it, dare one ask, even headed in the right direction? These are reasonable questions, but first we need to know where this subspecialty of pediatrics has been. The current phenomenon is all the more remarkable because it differs so completely from the past.

Game of Thrones is a popular, award-winning television series with an eight-season run on Home Box Office, based on the Song of Fire and Ice series of books by George R.R. Martin. It depicts a morally complex political situation in a fantasy environment that has some similarities to medieval Europe. In the midst of this setting, the series advocates a cynical attitude towards politics, social structures, and religion. Most notably, the series suggests that there is no such thing as political (...) legitimacy. This chapter identifies a pattern of cynicism throughout Game of Thrones but points towards the thoughts of John Locke and Thomas Aquinas as possible alternatives to the story’s cynicism. (shrink)

Providing the most thorough coverage available in one volume, this comprehensive, broadly based collection offers a wide variety of selections in four major genres, and also includes a section on film. Each of the five sections contains a detailed critical introduction to each form, brief biographies of the authors, and a clear, concise editorial apparatus. Updated and revised throughout, the new Fourth Edition adds essays by Margaret Mead, Russell Baker, Joan Didion, Annie Dillard, and Alice Walker; fiction by Nathaniel Hawthorne, (...) Ursula K. LeGuin, Anton Chekov, James Joyce, Katherine Mansfield, F. Scott Fitzgerald, William Faulkner, Alice Walker, Louise Erdrich, Donald Barthelme, and James McPherson; poems by John Donne, Robert Browning, Walt Whitman, Edwin Arlington Robinson, e.e. cummings, Langston Hughes, W.H. Auden, Philip Levine, and Louise Gluck; and plays by August Wilson, Marsha Norman, Wendy Wasserstein, and Vaclav Havel. The chapter devoted to film examines the relation of film to literature and gives the complete screenplay for Citizen Kane plus close analysis of a scene from the film. With its innovative structure, comprehensive coverage, and insightful and stimulating presentation of all kinds of literature, this is an anthology readers will turn to again and again. (shrink)

This is a brief review of Silverman's study of Plato's ontology, in particular his theory of Forms. Silverman writes from an analytic viewpoint. He accepts the developmentalist picture of Plato's thought, but holds that the development is gradual. He focuses on the issue of predication, and especially self-predication. He tends to treat Plato's ontology as a free-standing subject. All of these features are controversial. I wondered in particular whether the analytic approach required more precision than can be found (...) in the dialogues. (shrink)

v. 1. Medieval and early classical science.--v. 2. Classical and contemporary science.

Objective To determine the attitudes of Egyptian patients regarding their participation in research and with the collection, storage and future use of blood samples for research purposes. Design Cross-sectional survey. Study population Adult Egyptian patients (n=600) at rural and urban hospitals and clinics. Results Less than half of the study population (44.3%) felt that informed consent forms should provide research participants the option to have their blood samples stored for future research. Of these participants, 39.9% thought that consent forms should (...) include the option that future research be restricted to the illness being studied. A slight majority (66.2%) would donate their samples for future genetic research. Respondents were more favourable towards having their blood samples exported to other Arab countries (62.0%) compared with countries in Europe (41.8%, p<0.001) and to the USA (37.2%, p<0.001). Conclusions This study shows that many individuals do not favour the donation of a blood sample for future research. Of those who do approve of such future research, many favour a consent model that includes an option restricting the future research to the illness being studied. Also, many Egyptians were hesitant to have their blood samples donated for genetic research or exported out of the Arab region to the USA and European countries. Further qualitative research should be performed to determine the underlying reasons for many of our results. (shrink)

We review the psychological literature on the organization of valence, discussing theoretical perspectives that favor a single dimension of valence, multiple valence dimensions, and positivity and negativity as dynamic and flexible properties of mental experience that are contingent upon context. Turning to the neuroscience literature that spans three levels of analysis, we discuss how positivity and negativity can be represented in the brain. We show that the evidence points toward both separable and overlapping brain systems that support affective processes depending (...) on the level of resolution studied. We move from large-scale brain networks that underlie generalized processing, to functionally specific subcircuits, finally to intraregional neuronal distributions, where the organization and interaction across levels allow for multiple types of valence and mixed evaluations. (shrink)

Brief thumbnail sketches capture group interest and show the relevance of ethical considerations in real life situations. Bill Bain has considerable experience of business and is currently a PhD student at the Management School of London University's Imperial College, 53 Prince's Gate, Exhibition Road, London SW7 2PG.

I have before me a letter dated January 5, 2000 from Bradford Wilson, the executive director of the NAS. It begins, “I really enjoyed your contribution to the recent symposium in the January issue of First Things, so much so that I’ve also decided to invite you to join the NAS. Many of your fellow contributors including Robert George, Jeffrey Satinover, and Father Neuhaus are among our current members, and I think you’d find it well worth your while if you (...) joined ranks with us yourself.”. (shrink)

Contemporary thinkers who address the problem of causal relations generally favor Hume’s analysis, although some periodically manifest interest in Aristotle’s exposition as an important and viable alternative. Few, however, find among the many philosophers who came between Aristotle and Hume any worthwhile contributor to the development of this problematic. Some might note, for example, Nicholas of Autrecourt as a medieval precursor of Hume, but this merely keeps the discussion fluctuating between the same two poles. This essay aims to call attention (...) to a different and intermediate view, not hitherto noted, that was proposed in the High Middle Ages by Thomas Aquinas. It argues that Aquinas made a significant advance beyond Aristotle in his analysis of antecedent causation, and thereby made possible the certification of some elements in Hume’s analysis, without subscribing to its more extreme results. In so doing, moreover, Aquinas adumbrated some problems in contemporary analytic discussions of the causal relationships between events, and consequently may shed light on their solution. (shrink)

Microbial ecology is flourishing, and in the process, is making contributions to how the ecology and biology of large organisms is understood. Ongoing advances in sequencing technology and computational methods have enabled the collection and analysis of vast amounts of molecular data from diverse biological communities. While early studies focused on cataloguing microbial biodiversity in environments ranging from simple marine ecosystems to complex soil ecologies, more recent research is concerned with community functions and their dynamics over time. Models and concepts (...) from traditional ecology have been used to generate new insight into microbial communities, and novel system-level models developed to explain and predict microbial interactions. The process of moving from molecular inventories to functional understanding is complex and challenging, and never more so than when many thousands of dynamic interactions are the phenomena of interest. We outline the process of how epistemic transitions are made from producing catalogues of molecules to achieving functional and predictive insight, and show how those insights not only revolutionize what is known about biological systems but also about how to do biology itself. Examples will be drawn primarily from analyses of different human microbiota, which are the microbial consortia found in and on areas of the human body, and their associated microbiomes (the genes of those communities). Molecular knowledge of these microbiomes is transforming microbiological knowledge, as well as broader aspects of human biology, health and disease. (shrink)

A summary of basics for student and seminarian.

The study of the Second Sophistic is a relative newcomer to the Anglophone field of classics, and much of what characterizes it temporally and culturally remains a matter of legitimate contestation. This Handbook offers a diversity of scholarly voices that attempt to define the state of this developing field. Included are chapters that offer practical guidance on the wide range of valuable textual materials that survive, many of which are useful or even core to inquiries of particularly current interest (e.g., (...) gender studies, cultural history of the body, sociology of literary culture, history of education and intellectualism, history of religion, political theory, history of medicine, cultural linguistics, intersection of the classical traditions and early Christianity). (shrink)

We examined the relationship between leader behavioral integrity and leader behavioral courage using data from two studies. Results from Study 1, an online experiment, indicated that behavioral manifestations of leader behavioral integrity and situational adversity both have direct main effects on behavioral manifestations of leader courage. Results from Study 2, a multisource field study with practicing executives, indicated that leader behavioral courage fully mediates the effects of leader behavioral integrity on leader performance and leader executive image. Implications of these findings (...) and future directions are discussed. (shrink)

This essay focuses on what I shall call “cosmopolitan altruism”—the motivationally effective desire to assist needy or endangered strangers. Section I describes recent research that confirms the existence of this phenomenon. Section II places it within interlocking sets of moral typologies that distinguish among forms of altruism along dimensions of scope, interests risked, motivational source, and baseline of moral judgment. Section III explores some of the relationships between altruism—a concept rooted in modern moral philosophy and Christianity—and the understanding of virtue (...) and friendship characteristic of Aristotelian ethical analysis. Finally, Section IV argues that cosmopolitan altruism does not represent moral progress simpliciter over other, less inclusive views, and that the widening of moral sympathy to encompass endangered strangers entails significant moral costs. (shrink)

Research using economic decision-making tasks has established that direct reciprocity plays a role in prosocial decision-making: people are more likely to help those who have helped them in the past. However, less is known about how considerations of mutual exchange influence decisions even when the other party’s actions are unknown and direct reciprocity is therefore not possible. Using a two-party economic task in which the other’s actions are unknown, study 1 shows that prosociality critically depends on the potential for mutual (...) exchange; when the other person has no opportunity to help the participant, prosocial behavior is drastically reduced. In study 2, we find that theories regarding the other person’s intentions influence the degree of prosociality that participants exhibit, even when no opportunity for direct reciprocity exists. Further, beliefs about the other’s intentions are closely related to one’s own motivations in the task. Together, the results support a model in which prosociality depends on both the social conditions for mutual exchange and a mental model of how others will behave within these conditions, which is closely related to knowledge of the self. (shrink)

This book is a major contribution to the current theory of liberalism by an eminent political theorist. It challenges the views of such theorists as Rawls, Dworkin, and Ackerman who believe that the essence of liberalism is that it should remain neutral concerning different ways of life and individual conceptions of what is good or valuable. Professor Galston argues that the modern liberal state is committed to a distinctive conception of the human good, and to that end has developed characteristic (...) institutions and practices - representative governments, diverse societies, market economies, and zones of private action - in the pursuit of specific public purposes that give unity to the liberal state. These purposes guide liberal public policy, shape liberal justice, require the practice of liberal virtues, and rest on a liberal public culture. Consequently the diversity characteristic of liberal societies is limited by their institutional, personal, and cultural preconditions. (shrink)

This book is the first detailed reconstruction of the late work of John Rawls, who was perhaps the most influential philosopher of the twentieth century. Rawls's 1971 treatise, A Theory of Justice, stimulated an outpouring of commentary on 'justice-as-fairness,' his conception of justice for an ideal, self-contained, modern political society. Most of that commentary took Rawls to be defending welfare-state capitalism as found in Western Europe and the United States. Far less attention has been given to Rawls's 2001 book, Justice (...) as Fairness: A Restatement. In the Restatement, Rawls not only substantially reformulates the 'original position' argument for the two principles of justice-as-fairness but also repudiates capitalist regimes as possible embodiments. Edmundson further develops Rawls's non-ideal theory, which guides us when we find ourselves in a society that falls well short of justice. (shrink)

The use of mathematical models to support decision making is proliferating in both the public and private sectors. Advances in computer technology and greater opportunities to learn the appropriate techniques are extending modeling capabilities to more and more people. As powerful decision aids, models can be both beneficial or harmful. At present, few safeguards exist to prevent model builders or users from deliberately, carelessly, or recklessly manipulating data to further their own ends. Perhaps more importantly, few people understand or appreciate (...) that harm can be caused when builders or users fail to recognize the values and assumptions on which a model is based or fail to take into account all the groups who would be affected by a model's results. This volume provides a setting for a dialogue about ethics and shows the need to continue and define a vocabulary for exploring ethical concerns. It will become increasingly important for model builders and users to have a clear and strong code of ethics to guide them in making the ethical decisions they surely will have to face. (shrink)