Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

BackgroundObtaining informed consent for intravenous thrombolysis in acute ischemic stroke can be challenging, and little is known about if and how the informed consent procedure is performed by neurologists in clinical practice. This study examines the procedure of informed consent for intravenous thrombolysis in acute ischemic stroke in high-volume stroke centers in the Netherlands.MethodsIn four high volume stroke centers, neurology residents and attending neurologists received an online questionnaire concerning informed consent for thrombolysis with tissue-type plasminogen activator (tPA). The respondents were (...) asked to report their usual informed consent practice for tPA treatment and their considerations on whether informed consent should be obtained.ResultsFrom the 203 invited clinicians, 50% (n = 101) completed the questionnaire. One-third of the neurology residents (n = 21) and 21% of the neurologists (n = 8) reported that they always obtain informed consent for tPA treatment. If a patient is not capable of providing informed consent, 30% of the residents (n = 19) reported that they start tPA treatment without informed consent. In these circumstances, 53% of the neurologists (n = 20) reported that the resident under their supervision would start tPA treatment without informed consent. Most neurologists (n = 21; 55%) and neurology residents (n = 45; 72%) obtained informed consent within one minute. None of the respondents used more than five minutes for informed consent. Important themes regarding obtaining informed consent for treatment were patients’ capacity, and medical, ethical and legal considerations.ConclusionThe current practice of informed consent for thrombolysis in acute ischemic stroke varies among neurologists and neurology residents. If informed consent is obtained, most clinicians stated to obtain informed consent within one minute. In the future, a shortened information provision process may be applied, making a shift from informed consent to informed refusal, while still considering the patient’s capacity, stroke severity, and possible treatment delays. (shrink)

Selection on grandparental investment is more complex than Coall & Hertwig (C&H) propose. Patterns of investment are subject to an intergenerational conflict over how resources should be distributed to maximize fitness. Grandparents may be selected to distribute resources unevenly, while their descendants will be selected to manipulate investment in their own favor. Here we outline the evolutionary basis of this conflict.

The Statesman is Plato's neglected political work, but it is crucial for an understanding of the development of his political thinking. In some respects it continues themes from the Republic, particularly the importance of knowledge as entitlement to rule. But there are also changes: Plato has dropped the ambitious metaphysical synthesis of the Republic, changed his view of the moral psychology of the citizen, and revised his position on the role of law and institutions. In its presentation of the statesman's (...) expertise, the Statesman modifies, as well as defending in original ways, this central theme of the Republic. (shrink)

This edition of Martin Ostwald's revised version of J. B. Skemp's 1952 translation of _Statesman_ includes a new selected bibliography, as well as Ostwald's interpretive introduction, which traces the evolution in Plato's political philosophy from _Republic_ to _Statesman to Laws_--from philosopher-king to royal statesman.

INHALT: a. Besprechungen von J. P. Romangs Uber Willensfreiheit und Determinismus, 1835 - b. Anmerkungen zur [geplanten] 2. Auflage [des Lehrbuchs] der Religionswissenschaft - c. Materialien - d. Zur Athanasia - e. Zur Lebensbeschreibung - f. Herbarts System - g. Ein Vorschlag zur Vermeidung vieler Missverstandnisse in der Philosophie - h. Selbstanzeige der Wissenschaftslehre, 1837 - i. Skizze einer Anzeige der Logik fur die Freimuthigen Blatter - j. Uiber Hrn. Dr. und Prof. J. S. v. Drey Apologetik, 1838 - k. (...) Besprechung von J. A. Brunings Das Daseyn Gottes, 1838 - l. Einwurfe, die gegen Bolzano's Lehren bisher zum Vorschein gekommen, 1838 - m. Auseinandersetzung mit Notizen in Allgemeiner Religions- und Kirchenfreund und Kirchencorrespondent, 1839-1840 - n. Besprechung von M. Drobischs Neue Darstellung der Logik - o. Selbstanzeige von Prufung der Philosophie des seligen Georg Hermes, 1840 - p. Zur Biographie Stoppani's, 1848. (shrink)

In his celebrated masterpiece, Symposium, Plato imagines a high-society dinner-party in Athens in 416 BC at which the guests - including the comic poet Aristophanes and, of course, Plato's mentor Socrates - each deliver a short speech in praise of love. The sequence of dazzling speeches culminates in Socrates' famous account of the views of Diotima, a prophetess who taught him that love is our means of trying to attain goodness. And then into the party bursts the drunken Alcibiades, the (...) most popular and notorious Athenian of the time, who insists on praising Socrates himself rather than love, and gives us a brilliant sketch of this enigmatic character. The power, humour, and pathos of Plato's creation engages the reader on every page. This new translation is complemented by full explanatory notes and an illuminating introduction. (shrink)

"This edition, which replaces the original Loeb edition..., offers text, translation, and annotation that are fully current with modern scholarship"--Front flap of dust jacket, volume 1.

Artikelen en lezingen uit de periode 1970-1982.

Object-oriented ontologists understand relations of cause and effect to be sensory or aesthetic in nature, not involving direct interaction between objects. Four major arguments are used to defend an indirect view of causation: 1) that there are analogies between perception and causation, 2) that the indirect view can account for cases of causation which a direct view cannot, 3) an Occasionalist argument that direct interaction would make causation impossible, and 4) that the view simply fits better with object-oriented ontology’s own (...) premises. However, each argument is fallacious or otherwise unconvincing. The first affirms the consequent. The second fails because the relevant cases can easily be accounted for with a direct view. The third makes false assumptions about the relation between parts and wholes. And the fourth can also be used to argue against object-oriented ontology. Many of these problems can be traced to the methodological aspects of object-oriented ontology and might be avoided by emphasizing the role of non-argumentative justification in metaphysics. (shrink)

Despite the importance of the Judgement of Paris in the story of the Trojan War, theIliadhas only one explicit reference to it. This occurs, rather out of the blue, in the final book of the poem in a dispute among the gods about the treatment of Hector's body (24.25–30). Achilles keeps dragging the body around behind his chariot, but Apollo protects it with his golden aegis (24.18–21). Apollo then speaks among the gods and attacks the conduct of Achilles (24.33–54), claiming (...) at the end that he offends the dumb earth (24.54). Other gods too have their concerns about what is going on, and they keep trying to get Hermes to snatch the body away (24.23–4). The three most powerful divine enemies of Troy, however, Hera, Poseidon and Athena, will have none of this. They remain as hostile to Troy and Priam and his people as they ever were, and it is in this context that the Judgement of Paris is mentioned:ἔνθ' ἄλλοις μὲν πᾶσιν ἑήνδανɛν, οὐδέ πoθ' Ἥρῃοὐδὲ Ποσɛιδάων' οὐδὲ γλαυκώπιδι κούρῃ,ἀλλ' ἔχον ὥς σϕιν πρῶτον ἀπήχθɛτο Ἴλιος ἱρὴκαὶ Πρίαμος καὶ λαὸς Ἀλɛξάνδρου ἕνɛκ' ἄτης,ὃς νɛίκɛσσɛ θɛάς, ὅτɛ οἱ μέσσαυλον ἵκοντο,τὴν δ' ᾔνησ' ἥ οἱ πόρɛ μαχλοσύνην ἀλɛγɛινήν.(24.25–30)And this was pleasing to all the others, but never to Heranor to Poseidon, nor to the flashing-eyed maiden,but they remained hostile to sacred Ilios as in the beginning,and to Priam and to his people, because of Alexander's folly,he who insulted the goddesses when they came to his inner courtyardand praised her who provided his grievous lust. (shrink)

PLATO: PROTAGORAS, trans, with Notes by C. C. W. Taylor. Clarendon Press: O.U.P., 1976. vii+230 pp. £7.50 cloth, £3.75 paper.

Angelaki, Volume 18, Issue 4, Page 125-133, December 2013.

Quentin Meillassoux’s speculative materialism rests on the historical claim that European philosophy since Kant is “correlationist” in its denial that thought can know being as it is in itself rather than merely for us. But though the claim is central to Meillassoux, it has not been much explored in the literature on his work. This paper argues that Nietzsche does not fit so easily into Meillassoux’s story. Though there are certain superficially correlationist elements in Nietzsche’s thought, part of his core (...) project is an ethically motivated rejection of the issues with respect to which realism and correlationism are alternatives. Thus, rather than denying that thought can access being in itself, Nietzsche aims to leave behind ways of thinking within which the question of thought’s access or lack of access matters. This means that Meillassoux loses some of the motivation for his positive position. (shrink)

The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)

The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)

The protection of human subjects in biomedical research relies on two principal mechanisms: assessing and comparing the risks and potential benefits of proposed research, and obtaining potential subjects' informed consent. While these have been discussed extensively in the literature, no attention has been paid to whether the processes should be different when the objective of an experimental biomedical intervention is to improve individual appearance, performance, or capability rather than to prevent, cure, or mitigate disease . This essay examines this question (...) in order to ensure that subjects in biomedical enhancement research receive adequate protection. (shrink)

There are two critical steps in determining whether a medical experiment involving human subjects can be conducted in an ethical manner: assessing risks and potential benefits and obtaining potential subjects’ informed consent. Although an extensive literature on both of these aspects exists, virtually nothing has been written about human experimentation for which the objective is not to prevent, cure, or mitigate a disease or condition, but to enhance human capabilities. One exception is a 2004 article by Rebecca Dresser on preimplantation (...) genetic modification — one of the most controversial enhancement technologies — in which she states, “Under existing research ethics principles, it would be unethical for investigators to perform modifications exposing embryos expected to develop into healthy children to significant risk in exchange for a possible physical or mental enhancement.” But Dresser does not explain why such an experiment would be unethical under existing principles, and her conclusion is not self-evident. (shrink)

The United States, along with other nations and international organizations, has developed an elaborate system of ethical norms and legal rules to govern biomedical research using human subjects. These policies govern research that might provide direct health benefits to participants and research in which there is no prospect for participant health benefits. There has been little discussion, however, about how well these rules would apply to research designed to improve participants’ capabilities or characteristics beyond the goal of good health. When (...) mentioned at all in the literature, this so-called enhancement research, as opposed to research aimed at diagnosing, preventing, curing, or treating illnesses or medical conditions, is usually dismissed without explanation. (shrink)

There has been a rising interest in the study of Mary Wollstonecraft (1759-1797) in philosophy, political theory, literary studies and the history of political thought in recent decades. The Wollstonecraftian Mind seeks to provide a comprehensive survey of her work, not only placing it in its historical context but also exploring its contemporary significance. Comprising 38 chapters by a team of international contributors this handbook covers: the background to Wollstonecraft’s work Wollstonecraft’s major works the relationship between Wollstonecraft and other major (...) philosophers Wollstonecraftian philosophy Wollstonecraft’s legacy Essential reading for students and researchers in philosophy, Wollstonecraft’s work is central to the study of political philosophy, literature, French studies, political thought, and feminism. (shrink)

This book describes a program of research in computable structure theory. The goal is to find definability conditions corresponding to bounds on complexity which persist under isomorphism. The results apply to familiar kinds of structures (groups, fields, vector spaces, linear orderings Boolean algebras, Abelian p-groups, models of arithmetic). There are many interesting results already, but there are also many natural questions still to be answered. The book is self-contained in that it includes necessary background material from recursion theory (ordinal notations, (...) the hyperarithmetical hierarchy) and model theory (infinitary formulas, consistency properties). (shrink)

Banking, in common with other areas of finance, is often considered an amoral field focused purely on risk and return. However, ethics does have an important role to play, both traditionally and as business and banking evolve. Based on a speech to a European Union conference on financing small and medium–sized enterprises (SMEs), this paper seeks to provide an overview of ethics in banking using three terms. Integrity is important to generate the trust necessary for any banking system to flourish, (...) responsibility highlights contemporary banks’ need to take into account the consequences of their lending policies, and affinity refers to a set of relatively novel ways in which depositors and borrowers can be brought closer together than they are in conventional western banking. (shrink)

Banking, in common with other areas of finance, is often considered an amoral field focused purely on risk and return. However, ethics does have an important role to play, both traditionally and as business and banking evolve. Based on a speech to a European Union conference on financing small and medium–sized enterprises , this paper seeks to provide an overview of ethics in banking using three terms. Integrity is important to generate the trust necessary for any banking system to flourish, (...) responsibility highlights contemporary banks’ need to take into account the consequences of their lending policies, and affinity refers to a set of relatively novel ways in which depositors and borrowers can be brought closer together than they are in conventional western banking. (shrink)