This paper examines the concept of ‘openness with patients’ from the stand-point of the limitations of biomedical ethics. Initially we review contemporary critiques of bioethics and, in particular, of principlism; we relate how other; somewhat neglected, forms of medical ethics can yield useful information and provide moral guidance.The main section of the paper then shows how a bioethical approach to openness misses the social context in our example, the viewpoints of patients; we present some of the increasing wealth of research (...) evidence which points towards patients wanting more information and a greater degree of openness.Finally we put forward that a principlist’s objection to active encouragement of openness might be based on the risk of infringing upon the ‘right not to know’. We reject this by arguing how rights can be trumped. (shrink)

The similarity of documents in a large database of published Fractals articles was examined for redundancy. Three different text matching techniques were used on publisheds to identify redundancy candidates, and predictions were verified by reading full text versions of the redundancy candidate articles. A small fraction of the total articles in the database was judged to be redundant. This was viewed as a lower limit, because it excluded cases where the concepts remained the same, but the text was altered substantially.Far (...) more pervasive than redundant publications were publications that did not violate the letter of redundancy but rather violated the spirit of redundancy. There appeared to be widespread publication maximization strategies. Studies that resulted in one comprehensive paper decades ago now result in multiple papers that focus on one major problem, but are differentiated by parameter ranges, or other stratifying variables. This ‘paper inflation’ is due in large part to the increasing use of metrics (publications, patents, citations, etc) to evaluate research performance, and the researchers’ motivation to maximize the metrics. (shrink)

Die demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im deutschen Gesundheitswesen in Zukunft weiter verschärfen. Soll nicht nur kurzfristig akuten Sparzwängen ausgewichen werden, steht – wie in verschiedenen Ländern bereits geschehen – auch Deutschland auf Dauer eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Eines der seit einiger Zeit häufig öffentlich zitierten Kriterien der Verteilung von Mitteln in der Gesundheitsversorgung ist die Eigenverantwortung von Patienten. Deren Berücksichtigung in der Allokation (...) von Ressourcen birgt allerdings zahlreiche Probleme. Der vorliegende Beitrag untersucht die gerechtigkeitstheoretischen Grundlagen und die praktischen Probleme bzw. die möglichen Konsequenzen von Eigenverantwortung als Verteilungskriterium im Gesundheitswesen. Auf der Grundlage eines alternativen gerechtigkeitstheoretischen Vorschlags werden drei Möglichkeiten skizziert, Eigenverantwortung von Patienten im deutschen Gesundheitswesen in gerechter Weise stärker zu betonen. (shrink)

The ability to reason independently from one's own goals or beliefs has long been recognised as a key characteristic of the development of formal operational thought. In this article we present the results of a study that examined the correlates of this ability in a group of 10-year-old children ( N = 61). Participants were presented with conditional and relational reasoning items, where the content was manipulated such that the conclusion to the arguments were either congruent, neutral, or incongruent with (...) beliefs, and either logically valid or logically invalid. Participants also received a measure of working memory capacity (the counting span task) and a measure of inhibitory control (the stop signal task). Indices of belief bias and logical reasoning on belief-based problems were predicted independently by both measures. In contrast logical reasoning on belief neutral problems was predicted by working memory alone. The findings suggest that executive functions play a key role in the development of children's ability to decontextualise their thinking. (shrink)

The use of placebo in clinical trials has been repeatedly challenged as being unacceptable from an ethical point of view. The present paper responds to this criticism by taking up the issue in the light of the pertinent provisions of the Helsinki Declaration. Examples from different therapeutic areas are given that highlight the importance of placebo in situations in which its use is acceptable according to the Declaration. Particular emphasis is given to the question of active control trials, which, under (...) conditions of low assay sensitivity, may become an ethically less acceptable approach than the use of a placebo control. (shrink)

Sarah A. Mattice develops a comparative intervention in contemporary metaphilosophy. Drawing on resources from hermeneutics, cognitive linguistics, aesthetics, and Chinese philosophy, she explores how philosophical language is deeply intertwined with the definition and practice of the discipline.

Este manuscrito apresenta um ponto de vista sobre o conhecimento da origem do cosmos. A ciência afirma que o Universo teve um começo com o tempo, mas também declara que nenhuma lei natural pode ser aplicada no tempo inicial. Considerando que se trata de algo exclusivo da ciência divina, sugere-se então a instrumentalidade da fé para se conhecer aquilo que de fato é relevante sobre o início da história.

Séculos de intenso trabalho no discurso da origem da vida levaram a ciência a nenhuma descoberta significativa. As teorias mais progressivas se estagnaram no problema central da origem da informação genética, inimaginavelmente distante de qualquer concepção humana. Aparentemente o Criador reservou para si o conhecimento absoluto deste extraordinário acontecimento. Mas há algo surpreendente nessa investigação que está ao alcance do homem.

Este artigo contém um estudo sobre a Ciência a partir do ponto de vista bíblico, por meio da fé na revelação divinamente inspirada. A Bíblia revela a origem e a plenitude da Ciência no ato da criação do Universo e a apresenta como uma dádiva especial de Deus aos homens. As Escrituras também demonstram que a Ciência genuína existe para glorificar a Deus, sendo a sua instrumentalidade uma forma excelente de comunicação divina.

This paper examines some of the possible legal implications of the production, marketing and use of expert systems. The relevance of a legally useful definition of expert systems, comprising systems designed for use both by laymen and professionals, is related to the distinctions inherent in the legal doctrine underlying provision of goods and provision of services. The liability of the sellers and users of, and contributors to, expert systems are examined in terms of professional malpractice as well as product liability. (...) A recurring theme indicates that legislators may be inclined to restrict possibilities of liability suits in order to avoid disincentives to the creation of expert systems. (shrink)

A great variety of medical conditions are subject to the placebo effect. Although there is mounting evidence to suggest that the placebo effect is related to the expectation of clinical benefit, little is still known about the biochemical bases underlying placebo responses. Positron emission tomography studies have recently shown that the placebo effect in Parkinson’s disease, pain, and depression is related to the activation of the limbic circuitry. The observation that placebo administration induces the release of dopamine in the ventral (...) striatum of patients with Parkinson’s disease suggests a link between the placebo effect and reward mechanisms. In addition to Parkinson’s disease, the placebo-reward model may also apply to other disorders. However, the relative contribution of the different neurotransmitters and neuropeptides that are known to be involved in modulating the activity of the limbic system may be disease-specific. Thus, while the placebo-induced clinical benefit observed in Parkinson’s disease would mostly reflect the release of dopamine in the dorsal striatum, the activation of opioid and serotonin pathways could be particularly implicated in mediating placebo responses encountered in pain and depression, respectively. (shrink)

Bei der „terminalen Sedierung“ wird ein unheilbar kranker und schwer leidender Patient für den Rest seines Lebens in ein tiefes Koma versetzt. Das hierzu verwendete Morphin bzw. Midazolam kann lebensverkürzend wirken. Ist dies also eine Maßnahme, die das Leben des Patienten beendet, auf seinen Wunsch hin oder nicht? Gewöhnlich wird diese Frage mit nein beantwortet, wenn die lebensverkürzende Wirkung nur vorhersehbar, aber nicht beabsichtigt ist. Allerdings ist der Zugang der Menschen auch zu ihren eigenen Intentionen fallibel, so dass sogar ihre (...) Selbstangaben in komplexen Fällen nicht sehr zuverlässig sind. Wenn ein Arzt sagt, dass er „beabsichtigt“, das Leben eines Patienten zu verkürzen, meint er damit möglicherweise nur, dass dieses vorhersehbare Ergebnis ein erwünschtes ist. Diese Art der Einschätzung kann nicht als solche moralisch diskreditiert werden, weil sie bei anderen allgemein akzeptierten Entscheidungen unvermeidlich ist, z. B. von einer „vergeblichen“ Behandlung Abstand zu nehmen. Legitimerweise können wir von einem Fachmann erwarten, dass er begründet handelt. Deshalb sollte unsere Klassifikation von ärztlichem Handeln als „terminale Sedierung“ oder „Beendigung des Lebens des Patienten“ nicht von den Intentionen des Arztes abhängen, sondern von den in dieser speziellen Krankheitsphase bei diesem speziellen Patienten verwendeten Dosierungen. (shrink)

Through case studies that highlight the type of information that is seldom reported in the news, Faces of Environmental Racism exposes the type and magnitude of environmental racism, both domestic and international. The essays explore the justice of current environmental practices, asking such questions as whether cost-benefit analysis is an appropriate analytic technique and whether there are alternate routes to sustainable development in the South.

McTaggart's ideas on the unreality of time as expressed in "The Nature of Existence" have retained great interest for many years for scholars, academics and other philosophers. In this essay, there is a brief discussion which mentions some of the high points of this philosophical interest, and goes on to apply his ideas to modern physics and neuroscience. It does not discuss McTaggart's C and D series, but does emphasise how the use of derived versions of both his A and (...) B series can be of great virtue in discussing both the abstract physics of time, and the present and future importance of McTaggart's ideas to the subject of time. Indeed an experiment using human volunteers and dynamic systems modelling which was carried out is described, which illustrates this fact. The Many Bubble Interpretation, which also derives from McTaggart's ideas, is discussed and various examples of its use and effectiveness are referred to. The Schrodinger Cat paradox is essentially resolved in principle, the quantum Zeno effect interpretable, Kwiat's recent result referred to, and the newly discovered reverse Stickgold effect described. (shrink)

Historically, scientists in training have learned the rules of ethical conduct by the example of their advisors and other senior scientists and by practice. This paper is intended to serve as a guide for the beginning scientist to some fundamental principles of scientific research ethics. The paper focuses less on issues of outright dishonesty or fraud, and more on the positive aspects of ethical scientific behavior; in other words, what a scientist should do to maintain a high level of ethical (...) conduct in research.There are a number of fairly specific rules, guidelines, or commonly accepted operating principles that have evolved for the ethical conduct of science. In order to discuss this code of ethics, this paper is divided into sections dealing with specific areas of scientific ethics. These areas are: data collection and storage, ownership of data, confidentiality, communication, authorship, collaboration, the peer review system, and rules of dealing with ethical complaints. Illustrative case histories are presented to provide examples of the type of ethical dispute or problem being discussed. If scientific trainees learn the accepted rules of behavior that govern the conduct of science, ethical problems that arise out of ignorance, misunderstanding, or poor communication can be avoided. (shrink)

ABSTRACT Many people now believe that human reproductive cloning – once sufficiently safe and effective – should be permitted on the grounds that it will allow the otherwise infertile to have children that are biologically closely related to them. However, though it is widely believed that the possession of a close genetic link to our children is morally significant and valuable, we argue that such a view is erroneous. Moreover, the claim that the genetic link is valuable is pernicious; it (...) tends to give rise to highly undesirable consequences, and therefore should be combated rather than pandered to. The emphasis on the genetic is unwarranted and unfortunate; rather than giving us moral reason to support reproductive cloning in the case of infertility, the fact that cloning requests are likely to be motivated by the genetic argument gives us reason to oppose its availability. (shrink)

Selection theory requires multiple, distinct, simultaneously-actualized states. In cognition, each thought or cognitive state changes the 'selection pressure' against which the next is evaluated; they are not simultaneously selected amongst. Creative thought is more a matter of honing in a vague idea through redescribing successive iterations of it from different real or imagined perspectives; in other words, actualizing potential through exposure to different contexts. It has been proven that the mathematical description of contextual change of state introduces a non-Kolmogorovian probability (...) distribution, and a classical formalism such as selection theory cannot be used. This paper argues that creative thought evolves not through a Darwinian process, but a process of context-driven actualization of potential. (shrink)

The WHO Commission on the Social Determinants of Health revealed that there is a 28-year disparity between the life expectancy in the poorest postcode and the richest postcode of Glasgow (CSDH, 2008). There are two sets of questions that it is important to ask about health inequalities like these: first, epidemiological questions about the mechanisms that cause inequalities in health and the measures that are effective in reducing them. Second, normative questions about which inequalities in health are wrong and why (...) they are wrong. The papers in this symposium result from the inaugural conference of UCL's Centre for Philosophy, Justice and Health (CPJH) and focus on the relationship between these epidemiological and normative questions. (shrink)

The contemporary debate centering round the circumference of feminist discourse has of late been very potent in addressing the issues of certain prejudiced notions in our existing patriarchal structure. This paper is an attempt to show the ongoing paradox existing in the world of feminism which has thoroughly critiqued the patriarchal culture and has naturalized sexual identities, thereby glorifying man’s supremacy and dominion. The patriarchal culture lionized the ideals of brevity, courageousness, and intellect and thought of these as the only (...) special possessions of man in society. The qualities of being submissive, kind and caring in nature is considered to be “ideal” and exclusive qualities of a woman. Even though these qualities are “ideal” to women, they are discarded from being considered as universal in nature and are thought of as insignificant in the mainstream societal structure. These qualities are treated as inferior, and exclusively womanly and hence cannot make their stand in the conventional patriarchal social order. For this reason a dilemmatic situation arises here. My effort is to show that this dilemma cannot be exposed in the sense of gender specific human qualities. (shrink)

This article starts off with a historical section showing that deep disagreements among notions of social and political justice are a characteristic feature of the history of political thought. Since no agreement or consensus on distributive justice is possible, the article argues that political philosophers should – instead of continuously proposing new normative theories of justice – focus on analyzing the reasons, significance, and consequences of such kinds of disagreements. The next two sections are analytical. The first sketches five possible (...) reasons for deep disagreements among notions of social and political justice. The second discusses the meta-ethical relevance of the lack of consensus on justice and rejects ethical realism and cognitivism based on the argument from deep disagreements. (shrink)

A few weeks ago I received a copy of the PHILOSOPHICAL STUDIES, containing a review of my book John Henry Newman, Our Way to Certitude, written by Fr. Boekraad. It was very unfavourable so that anybody reading it is sure to make up his mind never to buy the book.

Eines der medizinischen Felder, in dem die ethische Diskussion um die „wunscherfüllende Medizin“ am intensivsten geführt wird, ist die Reproduktionsmedizin, die die Erfüllung des „Kinderwunsches“ verspricht. Strittig ist besonders, ob Sterilität als Krankheit definiert wird, die eine medizinische Intervention rechtfertigt, ob sich aus der Sterilität oder Infertilität lediglich ein Abwehr- oder auch ein positives Anspruchsrecht auf medizinische Ressourcen ergibt, ob legitime Fortpflanzungsmedizin Grenzen hat. Nach einer Übersicht über Eckpunkte der nationalen und internationalen Debatte beschreiben wir im zweiten Teil Ansichten zum (...) Status ungewollter Kinderlosigkeit, zum Recht auf Fortpflanzungsmedizin und zur möglichen Legitimität ihrer Begrenzung anhand der Ergebnisse unserer vom Bundesministerium für Bildung und Forschung (BMBF) geförderten Studien. Während der letzten fünf Jahre haben wir u. a. Paare mit und ohne Sterilitätsproblematik sowie verschiedene Expertengruppen qualitativ und standardisiert befragt. Die stark divergierenden Auffassungen konfrontieren wir im dritten Abschnitt mit internationalen Standards, zum anderen mit dem „Capability-Ansatz“ und dem freiheitsfunktionalen Liberalismus von Sen und Pauer-Studer. Dies ergibt, dass die Bereitstellung verschiedener Möglichkeiten der In-vitro-Fertilisations-(IVF-)Behandlung nicht lediglich einen Wunsch auf Elternschaft erfüllt sondern als die gesollte Erfüllung eines normativen Bedürfnissanspruchs begriffen werden muss. (shrink)

How an abstract immaterial being is connected to a physical thing has been viewed variously by western philosophers who considered the issue prior to their Muslim counterparts.Muslim theologians and philosophers, however, developed the related discussions which became heated following the translation of logical books and essays throughout the Translation Era.The focus of this article, besides clarifying the ideas raised by Muslim philosophers in this regard,is to shed light on Mulla Sadra's opinion and its influence on the later philosophers, Abd-ul-Razzaq Lahiji (...) in particular.To explain his opinion,Mulla Sadra primarily brings a proof to establish the unity of the soul,and to prove this,he has refuted the reasons used by the opposing philosophers through negation and affirmation.Using negation,he comments on why there can't be a unity of soul, and then refers to his opponent's inability to distinguish between specific unity and generic unity considering the latter equal to vegetable,animal and human spirits.Soul and body,Mulla Sadra reiterates,are attached to each other in two ways; in one way,soul is attached to body and yet it is contingent on itself and not on the person's being; in the other way,soul is attached to body while the person's potentialities are actualized; this second type of attachment relates to obtaining existential virtues.It must be noted that Mulla Sadra's belief in these two types of attachment results from his belief in the trans-substantial motion in which soul is also involved.Mulla Sadra works out a solution to the question of relation between soul and body and their effects on one another by proposing the mediation of a veiled spirit, since the soul which belongs to a world of pure light does not involve itself directly in the affairs of the dark body. The veiled spirit is as subtle as the non-material soul and as corporeal as it needs in connectionwith body.This view has been argued by Allameh Tabatabii who thinks corporeal qualities and ontological status must be kept separated and not be mixed.Lahiji,on the other hand, seems to have accepted Mulla Sadra's idea looking at it as a philosophical question,not a medical case. He,like Mulla Sadra, while considering unity for soul, thinks of it as having properties such as sensation imagination estimation intellection. According to Lahiji,the unity of soul and body is like the unity of matter and form; however,unlike natural forms,it does not subsist in matter and interestingly,this notion resembles Neo-Platonist views. (shrink)

Various facets of the MBI are discussed, and how it can be used in connection with experimental philosophy, experimental psychology and neuroscience. Brief historical references are given. The large implications of the MBI with regards to McTaggart's paradox and the resolution of the difficulties with quantum mechanics is mentioned. Later sections deal with the mereological fallacy, multiple universes, teletransportation, mind cloning and mind splitting. Dreamwork is chosen as a prime example of the use of the MBI and recent work by (...) Tononi and Baars is referred to. (shrink)

Este artigo tem por objetivo levantar um debate a respeito da legalização da prática abortiva no Brasil, em razão do Projeto de Lei nº 1.135/91, ainda em trâmite no Congresso Nacional, que pretende a legalização do aborto, até momentos antes do parto. Apresenta-se, de forma introdutória, a problemática do discurso do aborto frente ao Projeto de Lei nº 1.135/91. Para tanto, apresenta-se um discussão sobre a universalidade da vida, o aborto no código penal brasileiro, a questão do avanço do aborto (...) na realidade brasileira, aborto versus Vida, a proibição da pena de morte e a legalização do aborto no Brasil e o Projeto de Lei nº 1.135/91 no Brasil. Conclui-se afirmando que se espera que no Brasil a sociedade reconheça a gravidade da descriminalização do aborto e cobre do Estado seus direitos fundamentais, principalmente o direito a vida. (shrink)

O objetivo desse artigo é realizar uma revisitação, ou seja, uma tentativa de construir um diálogo entre o princípio da sacralidade da vida e o aborto. São apresen-tados quatro motivos para realizar esse diálogo. O primeiro é o fato de constante-mente o cristianismo e especialmente a Igreja Católica ser acusada de ter criado o princípio da sacralidade da vida. O segundo é o fato de que fundações multibilionárias planejam impor o aborto ao mundo até o ano de 2025. O terceiro (...) é que em muitos países o aborto foi legalizado por meio de medida judicial. O quarto é o fato de o Estado possuir uma taxa de nascimentos ideal. Após essa apresentação, são cons-truídas três reflexões sobre o tema. A primeira é que o princípio da sacralidade da vida não é uma construção ou invenção da Igreja Católica. A segunda é a dimensão da dignidade humana dentro das atuais pré-ocupações do Estado. A terceira é a crise do indivíduo. Por fim, afirma-se que a vida continua sendo um mistério para o ser humano. E este mistério carrega, em seu ventre, grande parcela do sagrado. A atual ideologia que propaga o aborto, como forma terapêutica do homem resolver seus problemas, não passa de pura alienação que nega a sacralidade da vida e, em seu lugar, deixa apenas um homem descarnado de sua própria dignidade. (shrink)