Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice (...) behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed. (shrink)

Background and aim With the increasing interest in lifestyle, health and consequences of unhealthy lifestyles for the healthcare system, a new kind of solidarity is gaining importance: lifestyle solidarity. While it might not seem fair to let other people pay for the costs arising from an unhealthy lifestyle, it does not seem fair either to punish people for their lifestyle. However, it is not clear how solidarity is assessed by people, when considering disease risks or lifestyle risks. The aim of (...) this study was to investigate the degree of solidarity with lifestyle as well as with other factors that are related to health outcomes—for example, old age—and the relation between this degree of solidarity and various characteristics. Methods This cross-sectional study is part of the Dutch longitudinal SMILE study. Data on the degree of solidarity with different lifestyles and old age, and the relation between the degree of solidarity and various demographic and other variables were obtained in a questionnaire survey. Results Solidarity with smokers and overweight people was moderate, as was solidarity with older people. Respondents were ambivalent about athletes. Respondents who were younger, male and highly educated, and those with a healthy lifestyle, a small social network, high quality of life and an internal locus of control, showed low solidarity. Conclusions Solidarity with an unhealthy lifestyle and old age is moderate and the degree of solidarity varies among the different subgroups. (shrink)

Focusing on the grammar and vocabulary of virtue in Kierkegaard’s upbuilding works, it is argued that the Danish philosopher represents a Christian conception of the moral life that is distinct from but—contrary to Alasdair MacIntyre’s claim—not completely opposed to Aristotelian and Thomistic virtue ethics. Although the realities of sin and salvation transcend virtue ethics based purely on human nature, it is demonstrated that this does not prevent Kierkegaard from speaking constructively about human nature, its teleology (a teleological conception of the (...) self) and about the virtues. Yet, from a Christian “upbuilding” perspective, general features of human nature must be transformed profoundly, which implies more than a harmonious perfection or completion of nature (Aquinas), but less than the complete replacement of nature by grace. Since this can be seen as a particular contribution to virtue ethics, in this specific sense, Kierkegaard may be called a virtue ethicist. (shrink)

Background: Spirometry for early detection of chronic obstructive pulmonary disease and smoking cessation is criticised because of the potential negative effects of labelling with disease. Aim: To assess the effects of opinions of smokers with mild to moderate COPD on the effectiveness of spirometry for smoking cessation, the justification of early detection of airflow limitation in smokers and the impact of confrontation with COPD. Design: Qualitative study with data from a randomised controlled trial. Setting: General population of Dutch and Belgian (...) Limburg. Methods: Semistructured ethical exit interviews were conducted with 205 smokers who were motivated to quit smoking and had no prior diagnosis of COPD but were detected with airflows limitation by means of spirometry. They received either counselling, including labelling with COPD, plus with nortriptyline for smoking cessation, counselling excluding labelling with COPD, plus nortriptyline for smoking cessation or care as usual for smoking cessation by the general practitioner, without labelling with COPD. Results: Of the participants, 177 agreed or completely agreed that it is justified to measure lung function in heavy smokers. These participants argued that measuring lung function raises consciousness of the negative effects of smoking, helps to prevent disease or increases motivation to stop smoking. Most of the 18 participants who disagreed argued that routinely measuring lung function in smokers would interfere with freedom of choice. Conclusions: Labelling with disease is probably a less important issue in the discussion about the pros and cons of early detection of COPD. (shrink)

Vaccine research, as well as the development, testing, clinical trials, and commercial uses of vaccines involve complex processes with various biological data that include gene and protein expression, analysis of molecular and cellular interactions, study of tissue and whole body responses, and extensive epidemiological modeling. Although many data resources are available to meet different aspects of vaccine needs, it remains a challenge how we are to standardize vaccine annotation, integrate data about varied vaccine types and resources, and support advanced vaccine (...) data analysis and inference. To address these problems, the community-based Vaccine Ontology (VO) has been developed through collaboration with vaccine researchers and many national and international centers and programs, including the National Center for Biomedical Ontology (NCBO), the Infectious Disease Ontology (IDO) Initiative, and the Ontology for Biomedical Investigations (OBI). VO utilizes the Basic Formal Ontology (BFO) as the top ontology and the Relation Ontology (RO) for definition of term relationships. VO is represented in the Web Ontology Language (OWL) and edited using the Protégé-OWL. Currently VO contains more than 2000 terms and relationships. VO emphasizes on classification of vaccines and vaccine components, vaccine quality and phenotypes, and host immune response to vaccines. These reflect different aspects of vaccine composition and biology and can thus be used to model individual vaccines. More than 200 licensed vaccines and many vaccine candidates in research or clinical trials have been modeled in VO. VO is being used for vaccine literature mining through collaboration with the National Center for Integrative Biomedical Informatics (NCIBI). Multiple VO applications will be presented. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 525 "an awareness of its perfection in perfect sell-identity" stems from his own theological bias: if God is to be connected with the world, His thinking cannot be merely a thinking about itself; His mind must also contain the Ideas of the sensible world. The inconsistency is quite apparent in the concluding paragraph of the introductory chapter three on "SellKnowledge ": If we study chapters seven and (...) nine of Book Lambda against the background of these texts on the meaning of friendship, it becomes apparent that a fortiori God's thinking must concern his own being and that "the thinking of thinking" is the supreme form of self-knowledge. Far from being an objectless returning to oneself, this knowledge concerns the very being of the First Principle. It would also seem to fot|ow that iust as knowing a friend is a certain degree of self-knowledge because of the ontological kinship between the self and a friend, God, in knowing himself, also knows, to a certain degree, the essential principles of things in so far as he is the first being encompassing within himself the perfections which other beings possess. This would, however, not imply that the first being would know the world as distinct from himself or as dependent on himself (pp. 33-34). How can God (the Unmoved Mover) think only of Himself, and at the same time, to a certain degree (whatever this means) know also the essential principles of things, the perfections which other beings possess? And what textual justification is there for attributing this position to Aristotle? There are a number of errors in the text. Some of them are as follows: (1) On p. 21 Elders quotes from Laws 987b, in spite of the fact that the Laws ends on 969c. The passage referred to would have to be in Epinomis, but at 987b there is nothing of the text he quotes, to wit, vo~g ~v n0ooXQf3o0oa~E~0~tv 6006g 0~tv. (2) On p. 24, note 41, he correctly gives the text at 432a4 as ~ ~oggdSEo~xotg do0n~o~g x6 vo~x6 ~oxt but makes it mean: '~ere are phantasmata in which the intelligible things are contained." Evidently he confuses this with the passage at 431b1--4. (3) On p. 279, p~.~oxr should read p~i~.t~r (4) On p. 5, ~oo~v should read 6.~ao6v. K. W. Hsaa~oroN Emery University In Our Image and Likeness: Humanity and Divinity in Italian Humanist Thought. Two Volumes. By Charles Trinkaus. (Chicago: The University of Chicago Press, 1970. Pp. 985. $22.50) I. Since the appearance of Burckhardt's classic essay more than a century ago, three schools of thought have grown up around the problem of the nature and extent of humanism 's relationship to Christianity. The classic position, represented by Burckhardt, Symends, Dilthey, Gentile, Cassirer, Saitta, and others, has interpreted humanism as an essentiaUy anti-Christian, anti-scholastic, rationatistic, and individualistic phenomenon caught up in an overwhelming concern for attaining to historical greatness in this world. If religion has been considered at all (and it is usually left to take care of itself), it has been so reinterpreted as to become consistent with the interests of emerging secularism, liberalism, and modern science. Opposing the Burckhardtian position, however, is one originally associated with the work of Giuseppe Toffanin and, more recently, Hiram Haydn. Here, Renaissance humanism is seen to be fundamentaUy Catholic, orthodox, and traditional---the two movements joined in perfect harmony by a common concern for antiquity and universaiism, for Latinity, faith, and corporate elitism, and by a common opposition to democratic particularism, heresy, individualism, modernity, and the vernaculars. What makes these two positions extreme, however, is the existence of the largest, most 526 HISTORY OF PHILOSOPHY moderate, and most diversified camp. Originating with Thode, Pastor, Olgiati, and Joachimsen, among a host of others, it has encompassed the general view that humanism and Christianity are separate yet interrelated. For some, medieval Catholicism is not the antithesis but the fountainhead of Renaissance humanism--the religious cause of a secular effect. For others, humanism is a novel intellectual movement, but one yet operating within a still... (shrink)

Argues that Americans must improve their understanding of probability and logic.

Next SectionEvidence based medicine is rightly at the core of current medicine. If patients and society put trust in medical professional competency, and on the basis of that competency delegate all kinds of responsibilities to the medical profession, medical professionals had better make sure their competency is state of the art medical science. What goes for the ethics of clinical trials goes for the ethics of medicine as a whole: anything that is scientifically doubtful is, other things being equal, ethically (...) unacceptable. This particularly applies to so called orphaned fields of medicine, those areas where medical research is weak and diverse, where financial incentives are lacking, and where the evidence regarding the aetiology and treatment of disease is much less clear than in laboratory and hospital based medicine. Examples of such orphaned fields are physiotherapy, psychotherapy, medical psychology, and occupational health, which investigate complex syndromes such as RSI, whiplash, chronic low back pain, and chronic fatigue syndrome. It appears that the primary ethical problem in this context is the lack of attention to the orphaned fields. Although we agree that this issue deserves more attention as a matter of potential injustice, we want to argue that, in order to do justice to the interplay of heterogeneous factors that is so typical of the orphaned fields, other ethical models than justice are required. We propose the coordination model as a window through which to view the important ethical issues which relate to the communication and interaction of scientists, health care workers, and patients. (shrink)

This book argues that Protestant theological ethics not only reveals basic virtue ethical characteristics, but also contributes significantly to a viable contemporary virtue ethics. Pieter Vos demonstrates that post-Reformation theological ethics still understands the good in terms of the good life, takes virtues as necessary for living the good life and considers human nature as a source of moral knowledge. Vos approaches Protestant theology as an important bridge between pre-modern virtue ethics, shaped by Aristotle and transformed by Augustine of Hippo, (...) and late modern understandings of morality. The volume covers a range of topics, going from eudaimonism and Calvinist ethics to Reformed scholastic virtue ethics and character formation in the work of Søren Kierkegaard. The author shows how Protestantism has articulated other-centered virtues from a theology of grace, affirmed ordinary life and emphasized the need of transformation of this life and its orders. Engaging with philosophy of the art of living, Neo-Aristotelianism and exemplarist ethics, he develops constructive contributions to a contemporary virtue ethics. (shrink)

This is the first complete, one-volume English translation of the ancient Chinese text Xunzi, one of the most extensive, sophisticated, and elegant works in the tradition of Confucian thought. Through essays, poetry, dialogues, and anecdotes, the Xunzi articulates a Confucian perspective on ethics, politics, warfare, language, psychology, human nature, ritual, and music, among other topics. Aimed at general readers and students of Chinese thought, Eric Hutton’s translation makes the full text of this important work more accessible in English than ever (...) before. Named for its purported author, the Xunzi has long been neglected compared to works such as the Analects of Confucius and the Mencius. Yet interest in the Xunzi has grown in recent decades, and the text presents a much more systematic vision of the Confucian ideal than the fragmented sayings of Confucius and Mencius. In one famous, explicit contrast to them, the Xunzi argues that human nature is bad. However, it also allows that people can become good through rituals and institutions established by earlier sages. Indeed, the main purpose of the Xunzi is to urge people to become as good as possible, both for their own sakes and for the sake of peace and order in the world. In this edition, key terms are consistently translated to aid understanding and line numbers are provided for easy reference. Other features include a concise introduction, a timeline of early Chinese history, a list of important names and terms, cross-references, brief explanatory notes, a bibliography, and an index. (shrink)