Participants in clinical research sometimes view participation as therapy or exaggerate potential benefits, especially in phase I or phase II trials. We conducted this study to discover what methods might improve cancer patients’ understanding of early-phase clinical trials. We randomly assigned 130 cancer patients from three U.S. medical centers who were considering enrollment in a phase I or phase II cancer trial to receive either a multimedia intervention or a National Cancer Institute pamphlet explaining the trial and its purpose. Intervention (...) participants were 32 times more likely to believe that the trial’s purpose was to examine safety and 60 % less likely to believe they would experience long-term benefit or cure. There was no difference in enrollment decision. However, while patients’ understanding of the trial’s purpose improved and expectations of long-term benefit diminished, half the respondents still believed they would experience long-term benefit or cure from participation. Therefore, we conclude that multimedia interventions such as this one may help oncologists to explain the risks and benefits of early-phase cancer trials in a way that patients can more easily understand, helping them to make more informed decisions about participation. But further research into other factors that influence patients’ beliefs about the outcome of enrollment is needed, both to modify the interventions and to determine how malleable patient beliefs are. (shrink)

While rooted in careful study of Mead’s original writings and transcribed lectures and the historical context in which that work was carried out, the papers in this volume have brought Mead’s work to bear on contemporary issues in metaphysics, epistemology, cognitive science, and social and political philosophy.

Cambridge’deki büyük akademik cemaatin sakinleri olan bizler bir araya geldik ve hoşgörü ve onun egemen politik iklim içerisindeki yeri hakkında dostça ama ateşli bir tartışma yürüttük. Okuyucu, bizim nerelerde aynı düşüncede olmadığımızı bulmakta hiçbir zorluk çekmeyecektir. Diğer taraftan, farklı başlangıç noktalarından ve farklı yollardan hareketle yaklaşık olarak aynı yere ulaştık. Her birimiz için, egemen hoşgörü kuramı ve pratiğinin, incelendiği takdirde, korkunç politik gerçekleri gizlemeye yarayan bir maske olduğu ortaya çıktı. Kızgınlığın tonu makaleden makaleye keskin bir şekilde artmakta; belki de boş (...) yere, okuyucuların bu noktaya getiren akıl yürütmeyi takip edeceklerini umuyoruz. Nihayetinde bu kızgınlık hem kafa hem de kalpte ikamet etmektedir…. (shrink)

Introduction: What is the critical spirit?--Utopianism, ancient and modern, by M.I. Finley.--Primitive society in its many dimensions, by S. Diamond.--Manicheanism in the Enlightenment, by R.H. Popkin.--Schopenhauer today, by M. Horkheimer.--Beginning in Hegel and today, by K.H. Wolff.--The social history of ideas: Ernst Cassirer and after, by P. Gay.--Policies of violence, from Montesquieu to the Terrorist, by E.V. Walter.--Thirty-nine articles: toward a theory of social theory, by J.R. Seeley.--History as private enterprise, by H. Zinn.--From Socrates to Plato, by H. Meyerhoff.--Rational society (...) and irrational art, by H. Read.--The quest for the Grail; Wagner and Morris, by C.E. Schorske.--Valéry; Monsieur Teste, by L. Goldmann.--History and existentialism in Sartre, by L. Krieger.--German popular biographies; culture's bargain counter, by L. Lowenthal.--The Rechtsstaat as magic wall, by O. Kirchheimer. (shrink)

Bibliographical footnotes. Introduction: What is the critical spirit?--Utopianism, ancient and modern, by M.I. Finley.--Primitive society in its many dimensions, by S. Diamond.--Manicheanism in the Enlightenment, by R.H. Popkin.--Schopenhauer today, by M. Horkheimer.--Beginning in Hegel and today, by K.H. Wolff.--The social history of ideas: Ernst Cassirer and after, by P. Gay.--Policies of violence, from Montesquieu to the Terrorist, by E.V. Walter.--Thirty-nine articles: toward a theory of social theory, by J.R. Seeley.--History as private enterprise, by H. Zinn.--From Socrates to Plato, by H. (...) Meyerhoff.--Rational society and irrational art, by H. Read.--The quest for the Grail; Wagner and Morris, by C.E. Schorske.--ValeÌ ry; Monsieur Teste, by L. Goldmann.--History and existentialism in Sartre, by L. Krieger.--German popular biographies; culture's bargain counter, by L. Lowenthal.--The Rechtsstaat as magic wall, by O. Kirchheimer. Revolution from above: some notes on the decision to collectivize Soviet agriculture, by E.H. Carr.--Winston Churchill, power politician and counter revolutionary, by A.J. Mayer.--Brahmins and business, 1870-1914; a hypothesis on the social basis of success in American history, by G. Kolko.--On the limits of professional thought, by M.R. Stein.--The limits of integration, by P. Mattick.--The society nobody wants; a look beyond Marxism and liberalism.--Marcuse as teacher, by W. Leiss, J.D. Ober and E. Sherover.--Marcuse bibliography, by W. Leiss, J.D. Ober and E. Sherover (p. 427-433). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 97 Unity and Reform: Selected Writings of Nicholas de Cusa. Edited by John P. Dolan. (Notre Dame, Indiana: University of Notre Dame Press, 1962. Pp. viii -I- 260. $6.50.) This volume was designed to serve both the cause of historical instruction and the cause of "unity and reform" as it has been stimulated by the present ecumenical movement and Council. Professor Dolan's Introduction emphasizes the practical aspects (...) of the Bishop's career, especially his efforts to combat the disintegration of the Respublica Christiana of the fifteenth century. He explains the Bishop's achievements, both ecclesiastical and philosophical, in terms of the problems of his own time. However, the reader soon discovers in the narrative of the Introduction as well as in the selections from Cusanus's works that the current revival of interest in this theologian and philosopher is due to the important bearing which he has on the Catholic efforts toward reunion and reform today. Only Book III of Learned Ignorance is included; then follow in their entirety Concerning Wisdom, The Vision of God or the Icon, Concerning Concord in Religious Belief (De Pace Fidei); and to illustrate Nicholas of Cusa's interest in mathematics and physics, the volume concludes with a dialogue on experiments in weighing. Hrne~a~T W. Sca~NEm~tt Claremont, California La cosmologie de Giordano Bruno. By Paul-Henri Michel. (Paris: Editions Hermann, 1962. Pp. 341.) Malgr~ les excellents travaux d~j~ publi~s (ceux d'Emile Namer, d'Augusto Guzzo et d'autres ~minents sp~cialistes bruniens), Giordano Bruno demeure une figure historique la lois tr~s c~l~bre et bien myst~rieuse au demeurant. L'exceUent ouvrage de Paul-Henri Michel rendra ainsi les plus grands services aux historiens de la pens~e qui se penchent avec curiosit~ sur la d~concertante p~iode de transition qui s~pare les philosophes de la Renaissance de l'av~nement en Europe d'attitudes proprement modernes devant la r~alit~ ext~rieure et l'homme. S'appuyant sans cesse sur les textes originaux de Bruno lui-mdme, pourvu d'un index complet, le bel ouvrage du Pr. Michel ne d~cevru passes lecteurs ~xudits. Comme il se dolt, rauteur commence par faire le point sur l'homme Bruno, s'attachant faire la distinction qui s'impose entre l'histoire et la l~gende--car la k~gende s'est empar ~e de ce philosophe, consid~r~ volontiers comme un athfie materialiste total ayant voulu d~truire la religion catholique, attitude louse ou vilipendfie selon clue Bruno sera vu comme un h~r~tique pervers ou, au contraire, comme un glorieux martyr de la "librepens ~" rationaliste. On appr~.iera tout sp~cialement les pages (p. 10 et suivantes) darts lesquelles M. Michel s'efforce de faire toute la lumi~re ~, propos du proc~s ecd~iastique de Giordano Bruno--sur lequel toute la lumi~re souhaitable n'avait pas encore ~t~ faite. Mais la majeure paxtie du volume est consacr~e ~ un expos~ m~thodique du syst~me du monde, telle clue l'~tude minutieuse de tousles textes accessibles permet de le structurer. En dix chapitres, l'auteur passe minutieusement--mais toujours d'une mani~re remarquablement logique et claire--les grandes articulations autour desquelles tourne toute la cosmologie brunienne: Le monde comme objet de connaissance, Cosmogonic, Ens mobile, LAme du Monde, La mati~re et l'univers infini, Le systkme solaire, Les mondes innombrables, L'univers vivant, Temps et dternit~. Le grand nombre des citations ~tendues faisant de cette belie ~tude une sorte de fort commode anthologie m~thodique de la pens~e brunienne. 98 HISTORY OF PHILOSOPHY I1 est incontestable que nous autres contemporains sommes toujours endins 5. voir en Giordano Bruno un penseur franchement "moderne," et le fait est qu'il brave volontiers, prenant intrdpidement parti pour le syst~me de Copernic, la philosophie scolastique et la th~ologie scripturaire; son grandiose hymne mdtaphysique 5. l'infini de l'univers et 5. la r6partition innombrable des syst~mes plan~taires rend be1 et bien un son r~volutionnaire pour son temps. Ce n'est d'ailleurs pas pour rien que Bruno rut mis 5. l'index pour... (shrink)

_Practical Bioethics_ offers a mix of theory and readings, presented in a format that is succinct and approachable. Each chapter begins and ends with a case study, illustrating the core issues at play and emphasizing the practical nature of the dilemmas arising in medicine. Primary source texts are provided to flesh out the issues, and each of these is carefully edited and presented with interwoven explanatory comments to assist student readers. Throughout, J.K. Miles shows the importance of health-care ethics to (...) us all, whether we be medical providers, patients, or both. (shrink)

This new edition of Law and Medical Ethics continues to chart the ever-widening field that the topics cover. The interplay between the health caring professions and the public during the period intervening since the last edition has, perhaps, been mainly dominated by wide-ranging changes in the administration of the National Health Service and of the professions themselves but these have been paralleled by important developments in medical jurisprudence.

Originally published in 1926, this book attempts to state 'what has been believed with regard to God's incapacity for suffering'. Mozley charts the development of the doctrine from the Apostolic Fathers through the Reformation to the modern influence of metaphysical philosophy and concludes with six questions intended to prompt further theological discussion on this point. This book will be of value to anyone with an interest in the history of Christian theology.

What sets off the termination of analysis and psychodynamic therapy from the variety of endings that enter into all human relationships? So asks Herbert J. Schlesinger in _Endings and Beginnings: On Terminating Psychotherapy and Psychoanalysis_, a work of remarkable clarity, conceptual rigor, and ingratiating readability. Schlesinger situates termination - which he understands, variously, as a phase of treatment, a treatment process, and a state of mind - within the family of "beginnings and endings" that permeate one another throughout the (...) course of therapy. For Schlesinger, therapeutic endings cannot be aligned with the final phase of treatment; ending-phase phenomena are ongoing accompaniments of therapeutic work. They occur whenever patients achieve some portion of their treatment goals and supervene when therapy stagnates. Small wonder that an assessment of the patient's relationship to time and capacity to end therapy are key aspects of diagnostic evaluation. By linking beginning and ending phases not to the chronology of treatment but to the patient’s experience of it, Schlesinger brings revivifying insight to a host of psychodynamic concepts. Nor does he shy away from a trenchant critique of the instrumental “medical model” of psychiatric and psychotherapeutic training, which militates against the therapeutic exploration of treatment endings. Schlesinger's exemplification of how to begin treatment from the point of view of ending; his sensitive delineation of the mid-treatment "ending" crises characteristic of "vulnerable patients"; his richly woven case vignettes illustrating various "ending" contingencies and permutations - these inquiries are gems of pragmatic clinical wisdom. _Endings and Beginnings_ distills lessons learned over the course of a half century of practicing, teaching, and supervising psychotherapy and psychoanalysis and is a gift to the profession. (shrink)

Recently, new developments took place in the Dutch debate on the legislation of euthanasia. After a brief account of that debate, the article discusses a new government proposal for legislation in this field, which was submitted to the Dutch parliament in November 1991. This proposal relates not only to euthanasia but also to some other medical decisions concerning the end of life. The author concludes that, for several reasons, it is unsatisfactory.

This book addresses one of the most urgent questions in American society today, one that is currently in the spotlight and hotly debated on all sides: Who shall rule the schools--parents or educators? _School Choice or Best Systems: What Improves Education?_ presents an overview of research and practical applications of innovative--even radical--school reforms being implemented across the United States. These fall along a continuum ranging from "parental choice" to "best systems." At the one extreme are schools of choice, which allow (...) parents to choose and even govern schools for their children. These include charter schools, traditional private and parochial schools, schools that are privately governed but publicly funded through vouchers, and those that are funded by private scholarships provided by both corporations and wealthy individuals. At the other extreme are centralized state or district systems, based on reform initiatives and new systems of education that have been developed in response to views of citizens and legislators that schools can do much better. These schools, which specify uniform goals, policies, and programs for each school, are highly innovative systems based on research or representing advanced thinking about "what works," and have attracted wide interest. Important questions related to schools of choice and best systems are addressed: How can we choose among schools of choice and best systems? Among the various approaches within each of these alternatives? How can we understand their guiding principles and operational practices? What results do they produce? How can we evaluate their claims? In choosing among the alternatives, how should issues of student achievement, accountability, costs, feasibility, and equity be factored in? This volume brings together leading researchers and education leaders who have carried out the latest studies and advances in the field, providing a forum for them to set forth the arguments and evidence that will be most helpful in making choices for tomorrow's schools. It does not provide a single "right" answer--values and preferences differ across parents, schools, districts, and states. However, there are benefits for all from seeing the rigorous research, challenging thinking, and alternate points of view this volume presents. (shrink)

Considering that getting along in civil society is based on the expectation that people will do what they say they will do, i.e., essentially live up to their explicit or implicit promises, it is amazing that so little scientific attention has been given to the act of promising. A great deal of research has been done on the moral development of children, for example, but not on the child’s ability to make and keep a promise, one of the highest moral (...) achievements. What makes it possible developmentally, cognitively, and emotionally to make a promise in the first place? And on the other hand, what compels one to keep a promise when there seems to be no personal advantage in doing so, and even when harm can be predicted? How do we know when a promise is offered seriously to be taken at face value, and how do we understand that another is only a polite gesture, not to be taken seriously? In _Promises, Oaths, and Vows: On the Psychology of Promising_, Herbert Schlesinger addresses these questions, drawing on the literature of moral development in children; the psychotherapy of a patient who regularly broke promises that were unnecessary in the first place; those who were regarded as "promising youngsters" who did not fulfill their "promise"; and those who feared making a promise, a commitment, or a threat out of fear that, once made, the utterance would take on a life of its own and could never be taken back. Furthermore, he illustrates his conclusions by examining the widespread use of promising in classical literature, such as Greek drama and the plays of Shakespeare, as well as the motivating and reifying power of the promise in Western religious traditions. With a style honed over the penning of two previous books, Schlesinger once again produces a work grounded in a firm analytic sensibility, but which also retains the wit and candor of the seasoned analyst. His seminal investigation of this all but neglected topic in the clinical literature is as timely as it is scholarly, and – with the title firmly in mind – _Promises, Oaths, and Vows_ is assured to be a worthy addition to any clinician’s library and a provoking investigation into Nietzsche’s notion of man as "the animal who makes promises.". (shrink)

Here is a simple, clear, useful proof that quantum mechanics contradicts Einstein, Podolsky, and Rosen's local realistic assumptions. It is a variant of the powerful argument first worked out by Daniel Mordechai Greenberger, Michael A. Horne, and Anton Zeilinger. This version uses the eigenstates of two orthogonal spin components for three spin-1/2 particles. No operator or matrix algebra is necessary. A novel discussion of the background and history serves to introduce this proof and to place it in the context of (...) Danny's work. (shrink)

The advent of personal genomics companies offering direct translation of scientific data into personal health information, calls into question traditional policies to refuse disclosure of such scientific data to research participants. This seems especially true for population biobanks, as they collect not only genotype information but also associated phenotype information, and thus may be in a unique position to translate their scientific findings into personal health information for their participants. Disclosure of such information seems mandated by the expectations raised by (...) biobanks and their participants' rights to know health information, to know clinical research results, to life and health and particularly their right to benefit. Refusals to disclose such information can be grounded in the lack of analytical validity and/or clinical utility of most findings, the need to avoid the therapeutic misconception, the complexity and costs involved in translation and disclosure and the disproportionate burden resulting from the obligation to respect participants' right not to know before any disclosure can be made. Currently, any demands by participants in population biobanks for full disclosure of all pertinent personal health information potentially resulting from the biobank's scientific findings are unlikely to be granted by a Dutch court under Dutch and international law. As the law stands now, a population biobank is neither a doctor nor a personal genomics company. However, in view of the rapid scientific, medical, technological, commercial and social developments, population biobanks must prepare to take more care of their participants' legitimate interest in receiving as much validated personal health information as reasonably possible, in a timely fashion, by developing appropriate translation and disclosure mechanisms. This paper examines whether population biobank participants have the right, under Dutch civil law and international law, to full disclosure, i.e. to all information generated by the biobank that is pertinent to their present and future health. It pioneers the format of a hypothetical court case to elucidate the legal and policy arguments" for and against full disclosure. (shrink)

This paper traces the development of parental rights to accept or to refuse treatment for a defective newborn infant in the United Kingdom and in the United States of America; its main purpose is to explore the common trends from which an acceptable policy may be derived. It is probable that the British law on parental decision-making in respect of infants suffering from Down's syndrome is to be found in the civil case of In Re B rather than in the (...) criminal case of R v Arthur. United States court decisions are strongly influenced by constitutional law and reflect the right to personal privacy. The position on each side of the Atlantic seems very similar but this similarity includes a sense of uncertainty as to legal responsibility. There is a case for agreed guidelines and a suggested format is offered for consideration. (shrink)

Mason and McCall Smith's classic textbook discusses the relationship of medical practice and ethics with the operation of the law. The subjects covered include natural and assisted reproduction, the impact of modern genetics on medicine, medical confidentiality, consent to medical treatment, the use of resources and problems surrounding death in the new medical era. It is of significance to anyone with an interest in the ethical and legal practice of medicine.

This article revisits long-standing questions about consent, membership and emigration in Locke’s thought. Commentators such as A John Simmons have argued that Locke opens political membership to both express consenters and some kind of tacit consenters, and not just to the former, as some have suggested. Simmons’s reading seems to render Locke more sensible in that it does not exclude large numbers of people from membership or burden the few members with all the civic duties, and also in that it (...) allows at least tacit-consenting members the right to relocate, while this right is denied to express-consenting members. Against this reading, the article shows, by resolving seemingly conflicting claims in the text, that people become members only by express consent. It also responds to the criticism that the express-consent-only reading would limit membership to a few and so would render Locke’s account implausible from a practical point of view. The article then addresses the purported restriction Locke imposes on express consenters’ right to emigrate, arguing that the restriction concerns the change of membership and not the right to relocate. (shrink)

In this paper certain basic assumptions about causation will be made explicit and then an attempt will be made to show, on the basis of those assumptions, that causation must be supplemented by an extra-causal operation of a selective nature. It is hoped that our assumptions will have in their own right a certain general acceptability, but since assumptions or “postulate sets”, whether antecedently acceptable or not are usually chosen for the purpose of proving something already deemed desirable, a word (...) should be said as to why it was thought desirable to argue for selectivity. (shrink)