Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

In "the first person" chisholm argues that the primary form of belief is non-Propositional belief about oneself. Belief about others is essentially indirect, Mediated by the attribution of a property to oneself. In this paper I argue that chisholm's account cannot give a non-Circular explanation of various plausible examples of "de re" belief.

First, I briefly characterize Dretske’s particular naturalization project, emphasizing his naturalistic reconstruction of the notion of representation. Second, I note some apparent similarities between his notion of representation and Husserl’s notion of intentionality, but I find even more important differences. Whereas Husserl takes intentionality to be an intrinsic, phenomenological feature of thought and experience, Dretske advocates an “externalist” account of mental representation. Third, I consider Dretske’s treatment of qualia, because he takes it to show that his representational account of mind (...) succeeds in naturalizing even the “subjective” features of experience. I claim that Dretske's argument for his account of qualia turns on an ambiguous characterization of qualia. I conclude that he succeeds in naturalizing qualia only if qualia are understood as nonphenomenological features of experience and that he therefore has less to say than he thinks about the subjective life of beings such as us. (shrink)

This is the first book to focus on science as a social institution based on a comprehensive analysis of the thought of Foucault and Habermas. A key aspect of this book is its standpoint which critiques science, whilst simultaneously interrogating philosophical critique which must in a certain sense accommodate science, and its effect on modernity.

Against theses of Bernard Williams and Bas C. van Fraassen, it is argued that there are no facts about moral dilemmas, characterizable independently of any moral theory. It is further argued that any adequate theory which denies that there are genuine moral dilemmas must provide a convincing account of how and why moral agents take themselves to be in dilemmatic situations. The ability of rationalist theories, which deny that genuine moral dilemmas occur, to provide such account is examined. Aquinas's contribution (...) receives particular attention. (shrink)

The philosophy of chemistry has been sadly neglected by most contempory literature in the philosophy of science. This paper argues that this neglect has been unfortunate and that there is much to be learned from paying greater philosophical attention to the set of issues defined by the philosophy of chemistry. The potential contribution of this field to such current topics as reduction, laws, explanation, and supervenience is explored, as are possible applications of insights gained by such study to the philosophy (...) of mind and the philosophy of social science. (shrink)

This paper discusses the contribution that the work of Sally Gadow makes to understandings of interpretive inquiry and it's potential to inform and influence nursing practice, research, and education. The discussion draws on several of Gadow's published works that make explicit her understandings of what it means to be interpretive, to be open to multiple truths, to hear multiple voices, to have a history, to be experienced, and to recognize agency in language. Situating this discussion of Gadow's contribution in opposition (...) to a metaphysics of genius is intended to move our understanding of particular work past the subjectivity that produced it, past the subjectivized responses to the work, past the reporting on myself – my thoughts, my perspectives, my experiences – to explore, to see the worthwhileness or even the possibilities of exploring the work itself and the worlds it evokes. This paper is a deliberate attempt to disrupt the call to the author to save us from the task of interpreting the questions that the work itself places us under. Gadow's work itself points us away from a valorization of the voice of the author of the work, a single voice, and towards a cultivation of a worldly repose where each interpretive account points us to some longstanding whole to which the work belongs and from which it gains its sense and significance. (shrink)

What is post-truth? -- Science denial as a road map for understanding post-truth -- The roots of cognitive bias -- The decline of traditional media -- The rise of social media and the problem of fake news -- Did post-modernism lead to post-truth? -- Fighting post-truth.

This essay is a study of Edmund Husserl’s conception of meaning. In this first section we indicate its importance for his conception of phenomenology. In Section 2 we see that Husserl’s conception of linguistic meaning, of its nature as “ideal” and its role in mediating reference, is almost exactly that of his contemporary Gottlob Frege. In Sections 3 and 4 we further argue that, for Husserl, linguistic meaning and noematic Sinn are one and the same. For, according to Husserl, every (...) linguistic meaning is a noematic Sinn expressed, and every noematic Sinn is in principle expressible and therefore a linguistic meaning. Section 3 argues the former; Section 4, the latter. (shrink)

Our analysis in this paper unfolds on two levels: a critique of the ‘realities’ of graduate nursing education and an argument to sustain its ‘ideals’. We open for discussion an aspect of graduate nursing education dominated by instrumental reason, namely the research industry, using an internal critique approach developed by Max Horkheimer and Theodor Adorno of the Early Frankfurt School. As we explain, internal critique arises out of, and relies on, the mismatch between goals, or ‘ideals’, and existing realities. Thinking (...) about ‘ideals’ of the academy, we draw on Hans-Georg Gadamer's view of the university as a place to think freely, creatively, and critically. The contemporary realities of the university, on the other hand, that emphasize the market values of the research industry forcefully shape nursing academic scholarship in a particular direction. In our attempt to recognize and disrupt the forces of the research industry with its instrumental reason, we consider Judith Butler's writings on how norms operate in society. We show that our growing involvement in the research industry makes it very difficult to disentangle ourselves from that situation. The values of the research industry actually suppress the very ideals of education and scholarship that we would like to uphold. As a contra-force, the internal critique of the ‘existing realities’ in the graduate nursing education unmasks the tyranny of the research industry and makes visible the importance of sustaining the higher goals and ideals in nursing scholarship. (shrink)

The corporate glass ceiling continues to be a challenge for many organizations. However, women executives may be facing a second pane of obstruction – an expatriate glass ceiling – that prevents them from receiving the foreign management assignments and experience that is becoming increasing critical for promotion to upper management. The responsibility to break the expatriate glass ceiling lies with both female managers and the multinational corporations that utilize expatriates. In this paper, we propose pre-assignment, on-assignment, and post-assignment strategies for (...) breaking the expatriate glass ceiling. (shrink)

In preparation for the development of a rapid tissue donation programme, we surveyed healthcare providers in our institution about knowledge and attitudes related to RTD with lung cancer patients. A 31-item web based survey was developed collecting data on demographics, knowledge and attitudes about RTD. The survey contained three items measuring participants’ knowledge about RTD, five items assessing attitudes towards RTD recruitment and six items assessing HCPs’ level of agreement with factors influencing decisions to discuss RTD. Response options were presented (...) on a 5-point Likert scale. Ninety-one HCPs participated in the study. 66% indicated they had never heard of RTD prior to the survey, 78% rated knowledge of RTD as none or limited and 95.6% reported not having ethical or religious concerns about discussing RTD with patients. The majority were either not comfortable or not sure if they felt comfortable discussing RTD with cancer patients . 56.1% indicated their knowledge of RTD would play an integral role in their decision to discuss RTD with patients. 71.4% reported concerns with RTD discussion and the emotional state of the patient. Physicians and nurses play an important role in initiating conversations about recruitment and donation to research that can ultimately influence uptake. Increasing HCP knowledge about RTD is a necessary step towards building an RTD programme. Our study provides important information about characteristics associated with low levels of knowledge and practice related to RTD where additional education and training may be warranted. (shrink)

John Fischer and Mark Ravizza defend in this book a painstakingly constructed analysis of what they take to be a core condition of moral responsibility: the notion of guidance control. The volume usefully collects in one place ideas and arguments the authors have previously published in singly or jointly authored works on this and related topics, as well as various refinements to those views and some suggestive discussions that aim to show how their account of guidance control might fit into (...) a more comprehensive account of moral responsibility. (shrink)

Burrowing mammals are ubiquitous on farms in South Africa and can hinder agricultural practices. This study explored farmer perspectives of these species, and specifically the factors that influence these perspectives. Forty-four farmers responded to a questionnaire that assessed their ecological knowledge of, tolerance towards and lethal management of burrowing mammals that occur on their farms. The results from generalised linear models showed that neither farmer age, nor level of education are accurate predictors of ecological knowledge, overall tolerance towards burrowers, or (...) their lethal management. Knowledge of burrowing mammals showed a significant relationship with tolerance, with more knowledgeable individuals displaying higher levels of tolerance. However, a farmer’s overall tolerance towards burrowing species did not affect the number of species managed. Our results also suggest that different values are attached to different species when it comes to lethal management. Thus, farmers commonly controlled the numbers of the problem rodent species, Highveld gerbil (Gerbilliscus brantsii) and Cape ground squirrel (Xerus inauris), but were less likely to manage black-backed jackal (Canis mesomelas) and warthog (Phacochoerus africanus), even when experiencing these as problematic. We suggest that the larger, more charismatic species possibly evoke more sympathy from farmers. Agro-ecosystems are likely to become increasingly important for conservation in the future, and we encourage continued studies on the environmental attitudes and approaches of agricultural practitioners as a means to understanding the current status and future trends in ecologically sustainable agriculture. (shrink)

Journal of Philosophy of Education, EarlyView.

The precise and proper territorial boundaries of skepticism, relativism, and pluralism have been perennial topics of debate in philosophy. Very few philosophers endorse these positions in an unqual...

The doctrine (or principle) of double effect is often invoked to explain the permissibility of an action that causes a serious harm, such as the death of a human being, as a side effect of promoting some good end. According to the principle of double effect, sometimes it is permissible to cause a harm as a side effect (or “double effect”) of bringing about a good result even though it would not be permissible to cause such a harm as a (...) means to bringing about the same good end. Does the principle of double effect play the important explanatory role that has been claimed for it? To consider this question, one must be careful to clarify just what the principle is supposed to explain. Three misinterpretations of the principle’s force or range of application are common. 1. To ensure that Double Effect is not misunderstood as principle issuing a blanket permission on causing any unintended harm that yields a benefit, applications must require that the agent seek to minimize the harm involved. 2. Since it is widely accepted that it is wrong to aim to produce harm to someone as an end, to rule this out is not part of double effect’s distinctive content. 3. Harms that were produced regretfully and only for the sake of producing a good end may be prohibited by double effect because they were brought about as part of the agent’s means to realizing the good end. (shrink)

This book provides an overview of some of the most important critics of “Enlightenment rationalism.” The subjects of the volume—including, among others, Burke, Kierkegaard, Nietzsche, T.S. Eliot, Wittgenstein, Heidegger, C.S. Lewis, Gabriel Marcel, Russell Kirk, and Jane Jacobs—do not share a philosophical tradition as much as a skeptical disposition toward the notion, common among modern thinkers, that there is only one standard of rationality or reasonableness, and that that one standard is or ought to be taken from the presuppositions, methods, (...) and logic of the natural sciences. The essays on each thinker are intended not merely to offer a commentary on that thinker, but also to place that thinker in the context of this larger stream of anti-rationalist thought. Thus, while this volume is not a history of anti-rationalist thought, it may contain the intimations of such a history. (shrink)