BackgroundThe increasing emphasis on research, development and innovation for health in providing solutions to the high burden of diseases in the African Region has warranted a proliferation of studies including clinical trials. This changing public health landscape requires that countries develop adequate ethics review capacities to protect and minimize risks to study participants. Therefore, this study assessed the readiness of national ethics committees to respond to challenges posed by a globalized biomedical research system which is constantly challenged by new public (...) health threats, rapid scientific and technological advancements affecting biomedical research and development, delivery and manufacture of vaccines and therapies, and health technology transfer.MethodsThis is a descriptive study, which used a questionnaire structured to elicit information on the existence of relevant national legal frameworks, mechanisms for ethical review; as well as capacity requirements for national ethics committees. The questionnaire was available in English and French and was sent to 41 of the then 46 Member States of the WHO African Region, excluding the five Lusophone Member States. Information was gathered from senior officials in ministries of health, who by virtue of their offices were considered to have expert knowledge of research ethics review systems in their respective countries.ResultsThirty three of the 41 countries responded. Thirty of respondent countries had a national ethics review committee ; 79 % of which were established by law. Twenty-five NECs had secretarial and administrative support. Over 50 % of countries with NECs indicated a need for capacity strengthening through periodic training on international guidelines for health research ethics; and allocation of funds for administrative and secretariat support.ConclusionsDespite the existing training initiatives, the Region still experiences a shortage of professionals trained in health research ethics/ethicists. Committees continue to face various capacity needs especially for evaluating clinical trials, for monitoring ongoing research, database management and for accrediting institutional ethics committees. Given the growing number of clinical trials involving human participants in the African Region, there is urgent need for supporting countries without NECs to establish them; capacity strengthening where they exist; and creation of a regional network and joint ethical review mechanisms, whose membership would be open to all NECs of the Region. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

Context Opioid treatment agreements (OTAs) are documents that clinicians present to patients when prescribing opioids that describe the risks of opioids and specify requirements that patients must meet to receive their medication. Notwithstanding a lack of evidence that OTAs effectively mitigate opioids’ risks, professional organizations recommend that they be implemented, and jurisdictions increasingly require them. We sought to identify the jurisdictions that require OTAs, how OTAs might affect the outcomes of lawsuits that arise when things go wrong, and instances in (...) which the law permits flexibility for clinicians and health care institutions to adopt best practices. -/- Methods We surveyed the laws and regulations of all 50 states and the District of Columbia to identify which jurisdictions require the use of OTAs, the circumstances in which OTA use is mandatory, and the terms OTAs must include (if any). We also surveyed criminal and civil judicial decisions in which OTAs were discussed as evidence on which a court relied to make its decision to determine how OTA use influences litigation outcomes. -/- Findings Results show that a slight majority (27) of jurisdictions now require OTAs. With one exception, the jurisdictions’ requirements for OTA use are triggered at least in part by long-term prescribing. There is otherwise substantial variation and flexibility within OTA requirements. Results also show that even in jurisdictions where OTA use is not required by statute or regulation, OTA use can inform courts’ reasoning in lawsuits involving patients or clinicians. Sometimes, but not always, OTA use legally protects clinicians from liability. -/- Conclusions -/- Our results show that OTA use is entwined with legal obligations in various ways. Clinicians and health care institutions should identify ways for OTAs to enhance clinician–patient relationships and patient care within the bounds of relevant legal requirements and risks. (shrink)

The corporate scandals of the twenty-first century have necessitated ethical behavior as a major component of the organizational process. These scandals occurred despite the ethical rules and laws in place, implying that rules and laws might not be effective in ensuring the ethical behavior of organizational participants at all times. Hence, a better approach to handling ethical decisions may be virtue ethics which demand the building of ethical character that intrinsically drives ethical behavior. Prudence was studied as a virtue which (...) builds character and can moderate ethical behavior. The moderating role of prudence was studied in the context of organizational political behavior. Employee political behavior in organizations can have either positive or negative consequences; hence, it is in the realm of ethical decision-making. Since studies have not identified how individuals can self-regulate their desire for political behavior, the study proposed political prudence, a character-building virtue, as a self-regulating variable which can be used by individuals to avoid drifting to the dark side of political behavior. The study participants were drawn from three organizations in Lagos, Nigeria, and a cross-sectional research design was adopted for data collection. The results confirmed that political prudence moderated the effects of political will on political behavior such that individuals engaged in benevolent political will and avoided self-serving political will. The importance of the findings is that organizations have a means of steering participants away from the dark side to the bright side of political behavior which is useful for productivity. (shrink)

Thirteen up-and-coming researchers in the philosophy of mathematics have been invited to write on what they take to be the right philosophical account of mathematics, examining along the way where they think the philosophy of mathematics is and ought to be going. A rich and diverse picture emerges. Some broader tendencies can nevertheless be detected: there is increasing attention to the practice, language and psychology of mathematics, a move to reassess the orthodoxy, as well as inspiration from philosophical logic.

Étienne de Páleč († c. 1422) fut l’un des premiers à soutenir le réalisme de Wyclif à la Faculté des arts de Prague. Cet article donne un aperçu de ses ouvrages sur les universaux, dont l’origine est à situer vers 1394-1396. Dans certains cas, le but d’Étienne était probablement de défendre le réalisme en général, et non pas seulement celui de Wyclif. L’article comprend l’édition d’une question d’Étienne sur les universaux. Sont également analysées la transmission textuelle de la quaestio et (...) l’influence possible d’un auteur réaliste anonyme attaqué par Buridan dans les années 1330. (shrink)

Martin Wrights original ground-breaking and influential analysis of the defects of the adversarial system of justice, plus the arguments in favour of a more ...

dicates implying a surplus in the background from previous negation) and the other three combinations . The second part of the study in relation to the issue of intersubjectivity summarizes Hegel's unhappy consciousness analysis of figures from the Phenomenology of Spirit and shows that it takes insufficient account of Hegel older authors, which is just Dionysios. In writings on mystical theology can find is the formal structure of intersubjectivity, and Hegel's analysis so they can not be correct.

[I]f you could know a priori that you are in a given mental state, and your being in that state conceptually or logically implies the existence of external objects, then you could know a priori that the external world exists. Since you obviously _can.

This article traces the limits of the understanding of beauty as unified multiplicity in Plotinus’ Enneads vi 2 and vi 6. These treatises can be read as insisting on the significance of multiplicity for beauty and as implying a distinction between the illuminated and the unilluminated beauty of Intellect. In treatise vi 7, this distinction is made explicit and a deeper understanding of beauty as the manifestation of the Good in Intellect is introduced.

Introduction of the philosophy of Pavlos Kalligas.

Though there has been an array of methods to evaluate the extent of sarcoidosis, it is generally difficult to detect central nervous system involvement. Recently it has become accepted that 18F-FDG PET is more sensitive than gallium scintigraphy in finding sarcoid lesions, however its usefulness and limitations for detecting sarcoidosis in the central nervous system, especially in the spinal cord, has rarely been investigated. Two patients with pathologically confirmed sarcoidosis manifested spinal symptoms. We conducted 18F-FDG PET along with conventional imagings (...) before and after treatment. Abnormal FDG uptakes which could not be detected by gallium scintigraphy were shown in the spinal cords in both patients. These abnormal uptakes were diminished in accordance with clinical improvement after treatment. Our findings suggest that 18F-FDG PET is effective in detecting and tracking the activity of spinal sarcoidosis. (shrink)

Heidegger in America explores the surprising legacy of his life and thought in the United States of America. As a critic of modern life, Heidegger often lamented the growing global influence of all things American. However, it was precisely in America where his thought inspired the work of generations of thinkers – not only philosophers but also theologians, architects, novelists, and even pundits. As a result, the reception and dissemination of Heidegger's philosophical writings transformed the intellectual and cultural history of (...) the United States at a time when American influence was itself transforming the world. A case study in the complex and sometimes contradictory process of transnational exchange, Heidegger in America recasts the scope and methods of contemporary intellectual and cultural history in the age of globalization, challenging what we think we know about Heidegger and American ideas simultaneously. (shrink)

The thesis investigates Plotinus' concept of beauty. Chapter 1 focuses on two methodological issues: development in Plotinus' thought and topics of the concerned Enneads. Since Plotinus wrote two Enneads directly devoted to this topic which were numbered and named by Porphyry I.6 On beauty and V.8 On intellectual beauty, these two treatises are addressed first in the context of other relevant Enneads. The outcome of these chapters is that beauty is primarily to be found in Intellect and that it is (...) closely linked with unity in multiplicity, so this topic is further investigated in more detail. Five mutually interconnected perspectives Plotinus assumes to describe the unity in multiplicity specific to the Intellect, are outlined. Two of them that are related to the nature of intellection and intelligible objects are discussed in chapters 2 and 3. The one related to Intellect's genesis is analysed throughout the thesis. Therefore, most of chapter 4 focuses on the remaining two perspectives which are connected with Intellect's hierarchical and structural unity in multiplicity. In chapter 5, Ennead VI.7 is analysed in order to deepen the concept of beauty and refine its relation to the Good, life and other predicates. The last chapter presents a systematic... (shrink)

Although Plotinus’ two treatises on beauty could be taken to reflect an evolution in his thought, a careful examination shows that he consistently argues for a conception of beauty as the illuminated unity in multiplicity of the Intellect.

The essay first succinctly points out shortcomings in previous interpretations of Plotinus’ notion of beauty. Beauty is to be connected primarily with Intellect, which is to be understood as a special unity in diversity. The section of the essay devoted to aesthetics is therefore preceded by a short analysis of Intellect’s unity and diversity. The hypothesis about the primary relation of beauty to the Intellect is then corroborated by a reading of Ennead V.8 and further developed. The emphasis is on (...) three basic aspects of beauty: its being a unity of a mixture whose character is shared by all ontological levels; its function of referring to what is above it; and its fundamental accessibility. Though Plotinus opposes the Stoic notion of beauty as symmetry and stresses beauty’s simplicity, it follows for him that beauty has the character of unitas multiplex, albeit a special one. (shrink)

The discussion of collective agency involves the reduction problem of the concept of a collective. Individualism and Cartesian internalism have long restricted orthodox theories and made them face the tension between an irreducible concept of a collective and ontological reductionism. Heterodox theories as functionalism and interpretationism reinterpret the concept of agency and accept it as realized on the level of a collective. In order to adequately explain social phenomena that have relations as their essence, in this paper we propose a (...) relational, holistic account of collective agency and argue that functionalism and interpretationism can be integrated into such an account. (shrink)

This chapter contains sections titled: Introduction Paraconsistent Logic and Latin America Thinking about Logic The Nature of Paraconsistent Logic A History of Paraconsistent Logic Philosophical Aspects of Paraconsistent Logic References Further Reading.

Modality - the question of what is possible and what is necessary - is a fundamental area of philosophy and philosophical research. The Routledge Handbook of Modality is an outstanding reference source to the key topics, problems and debates in this exciting subject and is the first collection of its kind. Comprising thirty-five chapters by a team of international contributors the Handbook is divided into seven clear parts: worlds and modality essentialism, ontological dependence, and modality modal anti-realism epistemology of modality (...) modality in science modality in logic and mathematics modality in the history of philosophy. Within these sections the central issues, debates and problems are examined, including possible worlds, essentialism, counterfactuals, ontological dependence, modal fictionalism, deflationism, the integration challenge, conceivability, a priori knowledge, laws of nature, natural kinds, and logical necessity. The Routledge Handbook of Modality is essential reading for students and researchers in epistemology, metaphysics and philosophy of language. It will also be very useful for those in related fields in philosophy such as philosophy of mathematics, logic and philosophy of science. (shrink)

Feinberg and Mallatt, in their presentation of neurobiological naturalism, have suggested that visual consciousness was acquired by early vertebrates and inherited by a wide range of descendants, and that its neural basis has shifted to nonhomologous nervous structures during evolution. However, their evolutionary scenario of visual consciousness relies on the assumption that visual consciousness is closely linked with survival, which is not commonly accepted in current consciousness research. We suggest an alternative idea that visual consciousness is linked to a specific (...) class of agency, consequently justifying their phylogenetic claim. We also examine the implication of their phylogenetic claim: visual consciousness is homologous across vertebrates, but its neural basis is not. This apparent incongruence illustrates a general phenomenon of homology, and that the resulting hierarchical view of visual consciousness and its neural basis can be straightforwardly accommodated by neurobiological naturalism. Throughout these discussions, we aim to address the potential theoretical issues in neurobiological naturalism and refine the picture illustrated by Feinberg and Mallatt regarding phylogenetic distribution and trajectories of visual consciousness. (shrink)

Dysfunctional attentional control is observed in patients with mental disorders. However, there is no established neurophysiological method to assess attention in such patients. We showed a discrepancy in alpha-band power in the tasks that evoked internal and external attention event-related alpha-band power changes in healthy subjects during self-reflection and working memory tasks in a preliminary study. In this study, we aimed at elucidating event-related alpha-band power changes in healthy subjects during the tasks, addressing the shortcomings of the previous study. Sixteen (...) healthy volunteers were examined for the event-related power change during the tasks. The results demonstrated the discrepancy of alpha-band ERpow at 8, 10, and 12 Hz in the parieto-occipital area between the WM and SR tasks for a period between a target stimulus and a command stimulus, where a participant switched to internal attention from external attention according to the SR task and remained at external attention according to the WM task. The results suggest that alpha-band ERpow in this area is associated with the direction of attention in response to cognitive stimuli, indicating that the findings of ERpow during the two tasks would potentially aid in the clarification of the pathophysiology of the dysfunctional change in attention in patients with psychiatric disorders. (shrink)

In this lively collection ten philosophers tackle the notoriously elusive issues raised by religious discourse in a series of linked debates. The debates focus on reason and faith; the logic of mysticism; the meaning of the word 'God'; language, biblical interpretation and worship; and religion and ethics. Through contemporary philosophical analysis it is possible to shed new light on teh status and language of religion, and in many ways the contributors to Religion and Philosophy break new ground in this perennially (...) controversial field. The collection is addressed to philosophers, theologians and anyone with a general intellectual interest in religion. Certainly it will be a valuable addition to the reading list of all teachers or students of the philosophy of religion. (shrink)

I defend a new reading of Spinoza's account of causation that reconciles the strengths of the mechanist and formal cause interpretations by locating instances of nature's fixed and unchanging laws inside individual natures; natures are efficacious because that's where the laws are. God's necessity, for instance, follows from certain logical principles contained within God's nature. Causes between finite particulars likewise stem entirely from finite natures. They do so, I argue, because finite instances of nature's fixed and unchanging laws are inscribed (...) within those natures. In each of these instances, effects follow from natures on account of laws contained within them. (shrink)

Moral luck is a puzzling aspect of our psychology: Why do we punish outcomes that were not intended (i.e. accidents)? Prevailing psychological accounts of moral luck characterize it as an accident or error, stemming either from a re‐evaluation of the agent's mental state or from negative affect aroused by the bad outcome itself. While these models have strong evidence in their favor, neither can account for the unique influence of accidental outcomes on punishment judgments, compared with other categories of moral (...) judgment. Why might punishment be particularly sensitive to moral luck? We suggest that such sensitivity is easily understood from the broader perspective of punishment's ultimate adaptive goal: Changing others’ behavior by exploiting their capacity to learn. This pedagogical perspective accounts for the exceptional influence of outcomes on punitive sentiments and makes predictions for additional moderators of punishment. We review evidence supporting the pedagogical hypothesis of punishment and discuss fruitful directions for future research. (shrink)

This article argues that effective corporate social responsibility (CSR) of multinational pharmaceutical companies in developing countries should reflect context, opportunity, proximity, time and impact in accordance with the social integration and ethical approaches to CSR. It proposes a CSR model expressed as CSR=COPTI+SI+E, which acknowledges access-to-medicines as a matter in the global public domain, a public choice problem and a moral responsibility issue for multinational pharmaceutical companies. This model recognises the globalisation of the principle of humanity in communities of place (...) and communities of interest as highlighted by the Global Economic Ethic Manifesto 2009 as an integral part of the responsibilities of multinational pharmaceutical companies. The model reflects a global application of the concept of disadvantaged consumer already known to some national laws. The article suggests an access-to-medicines CSR framework for pharmaceutical companies which may include pricing, patents, testing and clinical trials, research and development, joint public private initiative and appropriate use of drugs. (shrink)

Studies on students' perception of corporate social responsibility (CSR) have been growing in western scholarship. For students in African countries, such as Nigeria, there is little that is known about how and whether gender, level of study, and being enrolled in business education courses impact their perception of and disposition towards CSR. This study explores the significance of gender, academic status or level of study, and exposure to business ethics education (BEE) on Nigerian students' perception of CSR as a veritable (...) business ethic. Specifically, the effects of these factors on students' perception of CSR are examined using analysis of variance. The results show a significant effect of exposure to BEE and gender on CSR‐sensitivity, and a mild, but significant effect of academic status. This implies that male students and female students had different perspectives on CSR issues. Students who took ethics courses and those who did not would run businesses differently. However, age and experience on campus did not influence students' perception or position on CSR. The study recommends that more behavioral models be estimated with the inclusion of more demographic and socioeconomic variables to elicit more robust results. (shrink)

The author distinguishes two concepts of practical reason: (a) practical reason as a source of practical principles, and (b) practical reason as the theory of thought operations connected with action. He proves that there is no practical recognition in the sense (a). We can deal with actions only on the basis of dichotomic semantics. Critical analyses of some theories of practical reason are presented (Kant, Lorenzen, Apel, Alexy). The critical part of the paper mainly concerns the discourse theory and its (...) implications for practical philosophy and jurisprudence. (shrink)

Übereinstimmend mit Körner versteht der Autor unter 'praktischer Philosophie' die Gesamtheit der handlungsbezogenen Disziplinen. 'Handlung' ist informationsgelenktes Verhalten eines Subjektes. Der Handlungsbegriff wird durch den handlungsbestimmenden Informationsverarbeitungsprozeß charakterisiert. Handlungstheoretische Analysen erfordern eine erkenntnismäßig differenzierte Semantik. Der Begriff der Handlung setzt die Existenz von Handlungsspielräumen voraus. Der Autor kritisiert die Unterscheidung von kognitivem und präskriptivem Sollen und zeigt, daß Normsätze einer gegebenen Bedeutung in verschiedenen pragmatischen Funktionen verwendet werden können. Es werden die Begriffe 'Normenlogik' und 'deontische Logik' einander gegenübergestellt. Die Standardsysteme (...) der deontischen Logik sind keine geeignete Basis für die normativen Disziplinen. Der Autor fordert die Ausarbeitung einer genuinen Normenlogik, in der Sollsätzen eine primäre und Darfsätzen nur eine sekundäre Rolle zukommt. (shrink)