Catholic hospitals seek to offer health care in accord with the example of Christ. They have several models to assist in this effort. The first model is the values portrayed in the Gospels. The Catholic Church has sought to embody these Gospel values in specific teachings. These teachings have been further specified for hospitals in the United States by the National Conference of Catholic Bishops in the Ethical and Religious Directives. Finally, the Gospels values are also expressed for individual Catholic (...) health care systems in mission statements and statements of Catholic identity. This article examines the worth of mission and identity statements, and explains that the statements must be put into practice through a process of internalization before they will be able to be of worth to the Catholic health care apostolate. (shrink)

This article critically examines the recent papal allocution on patients in a persistent vegetative state with regard to the appropriate conditions for considering “reformable statements.” In the first part of the article, the purpose and meaning of the allocution are assessed. O'Rourke concludes that given consideration of the individual patient's best interest, prolonging artificial nutrition and hydration is not, in every case, the best option. Although he stresses favorability for preservation of the life of the patient through artificial nutrition (...) and hydration, costs and benefits to the patient should be weighed. Ultimately, he argues in favor of leaving the decision to the patient, his caregivers, and others immediately involved in the case. (shrink)

In a single convenient resource, this book organizes and presents clearly the documents of the Catholic church pertaining to medical ethics.

Like Saint Paul, I was “born out of due time” insofar as the study of bioethics is concerned. I spent 15 years in teaching and administration at the Aquinas Institute of Theology, then in Dubuque, Iowa, now on the campus of Saint Louis University. I was given a sabbatical study year in 1972–1973 to refresh my mind and spirit. Though my major study and research emphasis prior to the sabbatical study had been in the field of Church law and religious (...) government, I determined to direct my attention to the study of moral theology and ethics, because at that time there was confusion in this area of discipline, especially insofar as the Catholic community was concerned. With this in mind, I chose the University of Chicago as the locale for my study and was awarded a postdoctoral fellowship. (shrink)

This article critically examines the recent papal allocution on patients in a persistent vegetative state with regard to the appropriate conditions for considering “reformable statements.” In the first part of the article, the purpose and meaning of the allocution are assessed. O'Rourke concludes that given consideration of the individual patient's best interest, prolonging artificial nutrition and hydration is not, in every case, the best option. Although he stresses favorability for preservation of the life of the patient through artificial nutrition (...) and hydration, costs and benefits to the patient should be weighed. Ultimately, he argues in favor of leaving the decision to the patient, his caregivers, and others immediately involved in the case. (shrink)

From Harry and Louise through the McCaughey septuplets, this book explains stories and issues in health care ethics that have appeared in the news media.

In the 2008 Instruction Dignitas personae (The Dignity of the Person), the Congregation for the Doctrine of the Faith presented once again the teaching of the Church on in vitro fertilization. Much of this teaching was contained in the earlier Instruction Donum vitae (The Gift of Life, 1987), but the new document brings the teaching of the Church up to date. Because the teaching is not accepted in the secular scientific community and is often unknown in the Catholic community, this (...) article explores the process of IVF, the view of the Church concerning it, and the fundamental principles underlying the Church’s teaching. National Catholic Bioethics Quarterly 10.4 (Winter 2010): 709–722. (shrink)

James Walsh and Moira McQueen accurately conclude that the early delivery of anencephalic fetuses is morally acceptable, but the reasoning they use to reach that conclusion is flawed. First, the principle of double effect does not require a weighing of good and evil, but rather seeks a sufficient reason for tolerating the physical evil indirectly intended. Second, the principle of double effect requires a clear distinction between physical and moral causality. Third, the Catholic moral tradition will not admit direct and (...) intended killing of the innocent. Rather, early delivery of anencephalic fetuses is permissible because of the pathology associated with delivery of anencephalic fetuses at full term. Thus, the early delivery of an anencephalic infant is acceptable if the purpose of the moral act is avoiding a pathological condition on the part of the mother. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:LettersJames L. Walsh, Moira M. McQueen, Kevin O'Rourke, and Jean deBloisEarly Delivery of the Anencephalic InfantMadam:In the March 1994 issue of the Kennedy Institute of Ethics Journal, Kevin O'Rourke and Jean deBlois have replied to an article of ours (KIEJ, December 1993) on the early induction of the anencephalic fetus. They agree with our conclusion that such early delivery may be morally acceptable, but argue (...) that our justification is flawed. Exchanges on the subject probably could continue ad nauseam; here we simply state some of the elements of their article that leave us perplexed.1. The phrase "prolonging the life of" (p. 49) has one meaning in the case of artificial life supports, which may be unwarranted interventions, but it has a different meaning when it refers to not interfering with a person's enjoyment of necessary natural means of preserving his or her life. Inducing labor prior to viability, which denies the natural means of life support without a possible substitute, has more in common with smothering a dying patient than the nonemployment of or withdrawing of artificial means of life support. To refer to the death of the fetus here as an effect is rather like saying that I suffocated you and the effect of the suffocation is your death. This is quite different from induction after viability where the induction can have different effects.2. If the authors were correct that "the prohibition on inducing delivery before viability is predicated upon the assumption that the fetus in utero is a human being with the potential for further development" (p. 49) and the anencephalic has none, why is there need to employ the principle of double effect? They say that there is no moral obligation to prolong the life of the anencephalic fetus. Just as there is no need for the principle in cases of withdrawing unwarranted artificial life support, so there would be no need for it here. Because the authors seem to perceive a complete disjunction between direct and indirect killing (allowing to die being in the category of indirect killing), it seems that they are unable to let their argument rest here, but have to justify the death that occurs.3. The example concerning smothering and the nonemployment of aggressive interventions (p. 49) explains well the difference between killing and allowing to die. But allowing to die is not indirectly killing since it occurs as a result of the disease and not from the causality of the agent.4. How can we cause something and not intend it? There are instances in which we simply "permit" evil events, but where we are not the cause. For example, evil events may be attributable to the bad will of others. Legislators make just laws knowing that some people of bad will will break them for their own advantage. Here the legislators really do permit evil. Neither are we the cause of death when we allow a person to die by not imposing unwarranted means of life support; we permit his or her death. But can we so readily designate by "permit" [End Page 184] what we knowingly choose to bring about? O'Rourke and deBlois use interchangeably "indirectly intended" and "unintended" for what is caused by our actions; "indirectly intended" is a better designation than "unintended." The whole package, including all foreseen effects, is intended. Evil "happening" (p. 51) as a result of an action that I place can refer either to evil as caused by my action or to evil as arising from a cause apart from my action. Only in this latter sense do I permit evil and not intend it, either directly or indirectly.5. The fourth condition of the principle of double effect is given as follows: "There must be a proportionately grave reason for placing the act. The greater the evil, the more cogent the reason must be for performing the act" (p. 50). How the authors can abstract from balancing goods and evils here is beyond us.6. We cannot follow the authors' use of the term "morally good" with respect to the induced delivery (p. 50). The problem is concerned with the morally right... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:LettersJames L. Walsh, Moira M. McQueen, Kevin O'Rourke, and Jean deBloisEarly Delivery of the Anencephalic InfantMadam:In the March 1994 issue of the Kennedy Institute of Ethics Journal, Kevin O'Rourke and Jean deBlois have replied to an article of ours (KIEJ, December 1993) on the early induction of the anencephalic fetus. They agree with our conclusion that such early delivery may be morally acceptable, but argue (...) that our justification is flawed. Exchanges on the subject probably could continue ad nauseam; here we simply state some of the elements of their article that leave us perplexed.1. The phrase "prolonging the life of" (p. 49) has one meaning in the case of artificial life supports, which may be unwarranted interventions, but it has a different meaning when it refers to not interfering with a person's enjoyment of necessary natural means of preserving his or her life. Inducing labor prior to viability, which denies the natural means of life support without a possible substitute, has more in common with smothering a dying patient than the nonemployment of or withdrawing of artificial means of life support. To refer to the death of the fetus here as an effect is rather like saying that I suffocated you and the effect of the suffocation is your death. This is quite different from induction after viability where the induction can have different effects.2. If the authors were correct that "the prohibition on inducing delivery before viability is predicated upon the assumption that the fetus in utero is a human being with the potential for further development" (p. 49) and the anencephalic has none, why is there need to employ the principle of double effect? They say that there is no moral obligation to prolong the life of the anencephalic fetus. Just as there is no need for the principle in cases of withdrawing unwarranted artificial life support, so there would be no need for it here. Because the authors seem to perceive a complete disjunction between direct and indirect killing (allowing to die being in the category of indirect killing), it seems that they are unable to let their argument rest here, but have to justify the death that occurs.3. The example concerning smothering and the nonemployment of aggressive interventions (p. 49) explains well the difference between killing and allowing to die. But allowing to die is not indirectly killing since it occurs as a result of the disease and not from the causality of the agent.4. How can we cause something and not intend it? There are instances in which we simply "permit" evil events, but where we are not the cause. For example, evil events may be attributable to the bad will of others. Legislators make just laws knowing that some people of bad will will break them for their own advantage. Here the legislators really do permit evil. Neither are we the cause of death when we allow a person to die by not imposing unwarranted means of life support; we permit his or her death. But can we so readily designate by "permit" [End Page 184] what we knowingly choose to bring about? O'Rourke and deBlois use interchangeably "indirectly intended" and "unintended" for what is caused by our actions; "indirectly intended" is a better designation than "unintended." The whole package, including all foreseen effects, is intended. Evil "happening" (p. 51) as a result of an action that I place can refer either to evil as caused by my action or to evil as arising from a cause apart from my action. Only in this latter sense do I permit evil and not intend it, either directly or indirectly.5. The fourth condition of the principle of double effect is given as follows: "There must be a proportionately grave reason for placing the act. The greater the evil, the more cogent the reason must be for performing the act" (p. 50). How the authors can abstract from balancing goods and evils here is beyond us.6. We cannot follow the authors' use of the term "morally good" with respect to the induced delivery (p. 50). The problem is concerned with the morally right... (shrink)

The most important clarification we bring in our reply to commentators concerns the problem of the “explanatory gap”: that is, the gulf that separates physical processes in the brain from the experienced quality of sensations. By adding two concepts (bodiliness and grabbiness) that were not stressed in the target article, we strengthen our claim and clarify why we think we have solved the explanatory gap problem, – not by dismissing qualia, but, on the contrary, by explaining why sensations have a (...) “feel” and why “feels” feel the way they do. We additionally clarify our views on: internal representations (we claim internal representations cannot explain why sensation has a feel), on behaviorism (we are not behaviorists), on perception and action (we believe there can be perception without action), and on the brain (we believe the brain does do something important in perception). (shrink)

Abstract In this essay, I critically discuss a theory of utterance content and de re communication that Anne Bezuidenhout has recently developed in a series of articles. This theory regards the significance of utterances as more pragmatic in nature than allowed by traditional accounts; further, it downplays logical considerations in explaining de re communication, choosing instead to emphasize its psychological character. Included among the implications of this approach is the rejection of what can be called ?common content?, or utterance content (...) that is held in common by speaker and listener. After describing this theory, I argue that Bezuidenhout does not supply a compelling reason to prefer her account of utterance content over more traditional alternatives that make room for elements of content held in common between speaker and listener. Further, I argue that her account of de re communication supplies even more reason to reject the view of content to which she subscribes. In the end, it will be clear that she has no principled reason for rejecting common content. (shrink)

Few of us are free of all prejudices, however subtle and subconscious, and they may affect both patient care and teaching. Here I use reflection about a patient with HIV infection, from the points of view of two doctors caring for him and the patient himself, to explore prejudice against lifestyles that are considered “dangerous”. The paper then goes on to discuss research about physicians' attitudes to such cases, the teaching of ethics in a clinical environment and the need to (...) support junior medical staff. (shrink)

Many current neurophysiological, psychophysical, and psychological approaches to vision rest on the idea that when we see, the brain produces an internal representation of the world. The activation of this internal representation is assumed to give rise to the experience of seeing. The problem with this kind of approach is that it leaves unexplained how the existence of such a detailed internal representation might produce visual consciousness. An alternative proposal is made here. We propose that seeing is a way of (...) acting. It is a particular way of exploring the environment. Activity in internal representations does not generate the experience of seeing. The out- side world serves as its own, external, representation. The experience of seeing occurs when the organism masters what we call the gov- erning laws of sensorimotor contingency. The advantage of this approach is that it provides a natural and principled way of accounting for visual consciousness, and for the differences in the perceived quality of sensory experience in the different sensory modalities. Sev- eral lines of empirical evidence are brought forward in support of the theory, in particular: evidence from experiments in sensorimotor adaptation, visual “filling in,” visual stability despite eye movements, change blindness, sensory substitution, and color perception. (shrink)

The paper proposes a way of bridging the gapbetween physical processes in the brain and the ''''felt''''aspect of sensory experience. The approach is based onthe idea that experience is not generated by brainprocesses themselves, but rather is constituted by theway these brain processes enable a particular form of''''give-and-take'''' between the perceiver and theenvironment. From this starting-point we are able tocharacterize the phenomenological differences betweenthe different sensory modalities in a more principledway than has been done in the past. We are also (...) ableto approach the issues of visual awareness andconsciousness in a satisfactory way. Finally weconsider a number of testable empirical consequences,one of which is the striking prediction of thephenomenon of ''''change blindness''''. (shrink)

Meeting grand challenges requires responses that constructively combine multiple forms of expertise, both academic and non-academic; that is, it requires cross-disciplinary integration. But just what is cross-disciplinary integration? In this paper, we supply a preliminary answer by reviewing prominent accounts of cross-disciplinary integration from two literatures that are rarely brought together: cross-disciplinarity and philosophy of biology. Reflecting on similarities and differences in these accounts, we develop a framework that integrates their insights—integration as a generic combination process the details of which (...) are determined by the specific contexts in which particular integrations occur. One such context is cross-disciplinary research, which yields cross-disciplinary integration. We close by reflecting on the potential applicability of this framework to research efforts aimed at meeting grand challenges. (shrink)

In this article we argue that philosophy can facilitate improvement in cross-disciplinary science. In particular, we discuss in detail the Toolbox Project, an effort in applied epistemology that deploys philosophical analysis for the purpose of enhancing collaborative, cross-disciplinary scientific research through improvements in cross-disciplinary communication. We begin by sketching the scientific context within which the Toolbox Project operates, a context that features a growing interest in and commitment to cross-disciplinary research (CDR). We then develop an argument for the leading idea (...) behind this effort, namely, that philosophical dialogue can improve cross-disciplinary science by effecting epistemic changes that lead to better group communication. On the heels of this argument, we describe our approach and its output; in particular, we emphasize the Toolbox instrument that generates philosophical dialogue and the Toolbox workshop in which that dialogue takes place. Together, these constitute a philosophical intervention into the life of CDR teams. We conclude by considering the philosophical implications of this intervention. (shrink)

Are there natural kinds of things around which our theories cut? The essays in this volume offer reflections by a distinguished group of philosophers on a series of intertwined issues in the metaphysics and epistemology of classification.

Observers inspected normal, high quality color displays of everyday visual scenes while their eye movements were recorded. A large display change occurred each time an eye blink occurred. Display changes could either involve "Central Interest" or "Marginal Interest" locations, as determined from descriptions obtained from independent judges in a prior pilot experiment. Visual salience, as determined by luminance, color, and position of the Central and Marginal interest changes were equalized. -/- The results obtained were very similar to those obtained in (...) prior experiments showing failure to detect changes occurring simultaneously with saccades, flicker, or “mudsplashes” in the visual scene: Many changes were very hard to detect, and Marginal Interest changes were harder to detect than Central Interest changes. -/- Analysis of eye movements showed, as expected, that the probability of detecting a change depended on the eye’s distance from the change location. However a surprising finding was that both for Central and Marginal Interest changes, evenwhen observers were directly fixating the change locations (within 1 degree),more than 40% of the time they still failed to see the changes. It seems that looking at something does not guarantee you “ see” it. (shrink)

À la croisée de la philosophie et de l’histoire de l’art, Bernard Teyssèdre a ouvert des champs de recherche très divers, ce qui a suscité l’enthousiasme de ses étudiants, mais aussi déconcerté ceux qui restaient attachés à leur pré carré disciplinaire. Présenter aujourd’hui son parcours intellectuel revient à faire redécouvrir certains de ses travaux oubliés en esthétique afin de montrer leur singularité et leur cohérence profondément hégélienne, bien que ses recherches aient pris des formes très différentes et abordés avec érudition (...) des domaines très éloignés les uns des autres. Sans oublier de situer philosophiquement des aspects moins connus de ses activités, littéraires, artistiques et aussi institutionnelles avec sa contribution déterminante au développement de la discipline esthétique et à l’introduction des arts plastiques à l’université. Ce panorama n’aurait pas été complet si n’était pas signalée la place de ses recherches en paléontologie restées longtemps secrètes et a priori fort éloignées de l’esthétique. Alors que Bernard Teyssèdre avait publié en 2007 une nouvelle édition de son Roman de l’Origine revue et augmentée (et que Thierry Savatier était sur le point de publier une nouvelle édition de L’Origine du monde, Histoire d’un tableau de Gustave Courbet ), Jean Da Silva lui apprit qu’une photographie du tableau exposé au musée d’Orsay avait circulé en France pendant une vingtaine d’années avant d’être publiée en 1953 dans des revues oubliées ; ce qui bouleversait l’idée que l’on avait encore en 2009 de la connaissance de ce tableau. S’ensuivit ensuite un jeu de piste à deux, sur le blog, par courriels et au téléphone. (shrink)

Enhancing Communication & Collaboration in Interdisciplinary Research, edited by Michael O'Rourke, Stephen Crowley, Sanford D. Eigenbrode, and J. D. Wulfhorst, is a volume of previously unpublished, state-of-the-art chapters on interdisciplinary communication and collaboration written by leading figures and promising junior scholars in the world of interdisciplinary research, education, and administration. Designed to inform both teaching and research, this innovative book covers the spectrum of interdisciplinary activity, offering a timely emphasis on collaborative interdisciplinary work. The book’s four main parts focus (...) on theoretical perspectives, case studies, communication tools, and institutional perspectives, while a final chapter ties together the various strands that emerge in the book and defines trend-lines and future research questions for those conducting work on interdisciplinary communication. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 63.1 (2002) 41-62 [Access article in PDF] Pure of Heart: From Ancient Rites to Renaissance Plato Marjorie O'Rourke Boyle The philosopher who published Plato for Western thought praised him strangely. Marsilio Ficino commended his translation of the Phaedrus to his soul mate Iohannes Bessarion because in that dialogue Plato sought from God spiritual beauty. "When this gold was given to Plato by (...) God, it shone in him most brilliantly, because he was so pure in heart." The epithet "pure in heart" is not literally Ficino's diction: he wrote "in his Platonic bosom perfectly clean" (Platonico in sinu utpote mundissimo). 1 Although this philological variant insinuates his full meaning, the modern translation conveys his essential import. Ficino and Bessarion were both scholars and priests, convinced of the compatibility of Platonism with Christianity. The recipient of the letter, Bessarion, had defended the Phaedrusvigorously against protestations that, for promoting the criminal activity of pederasty, it was an obscene work of unchaste philosophy. "Love," he declared, "leads many to beatitude." 2 Ficino emphasized that "no one can attain beatitude, which consists in divine contemplation, unless he loves God ardently." 3 To that end he translated the complete works of Plato into Latin with commentaries. He also composed a speculative Theologia platonica. The pair would have approved of the application to Plato of the gospel promise "Blessed are the pure of heart [hoi katharoi t¯e kardia], for they shall see God" (Matt. 5:8). Was this promise not already fulfilled in Plato, even before Jesus' pronouncement? Did not Socrates in the Phaedrus soar to the vision of God in his myth of the charioteer, where among privileged souls he peered over the rim of intelligible being to behold the divine processional and true being? The [End Page 41] myth figured the recollection of the soul's primordial state of innocence, "when we were pure ourselves," and, beholding "the beatific vision," were initiated into its "most blessed" mystery. 4 Bessarion cited the passage defensively, declaring Socrates' speech "most holy." 5The beatitudes, from which "pure of heart" derived, emphatically comprised the opening discourse of Jesus' Sermon on the Mount. Jesus blessed the poor in spirit, the mourners, the meek, those hungry and thirsty for righteousness, the merciful, the pure of heart, the peacemakers, and those persecuted for righteousness. He pronounced a corresponding good for each type (Matt. 5:1-10). The first four beatitudes promised reversals for the unfortunate; the second four, eschatological rewards for the virtuous. 6 Ficino personalized the beatitudes. He applied them in a letter to an archbishop to his own contrasting status as a priest "of humble fortune." Indicating his slight financial means, he affirmed obedience to his lot, even contentment with his meager possessions. He then wielded the divine reversal of human judgment, so startling in the beatitudes, against his enemies. "I am certainly content with few possessions, even though I am often held in contempt by many; for these many ought to be deemed of little worth. Blessed are the poor in spirit. Blessed are the peacemakers." 7Ficino also philosophized the beatitudes. He argued in Theologia platonica that, although the celestial realm was usually considered fiery, it could be earthy, as poets imagined the Elysian Fields. Jesus' beatitude promising the possession of the earth to the meek was proof. Ficino expounded the nine grades of celestial beatitude as a belief shared by Platonists and Christians. He assigned these grades to varying degrees and combinations of three ends: the fear of divine power, the search for wisdom, and the love of good, which ultimately transformed the soul. This elaborate division Ficino compared to Jesus' beatitudes. "I think that this mystery is signified in the gospel, where the divine oracle nine times calls his disciples blessed, because through nine grades of merit, with God leading, the nine heavens are sought blessedly through nine degrees of contemplation." Despite his philosophical imposition on the biblical text, Ficino qualified his syncretism. The gospel admonished the dismissal of philosophical meanderings to pursue... (shrink)

This article examines the relevance of survey data of scientists’ attitudes about science and values to case studies in philosophy of science. We describe two methodological challenges confronting such case studies: 1) small samples, and 2) potential for bias in selection, emphasis, and interpretation. Examples are given to illustrate that these challenges can arise for case studies in the science and values literature. We propose that these challenges can be mitigated through an approach in which case studies and survey methods (...) are viewed as complementary, and use data from the Toolbox Dialogue Initiative to illustrate this claim. (shrink)

Drawing on Pennock’s theory of scientific virtues, we are developing an alternative curriculum for training scientists in the responsible conduct of research that emphasizes internal values rather than externally imposed rules. This approach focuses on the virtuous characteristics of scientists that lead to responsible and exemplary behavior. We have been pilot-testing one element of such a virtue-based approach to RCR training by conducting dialogue sessions, modeled upon the approach developed by Toolbox Dialogue Initiative, that focus on a specific virtue, e.g., (...) curiosity and objectivity. During these structured discussions, small groups of scientists explore the roles they think the focus virtue plays and should play in the practice of science. Preliminary results have shown that participants strongly prefer this virtue-based model over traditional methods of RCR training. While we cannot yet definitively say that participation in these RCR sessions contributes to responsible conduct, these pilot results are encouraging and warrant continued development of this virtue-based approach to RCR training. (shrink)

Many philosophers of language have held that a truth-conditional semantic account can explain the data motivating the distinction between referential and attributive uses of definite descriptions, but I believe this is a mistake. I argue that these data also motivate what I call “dual-aspect” uses as a distinct but closely related type. After establishing that an account of the distinction must also explain dual-aspect uses, I argue that the truth-conditional Semantic Model of the distinction cannot. Thus, the Semantic Model cannot (...) explain the data for which it is developed and so fails as an account of the referential/attributive distinction. (shrink)

One of the few studies to date which considers in a comprehensive way the relation between these remarkable thinkers. By concrete example and continual reference it illustrates both the pervasive influence of Pseudo-Dionysius and the profound originality of Aquinas.

Discussion of J. Kevin O’Regan’s “Why Red Doesn’t Sound Like a Bell: Understanding the Feel of Consciousness” Content Type Journal Article Pages 1-20 DOI 10.1007/s13164-012-0090-7 Authors J. Kevin O’Regan, Laboratoire Psychologie de la Perception, CNRS - Université Paris Descartes, Centre Biomédical des Saints Pères, 45 rue des Sts Pères, 75270 Paris cedex 06, France Ned Block, Departments of Philosophy, Psychology and Center for Neural Science, New York University, 5 Washington Place, New York, NY 10003, USA Journal Review of (...) Philosophy and Psychology Online ISSN 1878-5166 Print ISSN 1878-5158. (shrink)

We surveyed IRB chairs' perspectives on offering individual genetic research results to participants and families, including family members of deceased participants, and the IRB's role in addressing these issues. Given a particular hypothetical scenario, respondents favored offering results to participants but not family members, giving choices at the time of initial consent, and honoring elicited choices. They felt IRBs should have authority regarding the process issues, but a more limited role in medical and scientific issues.