Comprehension and recall of informed consent was assessed after the study closure in the parents/guardians of a birth cohort of children participating in an intensive three-year diarrhoeal surveillance. A structured questionnaire was administered by field workers who had not participated in the study's follow-up protocol. Of 368 respondents, 329 (89.4 per cent) stated that the study was adequately explained during enrolment, but only 159 (43.2 per cent) could recall that it was on diarrhoea. Nearly half (45.9 per cent) of the (...) respondents stated that they would not have participated if free medical treatment was not provided, although the free medical clinic was not offered at enrolment. Spousal approval (82.9 per cent) was the most important factor in the decision to participate. In the multivariate analysis, maternal education was associated with increased awareness about the disease under study: mothers without any formal education had the lowest awareness (OR = 3.47, 95 per cent CI = 1.60–7.51). Despite a high compliance with the study protocol, retention of understanding about the research study was low over a long period of time. Although the local government provides free healthcare in the study area, respondents cited free healthcare as an important reason for participation, highlighting the need for true health equity before meaningful informed consent can be obtained. (shrink)

This co-edited volume compares Chinese and Western experiences of engineering, technology, and development. In doing so, it builds a bridge between the East and West and advances a dialogue in the philosophy of engineering. Divided into three parts, the book starts with studies on epistemological and ontological issues, with a special focus on engineering design, creativity, management, feasibility, and sustainability. Part II considers relationships between the history and philosophy of engineering, and includes a general argument for the necessity of dialogue (...) between history and philosophy. It continues with a general introduction to traditional Chinese attitudes toward engineering and technology, and philosophical case studies of the Chinese steel industry, railroads, and cybernetics in the Soviet Union. Part III focuses on engineering, ethics, and society, with chapters on engineering education and practice in China and the West. The book’s analyses of the interactions of science, engineering, ethics, politics, and policy in different societal contexts are of special interest. The volume as a whole marks a new stage in the emergence of the philosophy of engineering as a new regionalization of philosophy. This carefully edited interdisciplinary volume grew out of an international conference on the philosophy of engineering hosted by the University of the Chinese Academy of Sciences in Beijing. It includes 30 contributions by leading philosophers, social scientists, and engineers from Australia, China, Europe, and the United States. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:We Walk the Path Together: Learning from Thich Nhat Hanh and Meister EckhartSeung Hee KangWe Walk The Path Together: Learning from Thich Nhat Hanh and Meister Eckhart. By Brian J. Pierce. New York: Maryknoll, 2005. 202 pp.Being that he is a contemplative, Pierce’s Trinitarian Christian love beautifully manifests itself in this book in his art of interdialoguing on the Buddhist-Christian religious traditions. Pierce’s manner of interdialoguing resonates with (...) what Ann Belford Ulanov also attempts: “I am writing not about how to prove that God exists but rather about what happens religiously when psyche and soul create a space for conversation [End Page 178] out of which life can flow.” 1 If someone asks whether Pierce and Ulanov point to two different absolute realities, my response would be, “Absolutely not!” The sacred inner space that Pierce points to, in light of the two contemporary mystics from different religious traditions, namely Thich Nhat Hanh and Meister Eckhart, also reminds me of Lao Tzu’s wisdom that permeates the Tao Te Ching, specifically in his concept of “useful emptiness.” 2We Walk the Path Together is neither an abstract account nor sheer philosophical speculation. The whole of the book is rooted in Pierce’s faith-based lived experience (pp. 1, 3, 5, 7, 11, 113, 163); this renders the book life-giving and deeply ecological in terms of its transcendence of either/or dichotomies.Chapter 1 summarizes the meaning and art of dialogue. Pierce utilizes mystical language to illustrate what the dialogue is. For Pierce, dialogue connotes “a mutual giving and receiving, and it posits a profound sense of being of one heart and mind” (p. 3). Pierce extends his personal experience of a vow of obedience into the meaning of dialogue. For Pierce, this vow means to “transcend any illusion of separateness” and thus “obedience liberates him from his tiny world of ego” (p. 4). In the process of dialogue, according to Pierce, “our hearts are challenged to grow larger, all-inclusive and universal” (p. 8). This expansion of the heart is what mystics call “magnanimity.” As Pierce is acutely aware, “magnanimity is one of life’s un-planned for graces; it teaches us to see and hear and learn things that we never dreamed were possible” (p. 9).Chapter 2 discusses mindfulness as a gateway to eternity. Pierce asserts that home is everywhere in the present moment; it is where freedom is possible. This particular point echoes with what Thomas Merton spoke about in reference to the prodigal son who turned away from his father: “sin is our refusal to be what we are, a rejection of our spiritual reality hidden in the mystery of God” (p. 23). However, when the prodigal son was restored his senses, he was able to attune himself back to present moment: “I’ll get up and go to my father” (cited by Pierce, ibid.). He became free from his sin, returning home. In this chapter, Pierce highlights the words of the mystics (St. Irenaeus, St. John of the Cross, Brother Lawrence, St. Augustine, Jan van Ruusbroec, and St. Catherine de Siena) who lived this present moment in order to help the readers understand the intrinsic relationship between our mindfulness of the present moment and eternity. He argues that Buddhist teachings on mindfulness and Christianity’s tradition concerning the kingdom of God are mutually informative (pp. 19, 21).In chapter 3, Pierce expands the meaning of present moment through its association with breathing; being present is not a concept, but a living reality, as we experience the Holy Spirit in our breathing practice, such as centering prayer and meditation (p. 36). Pierce carefully states, “contemplation is authentic only if it flows out in loving-kindness to others. When we breathe in all the spiritual energy of the universe, thus, we literally implode—a spiritual ego intoxication” (p. 40). Pierce explains further what contemplation means; breathing in the Holy Spirit and breathing out the Holy Spirit may mean two separate phenomena. Contemplation is, for Pierce, authentic, only when the Spirit that is breathed in reaches out to our community. [End Page 179] This is also Pierce’s ecological aspect... (shrink)

The traditional view of tax holds that consumption taxes fail tax the yield to capital, whereas income taxes do, leading to John Stuart Mill's criticism of the income tax as a "double tax" on wealth that is saved. A better analytic understanding illustrates that there are two types of consumption taxes. A prepaid consumption or (equivalently) wage tax indeed ignores the yield to capital. But a consistent progressive postpaid consumption tax gets at such yield, at the individual level, when but (...) only when the returns to capital are used to elevate lifestyles in material terms. Such a tax allows "ordinary" savings that move around labor earnings, in constant dollar terms, to different periods of an individual's life, such as times of retirement or heightened medical or educational needs. Because a progressive postpaid consumption tax falls on the yield to capital at the right time-when its use at the individual level becomes manifest-all other taxes on capital, such as capital gains, gift and estate, and corporate income taxes, can and should be repealed, in the name of fairness. Footnotesa I thank the editors, my research assistants Alex Baskin and Nina Kang, and the other contributors to this volume for their helpful comments. (shrink)

Introduction -- Tending the dark fire: the Boehmian notion of drive -- The night-side of nature: the early Schellingian unconscious -- The speculative psychology of dissociation: the later Schellingian unconscious -- Schellingian libido theory.

Background Empirical studies of surrogate decision-making tend to assume that surrogates should make only a 'substituted judgement'—that is, judge what the patient would want if they were mentally competent. Objectives To explore what people want in a surrogate decision-maker whom they themselves select and to test the assumption that people want their chosen surrogate to make only a substituted judgement. Methods 30 undergraduate students were recruited. They were presented with a hypothetical scenario about their expected loss of mental capacity in (...) the future and asked to answer some questions about their choice of surrogate. These data were analysed qualitatively using thematic content analysis. Results Most respondents talked about choosing someone who was caring and competent in certain ways, giving interesting evidence for their judgements. Surprisingly few highlighted how well they thought their chosen surrogate knew their preferences and would be able to make a substituted judgement. Moreover, few specified that their chosen surrogate had similar attitudes and values to their own and so would make a similar decision to theirs in the circumstances presented. Some respondents also referred to the social role of their chosen surrogate or the social dynamics of their situation which influenced their choices, as well as to ideas of reciprocity and characteristics of honesty and loyalty. Conclusion In the event that they lose mental capacity, many people will not select a surrogate to decide about medical treatments on their behalf solely on the basis that they expect their surrogate to make a substituted judgement. (shrink)

The early Schelling and the romantics constructed the unconscious in order to overcome the modern split between subjectivity and nature, mind and body, a split legislated by Cartesian representationalism. Influenced by Boehme and Kabbalah, the later Schelling modified his notion of the unconscious to include the decision to be oneself, which must sink beneath consciousness so that it might serve as the ground of one's creative and personal acts. Slavoj Zizek has read the later Schelling's unconscious as a prototype of (...) Lacan's reactive unconscious, an unconscious that only exists as the excluded other of consciousness. This reading, though close to the text of Schelling, misses something essential: the unconscious for Schelling is not a repression but a condition of the possibility of life and love. (shrink)

Context: Philosophical debates in recent decades have developed new ways of dealing with old philosophical problems such as reality, truth, knowledge, language, communication, and action. These new approaches deserve serious consideration because they can improve the discourse of radical constructivism. Problem: This paper discusses the following problem: How can we overcome dualistic and ontological approaches to basic philosophical problems – problems that are relevant to all scientific domains? Method: The method applied here can be roughly described as a transition from (...) entities/substantives/identities to actions and processes, the actions and processes from which so-called entities result. Action-orientation – or an actor-based process – is necessarily combined with sense-orientation as provided by culture and society. Results: The paper demonstrates how the problems mentioned above can be reformulated in a non-dualistic and non-ontological way. Implications: Opening up constructivist thinking to insights provided by neighbouring philosophical approaches facilitates interdisciplinary cooperation and helps overcome dualistic remnants – as well as the cognitive one-sidedness of traditional constructivism. (shrink)

In this paper the authors argue that research ethics committees should not be paternalistic by rejecting research that poses risk to people competent to decide for themselves. However it is important they help to ensure valid consent is sought from potential recruits and protect vulnerable people who cannot look after their own best interests. The authors first describe the tragic deaths of Jesse Gelsinger and Ellen Roche. They then discuss the following claims to support their case: competent individuals are epistemologically (...) and ethically in the best position to say which risks are reasonable for them, so RECs should be no more restrictive than the “normal” constraints on people taking risks with themselves; RECs do not judge individual competence ; individual liberty is mostly limited by what serves the public interest, and RECs do not determine public interest; RECs may have a paternalistic role in preventing exploitation of competent people vulnerable to the use of incentives, and in protecting the interests of incompetent people; however, the moral and political authority of RECs has not been established in this respect. (shrink)

Increasingly, medical students are required to face up to ethical issues in their training and practice. At the same time, there is growing interest in philosophy courses in the ethical issues raised by medical practice. This textbook, designed primarily for students of medicine, develops the issues to a philosophical level complex enough to be satisfying to students of philosophy as well as MA students on applied ethics courses. The author advocates an approach to medical ethics which breaks out of the (...) straitjacket of the narrow choice between utilitarian or deontological theory, and contains a valuable discussion of practical wisdom. It maintains a balance between case studies and philosophical arguments - which are developed in a historical context, and will be of interest at all levels of the medical profession. (shrink)

Increasingly, medical students are required to face up to ethical issues in their training and practice. At the same time, there is growing interest in philosophy courses in the ethical issues raised by medical practice. This textbook, designed primarily for students of medicine, develops the issues to a philosophical level complex enough to be satisfying to students of philosophy as well as MA students on applied ethics courses. The author advocates an approach to medical ethics which breaks out of the (...) straitjacket of the narrow choice between utilitarian or deontological theory, and contains a valuable discussion of practical wisdom. It maintains a balance between case studies and philosophical arguments - which are developed in a historical context, and will be of interest at all levels of the medical profession. (shrink)

In the academic year 1920-1921 at the University of Freiburg, Martin Heidegger gave a series of extraordinary lectures on the phenomenological significance of the religious thought of St. Paul and St. Augustine. The publication of these lectures in 1995 settled a long disputed question, the decisive role played by Christian theology in the development of Heidegger’s philosophy. The lectures present a special challenge to readers of Heidegger and theology alike. Experimenting with language and drawing upon a wide range of now (...) obscure authors, Heidegger is finding his way to Being and Time through the labyrinth of his Catholic past and his increasing fascination with Protestant theology. A Companion to Heidegger's Phenomenology of Religious Life is written by an international team of Heidegger specialists. (shrink)

This article concerns the morality of establishing regulated kidney markets in an effort to reduce the chronic shortage of kidneys for transplant. The article tries to rebut the view, recently defended by James Taylor, that if we hold autonomy to be intrinsically valuable, then we should be in favor of such markets. The article then argues that, under current conditions, the buying and selling of organs in regulated markets would sometimes violate two Kantian principles that are seen as moral constraints. (...) One principle forbids expressing disrespect for the dignity of humanity; the other forbids treating others merely as means. In light of the moral danger posed by regulated markets, the article advocates an alternative way of diminishing the current organ shortage, namely opt-out systems of cadaveric organ donation. (shrink)

Cora Diamond has recently criticised as mere legend the interpretation of a quip of Ramsey's, contained in the epigraph below, which takes him to be objecting to or rejecting Wittgenstein's Tractarian distinction between saying and showing. Whilst I agree with Diamond's discussion of the legend, I argue that her interpretation of the quip has little evidential support, and runs foul of a criticism sometimes made against intuitionism. Rather than seeing Ramsey as making a claim about the nature of propositions, as (...) Diamond does, we should understand him as making a claim about the grammar of the logical connectives. Such a view coheres with the extant evidence of the nature of Wittgenstein's and Ramsey's 1929 philosophical encounters. It is also compatible with attributing to Ramsey a recognition of Wittgenstein's distinction and with denying that criticising it is the lesson of the quip. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Who or What is the Preembryo?S.J. Richard A. McCormick (bio)IntroductionAlthough widely used by scientists, the term "preembryo" has raised some suspicions. Histopathologist Michael Jarmulowicz (1990), for example, asserts that the term was adopted by the American Fertility Society (AFS) and the Voluntary Licensing Authority (VLA) in Britain "as an exercise of linguistic engineering to make human embryo research more palatable to the general public."I cannot speak for the VLA, (...) but I can clarify that this was not the motive of the AFS. As a member of the AFS ethics committee that discussed and adopted this terminology, I know that our discussion was not tied to embryo research or moral issues. The term "preembryo" was adopted because the earliest stages of mammalian development primarily involve establishment of the nonembryonic trophoblast, rather than the formation of the embryo. As Clifford Grobstein (1988, p. 61), a distinguished basic scientist who also sat on the AFS committee notes:The scientific rationale for the term preembryo... is its greater accuracy in characterizing the initial phase of mammalian and human development.... The status implications of such a change in terminology were not at issue in the discussion.This is not to say that the moral status of the preembryo is not a concern worthy of independent consideration. It is an important question with significant practical implications, especially in the context of in vitro fertilization. At stake are issues such as: (1) what may be done to preembryos before transfer; (2) whether all preembryos must be transferred; and (3) what may be done to preembryos that are not transferred (Ethics Committee of the American Fertility Society (AFS) 1986, p. 29S). Furthermore, emergency treatment of rape cases may also depend on such a determination. [End Page 1]Cryopreservation, which entails freezing unused preembryos for possible later use, is one example of a procedure that raises issues associated with the moral status of the preembryo. Cryopreservation decreases the number of stimulated egg recovery cycles a woman must undergo and increases flexibility in transfer protocols. But thawing of the preembryos is not a completely benign process; significant numbers of the preembryos die in the process and injury cannot be excluded.In addition, down the road a year or so lies preimplantation genetic diagnosis, now being tested in several centers of reproductive research. This would involve the removal of one or more cells from a preembryo developing in vitro. The DNA from these cells would be studied and then only genetically normal preembryos would be transferred. With the growth in knowledge about single gene defects and the rapid advance of amplification technology, which allows gene visualization, it is not difficult to imagine scientists embarking on a variety of micromanipulations of the preembryo for the sake of gaining knowledge.Not all research with gametes involves preembryos, but clearly some experiments and procedures await resolution of the moral status of the preembryo. I contend in this paper that the moral status—and specifically the controversial issue of personhood—is related to attainment of developmental individuality (being the source of one individual). This contrasts with the view that holds that personhood occurs earlier, at the point of genetic uniqueness. I believe that an embryo that has developed to the point where it can be one individual and one individual only, differs in moral status from a preembryo that has not, even if in many cases we may choose to treat them similarly.The Scientific UnderpinningsTwo things must be kept in mind—and in a sense, in tension—in turning to science for help in assessing the status of the preembryo. First, science is not competent to decide the question of personhood or ensoulment. As the Catholic document, Declaration on Procured Abortion, which I will return to later, notes: "It is a philosophical problem" (Congregation for the Doctrine of the Faith (CDF) 1974, p. 10, endnote 19). On the other hand, another Catholic document, Donum vitae(CDF 1987), notes that the conclusions of science provide a "valuable indication" for reason's deliberations about personhood. We might say that if science cannot decide the question of personhood, neither can it be decided without science.For my review of embryological science... (shrink)

There is, in the Ramsey Archive at the Hillman Library of the University of Pittsburgh, a note, written in 1929, in Ramsey's hand and mostly in German, consisting of twenty paragraphs the contents...