Most donated organs in the United States come from brain dead donors, while a small percentage come from patients who die in “controlled,” or expected, circumstances, typically after the family or surrogate makes a decision to withdraw life support. The number of organs available for transplant could be substantially if donations were permitted in “uncontrolled” circumstances–that is, from people who die unexpectedly, often outside the hospital. According to projections from the Institute of Medicine, establishing programs permitting “uncontrolled donation after circulatory (...) determination of death,” or uDCDD, throughout the United States has the potential to provide 22,000 more donation opportunities annually. In contrast, U.S. controlled donation after circulatory determination of death, or cDCDD, cases have increased progressively over the past decade from 87 to 848 donors, but currently account for only 10.6 percent of all deceased donors. Following the IOM recommendations, several projects exploring the feasibility of uDCDD were funded by the federal government, including a grant from the Health Resources and Services Administration that supported a pilot project in New York City in which the authors of this article participated.A key feature of our protocol, and indeed of many uDCDD protocols, is the initiation of preservation methods such as chest compressions and extracorporeal membrane oxygenation shortly after death in order to perfuse and preserve the donor's organs. Critics of uDCDD argue that the means of determining death deviates from generally ascribed principles. They assert that reinstituting circulation in order to preserve organs has the effect of “undoing” the prior determination of death. The result is that cDCDD is widely accepted and practiced routinely even though it only marginally increases the number of organs available for transplantation, and uDCDD is widely considered unacceptable despite being ethically embraced and proven to significantly increase organ donation opportunities in other countries. This article explores the evolution of this counterintuitive state of affairs and calls for a policy that, in line with the IOM report, allows for both cDCDD and uDCDD protocols. (shrink)

In the late 1810s and 1820s the Edinburgh phrenologists were largely concerned with trying to establish phrenology as the true science of mind. They challenged the accepted theories about the nature of mind and the brain; in turn, phrenology was attacked by the proponents of Scottish common-sense philosophy and by some medical men. The ensuing debate, which is discussed as an example of conflict between incommensurable world-views, involved a wide range of contentious theological, philosophical, scientific and methodological issues.

ch. 1. Sistemnoe videnie obrazovanii︠a︡ -- ch. 2. Osnovnye poni︠a︡tii︠a︡ i zadachi -- ch. 5. Osushchestvlenie prot︠s︡essa.

Introduction No consent for health and medical research is appropriate when the criteria for a waiver of consent are met, yet some ethics committees and data custodians still require informed consent. Methods A single-blind parallel-group randomised controlled trial: 1129 families of children born at a South Australian hospital were sent information explaining data linkage of childhood immunisation and hospital records for vaccine safety surveillance with 4 weeks to opt in or opt out by reply form, telephone or email. A subsequent (...) telephone interview gauged the intent of 1026 parents (91%) in relation to their actions and the sociodemographic differences between participants and non-participants in each arm. Results The participation rate was 21% (n=120/564) in the opt-in arm and 96% (n=540/565) in the opt-out arm (χ2 (1 df) = 567.7, p<0.001). Participants in the opt-in arm were more likely than non-participants to be older, married/de facto, university educated and of higher socioeconomic status. Participants in the opt-out arm were similar to non-participants, except men were more likely to opt out. Substantial proportions did not receive, understand or properly consider study invitations, and opting in or opting out behaviour was often at odds with parents' stated underlying intentions. Conclusions The opt-in approach resulted in low participation and a biased sample that would render any subsequent data linkage unfeasible, while the opt-out approach achieved high participation and a representative sample. The waiver of consent afforded under current privacy regulations for data linkage studies meeting all appropriate criteria should be granted by ethics committees, and supported by data custodians. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12610000332022. (shrink)

While many aspects of Shapin's historical thesis are accepted, this paper raises objections to specific parts of his historical account, and also to the historiographical assumptions underlying his sociological programme. In particular, Shapin's claim to have explained the Edinburgh phrenology debate in social terms is analysed and rejected.

The participants in this round table have, I see, been basing their conclusions on their personal life experience. In the present situation that is perhaps the most suitable form of expression for me too.

Berkeley's "new theory of vision" and, In particular, His sensationalist solution to the problem of judging distance and magnitude were discussed by many eighteenth-Century authors who faced a variety of problem situations. More specifically, Berkeley's theory fed into the debate over whether the phenomena of vision were susceptible to mathematical analysis or were experientially determined. In this paper a variety of responses to berkeley are examined, Concluding with thomas reid's attempt to distinguish physical optics (which can be analyzed geometrically) from (...) the psychology of vision (in which experience plays a major role). (shrink)

‘Let us not forget this: when “I raise my arm”;, my arm goes up. And the problem arises: what is left over if I subtract the fact that my arm goes up from that fact that I raise my arm?’.

В монографии опубликованы статьи преподавателей, аспирантов кафедры философии ВГПУ и других вузов, посвященные актуальным проблемам философии науки, философским проблемам конкретно-научного знания.