A frequent feature of pharmaceutical research is the open label extension study, in which patients participating in double blind placebo controlled trials of new medications are invited, on completion of the initial trial, to take the study drug for some further period. Patients are openly given the active substance at this stage, regardless of their assignment in the initial trial. Investigators are typically reluctant to unblind the patients’ assignment at the point of entry into the open label phase, on the (...) grounds that this may introduce ascertainment bias in the main study.It is argued that patients invited to participate in open label extension studies cannot give a proper consent to such research unless they know to which arm of the main trial they were recruited. It is further argued that to recruit certain groups of patients from placebo controlled trials into open label extension studies may also be unethical for clinical reasons. (shrink)

This paper offers a realist critique of socialresearch on health inequalities. A conspectus of thefield of health inequalities research identifies twomain research approaches: the positivist quantitativesurvey and the interpretivist qualitative `casestudy'. We argue that both approaches suffer fromserious philosophical limitations. We suggest that aturn to realism offers a productive `third way' bothfor the development of health inequality research inparticular and for the social scientific understandingof the complexities of the social world in general.

As family physicians, general practitioners play a key role in safeguarding children. Should they suspect child abuse or neglect they may experience a conflict between responding to the needs and interests of the child and those of an adult patient. English law insists on the paramountcy of the interests of the child, but in family practice many other interests may be at stake. The authors argue that uncritical adoption of the paramountcy principle is too simplistic and can lead, paradoxically, to (...) greater harm. They argue for a more subtle and nuanced view of interests and of conflicts of interest in safeguarding children. (shrink)

There has been an increase in recent years in the use of empirical methods in healthcare ethics. Appeals to empirical data cannot answer moral questions, but insights into the knowledge, attitudes, experience, preferences and practice of interested parties can play an important part in the development of healthcare ethics. In particular, while we may establish a general ethical principle to provide explanatory and normative guidance for healthcare professionals, the interpretation and application of such general principles to actual practice still requires (...) interpretation and judgement. And many situations in healthcare practice are complex and may involve a variety of principles, each of which may conflict with the others. Simple surveys or interview studies may not be sufficient if we wish to develop a nuanced approach to ethical practice that can be set out in guidelines, codes or directives. We do not resolve moral questions by plebiscite. In this paper, the authors argue for the use of consensus methods to develop shared understanding of ethical practice, and they argue further for the combination of the Delphi method with the use of vignettes to illustrate the kind of situations that may occur in practice. They develop their argument in part by reference to their experience of using this approach in their recent research. (shrink)

Local review of research by ethics committees in the UK has long been held to be an important right of the local research ethics committee and, even with the introduction of the European Clinical Trials Directive, the governance arrangements for research ethics committees continue to allow for local review of multicentre studies. There is no requirement for local review in either the European Union directive or in the guidelines on good clinical practice, and there is little evidence of it anywhere (...) else in Europe. The idea that there can be “local”, as opposed to “central” ethical issues in research is an interesting one, which raises important issues about the nature of research ethics and ethical review. The aim of this paper is to argue that there are no such things as local issues in research ethics, and suggest that those questions currently addressed as local issues properly belong within the research governance framework. (shrink)

In this article we focus upon the embodiment of vulnerability as an area in which medicine, society and the humanities can be profitably conjoined. We illustrate our argument with two interrelated case studies of narratives of the embodiment of ageing and longevity. First, we draw upon Leoš Janáček’s opera The Makropulos Case (1926) as a locus for debates about human longevity. Second, we discuss 70-year-old Janáček’s decade of unrequited love for a woman 37 years younger than himself, through an examination (...) of their intimate letters. We suggest that both the opera and elements of Janáček’s biography illuminate the passionate emotions that are often hidden behind ‘the mask of ageing’. Finally, we propose that a focus on the embodiment of vulnerability is a productive catalyst for research on narratives of ageing. (shrink)

A quaint little volume "written through intense introspection" and the expression of a "personal outlook." Mr. Wainwright has ideas on frigidity in American woman, the anti-conviviality of litter-bugs, the oneness of everything, and the stationary passage of time. He also has intriguing views on the word-object relation, infinity, beauty, love, perception, personal identity, and of course freedom. There are traces of Zen and a strong predilection for relativism and subjectivism. Mr. Wainwright is thoroughly existentialistic.—P. S.

In lieu of an abstract, here is a brief excerpt of the content:WAiINWRIGHT, MARI'.rAIN, AND AQUINAS ON TRANSCENDENT EXPERIENCES1 Lours RoY, O.:P. Boston College Chestnut Hill, Massachusetts WHAT COULD ALLOW thoo1ogiianis to s1ay that rbrtanJScendent expmiences we, exiplicitly or implicitly, expenienoos of God? To ooswieir tMs question fully, one would ihavie Ibo ooga;ge in :two d:iisltmot mqumi1es. Fiirsit, religious, moml, iand psyoho101 giical icristeci:a 1are required in the evtalurution of concrete oases. They ctan he found in rthe grerut spi:ritUJal wriitings (...) of humankind. Secood, one mustt have reOOUTISe to ep;iisttemo1ogiica:l :and thieo1ogiaa1 foru.ndmbions if one wianits 1to 1an.swer tb.ie questtion in. its generality. ln,thJi:s a:riticle, I shall not preserut 1tihe religious, moral, 1and psychofogica1 criteria, because I sihou1d Jrike to OOiilCelllb:iaJte on mrueillecrtUJal prohliems invohiimg tihe sooond kmd of ·consideration. I shiaill use ais 1a ISl'bar:bing-pomt 1a book on mys:ticism written by Wiilliiam J. W1ainwcight. Turr tihe purposes of ttihis ess:ay, "trlanJScenidelllt experiences" wiilil. mean whmt W1affin:WI"ight calls " mystical experienoos " or " uniJtM"Y srbrubeis." 2 The phvase wi:ll. ailso inclUJde Otito'1s " nu:minoUJs etpeirieinces," Mrusforw's " peak expeme:nces" and, vecy hrorudJy, wll experiences that do not :focus on 1a, specific tidea :but afiectively open up to the mySltery wll:uich enoompas1ses hruman li£e. 1 I am grateful to the members of the Boston Theological Society for their questions and comments on the initial version of this essay. 2See his definition, in Mysticism: A. Study of Its Nature, Cognitive Value and Moral Implications (Madison: University of Wisconsin Press, 1981), IS. The rest of his first chapter offers a good discussion of problems of typology as well as of the distinction between descriptions and interpretations of mystical experiences. Unfortunately I cannot take account of this interesting discussion in the limits of this paper. 655 656 LOUIS ROY, O.P. In conrtending thrut my:stical experieTIJces ihav;e nnetic v:al,idity if they are ra speciiaI kind of perception, W ainw~igrhit tries to 'Settle an 1:epis1temo10-gicra1l is1sue; ill downplaying "doctrina1l con-.sideration:s" and iJn rejeobing ",a thieo1ogical op~nion whioh cannoit he esbaiblished ihy philosoplhi1oal rea1s10n," 3 he suggesit,s 1bhat his oolJJ!teTIJtiion can 1and should he 1supp01rted only by philosophioal a11gumelJJ!t1s. In thi'S esisay, I intend 1to ques1truon thi:s two.fo1d 1tlhesis of Wwinwrrtiight'1s 1and to explore an albernartive. Wa:inwright, whose manner of dea1ing wirbh iinitellectuaJ proh1ems 1acoo,rds with \the p11esent-day main lme in Ang1o-American philosophy of re1i§ion,4 non:ebheless pays metiiculou:s a.trbention Ito neoscho1a1s1tic theori!es of mys1tiioism in Chapter 4 of his hook. Such 1an a;t1t:empt 1at serious diJalogue is of specia,l :intel'es1t since :i:t illu:stria1tes the diffioulty of finding a mee1ting ground for three qUJite different scho1w1·Jy wo,rlds: the p0:s1t-rpie1t~st one, wihich I regard a,s W,ruinwr.ighit'·s, modern sohoilais1t1icrsm, and Thomas Aquinas. A1though W1a1inwr1igh1t does not refer 1 to the lat:ter's views on the.topic, these views nev:erthe1e:s,s de:serve examination bo1th 1a1s the sou11oe of neoscho:iJa,stic 1theorie1s and 1as conti :ia:sting in 1s1 evera1 111espects wiith,them. The first pa~t of my paper will sketch three of the intellec1tuaJ contexits in which triam:soendefll!t experi!enoes may be discussed. The second part will highlight some features of Aquinrus's episitmnology and theo1ogy of gmce which whll enable us fo dertel'ITl!iDJe 1 at whait levels of cogn:iition experienceis of 1t11amiscendence should be s]tua1ted 1 and in what 1s1ense they may rbe s1aid to he experielll!ceis of God. 'Iihe third rpart wm presie111t how Thomais envisages the role of love :in 1the affective knowledge tha1t rbe1ieviers i;eceiive of God. F1inailly, the fomlth pamt will indicrabe the modial~ty of such lmowledge, namely, the dimect a1iva:renerss of orur aets and fee1ings of 1ove. a Wainwright, 162-163 and 180. 4 Exemplified by such authors as John Hick, Stephen Katz, Ninian Smart, Walter T. Stace, R. C. Zaehner. TRANSCENDENT EXPERIENCES 657 I. Three lnterprretative Contexts Since Schleiermadher, moist German... (shrink)

Many believe that objective morality requires a theistic foundation. I maintain that there are sui generis objective ethical facts that do not reduce to natural or supernatural facts. On my view, objective morality does not require an external foundation of any kind. After explaining my view, I defend it against a variety of objections posed by William Wainwright, William Lane Craig, and J. P. Moreland.

Together again for the first time, Marx and Durkheim join forces in the pages of Disintegration: Bad Love, Collective Suicide, and the Idols of Imperial Twilight for a dialectical exploration of the moral economy of neoliberalism, animated, as it is not only by the capitalist chase for surplus value, but also by an immortal vortex of sacred powers. Classical sociology and psychoanalysis are reconstituted within Hegelian social ontology and dialectical method that differentiates between the ephemeral and free and the eternal (...) and fixed aspects of modern life. (shrink)

t. 1. Dialog s V. V. Davydovym -- t. 2. Nereshennye problemy razvivai︠u︡shchego obrazovanii︠a︡.

The Blackwell Guide to the Philosophy of Religion features fourteen new essays written by some of the most prominent philosophers working in the field. Contributors include Linda Zabzeski, Hugh McCann, Brian Leftow, Gareth B. Matthews, William L. Rowe, Elliott Sober, Derk Pereboom, Alfred J. Freddoso, William P. Alston, William J. Wainwright, Peter van Inwagen, Philip Kitcher and Philip Quinn. Features fourteen newly commissioned essays. Provides a comprehensive treatment of the major problems in the philosophy of religion. Surveys the field (...) and presents distinctive arguments. (shrink)

George Berkeley is one of the greatest and most influential modern philosophers. In defending the immaterialism for which he is most famous, he redirected modern thinking about the nature of objectivity and the mind's capacity to come to terms with it. Along the way, he made striking and influential proposals concerning the psychology of the senses, the workings of language, the aims of science, and the scope of mathematics. In this Companion volume a team of distinguished authors not only examines (...) Berkeley's achievements but also his neglected contributions to moral and political philosophy, his writings on economics and development, and his defense of religious commitment and religious life. The volume places Berkeley's achievements in the context of the many social and intellectual traditions - philosophical, scientific, ethical, and religious - to which he fashioned a distinctive response. (shrink)

Richard Swinburne is one of the most distinguished philosophers of religion of our day. In this volume, many notable philosophers in Britain and america unite to honour him and to discuss various topics to which he has contributed significantly. These include general topics in the philosophy of religion such as revelation, and faith and reason, and the specifically Christian doctrines of the Trinity, the Incarnation, and atonement. In the spirit of the movement which Richard Swinburned has spearheaded, the essays in (...) this collection use analytic philosophical methods to examine doctrines in particular religious traditions, expanding upon traditional discussions of theism. As such, this volume represents a field-report on the interaction of philosophy and Christian thought in the English-speaking world: a fitting tribute to the Nolloth Professor of the Philosophy of Christian Religion at the University of Oxford. Richard Swinburne has himself contributed and individual and personal Intellectural Autobiography.Contributors: William P. Alston, David Brown, Richard M. Gale, Rom Harré, Brian Hebblethwaite, John Hick, Peter van Inwagen, J. R. Lucas, David McNaughton, Philip L. Quinn, Eleonore Stump, William J. Wainwright, C. J. F. Williams. (shrink)

Doctors’ strikes are legally permissible in the UK, with the situation differing in other countries. But are they morally permissible? Doug McConnell and Darren Mann have systematically attempted to dismiss the arguments for the moral impermissibility of doctors’ strikes and creatively attempted to provide further moral justification for them. Unfortunately for striking doctors, they fail to achieve this. Meanwhile, junior doctors’ strikes have continued in the UK through 2023 and have now extended into 2024. In this response, which focuses on (...) the UK situation and specifically junior doctors’ strikes in the National Health Service (NHS) in England, I will demonstrate a central problem with their arguments—namely that they underplay the harms caused by prolonged doctors’ strikes by ignoring the harms to patients with cancer. This weakens their conclusion that strikes are morally permissible in terms of the conditions and thresholds they set. I then provide a psychological critique of their justification for strikes in terms of the interests of the public. It follows that invoking the controversial concept of supererogatory action is ungrounded but also absurd when you consider time-critical cancer care. If those representing striking doctors wish to maintain a modicum of moral respectability, they should mitigate for patients with cancer and negotiate reasonably and with urgency. (shrink)

The achievements of the textile industry in Roman Britain are often underestimated as a result of the meagreness of our available evidence. The Edict on maximum prices issued by Diocletian in A.D. 301 shows that British capes commanded high prices on the markets of the Empire, and that in the late third century A.D. British rugs were the best in the world. In view of the competition from the traditional centres of rug manufacture in the East, this is an astonishing (...) achievement. (shrink)

The received translation and interpretation of many of the technical terms current in the textile industry of the Roman Empire are inaccurate, because lexicographers have either fought shy of being precise, or have thought that they recognized in the ancient world technical processes which originated at a much later date. The evidence is often equivocal or insufficient, but may still yield details that have been overlooked. The textile expression scutulatus, to take an example, deserves more attention than Blümner has devoted (...) to it. When it refers to the appearance of a garment, Lewis and Short, s.v. scutulatus, translate ‘diamond or lozenge-shaped, checkered’. It seems worth while to attempt a more precise translation, and, if possible, to estimate the significance in context of the goods so designated. (shrink)

The introduction of novel diagnostic techniques in clinical domains such as genomics and radiology has led to a rich ethical debate on how to handle unsolicited findings that result from these innovations. Yet while unsolicited findings arise in both genomics and radiology, most of the relevant literature to date has tended to focus on only one of these domains. In this article, we synthesize and critically assess similarities and differences between “scanning the body” and “sequencing the genome” from an ethical (...) perspective. After briefly describing the novel diagnostic contexts leading to unsolicited findings, we synthesize and reflect on six core ethical issues that relate to both specialties: terminology; benefits and risks; autonomy; disclosure of unsolicited findings to children; uncertainty; and filters and routine screening. We identify ethical rationales that pertain to both fields and may contribute to more ethically sound policies. Considerations of preserving public trust and ensuring that people perceive healthcare policies as fair also support the need for a combined debate. (shrink)

Introduces an issue of Topoi on the topic, "Is theism a theory?" The issue contains articles by William J. Wainwright, D. Z. Phillips, William P. Alston, Stephen J. Wykstra, Stephen Maitzen, and James F. Sennett.

Background Noninvasive prenatal testing (NIPT) designed to screen for fetal genetic conditions, is increasingly being implemented as a part of routine prenatal care screening in the United States (US). However, these advances in reproductive genetic technology necessitate empirical research on the ethical and social implications of NIPT among populations underrepresented in genetic research, particularly Black women with sickle cell disease (SCD).Methods Forty (N = 40) semi-structured interviews were conducted virtually with Black women in the US (19 participants with SCD; 21 (...) participants without SCD) from June 2021 to January 2022. We employed a qualitative approach to examine the study participants’ perceptions of the potential advancement of NIPT for screening SCD in the fetus. Data were analyzed using NVivo 12 qualitative software.Results The themes revealed the complexities involving the intersectional lived experiences of SCD, prenatal care, lack of synergy among health providers, and NIPT decision-making. The results further revealed that even when Black women have shared commonalities in their lived experiences while navigating SCD and motherhood, their perceptions of NIPT screening technologies are divergent.Conclusion Expanding the ethical discourse on the social implications of NIPT is critical to fully elucidate how Black women perceive NIPT’s utility, particularly as NIPT advances to screen for SCD in the fetus. Neglecting to include Black women with genetic conditions in empirical studies on NIPT may contribute to ongoing health inequities and limit and constrain reproductive choices among Black women with and without SCD. (shrink)

Nearly everyone agrees that life has changed in our technological society, whether the contrast is with earlier stages in Western culture or with non-Western cultures. "Modernization" is just one of various terms that have been applied to the process by which we have arrived at the peculiar lifestyle typical of our age; whatever the term for the process, almost all analysts agree in finding technology to be one of its key ingredients. This is the judgment of critics of all sorts (...) - anthropologists, historians, literary figures, sociologists, theologians. Volume 4 in the Philosophy and Technology series brings the perspectives of philosophers to bear on the issue of characterizing contemporary life, mainly in high-technology societies. Some of the philosophers look at the issue directly. Others focus on work life - or on the living arrangements that surround or condition or offer refuge from work life in technological society. Still others reflect on particular technologies, especially biotechnology and computer technology, that are increasingly affecting both work and family life. There is also a paper on the nature of thinking in technologi cal praxis, along with two papers on whether it is appropriate to export this sort of thinking to Third World countries, and another paper on the issue of responsibility in technology - which would have fit better in volume 3 of the series, entitled Technology and Responsibility (1987). Finally, volume 4 closes with a broad-ranging bibliography that takes work and technology as its focus. (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)