This book offers a complete rethink of the institutional limits and possibilities of deliberative democracy and legitimacy. Examining several unresolved problems at the core of deliberative democratic theory, this volume will be vital reading for deliberative democratic theorists and public policy makers.

While euthanasia and assisted suicide have been the subject of continuing public debate, few studies have examined the attitudes of relevant patient groups. This study systematically reviews the research literature on patients’ attitudes from 1989 to 2003, to i) identify the number of studies, ii) evaluate study methods and measures, and iii) examine prevalence of favourable attitudes. A systematic search was undertaken across five databases. Methods of the 21 studies identified varied considerably. General support for euthanasia and assisted suicide was (...) substantial across patient groups, with lower support for these as a personal option. The cancer / terminally ill / palliative care patient group had the lowest median general support for euthanasia (60% [IQ1=47, IQ3=65]) and assisted suicide (50% [IQ1=38, IQ3=71]), while the general/older/younger patient group had the lowest median personal preference for these (18% [IQ1=14, IQ3=27]). The effect of question context on level of support was unclear, due to the variety and number of contexts used across questions. There is still work that needs to be done in this controversial area before any robust conclusions can be made concerning the attitudes of patients to euthanasia and assisted suicide, and the adoption of a minimum set of standard questions would enhance this work. (shrink)

Social responsibility on the part of business has various meanings, to some of which English law is more favourable than others. But the law could be changed. The author is a Solicitor and Lecturer in Law in the University of Bristol. His Corporate Power and Responsibility: Issues in the Theory of Company Law has recently been published by Oxford University Press.

Social responsibility on the part of business has various meanings, to some of which English law is more favourable than others. But the law could be changed. The author is a Solicitor and Lecturer in Law in the University of Bristol. His Corporate Power and Responsibility: Issues in the Theory of Company Law has recently been published by Oxford University Press.

Objectives: The aims of this study were to: (1) investigate patients’ views on euthanasia and physician-assisted suicide (PAS), and (2) examine the impact of question wording and patients’ own definitions on their responses. Design: Cross-sectional survey of consecutive patients with cancer. Setting: Newcastle (Australia) Mater Hospital Outpatients Clinic. Participants: Patients over 18 years of age, attending the clinic for follow-up consultation or treatment by a medical oncologist, radiation oncologist or haematologist. Main Outcome Measures: Face-to-face patient interviews were conducted examining attitudes (...) to euthanasia and PAS. Results: 236 patients with cancer (24% participation rate; 87% consent rate) were interviewed. Though the majority of participants supported the idea of euthanasia, patient views varied significantly according to question wording and their own understanding of the definition of euthanasia. Conclusions: Researchers need to be circumspect about framing and interpreting questions about support of ‘euthanasia’, as the term can mean different things to different people, and response may depend upon the specifics of the question asked. (shrink)

The theme of this paper is a philosophical theory of communication; more specifically, a theory about the understanding of language. It is an old theory, whose classical exponent was John Locke, and in the form that Locke expounded it the theory is now generally rejected by philosophers. But it is far from being a mere museum piece. The view about language that Locke put forward was a plausible one, and it has continued to be put forward in various forms. (...) My main concern here is with a very recent version of the theory, contained in a book published early in 1975; however, it will be helpful to begin with a brief account of Locke's version. This is not only classical, but is also simple and clear, and as such it may serve as a useful stepping-stone towards an understanding of the more modern version. (shrink)

Deep brain stimulation (DBS) is an effective treatment for the debilitating motor symptoms of Parkinson’s disease and other neurological disorders. However, clinicians and commentators have noted that DBS recipients have not necessarily experienced the improvements in quality of life that would be expected, due in large part to what have been described as the ‘psychosocial’ impacts of DBS. The premise of this paper is that, in order to realise the full potential of DBS and similar interventions, clinical services need (...) to be arranged in such a way that these psychosocial dimensions are recognised and managed. Our starting point is that the psychosocial effects of DBS ‘in the field’ present us with analytically-useful disruptions: they disturb and foreground deeply held assumptions relating to the individual, health and its treatment, and which in a crude form manifest as the myth of technological solutionism within health care. Drawing on scholarship in medical sociology and science and technology studies (STS), we argue that DBS brings to the fore the relational dimensions of personhood, and demonstrates the emotional and social turmoil that can result if the relational dimensions of personhood are ignored by clinical services. In light of this, we argue that DBS should be implemented within a regime of care. Drawing on ethnographic research of a paediatric DBS clinical service, we provide an example of a regime of care, and conclude by reflecting on what other DBS services might learn from this paediatric service. (shrink)

This study seeks to understand the subjective experience or lived world typical of patients with Parkinson’s disease. It uses qualitative methodology, grounded in a hermeneutic-phenomenological perspective, to consider lived experience in a small sample of 7 individuals. The analysis identified four themes that appear to be characteristic of the experience of PD: A) Denial, B) Emotion and symptom expression, C) Volitional and spontaneous action, and D) Alteration of temporal perspective. Concepts from existential-phenomenological philosophy were used to reflect upon these (...) themes to achieve a synthetic account of the subjective experience of PD. The findings of the study are compared to other findings in the phenomenological literature, and suggestions for further research are posed. (shrink)

Dysregulation of genes that control cell‐cycle progression and DNA repair is a hallmark of tumorigenesis. It is becoming increasingly apparent, however, that these defects also contribute to degeneration of post‐mitotic neurons under certain conditions. The gene for ataxia‐telangiectasia mutated (ATM) is a prototype for this dual mechanism of action, with loss‐of‐function mutations causing not only selective degeneration of cerebellar neurons but also increased susceptibility to breast cancer and hematologic malignancy. Increased dosage of amyloid precursor protein in Down syndrome (trisomy 21) (...) predisposes to dementia of Alzheimer type and may also contribute to acute leukemia and transient myeloproliferative disorder. The gene parkin, loss‐of‐function mutations in which account for about half of cases of early‐onset Parkinson disease, has been identified as a candidate tumor suppressor gene by several groups. Parkin is deleted or downregulated in several tumor types, and its re‐expression sensitizes derivative cell lines to inhibitors of cell‐cycle progression. The overlap of molecular pathways implicated in cancer and neurodegeneration challenges long‐held notions about differentiated cellular states and may open the door to novel therapeutic approaches to both groups of disorders. BioEssays 30:719–727, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

The decision to initiate invasive, first-in-human trials involving Parkinson’s disease presents a vexing ethical challenge. Such studies present significant surgical risks, and high degrees of uncertainty about intervention risks and biological effects. We argue that maintaining a favorable riskbenefit balance in such circumstances requires a higher than usual degree of confidence that protocols will lead to significant direct and/or social benefits. One critical way of promoting such confidence is through the application of stringent evidentiary standards for preclinical studies. We (...) close with a series of recommendations for strengthening the internal and external validity of preclinical studies, reducing their tendency toward optimism and publication biases, and improving the knowledge base used to design and evaluate preclinical studies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:FDA Releases Draft Guidance on Regulation of Genetically Engineered AnimalsJohn P. Gluck (bio) and Mark T. Holdsworth (bio)On 18 September 2008, the U.S. Food and Drug Administration (FDA) issued a draft set of guidelines for those involved in developing genetically engineered animals with heritable recombinant DNA (rDNA) constructs and is requesting comment from industry and the public about their content. The document does not impose new regulations but details (...) how existing laws and regulations apply to genetically engineered (GE) animals and offers advice to developers on how to negotiate the laws in the most efficient and productive manner. The draft guidance document is not legally enforceable at this juncture, but the guidelines are recommendations reflecting the FDA's "current thinking on a topic."The modification of GE animals being developed for commercialization, which are the focus of the document, fall into six categories: modifications intended to (1) enhance food quality—e.g., faster growing fish and meats with better nutritional profiles; (2) improve animal health via increased resistance to disease—e.g., mastitis in dairy cattle and Bovine Spongiform Encephalopathy (BSE); (3) create so-called "biopharm" animals capable of producing therapeutic products such as insulin, clotting factors, and tissues for human transplantation; (4) reduce the barriers to human animal interaction—e.g., hypoallergenic pets; (5) develop valid animal models of human disease—e.g., Parkinson's disease, Lesh-Nyhan's syndrome, and cancer; and (6) improve production of industrial or consumer products such as fiber. The timing of the guidelines coincides with the FDA's belief in an expected boon in the number of GE animals approaching the stage of commercialization.The FDA's involvement in the approval process emerges from the new animal drug provisions of the Federal Food Drug and Cosmetic Act and the definition of what constitutes a drug. The Act defines a new animal drug as "an article (other than food) intended to affect the structure or any function of the body of... animals." A rDNA construct intended to affect the structure or function of an animal meets the definition of a new animal drug, regardless of whether the resulting GE animals are intended for human food or the production of pharmaceuticals or any other substances. [End Page 393]Before proceeding to a review of the draft guidelines, it is important briefly to set the controversies around GE animals in historical and ethical context.The Ethical DebateFrom its inception, the intentional genetic modification or genetic engineering of molecules, plants, and animals by the techniques of gene splicing has consistently elicited strong responses from both the scientific community and the public. There are some data to suggest that although the concerns of scientists fall primarily into the category of possible biohazards, those of the public also reflect great concern about the intrinsic moral issues, such as whether there is something fundamentally wrong with this line of work, making it a form of forbidden knowledge (see, e.g., Gaskell 1997). When news of Paul Berg's attempts in 1970 to graft the primate tumor virus (SV 40) onto the intestinal tract bacteria Escherichia coli for the purpose of studying how normal cells may be transformed into cancerous cells was shared with colleagues, he was strongly encouraged to reflect on the potential public health risks if somehow the altered bacteria broke containment and entered the environment. Thanks to Berg's leadership, these concerns soon resulted in conferences held in Asilomar, California, and New Hampton, New Hampshire, where the ethical responsibilities of microbiologists involved in this research were discussed. These initial discussions resulted in what has come to be known as "The Moratorium Letter" (Shattuck 1996) published in the journal Science in 1974. This letter, signed by 11 leaders in the field, actually recommended restrictions on several types of experiments that were considered to be particularly risky and stated "that adherence to our major recommendations will entail postponement or possibly abandonment of certain types of scientifically worthwhile experiments" (Berg 1974). An international conference on the issues came to similar conclusions about the need for a research moratorium for the sake of public safety. Recommendations arising from conference participants led to the formation of the National Institutes... (shrink)

Northoff's target article presents a unifying theory of the pathophysiology of catatonia, as compared to Parkinson's disease. We address two arguments in particular that do not appear justified by available evidence: (1) The physiological basis of catatonia is the breakdown of right hemisphere prefrontal-parietal cortical connectivity, and (2) Dysfunction in this system results in specific deficits in termination of action.

On both sides of the debate on the use of embryos in stem cell research, and in reproductive technologies more generally, rhetoric and symbolic images have been evoked to influence public opinion. Human embryos themselves are described as either “very small human beings” or “small clusters of cells.” The intentions behind the use of these phrases are clear. One description suggests that embryos are already members of our community and share with us a right to life or at least respectful (...) treatment, whereas the other focuses on the differences between embryos and adult human beings with normal capacities, that is, their lack of sentience and of personal identity. The research on stem cells has been nicknamed “Frankenstein science” or presented as “research that could stop Parkinson disease.” Again, one description reminds us of scary science-fiction scenarios where the scientist is guilty of “playing God,” whereas the other description highlights the worth and potential benefits of the research outcomes. (shrink)

Online personalized genetic testing services offer accessible and convenient options for satisfying personal curiosity about health and obtaining answers about one’s genetic provenance. They are especially attractive to healthy people who wish to learn about their future risk of disease, as Paul Mason’s case study of “Jordan” illustrates. In this response, we consider how online genetic testing services are used by people diagnosed with a common neurodegenerative disease, Parkinson’s disease, to gain a sense of certainty regarding the future.

The phenomenological effects of deep brain stimulation (DBS) on the self of the patient remains poorly understood and under described in the literature, despite growing evidence that a significant number of patients experience postoperative neuropsychiatric changes. To address this lack of phenomenological evidence, we conducted in-depth, semistructured interviews with 17 patients with Parkinson's disease who had undergone DBS. Exploring the subjective character specific to patients' experience of being implanted gives empirical and conceptual understanding of the potential phenomenon of DBS-induced (...) self-estrangement. Our study concluded that (1) the more patients preoperatively felt alienated by their illness, the more they experienced postoperative self-estrangement, and (2) the notion of self-estrangement seems to exist in association with certain common qualitative characters, namely, loss of control, which reflects a deteriorative estrangement, and distorted perception of capacities, which reveals a restorative estrangement. These findings indicate that subjective self-reports help us to understand some aspects of the potential phenomenon of DBS-induced self-estrangement. (shrink)

While explaining a large proportion of any variance, accounts of the speed and accuracy of targetting movements use techniques (e.g., log transforms) that typically reduce variability before ''explaining'' the data. Therefore the predictive power of such accounts are important. We consider whether Plamondon's model can account for kinematics of targetting movements of clinical populations.

Recently it has been hypothesized that apoptotic cell death is involved in several neuropathological conditions including Parkinson's disease (PD). Initial morphological studies assessing the presence of apoptosis in Parkinsonian brain tissues yielded mixed results. Based on more recent studies in human PD brains as well in animal and cell culture models of the disease, a picture is emerging, however, that strongly suggests that many of the molecular players thought to participate in this type of neuronal cell death are active (...) in the disease. The task of researchers in the field is now to deduce how these players may be interacting with one another to bring about cell death in PD and to design effective therapies to interfere with these processes. BioEssays 23:640–646, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

The esteemed psychologist and thinker John Dewey headed for previously unexplored philosophical territory with this influential work. Written shortly after World War I, it embodies Dewey's system of pragmatic humanism and maintains that individuals can attain "a more ordered and intelligent happiness" by reconsidering the ultimate effects of their deepest beliefs and feelings. With its promise of achieving an understanding of the past and attaining a brighter future, Reconstruction in Philosophy remains ever relevant. "A modern classic." — Philosophy and (...) Phenomenological Research. (shrink)

The papers in this volume, first published in 1982, deal with a number of different aspects of Marx's ideas and the varying constructions put on them by later Marxists. Based on a lecture series, they examine Marxist views of the nature of philosophy, of history and historical explanation, the role and importance of politics, and of literature and the place of ethics. Among the Marxists considered are Lukacs, Sartre, Habermas, Althusser and Macherey. A continuous concern through the volume is the (...) relation within Marxist thought of fact and value, with the implications that will have for our actions. (shrink)

With precision and profundity born of 30 years of devoted study, John Boyle offers an essential introduction to St. Thomas Aquinas on Scripture, shedding helpful light on the goals, methods, and commitments that animate the Angelic Doctor's engagement with the sacred page. Because the genius of St. Thomas's approach to the Bible lies not so much in its novelty but rather in the fidelity and clarity with which he recapitulates the riches of the preceding interpretive Tradition, this initiation into (...) St. Thomas's vision of Scripture is itself an orientation to the Church's vision of Scripture, from the Fathers through and beyond the Middle Ages. St. Thomas's embeddedness within the Church's Tradition and his own historical context is integral to his approach to Scripture, yet it sets him at some distance from modern readers, for whom his interpretive vision may seem perplexing or even impenetrable. In this Primer, Boyle first provides an acclimation to this medieval context through a survey and explanation of pertinent technical terminology used by St. Thomas and characteristic of the scholastic theology of the time. With an eye to the medieval practice of considering Scripture according to the fourfold division of causes, Boyle builds on this initial foundation by exploring in turn St. Thomas's accounts of the end or use of Scripture (final cause), its divine and human authorship (efficient cause), its order and division (material cause), and its literary styles or genres (formal cause). Drawing on writings from across St. Thomas's corpus, but especially his work On the Commendation and Division of Sacred Scripture and the prologues to his biblical commentaries, Boyle masterfully elucidates both the hermeneutical principles and deep wisdom of the Angelic Doctor's approach to Scripture, imparting invaluable guidance not only for reading and understanding St. Thomas and other great masters of the Tradition, but also-and ultimately-for understanding Scripture in light of this Tradition and reading it with greater benefit and joy. (shrink)

Despite recurring efforts, a gap exists across a variety of contexts between the protection of patients' safety in theory and in practice. This timely Research Handbook highlights these critical issues and suggests both legal and policy changes are necessary to better protect patients' safety. Multidisciplinary in nature, this Research Handbook features contributions from eminent academics, policy makers and medical practitioners from the Global North and South, discussing the essential facets concerning patient safety and the law. It highlights how the role (...) of legislation and case law has the potential to influence, both positively and negatively, medical practice and the quality of care. Chapters explore patient safety and the global health agenda; physiotherapy; 'non-therapeutic' clinical research with children; patient safety awareness in healthcare education; and the increasing use of robotics and artificial intelligence in healthcare. Outlining a wide range of international perspectives on patient safety and the law, this Research Handbook will appeal to academics and researchers specialising in health and medical law, human rights and healthcare regulation. It will also serve as a valuable resource for legal and medical practitioners alike, as well as clinicians and professionals working in healthcare governance. (shrink)

The notion of proof is central to mathematics yet it is one of the most difficult aspects of the subject to teach and master. In particular, undergraduate mathematics students often experience difficulties in understanding and constructing proofs. Understanding Mathematical Proof describes the nature of mathematical proof, explores the various techniques that mathematicians adopt to prove their results, and offers advice and strategies for constructing proofs. It will improve students’ ability to understand proofs and construct correct proofs of their own. The (...) first chapter of the text introduces the kind of reasoning that mathematicians use when writing their proofs and gives some example proofs to set the scene. The book then describes basic logic to enable an understanding of the structure of both individual mathematical statements and whole mathematical proofs. It also explains the notions of sets and functions and dissects several proofs with a view to exposing some of the underlying features common to most mathematical proofs. The remainder of the book delves further into different types of proof, including direct proof, proof using contrapositive, proof by contradiction, and mathematical induction. The authors also discuss existence and uniqueness proofs and the role of counter examples. (shrink)

This article catalogs social processes contributing to construction of emotions across three time-scales, covering: natural selection; ontogenesis; and moment-by-moment transactions. During human evolution, genetic and cultural influences operate interdependently, not as separate forces working against each other. Further, leaving infants’ environment-open serves adaptive purposes. During ontogenesis, cultural socialization affects emotion development in various ways, not all of which depend on internalization of cultural meanings as emphasized in some earlier social constructionist accounts. Construction also operates over the moment-by-moment time-scale of real-time (...) interpersonal interactions, as emotions adjust to the constraints and affordances of immediate cultural environments. Claims that emotions are constructed, and that social processes contribute to their construction, are no longer contestable. Now the project is to specify how these processes operate and what materials they use. (shrink)

This volume of The Subjection of Women provides a reliable text in an inexpensive edition, with explanatory notes but no additional editorial apparatus. -/- .

Theories of discourse bring to realism new ideas about how knowledge develops and how representations of reality are influenced. We gain an understanding of the conceptual aspect of social life and the processes by which meaning is produced. This collection reflects the growing interest realist critics have shown towards forms of discourse theory and deconstruction. The diverse range of contributions address such issues as the work of Derrida and deconstruction, discourse theory, Eurocentrism and poststructuralism. What unites all of the contributions (...) is a sense that it is essential to provide a realist alternative to the hitherto dominance of social constructionism, hermeneutics and postmodernism, over many of the issues discussed. By developing a realist perspective the different authors attempt to embed discourse within the structured nature of the reality of the world. Realism can situate language, discourse and ideology within context specific, or 'causally efficacious' circumstances. Realism can help to uncover issues of power, representation, and subjectivity and how discursive and other social practices produce real effects. This can help us understand the manner in which social structures are reproduced through various forms of ideology and discourse. And by knowing this, we can start to address questions concerning human emancipation and how the world is to be transformed. (shrink)

This vital study offers a new interpretation of Hume's famous "Of Miracles," which notoriously argues against the possibility of miracles. By situating Hume's popular argument in the context of the 18th century debate on miracles, Earman shows Hume's argument to be largely unoriginal and chiefly without merit where it is original. Yet Earman constructively conceives how progress can be made on the issues that Hume's essay so provocatively posed about the ability of eyewitness testimony to establish the credibility of marvelous (...) and miraculous events. (shrink)

Part One reviews some recent history of epistemology, focusing on ways in which the intellectual virtues have been invoked to solve specific epistemological problems. This part gives a sense of the contemporary landscape that has emerged and clarifies some of the disagreements among those who invoke the virtues in epistemology. Part Two explores some problems about knowledge in greater detail, and defends a externalist approach in virtue epistemology.

A Norton Library edition of Locke's Second Treatise of Government, edited by A. John Simmons.