A new study published in Journal of Medical Ethics by van der Zande et al 1 further highlights why classifying pregnant women as a ‘vulnerable population’ in the context of research is deeply problematic. Because the designation of ‘vulnerable’ is otherwise applied to populations whose decision-making capacity about research participation is somehow compromised—such as children and adults of limited cognitive ability—many of us have been arguing for some time that using this designation for pregnant women is inappropriate and disrespectful.2–4 There (...) is nothing about the state of pregnancy that renders pregnant women incapable of offering valid research consents or refusals. Moreover, rather than protecting the health interests of pregnant women and their offspring, this designation has had the opposite effect. It has contributed to the widespread exclusion of pregnant women from research activities, which is itself pernicious to the health of pregnant women.5 We know that pregnant women encounter a range of health needs across their pregnancies. In the USA, for example, approximately 9 out of every 10 women use some kind of medication during pregnancy to manage health conditions.6 Yet because pregnant women have largely been …. (shrink)

The World Health Assembly has encouraged WHO member-states to establish capacity in health technology assessment (HTA) as a support for achieving universal health coverage (UHC). Simultaneously, the WHO has stated that UHC is “a practical expression of the concern for health equity and the right to health.” This has prompted questions about potential tensions between priority-setting efforts and the right to health on the road to UHC. South Africa (SA) is an ideal setting in which to explore how the priority-setting (...) work of an HTA body may be integrated with an existing rights framework. (shrink)

Given that health systems research involves different aims, approaches, and methodologies as compared to more traditional clinical trials, the ethical issues present in HSR may be unique or particularly nuanced. This article outlines eight pertinent ethical issues that are particularly salient in HSR and argues that the ethical review process should be better tailored to ensure more efficient and appropriate oversight of HSR with adequate human protections, especially in low- and middle-income countries. The eight ethical areas we discuss include the (...) nature of intervention, types of research subjects, units of intervention and observation, informed consent, controls and comparisons, risk assessment, inclusion of vulnerable groups, and benefits of research. HSR involving human participants is necessary to ensure health systems strengthening and quality of care and to guide public policy intelligently. Health systems researchers must carefully define their intent and goals and openly clarify the values that may influence the premises and design of protocols. As new types of population-level research activities become more commonplace, it is critical that institutional review board and research ethics committee review processes evolve to evaluate these research protocols in ways that address the nuanced features of these studies. (shrink)

Over the past few decades, there has been increasing attention focused on the ethics of health research, particularly in low- and middle-income countries. Despite the increasing focus on the literature addressing human protection, community engagement, appropriate consent procedures and ways to mitigate concerns around exploitation, there has been little discussion about how the duration of the research engagement may affect the ethical design and implementation of studies. In other words, what are the unique ethical challenges when researchers engage with host (...) communities for longer periods (10 years or more), and what special considerations does this time commitment generate when applying ethical principles to these kinds of studies? This article begins to outline key areas of ethical concern that arise during long-term, sustained research activities with communities in low-resource settings. Through a review of the literature and consultations with experts in health systems, we identified the following key themes: fair benefits and long-term beneficence; community autonomy, consultation and consent; impacts on local health systems; economic impacts of research participation; ethical review processes; and institutional processes and oversight within research organizations. We hope that this preliminary exploration will stimulate further dialogue and help inform ethical guidance around long-term research engagements in the developing world. (shrink)

As health policy-makers around the world seek to make progress towards universal health coverage, they must navigate between two important ethical imperatives: to set national spending priorities fairly and efficiently; and to safeguard the right to health. These imperatives can conflict, leading some to conclude that rights-based approaches present a disruptive influence on health policy, hindering states’ efforts to set priorities fairly and efficiently. Here, we challenge this perception. We argue first that these points of tension stem largely from inadequate (...) interpretations of the aims of priority setting as well as the right to health. We then discuss various ways in which the right to health complements traditional concerns of priority setting and vice versa. Finally, we set out a three-step process by which policy-makers may navigate the ethical and legal considerations at play. (shrink)

This chapter first surveys general issues in the epistemic internalism / externalism debate: what is the distinction, what motivates it, and what arguments can be given on both sides. -/- The second part of the chapter will examine the internalism / externalism debate as regards to the specific case of the epistemology of memory belief.

The acquisition of a new skill usually proceeds through five stages, from novice to expert, with a sixth stage of mastery available for highly motivated performers. In this chapter, we re-state the six stages of the Dreyfus Skill Model, paying new attention to the transitions and interrelations between them. While discussing the fifth stage, expertise, we unpack the claim that, “when things are proceeding normally, experts don’t solve problems and don’t make decisions; they do what normally works” (Dreyfus & Dreyfus, (...) 1988, pp. 30 – 31). This leads us to offer an account of the “perspectival deliberation” that arises for experts and masters and that is distinct from the calculative deliberation characteristic of the lower stages of skillfulness. (shrink)

We presuppose a position of scientific realism to the effect (i) that the world exists and (ii) that through the working out of ever more sophisticated theories our scientific picture of reality will approximate ever more closely to the world as it really is. Against this background consider, now, the following question: 1. Do the empirical theories with the help of which we seek to approximate a good or true picture of reality rest on any non-empirical presuppositions? One can answer (...) this question with either a 'yes' or a 'no'. 'No' is the preferred answer of most contemporary methodologists -- Murray Rothbard is one distinguished counterexample to this trend -- who maintain that empirical theories are completely free of non-empirical ('a priori') admixtures and who see science as a matter of the gathering of pure 'data' obtained through simple observation. From such data scientific propositions are then supposed to be somehow capable of being established. (shrink)

What are the most fundamental features of the world? Do minds stand outside the natural order? Is a unified picture of mental and physical reality possible? The Mind in Nature provides a staunchly realist account of the world as a unified system incorporating both the mental and the physical. C. B. Martin, an original and influential exponent of 'ontologically serious' metaphysics, echoes Locke's dictum that 'all things that exist are only particulars', and argues that properties are powerful qualities. He also (...) spells out the implications of this view for philosophical conceptions of causation, intentionality, consciousness, and the mind-body problem. Martin emphasizes the importance of non-conscious 'vegetative' systems, which provide clear examples of intentionality in the form of representational use. The slide from representational use to consciousness involves a change in the material of use, but not the form of representation. A concluding chapter provides an argument for the view that an ontology of particular substances and properties leads ineluctably to monism: the bus we board with Locke takes us directly to the world of Spinoza and Einstein. Along the way, we are led to understand the nature of minds and conscious states of mind in a way that avoids both reductionism and dualism. (shrink)

In this concise yet powerful book, one of the twentieth century's most respected political philosophers presents a controversial reassessment of the political ideas and intellectual legacy of Edmund Burke. A practicing politician and powerful writer, full of ideas, Burke was intent on getting those ideas translated into government policies. But he was too much the impatient practitioner to set out his principles in a single book in the manner of Locke or Hume, leaving both admirers and opponents ample scope to (...) reinterpret his work in different ways. Macpherson, however, finds Burke's views on political economy to be the one consistent factor in his thinking. Today Burke is often viewed as one of modern conservatism's founding lights, and in an era of global capitalism unfettered by national borders, Macpherson's reassessment of Burke's ideas is perhaps more timely than ever. (shrink)

First published in 1986, Knowledge, Belief, and Witchcraft remains the only analysis of indigenous discourse about an African belief system undertaken from within the framework of Anglo-American analytical philosophy. Taking as its point of departure W. V. O. Quine's thesis about the indeterminacy of translation, the book investigates questions of Yoruba epistemology and of how knowledge is conceived in an oral culture.

Bridging the gap between the world of science and the realm of the spiritual, B. Alan Wallace introduces a natural theory of human consciousness that has its roots in contemporary physics and Buddhism. Wallace's "special theory of ontological relativity" suggests that mental phenomena are _conditioned_ by the brain, but do not _emerge_ from it. Rather, the entire natural world of mind and matter, subjects and objects, arises from a unitary dimension of reality that is more fundamental than these dualities, as (...) proposed by Wolfgang Pauli and Carl Jung. To test his hypothesis, Wallace employs the Buddhist meditative practice of _samatha_, refining one's attention and metacognition, to create a kind of telescope to examine the space of the mind. Drawing on the work of the physicist John Wheeler, he then proposes a more general theory in which the participatory nature of reality is envisioned as a self-excited circuit. In comparing these ideas to the Buddhist theory known as the Middle Way philosophy, Wallace explores further aspects of his "general theory of ontological relativity," which can be investigated by means of _vipasyana_, or insight, meditation. Wallace then focuses on the theme of symmetry in reference to quantum cosmology and the "problem of frozen time," relating these issues to the theory and practices of the Great Perfection school of Tibetan Buddhism. He concludes with a discussion of the general theme of complementarity as it relates to science and religion. The theories of relativity and quantum mechanics were major achievements in the physical sciences, and the theory of evolution has had an equally deep impact on the life sciences. However, rigorous scientific methods do not yet exist to observe mental phenomena, and naturalism has its limits for shedding light on the workings of the mind. A pioneer of modern consciousness research, Wallace offers a practical and revolutionary method for exploring the mind that combines the keenest insights of contemporary physicists and philosophers with the time-honored meditative traditions of Buddhism. (shrink)

Om ironiens funktion i Søren Kierkegaards forfatterskab belyst ud fra Kierkegaards disputats om ironien.

Unit I. Fundamental characteristics of the common law. The source of law -- The jury -- The adversary system of trial -- Retroactivity: a return to stare decisis -- Unit II. The courts and their jurisdiction. Court systems in the United States -- Court system in England -- Unit III. Constitutional law. Judicial review -- Equal protection -- Freedom of speech -- Appendix I. Constitution of the United States -- Appendix II. Table of Supreme Court cases -- Appendix III. Common (...) case citations. (shrink)

Gegenstand der Erörterung ist die Offenlegung des faktischen und potentiellen Ethikbezugs von Technik. Grundlegend für jede Ethik ist ein je bestimmtes Verständnis des Menschen und seiner Wirklichkeit. Diese prinzipielle Positionalität ist gegenüber diskurs- und verfahrensethischen Ansätzen ebenso festzuhalten wie gegenüber utilitaristischen Nivellierungen grundlagentheoretischer Fragen. Die vorliegende Untersuchung aus evangelischer Perspektive zeigt anhand der Analyse zweier technikphilosophischer Konzeptionen der Gegenwart (G. Ropohl, W. Ch. Zimmerli) die Relevanz von Technikethik nicht nur für Techniker, sondern bezüglich menschlichen Handelns im allgemeinen.

Iyengar Yoga Wisdom & Practice" is a practical and an inspiring anthology of Iyengar's insights into yoga, life and the path to peace and happiness. Yoga practice lies at the heart of the book, and it is illustrated with over 60 new step-by-step sequences of yoga postures specially shot in India and accompanied by Iyengar's illuminating observations on technique, their significance, and their benefits. This book not only presents Iyengar's practical advice on how to perform key yoga postures, but also (...) draws on a wide range of other material taken from interviews and world lecture tours, to the many texts Iyengar has written about yoga and about his own life's journey. (shrink)