Contemplating Suicide: The Language and Ethnics of Self Harm By Gavin J. Fairbairn Routledge, 1995. Pp. xxx. ISBN 415?10606. £12.95(pbk). Religious Transformation in Western Society. The End of Happiness By Harvie Ferguson, Routledge, 1992. Pp. xvi + 269. ISBN 0?415?02574?5. £XX.xx. Feminism and the Self: The Web of Identity By Morwenna Griffiths Routledge, 1995. Pp. 191. ISBN 0?415?09821?1. £12.99 (pbk). Faith, Scepticism and Personal Identity. A Festschrift for Terence Penelhum Edited by J.J. Macintosh and H. A. Meynell University of Calgary (...) Press, 1994. Pp. vii + 304. CAN$27.95. The Shape of Space (second edition) By Graham Nerlich Cambridge University Press, 1994. ISBN 0?521?45645?2. Logical Learning Theory: A Human Teleology and its Empirical Support By Joseph F. Rychlak University of Nebraska Press, 1994. Pp. 387. ISBN 0?8032?3904?1. £32.95 Philosophical Idealism and Christian Belief By Alan P.F. Sell University of Wales Press, 1995. Pp. x + 338. (shrink)

Over the course of the past twenty-five years, feminist theory has had a forceful impact upon the history of Western philosophy. The present collection of essays has as its primary aim to evaluate past women’s published philosophical work, and to introduce readers to newly recovered female figures; the collection will also make contributions to the history of the philosophy of gender, and to the history of feminist social and political philosophy, insofar as the collection will discuss women’s views on these (...) issues. The volume contains contributions by an international group of leading historians of philosophy and political thought, whose scholarship represents some of the very best work being done in North and Central America, Canada, Europe and Australia. (shrink)

Focal brain metabolic effects detected by proton magnetic resonance spectroscopy (MRS) in obsessive-compulsive disorder (OCD) represent prospective indices of clinical status and guides to treatment design. Sampling bilateral pregenual anterior cingulate cortex (pACC), anterior middle cingulate cortex (aMCC), and thalamus in 40 adult patients and 16 healthy controls, we examined relationships of the neurometabolites glutamate+glutamine (Glx), creatine+phosphocreatine (Cr), and choline-compounds (Cho) with OCD diagnosis and multiple symptom types. The latter included OC core symptoms (Yale-Brown Obsessive-Compulsive Scale - YBOCS), depressive symptoms (...) (Montgomery-Åsberg Depression Rating Scale - MADRS), and general functioning (Global Assessment Scale - GAS). pACC Glx was 9.7% higher in patients than controls. Within patients, Cr and Cho correlated negatively with YBOCS and MADRS, while Cr correlated positively with the GAS. In aMCC, Cr and Cho correlated negatively with MADRS, while Cr in thalamus correlated positively with GAS. These findings present moderate support for glutamatergic and cingulocentric perspectives on OCD. Based on our prior metabolic model of OCD, we offer one possible interpretation of these group and correlational effects as consequences of a corticothalamic state of elevated glutamatergic receptor activity alongside below-normal glutamatergic transporter activity. (shrink)

Patient autonomy, as exercised in the informed consent process, is a central concern in bioethics. The typical bioethicist's analysis of autonomy centers on decisional capacity—finding the line between autonomy and its absence. This approach leaves unexplored the structure of reasoning behind patient treatment decisions. To counter that approach, we present a microeconomic theory of patient decision-making regarding the acceptable level of medical treatment from the patient's perspective. We show that a rational patient's desired treatment level typically departs from the level (...) yielding an absence of symptoms, the level we call ideal. This microeconomic theory demonstrates why patients have good reason not to pursue treatment to the point of absence of physical symptoms. We defend our view against possible objections that it is unrealistic and that it fails to adequately consider harm a patient may suffer by curtailing treatment. Our analysis is fruitful in various ways. It shows why decisions often considered unreasonable might be fully reasonable. It offers a theoretical account of how physician misinformation may adversely affect a patient's decision. It shows how billing costs influence patient decision-making. It indicates that health care professionals' beliefs about the ‘unreasonable’ attitudes of patients might often be wrong. It provides a better understanding of patient rationality that should help to ensure fuller information as well as increased respect for patient decision-making. (shrink)

Patient noncompliance with physician prescriptions, especially in nonsymptomatic chronic diseases, is frequently characterized in the literature as harmful and economically costly (Miller 1997).1 Nancy Houston Miller views patient noncompliance as harmful because noncompliance can result in continued or new health problems leading to hospital admissions. Further, she places the annual monetary cost of noncompliance at $100 billion.Patient noncompliance with prescribed treatment is considered the least understood form of health behavior (Coons 2001). Despite the plethora of attention in journal articles, the (...) issue of noncompliance remains unresolved even in terms of understanding the main correlates to .. (shrink)

Background Ensuring individual free and informed decision‐making for research participation is challenging. It is thought that preliminarily informing communities through ‘community sensitization’ procedures may improve individual decision‐making. This study set out to assess the relevance of community sensitization for individual decision‐making in research participation in rural Gambia. Methods This anthropological mixed‐methods study triangulated qualitative methods and quantitative survey methods in the context of an observational study and a clinical trial on malaria carried out by the Medical Research Council Unit Gambia. (...) Results/discussion Although 38.7% of the respondents were present during sensitization sessions, 91.1% of the respondents were inclined to participate in the trial when surveyed after the sensitization and prior to the informed consent process. This difference can be explained by the informal transmission of information within the community after the community sensitization, expectations such as the benefits of participation based on previous research experiences, and the positive reputation of the research institute. Commonly mentioned barriers to participation were blood sampling and the potential disapproval of the household head. Conclusion Community sensitization is effective in providing first‐hand, reliable information to communities as the information is cascaded to those who could not attend the sessions. However, further research is needed to assess how the informal spread of information further shapes people's expectations, how the process engages with existing social relations and hierarchies (e.g. local political power structures; permissions of heads of households) and how this influences or changes individual consent. (shrink)

Researchers designing a clinical trial may be aware of disputed evidence of serious risks from previous studies. These researchers must decide whether and how to describe these risks in their model informed consent document. They have an ethical obligation to provide fully informed consent, but does this obligation include notice of controversial evidence? With ACCORD as an example, we describe a framework and criteria that make clear the conditions requiring inclusion of important controversial risks. The ACCORD model consent document did (...) not include notice of prior trials with excess death. We develop and explain a new standard labeled risk in equipoise. We argue that our approach provides an optimal level of integrity to protect the informational needs of the reasonable volunteers who agree to participate in clinical trials. We suggest language to be used in a model consent document and the informed consent discussion when such controversial evidence exists. (shrink)

Bioethics in a Liberal Societ By Max Charlesworth, Cambridge University Press, 1993. Pp. 172. ISBN 0?521?44952?9. £9.95 pbk. The Logical Universe: The Real Universe By Noel Curran Avebury, 1994. Pp. 158. ISBN 1?85628?863?3. £32.50. Beyond Postmodern Politics: Lyotard, Rorty, Foucault By Honi Fern Haber Routledge, 1994. Pp.viii + 160. ISBN 0?415?90823?X. $15.95. Baudrillard's Bestiary: Baudrillard and Culture By Mike Gane Routledge, 1991, Pp. 184. ISBN 0?415?06307?8. £10.99 pbk. Truth, Fiction and Literature: A Philosophical Perspective By Peter Lamarque and Stein Haugom (...) Olsen Clarendon Press, 1994. Pp. 456. ISBN 0?19?824082?1. £45.00. Milton and the Drama of History: Historical Vision, Iconoclasm, and the Literary Imagination By David Loewenstein Cambridge University Press, 1990. Pp. x + 197. ISBN 0?521?37253?4. £25.00. Philosophy and Knowledge: A Commentary on Plato's Theaetetus Ronald M. Polansky Associated University Presses, 1992. Pp. 260. ISBN 0?8387?5215?2. £29.95. Heidegger and French Philosophy: Humanism, Antihumanism and Being By Tom Rockmore Routledge, 1995. Pp. xx + 250. ISBN 0?415?11181?1. £14.99 pbk. Living Poetically: Kierkegaard's Existential Aesthetics By Sylvia Walsh The Pennsylvania State University Press, 1994. Pp. 294. ISBN 0?271?01328?1. (shrink)

Volume 19, Issue 11, November 2019, Page 78-80.

Father Hugh P. O'Neill, professor of the Classics at St. Stanislaus Seminary, Florissant, gives us in this paper a few of the ways in which training in Logic can be of assistance to the grammarian. Father O'Neill's thoughts run in an original and thought-provoking vein, and we feel fortunate in being able to present his articlewhich may prove an added incentive to many.

The case of Twin B involves the decision to send a newborn to a less intensive Level 2 special care nursery (SCN) than to the Level 3 neonatal intensive care unit (NICU) that is considered optimal by the physician. The physician’s acceptance of the transfer is against the child’s best interest and is due to parental convenience. In analyzing the case, we reject the best interest standard. Our rejection is partly supported by the views of Douglas Diekema, John Hardwig, and (...) Lannie Ross. Instead of the best interest standard, we offer and defend an approach we base on a microeconomic analysis of externalities, such as those involved with automobile emissions. This extends our previously presented general microeconomic approach to patient decision-making. It provides a clearer way to evaluate situations, like those of Twin B, in which burdens faced by family members may be used to determine the appropriate level of treatment for a decisionally incapable patient. (shrink)

Introducing Applied Ethics Edited by Brenda Almond, Blackwell, 1995. Pp. 375. ISBN 0-631-19389-8. 45.00 (hbk), 14.99 (pbk). Environmental Ethics Edited by Robert Elliot, Oxford University Press, 1995. Pp. 255. ISBN 9-19-875144-3. 9.95 (pbk) Medicine and Moral Reasoning Edited by K.W.M. Fulford, Grant Gillett and Janet Martin Soskice Cambridge University Press, 1994. Pp. 207. ISBN 0-521-45325-9 37.50 (hbk), 12.95 (pbk). Enlightenment and Religion. Rational Dissent in Eighteenth-century Britain Edited by Knud Haakonssen, Cambridge University Press, 1996. Pp. xii + 348. ISBN 0-521-56060-8. (...) 40.00. Dialettica, Arte e Societ : Saggio su Theodor W. Adorno By Giacomo Rinaldi, Quattroventi, Urbino, 1994. Pp. 205. L. 30,000. Relevance: Communication and Cognition, new revised edition, By Dan Sperber and Deirdre Wilson, Blackwell, 1995. Pp. 326. ISBN 0-631-19878-4. 15.99. Autobiographical Reflections By Eric Voegelin (Edited, with Introduction, by Ellis Sandoz), Louisiana State University Press, 1996. Pp. 131. ISBN 0807120766 $10.95. (shrink)

Subjects and Simulations presents essays focused on suffering and sublimity, representation and subjectivity, and the relation of truth and appearance through engagement with the legacies of Jean Baudrillard and Philippe Lacoue-Labarthe.

Objective: Ethical guidelines are designed to ensure benefits, protection and respect of participants in clinical research. Clinical trials must now be registered on open-access databases and provide details on ethical considerations. This systematic survey aimed to determine the extent to which recently registered clinical trials report the use of standard of care and post-trial obligations in trial registries, and whether trial characteristics vary according to setting. Methods: We selected global randomized trials registered on http://www.clinicaltrials.gov and http://www.controlled-trials.com. We searched for intervention (...) trials of HIV/AIDS, malaria, and tuberculosis from 9 October 2004, the date of the most recent version of the Helsinki Declaration, to 10 April 2007. Results: We collected data from 312 trials. Fifty-eight percent (58%, 95% CI = 53 to 64) of trial protocols report informed consent. Fifty-eight percent (58%, 95% CI = 53 to 64) of trials report active controls. Almost no trials (1%, 95% CI = 0.5 to 3) mention post-trial provisions. Most trials measure surrogate outcomes. Twenty percent (20%, 95% CI = 16 to 25) of trials measure patient-important outcomes, such as death; and the odds that these outcomes are in a low income country are five times greater than for a developed country (odds ratio (OR) 5.03, 95% CI = 2.70 to 9.35, p = < 0.001). Pharmaceutical companies are involved in 28% (CI = 23 to 33) of trials and measure surrogate outcomes more often than nonpharmaceutical companies (OR 2.45, 95% CI = 1.18 to 5.09, p = 0.31). Conclusion: We found a large discrepancy in the quality of reporting and approaches used in trials in developing settings compared to wealthier settings. (shrink)

O rzeczywistym wpływie Dostojewskiego na Kafkę można mówić jedynie w przypadku powieści: Die Verwandlung, Der Prozeß i Der Bau. Studia porównawcze sprowadzają się jednakże najczęściej do badania poszczególnych motywów. Niniejszy szkic podejmuje próbę bardziej wnikliwego omówienia owych wpływów, a przedstawione fakty zdają się potwierdzać jednoznacznie duchowe powinowactwo Kafki i Dostojewskiego.

In lieu of an abstract, here is a brief excerpt of the content:A Báñezian Grounding for Counterfactuals of Creaturely Freedom:A Response to James Dominic Rooney, O.P.Taylor Patrick O'NeillIntroductionIn a recently published article, James Rooney, O.P., critiques a fundamental aspect of Réginald Garrigou-Lagrange's articulation of the relation between divine causality and creaturely freedom, which I also defended in my recent book.1 Specifically, Rooney argues that at least some of what Garrigou-Lagrange holds is rooted in a Molinist rather than Báñezian understanding of (...) human freedom and divine causality. The aim of this paper is to articulate the basic objections raised by Rooney and to show why the objections fail. We shall not provide an exegetical or textual analysis of Báñez himself, but rather will establish a speculative grounding and agreement between basic principles of Báñezianism and Garrigou-Lagrange's articulation, ultimately affirming the necessity of positing creaturely counterfactuals for Báñezianism.Rooney makes two distinct (but related) objections to Garrigou-Lagrange's treatment. First, he claims that Báñezianism as a system rejects the notion of "alternative possibilities" when considering the creaturely will and its relation to divine causality, especially in regard to physical premotion. I shall argue that this is incorrect, and indeed misses one of the constitutive elements of Báñezianism—in fact the very grounding for its claim that infallibly moved actions remain free. Second, Rooney claims that Garrigou-Lagrange posits [End Page 651] a circular argument regarding the reality of sin. Garrigou-Lagrange's argument would be circular if it corresponded to a single order of causality or if counterfactuals of creaturely freedom were incompatible with Báñezianism. But we shall argue that they are not. As such, the argument is not only not circular, but rather elucidates a constitutive element of the Báñezian system, thereby refuting the objection. In short, Garrigou-Lagrange's articulation of Báñezian premotion admits of counterfactuals without relying upon divine passivity, and it remains internally coherent.Rooney's Critique of the So-called "Garrigou Manoeuvre"Rooney begins the essay by outlining a few of the major differences between a Molinist and Báñezian view of human freedom. Rooney's argument is that there is a potential "grounding problem" for Báñezianism, or at least for Báñezianism as articulated by Garrigou-Lagrange. As Rooney notes, Báñezianism posits that God's efficacious grace is ontologically antecedent to our good actions (and his permission of sin is ontologically antecedent to our sin). But how does this position retain free choice, if divine causation or permission is infallibly determinative and antecedent to creaturely choice? Rooney says:The Banezians need to account for how it is possible that a creature can do otherwise in the special case when God moves the creature to act through grace. Specifically, what grounds the truth of the claim that, even when God determines human free choices from eternity such that a human being has only one course of action open to them, those human beings are morally responsible for their actions? If the Banezian view entails that human beings, acting under grace, strictly lack any ability to do otherwise, then the view is incoherent.2As such, we can see that "the ability to do otherwise" is an essential, grounding element for defending Báñezianism against radically compatibilist or double-predestinarian views of human freedom, which have been condemned by the Church at Trent and in subsequent condemnations of Jansenism.3 Of course, the phrase "ability to do otherwise" is metaphysically [End Page 652] ambiguous, which Rooney admits. Various articulations of a more metaphysically precise grounding for the preservation of free choice under the influence of efficacious grace (or while efficacious grace is withheld) have been put forth, and Rooney focuses on a particular "strategy" which he associates with Garrigou-Lagrange and myself.4 He terms this strategy the "Garrigou Manoeuvre."Rooney notes that "Garrigou-Lagrange claims that there is something in virtue of which God denies someone efficacious grace, and that this is in the control of the sinner."5 He quotes Garrigou-Lagrange as saying that a person "is deprived of efficacious grace because by sinning he resists sufficient grace.... [Therefore,] God... (shrink)

If we hope to see values of equality and democracy embodied in our societies’ institutions, then we have a range of good reasons to favor expansive public provision of goods and services, and to oppose many forms of privatization. While Joseph Heath is right to argue that there are at least some forms of ‘anodyne privatization’, and while he is also right to argue for a more nuanced philosophical debate about the different dimensions of choice between forms of public (...) and private provision, Heath fails to register various regards in which private provision can undermine these central public values. We often have strong egalitarian and democratic reasons to protect zones of decommodification; to resist the imposition of user-charges; and to favor insourcing and direct public procurement over various forms of outsourcing of public services. Public libraries provide a totemic illustration of some of the deep virtues of collective public provision in democratic societies. Overall, our reasons to reject privatization are stronger and more diverse than theorists such as Heath might have supposed. (shrink)