The usual representation of quantum algorithms is limited to the process of solving the problem. We extend it to the process of setting the problem. Bob, the problem setter, selects a problem-setting by the initial measurement. Alice, the problem solver, unitarily computes the corresponding solution and reads it by the final measurement. This simple extension creates a new perspective from which to see the quantum algorithm. First, it highlights the relevance of time-symmetric quantum mechanics to quantum computation: the problem-setting and (...) problem solution, in their quantum version, constitute pre- and post-selection, hence the process as a whole is bound to be affected by both boundary conditions. Second, it forces us to enter into relational quantum mechanics. There must be a representation of the quantum algorithm with respect to Bob, and another one with respect to Alice, from whom the outcome of the initial measurement, specifying the setting and thus the solution of the problem, must be concealed. Time-symmetrizing the quantum algorithm to take into account both boundary conditions leaves the representation to Bob unaltered. It shows that the representation to Alice is a sum over histories in each of which she remains shielded from the information coming to her from the initial measurement, not from that coming to her backwards in time from the final measurement. In retrospect, all is as if she knew in advance, before performing her problem-solving action, half of the information that specifies the solution of the problem she will read in the future and could use this information to reach the solution with fewer computation steps. This elucidates the quantum computational speedup in all the quantum algorithms examined. (shrink)

At a purely instrumental level, quantum theory is all about multiplication, addition and taking mod squares of complex numbers called probability amplitudes. The rules for combining amplitudes are deceptively simple. When two or more events are independent you multiply their respective probability amplitudes and when they are mutually exclusive you add them. Whenever you want to calculate probabilities you take mod squares of respective amplitudes. That’s it. If you are prepared to ignore the explanatory power of the theory (which you (...) should not) the rest is just a set of convenient mathematical tools developed for the purpose of book-keeping of amplitudes. Thus we tabulate amplitudes into state vectors and unitary matrices, and place them in Hilbert spaces. (shrink)

Joshua Crites and Eric Kodish focuses on unrealistic optimism as a significant factor in parental decisions when consenting for their child to participate in a phase I study.1 They define unrealistic optimism as ‘when people perceive their own personal outcomes as being more positive than those of other people in similar circumstances’. Faced with the dire circumstances of relapsed malignant disease with a fatal outcome, most parents are confronted with the dilemma of either accepting the inevitable death of their child (...) or clinging to straws of hope. When approached by an investigator who suggests that there is still something that can be done in the ‘fight against the disease’ there is an opportunity to retain a glimmer of hope. No matter how impartial and accurate …. (shrink)

Using fMRI, we investigated how right temporal lobe gliomas affecting the posterior superior temporal sulcus alter neural processing observed during speech perception and production tasks. Behavioural language testing showed that three pre-operative neurosurgical patients with grade 2, grade 3 or grade 4 tumours had the same pattern of mild language impairment in the domains of object naming and written word comprehension. When matching heard words for semantic relatedness (a speech perception task), these patients showed under-activation in the tumour infiltrated right (...) superior temporal lobe compared to 61 neurotypical participants and 16 patients with tumours that preserved the right postero-superior temporal lobe, with enhanced activation within the (tumour-free) contralateral left superior temporal lobe. In contrast, when correctly naming objects (a speech production task), the patients with right postero-superior temporal lobe tumours showed higher activation than both control groups in the same right postero-superior temporal lobe region that was under-activated during auditory semantic matching. The task dependent pattern of under-activation during the auditory speech task and over-activation during object naming was also observed in eight stroke patients with right hemisphere infarcts that affected the right postero-superior temporal lobe compared to eight stroke patients with right hemisphere infarcts that spared it. These task-specific and site-specific cross-pathology effects highlight the importance of the right temporal lobe for language processing and motivate further study of how right temporal lobe tumours affect language performance and neural reorganisation. These findings may have important implications for surgical management of these patients, as knowledge of the regions showing functional reorganisation may help to avoid their inadvertent damage during neurosurgery. (shrink)

§1. Mathematics and the physical world. Genuine scientific knowledge cannot be certain, nor can it be justified a priori. Instead, it must be conjectured, and then tested by experiment, and this requires it to be expressed in a language appropriate for making precise, empirically testable predictions. That language is mathematics.This in turn constitutes a statement about what the physical world must be like if science, thus conceived, is to be possible. As Galileo put it, “the universe is written in the (...) language of mathematics”. Galileo's introduction of mathematically formulated, testable theories into physics marked the transition from the Aristotelian conception of physics, resting on supposedly necessary a priori principles, to its modern status as a theoretical, conjectural and empirical science. Instead of seeking an infallible universal mathematical design, Galilean science usesmathematics to express quantitative descriptions of an objective physical reality. Thus mathematics became the language in which we express our knowledge of the physical world — a language that is not only extraordinarily powerful and precise, but also effective in practice. Eugene Wigner referred to “the unreasonable effectiveness of mathematics in the physical sciences”. But is this effectiveness really unreasonable or miraculous?Numbers, sets, groups and algebras have an autonomous reality quite independent of what the laws of physics decree, and the properties of these mathematical structures can be just as objective as Plato believed they were. (shrink)

Quantum computers use the quantum interference of different computational paths to enhance correct outcomes and suppress erroneous outcomes of computations. In effect, they follow the same logical paradigm as (multi-particle) interferometers. We show how most known quantum algorithms for factorising and counting, may be cast in this manner. Quantum searching is described as inducing a desired relative phase between two eigenvectors to yield constructive interference on the sought elements and destructive interference on the remaining terms.

§1. Mathematics and the physical world. Genuine scientific knowledge cannot be certain, nor can it be justified a priori. Instead, it must be conjectured, and then tested by experiment, and this requires it to be expressed in a language appropriate for making precise, empirically testable predictions. That language is mathematics.This in turn constitutes a statement about what the physical world must be like if science, thus conceived, is to be possible. As Galileo put it, “the universe is written in the (...) language of mathematics”. Galileo's introduction of mathematically formulated, testable theories into physics marked the transition from the Aristotelian conception of physics, resting on supposedly necessary a priori principles, to its modern status as a theoretical, conjectural and empirical science. Instead of seeking an infallible universal mathematical design, Galilean science usesmathematics to express quantitative descriptions of an objective physical reality. Thus mathematics became the language in which we express our knowledge of the physical world — a language that is not only extraordinarily powerful and precise, but also effective in practice. Eugene Wigner referred to “the unreasonable effectiveness of mathematics in the physical sciences”. But is this effectiveness really unreasonable or miraculous?Numbers, sets, groups and algebras have an autonomous reality quite independent of what the laws of physics decree, and the properties of these mathematical structures can be just as objective as Plato believed they were (and as Roger Penrose now advocates). (shrink)

While there are numerous doubts, controversies and lack of consensus on alternative definitions of human death, it is argued that it is more ethical to allow people to choose either cessation of cardio-respiratory function or loss of entire brain function as the definition of death based on their own views. This paper presents the law of organ transplantation in Japan, which allows people to decide whether brain death can be used to determine their death in agreement with their family. Arguably, (...) Japan could become a unique example of individual choice in the definition of death if the law is revised to allow individuals choose definition of death independently of their family. It suggests that such an approach is one of the reasonable policy options a country can adopt for legislation on issues related to the definition of death. (shrink)

Ludwig Wittgenstein (1889-1951) was an extraordinarily original thinker, whose influence on twentieth-century thinking far outside the bounds of philosophy alone. In this engaging Introduction, A.C. Grayling makes Wittgenstein's thought accessible to the general reader by explaining the nature and impact of Wittgenstein's views. He describes both his early and later philosophy, the differences and connections between them, and gives a fresh assessment of Wittgenstein's continuing influence on contemporary thought.

Background: The magnitude of bullying and harassment among psychiatrists is reportedly high, yet no peer-review published studies addressing this issue could be found. Therefore, it was decided to conduct a pilot study to assess the degree of the problem, the types of bullying/harassment and to provide some insights into the situation.Methods and Principal Findings: Following multiple focus group meetings, a yes/no response type questionnaire was developed to assess the degree and type of bullying and harassment experienced by psychiatrists. Over a (...) 3-month period the questionnaire was administered to a random sample of 60 psychiatrists. 57 out of the 60 psychiatrists reported harassment and bullying. Frequencies of the following response variables are presented in descending order: rumours 40% ; defamation 20% ; passing remarks 20% ; false accusations 15% ; threats 13.3% ; verbal abuse 13.3% ; unjustified complaints 13.3% ; promotion blocked 13.3% ; humiliation 13% ; bad reference given 10% ; credentials questioned 8.3% ; physical attacks 5% ; termination 5% ; derogatory remarks 1.7% and 1.7% were subjected to personal work. As a result of being subjected to harassment, 66.7% of the psychiatrists did not take any action, whereas 33.3% confronted the person they believed responsible. Asked whether the bullying and harassment caused distress, 18.3% of the psychiatrists did not report any effect, 30% reported mild distress, 40% moderate distress and severe distress was reported by 11.7%.Conclusions: It was concluded that the magnitude of bullying and harassment among psychiatrists may be quite high, as evidenced by this pilot study. There is a need for extensive systematic studies on this subject and to establish strategies to prevent and address this issue at a national and regulatory level. (shrink)

The urgency of the research topic is that the theoretical and methodological principles of psychology of managerial activity of the head in the conditions of the information society help to increase the levers of management and guidance. The purpose of management - the receipt of the desired result, which must be obtained after the actions of the management of the head as the main operating force, which is heading for transformations, tries to increase the self-governing principle in the organization. The (...) problem of research is that for effective management it is necessary to develop reliable mechanisms for the identification and development of manager's abilities, to increase the level of professionalism and competence of the head to the highest level, so that the management organism does not disorient. A person who works as a specialist, a professional, a competent person can be qualified to carry out the work of a manager. The hypothesis is put forward that the manager of a high level of professionalism and competence is able to form the psychological foundations of the organization, so that it worked as a single social organism. The task of the research is to analyze the psychological foundations of management activity in the conditions of the information society, which would allow the most optimal management of a particular organization. The methodological foundations of the psychology of management as the basis of effective leadership include methods of cultural development, which are used to solve the problems of organization, the formation of psychological culture, devoid of conflicts, contradictions, disasters. Methodological basis of scientific research of psychological principles of administrative activity as the basis of effective management are methods, such as system, structural, structural-functional, historical, comparative, which allow to achieve a higher level of organization and self-organization at the expense of skilful leadership. Therefore, the manager must use the whole set of methods, techniques, algorithms of actions, techniques, methods of achieving certain results that will lead to the management of a high level. It is concluded that the determinants of the optimization of the managerial psychology of the head is a model aimed at regulating relationships, which would use the resources of the information society, which is based on high information provision for improving the efficiency of management work. (shrink)

This introduction to the basic ideas of structural proof theory contains a thorough discussion and comparison of various types of formalization of first-order logic. Examples are given of several areas of application, namely: the metamathematics of pure first-order logic (intuitionistic as well as classical); the theory of logic programming; category theory; modal logic; linear logic; first-order arithmetic and second-order logic. In each case the aim is to illustrate the methods in relatively simple situations and then apply them elsewhere in much (...) more complex settings. There are numerous exercises throughout the text. In general, the only prerequisite is a standard course in first-order logic, making the book ideal for graduate students and beginning researchers in mathematical logic, theoretical computer science and artificial intelligence. For the new edition, many sections have been rewritten to improve clarity, new sections have been added on cut elimination, and solutions to selected exercises have been included. (shrink)

This exciting new Handbook offers a comprehensive overview of the contemporary state of the field. The editors' introduction and forty-five essays cover feminist critical engagements with philosophy and adjacent scholarly fields, as well as feminist approaches to current debates and crises across the world. Authors cover topics ranging from the ways in which feminist philosophy attends to other systems of oppression, and the gendered, racialized, and classed assumptions embedded in philosophical concepts, to feminist perspectives on prominent subfields of philosophy. The (...) first section contains chapters that explore feminist philosophical engagement with mainstream and marginalized histories and traditions, while the second section parses feminist philosophy's contributions to with numerous philosophical subfields, for example metaphysics and bioethics. A third section explores what feminist philosophy can illuminate about crucial moral and political issues of identity, gender, the body, autonomy, prisons, among numerous others. The Handbook concludes with the field's engagement with other theories and movements, including trans studies, queer theory, critical race, theory, postcolonial theory, and decolonial theory. The volume provides a rigorous but accessible resource for students and scholars who are interested in feminist philosophy, and how feminist philosophers situate their work in relation to the philosophical mainstream and other disciplines. Above all it aims to showcase the rich diversity of subject matter, approach, and method among feminist philosophers. (shrink)

The Problem of Perception offers two arguments against direct realism--one concerning illusion, and one concerning hallucination--that no current theory of ...

Extraterrestrial Altruism examines a basic assumption of the Search for Extraterrestrial Intelligence (SETI): that extraterrestrials will be transmitting messages to us for our benefit. This question of whether extraterrestrials will be altruistic has become increasingly important in recent years as SETI scientists have begun contemplating transmissions from Earth to make contact. Technological civilizations that transmit signals for the benefit of others, but with no immediate gain for themselves, certainly seem to be altruistic. But does this make biological sense? Should we (...) expect altruism to evolve throughout the cosmos, or is this only wishful thinking? Is it dangerous to send messages to other worlds, as Stephen Hawking has suggested, or might humankind benefit from an exchange with intelligence elsewhere in the galaxy? Would extraterrestrial societies be based on different ethical principles, or would we see commonalities with Earthly notions of morality? Extraterrestrial Altruism explores these and related questions about the motivations of civilizations beyond Earth, providing new insights that are critical for SETI. Chapters are authored by leading scholars from diverse disciplines—anthropology, astronomy, biology, chemistry, computer science, cosmology, engineering, history of science, law, philosophy, psychology, public policy, and sociology. The book is carefully edited by Douglas Vakoch, Director of Interstellar Message Composition at the SETI Institute and professor of clinical psychology at the California Institute of Integral Studies. The Foreword is by Frank Drake. This interdisciplinary book will benefit everybody trying to understand whether evolution and ethics are unique to Earth, or whether they are built into the fabric of the universe. (shrink)

Comment devient-on philosophe? Par quel sursaut un Aristoclès se fait-il Platon, jusqu'à s'imposer dans la liste des " auteurs philo " Il faut enquêter, non pas sur la vie privée, mais sur la vie intime : rumination intellectuelle, ton sur lequel on parle, motivations amoureuses... Ce qui fait un philosophe, c'est un immense travail sur soi, et la rencontre d'autres philosophes, vivants, de leurs problématiques. Mémoire sémantique + obsession métaphysique, voilà le code génétique du philosophe. Il débute par un attentat (...) religieux, puisqu'il commence sa carrière en niant tel ou tel sacré. Bien sûr, il vaut mieux être mâle, communiquer par les livres adopter la langue dominante, écrire quand on est célibataire. Comment gagner sa vie? Pas forcément en étant enseignant, comme c'est le cas aujourd'hui. Le profil du philosophe nous le révèle orphelin, vivant à l'étranger, souvent laid, jamais fou, et serial thinker, prêt à changer de philosophie pourvu qu'il reste, lui, à menacer le monde donnera ou donnera pas du sens à notre vie? Le philosophe est l'être inquiet qui pense inquiéter l'Être par deux trois mots bien aiguisés. (shrink)

How (Not) to Be Secular is what Jamie Smith calls "your hitchhiker's guide to the present" -- it is both a reading guide to Charles Taylor's monumental work A Secular Age and philosophical guidance on how we might learn to live in our times. Taylor's landmark book A Secular Age (2007) provides a monumental, incisive analysis of what it means to live in the post-Christian present -- a pluralist world of competing beliefs and growing unbelief. Jamie Smith's book is a (...) compact field guide to Taylor's insightful study of the secular, making that very significant but daunting work accessible to a wide array of readers. Even more, though, Smith's How (Not) to Be Secular is a practical philosophical guidebook, a kind of how-to manual on how to live in our secular age. It ultimately offers us an adventure in self-understanding and maps out a way to get our bearings in today's secular culture, no matter who "we" are -- whether believers or skeptics, devout or doubting, self-assured or puzzled and confused. This is a book for any thinking person to chew on. (shrink)

The philosophy of Epictetus, a freed slave in the Roman Empire, has been profoundly influential on Western thought: it offers not only stimulating ideas but practical guidance in living one's life. A. A. Long, a leading scholar of later ancient philosophy, gives the definitive presentation of the thought of Epictetus for a broad readership. Long's fresh and vivid translations of a selection of the best of Epictetus' discourses show that his ideas are as valuable and striking today as they were (...) amost two thousand years ago. This is a book for anyone interested in what we can learn from ancient philosophy about how to live our lives. (shrink)

Introduction: Conversion and the practice of transformation -- The philosophical structure of Jonathan Edwards's religious affections -- Habit, habit change, and conversion in C.S. Peirce -- Reconstructing faith : religious overcoming in Dewey's pragmatism -- Transforming obligation in William James -- Dwelling in absence: the reflective origin of conversion -- Creative transformation : the work of conversion -- The evasion of conversion in recent American philosophy.

Provability, Computability and Reflection.

In this article, we present results from a literature review of intrinsic, instrumental, and relational values of nature conducted for the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, as part of the Methodological Assessment of the Diverse Values and Valuations of Nature. We identify the most frequently recurring meanings in the heterogeneous use of different value types and their association with worldviews and other key concepts. From frequent uses, we determine a core meaning for each value type, which is (...) sufficiently inclusive to serve as an umbrella over different understandings in the literature and specific enough to help highlight its difference from the other types of values. Finally, we discuss convergences, overlapping areas, and fuzzy boundaries between different value types to facilitate dialogue, reduce misunderstandings, and improve the methods for valuation of nature's contributions to people, including ecosystem services, to inform policy and direct future research. © 2023 The Author(s). Published by Oxford University Press on behalf of the American Institute of Biological Sciences. (shrink)

We apply Hrushovski-Fraïssé's amalgamation procedure to obtain a theory of fields of prime characteristic of Morley rank 2 equipped with a definable additive subgroup of rank 1.

Resumo: A técnica é a ação de um agente Intencional, com uma determinada finalidade, sobre específicas propriedades físicas, ação que constitui um objeto técnico. O reconhecimento desta Intencionalidade da ação dos autores da técnica é necessário para o processo de compreensão desses objetos pelos receptores, principalmente para a compreensão dos objetos técnicos caracterizados também como suportes semióticos. A minha hipótese é que essa Intencionalidade pode vir “mascarada” pela própria ação técnica constituinte da forma do objeto, e também pelo discurso institucional, (...) dificultando a compreensão desses objetos pelo público. Trata-se também de esclarecer quais as propriedades que são realmente ontológicas nos objetos técnicos.: A technique is an action of an Intentional agent, with a determined purpose, upon specific physical properties. This action constitutes a technical object. Identifying the Intentionality of authors' actions is necessary for the comprehension of these objects by receivers, particularly for the comprehension of technical objects which are also characterized as semiotic supports. My hypothesis is that this Intentionality can be “disguised” by the technical action itself, particularly in questions of form, and also by institutional discourse, which problematizes the comprehension of these same objects by the public. It will be a matter as well of clarifying the ontological properties of technical objects. (shrink)

This book explores for the first time an idea common to both Plato and Aristotle: although people are separate, their lives need not be; one person's life may overflow into another's, so that helping someone else is a way of serving oneself. Price considers how this idea unites the philosophers' treatments of love and friendship (which are otherwise very different), and demonstrates that this view of love and friendship, applied not only to personal relationships, but also to the household and (...) even the city-state, promises to resolve the old dichotomy between egoism and altruism. (shrink)

Background: There is a shortage of reports on what potential recipients of implantable cardioverter–defibrillators need to be informed about and what role they can and want to play in the decision-making process when it comes to whether or not to implant an ICD.Aims: To explore how patients with heart failure and previous episodes of malignant arrhythmia experience and view their role in the decision to initiate ICD treatment.Patients and methods: A qualitative content analysis of semistructured interviews was used. The study (...) population consisted of 31 outpatients with moderate heart failure at the time of their first ICD implantation.Setting: The study was performed at Sahlgrenska University Hospital, Göteborg, Sweden.Results: None of the respondents had discussed the alternative option of receiving treatment with anti-arrhythmic drugs, the estimated risk of a fatal arrhythmia, or the expected time of survival from heart failure in itself. Even so, very little criticism was directed at the lack of information or the lack of participation in the decision-making process. The respondents felt that they had to rely on the doctors’ recommendation when it comes to such a complex and important decision. None of them regretted implantation of the ICD.Conclusions: The respondents were confronted by a matter of fact. They needed an ICD and were given an offer they could not refuse, simply because life was precious to them. Being able to give well-informed consent seemed to be a matter of less importance for them. (shrink)

Commentary on the Brahmasūtra of Bādarāyaṇa, aphoristic work on Vedanta philosophy.

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 41.1 (2003) 121-122 [Access article in PDF] Harold Tarrant. Plato's First Interpreters. Ithaca, NY: Cornell University Press, 2000. Pp. viii + 263. Cloth, $55.00. This is Tarrant's third book on the ancient Platonist tradition, following his Scepticism or Platonism? (1985) and Thrasyllan Platonism (1993). In those earlier volumes his focus was on the first centuries bc and ad. Here his scope is much (...) wider. Stating that "Platonic interpretation is today at a crossroads," he has written a book that explores "ancient attempts to wrestle with this corpus," with the ultimate objective "to encourage a fresh, almost primitive reading of Plato himself" (vii).He begins engagingly by confronting the ancients with questions any modern reader of Plato must ask: What kind of text is this? Are there doctrines here? Where do I look for Plato's doctrines? The second part of his book is a historical survey, taking us from Plato, the early Academy and Aristotle, through the Hellenistic and early Roman Imperial period, and concluding with the principal Neoplatonist interpreters. In the third and longest part, he focuses on the interpretation of specific dialogues, giving most space to the Gorgias and Theaetetus, but also dealing in particular detail with the Meno, Parmenides, and Philebus. Something is said about every dialogue, but Tarrant writes only briefly about such major works as the Republic and Timaeus. He explains his selectivity (not very convincingly) as due to his wish to "discuss issues of meta-interpretation, with emphasis on the period before Plotinus" (198).Taking his book as a whole, one realizes that few strands of modern interpretation were not prefigured to quite a large extent in antiquity. The two most obvious exceptions are the chronological and developmental approach (Early, Middle, and Late), at present under strong attack from some quarters, and the theological, numerological, and allegorical readings practiced by Neoplatonists. Plato's ancient interpreters were doctrinal unitarians, but they implicitly anticipated our tendency to distinguish "Socratic dialogues," which some of them called "gymnastic" and "inquisitive," from such "canonical" works as the Phaedo,Republic, Symposium, and Timaeus, to which they applied the labels "dogmatic" and "expository." And they recognized that both types of characteristics could be found in the same dialogue, as in the Meno and Theaetetus. Plato himself, they proposed, spoke primarily through the voices of Socrates, Timaeus, and the Eleatic and Athenian strangers; but other characters, such as Pausanias in the Symposium, or Protagoras in the dialogue of that name, utter thoughts with some philosophical value. In explaining difficult passages of one dialogue, they would typically refer to passages from other parts of the corpus. An especially intriguing instance is the strategy of the Anonymous Commentator on the Theaetetus, who reads the Meno into the dialogue on which he is officially commenting.Ancient scholars, just like ourselves, asked questions about the unifying themes of complex dialogues. Hence the sub-titles given to certain works: "On the soul" for the Phaedo, and "On justice" for the Republic, etc. For Olympiodorus (whose commentary on the Gorgias Tarrant has recently co-edited [Leiden, 1998]), earlier interpreters have seriously erred by giving too limited an account of that dialogue's scope. It is not, he says, simply about rhetoric, nor about justice and injustice; nor is its theme the divine demiurge (as some Neoplatonists had strangely proposed, on the basis of the concluding myth). Rather, the subject of the Gorgias is "the ethical principles that lead to constitutional well-being" (125). [End Page 121] However, Olympiodorus's eminently "sensible" reading (as Tarrant calls it) is deeply embedded in the Neoplatonic contrast between the "purificatory virtues" of the Phaedo and the "constitutional virtues" of Republic4.Strong or weak scepticism, esotericism, unwritten doctrines, spurious versus genuine, a canon of central dialogues, dramatic considerations, and the philosophical importance or non-importance of the dialogues' prologues—all of these are interpretive approaches that Tarrant surveys in this immensely learned book, and all of them continue to resonate for us. Modern scholars, who emphasize the literary and philosophical unity of each dialogue, are walking... (shrink)

During recent years we have seen and assisted at a significantly increased number of twin births. The main reason for this increase in the frequency of twin births is the increasing number of so called “induced pregnancies”, whether through hormonal stimulation or artificial insemination techniques.It is well known1 that twins have high mortality and morbidity rates during the perinatal and the following period. The characteristics of conception and pregnancy can determine the development of several pathologies, including prematurity and intrauterine growth (...) retardation, …. (shrink)

Since 1981 AIDS has illuminated, like a roving searchlight, a series of ethical questions, which extend far beyond the apparently narrow limits of one disease. It has revealed, one by one, human attitudes and behaviours that were previously unquestioned, or unobserved - based on unidentified but shaky pre-suppositions.This commentary offers two contrasting perspectives on the problems facing developing countries. In the first part, I comment on the preceding article, from the perspective of a clinician who has worked for many years (...) in Africa, and who witnessed the emergence of AIDS in the early 1980s and its medical, social, political and economic consequences.1 In the second, I comment on a conference in Lusaka in September 1999 that addressed many of the issues.Narrowing the gap?“Narrowing the gap” raises questions about truth or transparency in the activities of multinational companies, the ethics and economics of health care in global society and the distribution of responsibility for unwanted side effects of new treatments. The scale of HIV infection in developing countries draws attention to weaknesses or instability in theoretical and practical structures, which serve - or should serve - human wellbeing, whenever it is disturbed by disease.Truth and transparencyDuring the last 60 years, combined with improved standards of living, the products of pharmaceutical effort and ingenuity have resulted in large gains in life expectancy. These were most marked in rich northern societies, but even poor southern countries had seen it extended by 15 to 20 years, until recently.However, “the costs of drug development are not small”.2 A detailed study of costs of clinical trials found that the total cost of new drug development can be as high as $500 million per drug.3 Patent laws allow a temporary monopoly for the production and sale for a number of years. During this “protected” …. (shrink)