Background: Informed consent in clinical research is mandated throughout the world. Both patient subjects and investigators are required to understand and accept the distinction between research and treatment.Aim: To document the extent and to identify factors associated with therapeutic misconception in a population of patient subjects or parent proxies recruited from a variety of multicentre trials .Patients and methods: The study comprised two phases: the development of a questionnaire to assess the quality of informed consent and a survey of patient (...) subjects based on this questionnaire.Results: A total of 303 patient subjects or parent proxies were contacted and 279 questionnaires were analysed. The median age was 49.5 years, sex ratio was 1 and 61% of respondents were professionally active. Overall memorisation of the oral or written communication of informed consent was good , and satisfaction with the process was around 70%. Therapeutic misconception was present in 70% of respondents, who expected to receive better care and ignored the consequence of randomisation and treatment comparisons. This was positively associated with the acuteness and severity of the disease.Conclusion: The authors suggest that the risk of therapeutic misconception be specifically addressed in consent forms as an educational tool for both patients and investigators. (shrink)

Book Reviews Joël Boudreault, Dialogue: Canadian Philosophical Review/Revue canadienne de philosophie, FirstView Article.

RésuméDans cette réponse à mes commentateurs, je réagis aux critiques de Alysia Blackham, Jessica Eisen, Pablo Gilabert, Andrea Sangiovanni, Dale Smith, Iyiola Solanke, et Daniel Viehoff incluses dans ce numéro spécial consacré à mon livre, Faces of Inequality. Parmi les sujets abordés, j'analyse les liens entre l’égalité et la discrimination, le rôle que joue la subordination dans ma théorie de la discrimination, et la méthodologie dans les théories de la discrimination.

Long undervalued in France, philosophical anthropology has played an essential role in Germany, helping to address some of the most important issues straddling philosophy and the social sciences: humanity's place in nature and in history; the individual and others; and relations between human groups.

La modernité, dès ses débuts, attribue un rôle-clef aux passions : qu’elles soient hostiles à la Raison ou au contraire ses alliées, dangereuses ou fascinantes, elles marquent le rôle du corps, du désir, du langage et de l’imagination dans la nature de l’homme. La même époque voit se développer différentes variantes du matérialisme. Presque toutes réévaluent ce que la raison classique avait tendance à réprimer ou à considérer comme révélateur de la faiblesse humaine : le corps et tout ce qui, (...) dans l’âme ou dans la société, porte les traces de l’activité et de la positivité du corps. On peut donc s’attendre à ce que les matérialistes fassent un sort particulier aux passions, à ce qu’ils y reconnaissent des lois et non pas seulement des manques ou des vices, à ce qu’ils essaient d’en repérer l’efficace dans l’ensemble des activités humaines. Encore faut-il se demander comment chaque matérialisme procède, par quelle configuration propre il rend compte de ces phénomènes ou comment il dévie les discours de la théorie classique pour les forcer à passer par les objets qui sont les siens. Plutôt que de supposer l’existence d’une théorie matérialiste unique, une enquête s’impose donc qui prenne en vue la diversité de ces auteurs, les situe dans leur contexte et repère les points d’inflexion que rencontre chez chacun d’entre eux cette problématique générale des passions qui semble avoir gouverné plusieurs siècles. (shrink)

We propose that learning has a top-down component, but not in the propositional terms described by Mitchell et al. Specifically, we propose that a host of learning processes, including associative learning, serve to imbue the representation of the conditioned stimulus (CS) with affective meaning.

Cet article présente le dispositif de formation et ses objectifs ainsi que l’analyse d’écrits réflexifs produits dans le cadre des travaux certificatifs et dans lesquels les participantes décrivent quelques-uns des effets de la formation sur leurs pratiques professionnelles.

This essay argues that Plato’s Republic includes a widely overlooked meditation on the affective dimension of political judgment. This meditation occurs in the passages on music. In music, Plato identifies the possibility of an extra-rational aesthetic activity that prepares the soul for reasoned judgment: he makes musical mimesis the precondition to logos because of its ability to actualize in the soul the very ethos required of sound judgment. Music is able to do this because it is not imagistic; music does (...) not produce mediated representations but rather produces alterations in the condition of the soul itself. These alterations are made possible because the soul itself is structured musically. If music actualizes the conditions of the soul, so too does the soul instantiate the conditions of music. In his treatment of musical mimesis, Plato thereby makes disposition, or affect, the defining feature of sound judgment. (shrink)

Why do some invertebrates store so much carotenoids in their tissues? Storage of carotenoids may not simply be passive and dependent on their environmental availability, as storage variation exists at various taxonomic scales, including among individuals within species. While the strong antioxidant and sometimes immune-stimulating properties of carotenoids may be beneficial enough to cause the evolution of features improving their assimilation and storage, they may also have fitness downsides explaining why massive carotenoid storage is not universal. Here, the functional and (...) ecological implications of carotenoid storage for the evolution of invertebrate innate immune defenses are examined, especially in crustaceans, which massively store carotenoids for unclear reasons. Three testable hypotheses about the role of carotenoid storage in immunological (resistance and tolerance) and life-history strategies (with a focus on aging) are proposed, which may ultimately explain the storage of large amounts of these pigments in a context of host–pathogen interactions. (shrink)

Now in a third edition, Introduction to Philosophy: Classical and Contemporary Readings is a highly acclaimed, topically organized collection that covers five major areas of philosophy--theory of knowledge, philosophy of religion, philosophy of mind, freedom and determinism, and moral philosophy. Editor Louis P. Pojman enhances the text's topical organization by arranging the selections into a pro/con format to help students better understand opposing arguments. He also includes accessible introductions to each chapter, subsection, and individual reading, a unique feature for an (...) anthology of this depth. While the book focuses on a compelling sampling of classical material--including selections from Plato, Aristotle, Descartes, Locke, Berkeley, Hume, and Kant--it also incorporates some of philosophy's best twentieth-century and contemporary work, featuring articles by Bertrand Russell, Richard Taylor, John Searle, Thomas Nagel, and others. This third edition contains an expanded glossary, more extensive section introductions, and twelve new selections: Karl Popper: "Epistemology without a Knowing Subject" Richard Rorty: "Dismantling Truth: Solidarity Versus Objectivity" Daniel Dennett: "Postmodernism and Truth" Bruce Russell: "The Problem of Evil: Too Much Suffering" David Chalmers: "Against Materialism: Can Consciousness Be Reductively Explained?" Baron Paul Henri d'Holbach: "A Defense of Determinism" Michael Levin: "A Compatibilist Defense of Moral Responsibility" Plato: Socratic Morality: "Crito" Herodotus: "Custom Is King" J. L. Mackie: "The Subjectivity of Values" Louis P. Pojman: "A Critique of Mackie's Theory of Moral Subjectivism" Thomas Nagel: "Moral Luck". (shrink)

The aim of this paper is to provide a theoretical framework to understand how multicellular systems realize functionally integrated physiological entities by organizing their intercellular space. From a perspective centered on physiology and integration, biological systems are often characterized as organized in such a way that they realize metabolic self-production and self-maintenance. The existence and activity of their components rely on the network they realize and on the continuous management of the exchange of matter and energy with their environment. One (...) of the virtues of the organismic approach focused on organization is that it can provide an understanding of how biological systems are functionally integrated into coherent wholes. Organismic frameworks have been primarily developed by focusing on unicellular life. Multicellularity, however, presents additional challenges to our understanding of biological systems, related to how cells are capable to live together in higher-order entities, in such a way that some of their features and behaviors are constrained and controlled by the system they realize. Whereas most accounts of multicellularity focus on cell differentiation and increase in size as the main elements to understand biological systems at this level of organization, we argue that these factors are insufficient to provide an understanding of how cells are physically and functionally integrated in a coherent system. In this paper, we provide a new theoretical framework to understand multicellularity, capable to overcome these issues. Our thesis is that one of the fundamental theoretical principles to understand multicellularity, which is missing or underdeveloped in current accounts, is the functional organization of the intercellular space. In our view, the capability to be organized in space plays a central role in this context, as it enables (and allows to exploit all the implications of) cell differentiation and increase in size, and even specialized functions such as immunity. We argue that the extracellular matrix plays a crucial active role in this respect, as an evolutionary ancient and specific (non-cellular) control subsystem that contributes as a key actor to the functional specification of the multicellular space and to modulate cell fate and behavior. We also analyze how multicellular systems exert control upon internal movement and communication. Finally, we show how the organization of space is involved in some of the failures of multicellular organization, such as aging and cancer. (shrink)

Exploring the philosophical foundations of discrimination law as it exists in several jurisdictions, this collection of all new essays bridges the gap between abstract philosophical work on justice and fairness and legal work on specific types of discrimination.

In this commentary of Koonin’s target paper, we defend an extended view of CRISPR-Cas immunity by arguing that CRISPR-Cas includes, but cannot be reduced to, defence against nonself. CRISPR-Cas systems can target endogenous elements and tolerate exogenous elements. We conclude that the vocabulary of “defence” and “nonself” might be misleading when describing CRISPR-Cas systems.

The proceedings of the first major international conference on the philosophy of Spinoza to be held in the United States are published here.