BackgroundInnovations in technology have contributed to rapid changes in the way that modern biomedical research is carried out. Researchers are increasingly required to endorse adaptive and flexible approaches to accommodate these innovations and comply with ethical, legal and regulatory requirements. This paper explores how Dynamic Consent may provide solutions to address challenges encountered when researchers invite individuals to participate in research and follow them up over time in a continuously changing environment.MethodsAn interdisciplinary workshop jointly organised by the University of Oxford (...) and the COST Action CHIP ME gathered clinicians, researchers, ethicists, lawyers, research participants and patient representatives to discuss experiences of using Dynamic Consent, and how such use may facilitate the conduct of specific research tasks. The data collected during the workshop were analysed using a content analysis approach.ResultsDynamic Consent can provide practical, sustainable and future-proof solutions to challenges related to participant recruitment, the attainment of informed consent, participant retention and consent management, and may bring economic efficiencies.ConclusionsDynamic Consent offers opportunities for ongoing communication between researchers and research participants that can positively impact research. Dynamic Consent supports inter-sector, cross-border approaches and large scale data-sharing. Whilst it is relatively easy to set up and maintain, its implementation will require that researchers re-consider their relationship with research participants and adopt new procedures. (shrink)

The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists. Originally, these labels were invoked by volunteer research efforts propelled by amateurs outside of traditional research institutions and aimed at appealing to those looking for more “democratic,” “patient-centric,” or “lay” alternatives to the professional science establishment. As mainstream translational biomedical research requires increasingly larger participant pools, however, corporate, academic and governmental research programs (...) are embracing this populist rhetoric to encourage wider public participation. We examine the ethical and social implications of this recruitment strategy. We begin by surveying examples of “citizen science” outside of biomedicine, as paradigmatic of the aspirations this democratizing rhetoric was originally meant to embody. Next, we discuss the ways these aspirations become articulated in the biomedical context, with a view to drawing out the multiple and potentially conflicting meanings of “public engagement” when citizens are also the subjects of the science. We then illustrate two uses of public engagement rhetoric to gain public support for national biomedical research efforts: its post-hoc use in the “care.data” project of the National Health Service in England, and its proactive uses in the “Precision Medicine Initiative” of the United States White House. These examples will serve as the basis for a normative analysis, discussing the potential ethical and social ramifications of this rhetoric. We pay particular attention to the implications of government strategies that cultivate the idea that members of the public have a civic duty to participate in government-sponsored research initiatives. We argue that such initiatives should draw from policy frameworks that support normative analysis of the role of citizenry. And, we conclude it is imperative to make visible and clear the full spectrum of meanings of “citizen science,” the contexts in which it is used, and its demands with respect to participation, engagement, and governance. (shrink)

This paper starts by investigating Ackermann's interpretation of finite set theory in the natural numbers. We give a formal version of this interpretation from Peano arithmetic (PA) to Zermelo-Fraenkel set theory with the infinity axiom negated (ZF−inf) and provide an inverse interpretation going the other way. In particular, we emphasize the precise axiomatization of our set theory that is required and point out the necessity of the axiom of transitive containment or (equivalently) the axiom scheme of ∈-induction. This clarifies the (...) nature of the equivalence of PA and ZF−inf and corrects some errors in the literature. We also survey the restrictions of the Ackermann interpretation and its inverse to subsystems of PA and ZF−inf, where full induction, replacement, or separation is not assumed. The paper concludes with a discussion on the problems one faces when the totality of exponentiation fails, or when the existence of unordered pairs or power sets is not guaranteed. (shrink)

We give an examination of the automorphism group Aut of a countable recursively saturated model M of PA. The main result is a characterisation of strong elementary initial segments of M as the initial segments consisting of fixed points of automorphisms of M. As a corollary we prove that, for any consistent completion T of PA, there are recursively saturated countable models M1, M2 of T, such that Aut[ncong]Aut, as topological groups with a natural topology. Other results include a classification (...) of the normal subgroups of Aut of the form [lcub]g: g [uharr] A = idA[rcub], for sets A M, and a highly homogeneous representation of Aut as a subgroup of Aut. (shrink)

Current debate on business ethics in Australia continues apace as the excesses of the 1980s are exposed. Codes of Ethics have been a high profile instrument in the American business scene. A survey of Australia''s largest business corporations reveals a different situation. Codes are not as commonly used, tend to refer to legal requirements and do not have as high a profile within the corporation. Given the changing legal framework in Australia a greater role for Codes of Ethics may emerge.

_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

Background Randomized controlled trials are central to generating knowledge about effectiveness of interventions as well as risk, protective and prognostic factors related to diseases in emergency newborn care. Whether prospective participants understand the purpose of research, and what they perceive as the influence of the context on their understanding of the informed consent process for RCTs in emergency obstetric and newborn care are not well documented. Methods Conceptual review. Discussion Research is necessary to identify how the illnesses may be prevented, (...) to explore the causes, and to investigate what medications could be used to manage such illness. Voluntary informed consent requires that prospective participants understand the disclose information about the research, and use this to make autonomous informed decision about participation, in line with their preferences and values. Yet the emergency context affects how information may be disclosed to prospective research participants, how much participants may comprehend, and how participants may express their voluntary decision to participate, all of which pose a threat to the validity of the informed consent. I challenge the claim that the ‘understanding’ of research is always necessary for ethical informed consent for research during emergency care. I argue for reconceptualization of the value of understanding, through recognition of other values that may be equally important. I then present a reflective perspective that frames moral reflection about autonomy, beneficence and justice in research in emergency research. Conclusion While participant ‘understanding’ of research is important, it is neither necessary nor sufficient for a valid informed consent, and may compete with other values with which it needs to be considered. (shrink)

Dynamic Consent is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health (...) information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people.In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation. (shrink)

We present a comprehensive study of the axiom schemas IΣ - n , BΣ - n (induction and collection schemas for parameter free Σ n formulas) and some closely related schemas.

We show that Matijasevič's Theorem on the diophantine representation of r.e. predicates is provable in the subsystem I ∃ - 1 of Peano Arithmetic formed by restricting the induction scheme to diophantine formulas with no parameters. More specifically, I ∃ - 1 ⊢ IE - 1 + E ⊢ Matijasevič's Theorem where IE - 1 is the scheme of parameter-free bounded existential induction and E is an ∀∃ axiom expressing the existence of a function of exponential growth. We conclude by (...) examining the consequences of these results to the structure of countable nonstandard models of IE - 1. (shrink)

Biobanks are proliferating rapidly worldwide because they are powerful tools and organisational structures for undertaking medical research. By linking samples to data on the health of individuals, it is anticipated that biobanks will be used to explore the relationship between genes, environment and lifestyle for many diseases, as well as the potential of individually-tailored drug treatments based on genetic predisposition. However, they also raise considerable challenges for existing legal frameworks and research governance structures. This book critically examines the current governance (...) structures in place for biobanks in England and Wales. It shows that the technologies, techniques and practices involved in biobanking do not always conform neatly to existing legal principles and frameworks that apply to other areas of medical research. Using a socio-legal approach, including interview data gathered from the scientific community, this book provides unique insights and makes recommendations about appropriate governance mechanisms for biobanking in the future. It also explores the issues around the secondary use of information, such as consent and how to protect privacy, when biobanks are accessed by a number of different third parties. These issues have relevance both within England and Wales and to a wide international audience, as well as for other areas where large datasets are used.--Back cover. (shrink)

The use of genome-wide association studies in medical research and the increased ability to share data give a new twist to some of the perennial ethical issues associated with genomic research. GWAS create particular challenges because they produce fine, detailed, genotype information at high resolution, and the results of more focused studies can potentially be used to determine genetic variation for a wide range of conditions and traits. The information from a GWA scan is derived from DNA that is a (...) powerful personal identifier, and can provide information not just on the individual, but also on the individual's relatives, related groups, and populations. Furthermore, it creates large amounts of individual-specific digital information that is easy to share across international borders. This paper provides an overview of some of the key ethical issues around GWAS: consent, feedback of results, privacy, and the governance of research. Many of the questions that lie ahead of us in terms of the next generation sequencing methods will have been foreshadowed by GWAS and the debates around ethical and policy issues that these have created. (shrink)

Biobanks are increasingly being created specifically for research purposes. Concomitantly, we are seeing significant and evolving shifts in research ethics in relation to biobanking. Three discrete shifts are identified in this article. The first extends the ethical focus beyond the protection of human subjects to the promotion of broader community benefits of research utilizing biobanked resources, and an expectation that these benefits will be shared. The second involves the evolution of the traditional consent paradigm for future research uses of biobanks (...) resources that are not in contemplation at the time of donation. The third involves a move away from single project management to more dynamic governance accountability to research participants and the public. These shifts may take different local and institutional forms but share common recognizable elements. (shrink)

BackgroundInformed consent, whose goal is to assure that participants enter research voluntarily after disclosure of potential risks and benefits, may be impossible or impractical in emergency research. In low resource settings, there is limited information on the experiences of the informed consent process for randomized clinical trials in the emergency care context. The objective of this study was to explore the experiences of the informed consent process and factors that motivated participation in two obstetrics and newborn care randomized clinical trials (...) (RCTs).MethodsThis was a qualitative study conducted among former participants of RCTs in the emergency obstetric care context, conducted at Kawempe National Referral Hospital, Uganda. It employed 30 in-depth interviews conducted from June 1, 2019 to August 30, 2019. Issues explored included attitudes about research, the purpose of the research in which they participated, motivations to take part in the study, factors that influenced enrolment decisions, and experiences of the informed consent process.ResultsRespondents felt that research was necessary to investigate the cause, prevention or complications of illness. The decisions to participate were influenced by hope for material or therapeutic benefit, trust in the healthcare system and influence of friends and family members. Many were satisfied with the informed consent process, though they did not understand some aspects of the research.ConclusionRespondents valued participation in RCTs in emergency obstetric and newborn care. Hope for benefit, altruism, desire to further scientific knowledge and trust in the investigators featured prominently in the motivation to participate. Both intrinsic and extrinsic factors were motivators for RCT participation. (shrink)

Counterfactualism is a useful process for historians as a thought-experiment because it offers grounds to challenge an unfortunate contemporary historical mindset of assumed, deterministic certainty. This article suggests that the methodological value of counterfactualism may be understood in terms of the three categories of common ahistorical errors that it may help to prevent: the assumptions of indispensability, causality, and inevitability. To support this claim, I survey a series of key counterfactual works and reflections on counterfactualism, arguing that the practice of (...) counterfactualism evolved as both cause and product of an evolving popular assumption of the plasticity of history and the importance of human agency within it. For these reasons, counterfactualism is of particular importance both historically and politically. I conclude that it is time for a methodological re-assessment of the uses of such thought-experiments in history, particularly in light of counterfactualism's developmental relatedness to cultural, technological, and analytical modernity. (shrink)

This concise, accessible text provides a thorough introduction to quantum computing - an exciting emergent field at the interface of the computer, engineering, mathematical and physical sciences. Aimed at advanced undergraduate and beginning graduate students in these disciplines, the text is technically detailed and is clearly illustrated throughout with diagrams and exercises. Some prior knowledge of linear algebra is assumed, including vector spaces and inner products. However, prior familiarity with topics such as quantum mechanics and computational complexity is not required.

Showing key connections between Marx’s oeuvre and Buddhist thought, this book demonstrates connections between Marx and Nishida Kitaro, who many consider the key Japanese philosopher of the Kyoto School of Philosophy, the first modern philosophers in Japan.

I critically explore various forms of the language of thought (LOT) hypothesis. Many considerations, including the complexity of representational content and the systematicity of language understanding, support the view that some, but not all, of our mental representations occur in a language. I examine several arguments concerning sententialism and the propositional attitudes, Fodor's arguments concerning infant and animal thought, and Fodor's argument for radical concept nativism and show that none of these considerations require us to postulate a LOT that is (...) innate or otherwise distinct from spoken languages. Instead, I suggest that we maintain the more conservative hypothesis, supported by introspection, that some of our thoughts occur in the languages that we speak. (shrink)

ABSTRACTIlya Somin, like several other political epistemologists, effectively exposes the extent of public ignorance and the ways in which such ignorance may damage democratic outcomes. This underpins his case for a more streamlined state, leaving more to individual “foot voting”—where citizens are better incentivized to choose knowledgeably and rationally. One cannot dispute the fact of deep public ignorance. However, one can question the widespread assumption that ignorance is necessarily ethically significant, always productive of undesirable outcomes, or otherwise implicitly dangerous for (...) democracy. The sheer lack of individual efficacy in mass democracies not only incentivizes ignorance, but also creates conditions wherein such ignorance is individually harmless and unlikely in the aggregate to greatly contribute to one or another outcome. Beyond this, there may be no way to attain meaningful knowledge in the areas where democratic decision making is most fraught. Indeed, ignorance may at times lead to better outcomes than would knowledge. The seemingly unassailable status of democracy itself, and the valuable institutional stability that this status ensures, seem to be founded upon a bedrock of public ignorance as to the real nature of democracy. (shrink)

There is an urgent need to learn how to appropriately integrate technologies into dementia care. The aims of this Delphi study were to project which technologies will be most prevalent in dementia care in five years, articulate potential benefits and risks, and identify specific options to mitigate risks. Participants were also asked to identify technologies that are most likely to cause value tensions and thus most warrant a conversation with an older person with mild dementia when families are deciding about (...) their use. Twenty-one interdisciplinary domain experts from academia and industry in aging and technology in the U.S. and Canada participated in a two-round online survey using the Delphi approach with an 84% response rate and no attrition between rounds. Rankings were analyzed using frequency counts and written-in responses were thematically analyzed. Twelve technology categories were identified along with a detailed list of risks and benefits for each. Suggestions to mitigate the most commonly raised risks are categorized as follows: intervene during design, make specific technical choices, build in choice and control, require data transparency, place restrictions on data use and ensure security, enable informed consent, and proactively educate users. This study provides information that is needed to navigate person-centered technology use in dementia care. The specific recommendations participants offered are relevant to designers, clinicians, researchers, ethicists, and policy makers and require proactive engagement from design through implementation. (shrink)

BackgroundWhereas many adolescents and young people with HIV require the transfer of care from paediatric/adolescent clinics to adult ART clinics, this transition is beset with a multitude of factors that have the potential to hinder or facilitate the process, thereby raising ethical challenges of the transition process. Decisions made regarding therapy, such as when and how to transition to adult HIV care, should consider ethical benefits and risks. Understanding and addressing ethical challenges in the healthcare transition could ensure a smooth (...) and successful transition. The purpose of this study was to analyze the ethical challenges of transitioning HIV care for adolescents into adult HIV clinics.MethodsData presented were derived from 191 adolescents attending nine different health facilities in Uganda, who constituted 18 focus group discussions. In the discussions, facilitators and barriers regarding adolescents transitioning to adult HIV clinics were explored. Guided by the Silences Framework for data interpretation, thematic data analysis was used to analyze the data. The principles of bioethics and the four-boxes ethics framework for clinical care (patient autonomy, medical indications, the context of care, and quality of life) were used to analyze the ethical issues surrounding the transition from adolescent to adult HIV care.ResultsThe key emerging ethical issues were: reduced patient autonomy; increased risk of harm from stigma and loss of privacy and confidentiality; unfriendly adult clinics induce disengagement and disruption of the care continuum; patient preference to transition as a cohort, and contextual factors are critical to a successful transition.ConclusionThe priority outcomes of the healthcare transition for adolescents should address ethical challenges of the healthcare transition such as loss of autonomy, stigma, loss of privacy, and discontinuity of care to ensure retention in HIV care, facilitate long-term self-care, offer ongoing all-inclusive healthcare, promote adolescent health and wellbeing and foster trust in the healthcare system. Identifying and addressing the ethical issues related to what hinders or facilitates successful transitions with targeted interventions for the transition process may ensure adolescents and young people with HIV infection remain healthy across the healthcare transition. (shrink)

Background Factors that could potentially act as facilitators and barriers to successful recruitment strategies in perinatal clinical trials are not well documented. The objective was to assess lay persons’ understanding of the informed consent for randomized clinical trial in emergency obstetric and newborn care. Methods This was a qualitative study conducted among survivors of severe obstetric complications who were attending the post-natal clinic of Kawempe National Referral Hospital, Uganda, 6–8 weeks after surviving severe obstetric complications during pregnancy or childbirth. The (...) study that involved 18 in-depth interviews was conducted from June 1, 2019 to July 6, 2019. The issues explored included perceptions of the purpose and necessity to conduct such research how research-related information would be disclosed, and what could be the potential benefits and risks of participation. The data was analyzed by thematic analysis. Results Respondents felt that research was necessary to investigate the cause, prevention or complications of an illness, especially as much was known about some pregnancy and newborn complications. Most believed that the emergency contexts affects whether and what prospective participants may understand if information about research was disclosed. Whereas they did not see the value of procedures like randomization, they felt that if these and any other procedures necessary should be done transparently and fairly. The decisions to participate would significantly be influenced by possibility of risk to the unborn baby or the newborn. Solidarity was an important influence on decision-making. Conclusions Respondents valued participation in RCTs in emergency obstetric and newborn care. However, they expressed concerns and valued openness, transparency and accountability with regard to how clinical trials information is disclosed and the decision-making process for clinical trial participation. While autonomy and solidarity are contradictory values, they complement each other during decision-making for informed consent. (shrink)

This book is a comprehensive exposition of the Transcendental Deduction of the Categories in both editions of Kant’s Critique of Pure Reason.

In the 1950s and 1960s Freudian theory was deemed to be a vital part of the sociological tradition, but since then it has fallen from favor, largely because of the simplifications and misinterpretations both by Freud's sociological critics and by his supporters. Chief among such misunderstandings is the tendency to view Freud's social theory as a variant of that of Hobbes, in which a selfish and asocial human nature is made social through the imposition of external constraints; these constraints, as (...) Durkheim stated, eventually are "internalized" into the personalities of social beings. Against such a claim this paper argues that Freud's views differ profoundly from those of Hobbes and that the myth of the Hobbesian Freud has so distorted Freud's most fundamental concepts that their social theoretical significance has been largely obscured. (shrink)

This book is a groundbreaking history of balance, exploring how a new model of equilibrium emerged during the medieval period.

Over the past 25 years, there has been growing recognition of the importance of studying the Ethical, Legal and Social Implications of genetic and genomic research. A large investment into ELSI research from the National Institutes of Health Human Genomic Project budget in 1990 stimulated the growth of this emerging field; ELSI research has continued to develop and is starting to emerge as a field in its own right. The evolving subject matter of ELSI research continues to raise new research (...) questions as well as prompt re-evaluation of earlier work and a growing number of scholars working in this area now identify themselves as ELSI scholars rather than with a particular discipline. Due to the international and interdisciplinary nature of ELSI research, scholars can often find themselves isolated from disciplinary or regionally situated support structures. We conducted a workshop with Early Career Researchers in Oxford, UK, and this paper discusses some of the particular challenges that were highlighted. While ELSI ECRs may face many of the universal challenges faced by ECRs, we argue that a number of challenges are either unique or exacerbated in the case of ELSI ECRs and discuss some of the reasons as to why this may be the case. We identify some of the most pressing issues for ELSI ECRs as: interdisciplinary angst and expertise, isolation from traditional support structures, limited resources and funding opportunities, and uncertainty regarding how research contributions will be measured. We discuss the potential opportunity to use web 2.0 technologies to transform academic support structures and address some of the challenges faced by ELSI ECRs, by helping to facilitate mentoring and support, access to resources and new accreditation metrics. As our field develops it is crucial for the ELSI community to continue looking forward to identify how emerging digital solutions can be used to facilitate the international and interdisciplinary research we perform, and to offer support for those embarking on, progressing through, and transitioning into an ELSI research career. (shrink)

As in other countries, the traditional doctor-patient relationship in the Japanese healthcare system has often been characterised as being of a paternalistic nature. However, in recent years there has been a gradual shift towards a more participatory-patient model in Japan. With advances in technology, the possibility to use digital technologies to improve patient interactions is growing and is in line with changing attitudes in the medical profession and society within Japan and elsewhere. The implementation of an online patient engagement platform (...) is being considered by the Myotonic Dystrophy Registry of Japan. The aim of this exploratory study was to understand patients’ views and attitudes to using digital tools in patient registries and engagement with medical research in Japan, prior to implementation of the digital platform. We conducted an exploratory, cross-sectional, self-completed questionnaire with a sample of myotonic dystrophy patients attending an Open Day at Osaka University, Japan. Patients were eligible for inclusion if they were 18 years or older, and were diagnosed with MD. A total of 68 patients and family members attended the Open Day and were invited to participate in the survey. Of those, 59 % submitted a completed questionnaire. The survey showed that the majority of patients felt that they were not receiving the information they wanted from their clinicians, which included recent medical research findings and opportunities to participate in clinical trials, and 88 % of patients indicated they would be willing to engage with digital technologies to receive relevant medical information. Patients also expressed an interest in having control over when and how they received this information, as well as being informed of how their data is used and shared with other researchers. Overall, the findings from this study suggest that there is scope to develop a digital platform to engage with patients so that they can receive information about medical care and research opportunities. While this study group is a small, self-selecting population, who suffer from a particular condition, the results suggest that there are interested populations within Japan that would appreciate enhanced communication and interaction with healthcare teams. (shrink)

A theory of two-sided containers, denoted ZF2, is introduced. This theory is then shown to be synonymous to ZF in the sense of Visser (2006), via an interpretation involving Quine pairs. Several subtheories of ZF2, and their relationships with ZF, are also examined. We include a short discussion of permutation models (in the sense of Rieger–Bernays) over ZF2. We close with highlighting some areas for future research, mostly motivated by the need to understand non-wellfounded games.

We consider the quantifier hierarchy of Takahashi [1972] and show how it gives rise to reflection theorems for some large cardinals in ZF, a new natural subtheory of Zermelo's set theory, a potentially useful new reduction of the consistency problem for Quine's NF, and a sharpening of another reduction of this problem due to Boffa.

Responsible Research and Innovation (‘RRI’) is a cross-cutting priority for scientific research in the European Union and beyond. This paper considers whether the way such research is organised and delivered lends itself to the aims of RRI. We focus particularly on international consortia, which have emerged as a common model to organise large-scale, multi-disciplinary research in contemporary biomedical science. Typically, these consortia operate through fixed-term contracts, and employ governance frameworks consisting of reasonably standard, modular components such as management committees, advisory (...) boards, and data access committees, to co-ordinate the activities of partner institutions and align them with funding agency priorities. These have advantages for organisation and management of the research, but can actively inhibit researchers seeking to implement RRI activities. Conventional consortia governance structures pose specific problems for meaningful public and participant involvement, data sharing, transparency, and ‘legacy’ planning to deal with societal commitments that persist beyond the duration of the original project. In particular, the ‘upstream’ negotiation of contractual terms between funders and the institutions employing researchers can undermine the ability for those researchers to subsequently make decisions about data, or participant remuneration, or indeed what happens to consortia outputs after the project is finished, and can inhibit attempts to make project activities and goals responsive to input from ongoing dialogue with various stakeholders. Having explored these challenges, we make some recommendations for alternative consortia governance structures to better support RRI in future. (shrink)

In this fast-paced, enlightening guide, Sharon M. Kaye takes us on a whistle-stop tour of medieval philosophy, revealing its astounding legacy to the discipline today.

The rapid rise of international collaborative science has enabled access to genomic data. In this article, it is argued that to move beyond mapping genomic variation to understanding its role in complex disease aetiology and treatment will require extending data sharing for the purposes of clinical research translation and implementation.

Innovations in information technologies have facilitated the development of new styles of research networks and forms of governance. This is evident in genomics where increasingly, research is carried out by large, interdisciplinary consortia focussing on a specific research endeavour. The UK10K project is an example of a human genomics consortium funded to provide insights into the genomics of rare conditions, and establish a community resource from generated sequence data. To achieve its objectives according to the agreed timetable, the UK10K project (...) established an internal governance system to expedite the research and to deal with the complex issues that arose. The project’s governance structure exemplifies a new form of network governance called ‘pop-up’ governance. ‘Pop-up’ because: it was put together quickly, existed for a specific period, was designed for a specific purpose, and was dismantled easily on project completion. In this paper, we use UK10K to describe how ‘pop-up’ governance works on the ground and how relational, hierarchical and contractual governance mechanisms are used in this new form of network governance. (shrink)

This undergraduate textbook covers the key material for a typical first course in logic, in particular presenting a full mathematical account of the most important result in logic, the Completeness Theorem for first-order logic. Looking at a series of interesting systems, increasing in complexity, then proving and discussing the Completeness Theorem for each, the author ensures that the number of new concepts to be absorbed at each stage is manageable, whilst providing lively mathematical applications throughout. Unfamiliar terminology is kept to (...) a minimum, no background in formal set-theory is required, and the book contains proofs of all the required set theoretical results. The reader is taken on a journey starting with König's Lemma, and progressing via order relations, Zorn's Lemma, Boolean algebras, and propositional logic, to completeness and compactness of first-order logic. As applications of the work on first-order logic, two final chapters provide introductions to model theory and nonstandard analysis. (shrink)

There is unanimous agreement regarding the need to ethically conduct research for improving therapy for patients admitted to hospital with acute conditions, including in emergency obstetric care. We present a conceptual analysis of ethical tensions inherent in the informed consent process for randomized clinical trials for emergency obstetric care and suggest ways in which these could be mitigated. A valid consenting process, leading to an informed consent, is a cornerstone of this aspect necessary for preservation and maintenance of respect for (...) autonomy and dignity. In emergency obstetric care research, obtaining informed consent can be problematic, leading to ethical tension between different moral considerations. Potential participants may be vulnerable due to severity of disease, powerlessness or impaired decisional capacity. Time for the consent process is limited, and some interventions have a narrow therapeutic window. These factors create ethical tension in allowing potentially beneficial research while avoiding potential harms and maintaining respect for dignity, human rights, justice and autonomy of the participants. Informed consent in emergency obstetric care in low- and middle-income countries poses numerous ethical challenges. Allowing research on vulnerable populations while maintaining respect for participant dignity and autonomy, protecting participants from potential harms and promoting justice underlie the ethical tensions in the research in emergency obstetric and newborn care. Those involved in research conduct or oversight have a duty of fair inclusion, to avoid denying participants the right to participate and to any potential research benefits. (shrink)

She was to a degree the tool of her husband. However, despite the fact she was under his influence to a degree she cannot escape if the Bank took all reasonable steps to ensure that she had appreciated and understood what she was signing. It may be that Mrs Wright-Bailey did not have an adequate comprehension of the nature of the charge... [E]ven if she did not, the Bank did take all reasonable steps.

We present some general results concerning the topological space of cuts of a countable model of arithmetic given by a particular indicator Y.The notion of “indicator” is de.ned in a novel way, without initially specifying what property is indicated and is used to de.ne a topological space of cuts of the model. Various familiar properties of cuts are investigated in this sense, and several results are given stating whether or not the set of cuts having the property is comeagre.A new (...) notion of “generic cut” is introduced and investigated and it is shown in the case of countable arithmetically saturated models M ⊧ PA that generic cuts exist, indeed the set of generic cuts is comeagre in the sense of Baire, and furthermore that two generic cuts within the same “small interval” of the model are conjugate by an automorphism of the model.The paper concludes by outlining some applications to constructions of cuts satisfying properties incompatible with genericity, and discussing in model-theoretic terms those properties for which there is an indicator Y. (shrink)

Despite its focus on consent the new Human Tissue Act 2004 allows for testing without consent where a relative could benefitIn recognition of the fact that genetic test results in people can have implications for close relatives, the new Human Tissue Act 2004 allows for a direction to access a person’s tissue so that testing can be carried out for the benefit of a relative, without the consent of that person. Clinical practice governed by common law and statute, before this (...) act, acknowledged that the disclosure, without consent, of the results of a genetic test, is ethically permissible in extreme situations for the benefit of a relative. New testing for the benefit of a relative without donor consent challenges the principle that informed or adequate consent should be obtained before a genetic test with considerable predictive powers is carried out. The debate surrounding the analogous situation of HIV testing concluded that in very rare cases, disclosure of an HIV result without consent may be justified, but testing without consent is a professional misconduct. This part of the legislation is controversial and deserves further debate. The Human Tissue Authority should take measures to limit the potential harm that can be caused by this provision.IntroductionAfter much debate, the new Human Tissue Act 2004 was passed by parliament in November 2004. Implementation of this act may be staggered, but it will be fully operational in May 2006. This act has several provisions that have implications in clinical practice for the use of stored tissue or samples containing cells. These provisions allow the Human Tissue Authority to permit access to human tissue for the purpose of obtaining scientific or medical information about a person for the benefit of another family member, without the consent of the donor . …. (shrink)