The participation of vulnerable patients in clinical research poses apparent ethical dilemmas. Depending on the nature of the vulnerability, their participation may challenge the ethical principles of autonomy, non-maleficence, or justice. On the other hand, non-participation may preclude the building of a knowledge base that is a prerequisite for defining the optimal clinical management of vulnerable patients. Such clinical uncertainty may also incur substantial economic costs. We present the participation of pre-menopausal women with atrial fibrillation in trials of novel oral (...) anticoagulant drugs as a case study. Due to their non-participation in pivotal trials, it is uncertain whether for them, the risks that are associated with these drugs are outweighed by the advantages compared with conventional treatment. We addressed the question whether research of this new class of drugs in this subgroup would be appropriate from both, an ethical as well an economic perspective. We used the method of specifying norms as a wider framework to resolve the apparent ethical dilemma, while incorporating the question whether research of oral anticoagulants in premenopausal women with atrial fibrillation can be justified on economic grounds. For the latter, the results of a value-of-information analysis were used. Further clinical research on NOACs in premenopausal women with atrial fibrillation can be justified on both, ethical and economic grounds. Addressing apparent ethical dilemmas by invoking a method such as specifying norms can improve the quality of public practical reasoning. As such, the method should also prove valuable to committees that have formally been granted the authority to review trial protocols and proposals for scientific research. (shrink)

Physicists regularly invoke universal laws, such as those of motion and electromagnetism, to explain events. Biological and medical scientists have no such laws. How then do they acquire a reliable body of knowledge about biological organisms and human disease? One way is by repeatedly returning to, manipulating, observing, interpreting, and reinterpreting certain subjects—such as flies, mice, worms, or microbes—or, as they are known in biology, “model systems.” Across the natural and social sciences, other disciplinary fields have developed canonical examples that (...) have played a role comparable to that of biology’s model systems, serving not only as points of reference and illustrations of general principles or values but also as sites of continued investigation and reinterpretation. The essays in this collection assess the scope and function of model objects in domains as diverse as biology, geology, and history, attending to differences between fields as well as to epistemological commonalities. Contributors examine the role of the fruit fly Drosophila and nematode worms in biology, troops of baboons in primatology, box and digital simulations of the movement of the earth’s crust in geology, and meteorological models in climatology. They analyze the intensive study of the prisoner’s dilemma in game theory, ritual in anthropology, the individual case in psychoanalytic research, and Athenian democracy in political theory. The contributors illuminate the processes through which particular organisms, cases, materials, or narratives become foundational to their fields, and they examine how these foundational exemplars—from the fruit fly to Freud’s Dora—shape the knowledge produced within their disciplines. Contributors Rachel A. Ankeny Angela N. H. Creager Amy Dahan Dalmedico John Forrester Clifford Geertz Carlo Ginzburg E. Jane Albert Hubbard Elizabeth Lunbeck Mary S. Morgan Josiah Ober Naomi Oreskes Susan Sperling Marcel Weber M. Norton Wise. (shrink)

This study aims to examine the development of diversity and inclusion (D&I) literature and identify its prominent themes and blind spots. The research was conducted using bibliometric analysis on the Web of Science database and included 2510 publications. Results showed that the development of D&I literature had increased exponentially since the 1960s, mainly due to different political and societal events. The geographic development showed that research was primarily conducted in developed countries where quotas and other legislation are implemented. The thematic (...) development revealed a stable but narrow focus on diversity management, board diversity, and team diversity, with little attention to inclusion. The keyword analysis strongly emphasized surface-level diversity, such as gender, race, and cultural diversity, while deep-level diversity received less attention. This study concludes that previous D&I literature has mainly focused on the financial effects of D&I and neglected other elements, such as the effects on social performance, its ethical implications, and the relationship between diversity and inclusion. The study recommends future research to expand the interpretation of diversity, examine the relationship between diversity and inclusion, and explore the effects of diversity on non-financial outcomes such as social performance and ethics. This study provides a valuable contribution to the field of business ethics by highlighting the blind spots in D&I literature and encouraging future research to consider the ethical implications of diversity in the workplace. (shrink)

We present a one per cent measurement of the cosmic distance scale from the detections of the baryon acoustic oscillations in the clustering of galaxies from the Baryon Oscillation Spectroscopic Survey, which is part of the Sloan Digital Sky Survey III. Our results come from the Data Release 11 sample, containing nearly one million galaxies and covering approximately 8500 square degrees and the redshift range 0.2 < z < 0.7. We also compare these results with those from the publicly released (...) DR9 and DR10 samples. Assuming a concordance Λ cold dark matter cosmological model, the DR11 sample covers a volume of 13 Gpc3 and is the largest region of the Universe ever surveyed at this density. We measure the correlation function and power spectrum, including density-field reconstruction of the BAO feature. The acoustic features are detected at a significance of over 7σ in both the correlation function and power spectrum. Fitting for the position of the acoustic features measures the distance relative to the sound horizon at the drag epoch, rd, which has a value of rd,fid = 149.28 Mpc in our fiducial cosmology. We find DV = at z = 0.32 and DV = at z = 0.57. At 1.0 per cent, this latter measure is the most precise distance constraint ever obtained from a galaxy survey. Separating the clustering along and transverse to the line of sight yields measurements at z = 0.57 of DA = and H =. Our measurements of the distance scale are in good agreement with previous BAO measurements and with the predictions from cosmic microwave background data for a spatially flat CDM model with a cosmological constant. © 2014 The Author Published by Oxford University Press on behalf of the Royal Astronomical Society. (shrink)

Funke has taken upon himself the task of refining and answering the question "What is philosophy?" His answer results in the proof that all philosophy in order to be philosophy must not neglect the question as to the transcendental determination and form of its own consciousness. As such, philosophy is, according to Funke, neither merely stating facts nor describing qualities. Rather philosophy wants to know why something is the way it is, that is, why something occurs as a phenomenon in (...) exactly the way it does and not otherwise. Consequently, philosophy is a critical transcendental phenomenology that has to understand the object regressively as the correlate of a subjective achievement. Being a universal transcendental philosophy, pure phenomenology has the task of not merely seeking for the constitutive conditions of the phenomena in their peculiarity but also that of proving the validity of its own undertaking. Phenomenology as reflective consciousness has to turn back to the conditions of its own possibility. This demand leads back to an iterative regress in which each proposition about transcendentals must be justified transcendentally. The chapter on "The Reflective Consciousness and the Iterating Regress of the Conditions of Possibility" exhibits this problem while the chapter on "The Topical Consciousness and the Utopical Regress to the Ultimate Experiences of the Life-World" provides an answer and demonstrates why the phenomenological regress of reflection can and must never be completed. Interpreting Husserl, Funke explains that the transcendental reduction in Husserl does not lead back to an ego, a transcendental subjectivity as intersubjectivity, as generally assumed. Rather, as Funke attempts to prove, the state of awareness of subjectivity and the context of meaning of objectivity belong to one another correlatively and universally. According to Funke, phenomenology is essentially the method which in critical reflection makes reason advance further in its process of self-enlightenment. This book is written in an interesting and lively way and Funke does not fail to anticipate and address possible critical objections to his own position. At the same time he involves himself in an apologetic discussion with the philosophical literature on this issue.—H. E. M. H. (shrink)

Accumulating evidence indicates that simulated natural settings can engage mechanisms that promote health. Simulations offer alternatives to actual natural settings for populations unable to travel outdoors safely; however, few studies have contrasted the effects of simulations of natural settings to their actual outdoor counterparts. We compared the impacts of simulated and actual natural settings on positive and negative affect (mood) levels using a pooled sample of participants enrolled in extant experimental studies. Relevant articles were identified from a review of research (...) published/in press by March 2020 and updated during the peer review of the current study. Of 16 articles identified, 6 met the inclusion criteria and administered a single cross-cutting, standardized instrument [the Positive and Negative Affect Schedule (PANAS)] before and after exposure. Random effects meta-analysis of pooled effects showed that positive affect increased in the actual settings but not in their simulated counterparts (Hedge's g = 0.87; 95% CI, 0.54, 1.20). We observed little difference in effects on negative affect change scores ( g = −0.28; 95% CI, −0.62, 0.06), with studies generally showing reductions in negative affect in both settings. Further research with additional populations, settings, antecedent conditions, and durations would provide a more robust understanding of differences in effects between these two ways to enhance mood by viewing nature. (shrink)

_Zettel, _ an en face bilingual edition, collects fragments from Wittgenstein's work between 1929 and 1948 on issues of the mind, mathematics, and language.

Objectives: There are indications that institutional review board members do not find it easy to assess the risks and benefits in medical experiments, although this is their principal duty. This study examined how IRB members assessed the risk/benefit ratio of a specific phase II breast cancer clinical trial.Participants and methods: The trial was evaluated by means of a questionnaire administered to 43 members of IRBs at six academic hospitals and specialised cancer centres in the Netherlands. The questionnaire addressed: identification and (...) estimation of inconvenience, toxicity, psychosocial distress, and benefits of trial participation to patients; identification and estimation of benefits to future patients and medical science; assessment of the trial’s RBR; and assessment of its ethical acceptability.Results: Most IRB members expected trial participation to involve fairly or very serious inconvenience, fairly severe to sometimes life-threatening toxicity, and serious psychological and social consequences. Conversely, the perceived likelihood of benefits to patients was modest. Most regarded the study as important, and the balance between risks and benefits to be favourable, and believed that the protocol should be approved. The IRB members’ final judgement on the trial’s ethical acceptability was significantly correlated with their RBR assessment of the protocol.Conclusions: Because most patients who participate in clinical trials hope this will prolong their lives, it is suggested that patient information should better describe the anticipated benefits—for example, the likelihood of prolonging life. This would allow patients to make decisions regarding participation based on realistic expectations. (shrink)

Background The consistency of codes governing disclosure of terminal illness to patients and families in Islamic countries has not been studied until now. Objectives To review available codes on disclosure of terminal illness in Islamic countries. Data source and extraction Data were extracted through searches on Google and PubMed. Codes related to disclosure of terminal illness to patients or families were abstracted, and then classified independently by the three authors. Data synthesis Codes for 14 Islamic countries were located. Five codes (...) were silent regarding informing the patient, seven allowed concealment, one mandated disclosure and one prohibited disclosure. Five codes were silent regarding informing the family, four allowed disclosure and five mandated/recommended disclosure. The Islamic Organization for Medical Sciences code was silent on both issues. Conclusion Codes regarding disclosure of terminal illness to patients and families differed markedly among Islamic countries. They were silent in one-third of the codes, and tended to favour a paternalistic/utilitarian, family-centred approach over an autonomous, patient-centred approach. (shrink)

Representatives from eight European countries compared the legal, ethical and professional settings within which decision making for neonates takes place. When it comes to limiting treatment there is general agreement across all countries that overly aggressive treatment is to be discouraged. Nevertheless, strong emphasis has been placed on the need for compassionate care even where cure is not possible. Where a child will die irrespective of medical intervention, there is widespread acceptance of the practice of limiting aggressive treatment or alleviating (...) suffering even if death may be hastened as a result. Where the infant could be saved but the future outlook is bleak there is more debate, but only two countries have tested the courts with such cases. When it comes to the active intentional ending of life, the legal position is standard across Europe; it is prohibited. However, recognising those intractable situations where death may be lingering and unpleasant, Dutch paediatricians have reported that they do sometimes assist babies to die with parental consent. Two cases have been tried through the courts and recent official recommendations have set out standards by which such actions may be assessed. (shrink)

This bilingual edition of the Remarks on the Philosophy of Psychology presents the first English translation of an essential body of Wittgenstein's work. It elaborates Wittgenstein's views on psychological concepts such as expectation, sensation, knowing how to follow a rule, and knowledge of the sensations of other persons. It also shows strong emphasis on the "anthropological" aspect of Wittgenstein's thought.

Zettel is a collection of fragments which Wittgenstein cut from various of his typescripts and preserved for future use. More than half of the fragments were written in the years 1946-1948, after the completion of Part I and before the composition of Part II of the Philosophical Investigations. This collection may therefore be regarded as a companion volume to the Investigations, adding to both the scope and the Unity of Wittgenstein′s chef d′oeuvre. The fragments were kept in a box and (...) were not strictly ordered. Many have marks showing changes and improvements made after they were cut from the typescripts; some have remarks added in handwriting. Editing the collection for publication was thus a task of considerable difficulty. Since Zettel was first published, further research has been carried out on the fragments and minute comparisons have been made with their typescript and manuscript sources, revealing certain inaccuracies and misinterpretations in the first editing of the work. The second edition corrects these shortcomings and includes new explanatory footnotes; a detailed index, compiled by Stephen Amdur, has also been added. (shrink)

Much epistemological theorizing is the attempt to specify what makes for meritorious cognition, but epistemologists have not, despite meritorious effort, achieved unity when it comes to picking out the feature and principles that are distinctive of epistemic normativity. In this essay we explain why this is the inevitable outcome. We isolate important but overlooked variations in the link between epistemological theorizing and the idea of epistemic unification, and then argue that much epistemological theorizing is misguided because it aims toward complete (...) epistemic unification when only partial epistemic unification, at best, is possible. But our arguments — based on work in moral epistemology and philosophical psychology — stop short of epistemological eliminativism, and thus we stake out a middle ground between philosophers such as Descartes, the earlier Alston, Audi, and the earlier BonJour on one hand and Rorty, Fish, and Patricia Churchland on the other. (shrink)

Volume 20, Issue 7, July 2020, Page 150-152.