Surgical devices are often marketed before there is good evidence of their safety and effectiveness. Our paper discusses the ethical issues associated with the early marketing and use of new surgical devices from the perspectives of the six groups most concerned. Health Canada, which is responsible for licensing new surgical devices, should amend their requirements to include rigorous clinical trials that provide data on effectiveness and safety for each new product before it is marketed. Industry should comply with all Health (...) Canada requirements to obtain licenses for new products. Until Health Canada requires effectiveness and safety data, industry should cooperate with physicians in appropriate studies before releasing new products and should make balanced presentations of all the available evidence. Surgeons should, before using a new surgical device, assess the evidence on its effectiveness and safety and ensure they are properly trained and competent in using the device. Surgeons should provide their patients with an evaluation of the available evidence and inform them about possible complications and the surgeon's level of experience with the new device. Patients, who should be given an honest evaluation of the available evidence, possible complications, and the surgeon's experience, should be encouraged to evaluate the evidence and information to their own satisfaction to ensure that fully informed consent is given. Health institutions, responsible for regulating practice within their walls, should review new devices for safety, effectiveness, and economic impacts, before allowing their use. They should also limit the use of new surgical devices to surgeons trained and competent in the new technology. Professional societies should provide guidance on the early adoption of new surgical devices and technologies. We urge all those involved in the development, licensing, and use of new surgical devices to aim for higher ethical standards to protect the health and safety of patients requiring surgery. The lowest acceptable ethical standard would require device manufacturers to provide surgeons with accurate and timely information on the efficacy and safety of their products, allowing surgeons and patients to evaluate the evidence (and the significance of information not yet available) before surgery. (shrink)

Human clinical research has become a huge economic enterprise (Morin et al. 2002; Noah 2002). Because the human subject at the center can be so easily marginalized, many commentators recommend spec...

If the 1960’s did not see a resurgence of belief in God, they at least witnessed a renewed interest in him, stimulated by die writings of Harvey Cox, John Robinson and the so-called death-of-God theologians. These were concerned with the phenomenon of the ‘absence of God’, so called because, for all the difference he seemed to make in the day-to-day business of nations and cultures, God might just as well not exist. Whatever knowledge gaps may previously have existed have (...) already been plugged either in fact or in principle, and this without any explanation involving a God. The universe no longer seems to point beyond itself, but seems, on the contrary, pretty clearly self-sufficient. In such circumstances the ground has been cut from under anyone wanting to say that God exists. And if the claim continues to be made, it is from a philosophical viewpoint quite gratuitous. (shrink)

Cross-sector social partnerships (CSSPs) are relevant units of analysis for understanding sustainable business models (SBMs). This research examines how organizations value their motivations to participate in large sustainability-focused partnerships, how they perceive the value captured, and their structures implemented to address sustainability partnerships. Two hundred and twenty-four organizations partnering within four large sustainability CSSPs were surveyed using an augmented resource-based view (RBV) theoretical framework. Results show that partners were motivated by and captured value related to sustainability-, organizational-, and human-oriented resources, (...) and that organizations prefer more informal than formal structural elements to implement their partnerships’ sustainability strategies. Contributions to SBM and CSSP fields are revealed. SBM thinking is a provocation toward seeking integrated sustainable value creation, helping show the value of large CSSPs. Conversely, by conceiving of large, pluralistic CSSPs as “collaborative SBMs,” we extend the idea of the “business model” to the societal level, exploring how value is captured in partnership. (shrink)

This article investigates the propensity for academic dishonesty by university students using the partitioning method of decision tree analysis. A set of prediction rules are presented, and conclusions are drawn. To provide context for the decision tree approach, the partition process is compared with results of more traditional probit regression models. Results of the decision tree analysis complement the probit models in terms of predictive accuracy and confirm results previously found in the literature. In particular, students’ moral character—whether they believe (...) cheating is acceptable—is found to be the most important factor in determining the propensity for academic dishonesty. (shrink)

It is commonly agreed that Augustine's discussion of divine foreknowledge in DcD 5.9 is distinguished by its anti-Ciceronian polemic, but no one has analyzed the philosophical structure of this polemic to determine if it is compelling. I argue that Augustine's presentation has significant philosophical merit for two reasons. First, Augustine's rigorous application of the principle, shared with Cicero, that "nothing occurs unless it is preceded by an efficient cause" is capable of answeringforcefully one of the chief difficulties that Cicero poses (...) against the possibility of divine omniscience of human choice-making. Second, Augustine's presentation contains the potential to answer persuasively the epistemological problem that Cicero states against divine foreknowledge in his De Jato and De divinatione but which Augustine ignores in DcD 5.9. (shrink)

It is commonly agreed that Augustine's discussion of divine foreknowledge in DcD 5.9 is distinguished by its anti-Ciceronian polemic, but no one has analyzed the philosophical structure of this polemic to determine if it is compelling. I argue that Augustine's presentation has significant philosophical merit for two reasons. First, Augustine's rigorous application of the principle, shared with Cicero, that "nothing occurs unless it is preceded by an efficient cause" is capable of answeringforcefully one of the chief difficulties that Cicero poses (...) against the possibility of divine omniscience of human choice-making. Second, Augustine's presentation contains the potential to answer persuasively the epistemological problem that Cicero states against divine foreknowledge in his De Jato and De divinatione but which Augustine ignores in DcD 5.9. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume 29, Number 2, November 2003, pp. 223-266 A Diplomatic Transcription of Hume's "volunteer pamphlet" for Archibald Stewart: Political Whigs, Religious Whigs, and Jacobites M. A. BOX, DAVID HARVEY, AND MICHAEL SILVERTHORNE Many scholars interested in David Hume will have encountered his defense of the beleaguered Archibald Stewart as it appears in an appendix in John Valdimir Price's The Ironic Hume (Austin: University of Texas Press, (...) 1965). Additionally they might know of Price's discussion for The Biblioteck of 1973 of a copy with manuscript markings. A reason for revisiting this pamphlet is that the National Library of Scotland has graciously given permission to reproduce a copy (shelfmark NE.10.e.4) featuring a preface and significant markings in manuscript not in the copy that Price reproduced in his book. As Hume assumes considerable familiarity with the events to which he alludes, we have annotated the text to make it fully intelligible to readers two and half centuries after its composition. The rudimentary bibliographic facts and mysteries are as follows. Two editions survive to us, an octavo (in fours) and a rare duodecimo. Although there is no reason to regard the duodecimo as a second edition correcting or augmenting a first edition, it probably was manufactured after, and was textually derivative from, the octavo. We know nothing of the publishing of M. A. Box is Associate Professor of English, University of Alaska, Fairbanks, PO Box 755720, Fairbanks, AK 99775-5720, USA. David Harvey is at the Classics Department, University of Exeter, Queen's Building, Queen's Drive, Exeter EX4 4QH, UK. Michael Silverthorne is Associate Professor of History, McGiIl University, Stephen Leacock Building, 855 Sherbrooke St. West, Montreal H3A 2T7, Canada, e-mail: [email protected] 224 M. A. Box, David Harvey, and Michael Silverthorne the duodecimo, and doubtless that is as its producers intended. Its title page indicates, like that of the octavo, that the printing was done "for M. Cooper" in 1748, but William Strahan's ledgers register the printing in December 1747 of only the octavo in an edition of 1000 copies.1 The job is listed under bookseller Andrew Millar's account, not Mary Cooper's, probably for the reason that Cooper was a front whose role was to screen the true producers. It is possible that Millar hired someone other than Strahan to print the duodecimo, but it is also possible that someone other than Millar had it printed to mimic the octavo and take the opportunity it offered for concealment.2 A different editorial judgment is evinced in the duodecimo in that cosmetic measures are taken in it to obscure the identities of two military men ridiculed. For example, "Fowke" is rendered as "F—" and "John Cope" as "J-C-----." A digression on Mary Cooper is in order. This remarkable woman (died 1761) took over her husband Thomas's business upon his death 9 February 1743. That business had a history of "publishing" pamphlets and therefore made a plausible front for Millar, who in at least thirty-six other instances, none requiring courage, was willing to have his name appear on a title page with "M. Cooper." (This figure derives from a search by imprints using the English Short-Title Catalogue.) Until Thomas Cooper died, his name appeared on editions of John Armstrong's The Oeconomy of Love (1736 and thereafter) though only Millar's name is listed in the Stationers' Register (Foxon, English Verse A303-A311), and Mary's name is on the title page of the 1753 edition for which Strahan charged Millar (Strahan Papers, Add. MS 48800, s.v. August 1753). It was perhaps in this pattern that the second edition of Hume's heterodox Philosophical Essays (1750) would be reissued in 1751 with a new title page replacing Millar's name with Cooper's. That book was made temporarily a more alarming property by the superstitious panic of the London populace following the winter earthquakes in 1750, presaged by a bloody cloud. Within that year Bishop Thomas Sherlock caused a stir with a pastoral letter (A Letter from the Lord Bishop of London) blaming the earthquakes on several iniquities, "particularly heretical books" (Walpole, Correspondence 20... (shrink)

Current theories of knowledge, art, and power are locked into sterile debates around the question of representation. This book examines the limits of antirepresentationalism in these fields and argues that the anarchist tradition can point the way beyond our contemporary crisis of representation. The author rereads the theory and practical experiences of anarchism from the nineteenth century to the present, proposing a radical revision of received notions of the subject - from the equation of anarchy with literary decadence to the (...) interpretation of anarchism as yet another discourse founded on a notion of the human essence. What emerges, instead, is a complex portrait of anarchism as a body of thought that provides the framework for a kind of critical realism, with implications for fields ranging from aesthetics to economics, from philosophy to politics. Jesse Cohn teaches English at Purdue University North Central. (shrink)

There are signs of both secularization and religionization in the world today. Consistent with the modernization-secularization thesis, structural factors such as increasing economic security, societal complexity, and information flow are broadly associated with greater personal autonomy, worldview individualization, and erosion of some religious forms. At the same time, ‘counter-secular’ reassertions or transformations of religion have arisen for psychological, cultural, and political reasons. Amid these broad developments, active or public forms of atheism have also emerged, particularly in Europe and the Anglophone (...) world. Self-conscious, assertive atheism and other forms of philosophical or ideological secularism have both intended and unintended effects in the processes of secularization and religionization. But a quieter and potentially more pervasive result of all these forces may be greater worldview diversity and individualization across the secular-religious spectrum. (shrink)

Dr. Elisabeth Kübler-Ross is credited as one of the first clinicians to formalize recommendations for working with patients with advanced medical illnesses. In her seminal book, On Death and Dying,...

Professional attire has traditionally been regarded as a sign of ethicality. However, recent trends towards a more casual workplace may have altered the general public’s attire-based perceptions. To determine whether these trends have rendered the association between professional attire and ethicality obsolete, we draw on signaling theory and we examine, in two laboratory studies with working samples, the main effects of attire style (i.e., business formal, business casual, casual) on perceptions of employee ethicality. We also assess the mediating effects of (...) attire appropriateness, the moderating effects of context (industry type), as well as their combined moderated-mediation effects in the relation between attire style and the outcome of interest. We find that casual attire is perceived as less ethical than business casual attire in both studies but is perceived as less ethical than business formal attire in the first study only. Moreover, the effect of attire style on perceptions of ethicality is mediated by perceptions of attire appropriateness. Lastly, we found inconclusive results for the moderated-mediation model, which suggest a more intricate effect of industry type than originally proposed. Three subsequent focus groups with working professionals provided additional insights into our findings and revealed workplace-relevant outcomes associated with perceptions of ethicality. Theoretical and practical implications, study limitations, and future research avenues are discussed. (shrink)

-- James Der Derian, University of Massachusetts.