Many assumptions are made about public willingness to participate in epidemiological research, yet few empirical studies have been conducted to ascertain whether such assumptions are correct. Our qualitative study of the public and of expert stakeholders leads us to suggest that people are generally prepared to participate in epidemiological research, particularly if it is conducted by a trusted public institution such as a government health department, charity, or university. However, there is widespread community distrust of research conducted or sponsored by (...) pharmaceutical companies. Individuals are prompted to take part if the study concerns an illness they or a family member or friend have personally experienced or if they believe the research will confer a widespread public benefit. Preferences vary about the mode of contact for the research to be conducted. Willingness to participate in telephone surveys has decreased in recent years, and this may be a consequence of an increase in calls to homes by telemarketers and market researchers. Participants also stressed the importance of knowing where their names and contact details were sourced and suggested that this information be available to prospective study participants as a matter of course in the first approach or letter. We provide valuable information to epidemiologists in designing studies. (shrink)

Has the diversity of corporate boards of directors improved? Should it? What role does diversity play in reducing corporate wrongdoing? Will diversity result in a more focused board of directors or more board autonomy? Examining the state of Tennessee as a case study, the authors collected data on the board composition of publicly traded corporations and compared those data to an original study conducted in 1995. Data indicate only a modest improvement in board diversity. This article discusses reasons for the (...) scarcity of women on boards and concludes that, to enhance strategic decisions, board membership should reflect the corporation''s consumer population. Thus, women are a critical but overlooked resource. Areas for future research are also considered. (shrink)

Let your motto become "What would happen if...?" Infrared light offers photographers another artistic avenue to explore. You don't need years of experience or expensive equipment. Just grab an IR filter or a converted digital camera, and you're ready to enter the fascinating world of infrared photography. The unique effects you can create with IR photography are limited only by your imagination. In these pages, you'll discover the practical information about file formats and composition as well as plenty of creative (...) inspiration. Discover whether your camera can detect infrared light and compare different IR filters Learn how to see in IR and master IR composition Play with effects — extended exposures, shooting through glass, zooming, and painting with light Explore HDR and Photomerge options Open more creative possibilities with Photoshop. (shrink)

The intent of this study was to interpret the processes of journal keeping through written and electronic means to determine if the interns “saw” what their master teachers' saw in the myriad complexities of the social studies classroom. Three teachers identified as master teachers and interns placed under their tutelage examined interns tlieir written observations about how they “saw” phenomenon in the social studies classroom. It was precisely this type of educative setting where these interns learned about enacting effective social (...) studies teaching practice from a master teacher's guidance, one who modeled best practice and offered reflective mentorship. These three interns seemed to merely be able to catch a glimpse, or entertain a tacit notion of what their mentor teachers were able to “see” in the daily process of teaching and learning in the social studies. Most importantly, the optimal learning environment to nurture intern maturity and boost development is in a placement where the inservice teacher engages in consistent reflection about instruction and where language and theory are articulated as a support to decision making about social studies practice. (shrink)

Philosophers such as Dan Brock believe that surrogates who make health care decisions on behalf of previously competent patients, in the absence of an advance directive, should make these decisions based upon a substituted judgment principle. Brock favours substituted judgment over a best interests standard. However, Edward Wierenga claims that the substituted judgment principle ought to be abandoned in favour of a best interests standard, because of an inherent problem with the substituted judgment principle. Wierenga's version of the substituted judgment (...) principle and his counterexample to the principle's successful interpretation of valid surrogate consent is presented. A new version of what is meant by the substituted judgment principle is advanced. The new version is not beset with the problems Wierenga initially ascribed to the substituted judgment principle. (shrink)

Autism is one of the most compelling, controversial, and heartbreaking cognitive disorders. It presents unique philosophical challenges as well, raising intriguing questions in philosophy of mind, cognitive science, and philosophy of language that need to be explored if the autistic population is to be responsibly served. Starting from the "theory of mind" thesis that a fundamental deficit in autism is the inability to recognize that other persons have minds, Deborah R. Barnbaum considers its implications for the nature of consciousness, (...) our understanding of the consciousness of others, meaning theories in philosophy of language, and the modality of mind. This discussion lays the groundwork for consideration of the value of an autistic life, as well as the moral theories available to persons with autism. The book also explores questions about genetic decision making, research into the nature of autism, and the controversial quest for a cure. This is a timely and wide-ranging book on a disorder that commends itself to serious ethical examination. (shrink)

Biological kin share up to half of their genetic material, including predisposition to disease. Thus, variants of clinical significance identified in each individual’s genome can implicate an exponential number of relatives at potential risk. This has renewed the dilemma over family access to research participant’s genetic results, since prevailing US practices treat these as private, controlled by the individual. These individual-based ethics contrast with the family-based ethics – in which genetic information, privacy, and autonomy are considered to be familial – (...) endorsed in UK genomic medicine and by participants in a multi-method study of US research participants presented here. The dilemma reflects a conflict between US legal and ethical frameworks that privilege “the individual” and exclude “the family” versus actual human genetics that are simultaneously individual and familial. Can human genetics succeed in challenging bioethics’ hegemonic individualism to recognize and place the family at the center of the room where bioethics happens? (shrink)

Elizabeth Hamilton (1758–1816) has not so far been considered a philosopher, probably because she wrote novels and tracts on education rather than philosophical treatises. This paper argues that Hamilton’s novel Memoirs of Modern Philosophers (1800) should be read as a philosophical text, both for its close engagement with William Godwin’s moral theory and for what it suggests about Hamilton’s own moral theory and moral psychology. Studies of Memoirs have so far either characterized it as merely satire of Godwin, or, if (...) they have read it as containing arguments against Godwin’s views, have described those arguments in very broad strokes, without looking closely at the text to see if the descriptions are warranted. A careful examination of Memoirs shows that Hamilton objected primarily to one key aspect of Godwin’s moral theory, namely, his insistence that actions affecting others must be based on an impartial, disinterested assessment of a person’s contribution to general utility rather than on their particular relationship to the agent. Memoirs also points towards Hamilton’s own moral theory, as exemplified in her Series of Popular Essays (1813), with its emphasis on ‘benevolent affections’ that are directed towards family members and people in the agent’s social circle. (shrink)

This paper discusses the character of medical ethics and suggests that there are significant gaps that warrant greater attention. It describes ways in which the content and form of medical ethics may exclude or marginalise perspectives and contributions, thereby reducing its influence and its potential impact on, and value to, patients, students, carers and society. To consider what it is ‘to do good medical ethics’ suggests an active approach that seeks out, and learns from, contributions beyond the traditional boundaries of (...) scholarship. (shrink)

Trust is frequently discussed with reference to the professional–patient relationship. However, trust is less explored in relation to the ways in which understanding of, and responses to, questions of ethics are discussed by both the “public” and “experts.” Public engagement activity in healthcare ethics may invoke “trust” in analysing a moral question or problem but less frequently conceives of trust as integral to “public engagement” itself. This paper explores the relationship between trust and the ways in which questions of healthcare (...) ethics are identified and negotiated by both “experts” and the public. Drawing on two examples from the author’s “public engagement” work—a radio programme for the British Broadcasting Corporation and work with a playwright and theatre—the paper interrogates the ways in which “public engagement” is often characterized. The author argues that the common approach to public engagement in questions of ethics is unhelpfully constrained by a systemic disposition which continues to privilege the professional or expert voice at the expense of meaningful exchange and dialogue. By creating space for novel interactions between the “expert” and the “public,” authentic engagement is achieved that enables not only the participants to flourish but also contributes to trust itself. (shrink)

This paper discusses archaeological, historical, and contemporary ethnographic evidence for the use of the San Pedro cactus in northern Peru as a vehicle for traveling between worlds and for imparting the “vista” (magical sight) necessary for shamanic healers to divine the cause of their patients' ailments. Using iconographic, ethnohistorical, and ethnographic evidence for the uninterrupted use of this sacred plant as a means of access to the Divine and as a tool for healing, it describes the relationship between San Pedro, (...) ancestor worship, water/fertility cults and also the common symbolic associations between San Pedro and wind-spirits. It closes by suggesting that the more than 2000 year time-depth of using this plant as a means for accessing the realms of Spirit and as a tool for healing should serve to challenge the unfortunate tendency in the contemporary United States to consider this plant as a “recreational drug.”. (shrink)

The philosophical writings of Lady Mary Shepherd (1777–1847) reveal an astute and lively intellect. In An Essay upon the Relation of Cause and Effect (1824) and Essays on the Perception of an External Universe, and Other Subjects Connected with the Doctrine of Causation (1827), Shepherd engaged critically with the views of Hume, Berkeley, Reid, Stewart, de Condillac, and others, but she also presented an original and carefully argued philosophical system of her own. Highly regarded in her day, Shepherd's work faded (...) into obscurity after her death; this collection of selections from her writings is intended to bring her work back into focus for students and scholars. Selections include her writings about causation, knowledge of the external world, mathematical and physical induction, belief in miracles and God, and mind and body. This volume also includes an 1828 essay Shepherd published on vision and selections from her 1832 magazine article, "Lady Mary Shepherd's Metaphysics.". (shrink)

The voluntary and informed consent of subjects has been the central focus of concern in research reviews, overshadowing the importance of all other considerations. The Nuremberg Code, with its rights-based protection of the subject's autonomy above all else, made it difficult to justify research with no intended benefit when subjects are incompetent to make a valid informed choice to participate. Subsequent codes providing for research with incompetent subjects followed the lead of Nuremberg, substituting the informed authorization of a proxy for (...) the informed consent of the subject. (shrink)

One component of our conscious self-awareness is the voice we hear inside our heads, a form of 'inner speech'. This voice of our conscious thoughts is an exact reflection of our personal voice, with our vocabulary, favourite phrases, and regional idioms. In this paper I present a neurobiological model for the mechanism behind these language-based conscious thoughts. Central to this model is the process of associative conditioning. Through repeated pairings of the neural processes of speech with those of auditory perception (...) of the words spoken, when the action of speech is triggered, but in this case vocalization is inhibited, the neural mechanisms underlying its perception are activated and create 'hearing' the unspoken words. Interestingly, the model predicts the form in which the 'inner voice' of the deaf who have no spoken language and communicate through Sign actually experience their thoughts. (shrink)

The process of seeking the consent of a patient to a medical procedure is, arguably, one of the most important skills a doctor, or indeed any clinician, should learn. In fact, the very idea that doctors may institute diagnostic or treatment processes of any sort without a patient's consent is utterly counter-intuitive to the modern practice of medicine. It was not always thus, and even now it can be reliably assumed that consent is still not sought and gained appropriately in (...) every clinical encounter. To say that it should be sought and gained in this manner elevates the value of consent to a high level. It can be instructive to ask oneself why such a value might be held to be the case. The answer to this question lies in the philosophical underpinning of clinical consent, which sits within a notion of personal autonomy, and respect for autonomous decision making. (shrink)

Some authors argue that the ethics of medical care and the ethics of research differ, and that it is a mistake to conflate the two. They propose “that medical research and medical treatment are two distinct forms of activities, governed by different ethical principles.” This raises the question of whether physicians who are also clinical investigators may separate their role as physician from that of researcher when they are involved in clinical trials, thereby avoiding the obligations required in the physician-patient (...) relationship. Miller and Brody suggest that medical training is to blame for what they believe is the physicians’ tendency to confound the obligations of research and practice. “Physician-investigators, after all, went to medical school” they explain. They believe that considering research with patients outside the ethical framework of the physician-patient relationship may be “difficult and threatening” to physicians who have “psychological needs” to consider the ethical obligations flowing from their relationship with their patients. (shrink)

Lakatos' MSRP is utilized to provide a response to Koertge's claim (in her ‘Does Social Science Really Need Metaphysics?’) that the heuristic significance of metaphysics has been vastly overrated. By outlining the hard cores and positive heuristics of the two major research programmes in economics (namely, the ‘orthodox’ and ‘Marxist’ research programmes), the paper demonstrates (in opposition to Koertge's claim) not only that the metaphysical statements in the respective hard cores are far from vague but also how these exert an (...) important regulative influence both on the theories and economic policy recommendations generated within the respective programmes. It also indicates how the adoption of the MSRP method of appraisal in economics would help to protect against the danger of entrenched metaphysical dogmatism with its implications not only for economic policy recommendations but also for moral and political recommendations. * We appreciate the assistance given by Professor N. Koertge, who provided us with translations of her articles, and the helpful comments of an anonymous referee. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Descartes’ Natural Light ReconsideredDeborah Boyle1. INTRODUCTIONThe “natural light” occupies an important position in Descartes’ Third Meditation, where the meditator invokes it to provide the premises needed for his proof for the existence of a non-deceiving God. Descartes also refers to the natural light throughout his Replies to the Objections to the Meditations and in the Principles of Philosophy. Yet he says almost nothing about what the natural light is (...) supposed to be, apparently assuming that his readers already know what he means. English-speaking commentators on Descartes have said little about the natural light,1 and although French commentators have paid slightly more attention to this topic, they have nonetheless provided no detailed analysis of the concept of the natural light and the role it plays in Descartes’ Meditations.2In 1973, however, John Morris published an article entitled “Descartes’ Natural Light” in the Journal of the History of Philosophy, later reprinted in Eternal Truths and the Cartesian Circle.3 Morris argues that “the understanding can be regarded in an active and a passive sense, ”4 and that the natural light should [End Page 601] be equated with the passive function of the intellect. The natural light, he asserts, isa power of cognition, which contrasts with the “active” power of conceiving. Unlike this power, it does not form ideas, or bring them to consciousness. Instead, it simply gives a click of recognition when a true idea is brought before it.5However, the textual evidence for Morris’ interpretation of the natural light is slender, and in fact the texts support a quite different reading. I shall point out some problems with Morris’ reading, and offer the beginnings of an alternative account.2. ACTIVITY, PASSIVITY, AND THE MINDIn the Fourth Meditation, Descartes draws a distinction between two faculties of mind: intellect and will. Intellect, he says, allows him “to perceive the ideas which are subjects for possible judgements” (CSM II 39/AT VII 5),6 while the will “simply consists in our ability to do or not do something (that is, to affirm or deny, to pursue or avoid)” (CSM II 40/AT VII 57). Although he does not say so in the Fourth Meditation, Descartes suggests in two 1641 letters to Regius that the intellect is passive and the will is active; strictly speaking, he says, “understanding [intellectio] is the passivity of the mind and willing [volitio] is its activity” (CSMK III 182/AT III 372). A few months later, he writes that “we should use the term ‘action’ for what plays the role of a moving force, like volition in the mind, while we apply the term ‘passion’ to what plays the role of something moved, like intellection [intellectio] and vision in the same mind” (CSMK III 199/AT III 454–5). And in the Passions of the Soul Descartes states that while volitions are actions, “the various perceptions or modes of knowledge present in us may be called its passions, in a general sense” (CSM I 335/AT XI 342).In his early work, the Rules for the Direction of the Mind, Descartes does refer to “actions of the intellect.”7 If we do not allow for changes in Descartes’ thinking, we might assume that at the time of the Meditations, too, he would be willing to speak of “actions of the intellect.” But Descartes provides no account of the [End Page 602] will in the Rules; thus any activity he might have attributed to the mind would have to be included in the role of the intellect. In the Meditations, Descartes’ philosophy of mind has expanded to provide a place for the will, which can take over the active functions previously assigned to the intellect.John Morris’ reading of the role of the natural light in the Meditations takes as its starting point a passage in the Rules where Descartes claims that the intellect itself, the cognitive power or vis cognoscens, has both active and passive functions; it is, he says, sometimes like a seal, sometimes like wax.8 After describing the various functions of the cognitive power, Descartes concludes that “according to its different functions, then, the same power is... (shrink)

This article reviews four areas of pediatric research in which we have identified questionable levels of allowable risk, exceeding those foreseen by the Commission. They are the following: the categorization of increasingly risky interventions as minimal risk in a variety of protocols; the increasing number of applications for federal panel review of research not otherwise approvable because of higher projected risk levels; research on asymptomatic at risk children; and the inclusion of children and adolescents in placebo-controlled trials for participants of (...) all ages without performing subgroup analysis. While embracing the imperative to include children in research is an encouraging step towards providing the pediatric population with effective medical care and finally eradicating the therapeutic orphan, we must ensure that this research does not become overly permissive. (shrink)

There is an explanatory constraint on practical reasons: practical reasons have to be the kinds of things that we can act for. Some philosophers, notably Bernard Williams, have argued that the explanatory constraint favours internalism about reasons: for an agent to have a reason to x, it is at least a necessary condition that she would, after ideal deliberation, be motivated to x. Internalism suggests that naturalism about reasons is more plausible for, in this view, reasons are psychological states. However, (...) reasons must not only be the kinds of things we can act for, at least some reasons must be good reasons, i.e. normative requirements. Derek Parfit argues that internalist, naturalist accounts cannot capture the normative aspect of reasons. He takes this to be a point in favour of his own externalist, non-naturalist account. I ask first whether Williams' account does fail to account for the normativity of reasons as Parfit argues, and second whether Parfit's externalist account can adequately meet the explanatory constraint. Although I claim that the answer to the first question is yes and the second no, the answer to both questions turns on the nature of practical rationality. My case stands if practical rationality is procedural, and falls if practical rationality is substantive. I argue, however, that the burden of proof is on those who, like Parfit, wish to defend a substantive account of practical rationality. S. Afr. J. Philos. Vol.24(2) 2005: 97-108. (shrink)

It is argued that a link prevails between the phenomenology of externality present in classical liberal theory and the state of mind known as schizophrenia. To escape the social reality of possessive individualism, especially the conception of consequences, ends, habits, routine, the schizophrenic individual 'withdraws' or regresses into a psychic universe that contains a dimension unrelated to the consciousness and values of externality: the pursuit of wealth and things, the calculated regard of the other as an instrument for enriching the (...) self. The schizophrenic is incapable of adapting his 'ego' to the necessities of the social environment; he cannot defend himself in 'conventional' or 'normal' ways from the demands of living in a social milieu where the expectations and judgments of others impose intolerable pressures on consciousness. Instead the individual undergoing the painful process of withdrawal constructs a set of psychic defenses that from the standpoint of the external world appear to be 'strange', 'odd', 'bizarre', or 'demented'. The 'mode of Being' of the schizophrenic has nothing in common with the life-style of the acquisitive, status-conscious society. Some consideration is given to the political implications and meaning of the schizophrenic's withdrawal. (shrink)

Being empathetic (or compassionate) is an important trait that allows for those working in health care professions to successfully analyze cases and provide patients with adequate care. One standard and enormously important way to try and teach empathy involves the use of case studies. The case-study approach, however, has some unique limitations in teaching empathy. This paper describes an activity where students are asked to imagine that they have contracted a specific disease (one that lasts the entire semester) through a (...) process of random (or lottery) assignment. Having contracted a disease, students are then tasked with taking on the persona of that patient. In writing and adopting the perspective of that patient, students are better able to learn the kind of empathy needed to be a successful health care professional. (shrink)