Using payment to recruit research subjects is a common practice, but it raises ethical concerns that coercion or undue inducement could potentially compromise participants’ informed consent. This is the first national study to explore the attitudes of IRB members and other human subjects protection professionals concerning whether payment of research participants constitutes coercion or undue influence, and if so, why. The majority of respondents expressed concern that payment of any amount might influence a participant’s decisions or behaviors regarding research participation. (...) Respondents expressed greater acceptance of payment as reimbursement or compensation than as an incentive to participate in research, and most agreed that subjects are coerced if the offer of payment makes them participate when they otherwise would not or when the offer of payment causes them to feel that they have no reasonable alternative but to participate . Views about undue influence were similar. We conclude that human subjects protection professionals hold expansive and inconsistent views about coercion and undue influence that may interfere with the recruitment of research participants and impede valuable research. (shrink)

The first main result isolates some conditions which fail for the class of graphs and hold for the class of Abelian p-groups, the class of Abelian torsion groups, and the special class of "rank-homogeneous" trees. We consider these conditions as a possible definition of what it means for a class of structures to have "Ulm type". The result says that there can be no Turing computable embedding of a class not of Ulm type into one of Ulm type. We apply (...) this result to show that there is no Turing computable embedding of the class of graphs into the class of "rank-homogeneous" trees. The second main result says that there is a Turing computable embedding of the class of rank-homogeneous trees into the class of torsion-free Abelian groups. The third main result says that there is a "rank-preserving" Turing computable embedding of the class of rank-homogeneous trees into the class of Boolean algebras. Using this result, we show that there is a computable Boolean algebra of Scott rank ${\mathrm{\omega }}_{1}^{\mathrm{C}\mathrm{K}}$. (shrink)

This essay explores a tragic event that happened in China, which garnered much attention, the Li case: a young woman who was nine months pregnant and her baby died as a result of the failure to receive a medically necessary c-section due to the hospital having failed to secure her family's consent for the c-section. Differing from some critiques, this essay argues that the Li case should not be used to blame the Confucian family-determination model that has been applied in (...) Chinese society for thousands of years. Based on summarizing the reasons supporting the model, this essay indicates that it is an integral part of the model that, in emergency or special cases, the physician must take medical action to save the patient, without the need to secure the consent of a family member. In order to prevent tragic cases like the Li case from happening, we recommend that relevant Chinese laws be further developed and specified and that, most importantly, Chinese physicians must cultivate the Confucian virtue of benevolence in their practice of taking care of patients in a virtuous way, along with patients’ families. (shrink)

Most authors who work with moral status automatically dismiss the possibility that plants are the kinds of entities that have moral status. This dismissal coheres with our intuitions about common-sense morality: if plants do not have moral status then we do not have any direct moral obligations to plant life. An implication of such a view is that any suggestion otherwise commits one to be in favour of an absurd conclusion. However, given the recent literature and empirical evidence on plant (...) minds, there are reasons to accept a different perspective that finds the absurd conclusion plausible. (shrink)

Every healthcare organisation enacts a multitude of policies, but there has been no discussion as to what procedural and substantive requirements a policy writing process should meet in order to achieve good outcomes and to possess sufficient authority for those who are asked to follow it.Using, as an example, the controversy about patient’s refusal of blood transfusions, I argue that a hospital wide policy is preferable to individual decision making, because it ensures autonomy, quality, fairness, and efficiency.Policy writing for morally (...) controversial medical practices needs additional justification compared to policies on standard medical practices and secures legitimate authority for HCO members by meeting five requirements: all parties directed by the policy are represented; the deliberative process encompasses all of the HCO’s obligations; the rationales for the policy are made available; there is a mechanism for criticising, and for evaluating the policy. (shrink)

Inquiry is an important learning strategy, even for students who cannot or do not perform actual experiments. The authors describe two activities, other than experimentation, that they used in introductory biology learning groups to emphasize inquiry abilities. They also provide recommendations for creating additional inquiry activities.

This article examines an unstudied set of astronomical tables for the meridian of Cambridge, also known as the Opus secundum, which the English theologian and astronomer John Holbroke, Master of Peterhouse, composed in 1433. These tables stand out from other late medieval adaptations of the Alfonsine Tables in using a different set of parameters for planetary mean motions, which Holbroke can be shown to have derived from a tropical year of $$365\frac{1}{4} - \frac{1}{132}$$ 36514-1132 or $$365.\overline{24}$$ 365.24¯ days. Implicit in (...) this year length was a 33-year cycle of repeating solar longitudes and equinox times, which has left traces in other astronomical tables from fifteenth-century England. An analysis of the manuscript evidence suggests that Holbroke owed his value for the “true length of the year” to a certain Richard Monke, capellanus de Anglia, who employed this parameter and the corresponding 33-year cycle in an attempt to construct a perfect and perpetual solar calendar, leading to his Kalendarium verum anni mundi of 1434. (shrink)

There is an international consensus that medical research involving humans should only be undertaken in accordance with ethical principles. Paradoxically though, there is no consensus over the kinds of activities that constitute research and should be subject to review. In the UK and elsewhere, research requiring review is distinguished from clinical audit. Unfortunately the two activities are not always easy to differentiate from one another. Moreover, as the volume of audit increases and becomes more formal in response to the demand (...) for evidence-based practice in medicine, the overlap between research and audit grows more acute. Arguably, similar ethical standards and systems for ensuring that those standards are met should be applied regardless of whether or not a project is classified as research or audit. At a time when the research ethics review system in the UK is undergoing significant reform it is important that the opportunity is not missed to address the longstanding research-audit problem. We discuss suggestions for further reform that addresses this issue. (shrink)

This paper presents a clinically orientated illustration of the doctrine of double effect. The case of an elderly gentleman with advanced cancer is discussed, with particular emphasis on two dilemmas encountered during the terminal phase of his illness. The author describes how the doctrine of double effect was applied to help the team make some complex management decisions.