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)

Book reviewed in this article: Conscience and Convenience: The Asylum and its Alternatives in Progressive America. By David J. Rothman.

So far as I am aware, the commentators on the above passageall say that it is imitated from Euripides, Bacchae 492 sqq., and the commentators on Euripides, loc. cit., agree. It seems to me, however, that there is reason to suppose them all wrong; not of course that there is no connexion between the two passages, for there most obviously is, but that Horace is not imitating the Greek directly, but an imitation or adaptation of it by Pacuvius.

The notes of W. S. Maguinness on the Corpus Tibullianum contain several things which strike me as either true or at least highly plausible. In the above passage, however, I think both he and Postgate have missed the point of the first word. Tibullus has been telling the story of how Apollo turned herdsman for love's sake. He insists several times over that it is a story, not a thing he can vouch for. The infinitives in 14 a-c make it (...) sufficiently evident that the lost pentameter began with fertur or dicitur; in 18, Artemis dicitur to have blushed for her brother's unseemly occupation; in 29, fertur that the gods used to serve Venus openly. The same line reminds us that these stories refer to old days, olim. Now comes the couplet in question. (shrink)

Professor D'Arcy W. Thompson has recently revived a conjecture of Lauth on Geoponica, XIII, 8, 1, which runs as follows: εις οκ σονται ν χωρ ν νθιονἢ ρτεμσιον ἢ βρτονον περ τν πα$$υλιν υτεσς. τος δ ντας λσεις ν . The conjecture is that ντας is the Egyptian hontasu, ‘lizard.’ That this would make sense is obvious; but the usage of the Geop. itself, to say nothing of other authors, indicates that the word is simply what it appears to be, (...) namely the pres. part, of εμ. Thus we find in X, 46 τ ςκα σκληκας ¿ π¿ισειν μλλων φυτεειν μπξς σκλλ τν κλδ¿ν, τ¿ς δ ντας ναιρες ν κ.τ.λ. Here the explanation ‘lizards’ would hardly be reasonable; still more cogent, however, is XII, 8, 2–3, ¿κ σονται … τς δ οσας κμπας διαθερς, where no such conjecture is possible. Not dissimilar is XII, 19, 9, τς τε γρ οσας ψλλας θερεικα λλας οκ γενσθαι. All these extracts are taken from authors of the second and third centuries A.D., though we have no means of knowing how closely their actual wording is followed; it is therefore in point to cite a passage of Galen, the opening paragraph of the tractate περ αρσεων Medicine, he says, has for its aim health, and a physician must know how to bring about health if absent and preserve it if present . καλεται δ, he continues, τ μν ργαζμενα τν μ οσαν γειατν τε καβοηθματα, τ δ φυλττοντα τν οσαν γιειν διαιτματα. In other words, ὢν can be used in much the same sense as παρν. This is no novelty of Roman times, for we may compare, for instance, Soph. Ant. 1109, ο ' ντες ο τ'πντες, and El, 305 τς οσας … κα τς ποσας λπδας. (shrink)

So far as I am aware, the commentators on the above passageall say that it is imitated from Euripides, Bacchae 492 sqq., and the commentators on Euripides, loc. cit., agree. It seems to me, however, that there is reason to suppose them all wrong; not of course that there is no connexion between the two passages, for there most obviously is, but that Horace is not imitating the Greek directly, but an imitation or adaptation of it by Pacuvius.

‘Lapidem silicem tenebant iuraturi per Iouem, haec uerba dicentes: Si sciens fallo, tum me Dispiter salua urbe arceque bonis eiciat ut ego hunc lapidem.’ I do not propose to add to the mass of commentary and controversy which loads this passage of Paulus Diaconus , except to remind readers that it is a comparatively modern version of a very old formula. Under Dispiter lurks some early shape of the name of Iuppiter, certainly not of the Greek importation Dis, first worshipped (...) in Rome, apparently, in 505/249. I believe it to be older than the end of the regal period, probably much older, for it names the Arx as the important spot in Rome, not the Etruscanizing Capitol. However, this detail and my opinions concerning the oath and its takers matter little for my present purpose. It is enough if it be granted, as I think everyone will grant, that it is ‘eine alte Fetialformel’ as Fraenkel has it, at all events eine alte Formel, more ancient than the surviving literature. (shrink)

That mox means, or can mean, ‘soon,’ is an assertion which is made often and positively, in works of all sorts, from the ordinary dictionaries, such as Facciolati-Forcellini and Lewis and Short, and valuable writings on lexicography such as Merguet's lexicon to Cicero and Krebs-Schmalz' Antibarbarus, down to the latest little school book at which I have looked. As I had never been able to find a passage in which it clearly and unambiguously had that meaning, in any classical author, (...) I have thought it worth while to examine all the instances in a few good writers, with a view to finding out how they really do use it. (shrink)

Thatmox means, or can mean, ‘soon,’ is an assertion which is made often and positively, in works of all sorts, from the ordinary dictionaries, such as Facciolati-Forcellini and Lewis and Short, and valuable writings on lexicography such as Merguet's lexicon to Cicero and Krebs-Schmalz' Antibarbarus, down to the latest little school book at which I have looked. As I had never been able to find a passage in which it clearly and unambiguously had that meaning, in any classical author, I (...) have thought it worth while to examine all the instances in a few good writers, with a view to finding out how they really do use it. (shrink)

The Gods and Typhon.—The story of how the gods took bestial shape to hide from the fury of Typhon is several times told in Hellenistic and Latin authors. There seems no room for doubt that it is an aetiological myth, intended to explain the cult of beasts in Egypt, and also, in one or two versions, the sacredness of fish in Syria. That in one form, that given by Antoninus Liberalis, it goes back to Nikandros is reasonably certain. The doubtful (...) point, to my mind, is whether it can be traced much further, and, in particular, whether it was known to Pindar, as is commonly assumed. The authority for supposing that he knew and referred to it is a single passage of Porphyry, de abstinentia III. 16 . It runs: Πίνδαρος δ ν προσοδίοις παντας τος θεος ποίησεν τε ύπ Τυνος διώκοντα οủκ νθρώποις όμοιωθέντας λλ τοις λοις ζοις έρασθέντα δ Πασιάης Δία γενέσθαι μν ταρον νν δ ετν και κύκνον. (shrink)

The purpose of this paper is to indicate the slightness of the foundation on which a commonly received doctrine about Roman funerals rests, and to discuss a point in connexion with the ritual of funera acerba.

The purpose of this paper is to indicate the slightness of the foundation on which a commonly received doctrine about Roman funerals rests, and to discuss a point in connexion with the ritual of funera acerba.