"The fixed person for fixed duties, who in older societies was such a godsend, in the future ill be a public danger." Twenty years ago, a single legal metaphor accurately captured the role that American society accorded to physicians. The physician was "c- tain of the ship." Physicians were in charge of the clinic, the Operating room, and the health care team, responsible - and held accountabl- for all that happened within the scope of their supervision. This grant of responsibility (...) carried with it a corresponding grant of authority; like the ship's captain, the physician was answerable to no one regarding the practice of his art. However compelling the metaphor, few would disagree that the mandate accorded to the medical profession by society is changing. As a result of pressures from a number of diverse directions - including technological advances, the development of new health professionals, changes in health care financing and delivery, the recent emphasis on consumer choice and patients' rights - what our society expects phy- cians to do and to be is different now. The purpose of this volume is to examine and evaluate the conceptual foundations and the moral imp- cations of that difference. Each of the twelve essays of this volume assesses the current and future validity of the "captain of the ship" metaphor from a different perspective. The essays are grouped into four sections. In Section I, Russell Maulitz explores the physician's role historically. (shrink)

When a patient visits his doctor there is, as well as a spoken dialogue, also an unspoken, or tacit, dialogue between them. This may not be evident unless that dialogue breaks down when the psychological or moral terms of reference of each are seen to be different. The author of this paper tries to elucidate the framework in which physician and patient think, and in so doing allow an understanding of why the physician may appear to be rigid and authoritarian (...) in his dealing with his patients and the patient uncooperative. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office issued the report Scientific Research: Continued Vigilance Critical to Protecting Human Subjects. It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always clear (...) to clinicians. Controversy exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:WITTGENSTEIN: AN EXCHANGE In his review 1 of my The Argument of the 'Tractatus ': its Relevance to Contemporary Theories of Logic, Language, Mind and Phil,osophical Truth,2 John Churchill claims that my " eccentric " (C 171) 3 interpretation " does not persuade " (C 171). My interpretation is eccentric for, as Churchill himself stresses, there is a "fundamental point at which McDonough differs from virtually every (...) other reader of the Tractatus '', namely that " one can construct explicit logical argumentation, constituting a philosophical system, leading from [Wittgenstein's] 'fundamental idea' to certain explicit, systematic conclusions about ontology, mind, meaning, and so on" (C 171). In oppo· sition to my program Churchill writes, "By attributing to Wittgen· stein an argument or doctrine (in the sense just mentioned) he con· tradicts those commentators who have understood Wittgenstein to be earnestly requiring real silence about philosophy and to be asserting seriously that the Tractatus is a self-refuting treatise, to be kicked aside, once its lessons are learned" (C 166). My mistake, it seems, is to "make [LW's] system consistent" since, if we "take [LW] at genstein's "self-refuting treatise", that I sought an escape from this his word " it is " deep[ly] inconsistent " (C 171). Churchill regards himself as expressing the standard interpretation of " the plain sense of what [LW] wrote " (C 171). However, Black reports that Wittgenstein felt that the Tractatus "was misunderstood by Russell, Moore, Frege.. • and even Ramsey " 4 and so is even led to say that" there can he no question here of any definitive reading." 5 More recently, Pears has even said that the ideas in Wittgenstein's 1 Churchill, John, The Thomist 52, no. 1 (January, 1988). 2 McDonough, Richard M., The Argument of the ' Tractatus ': its Relevance to Contemporary Theories of Logic, Language, Mind, and Philosophical Tr1ith (State University of New York Press, 1986). The Thomist incorrectly stated the title of my book, substituting " Trust" for " Truth " in the subtitle. ain the text of my reply I have used the notation (Cai) and (My), respectively, to designate p. ai and p. y in Churchill's review and my book. 4 Black, Max, A Companion to Wittgensttin's 'Traotatus' (Ithaca, N.Y.: Cornell University Press, 1974), p. 1. s Ibid., p. vii. 819 320 RICHARD MCDONOUGH books do not even appear to "repeat the familiar patterns of Western thought ".6 Similar comments abound in most of the serious commentators. It is against this background, rather more pessimistic than Churchil's cheery vision of the universally acknowledged "plain sense" of Witt· genstein's "self-refuting treatise", that I sought an escape from this interpretative deadlock. If a definitive interpretation is to be established, then instead of indulging in the common practice of selectively removing remarks from the Tractatus to suit one's own fancies, one must found the interpretation on the remarks which Wittgenstein himself identified as its "fundamental ideas". Accordingly, the interpre· tative burden of my project falls on the plausibility of attributing this argument to the text. Churchill only mentions this 200+ page argument in the one dismissive sentence quoted above. But is it legitimate to dismiss the argument on such grounds? Let us assume that the Tractatus enjoins "real" silence "once its lessons are learned." The question is, when are its lessons learned? Churchill makes his own interpretative claims, and then insists (conveniently ) that one must he thereafter he silent. But perhaps its lessons are learned in digesting the argument of the Tractatus. The point is that one must still decide the correctness of the interpretation independently. Any interpreter can invoke the injunction to silence with equal justice, namely none, to enforce his own view. My interpretation is as consistent with such an injunction to silence as any other. Similar remarks apply to Churchill's dismissal of my interpretation on the grounds that it attributes a " doctrine " to Wittgenstein. Just as Churchill chooses not to view his own interpretative pronouncements as violations of the silence doctrine, while mine are violations, he also chooses not to view his own ascriptions to the Tractatus as doctrines, while, again, mine are. This kind of verhalism has infected far too much of the commentary on Tractatus. If it is... (shrink)

Philosophers of experiment have acknowledged that experiments are often more than mere hypothesis-tests, once thought to be an experiment's exclusive calling. Drawing on examples from contemporary biology, I make an additional amendment to our understanding of experiment by examining the way that `wide' instrumentation can, for reasons of efficiency, lead scientists away from traditional hypothesis-directed methods of experimentation and towards exploratory methods.

Philosophical discussions of species have focused on multicellular, sexual animals and have often neglected to consider unicellular organisms like bacteria. This article begins to fill this gap by considering what species concepts, if any, apply neatly to the bacterial world. First, I argue that the biological species concept cannot be applied to bacteria because of the variable rates of genetic transfer between populations, depending in part on which gene type is prioritized. Second, I present a critique of phylogenetic bacterial species, (...) arguing that phylogenetic bacterial classification requires a questionable metaphysical commitment to the existence of essential genes. I conclude by considering how microbiologists have dealt with these biological complexities by using more pragmatic and not exclusively evolutionary accounts of species. I argue that this pragmatism is not borne of laziness but rather of the substantial conceptual problems in classifying bacteria based on any evolutionary standard. (shrink)

Jonathan Edwards identified the central act of faith as ‘the cordial consent of beings to Being in general’, which is to say to God (see Holbrook, 1973, pp. 102ff). That equation, of Being, Truth and God, is rarely taken seriously in analytical circles. My argument will be that this is to neglect the real context of a great deal of past philosophy, particularly the very Cartesian arguments from which so many undergraduate courses begin. All too many students issue from such (...) courses immunized against enthusiasm, in the conceit that they have answers to all the old conundrums, which were in any case no more than verbal trickery. ‘By uttering the right words but failing to use themin propria persona, philosophy induces a kind of soporific amnesia bewitching us into forgetting our God-given task. That task is, of course, to do what Socrates did and to live as he lived' (Burrell, 1972, p. 4). Burrell's words are not wholly fair to academic philosophers, nor to the Lady Philosophy. Plenty of philosophers really mind about the truth, and want to be Socratic in pursuit of it. But the danger is a real one. If all that matters is debunking past philosophers, how does that differ from the repeated refutation of the Chaldaean Oracles or the Prophecies of Nostradamus? A pretty enough pastime for the young, but hardly serious business for adults (as Callicles remarks: Plato,Gorgias484 c 5ff). ‘If the history of philosophy is a process of ‘salvaging’ what you yourself have already thought, then why bother?’ (MacDonald Ross, 1985, p. 502). (shrink)

This study examines the frequency of consanguineous marriage and the coefficient of inbreeding in the United Arab Emirates. The study was conducted in Al Ain and Dubai cities between October 1994 and March 1995. A sample of 2033 married UAE females aged 15 years and over participated. The degree of consanguinity between each female and her spouse, and the degree of consanguinity between their parents were recorded. The rate of consanguinity in the present generation was high with a coefficient of (...) inbreeding of 0·0222. The commonest type of consanguineous marriage was between first cousins. Double first cousin marriages were common compared to other populations. The consanguinity rate in the UAE has increased from 39% to 50·5% in one generation. The level of consanguinity was higher in Al Ain than in Dubai. (shrink)

A comparative study of business related values among business students was conducted over the last 10 years in two neighbouring countries. Although Estonia and Finland are culturally related, according to an empirical study of managerial values, including the ethical values of business students, the two countries display significant differences. During the last decade, Estonia has changed from being a country characterised by an authoritarian, centralized, totalitarian state socialism, to a democratic country with a free market economy and different attitudes and (...) values. At the same time Finland has experienced almost a century of capitalism and democracy. It is argued that the differences in values exhibited by these two countries could be explained by using the institutional and historical context. The authors propose a model of value hierarchies in relation to institutionalism. (shrink)

L R Perry; Training and Education, Journal of Philosophy of Education, Volume 6, Issue 1, 30 May 2006, Pages 7–29, https://doi.org/10.1111/j.1467-9752.1972.tb00.

Examining those risk and benefit perceptions utilised in the formation of attitudes and opinions about emerging technologies such as nanotechnology can be useful for both industry and policy makers involved in their development, implementation and regulation. A broad range of different socio-psychological and affective factors may influence consumer responses to different applications of nanotechnology, including ethical concerns. A useful approach to identifying relevant consumer concerns and innovation priorities is to develop predictive constructs which can be used to differentiate applications of (...) nanotechnology in a way which is meaningful to consumers. This requires elicitation of attitudinal constructs from consumers, rather than measuring attitudes assumed to be important by the researcher. Psychological factors influencing societal responses to 15 applications of nanotechnology drawn from different application areas were identified using repertory grid method in conjunction with generalised Procrustes analysis. The results suggested that people differentiate nanotechnology applications based on the extent to which they perceive them to be beneficial, useful, necessary and important. The benefits may be offset by perceived risks focusing on fear and ethical concerns. Compared to an earlier expert study on societal acceptance of nanotechnology, consumers emphasised ethical issues compared to experts but had less concern regarding potential physical contact with the product and time to market introduction. Consumers envisaged fewer issues with several applications compared to experts, in particular food applications. (shrink)

L. R. Reinhardt; III—Dualism and Categories, Proceedings of the Aristotelian Society, Volume 66, Issue 1, 1 June 1966, Pages 71–92, https://doi.org/10.1093/aris.

This paper was first presented at the Annual Meeting of the American Society of Christian Ethics, Toronto School of Theology, Toronto, Ontario in January 1977. Robert Shelton aims to focus on the concept of 'right to health care,' its related principle, 'distributive justice' in an attempt to suggest 'where we are' at present and where we perhaps ought to be heading. The paper is divided into three parts, which in their turn explore the moral grounds, the US general public's policy (...) and the part justice and government are likely to play in the development and distribution of health care. He concludes by highlighting 'omissions', an intentional one of his own and the other a major gap in the literature. (shrink)

The third edition gives particular attention to neuroimaging, which has emerged in the past decade as one of the most active areas of research in the field.