It is unclear whether the regulatory distinction between non-identifiable and identifiable information—information used to determine informed consent practices for the use of clinically derived samples for genetic research—is meaningful to patients. The objective of this study was to examine patients' attitudes and preferences regarding use of anonymous and identifiable clinical samples for genetic research. Telephone interviews were conducted with 1,193 patients recruited from general medicine, thoracic surgery, or medical oncology clinics at five United States academic medical centers. Wanting to know (...) about research being done was important to 72% of patients when samples would be anonymous and to 81% of patients when samples would be identifiable. Only 17% wanted to know about the identifiable scenario but not the anonymous scenario. Curiosity-based reasons were the most common among patients who wanted to know about anonymous samples. Of patients wanting to know about either scenario, approximately 57% would require researchers to seek permission, whereas 43% would be satisfied with notification only. Patients were more likely to support permission in the anonymous scenario if they had more education, were Black, less religious, in better health, more private, and less trusting of researchers. The sample, although not representative of the general population, does represent patients at academic medical centers whose clinical samples may be used for genetic research. Few patients expressed preferences consistent with the regulatory distinction between non-identifiable and identifiable information. Data from this study should cause policy-makers to question whether this distinction is useful in relation to research with previously collected clinically derived samples. (shrink)

The standard contextualist solution to the skeptical paradox is intended to provide a way to retain epistemic closure while avoiding the excessive modesty of radical skepticism and the immodesty of Moorean dogmatism. However, contextualism’s opponents charge that its solution suffers from epistemic immodesty comparable to Moorean dogmatism. According to the standard contextualist solution, all contexts where an agent knows some ordinary proposition to be true are contexts where she also knows that the skeptical hypotheses are false. It has been hoped (...) that contrastivist theories of knowledge can mirror the contextualist solution while avoiding this epistemic immodesty. I review the main problems for contrastive closure and argue that none of the arguments currently in the literature pose an insurmountable problem for the contrastivist solution. However, I argue that contrastivist theories of knowledge, like their contextualist rivals, are indeed committed to epistemic immodesty. (shrink)

Is logical consistency required for a set of beliefs or propositions to be categorically coherent? An affirmative answer is often assumed by mainstream epistemologists, and yet it is unclear why. Cases like the lottery and the preface call into question the assumption that beliefs must be consistent in order to be epistemically rational. And thus it is natural to wonder why all inconsistent sets of propositions are incoherent. On the other hand, Easwaran and Fitelson have shown that particular kinds of (...) inconsistency entail the epistemically ‘irrationality’ of holding certain sets of beliefs. In cases of the latter kind of inconsistency, it seems more reasonable to insist that such sets of beliefs or propositions are categorically incoherent. What the precise relationship is between coherence and consistency depends on the nature of the coherence relation. We shall examine recent attempts to explicate the coherence relation in terms of probabilistic measures of confirmation or agreement to see what they can teach us about the relationship between coherence and consistency. We shall show that some probabilistic measures of coherence allow for inconsistent sets to be categorically coherent, while satisfying plausible epistemic rationality constraints. Other probabilistic measures of coherence impose very strong logical consistency requirements, and some measures are tolerant of most forms of inconsistency. As we try to understand what distinguishes coherence measures in this respect, we will also draw some important lessons about Bayesian confirmation measures and differences in the way that they treat contradictory propositions. (shrink)

A limiting factor in ethics education in medical training has been difficulty in assessing competence in ethics. This study was conducted to test the concept that content analysis of pediatric residents’ personal reflections about ethics experiences can identify changes in ethical sensitivity and reasoning over time. Analysis of written narratives focused on two of our ethics curriculum’s goals: 1) To raise sensitivity to ethical issues in everyday clinical practice and 2) to enhance critical reflection on personal and professional values as (...) they affect patient care. Content analysis of written reflections was guided by a tool developed to identify and assess the level of ethical reasoning in eight domains determined to be important aspects of ethical competence. Based on the assessment of narratives written at two times (12 to 16 months/apart) during their training, residents showed significant progress in two specific domains: use of professional values, and use of personal values. Residents did not show decline in ethical reasoning in any domain. This study demonstrates that content analysis of personal narratives may provide a useful method for assessment of developing ethical sensitivity and reasoning. (shrink)

One longstanding problem for glut theorists is the problem of ‘just true.’ On Beall's conservative version of glut theory advanced in Spandrels of Truth , he addresses the problem in two steps. The first is a rejection of the problem: he claims that the only general notion of ‘just true’ is just truth itself. On that view, the alleged problem of ‘just true’ is reduced to the problem of truth itself, which has a solution—glut theory. The second step is to (...) acknowledge that there is a notion of ‘just true’ which is more limited but nonetheless meets all reasonable criteria demanded by those who advance the longstanding just-true objection. Marcus Rossberg disagrees. According to Rossberg, a just-true operator ought to iterate and be non-arbitrary in ways that Beall's proposed just-true operator is not. My aim in this paper is to construct a new conditional in terms of which a new just-true operator may be defined, a necessity operator, and to show that it meets all of the target desiderata of the debate. I then use that new operator to address the arbitrariness worries raised by Rossberg. (shrink)

In this study, we investigated whether differences in the experience of regret may be a potential explanation for damaging behaviours associated with psychopathy and criminal offending. Participants were incarcerated offenders (n = 60) and non-incarcerated controls (n = 20). Psychopathic traits were characterised with the Psychopathic Checklist: Screening Version. Regret was assessed by responses to outcomes on a simulated gambling task. Incarcerated offenders experienced a reduced sense of regret as compared to non-incarcerated controls. We obtained some evidence that specific psychopathic (...) factors and facets could differentially relate to the experience and use of emotions. Our data provide initial evidence of important associations between negative emotions and decision behaviour in the context of criminal offending. (shrink)

The theory of personal identity should illuminate and be illuminated by the theory of personality, of which it is a part. I believe that Locke's theory succeeds in this more than that of any other great philosopher, and the modifications which it may need are not fundamental ones. The problems raised by Butler and Flew can be made to disappear.

The theory of personal identity should illuminate and be illuminated by the theory of personality, of which it is a part. I believe that Locke's theory succeeds in this more than that of any other great philosopher, and the modifications which it may need are not fundamental ones. The problems raised by Butler and Flew can be made to disappear.

This study aims to unravel the determinants of social entrepreneurial intention (SEI). Using a moderated mediation approach, we examine the direct and indirect effects of prior experience with social problems, proactive personality, and social self-efficacy on SEI via social entrepreneurial passion for founding (SEP) as a mediator. This study is based on data collected from a survey using questionnaires completed by 283 Saudis. To analyze data and test the developed hypotheses, we used exploratory and confirmatory factor analyses followed by structural (...) equation modeling to test the direct and indirect effects of the main variables on SEI. Our findings reveal positive relationships between prior experience with social problems and proactive personality and SEP with SEI. Surprisingly, no significant relationship was found between social self-efficacy and SEI; its effect was indirect through SEP. Finally, gender moderated the relationship between SEP and SEI. Academic contributions and practical implications are then proposed. (shrink)

Can the ontological and cosmological arguments for the existence of God, whose complex relationship was discussed by Kant, achieve more together than they can achieve apart? Yes, but what they achieve is not necessarily a proof of monotheism.

Leading members of the Slavophile circle shared a commonWeltanschauung, fostered by a complex reaction to thesocial and political changes taking place in mid-nineteenth-centuryRussia. There was, however, considerable diversity in their views aboutthe character and value of the Russian state apparatus. While theyall criticised the bureaucratic ethos of the tsarist state,a number of them recognised that it played a critical role in stabilising deep-seated social tensions in Russian society. Inthe late 1850s, some members of the Slavophile circle also cameto recognise that (...) the state apparatus could play a positiverole in eliminating serfdom. Nevertheless, in the wake ofthe Emancipation Edict of 1861, conflict over the roleof the Russian state became the most divisive issuefor surviving members of the Slavophile circle. (shrink)

It is necessary that, if the world is divided into nations, conflicts should arise in which there is no strong argument against terrorism or repression. By a strong argument I mean one that would sway all minds not blindly partisan, without moral commitments that are unusual or outlandish in the modern world and with as much aversion to violence as most people have. So I do not here consider, because it is unusual, heroic and absolute pacifism, much as I respect (...) it; on the other hand I do mention Christian moral objections applying specially to terrorism because it seems somewhat outlandish even now to ignore the Christian element in our tradition. (shrink)

The COVID-19 pandemic has inspired numerous opportunities for telehealth implementation to meet diverse healthcare needs, including the use of virtual communication platforms to facilitate the growth of and access to clinical ethics consultation (CEC) services across the globe. Here we discuss the conceptualization and implementation of two different virtual CEC services that arose during the COVID-19 pandemic: the Clinical Ethics Malaysia COVID-19 Consultation Service and the Johns Hopkins Hospital Ethics Committee and Consultation Service. A common strength experienced by both platforms (...) during virtual delivery included improved ability for local practitioners to address consultation needs for patient populations otherwise unable to access CEC services in their respective locations. Additionally, virtual platforms allowed for enhanced collaboration and sharing of expertise among ethics consultants. Both contexts encountered numerous challenges related to patient care delivery during the pandemic. The use of virtual technologies resulted in decreased personalization of patient-provider communication. We discuss these challenges with respect to contextual differences specific to each service and setting, including differences in CEC needs, sociocultural norms, resource availability, populations served, consultation service visibility, healthcare infrastructure, and funding disparities. Through lessons learned from a health system in the United States and a national service in Malaysia, we provide key recommendations for health practitioners and clinical ethics consultants to leverage virtual communication platforms to mitigate existing inequities in patient care delivery and increase capacity for CEC globally. (shrink)

Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

Traditional memory strategy training interventions improve older adults’ performance on tests of episodic memory, but have limited transfer to episodic memory tasks, let alone to everyday memory. We argue that an alternative approach is needed to assist older adults to compensate for age-related cognitive declines and to maintain functional capacity in their own natural ecologies. We outline a set of principles regarding how interventions can successfully train older adults to increase successful goal pursuit to reduce risks of everyday memory failures. (...) We argue that training individuals to use metacognitive self-regulatory strategies to proactively manage formulation and pursuit of daily goals can compensate for age-related cognitive changes and increase the likelihood of goal attainment. We then describe an intervention approach that instantiates these principles in a multi-modal intervention that is unique in its three-phase approach: individualized assessment of an individual’s current approaches to self-regulation; training memory strategies, self-management skills, and new habits of mind in a group training context; and a behavioral shaping period in which individuals receive coaching and feedback on their efforts to use trained procedures to improve everyday cognition. A recently completed study conducted an initial test of the intervention, with highly encouraging results. We advocate further efforts to replicate, extend, and fine-tune this type of intervention. The ultimate goal is to be able to deliver the intervention in a way that increases its potential reach, including to subpopulations of older adults at risk for everyday cognitive impairments. (shrink)

Berkeley was a bishop and a defender of orthodox Christianity in an age when science was beginning to be claimed as an ally by those who called themselves “freethinkers": people who wanted to modify religion and to discard awkward dogmas, or who might even be drawn towards atheism.

I defend my logic against the trenchant critique offered by Ellen Meiksins Wood and I take up the pertinent question, which she raises, of Locke's general attitude to the traditional constitution. I assume in this section, but will argue further in the next, that the mass of people were taxpayers in Locke's time. I begin, as ever, from Second Treatise ?158 and with Locke's preference for �just and lasting . . . just and undeniably equal measures�. Wood entertains the idea (...) that Locke thought that equal measures between taxpayers of different locality are of much greater importance than equal measures between taxpayers in all other respects. But this idea is surely mistaken, since Locke says nothing about rights which people have simply because of their locality and says much about the rights which all people have simply because they pay tax: it is these taxpayer rights which he depends upon even in his argument about localities. On the other hand, I think it is true that just measures for localities formed, in practical terms, the essential first step towards democratic changes: they still formed the essential first step in 1832, a fact which democrats of that time had to recognize, sometimes reluctantly. (shrink)

Modern and Postmodern Cutting Edge Films closely examines a wide variety of major filmic texts that have established permanent, iconic shifts in modern and postmodern US culture and filmic practices. These films and their often visionary, trend-setting auteurs each introduced new manners of seeing that were imitated by later directors and ultimately, absorbed by popular culture itself. The primary rationale for writing this collection was quite simple: it is new and different. No anthology exists that examines the concept of the (...) cutting edge film across such a remarkably wide variety of genres and with such a diversity of theoretical approaches and subject matter. Equally important, all the contributors bring a unique voice and multi-disciplinary perspective to their respective chapters. This anthology will be of great interest to scholars from a variety of disciplines, including film studies, historical studies, and gender and genre studies. As far as possible, contributors have minimized a great deal of typical theoretical terminology so that lay readers who possess some familiarity with basic film analysis and theory can understand the text. It can be used as a classroom text in both graduate and upper-level undergraduate film classes. Modern and Postmodern Cutting Edge Films is an anthology that instructors of film theory and history can use for many years to come. Indeed, we feel that this remarkable collection of essays will itself become an indispensable, cutting edge text of film scholarship. (shrink)

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The last few years have seen unprecedented changes in schools in England and Wales, as the government attempts to raise standards by a radical programme of educational reforms. This book reports the outcome of a major research programme - funded by the Economic and Social Research Council - on teaching and learning in the context of the current reforms. Written by some of the country's leading educational researchers, the book covers a wide range of ages and curriculum areas. It provides (...) much needed insight into the nature of teaching and learning, as well as practical advice for teachers, policy makers and parents. (shrink)

Jenefer Robinson specifies one very practical implication of her theory that literature offers an emotional education: "There is virtually nothing in [Ethan Frome and Silas Marner] for the average fifteen-year-old American (regardless of gender or ethnic background) to relate to his or her own experience" so that the reading of these two novels by fifteen-year-olds ends with "the dreadful result... that many kids are permanently alienated from two of the greatest novelists in the English language."1 According to Robinson, the average (...) fifteen-year-old should not read Ethan Frome and Silas Marner because he has nothing in his experience through with which these novels emotionally engage him. This claim suggests.. (shrink)

This case is another in a series intended to highlight the new questions emerging from advances in mapping the human genome and the application of genetic findings to clinical practice. The National Human Genome Research Institute, a component of the National Institutes of Health, by law is directed to designate a portion of its annual budget to furthering understanding of the ethical, legal, and social questions emerging from research on the human genome. As part of the effort, the Institute supports (...) research by scientists and scholars around the nation with the aim of clarifying and resolving the tough ethical and research choices facing this endeavor. But recently it has launched an intramural program, which is expected to take a catalytic role in grappling with the array of issues the researchers face in carrying out investigations in human genetics. (shrink)