The precautionary principle is often invoked in relation to pregnant women and may be one of the underlying reasons for their continuous underrepresentation in clinical research. The principle is appealing, because potential fetal harm as a result of research participation is considered to be serious and irreversible. In our paper, we explore through conceptual analysis whether and if so how the precautionary principle should apply to pregnant women. We argue that the principle is a decision-making strategy underlying risk-benefit decisions in (...) clinical research, which can be applied to pregnant women. However, the current application is a strong one, leading to the promotion of absolute exclusion or, less often, absolute inclusion of pregnant women. In order to change this paralyzing situation, a shift toward weak precautionary thinking is necessary. Instead of automatic extreme precaution, a balance will be found between harms and potential benefits of including pregnant women in clinical research. (shrink)

BackgroundThere is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as (...) a case-study.MethodsWe conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands.ResultsThree themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals’ individual perception of risk may influence recruitment.ConclusionsHealthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient, because the individual perception of risk also influences behaviour towards pregnant women in clinical research. Therefore, bioethicists and researchers might be interested in changing the perception of risk, which could be achieved by education and awareness about the actual benefits and harms of inclusion and exclusion of pregnant women. (shrink)

A 1999 Companion to Greek philosophy, invaluable for new readers, and for specialists.

While Caesar as man of letters is most famous for his commentarii, it should not be forgotten that he also wrote two volumes on Analogy and was the author of various verses, one set of which, on the comic playwright Terence and his relationship to Menander, runs as follows : tu quoque, tu in summis, o dimidiate Menander,poneris, et merito, puri sermonis amator.lenibus atque utinam scriptis adiuncta foret uis,comica ut aequato uirtus polleret honorecum Graecis neue hac despectus parte iaceres! 5unum (...) hoc maceror ac doleo tibi deesse, Terenti. (shrink)

On fundamentals of Vedanta and science; a study.

For the first time in print, well-known spiritual teacher A.H. Almaas presents the highest level and most profound teachings of the Diamond Approach on the true nature of reality and the path to enlightenment. For more than thirty years, A.H. Almaas has been developing and teaching the Diamond Approach, a spiritual path of self-realization and maturity based on an original synthesis of modern discoveries in the field of psychology and a new paradigm about spiritual nature. If we can say the (...) Diamond Approach has a goal it is to realize the truth at progressively deeper levels until one reaches the ultimate Truth, the Absolute, and to become integrated into that truth so that we are a living presence and embodiment of that truth. The teachings of this path have been unfolding over time, and Runaway Realization presents--for the first time in print--the highest level of teachings in the Diamond Approach in the most profound work by Almaas so far. In this book, Almaas offers a detailed look at the true nature of reality and the nature of enlightenment. He also talks about practice--what it is and what it isn't, and how practice relates to the process of realization. He looks at what it is to be a human being and what our role is in the totality of the universe. The material includes a discussion of the nature of space and time, as well as a view of more and more subtle levels of realization. (shrink)

Desde la perspectiva abierta por este libro no puede ya el estudio del Ser considerarse patrimonio de aquellas concepciones que lo entienden exento de contradicción, de gradualidad y de inserción en el devenir. Perfilase ahora una visión del Ser y de los seres que, a la vez que reconoce la absoluta realidad de aquél, concibe todo lo real con determinaciones mutuamente contradictorias, en un entretejimiento de ser y no-ser; visión que viene defendida adoptando el estilo de pensamiento de la filosofía (...) analítica: un proceder, hasta donde quepa, por argumentos formalizables y por definiciones rigurosas. Van desfilando ante esa instancia metodológica los grandes problemas de la metafísica, desembocándose en un racionalismo ontológico consecuente, a la vez que dialéctico. Pruébase, con un argumento trascendental, un principio de inteligibilidad de lo real, del cual van resultando los de razón suficiente, no-contradicción y tercio excluso; explicándose cómo, y en qué medida, coexiste su vigencia con la de lo contradictorio, en una realidad donde se cumple el principio de gradualidad: todas las diferencias son de grado. (shrink)

What significance does the body have in the process of teaching and learning? In what way can the thoughts of a contemporary junior-level teacher in this regard be connected to the theory of the lived body formulated by the French phenomenologist philosopher Maurice Merleau-Ponty (1908-1961), and vice versa? The aim of this paper is to illuminate, enable understanding and discuss the meaning of the body in the learning process, with specific focus on the learning of writing as embodied experience. In (...) the process, the boundaries of learning are also explored. While understanding the significance both of learning as embodied experience and of the boundaries of learning is essential within the educational field, in this paper the discussion is limited to exploring how learning as embodied experience and the boundaries of learning can be viewed by taking Merleau-Ponty's notions as theoretical starting points. In an attempt to answer the aim and connect the paper's theoretical point of departure with a voice from a teacher, an interview with a junior-level teacher was conducted. The paper thus offers a theoretical contribution to the field of educational research, but one in which the theory is exemplified by, and connected to, a teacher's voice. Accordingly, the paper concludes by summarising the common understandings of learning held theoretically by Merleau-Ponty and made real in the activities of the contemporary junior-level teacher. (shrink)