BackgroundThe increasing emphasis on research, development and innovation for health in providing solutions to the high burden of diseases in the African Region has warranted a proliferation of studies including clinical trials. This changing public health landscape requires that countries develop adequate ethics review capacities to protect and minimize risks to study participants. Therefore, this study assessed the readiness of national ethics committees to respond to challenges posed by a globalized biomedical research system which is constantly challenged by new public (...) health threats, rapid scientific and technological advancements affecting biomedical research and development, delivery and manufacture of vaccines and therapies, and health technology transfer.MethodsThis is a descriptive study, which used a questionnaire structured to elicit information on the existence of relevant national legal frameworks, mechanisms for ethical review; as well as capacity requirements for national ethics committees. The questionnaire was available in English and French and was sent to 41 of the then 46 Member States of the WHO African Region, excluding the five Lusophone Member States. Information was gathered from senior officials in ministries of health, who by virtue of their offices were considered to have expert knowledge of research ethics review systems in their respective countries.ResultsThirty three of the 41 countries responded. Thirty of respondent countries had a national ethics review committee ; 79 % of which were established by law. Twenty-five NECs had secretarial and administrative support. Over 50 % of countries with NECs indicated a need for capacity strengthening through periodic training on international guidelines for health research ethics; and allocation of funds for administrative and secretariat support.ConclusionsDespite the existing training initiatives, the Region still experiences a shortage of professionals trained in health research ethics/ethicists. Committees continue to face various capacity needs especially for evaluating clinical trials, for monitoring ongoing research, database management and for accrediting institutional ethics committees. Given the growing number of clinical trials involving human participants in the African Region, there is urgent need for supporting countries without NECs to establish them; capacity strengthening where they exist; and creation of a regional network and joint ethical review mechanisms, whose membership would be open to all NECs of the Region. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

Context Opioid treatment agreements (OTAs) are documents that clinicians present to patients when prescribing opioids that describe the risks of opioids and specify requirements that patients must meet to receive their medication. Notwithstanding a lack of evidence that OTAs effectively mitigate opioids’ risks, professional organizations recommend that they be implemented, and jurisdictions increasingly require them. We sought to identify the jurisdictions that require OTAs, how OTAs might affect the outcomes of lawsuits that arise when things go wrong, and instances in (...) which the law permits flexibility for clinicians and health care institutions to adopt best practices. -/- Methods We surveyed the laws and regulations of all 50 states and the District of Columbia to identify which jurisdictions require the use of OTAs, the circumstances in which OTA use is mandatory, and the terms OTAs must include (if any). We also surveyed criminal and civil judicial decisions in which OTAs were discussed as evidence on which a court relied to make its decision to determine how OTA use influences litigation outcomes. -/- Findings Results show that a slight majority (27) of jurisdictions now require OTAs. With one exception, the jurisdictions’ requirements for OTA use are triggered at least in part by long-term prescribing. There is otherwise substantial variation and flexibility within OTA requirements. Results also show that even in jurisdictions where OTA use is not required by statute or regulation, OTA use can inform courts’ reasoning in lawsuits involving patients or clinicians. Sometimes, but not always, OTA use legally protects clinicians from liability. -/- Conclusions -/- Our results show that OTA use is entwined with legal obligations in various ways. Clinicians and health care institutions should identify ways for OTAs to enhance clinician–patient relationships and patient care within the bounds of relevant legal requirements and risks. (shrink)

The discussion of collective agency involves the reduction problem of the concept of a collective. Individualism and Cartesian internalism have long restricted orthodox theories and made them face the tension between an irreducible concept of a collective and ontological reductionism. Heterodox theories as functionalism and interpretationism reinterpret the concept of agency and accept it as realized on the level of a collective. In order to adequately explain social phenomena that have relations as their essence, in this paper we propose a (...) relational, holistic account of collective agency and argue that functionalism and interpretationism can be integrated into such an account. (shrink)

Disjunctivism about perceptual appearances, as I conceive of it, is a theory which seeks to preserve a naïve realist conception of veridical perception in the light of the challenge from the argument from hallucination. The naïve realist claims that some sensory experiences are relations to mind-independent objects. That is to say, taking experiences to be episodes or events, the naïve realist supposes that some such episodes have as constituents mind-independent objects. In turn, the disjunctivist claims that in a case of (...) veridical perception like this very kind of experience that you now have, the experiential episode you enjoy is of a kind which could not be occurring were you having an hallucination. The common strategy of arguments from hallucination set out to show that certain things are true of hallucinations, and hence must be true of perceptions. For example, it is argued that hallucinations must have non-physical objects of awareness, or that such states are not relations to anything at all, but are at best seeming relations to objects. In insisting that veridical perceptual experience is of a distinct kind from hallucination, the disjunctivist denies that any of these conceptions of hallucination challenges our conception of veridical perceptions as relations to mind-independent objects. More specifically, I assume that the disjunctivist advocates naïve realism because they think that this position best articulates how sensory experience seems to us to be just through reflection. If the disjunctivist is correct in this contention, then anyone who accepts the conclusion of the argument from hallucination must also accept that the nature of sensory experience is other than it seems to us to be. In turn, one may complain that any such error theory is liable to lead to sceptical consequences. A Humean scepticism about the senses launches a challenge about our knowledge of the world through questioning the conception we have of what sense experience is, and how it can provide knowledge of the world. (shrink)

This paper argues that the allure of conspiracy theories lies in their evolutionary origins, specifically in our capacity to communicate unrepresented threats. Drawing on threat-detection psychology and error management theory, it posits that these theories serve as adaptive responses to perceived threats and social coalition-building, rather than as flaws in reasoning.

Article copyright 2002. We provide a battery of examples of delusions against which theoretical accounts can be tested. Then we identify neuropsychological anomalies that could produce the unusual experiences that may lead, in turn, to the delusions in our battery. However, we argue against Maher's view that delusions are false beliefs that arise as normal responses to anomalous experiences. We propose, instead, that a second factor is required to account for the transition from unusual experience to delusional belief. The second (...) factor in the etiology of delusions can be described superficially as a loss of the ability to reject a candidate for belief on the grounds of its implausibility and its inconsistency with everything else that the patient knows, but we point out some problems that confront any attempt to say more about the nature of this second factor. (shrink)

Frame -- Perspective -- Approach and Encounter -- To See and Look Away -- And What If the Animal Replied? -- Discussion Questions.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Disjunctivism about perceptual appearances, as I conceive of it, is a theory which seeks to preserve a na.

Wie kein anderer Philosoph vor oder nach ihm thematisierte Heidegger die metaphysischen Denkschemata, die der abendländisch-neuzeitlichen Technikentwicklung zugrunde liegen. Auf verständliche Weise rekonstruiert dieses Buch Heideggers radikal metaphysikkritischen Ansatz vor dem Hintergrund seiner frühen und mittleren Schriften. Dabei wird nicht nur deutlich, wie sehr sein spätes Denken der Technik in Kontinuität zu seinem frühen fundamentalontologischen Projekt (und dessen Scheitern) steht, sondern es werden auch die Alternativen zum rechnenden Denken und Handeln in Kunst und Dichtung aufgezeigt. (Quelle: www.buchhandel.de).

A noted author defends his personal attitudes toward the fundamental issues of classical philosophy, discussing the awesome mystery surrounding science and life and explaining why he considers himself a theist.

Some authors have recently claimed that relativism about knowledge sentences accommodates the context sensitivity of our use of such sentences as well as contextualism, while avoiding the counterintuitive consequences of contextualism regarding our inter-contextual judgments, that is, our judgments about knowledge claims made in other contexts. I argue that relativism, like contextualism, involves an error theory regarding a certain class of inter-contextual judgments.

Some authors have recently claimed that relativism about knowledge sentences accommodates the context sensitivity of our use of such sentences as well as contextualism, while avoiding the counterintuitive consequences of contextualism regarding our inter-contextual judgments, that is, our judgments about knowledge claims made in other contexts. I argue that relativism, like contextualism, involves an error theory regarding a certain class of inter-contextual judgments.

This article develops an ecological framework for understanding collective action. This is contrasted with approaches familiar from the collective intentionality debate, which treat individuals as fundamental units of collective action. Instead, we turn to social ecological psychology and dynamical systems theory and argue that they provide a promising framework for understanding collectives as the central unit in collective action. However, we submit that these approaches do not yet appreciate enough the relevance of social identities for collective action. To analyze this (...) aspect, we build on key insights from social identity theory and synthesize it with embodied and ecological accounts of perception and action. This results in the proposal of two new types of affordances. For an individual who enacts her "embodied social identity" of being a member of a particular collective, there can be what we call embodied social identity affordances. Moreover, when several individuals dynamically interact with each other against the background of their embodied social identities, this might lead to the emergence of a collective, which we understand as a dynamically constituted and ecologically situated perception-action system consisting of several individuals enacting relevant embodied social identity affordances. Building on previous work in social ecological psychology, we suggest that there can be genuine collective affordances, that is, affordances whose subject is not an individual, but a collective. (shrink)

Recent empirical findings from social psychology, ecological psychology, and embodied cognitive science indicate that situational factors crucially shape the course of human behavior. For instance, it has been shown that finding a dime, being under the influence of an authority figure, or just being presented with food in easy reach often influences behavior tremendously. These findings raise important new questions for the philosophy of action: Are these findings a threat to classical conceptions of human agency? Are humans passively pushed around (...) by situational factors, or are there agential aspects in the way we spontaneously experience and react to situations? How can one conceptualize the pervasive influence of situational factors on human action? What are situations in the first place, and how should the influence of these situations on action be thought of? This paper sets out to develop a new conceptual repertoire for thinking about the influence of situations on action, drawing on research from ecological psychology as well as from embodied and enactive cognitive science. The key proposal is the development of a philosophical sensorimotor account of agency: Action, it is proposed, should be conceived of as constant dynamical interaction of agential and environmental factors – factors which should all be conceptualized in new ways. (shrink)

Some philosophers hold that trust grows fragile when people become too rational. They advocate a retreat from reason and a return to local, traditional values. Others hold that truly rational people are both trusting and trustworthy. Everything hinges on what we mean by 'reason' and 'rational'. If these are understood in an egocentric, instrumental fashion, then they are indeed incompatible with trust. With the help of game theory, Martin Hollis argues against that narrow definition and in favour of a (...) richer, deeper notion of reason founded on reciprocity and the pursuit of the common good. Within that framework he reconstructs the Enlightenment idea of citizens of the world, rationally encountering, and at the same time finding their identity in, their multiple commitments to communities both local and universal. (shrink)

In these essays, written between 1909 and 1954 and first published as a collection in 1957, the eminent philosopher relates the "I-Thou" dialogue to such varied fields as religion, social thought, philosophy, myth, drama, literature, and art. Buber thus responds to the crises and challenges of the 20th century and enables the reader to follow his lifelong struggles toward "authentic existence.".

In this paper we present an overview, with historical and critical remarks, of two articles by S. Jaśkowski ([20, 21] 1948 and [22, 23] 1949), which contain the oldest known formulation of a paraconsistent logic. Jaśkowski has built the logic – he termed discussive (D2) – by defining two new connectives and by introducing a modal translation map from D2 systems into Lewis’ modal logic S5. Discussive systems, for their formal details and their original philosophical justification, have attracted discrete attention (...) among experts. Indeed, in what follows, after having introduced Jaśkowski methodology of building D2 and his main philosophical motivations for providing such a system, we will explore some of the main contributions to the development of D2. (shrink)

Feminist philosophers have long worried that intersectionality undermines the viability of the concept and category of woman, thereby undermining feminist theory and politics. Some have responded to this problem by abandoning intersectionality; others have attempted to find some suitably inclusive way of reconceptualizing woman. I provide a novel solution that focuses on conceptualizing oppression in light of intersectionality, rather than trying to provide an account of what it is to be a woman. By enabling us to understand feminism as responding (...) to gender oppression, this account shows that intersectionality does not conceptually undermine and fragment feminism. Feminism should be intersectional. (shrink)

Two more or less standard methods exist for the systematic, logical construction of classical mathematics, the so-called theory of types, due in the main to Russell, and the Zermelo axiomatic set theory. In systems based upon either of these, the connective of membership, “ε”, plays a fundamental role. Usually although not always it figures as a primitive or undefined symbol.Following the familiar simplification of Russell's theory, let us mean by alogical typein the strict sense any one of the following: (i) (...) the totality consisting exclusively of individuals, (ii) the totality consisting exclusively of classes whose members are exclusively individuals, (iii) the totality consisting exclusively of classes whose members are exclusively classes whose members in turn are exclusively individuals, and so on. Any entity from (ii) is said to beone type higherthan any entity from (i), any entity from (iii), one type higher than any entity from (ii), and so on. In systems based upon this simplified theory of types, the only significant atomic formulae involving “ε” are those asserting the membership of an entity in an entity one type higher. Thus any expression of the form “(x∈y)” is meaningless except where “y” denotes an entity of just one type higher than the type of the entity denoted by “x” It is by means of general type restrictions of this kind that the Russell and other paradoxes are avoided. (shrink)

Dream is a state of consciousness characterized by internally-generated sensory, cognitive and emotional experiences occurring during sleep. Dream reports tend to be particularly abundant, with complex, emotional, and perceptually vivid experiences after awakenings from rapid eye movement sleep. This is why our current knowledge of the cerebral correlates of dreaming, mainly derives from studies of REM sleep. Neuroimaging results show that REM sleep is characterized by a specific pattern of regional brain activity. We demonstrate that this heterogeneous distribution of brain (...) activity during sleep explains many typical features in dreams. Reciprocally, specific dream characteristics suggest the activation of selective brain regions during sleep. Such an integration of neuroimaging data of human sleep, mental imagery, and the content of dreams is critical for current models of dreaming; it also provides neurobiological support for an implication of sleep and dreaming in some important functions such as emotional regulation. (shrink)

This study adopted an empirical method to investigate lay people’s attitudes toward the bioethical issues of human-animal chimeric brains. The results of online surveys showed that (1) people did not entirely reject chimeric brain research, but showed slightly more negative responses than ordinary animal testing; and that (2) their ethical concerns arose in connection with the perception that chimerism in the brain would humanize the animal. This means that people’s psychology was consistent with the ethical argument that crossing the human-animal (...) boundary would bring moral confusion to our society. Meanwhile, it was not in line with another argument that moral status depended on having high capacities, and that chimerism would cause a problem if it enhanced animals’ capacities. Furthermore, this study analyzed additional psychological factors related to people’s moral judgment and the relationship among those factors. Several psychological factors, such as the perception that chimeric brain research is unnatural, were identified as mediating the relationship between perception of animal humanization and ethical concerns about creating and using chimeric brains. Introducing an empirical approach to the ethics of human-animal chimeric brains brought two findings: (1) this study informed us of socially shared intuition regarding this novel technology; and (2) it unveiled the psychological processes behind people’s ethical concerns in more detail than they spontaneously mentioned. These findings will help to build normative arguments and future policies that are understandable and acceptable to society. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reaching the Age of Majority:The Life Trajectory of the CIHR Institute of AgingYves Joanette, Anne Martin-Matthews, Réjean Hebert, and Joanne GoldbergThe Canadian Institutes of Health Research (CIHR) was created in 2001 under the Canadian Institutes of Health Research Act S.C. 2000, c. 6 (Government of Canada, 2000). The creation of CIHR was in follow-up to the Canadian Medical Research Council (MRC) as well as to the National Health (...) Research and Development Program of Health Canada that, up until that point in time, had supported the breadth of health research in Canada. Two important characteristics of CIHR were crucial for the development of research on aging. The first was that CIHR, unlike MRC, was entrusted with the challenge of supporting the whole spectrum of health research, from the basic biomedical perspective to clinical research, research on health services and policies as well as social aspects of health research, not to mention research on ethics and other perspectives (including the science of research). The second characteristic of the nascent CIHR that impacted the community of research on aging was the decision that a small part of the overall CIHR budget would be used to address priority-driven questions or topics (strategic competitions), while the majority of the budget would be invested in grants and awards programs that would be investigator-initiated, as in the time of the MRC (open competition). Since its inception, CIHR has included 13 institutes that are central to the priority-driven actions. Institutes not only play an important convener role within their communities and among their stakeholders, but they are also expected to listen to the needs, gaps and opportunities in their area and to introduce initiatives---most of the time involving more than one Institute---in order to tackle these needs and gaps and to seize upon the opportunities.The Institute of Aging was introduced at the same time as the other 12 Institutes and it is clear that many challenges were awaiting the new Institute since, at that time, research on aging was still in its early years. This article is about the trajectory of the CIHR Institute of Aging in its first 18 years of existence. Having now reached an age that is either the age of majority or quite close to it, it is important to be able to provide a reflection on the evolution of the priorities over this period, while also taking a peek at some of the priorities that will surely come in the near future.The Early Years (2001-2004)The founding Scientific Director of the Institute of Aging was Dr. Réjean Hébert. A well-known and prolific [End Page 1] geriatrician and researcher, Dr. Hébert was the perfect person to launch the Institute. One of his first actions was, in fact, to harmonize the French and English names of the Institute. In French, the name of the Institute focused on Aging (Institut du vieillissement) while, in English, the name of the Institute focused on Healthy Aging. The CIHR Institute of Healthy Aging thus became the CIHR Institute of Aging in all versions of its documentation. But above and beyond this important name change, the real work of Dr. Hebert, accompanied by the first Institute Advisory Board1, chaired by Prof. Dorothy Pringle, was to identify the gaps, the needs and the opportunities. After a rigorous process came the first Strategic Plan of the CIHR Institute of Aging, which was clearly influenced by Dr. Réjean Hébert's vision of the aging population as an opportunity, instead of a catastrophe, for our society that comes, of course, with its own challenges. Dr. Hébert left CIHR during his first mandate as he was called upon to become the Dean of his Faculty, and then went on to become the first CIHR Scientific Director to sit as a Minister of Health and Social Services in the Québec Government. The main outcomes of Dr. Hebert's years (2001-2004) can be summarized as follows2.• Organizing many workshops and meetings to ensure that the Institute of Aging would become the premier national convener for research on aging, bridging between disciplines... (shrink)

This comprehensive collection of original essays written by aninternational group of scholars addresses the central themes inLatin American philosophy. Represents the most comprehensive survey of historical andcontemporary Latin American philosophy available today Comprises a specially commissioned collection of essays, manyof them written by Latin American authors Examines the history of Latin American philosophy and itscurrent issues, traces the development of the discipline, andoffers biographical sketches of key Latin American thinkers Showcases the diversity of approaches, issues, and styles thatcharacterize the field.

This volume includes the texts of Erasmus's 1524 diatribe against Luther,De Libero Arbitrio, and Luther's violent counterattack,De Servo Arbitrio.

This is the lightly revised text of my commentary/response to David Carr’s keynote address, “Phenomenology of Crisis,” at the 2024 meeting of the Husserl Circle.

There is broad agreement that humans can be wronged independently of their incurring any harm, that is, when their welfare is not affected. Examples include unnoticed infringements of privacy, ridiculing unaware individuals, or disregarding individuals’ autonomous decision-making in their best interest. However, it is less clear whether the same is true of animals—that is, whether moral agents can wrong animals in situations that do not involve any harm to the animals concerned. In order to answer this question, I concentrate on (...) the illustrative case of treating animals in a demeaning yet harmless way that would be disrespectful if humans were concerned. I discuss whether such actions are permissible or unjustifiably discriminatory from a moral point of view. I conclude that moral agents cannot directly wrong animals without harming them and thus do not owe it to a particular animal to refrain from such actions. However, if the actions increase the likelihood that animal abuse will occur, this presents a strong indirect reason against performing them. Thus, the reasons for refraining from such actions are merely indirect rather than direct. (shrink)

Upon introspection, we judge that suffering feels bad. I argue there is no appearance-reality gap when it comes to introspective judgments about simple, intrinsic, nonrepresentational phenomenal states like itches, tingling, and suffering's feeling bad. On constitutivism about phenomenal introspection, there is no appearance-reality gap here because these judgments are literally constituted by the phenomenal states they are about. As a result, we are directly acquainted with the intrinsic properties of experience in having these judgments. Reflecting on our direct acquaintance with (...) intrinsic badness, we can know that our suffering instantiates this judgment-independent evaluative property. (shrink)

Name der Zeitschrift: Kant-Studien Jahrgang: 110 Heft: 1 Seiten: 49-73.

The aim of this paper is to provide a proof-theoretic characterization of relevant logics including fusion and fission connectives, as well as Ackermann’s truth constant. We achieve this by employing the well-established methodology of labelled sequent calculi. After having introduced several systems, we will conduct a detailed proof-theoretic analysis, show a cut-admissibility theorem, and establish soundness and completeness. The paper ends with a discussion that contextualizes our current work within the broader landscape of the proof theory of relevant logics.