In Setting Limits, Daniel Callahan advances the provocative thesis that age be a limiting factor in decisions to allocate certain kinds of health services to the elderly. However, when one looks at available data, one discovers that there are many more elderly women than there are elderly men, and these older women are poorer, more apt to live alone, and less likely to have informal social and personal supports than their male counterparts. Older women, therefore, will make the heaviest demand (...) on health care resources. If age were to become a limiting factor, as Dr. Callahan suggests it should, the limits that will be set are limits that will affect women more drastically than they affect men. This review essay examines the implications of Callahan's thesis for elderly women. (shrink)

Many of the demands being voiced for a "humanizing" of health care center on the public's concern that they have some say In determining what happens to the individual in health care institutions. The essays in this volume address fundamental questions of conflicts of rights and autonomy as they affect four selected, controversial areas in health care ethics: the Limits of Professional Autonomy, Refusing! Withdrawing from Treatment, Electing "Heroic" Measures, and Advancing Reproductive Technology. Each of the topics is addressed in (...) such a way that it includes an examination of the locus of responsibility for ethical decision making. The topics are not intended to exhaustively review those areas of health care provision where conflicts of rights might be said to be an issue. Rather they constitute an examination of the difficulties so often encountered in these specific contexts that we hope will illuminate similar conflicts in other problem areas by raising the level of the reader's moral awareness. Many books in bioethics appeal only to a limited audience in spite of the fact that their subject matter is of deep personal concern to everyone. In part, this is true because they are frequently written from the perspective of a single discipline or a single profession. As a result, one is often left with the impression that such a book views the philosophical, historical, and! or theological problems as essentially indifferent to clinical, legal, and! or policy-making problems. (shrink)

In Setting Limits, Daniel Callahan advances the provocative thesis that age be a limiting factor in decisions to allocate certain kinds of health services to the elderly. However, when one looks at available data, one discovers that there are many more elderly women than there are elderly men, and these older women are poorer, more apt to live alone, and less likely to have informal social and personal supports than their male counterparts. Older women, therefore, will make the heaviest demand (...) on health care resources. If age were to become a limiting factor, as Dr. Callahan sug-gests it should, the limits that will be set are limits that will affect women more dras” tically than they affect men. This review essay examines the implications of Callahan's thesis for elderly women. (shrink)

A series of letters between a professor of philosophy and an eleven-year-old girl.

In Setting Limits, Daniel Callahan advances the provocative thesis that age be a limiting factor in decisions to allocate certain kinds of health services to the elderly. However, when one looks at available data, one discovers that there are many more elderly women than there are elderly men, and these older women are poorer, more apt to live alone, and less likely to have informal social and personal supports than their male counterparts. Older women, therefore, will make the heaviest demand (...) on health care resources. If age were to become a limiting factor, as Dr. Callahan suggests it should, the limits that will be set are limits that will affect women more drastically than they affect men. This review essay examines the implications of Callahan's thesis for elderly women. (shrink)

Review of Alastair V. Campbell: Medicine, Health and Justice: The Problem of Priorities.

Epistemologies have power. They have the power not only to transform worlds, but to create them. And the worlds that they create can be better or worse. For many people, the worlds they create are predictably and reliably deadly. Epistemologies can turn sacred land into ‘resources’ to be bought, sold, exploited, and exhausted. They can turn people into ‘labor’ in much the same way. They can not only disappear acts of violence but render them unnamable and unrecognizable within their conceptual (...) architectures. Settler systems of epistemic and conceptual resources and the relations among them are constructed to preclude certain forms of knowledge. This is not an accident; it is a central goal of colonial violence. Colonization and land dispossession would not be possible without the violent disruption of Indigenous knowledge systems and ongoing organized attempts to disrupt their survival. Violently disrupting the relationships of people to land is as much an epistemic project as it is a material one, and these two projects are inherently linked. The task of theorizing epistemic oppression is not only about epistemic oppression. Epistemic oppression is a story that gives language to a phenomenon in order to get past it, to carry on with the maintaining and reviving the forms of Indigenous and diasporic knowledge that colonialism has worked tirelessly to corrupt and silence. (shrink)

The increasing use of cluster randomised trials in low-resource settings raises unique ethical issues. The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomised Trials is the first international ethical guidance document specific to cluster trials, but it is unknown if it adequately addresses issues in low-resource settings. In this paper, we seek to identify any gaps in the Ottawa Statement relevant to cluster trials conducted in low-resource settings. Our method is to analyse a prototypical cluster trial conducted (...) in a low-resource setting with the Ottawa Statement; to identify ethical issues in the design or conduct of the trial not captured adequately and to make recommendations for issues needing attention in forthcoming revisions to the Ottawa Statement. Our analysis identified six ethical aspects of cluster randomised trials in low-resource settings that require further guidance. The forthcoming revision of the Ottawa Statement should provide additional guidance on these issues: streamlining research ethics committee review for collaborating investigators who are affiliated with other institutions; the classification of lay health workers who deliver study interventions as health providers or research participants; the dilemma experienced by investigators when national standards seem to prohibit waivers of consent; the timing of gatekeeper engagement, particularly when researchers face funding constraints; providing ancillary care in health services or implementation trials when a routine care control arm is known to fall below national standards and defining vulnerable participants needing protection in low-resource settings. (shrink)

I Norge har vi hatt kontroverser omkring regulering avhumanmedisinsk bioteknologi siden 1980-tallet. Denneartikkelen analyserer et lite utsnitt av disse reguleringsdebattene,nærmere bestemt kontroversen omkring forskningpå befruktede egg. Med utgangspunkt i skriftlig materialeknyttet til tre reguleringsrunder undersøker vi her hvordan ulike aktører arbeidet forå ramme inn denne kontroversen, bl.a. ved hjelp av ulikevitenskapelige og politiske representasjoner av det befruktedeegget.Vi finner at det i perioden 1987–2007 ble arbeidet medulike innramminger som utgangspunkt for retoriske ogpolitiske strategier: På den ene siden ser vi forsøk på (...) å innrammekontroversen i et risikorammeverk som først ogfremst fokuserte på de potensielle negative sidene vedhumanmedisinsk bioteknologi, og som spesielt vektlarespekten for det ufødte liv. På den andre siden ser vi atman arbeidet med en forventningsinnramming som lahovedvekten på håpet om nye behandlingsregimer foralvorlig syke mennesker.Forbudet mot forskning på befruktede egg som ble vedtatti 1987, ble opprettholdt i 1994 og 2003. Med lovendringeni 2008 fikk vi imidlertid et markant brudd i dennorske lovgivningspraksisen, da forskning på befruktedeegg ble tillatt på visse premisser. Vi argumenterer for at den viktigste årsaken til denne lovendringen var Mehmet-saken, en sak som medførtesåkalte «oversvømmelser» i begge innrammingsforsøkenesom er omtalt ovenfor. Mehmet-saken eksponerte samtidig et generelt demokratiskdilemma. Saken illustrerte hvor sårbare lovregler og etiske prinsippkan være for det som for allmennheten fremstår som helt urimelig, og dennesaken etterspør slik sett mer hybride måter å tenke forholdet mellom det universelleog det partikulære, mellom prinsipiell etikk og lekmannsskjønn, mellomfakta og verdier som utgangspunkt for politikkutforming.Nøkkelord: humanmedisinsk bioteknologi, forskning på befruktede egg,kontrovers, representasjoner, Mehmet-sakenEnglish abstract: Effective representations? Concerns and expectationsregarding research on fertilized eggsSince the 1980s, there have been several debates and controversies concerningthe regulation of medical biotechnology. In this article, we analyze three suchinstances in Norway, mainly the debates concerning research on fertilizedeggs. Analyzing the debates surrounding the regulations of 1994, 2003/2004and 2008, we investigate how different stakeholders strived to mobilize whatwe call different framings of the controversy, utilizing the different scientificand political representations of the fertilized egg.Framing involves creating baselines for rhetorical and political stratagems.Two framings appear more pronounced than others in the Norwegian debate.On one hand, we find attempts of framing the controversy in a risk centricframework, which mostly emphasizes the potential negative effects of medicalbiotechnology as it focuses on the universal reverence for the unborn life. Onthe other hand, we see attempts to mobilize a positive frame of expectationthat emphasizes on the hope of finding new and effective treatment options forthe severely ill.The ban against research on fertilized eggs that was passed in Norway in1987 was repeated in 1994 and 2003. However, with the changes introducedto the law in 2008, there was a noticeable shift in Norwegian legislation, asresearch on fertilized eggs became permissible if specific conditions were met.We argue that the turning point in this regulative change was the Mehmentcase, a particular case that entailed the so-called «overflowing» in both the negative and the positive frame. The Mehmet case exposed a moregeneral democratic and political dilemma. In our opinion, it illustrates howvulnerable can regulation that is based on general ethical principles be in theface of what appears to the laity as unreasonable. Thus, we argue that thisactualizes the need for more hybridized ways to view the relationship betweenthe universal and the particular, between principle-based ethics and theunderstandings of lay people, between facts, and values and actual cases inpolicy shaping and practice. (shrink)

[1] Elul. Yamim Noraʼim. Sukot -- [2] Pesaḥ. Shevuʻot. Galut u-geʼulot. Ḥanukah. Purim.

ha-R. ha-ḳ. R. Mosheh mi-Drogiṭshin -- ha-R. ha-ḳ. R. Avraham me-Ulinov -- ha-R. ha-ḳ. R. Shelomoh Leyb mi-Lenṭshna -- ha-R. ha-ḳ. R. Meʼir mi-Primishla -- ha-R. ha-ḳ. R. Avraham mi-Miḳalyov -- ha-R. ha-ḳ. R. Daṿid mi-Zovliṭov -- ha-R. ha-ḳ. R. Shmelḳe mi-Sasov -- ha-R. ha-ḳ. R. Yeshaʻy. Shor -- ha-R. ha-ḳ. R. Yeḥiʼel Mikhal.

[1] Pinḳas ha-ḳabalot -- [2] Talmidaṿ (2 v.) -- [3] ʻInyene Elul ṿe-Yamim Noraʼim -- [4] ʻInyene Ḥanukah u-Furim.

v. 1. Chugŭl ttae kkaji i kŏrŭm ŭro -- v. 2. kyŏul i manil ondamyŏn -- v. 3. pabosae ŭi norae.

ḳerekh rishon. ʻInyane Elul ṿe-Yamim noraʼim.

[1] Tseṭil ḳaṭan -- [2] Hanhagot ha-adam -- [3] Mikhtav ḳodesh -- [4] Liḳuṭim neʻimim -- [5] Igeret ha-ḳodesh -- [6] Kitve ḳodesh -- [7] Tefilah noraʼah -- [8] Noʻam Elimelekh -- [9] Yalḳuṭ Darkhe tsedeḳ.

I examine the epistemic import of collaborative research in science. I develop and defend a functional explanation for its growing importance. Collaborative research is becoming more popular in the natural sciences, and to a lesser degree in the social sciences, because contemporary research in these fields frequently requires access to abundant resources, for which there is great competition. Scientists involved in collaborative research have been very successful in accessing these resources, which has in turn enabled them to realize the epistemic (...) goals of science more effectively than other scientists, thus creating a research environment in which collaboration is now the norm. (shrink)

1-pu. Ttang ŭi soksagim -- 2-pu. Mul ŭi norae -- 3-pu. Pulkkot ch'ŏrŏm -- 4-pu. Param ŭi hŭnjŏk.

In this book K. Brad Wray provides a comprehensive survey of the arguments against scientific realism. In addition to presenting logical considerations that undermine the realists' inferences to the likely truth or approximate truth of our theories, he provides a thorough assessment of the evidence from the history of science. He also examines grounds for a defence of anti-realism, including an anti-realist explanation for the success of our current theories, an account of why false theories can be empirically successful, and (...) an explanation for why we should expect radical changes of theory in the future. His arguments are supported and illustrated by cases from the history of science, including a sustained study of the Copernican Revolution, and a study of the revolution in early twentieth century chemistry, when chemists came to classify elements by their atomic number rather than by their atomic weight. (shrink)

Argues against D. Hume's (1825) treatise "Of Miracles," which is often used to disprove the existence of psi. Hume states that a miracle is a violation of the laws of nature which are proved to be true by common experience, and that the only sufficient testimony for a miracle would be testimony whose falsehood would be even more miraculous than the miracle itself. The primary objections to Hume's argument are that (1) it is tautological, since it presupposes the nonexistence of (...) miraculous events, and (2) as a metaphysical statement, it is inappropriate when considering empirical evidence, which should be judged by its own rule. (shrink)

David Hull accounts for the success of science in terms of an invisible hand mechanism, arguing that it is difficult to reconcile scientists' self-interestedness or their desire for recognition with traditional philosophical explanations for the success of science. I argue that we have less reason to invoke an invisible hand mechanism to explain the success of science than Hull implies, and that many of the practices and institutions constitutive of science are intentionally designed by scientists with an eye to realizing (...) the very goals that Hull believes need to be explained by reference to an invisible hand mechanism. Thus, I reduce the scope of Hull's invisible hand explanation and supplement it by appealing to a hidden hand explanation. (shrink)

ḥeleḳ 1. Dine birkot ha-nehenin--ḥeleḳ 2. Ṭohorat ha-lashon ṿeha-nefesh--ḥeleḳ 3. Dine teḥilat ha-yom--ḥeleḳ 4. Dine tefilat ha-shaḥar--ḥeleḳ 5. Neśiʼat-kapayim ṿe-taḥanun--ḥeleḳ 6. Dine ḳeriʼat ha-Torah--ḥeleḳ 7. Sheʼar tefilot ha-yom--ḥeleḳ 8. Tefilah be-Shabat uve-moʻed--ḥeleḳ 9. Dine Yamim Noraʼim--ḥeleḳ 10. Dine Ḥanukah u-Furim--ḥeleḳ 11. Mafteaḥ kelali meforaṭ.

In lieu of an abstract, here is a brief excerpt of the content:The Sources of MemoryJeffrey Andrew Barash“What does it mean to remember?” This question might seem commonplace when it is confined to the domain of events recalled in past individual experience; but even in this restricted sense, when memory recalls, for example, a first personal encounter with birth or with death, the singularity of the remembered image places the deeper possibilities of human understanding in relief. Such experiences punctuating everyday (...) life highlight the central place of memory as a source of human identity.With a few notable exceptions, such as Henri Bergson or Maurice Halb-wachs, this central role of memory was rarely a topic of interest in the theoretical orientations of our century. It played only a peripheral role in the different philosophical orientations and in the human sciences of this century until, very recently, new attempts have been made to comprehend the significance of memory, above all in the fields of intellectual history and philosophy. Without dealing exhaustively with the bibliography of works on memory, I will mention what seem to me to be the signs of a recent renewal of questioning in this area of interest to historians and philosophers alike. This will lead me to the specific problem I will address in the pages that follow.One of the chief sources of the historian’s recent interest in memory has been the historians’ conflict (Historikerstreit) of the 1980s concerning the interpretation of the German and European past since the rise to power of Nazism and in the aftermath of World War II. As the generations who lived through and—from a given perspective—remembered these events increasingly disappear, the question concerning their precise historical meaning has reemerged with a new urgency. In this vein, for example, as the relatively new periodical History and Memory: Studies in the Representation of the Past and the collection of essays Probing the Limits of Representation: Nazism and the “Final Solution,” edited by Saul Friedlander, amply attest, the relation of memory to historical narrative is as important as it is problematic: to the extent that eyewitness memory claims a status of objectivity beyond the fictional sphere of [End Page 707] the imagination, its role in informing historical narrative involves the very issue of objectivity itself. 1Independently of this query concerning the relation of memory and history in recent scholarship focusing on the twentieth century, a number of studies have attempted to place the idea of memory in historical perspective during premodern periods. In this regard, we may cite Janet Coleman’s recently published work, Ancient and Medieval Memories: Studies in the Reconstruction of the Past and Mary Carruthers’s treatment of the subject of memory in the medieval period in The Book of Memory: A Study of Memory in Medieval Culture. 2 A number of other recent works in the field of intellectual history have attempted to grapple with the intriguing problem of the historicity of the phenomenon of memory in the West. This idea of the historicity of memory has been inspired at least in part by Pierre Nora’s essay, “Between Memory and History,” which introduced the multi-volume series he directed, Les Lieux de mémoire. In this vein, Patrick H. Hutton’s History as an Art of Memory, Matt K. Matsuda’s The Memory of the Modern, and Richard Terdiman’s Present Past: Modernity and the Memory Crisis all center on the historical transforma-tions to which, according to the different perspectives of their works, “memory” has been subject. 3 Like Nora, they link this historicity of the social and cultural role of memory to the radical transformations that Western civilization has undergone in the modern period.In a philosophical perspective David Farrell Krell’s work, Of Memory, Reminiscence, and Writing: On the Verge, presents a very different idea of the phenomenon of memory. 4 Where the intellectual historians of modernity stress the mutations in the role of memory, Krell, following in the footsteps of Jacques Derrida, emphasizes one essential line of continuity that, to his mind, has tied [End Page 708] together the tradition of philosophical reflection on memory from Plato and Aristotle up until Freud: the metaphoric reference to memory as the faculty... (shrink)

Though many agree that we need to account for the role that social factors play in inquiry, developing a viable social epistemology has proved to be difficult. According to Longino, it is the processes that make inquiry possible that are aptly described as "social," for they require a number of people to sustain them. These processes, she claims, not only facilitate inquiry, but also ensure that the results of inquiry are more than mere subjective opinions, and thus deserve to be (...) called "knowledge." In this paper, I (a) explain Longino's epistemology, and (b) defend it against charges that have recently been raised by Kitcher, Schmitt, and Solomon. Longino rightly recognizes that not all social factors have the same (adverse) affect on inquiry. She also recommends that we distinguish knowledge from mere opinion by reference to a social standard. (shrink)

The ethical treatment of cancer patientsparticipating in clinical trials requiresthat patients are well-informed about thepotential benefits and risks associated withparticipation. When patients enrolled in phaseI clinical trials report that their chance ofbenefit is very high, this is often taken as evidence of a failure of the informed consent process. We argue, however, that some simple themes from the philosophy of language may make such a conclusion less certain. First, the patient may receive conflicting statements from multiple speakers about the expected (...) outcome of the trial. Patients may be reporting the message they like best. Second, there is a potential problem of multivocality. Expressions of uncertainty of the frequency type can be confused with expressionsof uncertainty of the belief type. Patients may be informed using frequency-type statements and respond using belief-type statements. Third, each speech episode involving the investigator and the patient regarding outcomes may subservemultiple speech acts, some of which may beindirect. For example, a patient reporting ahigh expected benefit may be reporting a beliefabout the future, reassuring family members,and/or attempting to improve his or her outcome by apublic assertion of optimism. These sources oflinguistic confusion should be considered injudging whether the patient's reported expectation isgrounds for a bioethical concern that there hasbeen a failure in the informed consent process. (shrink)

The paper discusses the attitude of the bhagavadgita in relation to war and peace and justifies its views on independent grounds. The views that the gita is primarily interested in teaching either war or peace, And that the teachings of war and peace are necessarily incompatible are repudiated. The paper shows that the central message of the gita is something more basic and comprehensive, And that the war, As envisaged by the gita, Is not incompatible with a life of peace (...) and righteousness. In this context the concept of 'righteous war' is explained and its scrupulous and exceptional use vindicated. (shrink)