The problem of resource allocation in health has stimulated much thought and research, in attempts to provide objective, rational methods by which necessary choices can be made. One such method was proposed in a paper in this journal. The authors argued for a utilitarian approach, which they claimed to demonstrate was acceptable to society at large. This paper argues that the evidence supporting such a claim was flawed; such a utilitarian approach is not socially acceptable, and is therefore not relevant. (...) Rather more relevant directions for research are discussed, based on the assertion that a degree of realism is essential when considering the problems of resource allocation. (shrink)

Is faith that p compatible with disbelief that p? I argue that it is. After surveying some recent literature on the compatibility of propositional and non-propositional forms of faith with the lack of belief, I take the next step and offer several arguments for the thesis that both these forms of faith are also compatible, in certain cases, with outright disbelief. This is contrary to the views of some significant recent commentators on propositional faith, including Robert Audi and Daniel Howard-Snyder. (...) The primary argument revolves around the possibility of maintaining a single faith through drastic changes in cognitive attitude. I argue that once we allow that propositional faith is compatible with weaker cognitive attitudes than belief, such as acceptance or assent, there is prima facie reason to consider propositional faith as sometimes compatible with disbelief. I then consider objections and offer some final reflections on the significance of the thesis. (shrink)

This reply to P Whitaker's `Resource allocation: a plea for a touch of realism' acknowledges that health-care ethics should be relevant to events in the real world, but questions the extent to which philosophical inquiry should be confined to parameters determined by existing sociopolitical forces. The reading of the daily paper is the morning prayer of the realist.

This guide accompanies the following article(s): ‘Full Disclosure of the “Raw Data” of Research on Humans: Citizens’ Rights, Product Manufacturer’s Obligations and the Quality of the Scientific Database.’Philosophy Compass 6/2 (2011): 90–99. doi: 10.1111/j.1747‐9991.2010.00376.x Author’s Introduction Securing consent (and informed consent) from patients and research study participants is a key concern in patient care and research on humans. Yet, the legal doctrines of consent and informed consent differ in their applications. In patient care, the judicial doctrines of consent and informed (...) consent are disclosure doctrines based on the obligation of physicians to inform their patients of the following types of information: the nature of the procedure the physician is recommending in the patent’s care (P), the alternatives to the physician‐recommendation (A), and the risks of procedure and its alternatives (R). In addition, the physician must provide truthful answers to the patient’s questions (Q) to the best of the physician’s abilities. In research on humans, the onus of disclosure by study sponsors and principal investigators is much greater than in patient care precisely because the purpose of research is not patient care. The purpose of research is the identification and development of new generalizable knowledge. Thus, participation in a research study or trial may not benefit the study volunteer at all. In addition, the participant may carry a heavy risk burden in relationship to any testing of a newly designed drug or device as part of their experiences in the research study. Presently, despite the risks borne by the research study participant, the raw data collected from volunteers in research trials are treated by courts as if they were the private property of the study sponsor rather than generally owed to the public as would be expected by an effort like research participation aimed at contributing to the development of generalizable knowledge. This paper reviews the obligations that study sponsors owe to their study participants based on the very definition of research as a systematic activity whose purpose is to develop generalizable knowledge to help all humans. Author Recommends Court cases Canterbury v. Spence, United States Court of Appeals, District of Columbia Circuit 464 F.2d 772 (1972). (Federal appellate decision heard in the District of Columbia, USA) Reibl v. Hughes, 2 S.C.R. 880 (1980). (Supreme Court of Canada) Rogers v. Whitaker, 175 C.L. R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Canterbury v. Spence is the landmark Federal informed consent case in the United States heard in the District of Columbia. In this case, Judge Spottswood Robinson articulated the reasonable person standard of informed consent. This standard was subsequently adopted by the Supreme Court of Canada (Reibl v. Hughes, 2 S.C.R. 880 (1980)) and the High Court of Australia (Rogers v. Whitaker, 175 C.L. R. 479 (1992)). The House of Lords rejected the reasonable person standard in England in Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985). Book Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. This book is a detailed guide for the review of scientific and ethical aspects of research on humans contained in the research study protocols and research informed consent forms which need to be submitted by study sponsors and principal investigators to institutional review boards (IRBs) for IRB review before a research study can receive approval to be conducted within a human study population in those institutions over which the IRB has authority. It also presents basic definitions in the area of research on humans and basic approaches to help conduct a deep review of the underlying scientific and ethical issues that are present within a research study protocol and its accompanying research informed consent form. Report National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). This U.S. National Commission in the Belmont Report argued for the necessity of a reasonable volunteer standard in research on humans in the United States. Arguing that the professional standard and the reasonable person standard of consent and informed consent were insufficient to base a disclosure standard in research on humans, this National Commission developed the reasonable volunteer standard where a study participant is to be approached in research informed consent with that information that a reasonable volunteer would want to know. Online Materials Belmont Report: Syllabus Topics for Lecture and Discussion Week I: Introduction and Overview Readings: Rogers v. Whitaker, 175 C.L.R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week II: The Different Standards of Consent and Informed Consent Readings: Canterbury v. Spence, 464 F.2d 772 (1972). (Federal appellate opinion heard in the District of Columbia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week III: Definition of Research Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 2 and 3) Week IV: How to Review a Research Study Protocol and Research Informed Consent Form Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 4–6, 10, and 12–14) Week V: Obligations in Research of Humans Versus Patient Care Reading: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). Focus Questions • How do the judicial doctrines of consent in England and Australia compare to the judicial doctrines of informed consent in the United States and Canada? • How does a professional standard of disclosure differ from a reasonable person standard of disclosure? • What is the definition of research? • How is a research study (study proposal and research informed consent form) reviewed from scientific and ethical bases for considerations of approval by an IRB? • How do the obligations of a study sponsor, a principal investigator, and a research team conducting a research trial on human study participants differ from the obligations of a physician caring for a patient? • Should all raw data of research derived from humans be made available to the public for use in developing generalizable knowledge to help others, or should raw data be considered the private property of the study sponsors (for example, prescription drug manufacturers), who fund the research trials? Seminar/project Idea Draw a timeline of the development of the basic concepts of consent and informed consent in patient care and in patient research. On this timeline, first place the dates of the key court cases in England, the United States, Canada, and Australia on consent and informed consent. Then place the date of the development of the Belmont Report. Why do differences exist between these four countries in terms of the legal requirements of informedness of a patient (in medical care) and a study participant (in medical research)? What roles if any do the concepts of self‐determination and self‐decision have in consent and informed consent in patient care and in informed consent in research on humans among the four countries of interest? What are the realities of research on human participants that require a new standard of informed consent, the reasonable volunteer standard, to be developed beyond the two standards in patient care, the professional standard, and the reasonable person standard? Counterpoint Arguments The following are counterpoint arguments that need to be appreciated to more fully understand the concepts that impact the thesis that ‘raw data’ should be open to the public to allow the opportunity of checking of the results of its associated scientific paper and for further analysis. De‐Identified (Anonymized) Raw Data A current approach to identifying (anonymizinig) raw data is based on the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L.104‐191). HIPAA was enacted by the U.S. Congress in 1996 to keep a person’s medical information private. In a research study, a person’s private medical information can become research data. HIPAA’s Privacy Rule allows a covered entity to de‐identify data by removing all 18 elements that could be used to identify the individual or the individual’s relatives, employers, or household members; these elements are enumerated in the Privacy Rule. The covered entity must also have no actual knowledge that the remaining information could be used alone or in combination with other information to identify the individual who is the subject of the information. Under this method, the identifiers that must be removed are the following: 1 Names. 2 All geographic subdivisions smaller than a state, including street address, city, county, precinct, ZIP Code, and their equivalent geographical codes, except for the initial three digits of a ZIP Code if, according to the current publicly available data from the Bureau of the Census: 2a. The geographic unit formed by combining all ZIP Codes with the same three initial digits contains more than 20,000 people. 2b. The initial three digits of a ZIP Code for all such geographic units containing 20,000 or fewer people are changed to 000. 3 All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, and date of death, and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older. 4 Telephone numbers. 5 Facsimile numbers. 6 Electronic mail addresses. 7 Social security numbers. 8 Medical record numbers. 9 Health plan beneficiary numbers. 10 Account numbers. 11 Certificate/license numbers. 12 Vehicle identifiers and serial numbers, including license plate numbers. 13 Device identifiers and serial numbers. 14 Web universal resource locators (URLs). 15 Internet protocol (IP) address numbers. 16 Biometric identifiers, including fingerprints and voiceprints. 17 Full‐face photographic images and any comparable images. 18 Any other unique identifying number, characteristic, or code, unless otherwise permitted by the Privacy Rule for re‐identification. Even though ‘raw data’ can be de‐identified (anonymized) so that there is no way to trace back the data to the study participant from which it was drawn, there are still questions whether the ‘de‐identified raw data’ can be given to other researchers or made public without the original study participant’s approval. It may be the case that this approval could be done at the start of any research study where the individual considering study participation would be counseled on what the process of de‐identification consists of and would be asked whether the participant would allow use of the data by other researchers or made available to the public in a de‐identified state. However, there may be questions of the study participants as to whether the data are truly de‐identified and untraceable back to the study participant since the participant would not be able to see the process actually being carried out in detail in all relevant circumstances. Using Raw Data in Context Simply being in possession of raw data is never enough to build on that data from a research perspective. Researchers need to understand the context of the scientific research study in which the data were collected. This research context includes (but is not limited to): (i) the scientific hypothesis of the research study, (ii) the inclusion and exclusion criteria selected by the research designers of the study to determine which study participants were included and which were excluded from the study, (iii) the methods used to collect the data and possibilities of errors in the data collection processes, and (iv) answers to questions regarding whether any data were excluded from the study data and why these data were excluded. Ownership Rights Over Data There are ownership rights over data. Ownership rights include court decision making related to the question which parties are to be considered as the owners of the data. Possible owners here include (but are not limited to) (i) the study sponsor whose only role was to fund that study, (ii) the principal investigator(s) who developed the scientific hypothesis, and (iii) individual study participants through special contracts made by individual participants who negotiate such contracts with study sponsors and principal investigators to share in the ownership of data. Examples of such data are participant sources of unique gene lines or unique cell lines to be used in future research. Objections to Data Sharing Finally, individual researchers may simply object to sharing data. A researcher’s arguments here may be simply stating that he or she has a right to fully analyze the data since the collection of the data was the researchers’ idea in the first place. These researchers may argue that they have the right to mine the data as fully as they can before deciding to make the data open to the public for others to analyze. Works Cited 1 Kaiser, J. ‘Making Clinical Data Widely Available.’Science 322.5899 (10 Oct. 2008): 217–8. 2 de Lusignan, S., J.F. Metsemakers, P. Houwink, V. Gunnarsdottir, and J. van der Lei. ‘Routinely Collected General Practice Data: Goldmines for Research? A Report of the European Federation for Medical Informatics Primary Care Informatics Working Group (EFMI PCIWG) from MIE2006, Maastricht, The Netherlands.’Informatics in Primary Care 14.3 (2006): 203–9. 3 Sim, I. ‘Human Studies Database Project’, CTSA Data Repositories Symposium (17 Oct. 2008). 23 Nov. 2010. 4 Sim, I., C.G. Chute, H. Lehmann, R. Nagarajan, M. Nahm, and R.H. Scheuermann. ‘Keeping Raw Data in Context.’Science 323.5915 (6 Feb. 2009): 713. 5 U.S. Department of Health and Human Services, National Institutes of Health, HIPAA Privacy Rule, Information for Researchers. 13 Nov. 2010. 6 Wilczynski, N.L., R.B. Haynes, and Hedges Team. ‘EMBASE Search Strategies for Identifying Methodologically Sound Diagnostic Studies for Use by Clinicians and Researchers.’BMC Medicine 29.3 (March 2005): 7. (shrink)

This guide accompanies the following article(s): ‘Full Disclosure of the “Raw Data” of Research on Humans: Citizens’ Rights, Product Manufacturer’s Obligations and the Quality of the Scientific Database.’Philosophy Compass 6/2 (2011): 90–99. doi: 10.1111/j.1747‐9991.2010.00376.x Author’s Introduction Securing consent (and informed consent) from patients and research study participants is a key concern in patient care and research on humans. Yet, the legal doctrines of consent and informed consent differ in their applications. In patient care, the judicial doctrines of consent and informed (...) consent are disclosure doctrines based on the obligation of physicians to inform their patients of the following types of information: the nature of the procedure the physician is recommending in the patent’s care (P), the alternatives to the physician‐recommendation (A), and the risks of procedure and its alternatives (R). In addition, the physician must provide truthful answers to the patient’s questions (Q) to the best of the physician’s abilities. In research on humans, the onus of disclosure by study sponsors and principal investigators is much greater than in patient care precisely because the purpose of research is not patient care. The purpose of research is the identification and development of new generalizable knowledge. Thus, participation in a research study or trial may not benefit the study volunteer at all. In addition, the participant may carry a heavy risk burden in relationship to any testing of a newly designed drug or device as part of their experiences in the research study. Presently, despite the risks borne by the research study participant, the raw data collected from volunteers in research trials are treated by courts as if they were the private property of the study sponsor rather than generally owed to the public as would be expected by an effort like research participation aimed at contributing to the development of generalizable knowledge. This paper reviews the obligations that study sponsors owe to their study participants based on the very definition of research as a systematic activity whose purpose is to develop generalizable knowledge to help all humans. Author Recommends Court cases Canterbury v. Spence, United States Court of Appeals, District of Columbia Circuit 464 F.2d 772 (1972). (Federal appellate decision heard in the District of Columbia, USA) Reibl v. Hughes, 2 S.C.R. 880 (1980). (Supreme Court of Canada) Rogers v. Whitaker, 175 C.L. R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Canterbury v. Spence is the landmark Federal informed consent case in the United States heard in the District of Columbia. In this case, Judge Spottswood Robinson articulated the reasonable person standard of informed consent. This standard was subsequently adopted by the Supreme Court of Canada (Reibl v. Hughes, 2 S.C.R. 880 (1980)) and the High Court of Australia (Rogers v. Whitaker, 175 C.L. R. 479 (1992)). The House of Lords rejected the reasonable person standard in England in Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985). Book Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. This book is a detailed guide for the review of scientific and ethical aspects of research on humans contained in the research study protocols and research informed consent forms which need to be submitted by study sponsors and principal investigators to institutional review boards (IRBs) for IRB review before a research study can receive approval to be conducted within a human study population in those institutions over which the IRB has authority. It also presents basic definitions in the area of research on humans and basic approaches to help conduct a deep review of the underlying scientific and ethical issues that are present within a research study protocol and its accompanying research informed consent form. Report National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). This U.S. National Commission in the Belmont Report argued for the necessity of a reasonable volunteer standard in research on humans in the United States. Arguing that the professional standard and the reasonable person standard of consent and informed consent were insufficient to base a disclosure standard in research on humans, this National Commission developed the reasonable volunteer standard where a study participant is to be approached in research informed consent with that information that a reasonable volunteer would want to know. Online Materials Belmont Report: Syllabus Topics for Lecture and Discussion Week I: Introduction and Overview Readings: Rogers v. Whitaker, 175 C.L.R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week II: The Different Standards of Consent and Informed Consent Readings: Canterbury v. Spence, 464 F.2d 772 (1972). (Federal appellate opinion heard in the District of Columbia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week III: Definition of Research Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 2 and 3) Week IV: How to Review a Research Study Protocol and Research Informed Consent Form Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 4–6, 10, and 12–14) Week V: Obligations in Research of Humans Versus Patient Care Reading: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). Focus Questions • How do the judicial doctrines of consent in England and Australia compare to the judicial doctrines of informed consent in the United States and Canada? • How does a professional standard of disclosure differ from a reasonable person standard of disclosure? • What is the definition of research? • How is a research study (study proposal and research informed consent form) reviewed from scientific and ethical bases for considerations of approval by an IRB? • How do the obligations of a study sponsor, a principal investigator, and a research team conducting a research trial on human study participants differ from the obligations of a physician caring for a patient? • Should all raw data of research derived from humans be made available to the public for use in developing generalizable knowledge to help others, or should raw data be considered the private property of the study sponsors (for example, prescription drug manufacturers), who fund the research trials? Seminar/project Idea Draw a timeline of the development of the basic concepts of consent and informed consent in patient care and in patient research. On this timeline, first place the dates of the key court cases in England, the United States, Canada, and Australia on consent and informed consent. Then place the date of the development of the Belmont Report. Why do differences exist between these four countries in terms of the legal requirements of informedness of a patient (in medical care) and a study participant (in medical research)? What roles if any do the concepts of self‐determination and self‐decision have in consent and informed consent in patient care and in informed consent in research on humans among the four countries of interest? What are the realities of research on human participants that require a new standard of informed consent, the reasonable volunteer standard, to be developed beyond the two standards in patient care, the professional standard, and the reasonable person standard? Counterpoint Arguments The following are counterpoint arguments that need to be appreciated to more fully understand the concepts that impact the thesis that ‘raw data’ should be open to the public to allow the opportunity of checking of the results of its associated scientific paper and for further analysis. De‐Identified (Anonymized) Raw Data A current approach to identifying (anonymizinig) raw data is based on the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L.104‐191). HIPAA was enacted by the U.S. Congress in 1996 to keep a person’s medical information private. In a research study, a person’s private medical information can become research data. HIPAA’s Privacy Rule allows a covered entity to de‐identify data by removing all 18 elements that could be used to identify the individual or the individual’s relatives, employers, or household members; these elements are enumerated in the Privacy Rule. The covered entity must also have no actual knowledge that the remaining information could be used alone or in combination with other information to identify the individual who is the subject of the information. Under this method, the identifiers that must be removed are the following: 1 Names. 2 All geographic subdivisions smaller than a state, including street address, city, county, precinct, ZIP Code, and their equivalent geographical codes, except for the initial three digits of a ZIP Code if, according to the current publicly available data from the Bureau of the Census: 2a. The geographic unit formed by combining all ZIP Codes with the same three initial digits contains more than 20,000 people. 2b. The initial three digits of a ZIP Code for all such geographic units containing 20,000 or fewer people are changed to 000. 3 All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, and date of death, and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older. 4 Telephone numbers. 5 Facsimile numbers. 6 Electronic mail addresses. 7 Social security numbers. 8 Medical record numbers. 9 Health plan beneficiary numbers. 10 Account numbers. 11 Certificate/license numbers. 12 Vehicle identifiers and serial numbers, including license plate numbers. 13 Device identifiers and serial numbers. 14 Web universal resource locators (URLs). 15 Internet protocol (IP) address numbers. 16 Biometric identifiers, including fingerprints and voiceprints. 17 Full‐face photographic images and any comparable images. 18 Any other unique identifying number, characteristic, or code, unless otherwise permitted by the Privacy Rule for re‐identification. Even though ‘raw data’ can be de‐identified (anonymized) so that there is no way to trace back the data to the study participant from which it was drawn, there are still questions whether the ‘de‐identified raw data’ can be given to other researchers or made public without the original study participant’s approval. It may be the case that this approval could be done at the start of any research study where the individual considering study participation would be counseled on what the process of de‐identification consists of and would be asked whether the participant would allow use of the data by other researchers or made available to the public in a de‐identified state. However, there may be questions of the study participants as to whether the data are truly de‐identified and untraceable back to the study participant since the participant would not be able to see the process actually being carried out in detail in all relevant circumstances. Using Raw Data in Context Simply being in possession of raw data is never enough to build on that data from a research perspective. Researchers need to understand the context of the scientific research study in which the data were collected. This research context includes (but is not limited to): (i) the scientific hypothesis of the research study, (ii) the inclusion and exclusion criteria selected by the research designers of the study to determine which study participants were included and which were excluded from the study, (iii) the methods used to collect the data and possibilities of errors in the data collection processes, and (iv) answers to questions regarding whether any data were excluded from the study data and why these data were excluded. Ownership Rights Over Data There are ownership rights over data. Ownership rights include court decision making related to the question which parties are to be considered as the owners of the data. Possible owners here include (but are not limited to) (i) the study sponsor whose only role was to fund that study, (ii) the principal investigator(s) who developed the scientific hypothesis, and (iii) individual study participants through special contracts made by individual participants who negotiate such contracts with study sponsors and principal investigators to share in the ownership of data. Examples of such data are participant sources of unique gene lines or unique cell lines to be used in future research. Objections to Data Sharing Finally, individual researchers may simply object to sharing data. A researcher’s arguments here may be simply stating that he or she has a right to fully analyze the data since the collection of the data was the researchers’ idea in the first place. These researchers may argue that they have the right to mine the data as fully as they can before deciding to make the data open to the public for others to analyze. Works Cited 1 Kaiser, J. ‘Making Clinical Data Widely Available.’Science 322.5899 (10 Oct. 2008): 217–8. 2 de Lusignan, S., J.F. Metsemakers, P. Houwink, V. Gunnarsdottir, and J. van der Lei. ‘Routinely Collected General Practice Data: Goldmines for Research? A Report of the European Federation for Medical Informatics Primary Care Informatics Working Group (EFMI PCIWG) from MIE2006, Maastricht, The Netherlands.’Informatics in Primary Care 14.3 (2006): 203–9. 3 Sim, I. ‘Human Studies Database Project’, CTSA Data Repositories Symposium (17 Oct. 2008). 23 Nov. 2010. 4 Sim, I., C.G. Chute, H. Lehmann, R. Nagarajan, M. Nahm, and R.H. Scheuermann. ‘Keeping Raw Data in Context.’Science 323.5915 (6 Feb. 2009): 713. 5 U.S. Department of Health and Human Services, National Institutes of Health, HIPAA Privacy Rule, Information for Researchers. 13 Nov. 2010. 6 Wilczynski, N.L., R.B. Haynes, and Hedges Team. ‘EMBASE Search Strategies for Identifying Methodologically Sound Diagnostic Studies for Use by Clinicians and Researchers.’BMC Medicine 29.3 (March 2005): 7. (shrink)

In their article, Crutchfield and Redinger (2024) outline the conditions that they have identified as situations in which it is ethically permissible to use chemical restraints, defined as medicati...

Originally published in 1936, this book presents the ancient Greek text of the paraphrases and quotations of Zeno's philosophical arguments, together with a facing-page English translation and editorial commentary. Detailed notes are incorporated throughout and a bibliography is also included. This book will be of value to anyone with an interest in Zeno and ancient philosophy.

Explores mind-body philosophy from an Asian perspective.

The ontic structural realist stance is motivated by a desire to do philosophical justice to the success of science, whilst withstanding the metaphysical undermining generated by the various species of ontological underdetermination. We are, however, as yet in want of general principles to provide a scaffold for the explicit construction of structural ontologies. Here we will attempt to bridge this gap by utilizing the formal procedure of quantization as a guide to ontic structure of modern physical theory. The example of (...) non-relativistic particle mechanics will be considered and, for that case, it will be shown that a viable candidate for an ontic structural realism framework can be constituted in terms of the combination of a state-space with Poisson bracket structure, and a set of observables, with Lie algebra structure. 1 Introduction2 Formulation Underdetermination and Structural Ontologies3 Quantization and Structural Ontologies4 The Case of Non-relativistic Particle Mechanics4.1 Formulation underdetermination4.2 The classical ontology4.3 Quantum theory and the generalized structural ontology4.4 Interpretation of results5 Conclusion and Prospects. (shrink)

Beliefs are freely attributed to God nowadays in Anglo–American philosophical theology. This practice undoubtedly reflects the twentieth–century popularity of the view that knowledge consists of true justified belief . The connection is frequently made explicit. If knowledge is true justified belief then whatever God knows He believes. It would seem that much recent talk of divine beliefs stems from Nelson Pike's widely discussed article, ‘Divine Omniscience and Voluntary Action’. In this essay Pike develops a version of the classic argument for (...) the incompatibility of divine foreknowledge and free will in terms of divine forebelief. He introduces this shift by premising that ‘ A knows X ’ entails ‘A believes X ’. As a result of all this, philosophers have increasingly been using the concept of belief in defining ‘omniscience’. (shrink)

Cheating is a serious issue among business students worldwide. However, research investigating the social factors that may help prevent cheating in Chinese higher education is rare. The present study examined two key social relationship factors of perceived teacher-student relationships and peer relationships by the students. It attempted to build a model which addressed the effects of two variables on Chinese business students’ cheating behaviour: the teacher’s approachability and the relationship goal of the students. Two important social influence factors were also (...) tested as mediators: neutralizing attitudes and perceived cheating norms of the students. A student survey was conducted with 1329 questionnaires collected. The results showed the negative effects of both social relationship variables on cheating, and that their effects were fully mediated by neutralizing attitudes. Moreover, perceived cheating norms fully mediated the effect of the teacher’s approachability, but not so for the relationship goal of the students. This study provided novel insights and recommendations for promoting academic integrity in Chinese business schools and universities. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Sacramental Wisdom:Humilitatio, Eruditio, Exercitatio in the Scholastics and TodaySr. Albert Marie Surmanski O.P.IntroductionThe relationship between human nature and the sacraments is often characterized in a way that takes away from the beauty and power of the sacraments. Sacraments are sometimes viewed today as something basically irrelevant to human life, an interesting spiritual "option" for those who find comfort in ritual. This view leads to a sacramental practice that is (...) occasional, irregular, or nonexistent. Many young people who fail to grasp religion as important to their reality implicitly embrace this perspective. The difficulty parishes have had in the past few years in convincing parishioners to return to liturgical prayer after each wave of the coronavirus pandemic demonstrates this viewpoint.In another perspective, the sacraments might be viewed precisely as expressions of what it means to be human, or one might say, to be human in a world in which God reveals himself at all times.1 In this view, the sacraments [End Page 1391] are our own graced self-expression as a community. They merely make thematic what already happens each moment. Alternatively, they celebrate who we are, and perhaps can be radically updated to reflect changing categories of social identity. 2Both of these viewpoints overlook the fallen state of human nature that cries out for healing from God. The first view does not preclude knowledge of human violence and fragility, but fails to recognize the sacraments as a medicine needed for the remedy of human ills. The second viewpoint, while professing a need for Christ, looks to the human person or community for healing rituals. This approach risks being enmeshed with human nature in a disordered state in such a way that it celebrates human disorder instead of healing it. Alternatively, the viewpoint may lead to the abandonment eschatological hope and wither into inanity.There are profound metaphysical and anthropological issues that play out in these two opposite but strangely united viewpoints. Rather than directly analyze these errors, this paper would like to propose the recovery of a medieval viewpoint that offers another perspective. This is Hugh of St. Victor's explanation that the sacraments fit and heal human nature through offering humanity humility, instruction, and exercise. 3 This paper will briefly survey Hugh's contribution, analyze its reception by several of the thirteenth-century Scholastics, shows its deep rootedness in biblical wisdom, and then show how it fruitfully opposes current-day challenges.Hugh of St. VictorHugh of St. Victor was a twelfth-century canon of the Parisian Abbey of St. Victor. The most influential writer of the Victorine school, his work is characterized by an Augustinian concern for the re-formation of the image of God in man, a sense of the wise ordering of salvation history, and an emphasis on both virtue and liturgical practice. In his masterwork, De Sacramentis Christianae Fidei, Hugh of St. Victor divides the works of God into two main periods: the work of creation and the work of restoration. Within the [End Page 1392] work of restoration, there are three periods: the period of the natural law, that of the Mosaic or written law, and that of grace, inaugurated by Christ.4 His book's division into two parts cuts across these distinctions: Part 1 of Hugh's text covers creation, the restoration in general, faith, sacraments in general, as well as particulars of the sacraments of the periods of the natural and written law. Part 2 includes the Incarnation, the Church, various Christian rituals, and the final restoration of Christ's return.Hugh is writing around the time when theologians began to list the number of the sacraments of the Church as seven. Emerging from the wider use of the term, Hugh uses the word "sacrament" in a wide sense, but distinguishes several categories of sacraments. Following Dominique Poirel, scholars recognize that Hugh uses the word sacramentum in five main ways.5 The first is a general definition: (1) any sign of anything sacred. The second through fourth are more specific usages, to which we do not commonly give the term "sacrament" today: (2) Scripture, which signifies sacred realities both through its text and the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesZohar Lederman, Ola Ziara, Rachel Coghlan, Oksana Sulaieva, Anna Shcherbakova, Oleksandr Dudin, Vladyslava Kachkovska, Iryna Dudchenko, Anna Kovchun, Lyudmyla Prystupa, Yuliya Nogovitsyna, Ghaiath Hussein, Kathryn Fausch, P. P. Kyaw, Ayesha Ahmad, Richard W Sams II, Handreen Mohammed Saeed, Artem Riga, Ryan C. Maves, Elizabeth Dotsenko, Irina Deyneka, Eva V. Regel, and Vita Voloshchuk• An Unsettling Affair• How We Keep Caring While Walking Through Our Pain• (...) Adjusting Laboratory Practices to the Challenges of Wartime• Why We Stay• A Semi-Personal Story from a Ukrainian NGO Professional (or a Semi-Professional Story from a Ukrainian Person) Living through the War• When Ethics Survives Where People Do Not: A Story From Darfur• Burma’s Healthcare Under Fire: My Experience as an Exiled Medical Professional• When a Conflict Collapses on a Child: An (Aborted) Medical Evacuation of a Hazara Toddler During the Kabul Airport Blast and the Taliban Takeover• The Vagaries and Vicissitudes of War• Providing Care to a Potential Aggressor: An Ethical Dilemma• One Surgeon’s Experience During Armed Conflict in Ukraine• The Limits of Our Obligations• A Liberating Breath• Soldiers of the Invisible Front: How Ukrainian Therapists Are Fighting for the Mental Health of the Nation Under Fire• Stories of Families with Chronically Ill Pediatric Patients during the War in UkraineCopyright © 2023 Johns Hopkins University Press... (shrink)

Introduction 1 P. D. Magnus and Jacob Busch 1. Form-driven vs. Content-driven Arguments for Realism 8 Juha Saatsi 2. Optimism about the Pessimistic Induction 29 Sherrilyn Roush 3. Metaphysics between the Sciences and Philosophies of Science 59 Anjan Chakravartty 4. Nominalism and Inductive Generalizations 78 Jessica Pfeifer 5. Models and Scientific Representations 94 Otávio Bueno 6. The Identical Rivals Response to Underdetermination 112 Gregory Frost-Arnold and P. D. Magnus 7. Scientific Representation and the Semiotics of Pictures 131 Laura Perini 8. (...) Philosophy of the Environmental Sciences 155 Jay Odenbaugh 9. Value Judgements and the Estimation of Uncertainty in Climate Modeling 172 Justin Biddle and Eric Winsberg 10. Feminist Standpoint Empiricism: Rethinking the Terrain in Feminist Philosophy of Science 198 Kristen Intemann 11. Naturalism and the Enlightenment Ideal: Rethinking a Central Debate in the Philosophy of Social Science 226 Daniel Steel 12. New Approaches to the Division of Cognitive Labor 250 Michael Weisberg. (shrink)

1. The Tractatus doctrine of saying and showing In a letter to Russell dated 19.4.1919, written shortly after he had finished the Tractatus, Wittgenstein told Russell that the main contention of the book, to which all else, including the account of logic, is subsidiary, ‘is the theory of what can be expressed (gesagt) by prop[osition]s -- i.e. by language -- (and, which comes to the same, what can be thought) and what cannot be expressed by prop[osition]s, but only shown (gezeigt); (...) which I believe is the cardinal problem of philosophy’ (CL 68). This was emphasized in both preface and conclusion of the book. The preface observes that the whole sense of the book can be summed up in the following words: ‘what can be said at all can be said clearly, and what we cannot talk about we must pass over in silence’ (TLP p.3). The conclusion of the book (TLP 7) simply repeats this. The preceding three remarks, however, are noteworthy. They make three claims. First, ‘There are, indeed, things that cannot be put into words. They make themselves manifest. They are what is mystical’ (TLP 6.522). This reiterates the leitmotif of the book, namely that there are things that cannot, by the very nature of representation, be said. But though they cannot be said, they are shown by features of the relevant system of representation. Secondly, the correct method in philosophy would really be to say nothing except what can be said, i.e. empirical propositions that have nothing to do with philosophy, and then, when someone wanted to say something metaphysical, to demonstrate to him that he had failed to give meaning to certain signs in his propositions (TLP 6.53). This method, of course, is not the method that has been followed throughout the book, which consists almost exclusively of modal assertions concerning what must, can or cannot be thus and so in reality, in language and in the relation between language and reality.. (shrink)

The reimagined Battlestar Galactica series (2003–2009) and its prequel series Caprica (2009–2010) provoked viewers to consider anew perennial philosophical questions regarding, among others, the nature of personhood and the role of religion in culture and politics. While no single philosophical viewpoint encapsulates the creators’ vision as a whole, the theory of biopolitics, as formulated by Michel Foucault, Giorgio Agamben, and others, is a fruitful lens through which various points of story and character development may be analyzed. Two noteworthy areas of (...) attention are, first, whether a race of intelligent, self-aware beings, who have been artificially created, should be considered “persons” with attendant moral and legal status, and second, whether the purported ontological division between the “biological” and the “artificial” has moral import concerning the degree of control one class of beings may legitimately exercise over another. (shrink)

The COVID-19 pandemic provided an opportunity for management scholars to address large-scale and complex societal problems and strive for greater practical and policy impact. A brief overview of the most-cited work on COVID-19 reveals that, compared with their counterparts in other disciplines, leading management journals and professional associations lagged in providing a platform for high-impact research on COVID-19. To help management research play a more active role in responding to similar global challenges in the future, we propose an integrative framework (...) that emphasizes a phenomenon’s impact, the conditions that the phenomenon creates at multiple levels, and the responses of actors to such conditions, as well as the dynamic relationships and interactions among these actors. By shifting attention to phenomena and their overall impact, this framework can help scholars better position their work to address large-scale and complex problems and also to assess research for its contribution to generate impact beyond academia. (shrink)

The decision whether to have a realist or an anti-realist attitude towards scientific hypotheses is interpreted in this paper as a choice that scientists themselves have to face in their work as scientists, rather than as a ‘philosophical’ problem. Scientists’ choices between realism and instrumentalism (or other types of anti-realism) are interpreted in this paper with the help of two different conceptual tools: a deflationary semantics grounded in the inferentialist approach to linguistic practices developed by some authors (e.g., Sellars, Brandom), (...) and an epistemic utility function that tries to represent the cognitive preferences of scientists. The first tool is applied to two different questions traditionally related to the problem of scientific realism: the non-miracle argument, and the continuity of reference. The second one is applied to the problem of unconceived alternatives, and to the distinction between realist and instrumentalist attitudes towards scientific hypotheses. (shrink)

The study relevance lies in understanding strategic objectives' content concerning intelligent technologies’ application. The development and application of artificial intelligence in various branches of human activity carry the potential for global changes in society, which, in methodological terms, increases the relevance of considering these problems. The study of ethical problems of artificial intelligence in the concept of sustainable development of society is connected with the dynamic development of innovative artificial intelligence (AI) technologies, which are considered a process of becoming a (...) new technosubject in the context of neuroscience development. The article emphasizes that the development of artificial intelligence acts as an innovative form of technology development when a new kind of human-machine technosubject is formed. The authors identify social problems of artificial intelligence application as the digitalization of life becomes a global anthropological challenge. Innovations of artificial intelligence are directly related to a number of ethical problems, as they contribute not only to the sustainable development of society but also cause dehumanization of relations between people and society. Based on the analysis of qualitative changes in scientific and technological research, using human-machine devices is becoming inevitable. Humankind must develop ethical guidelines for the application of AI systems. (shrink)

Glowacki defines peace as harmonious relationships between groups maintained without the threat of violence, where groups can be anything from families to nation states. However, defining such contentious concepts like “peace” and “groups” is a difficult task, and we discuss the implications of Glowacki's definitions for understanding intergroup relationships and their evolutionary history.

The Secret Doctrine comprises a virtual encyclopaedia of the "anciently universal wisdom-tradition" -- scarcely an issue of consequence in the broad range of human experience is left untouched. As part of the Secret Doctrine Centenary project, this 441-page Index provides ready access to the vast quantity of material from many cultures set forth in the SD's original two volumes published in 1888. Due to the topics covered, it is as much an index of ideas as it is of subjects, works, (...) persons, and proper names. To aid the reader, major subject entries are cross-referenced; foreign terms are identified by language and, where possible, given in both their 1888 spelling(s) and as modernly transliterated, often with one or two word definitions. Subentries are arranged alphabetically. Cited works and authors, whose titles or names are not given in the SD are placed in brackets for convenient identification. Also included is an Appendix of foreign phrases with translation and source reference -- all helping to make this Index an invaluable reference tool for students of The Secret Doctrine. (shrink)

The scientist’s decision of accepting a given proposition is assumed to be dependent on two factors: the scientist’s ‘private’ information about the value of that statement and the proportion of colleagues who also accept it. This interdependence is modelled in an economic fashion, and it is shown that it may lead to multiple equilibria. The main conclusions are that the evolution of scientific knowledge can be path-dependent, that scientific revolutions can be due to very small changes in the empirical evidence, (...) and that not all possible equilibria are necessarily efficient, neither in the economic nor in the epistemic sense. These inefficiencies, however, can be eliminated if scientists can form coalitions. (shrink)

The federal government is funding a sea change in health care by investing in interventions targeting social determinants of health, which are significant contributors to illness and health inequity. This funding power has encouraged states, professional and accreditation organizations, health care entities, and providers to focus heavily on social determinants. We examine how this shift in focus affects clinical practice in the fields of oncology and emergency medicine, and highlight potential areas of reform.

Software piracy is an instance of unauthorized duplication of information goods where laws and norms are not agreed-upon. This article presents a content analysis of articles from the five highest circulating U.S. newspapers 1989-2004 as evidence of the prevailing social environment surrounding software piracy. The rationales in the news articles are analyzed as evidence of the social and psychological underpinnings of attitudes toward software piracy. An expanded version of Sykes and Matza's (American Sociological Review 22, 664-670, 1957); Zamoon and Curley (...) (Working paper, Kuwait University, Kuwait, 2007) neutralization framework is applied to analyze the content of the articles. We found that rationales condoning piracy showed a more balanced use of neutralization approaches, and less moral intensity toward the behavior. In contrast, rationales condemning piracy mostly promoted the injury aspect of software piracy, and suggested higher moral intensity. The discrepancies have practical implications as a barrier to the ability to connect the two sides of the debate concerning software piracy. (shrink)

Suppose COVID-19 is the runaway tram in the famous moral thought experiment, known as the “Bystander at the Switch.” Consider the two differentiated responses of governments around the world to this new threat, namely the option of quarantine/lockdown and herd immunity. Can we contrast the hypothetical with the real scenario? What do the institutional decisions and strategies for dealing with the virus, in the beginning of 2020, signify in a normative moral framework? This paper investigates these possibilities in order to (...) highlight the similarities and, more importantly, the differences that exist between utilitarianism and Kantian ethics. Analysis shows that the hypothetical scenario can never be fully compared to the complex multifactorial nature of the real world. But if a comparison is attempted, the most obvious difference between the two governmental strategies is the concept of duty within the Kantian perspective. Ultimately, it is a matter of comparing freedom and life. Attributing a moral “priority ticket” to one or the other can be analysed through interpersonal aggregation. (shrink)

Steinsvold (2020) has provided two semantics for the basic modal language enriched with propositional quantifiers (∀p). We define an extension EM of the system KD45_{\Box} and prove that EM is sound and complete for both semantics. It follows that the two semantics are equivalent.

In lieu of an abstract, here is a brief excerpt of the content:The Adoro Te Devote of St. Thomas AquinasSr. Lucia Marie of the Visitation Langford O.P.The Adoro te devote is perhaps the most well-beloved Eucharistic hymn of our time, popularly attributed to St. Thomas Aquinas, the medieval Dominican friar known for his theological treatises as well as his Eucharistic hymnography. Unlike most of Aquinas's work, the poem reveals the intensely personal side of his faith. Rich in theological content and (...) inspiring deep Eucharistic devotion, this poem amply repays a closer investigation. We will look first at the questions of authorship, background, and structure before moving on to a discussion of the text itself.The "Disputed Question" of AuthorshipWhile the Adoro te has traditionally been attributed to St. Thomas Aquinas, the Thomistic authorship of the text was contested in the twentieth century, with two main objections being raised. The first claims that the content of the poem contradicts Thomas's own teachings and cannot have flowed from the same pen. The second objection is historical, claiming that a lack of evidence makes Thomistic authorship improbable.The first objection, claiming that the content of the poem is irreconcilable with Thomistic authorship, takes objection to a line in the poem which seems to claim that sense perception is unreliable and inaccurate, at least with regard to the Eucharist. The text of the Adoro te uses the word fallitur (deceived) with reference to the senses: "Visus, tactus, gustus in te fallitur"—"Sight, touch, taste in you are deceived." Some scholars have claimed that this line contradicts the teaching of Aquinas that the senses are [End Page 365] infallible in regard to their proper sensibles.1 Robert Wielockx addresses this charge in his study of the Adoro te, arguing that "the text does not contradict the continuous teaching of Thomas according to which the senses are not wrong when they judge their proper object, which as far as the Eucharist is concerned, is only the sacramental species."2 The substantial presence of Christ in the Eucharist is a mystery which is not knowable by the senses, and as Paul Murray, O.P., observes: "That's surely the point St. Thomas is making."3 However, the Thomistic insistence that all knowledge comes through our senses is not missing even here. While sight, touch, and taste fall short of comprehending the truth before them, the Adoro te itself proclaims that it is another sense—hearing—which reveals the mystery: "sed auditu solo tute creditur"—"but by hearing alone it is safely believed."4Thus there is no solid objection to Thomistic authorship based on the poem's content. But what about the historical evidence? Dom André Wilmart published a comprehensive study of the manuscript tradition in 1929. Noting that there were no extant copies of the text dating to Aquinas's lifetime and that the biography of Aquinas written by his own Dominican confrere and contemporary, William of Tocco, made no mention of the Adoro te, he considered it most probable that the poem was authored at a later date and ascribed to Aquinas.5However, Dom Wilmart did not know that he was not working with William of Tocco's final version of his work. The publication of a critical edition of William of Tocco's Ystoria Sancti Thome de Aquino in 1996 demonstrated that Tocco published his work in four successive redactions. The fourth and final version of his text (unknown to Dom Wilmart) was finished just before his death in 1323, and in this final version, Tocco includes the text of the Adoro te, attributing its authorship to St. Thomas.6 [End Page 366] Furthermore, Wielockx published a study of the Adoro te in 1998; his investigation of the manuscript tradition found that, of fifty-one sources, forty-four explicitly cite St. Thomas as their author. The remaining sources simply lacked any attribution. We may thus conclude with Wielockx: "External evidence, which must be given priority in sound criticism, wholly favors Thomas Aquinas's authorship of the poem."7BackgroundWith the attribution of the poem to St. Thomas Aquinas on secure footing, we now move to the background of the poem. Unlike Aquinas's Eucharistic hymns such as... (shrink)

info:eu-repo/semantics/publishedVersion.

IntroductionBisphenol A is highly debated and studied in relation to a variety of health outcomes. This large variation in the literature makes BPA a topic that is prone to selective use of literature, in order to underpin one’s own findings and opinion. Over time, selective use of literature, by means of citations, can lead to a skewed knowledge development and a biased scientific consensus. In this study, we assess which factors drive citation and whether this results in the overrepresentation of (...) harmful health effects of BPA.MethodsA citation network analysis was performed to test various determinants of citation. A systematic search identified all relevant publications on the human health effect of BPA. Data were extracted on potential determinants of selective citation, such as study outcome, study design, sample size, journal impact factor, authority of the author, self-citation, and funding source. We applied random effect logistic regression to assess whether these determinants influence the likelihood of citation.ResultsOne hundred sixty-nine publications on BPA were identified, with 12,432 potential citation pathways of which 808 citations occurred. The network consisted of 63 cross-sectional studies, 34 cohort studies, 29 case-control studies, 35 narrative reviews, and 8 systematic reviews. Positive studies have a 1.5 times greater chance of being cited compared to negative studies. Additionally, the authority of the author and self-citation are consistently found to be positively associated with the likelihood of being cited. Overall, the network seems to be highly influenced by two highly cited publications, whereas 60 out of 169 publications received no citations.ConclusionIn the literature on BPA, citation is mostly driven by positive study outcome and author-related factors, such as high authority within the network. Interpreting the impact of these factors and the big influence of a few highly cited publications, it can be questioned to which extent the knowledge development in human literature on BPA is actually evidence-based. (shrink)

Moulines’ arguments against several types of realism in his book Pluralidad y recursion are considered and a defence of scientific realism consistent with structuralism is offered as a plausible answer to Moulines’ criticisms.

The process of scientific investigation is reconstructed as a process of empirical approximation to the truth. This last concept is explicated as a combination of “degree of simmilarity between theory A and the strongest accepted empirical law at moment t” and the “degree of depth of this empirical law”. A number of methodological theorems are proved, and avision of science closer to sophisticated falsificationism is mathematically deduced from our definitions.