In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office issued the report Scientific Research: Continued Vigilance Critical to Protecting Human Subjects. It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always clear (...) to clinicians. Controversy exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

When a patient visits his doctor there is, as well as a spoken dialogue, also an unspoken, or tacit, dialogue between them. This may not be evident unless that dialogue breaks down when the psychological or moral terms of reference of each are seen to be different. The author of this paper tries to elucidate the framework in which physician and patient think, and in so doing allow an understanding of why the physician may appear to be rigid and authoritarian (...) in his dealing with his patients and the patient uncooperative. (shrink)

"The fixed person for fixed duties, who in older societies was such a godsend, in the future ill be a public danger." Twenty years ago, a single legal metaphor accurately captured the role that American society accorded to physicians. The physician was "c- tain of the ship." Physicians were in charge of the clinic, the Operating room, and the health care team, responsible - and held accountabl- for all that happened within the scope of their supervision. This grant of responsibility (...) carried with it a corresponding grant of authority; like the ship's captain, the physician was answerable to no one regarding the practice of his art. However compelling the metaphor, few would disagree that the mandate accorded to the medical profession by society is changing. As a result of pressures from a number of diverse directions - including technological advances, the development of new health professionals, changes in health care financing and delivery, the recent emphasis on consumer choice and patients' rights - what our society expects phy- cians to do and to be is different now. The purpose of this volume is to examine and evaluate the conceptual foundations and the moral imp- cations of that difference. Each of the twelve essays of this volume assesses the current and future validity of the "captain of the ship" metaphor from a different perspective. The essays are grouped into four sections. In Section I, Russell Maulitz explores the physician's role historically. (shrink)

This paper attempts to explore a number of conceptual issues surrounding genetic testing. It looks at the meaning of the terms, genetic information and genetic testing in relation to the definition set out by the Advisory Committee on Genetic Testing in the UK, and by the Task Force on Genetic Testing in the USA. It argues that the special arrangements that may be required for the regulation of genetic tests should not be determined by reference to the nature or technology (...) of the test, but by considering those morally relevant features that justify regulation. Failure to do so will lead to the regulation of genetic tests that need not be regulated, and would fail to cover other tests which should be regulated. The paper also argues that there is little in the nature of the properties of gene tests, using DNA or chromosomes, that in itself justifies a special approach. (shrink)

I propose to begin with some fairly unexciting and uncontroversial remarks about possibility-statements, and then in their light to examine two problems philosophers have raised about certain statements of this kind which might be made in Christian theology where it touches on the doctrine of the Incarnation.

Mr D. H. Mellor, in his article of this title in Religious Studies , Vol. 5 , distinguishes three senses of words such as ‘probable’ which might be used in a religious context, especially in that of attempted theistic proofs: statistical, subjective, and inductive probability. In each case he concludes that it is misleading to use these words in such contexts at all. With his discussion of the second I do not wish to quarrel; but there seem to me to (...) be serious defects in his discussions of the first and third. (shrink)

The ‘traditional’ view among philosophical theologians, that God is eternal not merely in the sense of being everlasting but in the sense of being outside time altogether, has come under sharp criticism in recent years, both from biblical theologians and from philosophers. It is against the latter form of attack, particularly as represented by the detailed criticisms of Professor Nelson Pike, that I wish to try and defend the notion of a divine timelessness.

When philosophers approach philosophy of religion, they typically ask two questions: are there any sound arguments to prove the existence of God; and is talk about God even rationally intelligible? Theologians, for their part, primarily expound the meaning and relevance of Christianity. I am by profession a philosopher, but apart from Secs. VI and VII I am here writing as a puzzled twentieth-century man. My prime worry is whether we philosophers and theologians are beginning with the right questions.

I have come to believe that the whole framework of our current thought is about to begin a long and radical transformation, based on what I shall call a new science of pure consciousness. The content of most of the matters to be considered by this science have hitherto been the concern of some areas of religion, particularly what in our culture we call ‘mysticism’; but the treatment of it would legitimately be called scientific. Thus one aspect of the transformation (...) would be to overcome that apparent conflict between ‘science’ and ‘religion’, which has been so characteristic of our culture over the last few centuries. (shrink)

Alberto Cortes, in [1], attempts to show that Leibniz's Principle of The Identity of Indiscernibles is a principle restricted to individuals, and that photons appear to violate L. L is stated by Leibniz as “no two substances are completely similar, or differ solo numero.” In second-order quantification theory with identity L becomes.

This paper explores the use of advance directives in clinical dementia research. The focus is on advance consent to participation of demented patients in non-therapeutic research involving more than minimal risks and/or burdens. First, morally relevant differences between advance directives for treatment and care, and advance directives for dementia research are discussed. Then attention is paid to the philosophical issue of dementia and personal identity, and the implications for the moral authority of research advance directives. Thirdly, a number of practical (...) shortcomings of advance directives for non-therapeutic dementia research are explored and attention is paid to the role of proxies. It is concluded that upon a closer look the initial attractiveness of advance directives for dementia research is lessened, and that it is doubtful whether these instruments can compensate for the lack of subject consent in case of non-therapeutic dementia research involving more than minimal risks and/or burdens for the incompetent demented subject. (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.

The notion of autonomy commonly employed in medical ethics literature and practices is inadequate on three fronts: it fails to properly identify nonautonomous actions and choices, it gives a false account of which features of actions and choices makes them autonomous or nonautonomous, and it provides no grounds for the moral requirement to respect autonomy. In this paper I offer a more adequate framework for how to think about autonomy, but this framework does not lend itself to the kinds of (...) practical application assumed in medical ethics. A general problem then arises: the notion of autonomy used in medical ethics is conceptually inadequate, but conceptually adequate notions of autonomy do not have the practical applications that are the central concern of medical ethics. Thus, a revision both of the view of autonomy and the practice of “respect for autonomy” are in order. (shrink)

Sham surgery is a controversial and rarely used component of randomised clinical trials evaluating surgical interventions. The recent use of sham surgery in trials evaluating efficacy of intracerebral fetal tissue grafts in Parkinson’s disease has highlighted the ethical concerns associated with sham surgery controls. Macklin, and Dekkers and Boer argue vigorously against use of sham surgery controls. Macklin presents a broad argument against sham surgery controls while Dekkers and Boer present a narrower argument that sham surgery is unnecessary in the (...) specific setting of fetal tissue engraftment for Parkinson’s disease. I defend sham surgery controls against both these criticisms. Appropriate clinical trial design, sometimes including sham surgery, is needed to ensure that false positive trial results do not occur and endanger public safety. Results of a completed trial of fetal tissue grafting for Parkinson’s disease are used to illustrate the potential benefits of, and problems associated with, sham surgery controls. Sham surgery controls, however, should be employed only when absolutely necessary. I suggest criteria for appropriate use of sham surgery controls. (shrink)

This graduate-level_text by a master in the field builds a function theory of the rational field that combines aspects of classical and intuitionist analysis. Topics include recursive convergence, recursive and relative continuity, recursive and relative differentiability, the relative integral, elementary functions, and transfinite ordinals. 1961 edition.

Professor Plant has presented a briefer treatment of Hegel’s philosophical development than did H. S. Harris in Towards the Sunlight, and a considerably more historical, epistemological and metaphysical treatment than is presented in Pelcynski’s Hegel; Political Philosophy and not so exhaustive an account of the political and social philosophy as appears in Avineri’s Hegel’s Philosophy of the Modern State. These four books taken together testify to the importance of Hegel on the contemporary philosophic scene. Plant’s volume is perhaps the best (...) in that it pulls together the various philosophical, political, and social strains in brief compass, for he demonstrates quite convincingly, as did Avineri and Harris, that the political and metaphysical writings of Hegel are closely interconnected and that the interpretation of art and religion flow from his considered interpretation of his contemporary cultural situation. Plant, with Marx, Engels, Kierkegaard, Baur, Feuerbach et al. and against Findlay and Bergman, argues that there is a Christian theological residue in Hegel’s system, but surprisingly, the fruit of the system is clarification not mystification. Only with that residue is the system and totality really explicable. An altogether welcome book.—R.L.P. (shrink)

The volume contains new translations of the introduction and preface to the second edition of The Essence of Christianity and Principles of the Philosophy of the Future. This comprises about one-half of the book. The remainder is Hanfi’s fifty-page introduction and translations of "Towards a Critique of Hegel’s Philosophy," "The Beginning of Philosophy," "The Necessity of a Reform of Philosophy," "Preliminary Theses on the Reform of Philosophy," and "Fragments Concerning the Characteristics of My Philosophical Development." The translations are quite readable. (...) Hanfi’s introduction refers to the relation of Feuerbach to Marx in the first and third sections while the second is given over to a survey of Feuerbach’s development and thought. Another aspect, and one of the most suggestive, is at the end of the first section where Hanfi attempts to show how Feuerbach’s anthropology relates to Heidegger’s Daseinsanalytik. One of the most interesting sections of Feuerbach’s text is "On the beginning of Philosophy," for Kierkegaard, in the context of fathering another philosophy of a very different kind, came upon some of the same criticisms of Hegel’s philosophy. This translation, along with those of Essence of Christianity, and the more recent The Essence of Religion, The Essence of Faith According to Luther, and the book by Kamenka, The Philosophy of Ludwig Feuerbach, bespeak a renewed interest in the essential Feuerbach.—R.L.P. (shrink)

This paper was first presented at the Annual Meeting of the American Society of Christian Ethics, Toronto School of Theology, Toronto, Ontario in January 1977. Robert Shelton aims to focus on the concept of 'right to health care,' its related principle, 'distributive justice' in an attempt to suggest 'where we are' at present and where we perhaps ought to be heading. The paper is divided into three parts, which in their turn explore the moral grounds, the US general public's policy (...) and the part justice and government are likely to play in the development and distribution of health care. He concludes by highlighting 'omissions', an intentional one of his own and the other a major gap in the literature. (shrink)

Background Central to the involvement of children in health research is the notion of risk. In this paper we present one of the factors, a matter of trust, that shaped Canadian parents' and children's perceptions and assessments of risk in child health research. Participants and methods Part of a larger qualitative research study, 82 parents took part an in-depth qualitative interview, with 51 parents having children who had participated in health research and 31 having children with no research history. 51 (...) children ranging from 6 to 19 years of age were also interviewed, with 28 having a history of participation in child health research and 23 having no history. Children also took part in 3 focus groups interviews. Themes emerged through a grounded theory analysis of coded interview transcripts. Findings The presence or absence of trust was not only perceived by parents and children as a contributing factor to involving children in health research, but also shaped their perceptions and assessments of risk. Three interrelated subthemes identified were: (1) relationships of trust; (2) placing trust in symbols of authority; and (3) the continuum of trust. Conclusions Our study reinforces that trust is an important factor when parents assess risk in child health research and shows that children use the language of trust in relation to risk. More discussion regarding trust in training researchers is warranted given the trust in researchers and institutions evident in this study. We also recommend further study of the continuum of trust in child health research. (shrink)