BackgroundAlthough the number of reporting guidelines has grown rapidly, few have gone through an updating process. The STARD statement (Standards for Reporting Diagnostic Accuracy), published in 2003 to help improve the transparency and completeness of reporting of diagnostic accuracy studies, was recently updated in a systematic way. Here, we describe the steps taken and a justification for the changes made.ResultsA 4-member Project Team coordinated the updating process; a 14-member Steering Committee was regularly solicited by the Project Team when making critical (...) decisions. First, a review of the literature was performed to identify topics and items potentially relevant to the STARD updating process. After this, the 85 members of the STARD Group were invited to participate in two online surveys to identify items that needed to be modified, removed from, or added to the STARD checklist. Based on the results of the literature review process, 33 items were presented to the STARD Group in the online survey: 25 original items and 8 new items; 73 STARD Group members (86 %) completed the first survey, and 79 STARD Group members (93 %) completed the second survey.Then, an in-person consensus meeting was organized among the members of the Project Team and Steering Committee to develop a consensual draft version of STARD 2015. This version was piloted in three rounds among a total of 32 expert and non-expert users. Piloting mostly led to rewording of items. After this, the update was finalized. The updated STARD 2015 list now consists of 30 items. Compared to the previous version of STARD, three original items were each converted into two new items, four original items were incorporated into other items, and seven new items were added.ConclusionsAfter a systematic updating process, STARD 2015 provides an updated list of 30 essential items for reporting diagnostic accuracy studies. (shrink)

Kant as anthropologist forms the center of attention in this collection of four lectures delivered at Yale University in 1955: John E. Smith explores the connection between questions "What can I know?" "What ought I to do?" and "What may I hope?" and the fourth question, "What is man?" George E. Schrader follows Kant's concepts of human will and character through their development in existentialism. René Wellek describes Kant's place among the aestheticians who raised and treated the question of the (...) place of man and his works of art in the realms of beauty and purpose. And C. W. Hendel examines Kant's concepts of reason, faith, hope, duty, law, freedom, responsibility, and peace in the world of the French and American revolutions and in ours.--R. F. T. (shrink)

Liebe Frau Henry! Soeben bekomme ich Ihren Brief, Die Freude, die mir Ihre Ankündigung macht, veranlaßt mich, Ihnen sofort zu antworten. Sie wissen wohl, daß ich seit Jahren wünsche, Sie möchten Ihre philosophischen Arbeiten fortsetzen und möchten die dafür notwendige Muße finden. Ich weiß nicht, ob Sie wissen, daß ich Sie mehrfach für philosophische Lehrstühle, über deren Besetzung ich unter dem Gesichtspunkt der Naturphilosophie gefragt worden bin, vorgeschlagen habe.

Liebe Frau Henry! Herzlichen Dank für Ihren Brief und für die beiden Artikel Sie sind der erste Mensch, der es meiner Kenntnis nach erreicht hat, dass die Resolutionen in extenso abgedruckt wurden, und ich bin sehr froh, dass es an dieser Stelle gerade geschehen ist. Ich habe mich übrigens mit hiesigen physikalisch-mathematischen Studienräten verabredet, einmal an ihrem Unterricht teilzunehmen und dann das Problem der Stoffbeschränkung in der Physik mit ihnen zu besprechen.

Liebe Frau Henry! Auf Ihren Brief antworte ich sofort. Ihren gemeinsamen Brief an Herrn Picht und mich habe ich freilich immer noch nicht beantwortet, aber dazu braucht es mehr Gelassenheit, als mir im Moment eine etwas mir über den Kopf wachsende Reisetätigkeit gelassen hat. Nun aber zu Ihren praktischen Fragen.

Curio’s six lictors with laureled fasces (Cic. Att. 10.4.9) are best explained by his holding command in 49 BC not as Caesar’s legatus, but pro praetore with imperium nominally in his own right, granted (‘extra-constitutionally’) by Caesar directly, without vote of Senate and People.

It is argued that (1) the alleged violation of the auspices by both the Consuls of 249 B. C. did in fact occur and (2) resulted in separate prosecutions directed at each of them; (3) the name ‘Pullius’, reported for one of the plebeian Tribunes that prosecuted P. Claudius Pulcher, is probably authentic; (4) the cognomen of L. Iunius Pullus is not spun out the violation of the auspices attributed to him and his colleague; and (5) the cognomen ‘Pulcher’, first (...) born by the Consul of 249, may actually derive from his drowning of the Chickens. (shrink)

Tradition in either of its two senses—the act of handing on , and what is handed on—is a particular instance of a law of human existence that men live in dependence on one another and by the processes of giving and receiving. So a sociologist can write, ‘If we are able to speak of real tradition, we must find the past spontaneously taken into account as the meaning of the present, without any discontinuity of social time, and without any consideration (...) of the past as irrelevant’ . ‘If democracy’, wrote Chesterton, ‘means that I give a man a vote even though he is my chauffeur, tradition means that I give a man a vote even though he is my great-great-grandfather’. What is handed on, however, is not existence of a purely biological kind, to remain always what it has been or to change very slowly over a space of aeons. Except in primitive tribes even tradition is not simply passed on as something static and timeless, and it is received by men who, though themselves in time, are not totally time-bound or restricted by what they receive. They believe themselves to be capable of significant action which is more than the repetition and reproduction of what has gone before. They are able to grasp a span of time and to call it history; they believe themselves to have a history, and they write history. (shrink)

The author discusses the ways in which she finds the University of Pittsburgh Medical Center protocol for procuring organs from "non-heart-beating cadaver donors" medically and morally questionable and irreverent. She also identifies some of the factors that contributed to the composition of this troubling protocol, and to its institutional approval.

Interdisciplinarity has seemingly become a paradigm for modern and meaningful research. Clearly, the interdisciplinary modus of deliberation enables to unfold relevant but quite different disciplinary perspectives to the reflection of broader scientific questions or societal problems. However, whether the comprehensive results of interdisciplinary reflection prove to be valid or to be acceptable in trans-disciplinary terms depends upon certain preconditions, which have to be fulfilled for securing scientific quality and social trust in advisory contexts. The present book is written by experts (...) and practitioners of interdisciplinary research and policy advice. It analyses topical and methodological approaches towards interdisciplinarity, starting with the current role of scientific research in society. The volume continues with contributions to the issues of knowledge and acting and to trans-disciplinary deliberation. The final conclusions address the scientific system as substantial actor itself as well as the relevant research and education politics. (shrink)

To quote Yogi Berra, writing this editorial is a “déja vu all over again” experience for us. It entails not only collaborating once more as coauthors but also reiterating some of the criticisms and concerns that have figured prominently in virtually all our previous publications about bioethics—most recently in our book Observing Bioethics.

In 1986, philosopher-bioethicist Samuel Gorovitz published an essay entitled “Baiting Bioethics,” in which he reported on various criticisms of bioethics that were “in print, or voiced in and around … the field” at that time, and set forth his assessment of their legitimacy. He gave detailed attention to what he judged to be the particularly fierce and “irresponsible attacks” on “the moral integrity” and soundness of bioethics contained in two papers: “Getting Ethics” by philosopher William Bennett and “Medical Morality Is (...) Not Bioethics,” coauthored by us. Gorovitz attributed some of the criticisms that bioethics was eliciting to the fact that this new, rapidly rising, and increasingly visible field had brought “scholars and practitioners together who otherwise would have little exposure to one another's disciplines. Their interactions are mutually enriching at times,” he declared, “but mutually baffling and even infuriating at other times.” In this latter regard, he suggested that “perhaps” Fox and Swazey's characterization of bioethics in the article he dissected “reflects a general revulsion at endeavors they see as inadequately like the social sciences or insufficiently respectful of them.” He went on to say that despite his objections to our “complaints” about bioethics—especially to our claim that “autonomy [had] been an unduly emphasized value” in the field—he had “a lingering sense” that there might be “a grain of truth” in them. Gorovitz ended his essay with an affirmation about the “benefit” that bioethics can derive from “responsible” and even from “irresponsible” criticism. “The unexamined discipline invites the philosopher's critical scrutiny no less than the unexamined life,” he aphoristically concluded. a. (shrink)

Book reviewed in this article: The Puzzle People: Memoirs of a Transplant Surgeon. By Thomas E. Starzl.

Corporate governance is increasingly becoming an issue of global concern, not least because we are more and more living in a corporate world that transcends international boundaries. The main purpose and motivation of this study is to determine how the international community should motivate businesses in fostering exemplary corporate governance, therefore eliminating obstacles to ethically exemplary behavior. The empirical approach utilized here has been applied to 161 businesses, both listed and over-the-counter (OTC) companies, with the results indicating that ethical considerations, (...) corporate governance and organizational performance are inextricably linked and, to an extent, demonstrably proportional. This study also indicates a major finding that family management is a significant mediating variable of the ethical considerations of corporate governance and organizational performance. Finally, this study has developed an operational model of ethical considerations of corporate governance as a consultancy aid for businesses that wish to implement and/or boost their performance in respect to corporate governance. (shrink)

IX. 6. 12. iacere indolem illam Romanam ablatosque cum armis animos; non reddere salutem, non salutantibus dare responsum, non hiscere quemquam prae metu potuisse.

“Bioethics is not just Bioethics.” This is the aphoristic way in which I have recurrently expressed my historical and social perspective on the significance of bioethics, whose import I regard as extending beyond the emergence, development, and establishment of an intellectual field that is primarily concerned with advances in biology and medicine, their relationship to illness and health, and their ethical concomitants. In my view, although they are expressed through the medium of medicine, some of the value and belief questions (...) with which bioethics has been preoccupied since its inception are connected with broad and deep moral issues that are integral to what the illustrious French sociologist Émile Durkheim... (shrink)

Les résultats quantitatifs que la psychologie et la physiologie n'ont cessé d'accumuler depuis le début du siecle à propos du sens tactile laissent apparaître aujourd'hui une certaine ambiguïteé. D'un côté en effet, la préoccupation de connaître les sensibilities cutanées spécifiques telles qu'elles se présentent de manière isolée à l'analyse objective des récepteurs stimulés: les sensations de chaud et de froid, de pression et de contact, de douleur, de vibration. D'un autre côté, le désir de sauvegarder l'unité fonctionnelle du sens tactile (...) c.a.d. sa spécificité propre par rapport aux quatre autres sens traditionnels. Ainsi, par exemple, une analyse neurophysiologique des récepteurs tactiles5 ne manque pas de mentionner plusieurs catégories fonctionnelles de la sensibilité cutanée: la douleur, comme signal d'un danger qui peut menacer l'existence de l'organisme; la perception des qualités d'un objet, comme intégration du toucher et de la kinesthésie au cours d'une exploration active de la main; les expériences somatiques complexes telles que le chatouillement et les sensations sexuelles. Pour le phénoménologue, un tel compromis s'apparente à une confusion et provient des positions épistémologiques qui ont animé l'orientation méthodologique des recherches, depuis la psychophysiologie mécaniste jusqu'à la psychologie cybernétique de l'information sensorielle. En cela, la domaine de la sensation tactile reste l'apanage de la psychophysique, et nous tenterons de clarifier pourquoi cette position ne peut aboutir qu'à des résultats problématiques. A partir d'une psychologie anthropologique du sens tactile,14 nous défendrons l'idée d'une psychologie comparée qui permettrait une investigation empirique, objective des comportements animaux, sur la base de prolégomènes phénoménologiques. (shrink)

In 1999, Médecins Sans Frontières set out to explore and demonstrate the feasibility of preventing and treating HIV/AIDS in a so-called resource-poor, economically and socially disadvantaged setting. The first MSF mission to incorporate antiretroviral treatment into its HIV-AIDS-oriented medical program was undertaken in Bangkok. The second project was launched in Khayelitsha where MSF has been providing ARV treatment for persons with HIV/AIDS since May 2001. Khayelitsha is an enclave of some 500,000 inhabitants, most of whom live in corrugated-iron shacks, without (...) running water or electricity. Unemployment is extremely high; crime and violence are rampant. The general prevalence of HIV/AIDS is 26%, measured among pregnant women. The tuberculosis incidence rate is one of the world's highest for open-space sites. Unsurprisingly, TB/HIV coinfection is very high too: 63% of those with TB are also infected with HIV. (shrink)

Twelve narratives written by surgeons on ethical decision-making are analyzed in this commentary. Several major themes in their narratives are discussed: the preponderance of end-of-life issues; the struggle to be inclusively empathetic, even under emotionally alienating circumstances; social justice; and the disagreement among colleagues about how to deal with patients in situations of medical uncertainty. The commentary not only discusses the areas of stress that the surgeons identify in their accounts. It also highlights phenomena and themes that are missing from (...) them, and calls for more work to be done gathering stories from surgeons to explore and explain the “gaps” in this narrative collection. (shrink)

They have watched, as insiders, the first fumbling attempts to transplant kidneys, then hearts, then live‐donated lobes of liver and lung. Now the two sociologists most closely identified with organ transplantation have concluded that they must leave the field.

Local food systems can have economic and social benefits by providing income for producers and improving community connections. Ongoing global climate change and the acute COVID-19 pandemic crisis have shown the importance of building equity and resilience in local food systems. We interviewed ten stakeholders from organizations and institutions in a U.S. midwestern city exploring views on past, current, and future conditions to address the following two objectives: 1) Assess how local food system equity and resilience were impacted by the (...) COVID-19 pandemic, and 2) Examine how policy and behavior changes could support greater equity and resilience within urban local food systems. We used the Community Capitals Framework to organize interviewees’ responses for qualitative analyses of equity and resilience. Four types of community capital were emphasized by stakeholders: cultural and social, natural, and political capital. Participants stated that the local food system in this city is small; more weaknesses in food access, land access, and governance were described than were strengths in both pre- and post-pandemic conditions. Stakeholder responses also reflected lack of equity and resilience in the local food system, which was most pronounced for cultural and social, natural and political capitals. However, local producers’ resilience during the pandemic, which we categorized as human capital, was a notable strength. An improved future food system could incorporate changes in infrastructure (e.g., food processing), markets (e.g., values-based markets) and cultural values (e.g., valuing local food through connections between local producers and consumers). These insights could inform policy and enhance community initiatives and behavior changes to build more equitable and resilient local food systems in urban areas throughout the U.S. Midwest. (shrink)

Char et al. question the extent and degree to which machine learning applications should be treated as exceptional by ethicists. It is clear that of the suite of ethical issues raised by mac...

_Readings in Ethics_ offers a vast collection of carefully edited readings arranged chronologically across five historical periods. The selections cover many major Western and non-Western schools of thought, including Daoism, virtue ethics, Buddhism, natural law, deontology, utilitarianism, contractarianism, liberalism, Marxism, feminism, and communitarianism. In addition to texts from canonical philosophers such as Plato, Mill, Wollstonecraft, and Rawls, the volume draws from other sources of wisdom: stories, fables, proverbs, medieval mystical treatises, literature, and poetry. The editors have also written substantial introductions, (...) annotations, discussion questions, and suggestions for further reading, making for a thorough guided tour of our ethical past and present. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Striving To Do Good:Well-Springs, Realities, and Paradoxes of Medical Humanitarian WorkRenée C. FoxThe voices that speak from the pages of these testimonial narratives are those of physicians who are engaged in medical humanitarian work. The preponderance of them are based in U.S. academic medical centers where they have clinical, teaching, and research responsibilities from which they regularly "commute" to care for patients in what the euphemistic language of "global (...) health" terms "resource-limited," rather than "poor" countries." This "hybrid life," as one of the physicians (Robert Riviello) refers to it, has transported them periodically to numerous African societies (to Algeria, Ethiopia, Gabon, Morocco, Rwanda, Sudan, Tanzania, and Uganda), to Haiti, to India and Nepal, and to Guatemala and Mexico. Three of the "stories" are written by physicians at work in the countries where they were born (Prasanta Tripathy in Eastern India, Sridevi Seetharam and colleagues in Southern India, and Paul Pierre, in Haiti).Only one group of physician-coauthors (Maricruz Merino, Jonathan Iralu, and Sonya Shin) write about their experiences in practicing medicine among poor and socially disadvantaged patients on the American mainland—in the setting of the Navajo Indian reservation in Gallup, New Mexico.All these physicians describe their involvement in humanitarian medicine as emanating from their commitment to "social justice," to "saving lives," and to "caring for the poor"; to their universalistic convictions about "human solidarity," and the non- otherness of others; to their indignation about the inequities and injustices of the world, particularly with regard to access to health care (in the words of Jeffrey Deal, "[They] deserve better. They all do"); and to their "passionate" desire, not just their "sense of duty," to help rectify these wrongs (Richard Keiden). I was struck by the fact that none of them uses the word "suffering" to describe the plight of the persons whom they feel they have been called to medically assist.Three of the physicians express the wellsprings of their motivation in religious terms. Richard Keiden refers to a "guiding principle of Judaism" on which his medical humanitarian work has been founded—"tzedakah"—which "translates as charity but actually means righteousness," is based on a "concept of social justice," and is "an obligation, not a choice." Robert Riveillo says that at the time of his graduation from high school he envisioned his "life's work as a long-term missionary surgeon"; he invokes "loving mercy," as well as justice, "in this work of solidarity" that he has undertaken; and he poignantly admits that "most days I still long to pack my things, my family, and our efforts and move to Africa for a life of direct service." What Jeffrey Deal writes is the most explicitly and ardently religious of all. He identifies his work as a physician in Sudan with Jesus's "desire for us to care [End Page 115] for the poor and downtrodden in His stead." He is haunted by his "failure" to deliver alive a "partially born" baby girl who for him incarnated "the least of the least" of whom Jesus "spoke passionately." And in touching "ever so briefly... [that] one, tiny being [he] encountered... [on ] that hot morning in Sudan," he attests, he "touched Jesus."Jeffrey Deal is not the only one who was so stricken by the death of a baby or a child. For a number of these physicians (Sadath Sayeed, Maneesh Batra, and for Sridevi Seetharam, Lisa Adams and their colleagues), it was a tragedy that they found hard to bear with "detached enlightenment" (Sayeed), or to accept. The most demonstrably heartbroken and morally outraged among them is Sadath Sayeed, who "wept uncontrollably" over the death of a baby boy, born "at home" in Haiti, "probably in one of the hundreds of make-shift tent cities." The baby was not breathing continuously, and was "handed" to him to care for. At the close of the "story " about this experience that he recounts, Sayeed lashes out with fury and angst at those who were likely to ask him, "How was it in Haiti?" Do you want to hear "my real answer?" he replies:... [L]et me summarize my last patient for you: Good luck Dad... (shrink)

In the expanding repertoire of practices designed to increase the supply of organs for transplantation, non-heart-beating cadaver organ donation has generated an ongoing debate in the literature. The continuing stream of articles is disquieting in part because it documents a troubling "trial-and-error ethics" approach to the formulation of organ procurement policy, and because it raises serious questions about the reasons that the development of this policy is being mediated by published communication. In the light of concerns about the implicit support (...) and credibility that professional publications give to organ procurement policies, restraint in publishing articles about non-heart-beating organ donation as well as in devising such policies is strongly advocated. (shrink)