This book is a small handbook designed to give Institutional Review Board (IRB) members the information they need to protect the rights and welfare of research subjects in a way that is both effective and efficient. The chapters of this book are short and to the point. Topic-specific chapters list the criteria IRB members should use to determine how to vote on specific kinds of studies and offer practical advice on what IRB members should do before and during full-committee meetings.

The risk of stroke for a child with SCD is many times greater than that of a healthy child without SCD or heart disease. There is a technique that allows the identification of the children with SCD who have high risk even within this relatively high-risk group. And there is a highly effective preventive treatment. While this would on the surface appear to be a straightforward medical decision, it is not. One must weigh the benefits of preventing permanent brain damage (...) against the risks of infection from transfused blood, iron overload, which is the result of the frequent transfusions, and rare transfusion reactions. (shrink)

Sickle cell anemia is a disease characterized by abnormal hemoglobin structure. There is a mutation in the beta-globin gene that changes the sixth amino acid from glutamic acid to valine causing the mutated hemoglobin to polymerize reversibly when deoxygenated to form a gelatinous network of fibrous polymers that stiffen and distort the red blood cell membrane. This leads to episodes of microvascular vasoocclusion and premature RBC destruction leading to hemolytic anemia. For reasons that are unclear, some children develop a large (...) artery vasculopathy involving the intracranial arteries supplying the brain.The risk of stroke for a child with SCD is many times greater than that of a healthy child without SCD or heart disease. There is a technique that allows the identification of the children with SCD who have high risk even within this relatively high-risk group. And there is a highly effective preventive treatment. (shrink)

In late September 1838, Darwin read Malthus's Essay on Population, which left him with “a theory by which to work.”115 Yet he waited some twenty years to publish his discovery in the Origin of Species. Those interested in the fine grain of Darwin's development have been curious about this delay. One recent explanation has his hand stayed by fear of reaction to the materialist implications of linking man with animals. “Darwin sensed,” according to Howard Gruber, “that some would object to (...) seeing rudiments of human mentality in animals, while others would recoil at the idea of remnants of animality in man.”116 With this link closed, Darwin hung the materialist chain around his own neck, where it rested most uncomfortably. Stephen Gould, supporting Gruber's argument, finds evidence for this reconstruction in Darwin's M and N notebooks, whichinclude many statements showing that he espoused but feared to expose something he perceived as far more heretical than evolution itself: philosophical materialism-the postulate that matter is the stuff of all existence and that all mental and spiritual phenomena are its by-products. No notion could be more upsetting to the deepest traditions of Western thought than the statement that mind-however complex and powerful-is simply a product of brain.117The proferred hypothesis suggests, then, that Darwin was acutely sensible of the social consequences of equating men with animals and therefore mind with brian, and that he thus shied from publically revealing his views until the intellectual climate became more tolerant.The history I have examined makes this hypothesis implausible. Even if Darwin warily explored the implications of his emerging theory in his notebooks, his subsequent study of Fleming, Wells, Brougham, and Kirby should have quieted any trepidation. If these natural theologians did not flinch at seeing human reason prefigured in the mind of a worm, should Darwin have? Moreover, he recognized in his M notebook that the thesis of evolutionary continuity between men and animals did not require an explicit avowal of his conviction that brain was the agent of thought.118 And in any case, his materialism was of a rather benign sort; at least he so expressed it in an annotation in Abercrombie's Inquiries concerning the Intellectual Powers (1838): “By materialism I mean, merely the intimate connection of thought with form of brain — like kind of attraction with nature of element.”119 This belief would have held little terror for British intellectuals, who were quite familiar — some even comfortable-with Locke's anti-Cartesian argument that there was nothing contradictory in supposing God could make matter to think.120 Finally, even if the intellectual atmosphere of early nineteenth-century Britain were inhospitable to Darwin's brand of materialism, there is little reason to believe he breathed a different air at mid-century while preparing his manuscript.That Darwin should not have feared suspicions of materialism, of course, does not mean that he did not. But I think there were other, more persistent sources of anxiety that kept him from rushing to publish: namely, the several conceptual obstacles he had to overcome if his theory of evolution by natural selection were to be made scientifically acceptable. Prominent among these were the problems surrounding his changing notions of instinct.The inertia of his older ideas about instinct at first made it hard for Darwin to gauge how far the theory of natural selection might be applied to behavior. By the early 1840s he finally felt ready to meet the challenge of the natural theologians by providing a naturalistic explanation for the wonderful instincts of animals. In his “Essays” of 1842 and 1844 one sort of instinct is, however, not considered-that of neuter insects. Yet Darwin seems to have appreciated the difficulties such instincts entailed at least by 1843, when he read Kirby and Spence. He simply required time to work out a solution to a problem he initially perceived as “fatal to my whole theory.” Even while writing the “Species Book” in the summer of 1857, he was still juggling several possible solutions compatible with natural selection. It was only a short time before he actually turned to work on the Origin of Species that he appears to have settled on a single explanation for the difficulties posed by the instincts of worker bees and ants. The force of his theory of community selection snapped the last critical support of the creationist hypothesis and, conveniently enough, also fractured the generalized Lamarckian account of the evolution of behavior. These results were worth waiting for. (shrink)

The sciences of ethology and sociobiology have as premisses that certain dispositions and behavioural patterns have evolved with species and, therefore, that the acts of individual animals and men must be viewed in light of innate determinates. These ideas are much older than the now burgeoning disciplines of the biology of behaviour. Their elements were fused in the early constructions of evolutionary theory, and they became integral parts of the developing conception. Historians, however, have usually neglected close examination of the (...) role behaviour has played in the rise of evolutionary thought. (shrink)

In Howard Kahane's current reply to my previous discussion of Goodman's elimination rules, he suggests both that the notion of conflict required by the first elimination rule cannot be made clear, and that both proposed revisions of the second elimination rule are too strong [4]. These seem to me to be the points which require settlement, and I would like to discuss them in this paper.

.s From Philosophy of Science. Inquiry: Vol. 17, No. 1-4, pp. 143-149.

One hundred years ago, Flexner emphasized the role of science in medical education. With a 21st-century perspective, the question may be posed anew: is science relevant to medical education and practice? If so, then which areas of science are fundamental to learning and making ongoing decisions in medicine? The answers to these questions should determine what is needed in the preparation of an undergraduate student for medical school.Educators and students alike question the relevance of current premedical requirements, and there is (...) concern that these in fact diminish student interest in medical or biomedical research careers. For example, premedical science courses are viewed by many students (including those who .. (shrink)

THERE is no trap that is easier to stumble into than that of trying to show whether one philosopher did or did not answer the problem of another philosopher. The trap consists in the tendency to think that both philosophers handled the problem in precisely the same way, even though they represent two quite different traditions. This is especially true of thinkers like David Hume and Charles Sanders Peirce. John Smith has shown quite convincingly that we cannot understand the American (...) pragmatists by limiting discussion to the epistemological questions of the British empiricist tradition stemming from Hume, Mill, and Russell. And A. J. Ayer can be faulted for attempting to do just that. However, it is possible for one to treat of Peirce's answer to Hume on necessary connection without falling into the trap. First of all, both philosophers raised the same kind of question. It is clear that Peirce had Hume specifically in mind when on many an occasion he attacked nominalism and defended real connections. But they differed in that Peirce defended his position from a broader perspective enabling him to arrive at a more satisfactory conclusion. To establish this thesis, it will be necessary to focus on several aspects of their thought that bear upon the topic under discussion. Undoubtedly the task of selection and interpretation of details has many a trap of its own, but it is hoped that the more obvious ones can be avoided. (shrink)

A divine approval theory in ethics may be construed as one of a class of subjective-reaction theories, those which hold that the rightness or wrongness of actions is constituted by the response to these actions (e.g., approval or disapproval) on the part of some person or persons, actual or ideal. There are peculiar difficulties connected with a divine approval theory, arising from God's omnipotence. But waiving difficulties which apply especially or peculiarly to a divine approval account, we can see by (...) a simple argument that the entire set of subjective-reaction theories is subject to the logical difficulty that taking attitudes as definitive or otherwise constitutive of ethical value is self-defeating. (shrink)

I exhort you never to debase the moral currency or to lower the standard of rectitude, but to try others by the final maxim that governs your own lives and to suffer no man and no cause to escape the undying penalty which history has the power to inflict on wrong.2 In 1902, the year after Acton died, the president of the American Historical association, Henry Lea, in dubious celebration of his British colleague, responded to the exordium with a contrary (...) claim about the historian’s obligation, namely objectively to render the facts of history without subjective moralizing. Referring to Acton’s lecture, Lea declared. (shrink)