This is an exploration of modernism and postmodernism in regard to knowledge: methods of inquiry, operations of the mind, the role of values, conceptions of self, and the problematic of reason.

The U.S. Food and Drug Administration's rationale for supporting the development and approval of BiDil for heart failure specifically in black patients was based on under-powered, post hoc subgroup analyses of two relatively old trials , which were further complicated by substantial covariate imbalances between racial groups. Indeed, the only statistically significant difference observed between black and white patients was found without any adjustment for potential confounders in samples that were unlikely to have been adequately randomized. Meanwhile, because the accepted (...) baseline therapy for heart failure has substantially improved since these trials took place, their results cannot be combined with data from the more recent trial amongst black patients alone. There is therefore little scientific evidence to support the approval of BiDil only for use in black patients, and the FDA's rationale fails to consider the ethical consequences of recognizing racial categories as valid markers of innate biological difference, and permitting the development of group-specific therapies that are subject to commercial incentives rather than scientific evidence or therapeutic imperatives. This paper reviews the limitations in the scientific evidence used to support the approval of BiDil only for use in black patients; calls for further analysis of the V-HeFT I and II data which might clarify whether responses to H-I vary by race; and evaluates the consequences of commercial incentives to develop racialized medicines. We recommend that the FDA revise the procedures they use to examine applications for race-based therapies to ensure that these are based on robust scientific claims and do not undermine the aims of the 1992 Revitalization Act. (shrink)

Crystallography has proven a rich source of ideas over several centuries. Among the many ways of looking at space groups, N. David Mermin has pioneered the Fourier-space approach. Recently, we have supplemented this approach with methods borrowed from algebraic topology. We now show what topology, which studies global properties of manifolds, has to do with crystallography. No mathematics is assumed beyond what the typical physics or crystallography student will have seen of group theory; in particular, the reader need not have (...) any prior exposure to topology or to cohomology of groups. (shrink)

Numerous articles in the popular press together with an examination of websites associated with the medical, legal, engineering, financial, and other professions leave no doubt that the role of professions has been impacted by the Internet. While offering the promise of the democratization of expertise – expertise made available to the public at convenient times and locations and at an affordable cost – the Internet is also driving a reexamination of the concept of professional identity and related claims of expertise (...) and standards of integrity. This paper begins with a presentation of case studies illustrating the ease by which impostors infiltrate the ranks of professionals. Reports of individuals masquerading as professionals via the Internet often reveal that these imposters cause harm to the unwary victims who rely on assertions of professional expertise. Such reports motivated the authors to examine the origins and evolution of the traditional roles of professions and professionals in today’s society, as well as question how, or whether, the standards for professional practice have been adapted to the challenges posed by technology, i.e., do statements of professional ethics provide a ‘guiding light’ for practitioners and their clients in the cyber age? The authors challenge the professions to consider the notion that technology forces a confrontation between the guild-like aspects of a profession that have served, on the one hand, to protect a profession from encroachment and, on the other hand, have purportedly protected the public. (shrink)

Objective: To audit doctors’ knowledge of informed consent.Design: 10 consent scenarios with “true”, “false”, or “don’t know” answers were completed by doctors who care for children at a large district general hospital. These questions tested clinicians’ knowledge of who could give consent in different clinical situations.Setting: Royal United Hospital, Bath, UK.Results: 51 doctors participated . Paediatricians scored higher than other clinicians . Only 36% of paediatricians and 8% of other clinicians realised that the biological father of a child born before (...) 1 December 2003 needed a court order or a parental responsibility agreement to acquire parental responsibility, and thus be able to consent on behalf of his child, if he was not married to the child’s mother. Non-paediatric clinicians were unsure or incorrect when tested on situations where people with parental responsibility do not agree, or where young people , who are Fraser competent do not want to consult their parents. Most clinicians did not know that the parents of a 20-year-old man with severe learning difficulties are unable to consent to surgery on his behalf, and many non-paediatricians were unclear on who could give consent when a child lived with foster parents.Conclusion: Clinicians who obtain consent for the treatment of children need to increase their knowledge on who is able to give informed consent to ensure best practice. (shrink)

These notebooks were written during the years that F. W. J. Schelling spent as a student at the Tübinger Stift (1790–1795). From dates written by Schelling in the margins, we can surmise that the first portion (AA II/4: 15–28) was begun in August of 1792, and the latter portion (AA II/5: 133–142) was written in early 1794. To this latter portion is appended a substantial work, Schelling’s Timaeus-commentary, which is not included in the present translation. It appeared as “Timaeus (1794)” (...) (translated by Adam Arola, Jena Jolissaint, Peter Warnek) in Epoché 12: 2. These notebooks offer a window into Schelling’s philosophical development and proclivities, in light of his engagement with various Platonic dialogues, most notably the Ion, Theaetetus, Meno, Timaeus, and Philebus. They include discussions of divine power, rapture, and genius, especially as these relate to poetry, prophecy, and ordinary forms of human knowledge. These topics are discussed in the first portion (AA II/4: 15–25). In the latter portion, Schelling discusses myth, its function and relation to human greatness, Socrates’s daimonion, and the authority of tradition (AA II/4: 25–28; II/5: 133–142). (shrink)

The purpose of this study was to describe the extent to which nurses perceive the ethical dimensions of clinical practice situations involving patients, families and health care professionals. Using the composite theory of basic moral principles and the professional standard of care established by legal custom as a framework, situations involving ethical dilemmas were gleaned from the nursing literature. They were reviewed for content validity, clarity and representativeness in a two-stage process by expert panels. The situations were presented in a (...) written format to a convenience sample of nurses (n = 125), who were primarily staff nurses (65.6%). Respondents' judgements about whether the main issue of each situation concerned ethics ranged from a low of 0.8% to a high of 40%. From analyses of the categories into which the majority of subjects placed each situation, it was concluded that these nurses generally perceived ethics as the main issue in situations that directly involve patients' autonomy. Analysis yielded unanticipated findings about the themes in ethical situations to which nurses in practice may respond. (shrink)

Though antiretroviral therapy is the standard of care for people living with HIV, its treatment limitations, burdens, stigma and costs lead to continued interest in HIV cure research. Early-phase cure trials, particularly those that include analytic treatment interruption, involve uncertain and potentially high risk, with minimal chance of clinical benefit. Some question whether such trials should be offered, given the risk/benefit imbalance, and whether those who choose to participate are acting rationally. We address these questions through a longitudinal decision-making study (...) nested in a Thai acute HIV research cohort. In-depth interviews revealed central themes about decisions to join. Participants felt they possessed an important identity as members of the acute cohort, viewing their bodies as uniquely suited to both testing and potentially benefiting from HIV cure approaches. While acknowledging risks of ATI, most perceived they were given an opportunity to interrupt treatment, to test their own bodies and increase normalcy in a safe, highly monitored circumstance. They were motivated by potential benefits to themselves, the investigators and larger acute cohort, and others with HIV. They believed their own trial experiences and being able to give back to the community were sufficient to offset participation risks. These decisions were driven by the specific circumstances experienced by our participants. Judging risk/benefit ratios without appreciating these lived experiences can lead to false determinations of irrational decision- making. While this does not minimise vital oversight considerations about risk reduction and protection from harm, it argues for inclusion of a more participant-centered approach. (shrink)

One of the more obscure arguments for Rawls’ difference principle dubbed ‘the Pareto argument for inequality’ has been criticised by G. A. Cohen (1995, 2008) as being inconsistent. In this paper, we examine and clarify the Pareto argument in detail and argue (1) that justification for the Pareto principles derives from rational selfinterest and thus the Pareto principles ought to be understood as conditions of individual rationality, (2) that the Pareto argument is not inconsistent, contra Cohen, and (3) that the (...) kind of bargaining model required to arrive at the particular unequal distribution that the difference principle picks out is a model that is not based on bargaining according to one’s threat advantage. (shrink)

The current study is a pilot trial to examine the effects of a nonelective, classroom-based, teacher-implemented, mindfulness meditation intervention on standard clinical measures of mental health and affect in middle school children. A total of 101 healthy sixth-grade students (55 boys, 46 girls) were randomized to either an Asian history course with daily mindfulness meditation practice (intervention group) or an African history course with a matched experiential activity (active control group). Self-reported measures included the Youth Self Report (YSR), a modified (...) Spielberger State-Trait Anxiety Inventory, and the Cognitive and Affective Mindfulness Measure –Revised. Both groups decreased significantly on clinical syndrome subscales and affect but did not differ in the extent of their improvements. Meditators were significantly less likely to develop suicidal ideation or thoughts of self-harm than controls. These results suggest that mindfulness training may yield both unique and non-specific benefits that are shared by other novel activities. (shrink)

This collection brings together fourteen contributions by authors from around the globe. Each of the contributions engages with questions about how local and global bioethical issues are made to be comparable, in the hope of redressing basic needs and demands for justice. These works demonstrate the significant conceptual contributions that can be made through feminists' attention to debates in a range of interrelated fields, especially as they formulate appropriate responses to developments in medical technology, global economics, population shifts, and poverty.

In The Ethics of Food, Gregory E. Pence brings together a collection of voices who share the view that the ethics of genetically modified food is among the most pressing societal questions of our time. This comprehensive collection addresses a broad range of subjects, including the meaning of food, moral analyses of vegetarianism and starvation, the safety and environmental risks of genetically modified food, issues of global food politics and the food industry, and the relationships among food, evolution, and human (...) history. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Dive et al. argue to limit the scope, scale, and quantity of results in genomic screening programs at the population level. Their analysis offers two interrelated reasons for this recommendation: f...

Dagfinn Føllesdal: “Developments in Quine's Behaviorism”: Quine insisted throughout his life that he was a behaviorist. He began briefly as an “ontological behaviorist,” that is, he held that there is nothing mental. However, very early he switched to evidential behaviorism: the view that behavior provides the only evidence we have for the mental and its properties. Ultimately, Quine's behaviorism springs from his empiricism. All knowledge about the world around us and about other people reaches us through our senses: “Behaviorism, as (...) far as I'm concerned, is only an intersubjective empiricism.” Quine applied this to language and communication. His acute problem awareness led him from the discussion of stimuli in Word and Object to a much more refined behaviorism in his latest works, in which full‐fledged perception and the individuation of the world into objects play a crucial role. (shrink)

This provocative book paved the way for nursing research informed by f eminist scholarship, critical theory, and post-modern thought. Controv ersial then, relevant today.