The process of obtaining informed consent continues to be a contentious issue in clinical and public health research carried out in resource-limited settings. We sought to evaluate this process among human research participants in randomly selected active research studies approved by the School of Medicine Research and Ethics Committee at the College of Health Sciences, Makerere University.

Background: The process of obtaining informed consent continues to be a contentious issue in clinical and public health research carried out in resource-limited settings. We sought to evaluate this process among human research participants in randomly selected active research studies approved by the School of Medicine Research and Ethics Committee at the College of Health Sciences, Makerere University. Methods: Data were collected using semi-structured interviewer-administered questionnaires on clinic days after initial or repeat informed consent procedures for the respective clinical studies (...) had been administered to each study participant. Results: Of the 600 participants interviewed, two thirds (64.2 %, 385/600) were female. Overall mean age of study participants was 37.6 (SD = 7.7) years. Amongst all participants, less than a tenth (5.9 %, 35/598) reported that they were not given enough information before making a decision to participate. A similar proportion (5.7 %, 34/597) reported that they had not signed a consent form prior to making a decision to participate in the study. A third (33.7 %, 201/596) of the participants were not aware that they could, at any time, voluntarily withdraw participation from these studies. Participants in clinical trials were 50 % less likely than those in observational studies [clinical trial vs. observational; (odds ratio, OR = 0.5; 95 % CI: 0.35-0.78)] to perceive that refusal to participate in the parent research project would affect their regular medical care. Conclusions: Most of the participants signed informed consent forms and a vast majority felt that they received enough information before deciding to participate. On the contrary, several were not aware that they could voluntarily withdraw their participation. Participants in observational studies were more likely than those in clinical trials to perceive that refusal to participate in the parent study would affect their regular medical care. (shrink)

The book's significance is two-fold: it argues for a new stage in the development of contemporary Confucian philosophy, and it demonstrates the value to Western ...

Einstein said that the most incomprehensible thing about the universe is that it is comprehensible. But was he right? Can the quantum theory of fields and Einstein's general theory of relativity, the two most accurate and successful theories in all of physics, be united in a single quantum theory of gravity? Two of the world's most famous physicists - Stephen Hawking and Roger Penrose - disagree. Here they explain their positions in a work based on six lectures with a (...) final debate, all originally presented at the Isaac Newton Institute for Mathematical Sciences at the University of Cambridge. (shrink)

Stephen Toulmin argues that the potential for reason to improve our lives has been hampered by a serious imbalance in our pursuit of knowledge. The centuries-old dominance of rationality has diminished the value of reasonableness. Toulmin issues a powerful call to redress the balance between rationality and reasonableness.

l i ver Cromwell delivered history's most famous rebuke to the heroworshiping that irons all subtlety into flawless cardboard: Mr. Lely, I desire you would use all your skill to paint my picture truly like me, and not flatter me at al l ; but remark all these roughnesses, pimples, warts, and everything as you see me, otherwise I will never pay a farthing for it. Helena Cronin, in The Ant and the Peacock , displays a raw talent clearly equal (...) to that of our finest portraitists, but has placed herself into a position even worse than Mr. Lely's. Cromwell's painter at least faced the subject himself; Cronin has produced an uncritical gloss upon a false and simplistic view that never was more than a caricature of Darwinian theory. (shrink)

Elizabeth Anscombe famously argued that "modern moral philosophy" centrally involved unsupported notions of obligation and culpability. Modern Moral Philosophy: From Grotius to Kant exhibits, for the first time, resources that modern moral philosophers had to respond to Anscombe's challenge, also enhancing our own philosophical grasp of morality and its foundations.

Understanding after the fact confers no special perspicacity. The real test for any diviner can only lie in grasping the outcome at the outset. Correct predictions, in themselves, offer no proof of true wisdom, for how can we distinguish dumb luck from horse sense? The only good experiment is, alas, the most undoable of all intriguing thoughts in a world of irrevocable history-to run back the tape and play it again, Sam.

Stephen Makin presents a clear and accurate new translation of an influential and much-discussed part of Aristotle's philosophical system, accompanied by an analytical and critical commentary focusing on philosophical issues. In Book Theta of the Metaphysics Aristotle introduces the concepts of actuality and potentiality---which were to remain central to philosophical analysis into the modern era---and explores the distinction between the actual and the potential.

The Hedgehog, the Fox, and the Magister's Pox is a controversial discourse, rich with facts and observations gathered by one of the most erudite minds of our ...

In The Ethos of a Late-Modern Citizen, Stephen K. White contends that Western democracies face novel challenges demanding our reexamination of the role of citizens. White argues that the intense focus in the past three decades on finding general principles of justice for diversity-rich societies needs to be complemented by an exploration of what sort of ethos would be needed to adequately sustain any such principles. Accessible, pithy, and erudite, The Ethos of a Late-Modern Citizen will appeal to a (...) wide audience. (shrink)

How did science come to have such a central place in Western culture? How did our ways of thinking, and our moral, political, and social values, come to be modelled around scientific values? Stephen Gaukroger traces the story of how these values developed, and how they influenced society and culture from the 19th to the mid-20th century.

Can we talk meaningfully about God? The theological movement known as Grammatical Thomism affirms that religious language is nonsensical, because the reality of God is beyond our capacity for expression. Stephen Mulhall critically evaluates the claims of this movement to be a legitimate inheritor of Wittgenstein's philosophical methods as well as Aquinas's theological project. The major obstacle to this claim is that Grammatical Thomism makes the nonsensicality of religious language when applied to God a touchstone of Thomist insight, whereas (...) 'nonsense' is standardly taken to be solely a term of criticism in Wittgenstein's work. Mulhall argues that a place can be found in both his early work and his later writings for a more positive role to be assigned to nonsensical utterances--one which depends on exploiting an analogy between religious language and riddles. This allows us to see various ways in which his later work has a perfectionist dimension, and results in a radical reconception of the role of analogous usage in language, and in the relation between philosophy and theology. (shrink)

In a world where every person is exposed daily through the mass media to images of violence and suffering, as most dramatically exemplified in recent years by the ongoing tragedy in Darfur, the question naturally arises: What responsibilities do we, as bystanders to such social injustice, bear in holding accountable those who have created the conditions for this suffering? And what is our own complicity in the continuance of such violence—indeed, how do we contribute to and benefit from it? How (...) is our responsibility as individuals connected to our collective responsibility as members of a society? Such questions underlie Stephen Esquith’s investigation in this book. For Esquith, being responsible means holding ourselves accountable as a people for the institutions we have built or tolerated and the choices we have made individually and collectively within these institutional constraints. It is thus more than just acknowledgment; it involves settling accounts as well as recognizing our own complicity even as bystanders. (shrink)

The Limits of Influence is a detailed examination and defense of the evidence for largescale-psychokinesis. It examines the reasons why experimental evidence has not, and perhaps cannot, convince most skeptics that PK is genuine, and it considers why traditional experimental procedures are important to reveal interesting facts about the phenomena.

Geoengineering – roughly “the intentional manipulation of the planetary systems at a global scale” (Keith 2000) – to combat climate change is often introduced as a “plan B”: an alternative solution in case “plan A”, reducing emissions, fails. This framing is typically deployed as part of an argument that research and development is necessary in case robust conventional mitigation is not forthcoming, or proves insufficient to prevent dangerous climate impacts. Since coming to prominence with the release of the Royal Society (...) report in 2009 (Shepherd et al. 2009, v), the Plan B framing has proved popular with scientists, in policy circles, and in the news media (see Nerlich and Jaspal 2012; Luokkanen, Huttunen, and Hilden 2014). Though sometimes used to refer to geoengineering as a whole, it is associated particularly strongly with stratospheric sulfate injection (SSI) techniques. Consequently, these will be our focus here. We argue that the plan B framing is particularly ill-suited to the integrative assessment of options within climate policy, because it oversimplifies a complex issue in a misleading and deceptive way. For instance, it highlights extreme positions, presents SSI as an alternative independent from mainstream policies, ignores the multiplicity of options available, and neglects threats of morally indecent SSI in a context of ongoing political inertia. We are particularly concerned about the way ‘Plan B’ risks conveying an implicit hyper-optimism about SSI, and so obscures the need for ethical standards. (shrink)

This paper argues that calls for neurorights propose an overcomplicated approach. It does this through analysis of ‘rights’ using the influential framework provided by Wesley Hohfeld, whose analytic jurisprudence is still well regarded in its clarificatory approach to discussions of rights. Having disentangled some unclarities in talk about rights, the paper proposes the idea of ‘novel human rights’ is not appropriate for what is deemed worth protecting in terms of mental integrity and cognitive liberty. That is best thought of in (...) terms of Hohfeld’s account of ‘right’ as privilege. It goes on to argue that as privileges, legal protections are not well suited to these cases. As such, they cannot be ‘novel human rights’. Instead, protections for mental integrity and cognitive liberty are best accounted for in terms of familiar and established rational and discursive norms. Mental integrity is best thought of as evaluable in terms of familiar rational norms, and cognitive freedom is constrained by appraisals of sense-making. Concerns about how neurotechnologies might pose particular challenges to mental integrity and cognitive liberty are best protected through careful use of existing legislation on data protection, not novel rights, as it is via data that risks to integrity and liberty are manifested. (shrink)

The thesis that scientists give greater weight to novel predictions than to explanations of known facts is tested against historical cases in physical science. Several theories were accepted after successful novel predictions but there is little evidence that extra credit was given for novelty. Other theories were rejected despite, or accepted without, making successful novel predictions. No examples were found of theories that were accepted primarily because of successful novel predictions and would not have been accepted if those facts had (...) been previously known. (shrink)

Disability and enhancement are often treated as opposing concepts. To become disabled in some respect is to move away from those who are enhanced in that same respect; to become enhanced is to move away from the corresponding state of disability. This chapter examines how best to understand the concepts of disability and enhancement in this symmetrical way. After considering various candidates, two types of accounts are identified as the most promising: welfarist accounts and typical-functioning accounts. The authors ultimately defend (...) a complex typical-functioning account as the best way to achieve a symmetrical understanding of disability and enhancement. (shrink)

Stephen Makin; VIII*—An Ancient Principle about Causation, Proceedings of the Aristotelian Society, Volume 91, Issue 1, 1 June 1991, Pages 135–152, https://doi.

This paper explores some of the ethical issues around offering COVID-19 vaccines to children. My main conclusion is rather paradoxical: the younger we go, the stronger the grounds for justified parental hesitancy and, as such, the stronger the arguments for enforcing vaccination. I suggest that this is not thereductio ad absurdumit appears, but does point to difficult questions about the nature of parental authority in vaccination cases. The first section sketches the disagreement over vaccinating teenagers, arguing that the UK policy (...) was permissible. The second section outlines a problem for this policy, that it faces justified vaccine hesitancy. The third section discusses three strategies for responding to this problem, arguing that there may be no simple way of overcoming parents’ reasons to resist vaccinations. (shrink)

What might it mean to think of philosophy as being in the condition of modernism -- in which its relation to its own past, and hence its sense of its own future, has become an undismissable problem? If philosophy's hitherto-defining conventions can neither be taken for granted nor rejected, they must be put in question -- which menans re-evealuating the relation between the form and content of philosophical writing, rethinking the demands that such writing must place on its readers, and (...) reconceiving the nature of philosophy itself. Inheritance and Originality argues that the writings of Wittgenstein, Heidegger, and Kierkegaard are best understood as responsive to such questions, and as driven in consequence to strikingly similar reconceptions of language, reason, and understanding, doubt and scepticism, morality, and the structure of selfhood. Through detailed re-readings of these authors' most influential texts, as attentive to their specificity as to their family resemblances, Stephen Mulhall reorients our sense of the philosophical work each text aims to accomplish, to engender a critical dialogue betweeen them from which the elements of a new conception of philosophy might emerge, and to uncover that conception's indebtedness to certain fundamental theological preoccupations. (shrink)

In this volume some of the leading philosophers, psychologists, and theologians in the world shed light on the various ways in which we understand the world, pushing debates on this issue to new levels of sophistication and insight.

Foucault, Power, and Education invites internationally renowned scholar Stephen J. Ball to reflect on the importance and influence of Foucault on his work in educational policy.

The current system of ethical oversight in the United States is based on Institutional Review Board (IRB) review. The system was established in response to well-known and egregious mistreatment of subjects in both biomedical and social and behavioral research. In the decades since the research regulations were enacted, reaction to the burden of IRB oversight has led the system to focus on compliance and limit its active oversight disproportionately to studies that could present the risk of physical harm. At the (...) same time, the characteristics of the research enterprise have changed and methodologies now present novel risks that were not envisioned in the regulations. We convened a group of IRB professionals, academic leaders, and others to discuss limitations of the current system, how that system could be changed to recognize evolving risks and an increasing focus on participant and community voice, and how it could better serve the needs of researchers and support the societal project of science as a public good. Recommendations included a call to reexamine the academic incentive structure, to develop a system to support consideration of ethical principles from the time of study design, and to explicitly provide different ethical support and oversight for high-risk interventional trials and lower risk biomedical and social behavioral research. (shrink)

This paper chronicles my introduction to and subsequent investigation of the Felix Experimental Group (FEG) and its exhibitions of classical physical mediumship. It’s been nearly a century since investigators have had the opportunity to carefully study standard spiritistic phenomena, including the extruding of ectoplasm, and the FEG is the only current physical mediumistic circle permitting any serious controls. The paper details a progressively stringent, personally supervised series of séances, culminating in some well-controlled experiments with video documentation in a secure and (...) private location belonging to one of the investigators. Regrettably, recent indications of fraud (explored also by Michael Nahm in this issue) have tarnished the case as a whole. However, it remains unclear how extensive the fraud has been. Accordingly, this paper evaluates the arguments both for and against the paranormality of the phenomena displayed under the author’s supervision. (shrink)

Do people who cause themselves to be ill (e.g. by smoking) forfeit some of their rights to healthcare? This paper examines one argument for the view that they do, the restoration argument. It goes as follows. Smokers need more health‐resources than non‐smokers. Given limited budgets, we must choose between treating everyone equally (according to need) or reducing smokers' entitlements. If we choose the former, non‐smokers will be harmed by others' smoking, because there will be less resources available for them than (...) if no‐one smoked. This is unfair: why should non‐smokers suffer because of others' unhealthy lifestyle choices? We should therefore choose the latter and reduce smokers' entitlements. This paper criticises the restoration argument on the following grounds. In order to avoid generating unpalatable conclusions elsewhere, it must be combined with a principle according to which activities which are sufficiently ‘socially valuable’ (e.g. parenting) are immune from restoration claims. This however means that what was supposed to be one of the argument's most attractive features, its compatibility with ‘liberal neutrality’ with respect to the value of different lifestyles, doesn't really exist. Hence, the restoration argument is nowhere near as attractive as it at first appears to be. (shrink)

This article argues that teaching medical and nursing students health care ethics in an interdisciplinary setting is beneficial for them. Doing so produces an education that is theoretically more consistent with the goals of health care ethics, can help to reduce moral stress and burnout, and can improve patient care. Based on a literature review, theoretical arguments and individual observation, this article will show that the benefits of interdisciplinary education, specifically in ethics, outweigh the difficulties many schools may have in (...) developing such courses. (shrink)

Big Brother, the tyrant of George Orwell's 1984, directed his daily Two Minutes Hate against Emmanuel Goldstein, enemy of the people. When I studied evolutionary biology in graduate school during the mid-1960s, official rebuke and derision focused upon Richard Goldschmidt, a famous geneticist who, we were told, had gone astray. Although 1984 creeps up on us, I trust that the world will not be in Big Brother's grip by then. I do, however, predict that during this decade Goldschmidt will be (...) largely vindicated in the world of evolutionary biology. (shrink)

There are tensions within formal education between imparting knowledge and the development of skills for handling that knowledge. In the primary school sector, the latter can also be squeezed out of the curriculum by a focus on basic skills such as literacy and numeracy. What happens when an explicit attempt is made to develop young children's reasoning—both in terms of their apparent cognitive abilities and their basic skills? This paper reports an independent evaluation of an in-class intervention called ‘Philosophy for (...) Children’, after just over one year of schooling. The intervention aims to help children become more willing and able to question, reason, construct arguments and collaborate with others. A group of 48 volunteer schools were randomised to receive P4C or act as a control for one year. This paper reports the CAT results for all pupils in years 4 and 5 initially, and the Key Stage 2 attainment in English and Maths for those starting in year 5. There was no school dropout. Individual attrition from a total of 3,159 pupils was around 11 percent—roughly equal between groups. There were small positive ‘effect’ sizes in favour of the P4C group in progress in reading and maths, and even smaller perhaps negligible improvements in CAT scores and writing. The results for the most disadvantaged pupils were larger for attainment, but not for CATs. Observations and interviews suggest that the intervention was generally enjoyable and thought to be beneficial for pupil confidence. Our conclusion is that, for those wishing to improve attainment outcomes in the short term, an emphasis on developing reasoning is promising, especially for the poorest students, but perhaps not the most effective way forward. However, for those who value reasoning for its own sake, this evaluation demonstrates that using curriculum time in this way does not damage attainment, and so suggests that something like P4C is an appropriate educational approach. (shrink)

Twenty years ago, people thought only cranks or sentimentalists could be seriously concerned about the treatment of non-human animals. However, since then philosophers, scientists and welfarists have raised public awareness of the issue; and they have begun to lay the foundations for an enormous change in human practice. This book is a record of the development of 'animal rights' through the eyes of one highly-respected and well-known thinker. This book brings together for the first time Stephen R.L. Clark's major (...) essays in one volume. Written with characteristic clarity and persuasion, Animals and Their Moral Standing will be essential reading for both philosophers and scientists, as well as the general reader concerned by the debates over animal rights and treatment. (shrink)