For decades, the discussion on children’s competence to consent to medical issues has concentrated around normative concerns, with little progress in clinical practices. Decision-making competence is an important condition in the informed consent model. In pediatrics, clinicians need to strike a proper balance in order to both protect children’s interests when they are not fully able to do so themselves and to respect their autonomy when they are. Children’s competence to consent, however, is currently not assessed in a standardized way. (...) Moreover, the correlation between competence to give informed consent and age in children has never been systematically investigated, nor do we know which factors exactly contribute to children’s competence. (shrink)

Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

Acetyltransferase enzymes expressed in hepatic and extrahepatic tissues are products of an acetyltransferase gene locus. Acetylation capacity is regulated by simple autosomal Mendelian inheritance of two codominant alleles at this locus. Human slow acetylators are predisposed to bladder cancer from arylamine chemicals. The role of the bladder in arylamine metabolism and of bladder acetyltransferases in the etiology of bladder cancer is not fully understood, but the acetylator genotype‐dependent expression of arylamine N‐acetyltransferase and N‐hydroxyarylamine O‐acetyltransferase in bladder cytosol may contribute towards (...) the genetic predisposition of human slow acetylators to arylamine‐induced bladder cancer. (shrink)

This essay first contextualizes Adorno's essays in literary criticism in relation to his historico‐philosophical account of modern rationalization and late capitalism, his dialectical theory of culture, and his return to postwar Germany. It then presents the neo‐Marxist and formalist principles that inform his literary criticism, emphasizing the artwork's critical relationship to society, on the one hand, and the theory of aesthetic experience undergone by the artwork's recipient on the other. These principles are exemplified in selective readings of Adorno's essays on (...) Heinrich Heine and Friedrich Hölderlin. The essay concludes by polemically juxtaposing Adorno's practice of literary criticism with that of neo‐Aristotelian “ethical criticism.”. (shrink)

The author, a noted literary critic, presents a selection of his thought on Balzac, Valery, Dickens, Goethe, Heine, Hoelderlin, lyric poetry, realism, the essay and the contemporary novel.

How are the teachings of a thirteenth-century master relevant today? Twenty contemporary writers unpack Dogen's words and show how we can still find meaning in his teachings. Engaging Dogen's Zen is a practice oriented study of Shushogi (a canonical distillation of Dogen's thought used as a primer in the Soto School of Zen) and Fukanzazengi (Dogen's essential text on the practice of "just sitting," a text recited daily in the Soto School of Zen). It is also a study of the (...) entire self. Here, the principles of Soto Zen practice are unpacked and explained by leading contemporary Buddhists from the living tradition--monks, priests, academics, and community teachers. Tackling Dogen's approach to key issues, such as the preeminence of shikantaza, universal buddha nature, and what it means to be a Mahayana Buddhist, the contributors to the volume help Zen practitioners and any who are trying to deepen their lives to appreciate better the teachings of Soto Zen and make these teachings part of their lives. By revisiting what remains precious in Shushogi and Fukanzazengi, we let them breathe just as we learn to breathe in zazen. We find that Soto practice not only engages Dogen and Sakyamuni, but all of our sisters and brothers, and indeed the great earth itself. Includes essays from Kosho Itagaki, Taigen Dan Leighton, Tenshin Charles Fletcher, Shudo Brian Schroeder, Glen A. Mazis, David Loy, Drew Leder, Steven DeCaroli, Steve Bein, John Maraldo, Michael Schwartz, Tetsuzen Jason M. Wirth, Leah Kalmanson, Erin Jien McCarthy, Dainen David Putney, Steven Heine, Graham Parkes, Mark Unno, Shudo Brian Schroeder, and Kanpu Bret W. Davis. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:488 HISTORY OF PHILOSOPHY most extensive study of this aspect of Schelling's thought, at least until 1806. However, even if Schelling was not, as it is frequently stated, indifferent to the problems and the vicissitudes of politics, his theoretical thinking on this subject never went beyond temporary systematizations, to be given up, or modified, after a while. The author shows how Schelling, especially in this fieM, was influenced either (...) by his environment in general, or by some personalities he happened to contact: first his "republican" and francofile friends of the Ttibingen Stilt, afterwards the romantic circle of Jena, and, between 1801 and 1803, Hegel. The author studies in his first chapter, devoted tO the non-philosophic writings of the TUbingen period (1790-1795), not only Kant's and Herder's influence on Schelling, which are usually taken for granted, but also the impact of C. G. Heine and of other GSttingen scholars. This is a stimulating suggestion, showing the need for a more detailed study on the diffusion of the "historicocritical" method in circles, as the Ttibingen school, dominated rather by philosophical and theological than by philological and historical interests. In the following chapters, Schelling is closely related again to the intellectual history of his time; Schelling's relationship to the Aufkliirer Nicolai produces some surprises, and the same may be said about some new particulars (implementing F. Rosenzweig's and F. Bthm's research) on the close connection between Schelling and Htlderlin in 1795-1796. The fourth chapter is devoted to the correlation between theories on "natural philosophy" and moral political theories. The fifth concerns the philosophy of history and of government. This remarkable study, founded on sound scholarship, and conducted with a sharp historical mind, is to be recommended not only to students of Schelling, but to all those who have some interest in early XIXth Century German political thought. GIORGIO TONELLI State University of New York at Binghamton Gesammelte Werke, Vol. IV. By Georg Wilhelm Friedrich Hegel. Ed. Hartmut Buehner and Otto Ptggeler. (Hamburg: Felix Meiner, 1968. Pp. 622. DM 86.00) Despite the high reputation Germany has long enjoyed with regard to its scientifically reliable editions, up to this very moment, a historic-critical edition of the totality of Hegel's works has not existed. There were only provisional texts of single works available whose philological reliability differed in its sometimes doubtful variety. This is a rather strange fact, considering that Hegel died in 1831. It can be explained only by a phenomenon peculiar to this philosopher: at the peak of his fame, numerous students from all countries of the world attended Hegel's lectures, assiduously taking notes and frequently publishing as authentic what they had understood and jotted down. The philosopher was very generotis in authorizing various versions of his lectures and thus, the international market was swamped with quite incongruous editions of some of his writings at the moment of Hegel's death. Despite this rather confused state of affairs, distinguished scholars have tried, for BOOK REVIEWS 489 more than six decades, to bring order into the posthumous manuscripts of the philosopher, and these efforts were successful, but only to a certain extent. Next to the pioneering publications of Wilhelm Dilthey, Herman Nohl and Frans Rosenzweig, lesser known savants, in the first place, Georg Lasson and Johannes Hoffmeister have devoted many years of self-denying efforts to make /mportant parts of Hegel's manuscripts available to the public and looked for new possibilities to edit the large body of lectures. But the task proved too difficult for individual scholars. For this reason, the Deutsche Forschungsgemeinschaft, a government-sponsored organization, has commissioned the publication of an all-encompassing historic-critical edition of Hegel's works and arranged for the appointment of a senatorial commission for advising the editors of such a mammoth undertaking. Members of the commission were the aforementioned scholars (see title) and W. Wieland. The Ministry of Education of the State of Nordrhein-Westfalen has opened a research center, originally directed by F. Nicolin, since 1968 by O. Ptggeler. Thus the edition can now be published continuously. Before discussing the contents of volume four, the only volume hitherto published, let's take... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:488 HISTORY OF PHILOSOPHY most extensive study of this aspect of Schelling's thought, at least until 1806. However, even if Schelling was not, as it is frequently stated, indifferent to the problems and the vicissitudes of politics, his theoretical thinking on this subject never went beyond temporary systematizations, to be given up, or modified, after a while. The author shows how Schelling, especially in this fieM, was influenced either (...) by his environment in general, or by some personalities he happened to contact: first his "republican" and francofile friends of the Ttibingen Stilt, afterwards the romantic circle of Jena, and, between 1801 and 1803, Hegel. The author studies in his first chapter, devoted tO the non-philosophic writings of the TUbingen period (1790-1795), not only Kant's and Herder's influence on Schelling, which are usually taken for granted, but also the impact of C. G. Heine and of other GSttingen scholars. This is a stimulating suggestion, showing the need for a more detailed study on the diffusion of the "historicocritical" method in circles, as the Ttibingen school, dominated rather by philosophical and theological than by philological and historical interests. In the following chapters, Schelling is closely related again to the intellectual history of his time; Schelling's relationship to the Aufkliirer Nicolai produces some surprises, and the same may be said about some new particulars (implementing F. Rosenzweig's and F. Bthm's research) on the close connection between Schelling and Htlderlin in 1795-1796. The fourth chapter is devoted to the correlation between theories on "natural philosophy" and moral political theories. The fifth concerns the philosophy of history and of government. This remarkable study, founded on sound scholarship, and conducted with a sharp historical mind, is to be recommended not only to students of Schelling, but to all those who have some interest in early XIXth Century German political thought. GIORGIO TONELLI State University of New York at Binghamton Gesammelte Werke, Vol. IV. By Georg Wilhelm Friedrich Hegel. Ed. Hartmut Buehner and Otto Ptggeler. (Hamburg: Felix Meiner, 1968. Pp. 622. DM 86.00) Despite the high reputation Germany has long enjoyed with regard to its scientifically reliable editions, up to this very moment, a historic-critical edition of the totality of Hegel's works has not existed. There were only provisional texts of single works available whose philological reliability differed in its sometimes doubtful variety. This is a rather strange fact, considering that Hegel died in 1831. It can be explained only by a phenomenon peculiar to this philosopher: at the peak of his fame, numerous students from all countries of the world attended Hegel's lectures, assiduously taking notes and frequently publishing as authentic what they had understood and jotted down. The philosopher was very generotis in authorizing various versions of his lectures and thus, the international market was swamped with quite incongruous editions of some of his writings at the moment of Hegel's death. Despite this rather confused state of affairs, distinguished scholars have tried, for BOOK REVIEWS 489 more than six decades, to bring order into the posthumous manuscripts of the philosopher, and these efforts were successful, but only to a certain extent. Next to the pioneering publications of Wilhelm Dilthey, Herman Nohl and Frans Rosenzweig, lesser known savants, in the first place, Georg Lasson and Johannes Hoffmeister have devoted many years of self-denying efforts to make /mportant parts of Hegel's manuscripts available to the public and looked for new possibilities to edit the large body of lectures. But the task proved too difficult for individual scholars. For this reason, the Deutsche Forschungsgemeinschaft, a government-sponsored organization, has commissioned the publication of an all-encompassing historic-critical edition of Hegel's works and arranged for the appointment of a senatorial commission for advising the editors of such a mammoth undertaking. Members of the commission were the aforementioned scholars (see title) and W. Wieland. The Ministry of Education of the State of Nordrhein-Westfalen has opened a research center, originally directed by F. Nicolin, since 1968 by O. Ptggeler. Thus the edition can now be published continuously. Before discussing the contents of volume four, the only volume hitherto published, let's take... (shrink)