Definite descriptions (e.g. 'The king of France in 1997', 'The teacher of Aristotle') do not stand for particulars. Or so I will assume. The semantic alternative has seemed to be that descriptions only have meaning within sentences: i.e., that their semantic contribution is given syncategorimatically. This doesn't seem right, however, because descriptions can be used and understood outside the context of any sentence. Nor is this use simply a matter of "ellipsis." Since descriptions do not denote particulars, but seem to (...) have a meaning in isolation, I propose that they be assigned generalized quantifiers as denotations — i.e. a kind of function, from sets/properties to propositions. I then defend the pragmatic plausibility of this proposal, using Relevance Theory. Specifically, I argue that, even taken as standing for generalized quantifiers, descriptions could still be used and understood in interpersonal communication. (shrink)

If you believe that there are restrictions on what we as moral agents can do to others, but that these restrictions can give way in the face of competing considerations, then you believe in thresholds for rights. In this dissertation I develop an account of thresholds for rights, in defence of a position which is often stated but rarely explained or defended. I begin with the obvious question: How much needs to be at stake before a right's claim is overridden? (...) ;Less obvious, but equally crucial, are questions about the distribution of the total which needs to be at stake. After developing a framework for answering that question, in subsequent chapters I deal with other factors which may influence our judgements about the overridability of rights' claims, including the numbers and identities of the agents involved. (shrink)

Heated debate surrounds the question whether the relationship between physician-researcher and patient-subject is governed by a duty of care. Miller and Weijer argue that fiduciary law provides a strong legal foundation for this duty, and for articulating the terms of the relationship between physician-researcher and patient-subject.

Philosophical theorizing about language now involves an increasing emphasis on empirical work and a renewed convergence with philosophy of mind, formal semantics and logic. This new text reflects this evolution. -/- Philosophical Perspectives on Language is distinguished in several important respects from other introductions to the topic. Rather than looking at philosophy of language as a collection of (at best) loosely related topics—speech acts, demonstratives, sense and reference, truth and meaning, etc.—this book is organized around a unifying theme: language as (...) a system of symbols that is known and used. (shrink)

[Publisher's description] -/- * Authoritative review of this dynamic field placed in an interdisciplinary context * Approximately 175 articles by leaders in the field * Compact and affordable single-volume format -/- The application of philosophy to language study, and language study to philosophy, has experienced demonstrable intellectual growth and diversification in recent decades. This work comprehensively analyzes and evaluates many of the most interesting facets of this vibrant field. An edited collection of articles taken from the award-winning Encyclopedia of Language (...) and Linguistics 2nd edition, this volume acts as a single-stop desk reference resource for the field, comprising contributions from the foremost scholars of philosophy of linguistics in their various interdisciplinary specializations. From Plato's Cratylus to Semantic and Epistemic Holism, this fascinating work authoritatively unpacks the diverse and multi-layered concepts of meaning, expression, identity, truth, and countless other themes and subjects straddling the linguistic-philosophical meridian, in 175 articles and over 900 pages. Readership: Relevant to any department, institute or individual interested in the philosophical aspects of language. (shrink)

Emergency medicine research requires the enrollment of subjects with varying decision-making capacities, including capable adults, adults incapacitated by illness or injury, and children. These different categories of subjects are protected by multiple federal regulations. These include the federal Common Rule, the Department of Health and Human Services (DHHS) regulations for pediatric research, and the Food and Drug Administration's (FDA) Final Rule for the Exception from the Requirements of Informed Consent in Emergency Situations. Investigators should be familiar with the relevant federal (...) research regulations to optimally protect vulnerable research subjects, and to facilitate the institutional review board (IRB) review process. IRB members face particular challenges in reviewing emergency research. No regulations exist for research enrolling incapacitated subjects using proxy consent. The wording of the Final Rule may not optimally protect vulnerable subjects. It is also difficult to apply conflicting regulations to a single study that enrolls subjects with differing decision-making capacities. This article is intended as a guide for emergency researchers and IRB members who review emergency research. It reviews the elements of Federal Regulations that apply to consent, subject selection, privacy protection, and the analysis of risks and benefits in all emergency research. It explores the challenges for IRB review listed above, and offers potential solutions to these problems. (shrink)

Michael Dummett has nicely expressed a rather widespread doctrine about the primacy of sentences. He writes: "you cannot DO anything with a word — cannot effect any conventional act by uttering it — save by uttering some sentence containing that word ...". In this paper we argue that this doctrine is mistaken: it is not only sentences, but also ordinary words and phrases which can be used in isolation. The argument involves two steps. First: we show — using Sperber and (...) Wilson's relevance theory — that an utterance of "John's father" could COMMUNICATE a proposition. Second: we point out that, in this context, this proposition would be asserted rather than merely implicated. Because there is nothing importantly idiosyncratic about the phrase "John's father", we infer that words and phrases generally can be used in isolation to make assertions. (shrink)

The definition of the study population for a clinical trial via the criteria for trial eligibility has implications for the validity of the study and its applicability to clinical practice. Though issues of equity regarding the selection of subjects for research have long been a concern of ethicists, issues regarding the impact of subject selection on a trial's generalizability have only recently attracted ethical scrutiny. After a review of the history of the ethics of subject selection, I focus on three (...) empirical questions regarding the generalizability of clinical trials. (1) What proportion of diseased populations are studied in clinical trials? (2) How are subjects selected for clinical trial participation (and what are the main barriers to participation)? (3) Are clinical trial participants comparable to non-participants? Finally, the role of the Institutional Review Board--Research Ethics Board in Canada--in assessing the generalizability of clinical research is discussed. (shrink)

This comprehensive volume contains much of the important work in political and social philosophy from ancient times until the end of the nineteenth century. The anthology offers both depth and breadth in its selection of material by central figures, while also representing other currents of political thought. Thucydides, Seneca, and Cicero are included along with Plato and Aristotle; Al-Farabi, Marsilius of Padua, and de Pizan take their place alongside Augustine and Aquinas; Astell and Constant are presented in the company of (...) Locke, Rousseau, and Wollstonecraft. -/- The editors have made every effort to include translations that are both readable and reliable. Every selection has been painstakingly annotated, and each figure is given a substantial introduction highlighting his or her major contribution within the tradition. In order to ensure the highest standards of accuracy and accessibility, the editors have consulted dozens of leading academics during the course of the anthology's development (a number of whom have contributed introductory material as well as advice). The result is an anthology with unparalleled pedagogical benefits, and one that truly breaks new ground. -/- . (shrink)

Speaking from our experience as department chairs in fields in which women are traditionally underrepresented, we offer reflections and advice on how one might move beyond the chilly climate and create a warmer environment for women students and faculty members.

The existing EELS literature has usefully identified the scope of ethical issues posed by pharmacogenetic and pharmacogenomic research. The time has come for in-depth examination of particular ethical issues. The involvement of racial and ethnic communities in pharmacogenetic and pharmacogenomic research is contentious precisely because it touches upon the science and politics of studying racial and ethnic difference. To date, the ethics literature has not seriously taken account of the fact that such research impinges upon the interests of communities, and (...) that taking such interests seriously requires that we both protect and empower communities in research. We propose a framework that rests upon the recognition that communities are heterogeneous human associations and differing policies are appropriate for differing communities. Community consent and consultation and community consultation alone are neither appropriate nor required for all pharmacogenetic and pharmacogenomic research. Rather, application of these policy protections must take into account particulars of both planned research and the communities involved. (shrink)

Procedures for the selection of subjects for participation in randomized clinical trials--usually formalized as eligibility criteria in the study protocol--have both scientific and ethical implications. In this thesis, I undertake an examination of eligibility criteria at three stages in the genesis and dissemination of medical knowledge: clinical trial protocol, interpretation by investigators, and reporting of study results.In the first chapter, ethical issues in subject selection are reviewed and the main study questions are presented. In the second chapter, the results of (...) an examination of eligibility criteria in two sets of clinical trials, one sponsored by the NSABP, the other sponsored by POG, covering a twenty-year time span are presented. The POG trials had far fewer eligibility criteria than the NSABP studies, suggesting that large numbers of criteria may not be necessary for high quality research. In the third chapter, the impact of subjective eligibility criteria on enrollment and investigator uncertainty is explored. Subjective criteria were associated with more variable enrollment decisions and greater uncertainty. Such criteria represent a threat to the validity, conduct and interpretation of trials and, therefore, should only be included when carefully justified. The fourth chapter examines the accuracy of the reporting of eligibility criteria in sets of corresponding study protocol, methods paper, journal article, and Clinical Alert. Important information is lost at each step in the dissemination of study results. Unnecessary criteria ought to be dropped at a trial's inception; all other criteria must be reported faithfully. The fifth chapter attempts to provide a comprehensive philosophical account of just selection procedures for clinical research using the political philosophy of Michael Walzer. The sixth, and last, chapter, discusses explanatory and pragmatic approaches to clinical trial design, overlapping scientific and ethical concerns related to eligibility criteria, and questions for further study. (shrink)

The article aims to distinguish autonomy from integrity. I claim that integrity is different from a form of autonomy at least, but that integrity and autonomy overlap considerably. Integrity itself is a form of autonomy: what ethicists call ‘moral autonomy.’ (They tend to distinguish between personal and moral autonomy.) Autonomy is the genus, one might say, with integrity (i.e., moral autonomy) and personal autonomy being species of it.

McGill ethicists help ensure that medical research conforms to the highest scientific and ethical standards.

Now that stem cell scientists are clamouring for human eggs for cloning-based stem cell research, there is vigorous debate about the ethics of paying women for their eggs. Generally speaking, some claim that women should be paid a fair wage for their reproductive labour or tissues, while others argue against the further commodification of reproductive labour or tissues and worry about voluntariness among potential egg providers. Siding mainly with those who believe that women should be financially compensated for providing eggs (...) for research, the new stem cell guidelines of the International Society for Stem Cell Research (ISSCR) legitimise both reimbursement of direct expenses and financial compensation for many women who supply eggs for research. In this paper, the authors do not attempt to resolve the thorny issue of whether payment for eggs used in human embryonic stem cell research is ethically legitimate. Rather, they want to show specifically that the ISSCR recommended payment practices are deeply flawed and, more generally, that all payment schemes that aim to avoid undue inducement of women risk the global exploitation of economically disadvantaged women. (shrink)

PURPOSE: The offer to return research results to participants is increasingly recognized as an ethical obligation, although few researchers routinely return results. We examined the needs and attitudes of parents of children with cancer and of adolescents with cancer to the return of research results. METHODS: Seven experts in research ethics scored content validity on parent and adolescent questionnaires previously developed through focus group and phone interviews. The questionnaires were revised and provided to 30 parents and 10 adolescents in a (...) tertiary care oncology setting. RESULTS: The content validity index for individual questions and the overall questionnaires scored as 0.86 for both questionnaires. All 30 parents and 10 adolescents who agreed to participate returned questionnaires. The majority (>95%) indicated that they had a strong or very strong right to receive results. Letter or e-mail was a satisfactory means to return results described as good or neutral (66% parents, 100% adolescents) but more participants wished face-to-face disclosure of results with negative implications (50% parents, 60% adolescents). Very few wanted results disseminated through a Web site. The majority acknowledged the need for peer-review before disclosure (60% of adolescents and parents) but did not want "to be the last to know." CONCLUSIONS: Our data suggest that pediatric oncology patients and parents of children with cancer strongly feel that they have a right to research results, and that they wish to receive these in a timely manner. (shrink)

Public attention on embryo research has never been greater. Modern reproductive medicine technology and the use of embryos to generate stem cells ensure that this will continue to be a topic of debate and research across many disciplines. This multidisciplinary book explores the concept of a 'healthy' embryo, its implications on the health of children and adults, and how perceptions of what constitutes child and adult health influence the concept of embryo 'health'. The concept of human embryo health is considered (...) from preconception to pre-implantation genetic diagnosis to recent foetal surgical approaches. Burgeoning capacities in both genetic and reproductive science and their clinical implications have catalysed the necessity to explore the concept of a 'healthy' embryo. The authors are from five countries and 13 disciplines in the social sciences, humanities, biological sciences and medicine, ensuring that the book has a broad coverage and approach. (shrink)

Although for the last 50 years, ethicists dealing with human experimentation have focused primarily on the need to protect individual research subjects and vulnerable groups, biomedical research, especially in genetics, now requires the establishment of standards for the protection of communities. We have developed such a strategy, based on five steps. (i) Identification of community characteristics relevant to the biomedical research setting, (ii) delineation of a typology of different types of communities using these characteristics, (iii) determination of the range of (...) possible community protections, (iv) creation of connections between particular protections and one or more community characteristics necessary for its implementation, and (v) synthesis of community characteristics and possible protections to define protections appropriate for each type of community. Depending on the particular community, consent and consultation, consultation alone, or no added protections may be required for research. (shrink)

Issues: We present key aspects of our paper, commissioned by UNAIDS in 2005, entitled, “Revisiting the ethics of HIV prevention research in developing countries.” In 2004 and 2005 we witnessed the closure or suspension of three international clinical trials testing tenofovir in the prevention of HIV infection in high risk groups due to the failure to provide free treatment to those who seroconvert during the conduct of the study. We examine critically moral claims for the provision of treatment to those (...) who seroconvert in HIV prevention trials and ask whether it is a matter of moral obligation or moral negotiation?Description: Using the tools of philosophical and regulatory analysis we examine the moral foundations of research ethics, international regulation, and the contemporary literature in search of valid arguments in support of a moral obligation to treat. Arguments supporting the obligation to provide such treatment are found in a wide variety of documents. These claims are variously rooted in the demand to compensate for research-related injury, maximization of research benefit, justice as reciprocity, and justice as equality.Lessons learned: Our analysis reveals that there is as of yet no robust moral argument supporting a moral obligation to provide treatment to participants in HIV prevention trials who seroconvert. We argue that moral negotiation offers distinct advantages over moral obligation. Moral negotiation finds support in the principle of respect for communities that holds researchers responsible to respect communal values, protect and empower social institutions and abide by the decisions of accepted communal authorities.Recommendations: Moral negotiation, rather than moral obligation, reduces the chance of polarization of positions by inviting trial participants, sponsors, researchers and all other involved parties to the table for discussion. Moral negotiation favors middle ground solutions that fit the specific health needs and priorities of the community in question. (shrink)

The institutional review board is the social-oversight mechanism charged with protecting research subjects. Performing this task competently requires that the IRB scrutinize informed-consent procedures, the balance of risks and potential benefits, and subject-selection procedures in research protocols. Unfortunately, it may be said that IRBs are spending too much time editing informed-consent forms and too little time analyzing the risks and potential benefits posed by research. This time mismanagement is clearly reflected in the research ethics literature. A review of articles published (...) between 1979 and 1990 in IRB: A Review of Human Subjects Research, for example, reveals a large number of articles on informed consent and confidentiality and considerably fewer on the assessment of risks and potential harms, study design, and subject-selection procedures. (shrink)

Background: Low rates of participation of adolescents and young adults (AYAs) in clinical oncology trials may contribute to poorer outcomes. Factors that influence the decision of AYAs to participate in health research and whether these factors are different from those that affect the participation of parents of children with cancer. Methods: This is a secondary analysis of data from validated questionnaires provided to adolescents (>12 years old) diagnosed with cancer and parents of children with cancer at 3 sites in Canada (...) (Halifax, Vancouver, and Montreal) and 2 in the United States (Atlanta, GA, and Memphis, TN). Respondents reported their own research participation and cited factors that would influence their own decision to participate in, or to provide parental authorization for their child to participate in health research. Results: Completed questionnaire rates for AYAs and parents were 86 (46.5%) of 185 and 409 (65.2%) of 627, respectively. AYAs (n = 86 [67%]) and parents (n = 409 [85%]) cited that they would participate in research because it would help others. AYAs perceived pressure by their family and friends (16%) and their physician (19%). Having too much to think about at the time of accrual was an impediment to both groups (36% AYAs and 47% parents). The main deterrent for AYAs was that research would take up too much time (45%). Nonwhite parents (7 of 56 [12.5%]) were more apt to decline than white parents (12 of 32 [3.7%]; P < .01). Conclusions: AYAs identified time commitment and having too much to think about as significant impediments to research participation. Addressing these barriers by minimizing time requirements and further supporting decision-making may improve informed consent and impact on enrollment in trials. (shrink)

This concise and affordable anthology is designed for use as a textbook in both undergraduate and graduate courses in philosophy of language. It aims to provide a core of essential primary sources and may be used either on its own, or in conjunction with a secondary source.

The issue of the protection of communities in clinical research first arose 10 years ago in studies conducted in technologically developing countries by scientists from technologically developed nations. The question was, which ethical standards ought to apply, those of the Western investigators or local standards?