Objective Ethical standards state research participation must be voluntary and free of coercion and undue influence, but what if a third party appears to engage in research-relevant coercion, without the researchers’ knowledge? This case study describes this type of situation and its resolution. Methods We are engaged in a randomized clinical trial evaluating pedestrian safety with 7- and 8- years old. Depending on children's rate of learning, families receive up to $1275 for their time. We recently learned a third-party “talent (...) agency,” a firm placing children in modeling and acting jobs, was referring families to our research with the expectation that families would share 20% of study reimbursements. Results We sensed clear impropriety, but identified no ethical violations on our part as researchers. Once paid a study reimbursement, participants can spend funds how they wish. We were concerned, however, that the third-party was exploitatively coercing families to participate. Conclusions We pursued four avenues to resolve the issue. First, we documented the situation to our university Institutional Review Board. Second, we contacted the talent agency and requested they stop referring families to our research. They agreed. Third, we retained children engaged in our study who were referred from the talent agency; removing them partway through the clinical trial could impact study results. In doing so, we explained that we were unaware of the talent agency referral and that they were not obligated by us to offer a portion of the study reimbursement to the talent agency. Last, we asked newly enrolled families about their referral source. (shrink)

Three standard psychometric tests were administered to parents who volunteered their children for a randomised, double-blind placebo-controlled trial of a new asthma drug and to a control group of parents whose children were eligible for the trial but had declined the invitation. The trial took place at a children's hospital in Australia. The subjects comprised 68 parents who had volunteered their children and 42 who had not, a participation rate of 94 per cent and 70 per cent, respectively. The responses (...) of these parents to the Gordon Survey of Interpersonal Values Questionnaire, the Coopersmith Self-Esteem Inventory and the Cattell Sixteen Personality Factor Questionnaire were analysed by computer. There was a marked difference between the psychological profiles of the two groups of parents. Volunteering parents put more value on benevolence while non-volunteering parents were more concerned with power and prestige. The self-esteem of volunteering parents was much lower than that of non-volunteering parents. Finally, volunteering parents were more introverted, exhibited greater anxiety and low supergo, while non-volunteering parents appeared to have greater social confidence and emotional stability. Since an individual's values, self-esteem and personality may be important antecedents of behaviour, these findings suggest that parents who volunteer their children for clinical research are not only socially disadvantaged and emotionally vulnerable, but may also be psychologically predisposed to volunteering. Furthermore, these findings provide evidence for the existence of a psychosocial 'filter' effect of the informed consent procedure, which may be discouraging the better educated, more privileged and psychologically resilient members of society from participation as research subjects. (shrink)

A collection of new essays on the influential medieval philosopher John Buridan, written by leading Buridan scholars. The volume places Buridan in his philosophical context and examines his writings on topics including logic, modal logic, paradoxes, metaphysics, epistemology, theory of knowledge, moral philosophy, and natural philosophy.

Professor Brian V. Johnstone, CSsR, has been quietly and unobtrusively contributing to the intellectual life of Catholicism, especially in the field of moral theology, for nearly four decades. Having published numerous theological articles on many topics, including biomedical ethics, peace and war, and fundamental moral theology, and directed many doctoral dissertations, it is no exaggeration to say that he has dedicated his entire life to teaching and writing theology. In honor of Johnstone's work, this felicitation volume covers a wide range (...) of themes in the Christian moral life with original articles written by internationally recognized theologians. In the spirit of Johnstone's thought and work, each article challenges the reader to reflect upon the present while contemplating the future of moral theology. (shrink)

The teaching of ethics in UK medical schools has recently been reviewed, from the perspective of the teachers themselves. A questionnaire survey of medical undergraduates at King’s College London School of Medicine provides useful insight into the students’ perception of ethics education, what they consider to be the value of learning ethics and law, and how engaged they feel with the subject.

The Mental Capacity Act received Royal Assent on 7 April 2005, and it will be implemented in 2007. The Act defines when someone lacks capacity and it supports people with limited decision-making ability to make as many decisions as possible for themselves. The Act lays down rules for substitute decision making. Someone taking decisions on behalf of the person lacking capacity must act in the best interests of the person concerned and choose the options least restrictive of his or her (...) rights and freedoms. Decision making will be allowed without any formal procedure unless specific provisions apply, such as a written advance decision, lasting powers of attorney or a decision by the court of protection. (shrink)

Knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. In the UK, the General Medical Council requires that medical graduates behave according to ethical and legal principles and must know about and comply with the GMC’s ethical guidance and standards. We suggest that these standards can only be achieved when the teaching and learning of medical ethics, law and professionalism are fundamental to, and thoroughly integrated both vertically (...) and horizontally throughout, the curricula of all medical schools as a shared obligation of all teachers. The GMC also requires that each medical school provides adequate teaching time and resources to achieve the above. We reiterate that the adequate provision and coordination of teaching and learning of ethics and law requires at least one full-time senior academic in ethics and law with relevant professional and academic expertise. In this paper we set out an updated indicative core content of learning for medical ethics and law in UK medical schools and describe its origins and the consultative process by which it was achieved. (shrink)

A half century ago electronic fetal monitoring was rushed into clinical use with the promise that the secrets of fetal heart rate decelerations had been discovered and that the newly discovered knowledge would prevent cerebral palsy with just in time cesarean sections preventing babies from experiencing asphyxia, which was thought to be the primary cause of cerebral palsy. In the years since electronic fetal monitoring’s debut, it has been discovered that asphyxia is a rare cause of cerebral palsy. At the (...) same time electronic fetal monitoring use increased to 85% of all labors, the C-section rate increased to 33% without an attributable decrease in the rate of cerebral palsy. What went wrong with electronic fetal monitoring? The answer lies in a new analysis of the physiologic theories concerning fetal heart rate decelerations, demonstrating that the earlier electronic fetal monitoring theories were wrong. This revelation is only the latest evidence that electronic fetal monitoring use today... (shrink)

The Alice Books, full of illogical thoughts, words, and contradictions, were unrivaled entertainment until the publication of the medical literature promoting electronic fetal monitoring for every pregnancy. The modern-day EFM advocates acknowledge EFM’s decades long failure but simultaneously recommend EFM use for lawsuit protection and because the profession has used EFM for every pregnancy for fifty years, therefore, it must be efficacious. These self-indulgent, illogical rationalizations ignore the half century of evidence-based scientific research proving that EFM is a complete failure (...) as well as ignoring the fact that continued EFM use violates the fundamental principles of modern bioethics. This blind advocacy perpetuates four pernicious EFM harms occurring to mothers, babies, and the medical profession itself. This article sets out these four EFM harms with the goal of abolishing the misguided, illogical, contradictory, arguments used by the twenty-first century EFM Lewis Carroll mimics. (shrink)

The aim of this paper is to look at the arguments advanced by three Parisian arts masters about how to understand Prior Analytics II 4 and the more general discussion that medieval authors situate...

Labor and Global Justice combines conceptual and theoretical perspectives across a multiplicity of relevant differences, both geographical and disciplinary, to develop a transnational perspective on labor and justice and to make clear how justice requires a rethinking of the relation between labor and global capital.

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

Attentional bias towards threat can be demonstrated by enhanced processing of threat-related targets and/or greater interference when threat-related distractors are present. These effects are argued to reflect processing within the orienting and executive control networks of the brain respectively. This study investigated behavioural and electrophysiological correlates of early selective attention and top-down attentional control among females with high or low spider fear. Participants completed a novel flanker go/nogo task in which a central schematic flower or spider stimulus was flanked by (...) either congruent or incongruent distractors. Participants responded to green stimuli and withheld response to yellow stimuli. High fear participants demonstrated significantly shorter reaction times and greater P1 amplitude to spider targets, suggesting specific hypervigilance towards threat-relevant stimuli. In contrast to predictions, there was little evidence for behavioural interference effects or differences in N2 amplitude when distractor stimuli were threat-relevant. (shrink)

The randomised controlled trial (RCT) constitutes a quantitative, comparative, controlled study of a particular treatment, and provides invaluable evidence regarding its pharmacotherapeutic efficacy. These studies are generally predicated upon the ethical principle of clinical equipoise. However, this may be insufficient to justify withholding treatment from a control group while assessing drug therapy in a potentially fatal disease. Thus, the criteria for randomisation, informed consent methodology and timing, and consideration of treatment options in such a scenario remain the province of medical (...) ethics. This paper addresses the need for an RCT of ribavirin in the treatment of Crimean Congo haemorrhagic fever, and highlights underlying ethical concerns in light of the current medical, virological and ethical literature. (shrink)

There is more to law than rules, robes and precedents. Rather, law is an integral part of social practices and policies, as diverse and complex as society itself. Thinking About Law offers a comprehensive introduction to the ways in which law has been presented and represented. It explores historical, sociological, economic and philosophical perspectives on the major legal and political debates in Australia today. The contributors examine the position of Aborigines in the Australian legal system and the impact of the (...) Mabo case; divisions of power in Australian society and law; the question of objectivity in law; the relationship between legislation and social change; judicial decision-making and other issues. Accessibly written, Thinking About Law is essential reading for students and anyone interested in understanding our legal system. (shrink)

_John Dewey and Continental Philosophy_ provides a rich sampling of exchanges that could have taken place long ago between the traditions of American pragmatism and continental philosophy had the lines of communication been more open between Dewey and his European contemporaries. Since they were not, Paul Fairfield and thirteen of his colleagues seek to remedy the situation by bringing the philosophy of Dewey into conversation with several currents in continental philosophical thought, from post-Kantian idealism and the work of Friedrich Nietzsche (...) to twentieth-century phenomenology, hermeneutics, and poststructuralism. This unique volume includes discussions comparing and contrasting Dewey with the German philosophers G. W. F. Hegel, Friedrich Nietzsche, Martin Heidegger, and Hans-Georg Gadamer on such topics as phenomenology, naturalism, organicism, contextualism, and poetry. Others investigate a series of connections between Dewey and contemporary French philosophy, including the notions of subjectivity, education, and the critique of modernity in Michel Foucault; language and politics in Jacques Derrida; and the concept of experience in Gilles Deleuze. Also discussed is the question of whether we can identify traces of _Bildung_ in Dewey’s writings on education, and pragmatism’s complex relation to twentieth-century phenomenology and hermeneutics, including the problematic question of whether Heidegger was a pragmatist in any meaningful sense. Presented in intriguing pairings, these thirteen essays offer different approaches to the material that will leave readers with much to deliberate. _ John Dewey and Continental Philosophy_ demonstrates some of the many connections and opportunities for cross-traditional thinking that have long existed between Dewey and continental thought, but have been under-explored. The intersection presented here between Dewey’s pragmatism and the European traditions makes a significant contribution to continental and American philosophy and will spur new and important developments in the American philosophical debate. (shrink)

This chapter contains sections titled: Overview Ralph Waldo Emerson John Dewey Richard Rorty Martha Nussbaum Conclusion.

In the last 30 years there has been growing interest in and a greater appreciation of the unique contributions that medieval authors have made to the history of logic. In this thesis, we compare and contrast the modal logics of Robert Kilwardby and John Buridan and explore how their two conceptions of modality relate to and differ from modern notions of modal logic. We develop formal reconstructions of both authors' logics, making use of a number of different formal techniques. In (...) the case of Robert Kilwardby we show that using his distinction between per se and per accidens modalities, he is able to provide a consistent interpretation of the apodictic fragment of Aristotle's modal syllogism and that, by generalising this distinction to hypothetical construction, he can develop an account of connexive logic. In the case of John Buridan we show that his modal logic is a natural extension of the usual Kripke-style possible worlds semantics, and that this modal logic can be shown to be sound and complete relative to a proof-theoretic formalisation of Buridan's treatment of the expository syllogism. (shrink)

This article explores the attitudes of consultants in a large UK teaching hospital to the need for formal clinical ethics support. Data obtained through an anonymous online questionnaire illustrate the ways in which consultants deal with clinical ethical dilemmas and their confidence in such decision-making. In the absence of formal ethics support a large proportion of consultants who took part in the survey said that they would consult with colleagues when faced with a clinical ethical dilemma and the majority considered (...) that this satisfactorily resolved the issue. However, 80% of respondents stated that they would find a form of ethics support within the Trust to be useful. Consultants also noted the reasons for, and barriers to, using ethics support. The response rate to the survey was low, perhaps indicating a lack of interest in the topic or that clinical ethics discussion is of low priority. (shrink)

Robert Kilwardby occupies an important place in the history of logic, and the history of western thought more generally. Perhaps best known to scholars for his Oxford condemnations of 1277...

This ancient text represents one of yoga's most influential and important works. Dating back to India of the second century B.C., the yoga sutras constitute a complete manual for the study and practice of the philosophical system. The sutras, or threads, are aphorisms of wisdom that offer guidelines to living a meaningful and purposeful life. This volume explains the eight limbs of the discipline: restraint, observances, posture, breath control, withdrawal from the senses, attention, meditation, and stillness. Little is known about (...) the life of Patanjali beyond the assumption that he was a contemporary of the Buddha. Charles Johnston, an immensely learned scholar of Eastern traditions, offers modern readers a straightforward translation of Patanjali's writings. This easy-to-follow interpretation will prove a rewarding companion to yoga students, participants in teacher-training programs, and students of Eastern philosophy. (shrink)