The new science of genomics endeavors to chart the genomes of individuals around the world, with the dual goals of understanding the role genetic factors play in human health and solving problems of disease and disability. From the perspective of indigenous peoples and developing countries, the promises and perils of genomic science appear against a backdrop of global health disparity and political vulnerability. These conditions pose a dilemma for many communities when attempting to decide about participating in genomic research or (...) any other biomedical research. Genomic research offers the possibility of improved technologies for managing the acute and chronic diseases that plague their members. Yet, the history of particularly biomedical research among people in indigenous and developing nations offers salient examples of unethical practice, misuse of data, and failed promises. This dilemma creates risks for communities who decide either to participate or not to participate in genomic science research. Some argue that the history of poor scientific practice justifies refusal to join genomic research projects. Others argue that disease poses such great threats to the well-being of people in indigenous communities and developing nations that not participating in genomic research risks irrevocable harm. Thus, some communities particularly among indigenous peoples have declined to participate as subjects in genomic research. At the same time, some communities have begun developing new guidelines, procedures, and practices for engaging with the scientific community that offer opportunities to bridge the gap between genomic science and indigenous and/or developing communities. Four new approaches warrant special attention and further support: consulting with local communities; negotiating the complexities of consent; training members of local communities in science and health care; and training scientists to work with indigenous communities. Implicit is a new definition of “rigorous scientific research,” one that includes both community development and scientific progress as legitimate objectives of genomic research. Innovative translational research is needed to develop practical, mutually acceptable methods for crossing the divide between genomic researchers and indigenous communities. This may mean the difference between success and failure in genomic science, and in improving health for all peoples. (shrink)
Objectives—To evaluate a departmental computer system.Design—a. Direct comparison of the time taken to use a manual system with the time taken to use a computer system for lung function evaluation, loan of equipment and production of correspondence. b. Analysis of the accuracy of data capture before and after the introduction of the computer system. c. Analysis of the comparative running costs of the manual and computer systems.Setting—Within a department of respiratory medicine serving a hospital of 1323 beds.Main Outcome Measures—a. Time (...) taken to perform functions with the assistance of computerised methods, in comparison to the manual method used alone. b. Accuracy of data capture. c. Relative running costs.Results—a. The computer system (CS) was significantly faster than the manual system (MS) for lung function evaluation (CS=7.63 min/test, MS=12.25 min/test), loan of equipment (CS=0.40 min/loan, MS=2.07 min/loan), and checking for overdue equipment (CS=0.49 s/record, MS=9 s/record). The production of correspondence was slightly slower with the computer (CS=9.30 min/letter, MS=8.54 min/letter). b. All outpatient episodes, but only 43 of 65 (66%) of inpatient episodes, were captured. Lung function and managerial report data were accurate using both manual and computerised methods. The manual system for equipment loans was inefficient, and use of the computer resulted in the recovery of 221 nebulisers. c. Development costs for 1988–1990 were high (£72 178). Only £1200 to £1845 per year was recovered directly from staff time saved by the computer but larger savings resulted from changes in work practice (£4049–4765). After 10 years the projected deficit is £10 000 per annum in running costs.Conclusions—In comparison with the manual methods, the computer system has shown significant advantages which provide accurate information, with significant favourable effects on working practices. In evaluating computer systems used in clinical practice it is essential to ensure that the projected work practice benefits are achieved without unacceptable costs in staff time, inaccurate data and high financial outlay. (shrink)
Turning Images in Philosophy, Science, and Religion: A New Book of Nature brings together new essays addressing the role of images and imagination recruited in the perennial debates surrounding nature, mind, and God. -/- The debate between "new atheists" and religious apologists today is often hostile. This book sets a new tone by locating the debate between theism and naturalism (most "new atheists" are self-described "naturalists") in the broader context of reflection on imagination and aesthetics. The eleven essays will be (...) of interest to anyone who is fascinated by the power of imagination and the role of aesthetics in deciding between worldviews or philosophies of nature. Representing a variety of points of view, authors include outstanding philosophers of religion and of science, a distinguished art historian, and a visual artist. -/- The book begins with Martin Kemp's essay on the work of the biologist, mathematician and classical scholar D'Arcy Wentworth Thompson in which Kemp develops the idea of "structural intuitions and a critique of reductive thinking about the natural world. This is followed by Geoffrey Gorham's overview and analysis of images of nature and God found in early modern science and philosophy. Anthony O'Hear questions a reductive, naturalist account of the origin of mind and values. Dale Jacquette offers a thoroughgoing naturalistic philosophy of the emergence of intentionality and a unique argument about the emergence of art and the aesthetic appreciation of nature. E.J. Lowe brings to light some challenges facing naturalistic approaches to human imaginative sensibility. Douglas Hedley articulates and defends a cognitive account of imagination, highlighting some of the difficulties confronting naturalism. Daniel N. Robinson offers a sweeping treatment of nature and naturalism, historically engaging Aristotle, Kant, Hegel and others. Conor Cunningham provides an aggressive critique of contemporary naturalism. Gordon Graham investigates the resources of naturalism in accounting for our sense of the sacred. Mark Wynn provides a subtle understanding of imagination and perception, suggesting how these may play into the theism - naturalism debate. The book concludes with Jil Evans' reflections on how images of the Galapagos Islands have been employed philosophically to picture either a naturalist or theistic image of nature. (shrink)
3734 π +-? +-e+ decays have been observed in a propane bubble chamber and the angular distribution of the positions found to be The decay and absorption of ?? -mesons in propane have also been investigated.
The best case for thinking that quantum mechanics is nonlocal rests on Bell's Theorem, and later results of the same kind. However, the correlations characteristic of Einstein–Podolsky–Rosen (EPR)–Bell (EPRB) experiments also arise in familiar cases elsewhere in quantum mechanics (QM), where the two measurements involved are timelike rather than spacelike separated; and in which the correlations are usually assumed to have a local causal explanation, requiring no action-at-a-distance (AAD). It is interesting to ask how this is possible, in the light (...) of Bell's Theorem. We investigate this question, and present two options. Either (i) the new cases are nonlocal too, in which case AAD is more widespread in QM than has previously been appreciated (and does not depend on entanglement, as usually construed); or (ii) the means of avoiding AAD in the new cases extends in a natural way to EPRB, removing AAD in these cases too. There is a third option, viz., that the new cases are strongly disanalogous to EPRB. But this option requires an argument, so far missing, that the physical world breaks the symmetries which otherwise support the analogy. In the absence of such an argument, the orthodox combination of views—action-at-a-distance in EPRB, but local causality in its timelike analogue—is less well established than it is usually assumed to be. 1 Introduction1.1 Background1.2 Outline of the argument2 The Experiments2.1 Standard EPRB2.2 Sideways EPRB2.3 Comparing the experiments2.4 The need for beables3 The Symmetry Considerations3.1 The action symmetry3.2 Time-symmetry in SEPRB4 The Basic Trilemma4.1 An intuitive defence of Option III?5 Avoiding the Trilemma?6 The Classical Objection7 Defending Option III7.1 The free will argument7.2 Independence and consistency8 Entanglement and Epistemic Perspective. (shrink)
In this article I explore the underlying political philosophy of public bioethics by comparing it to technocratic authority, particularly the technocratic authority claimed by economists in Mexico in the 1980s and 1990s. I find that public bioethics - at least in the dominant forms - is implicitly designed for and tries to use technocratic authority. I examine how this type of bioethics emerged and has continued. I finish by arguing that, as claims to technocratic authority go, bioethics is in an (...) incredibly weak position, which partly explains why it has never gained the degree of public legitimacy that other technocracies have gained. I conclude by arguing for a "technocracy-lite" orientation for public bioethics. (shrink)
ISBN-13: 978-0-226-11360-9 (cloth : alk. paper) ISBN-10: 0-226-11360-4 ... HM651.C64 2007 158.1—dc22 2007022671 The paper used in this publication meets the minimum requirements of the American National Standard for Information ...
This paper first distinguishes governance (collective, autonomous self-regulatory processes) from government (externally-imposed mandatory regulation); it proposes that the second of these is essentially incompatible with a conception of the medical humanities that involves imagination and vision on the part of medical practitioners. It next develops that conception of the medical humanities, as having three distinguishable aspects (all of them distinct from the separate phenomena popularly known as “arts-in-health”): first, an intellectual enquiry into the nature of clinical medicine; second, an important (...) dimension of medical education; third, a resource for moral and aesthetic influences upon clinical practice, supporting “humane health care” as the moral inspirations behind organised medicine. Medical humanities sustains these three aspects through paying proper attention to the existential and subjective aspects of medicine. By encouraging authentic imagination among health care practitioners, medical humanities aligns well with both humane health care and governance in the sense of self-regulation. However, it can neither be achieved mechanistically nor well-measured through proxies such as patient satisfaction. Above all, it should not be allowed to supply, through inappropriate qualitative “targets,” new forms of management tyranny. (shrink)
Patients participating in the shared benefits of publicly funded health care enjoy the benefits of treatments tested on previous patients. Future patients similarly depend on treatments tested on present patients. Since properly designed research assumes that the treatments being studied are—so far as is known at the outset—equivalent in therapeutic value, no one is clinically disadvantaged merely by taking part in research, provided the research involves administering active treatments to all participants. This paper argues that, because no other practical or (...) moral considerations count decisively against so doing, we could and should oblige patients to agree to receive indicated treatment within the terms of any concurrent research protocols. This ensures their treatment will benefit not only themselves but also future patients through contributing to new knowledge. By analogy with the paying of income tax, patients should not be allowed to “veto” their social responsibility to take part in clinical research. (shrink)
A propane bubble chamber of effective volume 1 litre has been constructed for experiments on the elastic scattering of low energy (< 40 Mev) π+-mesons on hydrogen and carbon. Stereoscopic pairs of pictures are taken on 35 mm film with a stero angle of 90°. The design and operation of the chamber and associated equipment is described, and examples of pictures taken are shown.
In their recent paper on void ordering, Barashev and Golubov 1 describe cavity lattice formation in austenitic steel under electron irradiation as a bubble lattice rather than a void lattice. While this is convenient for the model they propose, this comment gives several reasons why the bubble lattice assignation cannot be justified. In addition, some remarks made by Barashev and Golubov on the results of one-dimensional (1D) Monte Carlo simulations 2, and the role of 1D self-interstitial atom clusters in creating (...) the planar ordering found in experimental void lattice formation results 3, are critically discussed. (shrink)
Two well-recognised, but inherently reductionist, relations between medicine and music are the attempted neuro-scientific understanding of responses to music and interest in music’s contributions to clinical therapy. This paper proposes a third relation whereby music is seen as an organising metaphor for clinical medicine as a practice. Both music and clinical medicine affirm human well-being, and both do this inter alia through varieties of skilful, crafted yet spontaneous mutual engagement between a ‘performer’ and an ‘audience’. I argue that this organising (...) metaphor offers a corrective to the reductionist influences of the first two relations, illuminates a number of medicine’s important features, and reaffirms the existential as being at the core of medicine’s telos. (shrink)
“Medical humanities” is a phrase whose currency is wider than its agreed meaning or denotation. What sort of study is it, and what is its relation to the study of philosophy of medicine? This paper briefly reviews the origins of the current flowering of interest and activity in studies that are collectively called “medical humanities” and presents an account of its nature and central enquiries in which philosophical questions are unashamedly central. In the process this paper argues that the field (...) of enquiry is well-conceived as being philosophical in character, and as having philosophy — albeit pursued over a larger canvas — at the core of its contributing humanities disciplines. The paper characterises humanities disciplines as having an important focus on human experience and subjectivity, of which the experiences and subjectivities at stake in health, medicine and illness form an important sub-set, the preoccupation of the medical humanities as a whole. Claims of interdisciplinarity (as distinct from multidisciplinarity) are noted, but such claims need to be recognised for the high and stern ambition that they embody, and should not be made lightly. (shrink)
This paper describes the use of simulation techniques to examine some of the processes involved in the alignment of voids under the influence of 2-dimensional self-interstitial atom (2-d SIA) transport. It follows an earlier paper in which the effects of 1-d SIA transport were investigated and uses similar methodology. In contrast to the 1-d SIA results, with 2-d SIA transport there is no difficulty in simulating the formation of simple cubic void lattices. In addition the work has been extended to (...) demonstrate the formation of perfect bcc and fcc void lattices. One important feature was that lattice formation took place some 100 times faster than found experimentally. The possibility that this might be due to a diluting effect of out of plane jumps was investigated but seemed very unlikely. This led to the alternative conclusion that the 2-d diffusing defect could not be the basic single interstitial but instead was a larger interstitial defect, such as a di-interstitial, present in far lower concentrations. One consequence of the new approach is that the phenomenon of void swelling would be essentially unaffected by the defect responsible for void lattice formation. This crucially avoids the fast swelling which, as suggested recently, might otherwise occur as void lattices form, and which would conflict with the often quoted association of void swelling saturation and void lattice formation. This association is now more likely to be controlled by a common factor such as high void density than by any direct mechanism. A possible explanation for the influence of impurities on void lattice formation in ion irradiated Nb, Nb-1%Zr, Ta, and Mo is discussed. (shrink)
In terms of intervening in embodied experience, medical treatment is wonder-full in its ambition and its metaphysical presumption; yet, wonder’s role in clinical medicine has received little philosophical attention. In this paper, I propose, to doctors and others in routine clinical life, the value of an openness to wonder and to the sense of wonder. Key to this is the identity of the central ethical challenges facing most clinicians, which is not the high-tech drama of the popular conceptions of medical (...) ethics but, rather, the routine of patients’ undramatic but unremitting demands for the clinician’s time and respectful attention. Wonder (conceived as an intense and transfiguring attentiveness) is a ubiquitous ethical source, an alternative to the more familiar respect for rational autonomy, a source of renewal galvanizing diagnostic imagination, and a timely recalling of the embodied agency of both patient and clinician. (shrink)