This paper explores the psychological foundations of the 'Willingness to Pay/Willingness to Accept' discrepancy. Using a qualitative approach we find that the two response modes appear to invoke different strategies for completion. An examination of the heuristics used by respondents to answer questions concerning the buying and selling of the chance to play a straightforward lottery shows that only some could be taken as supporting current theories which aim to explain the discrepancy.
Randomized controlled clinical trials play an important role in the development of new medical therapies. There is, however, an ethical issue surrounding the use of randomized treatment allocation when the patient is suffering from a life threatening condition and requires immediate treatment. Such patients can only benefit from the treatment they actually receive and not from the alternative therapy, even if it ultimately proves to be superior. We discuss a novel new way to analyse data from such clinical trials based (...) on the use of the recently developed theory of imprecise probabilities. This work draws an explicit distinction between the related but nevertheless distinct questions of inference and decision in clinical trials. The traditional question of scientific interest asks 'Which treatment offers the greater chance of success?' and is the primary reason for conducting the clinical trial. The question of decision concerns the welfare of the patients in the clinical trial, asking whether the accumulated evidence favours one treatment over the other to such an extent that the next patient should decline randomization and instead express a preference for one treatment. Consideration of the decision question within the framework of imprecise probabilities leads to a mathematical definition of equipoise and a method for governing the randomization protocol of a clinical trial. This paper describes in detail the protocol for the conduct of clinical trials based on this new method of analysis, which is illustrated in a retrospective analysis of data from a clinical trial comparing the anti-emetic drugs ondansetron and droperidol in the treatment of postoperative nausea and vomiting. The proposed methodology is compared quantitatively using computer simulation studies with conventional clinical trial designs and is shown to maintain high statistical power with reduced sample sizes, at the expense of a high type I error rate that we argue is irrelevant in some specific circumstances. Particular emphasis is placed on describing the type of medical conditions and treatment comparisons where the new methodology is expected to provide the greatest benefit. (shrink)
Recent advances in basic neuroscience research across a wide range of methodologies have contributed significantly to our understanding of human cortical electrophysiology and functional brain imaging. Translation of this research into clinical neurosurgery has opened doors for advanced mapping of functionality that previously was prohibitively difficult, if not impossible. Here we present the case of a unique individual with congenital blindness and medically refractory epilepsy who underwent neurosurgical treatment of her seizures. Pre-operative evaluation presented the challenge of accurately and robustly (...) mapping the cerebral cortex for an individual with a high probability of significant cortical re-organization. Additionally, a blind individual has unique priorities in one’s ability to read Braille by touch and sense the environment primarily by sound than the non-vision impaired person. For these reasons we employed additional measures to map sensory, motor, speech, language, and auditory perception by employing a number of cortical electrophysiologic mapping and functional magnetic resonance imaging methods. Our data show promising results in the application of these adjunctive methods in the pre-operative mapping of otherwise difficult to localize, and highly variable, functional cortical areas. (shrink)
In 1987, a young woman named Angela Carder, pregnant and dying from cancer, was ordered by a court of law to undergo a cesarean delivery against her and her family’s wishes. She and her baby both died. Three years later, an appeals court took an extraordinary stand: it vacated the order that ended their lives and upheld pregnant women’s rights to informed consent and bodily integrity. The “unkindest cut of all,”1 it seemed, had been condemned by the courts.2 Yet shortly (...) before the twenty-year anniversary of this landmark case, the same rights were stripped from another young pregnant woman. In January of this year, oral arguments were heard in the case of Samantha Burton. She had been twenty-five weeks .. (shrink)
In 1948 E. C. Mossner published a set of Hume's manuscript papers, preserved in the Royal Society of Edinburgh, in the essay "Hume's Early Memoranda: A Complete Text."1 As the subtitle indicates, Mossner intended to publish the complete manuscript with his own historical introduction. John Hill Burton had made the first attempt to carry out a similar project in the past. However, while Burton argued simply that the manuscript might have been related to Hume's various works, ranging over (...) the Essays, Moral and Political (1741-1742), Political Discourses (1752) and even the Natural History of Religion (1757),2 Mossner tried, instead, to establish the thesis that the memoranda as a whole ought to be regarded as Hume's .. (shrink)
This article seeks to explain the variable implementation of gender mainstreaming as a `policy frame' over time and across various international organisations (I.O.s). In the years since the U.N. Fourth World Women's Conference in Beijing (1995),mainstreaming has been endorsed and adopted by a wide range of international organisations, and we compare the adoption and implementation of mainstreaming in four specific I.O.s: the World Bank, the United Nations Development Programme, the Organisation for Security and Cooperation in Europe, and the European Union. (...) The rhetorical acceptance of mainstreaming by various international organisations, however, obscures considerable variation in both the timing and the nature of the mainstreaming process within and among organisations. This variation, in turn, can be explained in terms of the categories of political opportunity, mobilising structures and strategic framing, which have been put forward by social movement theorists. (shrink)