Bioethicists have long been concerned that seriously ill patients entering early phase (‘phase I’) treatment trials are motivated by therapeutic benefit even though the likelihood of benefit is low. In spite of these concerns, consent forms for phase I studies involving seriously ill patients generally employ indeterminate benefit statements rather than unambiguous statements of unlikely benefit. This seeming mismatch between attitudes and actions suggests a need to better understand research ethics committee members’ attitudes toward communication of potential benefits and risks (...) of early phase studies to potential subjects. We surveyed the members of two U.S. research ethics committees using a phase I gene transfer study scenario, and compared the results to a previous survey of potential subjects’ perceptions and attitudes toward benefit and risk for the same protocol. The results show that there is indeed a gap between the subjects’ perceptions and the committee members’ views on what is appropriate to be communicated to research subjects. This discrepancy is the product of both the commonly assumed optimism of the subjects and to a “protective pessimism” of the research ethics committee members. We discuss this discrepancy using “frameworks of trust” and demonstrate the need to incorporate these frameworks into the existing model of informed consent. (shrink)

During the set-up phase of an international study of genetic influences on outcomes from sepsis, we aimed to characterise potential differences in ethics approval processes and outcomes in participating European countries. Between 2005 and 2007 of the FP6-funded international Genetics Of Sepsis and Septic Shock project, we asked national coordinators to complete a structured survey of research ethic committee approval structures and processes in their countries, and linked these data to outcomes. Survey findings were reconfirmed or modified in 2017. Eighteen (...) countries participated in the study, recruiting 2257 patients from 160 ICUs. National practices differed widely in terms of composition of RECs, procedures and duration of the ethics approval process. Eight countries used a single centralised process for approval, seven required approval by an ethics committee in each participating hospital, and three required both. Outcomes of the application process differed widely between countries because of differences in national legislation, and differed within countries because of interpretation of the ethics of conducting research in patients lacking capacity. The RECs in four countries had no lay representation. The median time from submission to final decision was 1.5 months; in nine approval was received within 1 month; six took over 6 months, and in one 24 months; had all countries been able to match the most efficient approvals processes, an additional 74 months of country or institution-level recruitment would have been available. In three countries, rejection of the application by some local RECs resulted in loss of centres; and one country rejected the application outright. The potential benefits of the single application portal offered by the European Clinical Trials Regulation will not be realised without harmonisation of research ethics committee practices as well as national legislation. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

This article focuses on emergency medical care in black urban populations, suggesting that the classification of a ?community? within clinical trial language is problematic. The article references a cultural history of black Americans with pre-hospital emergency medical treatment as relevant to contemporary emergency medicine paradigms. Part I explores a relationship between ?autonomy? and ?community.? The idea of community emerges as a displacement for the ethical principle of autonomy precisely at the moment that institutionalized medicine focuses on diversity. Part II examines (...) a clinical trial for the blood substitute PolyHeme? (Northfield Laboratories, Inc., Evanston, IL). It illustrates the ways in which bias in research paradigms and Institutional Review Board decisions attach to the notion and utility of the language of ?community.? The conclusion's contemporary anecdote makes apparent the vitality of the issues of prehospital emergency medical care and the ways in which decisions and practices fall too easily into a narrative of culturally biased treatment. (shrink)

When I first starting hearing and reading about Jacques Rancière a number of years ago, I was deeply skeptical. Wasn’t this yet another European man becoming the new political theory “It Girl”? Wasn’t the claim that Rancière had a singular, fresh approach to dissent and protest overblown, when other people—especially critical race scholars, postcolonial theorists, feminists, queer theorists, and so on—had already addressed these topics thoroughly but were rarely acknowledged in mainstream scholarship? Did we really need to deify and create (...) a cottage industry around yet one more white male Western theorist, especially one who so rarely deigns to cite his influences or the work of others? It took... (shrink)

“Buddhisms” captures the challenge inherent in the diverse practices and beliefs of this religion. In this book, grounding the analysis in the bodies of practitioners provides a new opportunity for coherence that reaches across vast expanses of time and space.

People are susceptible to forces that are not fully understood. In his thought-provoking new book Richard Holloway holds a mirror up to the human condition.

This article aims to read feminist new materialisms (Barad), together with ‘postulated’ linguistic or cultural primacy of Queer Theory (Butler), to show how both are engaged in similar critical-ethical endeavours. The central argument is that the criticism of Barad and new materialisms misses Butler’s materialistic insights due to a narrow interpretation of Butler's alleged social-constructivist position. There is, therefore, a specific focus on where they both make similar ethical appeals. Moreover, the article relies on Adorno's negative dialectic to highlight an (...) interpretation of Barad and Butler as being part of the same dialectical movement, in which materialism and idealism fluctuate in their mutual criticisms, thus continuing the procession towards 'new knowledge' and emancipation, or freedom, through their motions back and forth. (shrink)

There are two different ways of understanding alienation: as a condition and as a struggle. On this distinction turns the whole theory and practice of Marxism.

This is a study of the nature of time. In it, redeploying an argument first presented by McTaggart, the author argues that although time itself is real, tense is not. He accounts for the appearance of the reality of tense - our sense of the passage of time, and the fact that our experience occurs in the present - by showing how time is indispensable as a condition of action. Time itself is further analysed, and Dr Mellor gives answers to (...) most of the metaphysical questions it provokes, concerning the relation of time to space, the dissection of time, and its relation to change and causation. (shrink)

1 MONSTER . . . evil is, not, as we thought, deeds that must be punished, but our lack of faith, our dishonest mood of denial, the concupiscence of the ...

"First published by Oxford University Press, 1916."--Title page verso.

This paper explores the analytical relevance of Foucault's notion of biopower in the context of regulating and managing non-human lives and populations, specifically those animals that are the focus of livestock breeding based on genetic techniques. The concept of biopower is seen as offering theoretical possibilities precisely because it is concerned with the regulation of life and of populations. The paper approaches the task of testing the 'analytic mettle' of biopower through an analysis of four policy documents concerned with farm (...) animal genetics: the UK's National Scrapie Plan (2003); the UK National Action Plan on Farm Animal Genetic Resources (2006); the Agriculture and Environment Biotechnology Committee's report on Animals and Biotechnology (2002); and the Farm Animal Welfare Council's report on the Welfare Implications of Animal Breeding and Breeding Technologies in Commercial Agriculture (2004). Of interest is whether and how the four policy case studies articulate a form of biopower in relation to human-livestock animal relations in the context of genetic approaches to livestock breeding, and how biopower is variably expressed in relation to the different policy issues addressed. In concluding, the paper considers the overall applicability and relevance of biopower in the context of regulating animal lives within livestock breeding, highlighting both possibilities and limitations, and offers suggestions for taking forward research on livestock populations from a neo-Foucaultian perspective. (shrink)

In this challenging new book John Holloway explores one of the most significant aspects of contemporary culture, arguing that over the last hundred years or so there has been a radical change in the very nature of individual consciousness. He traces a crucial shift from an 'Apollonian' ideal of human involvement in the widest range of experience (implying a sense of the individual consciousness as spacious, orderly, and comprehensive) to a narrower and less integrated engagement with the world (and (...) a more reductive conception of consciousness as random and fragmented). He plots this shift through a number a quite different fields: there are chapters on the visual arts, on colloquial language and slang, on cartoons, on political rhetoric, and on 'personality' studies by psychologists. He goes on to examine the work of certain literary figures (notably Hardy, Edwin Muir, Wyndham Lewis, Patrick White, John Cowper Powys, and Gary Snyder) who seem to have recognized, and registered in imaginative terms, the pervasive but generally unrecorded changes in consciousness for which the book is arguing. (shrink)

"Using hundreds of examples from newsrooms large and small, author Ron F. Smith challenges readers to determine how they would face moral dilemmas on the job. Chapters evaluate the search for principles, accountability, truth and objectivity, errors and corrections, diversity, "faking" the news, reporters and their sources, privacy, the government watch, deception, compassion, the business of news, journalists and their communities, and financial concerns. New to this edition: a chapter on improving coverage of minorities, expanded discussion of broadcast journalism and (...) reporting on the Internet, and stories from recent front pages and TV news programs."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved. (shrink)

Le temps est un grand maître en médecine. Il fait évoluer la maladie, le malade et sa relation avec le médecin. Il revient à ce dernier d'en prendre la mesure pour la maîtriser et l'exploiter plutôt que de s'en laisser dominer. C'est ce que l'auteur fait approcher par petites touches au fil d'une cinquantaine de réflexions puisées dans son expérience et ses lectures, alimentés de données parfois dérangeantes. Elles doivent aider à gérer une denrée précieuse, d'une manière simple, mais qui (...) ne va pas toujours de soi et peut contredire un bon sens élémentaire. Il en va de la qualité d'une pratique médicale et des satisfactions que patients comme soignants peuvent en retirer, en choisissant plutôt qu'en subissant. (shrink)

According to the orthodox treatment of risk preferences in decision theory, they are to be explained in terms of the agent's desires about concrete outcomes. The orthodoxy has been criticised both for conflating two types of attitudes and for committing agents to attitudes that do not seem rationally required. To avoid these problems, it has been suggested that an agent's attitudes to risk should be captured by a risk function that is independent of her utility and probability functions. The main (...) problem with that approach is that it suggests that attitudes to risk are wholly distinct from people's (non-instrumental) desires. To overcome this problem, we develop a framework where an agent's utility function is defined over chance propositions (i.e., propositions describing objective probability distributions) as well as ordinary (non-chance) ones, and argue that one should explain different risk attitudes in terms of different forms of the utility function over such propositions. (shrink)

While the dominant approaches to the current study of political philosophy are various, with some friendlier to religious belief than others, almost all place constraints on the philosophic and political role of revelation. Mainstream secular political theorists do not entirely disregard religion. But to the extent that they pay attention, their treatment of religious belief is seen more as a political or philosophic problem to be addressed rather than as a positive body of thought from which we might derive important (...) insights about the nature of politics and the truth of the human condition. In a one-of-a-kind collection, DeHart and Holloway bring together leading scholars from various fields, including political science, philosophy, and theology, to challenge the prevailing orthodoxy and to demonstrate the role that religion can and does play in political life. Contributing authors include such important thinkers as Peter Augustine Lawler, Robert C. Koons, J. Budziszewski, Francis J. Beckwith, and James Stoner. (shrink)

The book challenges the values of much of contemporary bioethics and health care policy by confronting their failure to secure the moral norms they seek to apply.