Background: Many people participating in dementia research may lack capacity to give informed consent and the relationship between cognitive function and capacity remains unclear. Recent changes in the law reinforce the need for robust and reproducible methods of assessing capacity when recruiting people for research.Aims: To identify numbers of capacitous participants in a pragmatic randomised trial of dementia treatment; to assess characteristics associated with capacity; to describe a legally acceptable consent process for research.Methods: As part of a pragmatic randomised controlled (...) trial of Ginkgo biloba for mild-moderate dementia, we used a consenting algorithm that met the requirements of existing case law and the exigencies of the new Mental Capacity Act. We decided who had capacity to give informed consent for participation in the trial using this algorithm and sought predictors of capacity.Results: Most participants with mild-moderate dementia in this trial were unable to give informed consent according to the legal criteria. When adjusted for confounding, the Mini Mental State examination did not predict the presence of capacity.Conclusion: Cognitive testing alone is insufficient to assess the presence of capacity. Researchers and clinicians need to be aware of the challenging processes regarding capacity assessment. We outline a procedure which we believe meets the ethical and legal requirements. (shrink)

The Mental Capacity Act 2005 gives statutory force to the common law principle that all adults are assumed to have capacity to make decisions unless proven otherwise. In accord with best practice, this principle places the evidential burden on researchers rather than participants and requires researchers to take account of short-term and transient understandings common among some research populations. The aim of this paper is to explore some of the implications of the MCA 2005 for researchers working with 'vulnerable' populations (...) in health and social care settings. The Cyclical Consent Model is described and offered as a process by which researchers might develop good practice when engaged in research involving vulnerable people. (shrink)

Barresi & Moore provide an impressive account of how the coordination of first and third person information about the self and other could produce an account of intentional relations. They are less explicit as to how the child comes to understand the basic epistemic relation between experience and knowledge, that is, how informational access causes belief. We suggest one route.

This book builds on the idea that pragmatics and philosophy are strictly interconnected and that advances in one area will generate consequential advantages in the other area. The first part of the book, entitled ‘Theoretical Approaches to Philosophy of Language’, contains contributions by philosophers of language on connectives, intensional contexts, demonstratives, subsententials, and implicit indirect reports. The second part, ‘Pragmatics in Discourse’, presents contributions that are more empirically based or of a more applicative nature and that deal with the pragmatics (...) of discourse, argumentation, pragmatics and law, and context. The book presents perspectives which, generally, make most of the Gricean idea of the centrality of a speaker’s intention in attribution of meaning to utterances, whether one is interested in the level of sentence-like units or larger chunks of discourse. (shrink)

The diffusion of technology in the US has taken place in an environment of both regulation and free enterprise. Each has been subject to manipulation by doctors and medical administrators that has fostered unprecedented ethical dilemmas and legal challenges. Understanding these developments and historical precedents may allow a more rational diffusion policy for medical technology in the future.

ABSTRACT There is limited guidance about whether and how to provide psychological assessment results to research participants. This paper considers several ethical challenges associated with offering individual research results in psychological assessment research. Additionally, the process used to return individual results within a study examining neurodevelopmental effects of anesthesia exposure in children and adolescents is described. Almost all participants requested to know if results were concerning; however, only around a third of those with concerning findings sought additional feedback. Ongoing research (...) and guidance are necessary to establish evidence-based practices and manage challenges that may emerge when disclosing such results. (shrink)

AI-driven decisions can draw data from virtually any area of your life to make a decision about virtually any other area of your life. That creates fairness issues. Effective regulation to ensure fairness requires that AI systems be transparent. That is, regulators must have sufficient access to the factors that explain and justify the decisions. One approach to transparency is to require that systems be explainable, as that concept is understood in computer science. A system is explainable if one can (...) provide a human-understandable explanation of why it makes any particular prediction. Explainability should not be equated with transparency. To address transparency and characterize its relation to explainability, we define transparency for a regulatory purpose. A system is transparent for a regulatory purpose (r-transparent) when and only when regulators have an explanation, adequate for that purpose, of why it yields the predictions it does. Explainability remains relevant to transparency but turns out to be neither necessary nor sufficient for it. The concepts of explainability and r-transparency combine to yield four possibilities: explainable and either r-transparent or not; and not explainable and either not r-transparent or r-transparent. Combining r-transparency with ideas from the Harvard computer scientist Cynthia Dwork, we propose four requirements on AI systems. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Martin Warner PHILOSOPHICAL POETRY: THE CASE OF FOUR QUARTETS I FOR plato the quarrel between philosophy and poetry was already an ancient one. Since his day strenuous efforts have been made to eliminate it by circumscribing each widiin carefully specified boundaries, on die principle that strong fences make good neighbors, and allowing die one to venture onto the territory of the other only as licensed. Thus until recently (...) assessments of the literary quality of a philosopher's writing have commonly been treated as extraneous to its value as philosophy, and philosophical probing of die thought of a poem as irrelevant to a literary critic's final assessment ofit. For some works, however, such compromises seem forced; Four Quartets is a case in point. Here we have a sustained effort to explore issues of a philosophical and theological nature in poetic terms — in a manner that challenges our understanding and lays claim to our assent. The poetry does not merely encapsulate a theoretical position, but enacts a process ofthought perceived as bearing on diese topics at least as significandy as do those processes commonly termed "philosophical," and diereby raises by implication more general issues concerning die status of those "philosophical" modes themselves. F. R. Leavis is well known both for his engagement with the poetry of T. S. Eliot, and for his insistence on a clear separation between literary criticism and philosophy; dius his raising of philosophical questions as an integral and decisive element in his final and most extensive analysis ofthe Quartets is particularly striking: That Four Quartets offers us thought, searching, basic and rigorous, we have our assurance in the first ten lines of"Burnt Norton".... As thought, it aspires to a general validity.... 222 Martin Warner223 The questions, how must reality be conceived, and what is the nature of the human situation, have been raised in a way diat compels one to determine and verify one's own ultimate beliefs.1 Of course, Leavis is clear that the manner in which die poem raises these questions is not that traditionally associated with philosophy: "The 'music' of Four Quartets challenges a criterion that is not logic, but something equivalent in the field of total meaning. We can only tell what it is by intelligent self-exposure to the poetry" (p. 159). Similarly his mode of"determining " and "verifying" his own beliefs in response is that proper to literary criticism. But the questions are plainly philosophical ones, and one does not need the authority of Leavis to see that the poem raises them. From a philosophical point ofview, the interesting questions are the status of the manner in which it does so and the nature of the "criterion that is not logic" which is said to have an internal relation to that "intelligent selfexposure to the poetry" which Leavis in his critical practice seeks to exemplify. Unfortunately, this late commentary on Eliot's poetry is among the weakest in the Leavis corpus, precisely lacking "intelligent self-exposure to the poetry";2 but this should not lead us to dismiss its more general claims. In earlier and far stronger criticism Leavis had already argued that "Burnt Norton" does "by strictly poetical means the business ofan epistemological and metaphysical inquiry" ("Eliot's Later Poetry," p. 65). Further, die most distinguished recent criticism of Eliot's poetry is probably that of A. D. Moody,3 and he too finds himself driven to place his own "ultimate beliefs" in relation to it. On the one hand, "There is likely to be at least some degree of essential conformity between the way we live now and die way in which the poem would order life; and to that extent the poem can be said to express, and to give a form to, the sensibUity ofits age" (p. 264). But on the other, "It is a neurotic vision, one arising from some disorder or disease of the personality — or of his culture.... It is not easy to attain a detached view of die neurosis which is like a dominant gene in our culture. It is a matter... of the alienation ofman from mat to which he properly, of his nature, belongs — his being cut off from... (shrink)

In their inimitable history book, 1066 and All That (“A Memorable History of England, Comprising All the Parts You Can Remember”), first published in 1930, W. C. Sellar and R. J. Yeatman note that...

The purpose of this article is to illustrate through representative examples the principal ways in which Valerius Flaccus borrowed from Homer. Earlier articles1 examined Valerius' attitude towards Apollonius and his debt to Virgil. While not nearly as numerous as the Virgilian echoes, those from Homer are unmistakable, deliberate, sometimes erudite, or with a subtle twist. A convenient classification of them may be into verbal usages, situations, similes. Although the last merges with the previous category, it deserves separate treatment, (...) being greatest in size as well as complexity. (shrink)

We use Homer and Sun Tzu as a background to better understand and reformulate confrontation, anger and violence in medicine, contrasting an unproductive ‘love of war’ with a productive ‘art of war’ or ‘art of strategy’. At first glance, it is a paradox that the healing art is not pacific, but riddled with militaristic language and practices. On closer inspection, we find good reasons for this cultural paradox yet regret its presence. Drawing on insights from Homer's The Iliad (...) and The Odyssey, we argue for better understanding of confrontation, anger, bullying, intimidation and violence in medicine in order to change the culture. For example, equating medicine with war is not a given condition of medicine but a convenient metaphor with historical origins and a historical trajectory. Other, non-martial metaphors, such as medicine as collaboration, may be more appropriate in an age of team-based care. Taking lessons from Homer, we suggest three key ways in which cold-hearted confrontation and anger in medicine can be transformed into productive, warm-hearted engagement: the transformation of angry impulse into reflection, moral courage and empathy. Thinking with Homer can offer an aesthetically and morally charged alternative to the current body of literature on topics, such as anger in doctors, and how this may be ‘managed’, without recourse to an instrumental economy where emotions are viewed as commodities, and emotional responses can be ‘trained’ through communication skills courses. (shrink)

In their inimitable history book, 1066 and All That (“A Memorable History of England, Comprising All the Parts You Can Remember”), first published in 1930, W. C. Sellar and R. J. Yeatman note that...