Patient consent has been formulated in terms of radical individualism rather than shared benefits. Medical education relies on the provision of patient consent to provide medical students with the training and experience to become competent doctors. Pelvic examination represents an extreme case in which patients may legitimately seek to avoid contact with inexperienced medical students particularly where these are male. However, using this extreme case, this paper will examine practices of framing and obtaining consent as perceived by medical students. This (...) paper reports findings of an exploratory qualitative study of medical students and junior doctors. Participants described a number of barriers to obtaining informed consent. These related to misunderstandings concerning student roles and experiences and insufficient information on the nature of the examination. Participants reported perceptions of the negative framing of decisions on consent by nursing staff where the student was male. Potentially coercive practices of framing of the decision by senior doctors were also reported. Participants outlined strategies they adopted to circumvent patients’ reasons for refusal. Practices of framing the information used by students, nurses and senior doctors to enable patients to decide about consent are discussed in the context of good ethical practice. In the absence of a clear ethical model, coercion appears likely. We argue for an expanded model of autonomy in which the potential tension between respecting patients’ autonomy and ensuring the societal benefit of well-trained doctors is recognised. Practical recommendations are made concerning information provision and clear delineations of student and patient roles and expectations. (shrink)

The glucocorticoid receptor belongs to an important class of transcription factors that alter the expression of target genes in response to a specific hormone signal. The glucocorticoid receptor can function at least at three levels: (1) recruitment of the general transcription machinery; (2) modulation of transcription factor action, independent of DNA binding, through direct protein‐protein interactions; and (3) modulation of chromatin structure to allow the assembly of other gene regulatory proteins and/or the general transcription machinery on the DNA. This review (...) will focus on the multifaceted nature of protein‐protein interactions involving the glucocorticoid receptor and basal transcription factors, coactivators and other transcription factors, occurring at these different levels of regulation. (shrink)

The problem of disease definition is related to theproblem of proving that a certain agent is thenecessary cause of a certain disease. Natural kindterms like ‘rheumatoid arthritis’ and ‘AIDS’ refer toessences which are discoverable rather thanpredeterminate. No statement about such diseases isa priori necessarily true. Because theories onnecessary causes involve natural kind semantics,Koch's postulates cannot be used to falsify or verifysuch theories. Instead of proving that agent A is thenecessary cause of disease D, we include A in atheoretical definition of (...) D, take this to representthe real meaning of ‘D’, and discard thepretheoretical definition. This is illustrated byKoch's own attempt to prove he had discovered thenecessary cause of tuberculosis. Methodologicalarguments about disease causation require a clear viewof our use of diagnostic terms. Medical lexicographersshould do more to provide such a view. (shrink)

Fair Trade companies have pulled off an astonishing tour de force. Despite their relatively small size and lack of resources, they have managed to achieve considerable commercial success and, in so doing, have put the fair trade issue firmly onto industry agendas. We analyse the critical role played by social capital in this success and demonstrate the importance of values as an exploitable competitive asset. Our research raises some uncomfortable questions about whether fair trade has 'sold out' to the mainstream (...) and whether these companies have any independent future or whether their ultimate success lies in the impact they have had on day-to-day trading behaviour. (shrink)

Directed cell migration is a fundamental component of numerous biological systems and is critical to the pathology of many diseases. Although the importance of secreted chemoattractant factors in providing navigational cues to migrating cells bearing specific chemoattractant receptors is now well‐established, how the function of these factors is regulated is not so well understood and may be of key importance to the design of new therapeutics for numerous human diseases. While regulation of migration clearly takes place on a number of (...) different levels, it is becoming clear that so‐called ‘atypical’ receptors play a role in scavenging, or altering the localisation of, chemoattractant molecules such as chemokines and complement components. These receptors do this through binding and/or internalising their chemoattractant ligands without activating signal transduction cascades leading to cell migration. The atypical chemokine receptor family currently comprises the receptors D6, DARC and CCX‐CKR. In this review, we discuss the evidence from in vitro and in vivo studies that these receptors play a role in regulating cell migration, and speculate that other orphan receptors may also belong to this family. Furthermore, with the advent of gene therapy on the horizon, the therapeutic potential of these receptors in human disease is also considered. BioEssays 29: 237–247, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Hindbrain development is orchestrated by a vertebrate gene regulatory network that generates segmental patterning along the anterior–posterior axis via Hox genes. Here, we review analyses of vertebrate and invertebrate chordate models that inform upon the evolutionary origin and diversification of this network. Evidence from the sea lamprey reveals that the hindbrain regulatory network generates rhombomeric compartments with segmental Hox expression and an underlying Hox code. We infer that this basal feature was present in ancestral vertebrates and, as an evolutionarily constrained (...) developmental state, is fundamentally important for patterning of the vertebrate hindbrain across diverse lineages. Despite the common ground plan, vertebrates exhibit neuroanatomical diversity in lineage‐specific patterns, with different vertebrates revealing variations of Hox expression in the hindbrain that could underlie this diversification. Invertebrate chordates lack hindbrain segmentation but exhibit some conserved aspects of this network, with retinoic acid signaling playing a role in establishing nested domains of Hox expression. (shrink)

It is often argued that human emotions, and the cognitions that accompany them, involve refinements of, and extensions to, more basic functionality shared with other species. Such refinements may rely on common or on distinct processes and representations. Multi-level theories of cognition and affect make distinctions between qualitatively different types of representations often dealing with bodily, affective and cognitive attributes of self-related meanings. This paper will adopt a particular multi-level perspective on mental architecture and show how a mechanism of subsystem (...) differentiation could have allowed an evolutionarily “old” role for emotion in the control of action to have altered into one more closely coupled to meaning systems. We conclude by outlining some illustrative consequences of our analysis that might usefully be addressed in research in comparative psychology, cognitive archaeology, and in laboratory research on memory for emotional material. (shrink)

Prefrontal cortex is dysregulated in women with restricting anorexia nervosa . It is not known whether appetitive non-conscious stimuli bias cognitive responses in those with RAN. Thirteen women with RAN and 20 healthy controls completed a dorsolateral PFC working memory task and an anterior cingulate cortex conflict task, while masked subliminal food, aversive and neutral images were presented. During the DLPFC task, accuracy was higher in the RAN compared to the HC group, but superior performance was compromised when subliminal food (...) stimuli were presented: errors positively correlated with self-reported trait anxiety in the RAN group. These effects were not observed in the ACC task. Appetitive activation is intact and anxiogenic in women with RAN, and non-consciously interacts with working memory processes associated with the DLPFC. This interaction mechanism may underlie cognitive inhibition of appetitive processes that are anxiety inducing, in people with AN. (shrink)

Two important debates have characterized mainstream epistemology in recent years. The first is the debate between foundationalists and anti-foundationalists. The second is the debate over the details of a naturalized epistemology. Both debates have meant that traditional concepts of rationality and justification are now understood in a new light. Both debates have helped focus attention on the future direction of epistemology, its goals and its limitations.

E.J. Lowe has recently proposed a model of mental causation on which mental events are emergent, thus exerting a novel, downward causal influence on physical events. Yet on Lowe's model, mental causation is at the same time empirically undetectable, and in this sense is "invisible". Lowe's model is ingenious, but I don't think emergentists should welcome it, for it seems to me that a primary virtue of emergentism is its bold empirical prediction about the long-term results of human physiology. Here (...) I'll try to restore emergentism's empirical status, but my broader aim is to use Lowe's model to explore some central topics in the mental causation debate, including the "causal closure" of the physical world and the nature of causal powers. (shrink)

Health technology assessment (HTA) is often biased in the sense that it neglects relevant perspectives on the technology in question. To incorporate different perspectives in HTA, we should pursue agreement about what are relevant, plausible, and feasible research questions; interactive technology assessment (iTA) might be suitable for this goal. In this way a kind of procedural ethics is established. Currently, ethics too often is focussed on the application of general principles, which leaves a lot of confusion as to what really (...) is the matter in specific cases; in an iTA clashes of values should not be approached by use of such ethics. Instead, casuistry, as a tool used within the framework of iTA, should help to articulate and clarify what is the matter, as to make room for explication and consensus building. (shrink)

The Varieties of British Political Thought 1500?1800 edited by J. G. A. Pocock with the assistance of Gordon J. Schochet and Lois G. Schwoerer, Cambridge, Cambridge University Press, in association with the Folger Institute, Washington D.C., 1993, pp. 373 + x, ISBN 0 521 443776, £40.00 $59.95.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Hegel and the Problem of Beginning: Scepticism and Presuppositionlessness by Robb DUNPHYJ. M. FritzmanDUNPHY, Robb. Hegel and the Problem of Beginning: Scepticism and Presuppositionlessness. Lanham, Md.: Rowman & Littlefield, 2023. x + 213 pp. Cloth, $105.00This rich, learned, and important book investigates and critically evaluates how, according to Hegel, philosophy should begin. Briefly stated, the problem of beginning philosophy is that any beginning seems susceptible to a skeptical (...) challenge that takes the form of a dilemma. On the one side, if philosophy begins immediately with a presuppositionless assertion, skeptics will contend that it is dogmatic. On the other side, if philosophy begins mediately with a claim that presupposes an argument, skeptics will confront each premise of that argument with a trilemma: The premise is either only a dogmatic assertion; it is the conclusion of an argument whose premises must in turn be justified (which threatens an infinite regress); or it depends on an argument that is viciously circular. Hegel solves this problem with a beginning that is simultaneously immediate and mediate.The introduction explains that this book has three goals. First, it critically analyzes the problem of beginning, showing how Hegel responds to the skeptical challenge. Second, it explains how Hegel’s approach to the problem and his solution are informed by his deep engagement with the tradition of Pyrrhonian skepticism. Finally, it provides a guide to reading Hegel’s essay “With What Must the Beginning of the Science be Made?” in the Science of Logic.Chapter 1, “Hegel and Pyrrhonian Scepticism,” presents the essentials of Pyrrhonism and Hegel’s interpretation of it. Pyrrhonism is a way of life. It aims to find an equally good counterargument for every argument it encounters, thus leading to a suspension of judgment that allows the skeptic to live in a state of undisturbedness. Pyrrhonism presents encountered arguments with a trilemma: Either they depend on dogmatic assertions; they generate an infinite regress of arguments; or they are viciously circular. Hegel’s interpretation emphasizes skepticism’s equipollence, whereby it opposes every argument with a counterargument that is equally persuasive. Viewed historically, Pyrrhonism seems to have confronted arguments only as it happened to encounter them and to have restricted itself to epistemology. However, Hegel is open to the interpretation that skepticism’s inquiry could be completed. This would allow it to demonstrate that for every argument there will always be an [End Page 143] equally persuasive counterargument. He also interprets skepticism as accepting a metaphysical principle regarding the inherent instability of objects.“A Short History of the Problem of Beginning,” chapter 2, provides a detailed précis of Hegel’s essay. It also gives the brief history of the problem of beginning, discussing Descartes, Kant, Reinhold, Fichte, and Schelling. It notes that some philosophers posit an objective beginning, others a subjective beginning. It explains why Hegel regards previous attempts to solve the problem of beginning as inadequate. It recognizes that Fichte’s solution can be interpreted as much closer to that of Hegel than Hegel acknowledges.Chapter 3, “The Problem of Beginning,” supplies Hegel’s own account of the problem. His solution has two versions, one in the Science of Logic and the other in the Encyclopedia Logic. Each version posits a beginning without determinate content. In the Science of Logic, Hegel states that absolute knowing, the culminating shape of consciousness in the Phenomenology of Spirit, corresponds to the empty thinking with which philosophy begins. Philosophy’s beginning in the Science of Logic is mediate as it emerges from the progression of shapes of consciousness in the Phenomenology of Spirit and immediate as it does not have an object of thought. In the Encyclopedia Logic, Hegel proposes that a completed skepticism corresponds to the abstract concept of being with which philosophy begins. Philosophy’s beginning in the Encyclopedia Logic is mediate as it emerges from the skepticism’s equipollence and immediate as being without content. Hegel ultimately denies that a completed skepticism could play this role, however, which suggests that he believes that philosophy can begin immediately.“Meditation I—Phenomenology,” chapter 4, argues that Hegel’s first version is unsuccessful. To succeed, William Maker’s interpretation would have to be accepted, which... (shrink)

In his rieview-like outline the author gives us a view of an important stream of the American and English philosophical thought of the XXth century, which has been unjustly neglected. First he briefly describes the five generation waves of the American personalism - from G. H. Howinson, J. W. E. Bowen, P. A. Bertocii. M. L. King up to C. R. Robb. He sheds light on the specific aspect of the development of this stream in Great Britain. Further, he examines (...) the mean sterams of the Anglo-American personalism, its idealiastic as well as its realistic branches. He presents all sterams of these two branches, emphasizing their respective characte_ristic features in the works of their important representatives. More than hundred representatives of personalism proof the manifold of the interpretations of the fundamental concept of the person. (shrink)

Questions about the status of literary truth are as old as literary criticism, but they have become both more intricate and more compelling as literature has grown progressively more self-conscious and labyrinthian in its dealings with "reality." One might perhaps read The Iliad or even David Copperfield without raising such issues. But authors like Gide , Nabokov, Borges, and Robbe-Grillet seem continually to remind their readers of the complex nature of literary truth. How, for instance, are we to deal with (...) a passage like the following from William Demby's novel The Catacombs:"When I began this novel, I secretly decided that, though I would exercise a strict selection of the facts to write down, be they 'fictional' facts or 'true' facts taken from newspapers or directly observed events in my own life, once I had written something down I would neither edit not censor it ."1What does this sentence mean? When an apparently fictional narrator distinguishes between "fictional" and "true" facts, what is the status of the word "true"? It clearly does not mean the same as "fictional," for he opposes it to that term. Yet it cannot mean "true" in the sense that historians would use, for he calls what he is writing a novel, and even if he quotes accurately from newspapers, the events of a narrator's life are not "historically" true. · 1. William Demby, The Catacombs , p.93. Peter J. Rabinowitz, assistant professor at Kirkland College, is currently working on articles on Raymond Chandler, Faulkner, and Dostoyevsky and is, as well, a music critic for the Syracuse Guide. He wrote his doctoral dissertation in comparative literature on the philosophical implications of Nabokov's use of humor and terror. "Truth in Fiction" is the first article he has had published in a scholarly journal. (shrink)

Introduction , Sophie Gibb 1. Mental Causation , John Heil 2. Physical Realization without Preemption , Sydney Shoemaker 3. Mental Causation in the Physical World , Peter Menzies 4. Mental Causation: Ontology and Patterns of Variation , Paul Noordhof 5. Causation is Macroscopic but not Irreducible , David Papineau 6. Substance Causation, Powers, and Human Agency , E. J. Lowe 7. Agent Causation in a Neo-Aristotelian Metaphysics , Jonathan D. Jacobs and Timothy O’Connor 8. Mental Causation and Double Prevention , (...) Sophie Gibb 9. The Identity Theory as a Solution to the Exclusion Problem , David Robb 10. Continuant Causation, Fundamentality, and Freedom , Peter Simons 11. There is no Exclusion Problem , Steinvor Tholl Arnadottir and Tim Crane. (shrink)

In this monograph the author presents the special and general theories of relativity from a geochronometrical viewpoint. The amount of mathematics demanded is not too great, and one can get quite far along on the material on vectors presented early in the book. The first three chapters especially derive from the work of A. A. Robb several decades ago: they treat foundations of geochronometry, one-plus-one geochronometry and its generalization to a one-plus-three system. Later chapters cover such staples as the Lorentz (...) transformation, the metric and dynamical tensors, dynamical relationships of particles, accelerating and curving events, geodesics, and applications to the red-shift of spectral lines and bending of light-rays. The best introduction to the study of the foundation of physics is physics itself; so those philosophers interested in the foundations of relativity theory will find here a lucid and logically respectable exposition of that theory, and in that way an understanding of its fundamentals and problems will be reached.—P. J. M. (shrink)

45~ JOURNAL OF THE HISTORY OF PHILOSOPHY 34:3 JULY 1996 text" , and an element of "oralism" remains in all of Plato's written works. Nonetheless, Robb's "speculations" on the Platonic dialogues are certainly worth reading. Robb is quite aware that his book stirs up controversial issues, and some of these are briefly stated and discussed in his concluding chapter, "Homer, the Alphabet, and the Progress of Greek Literacy and Paideia." And yet in the very notions of "literacy" and "progress," some (...) weaknesses in Robb's work can be found. For example, as W. V. Harris observed in his Ancient Literacy , 3ft., there is no single definition of literacy or orality, and although Robb cites Harris's book , he takes no special account of it in attempting to define or characterize what he means by "orality" and "literacy." And in his zeal to provide a survey of the influence of alphabetic literacy on Plato, Robb perhaps oversimplifies the tension that existed between the spoken and written work in the ancient world. Much of Greek "literature" remains the product of literate, slave- owning, and well-educated authors, written for their peers. Robb suggests as much in his discussion of mousild and sunousia , and one might desire a "sociology" of ancient Athens, for example, in which economic status and.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Thales of Miletus: The Beginnings of Western Science and PhilosophyKevin RobbPatricia F. O’Grady. Thales of Miletus: The Beginnings of Western Science and Philosophy. Aldershot, England: Ashgate, 2002. Pp xxii + 310. Paper, $84.95.This book has a consistent thesis: Thales of Miletus was the first Western scientist and philosopher not just for what he began, but for what he himself said (or, as O'Grady believes, wrote). On this view, (...) Thales made significant contributions to metaphysics ("He asked the question: 'What is real?' no less than Plato and Aristotle did," 249), cosmology (on the earth and earthquakes, 87 ff.), astronomy (notably the eclipse, 126 ff.), mathematics (Proclus attributes Euclidean theorems to Thales, 191 ff.), psychology (on psyche) and theology (on "full of the gods," 108 ff.). O'Grady's thesis is that we know enough about Thales' thoughts in these areas (each a treacherous minefield of scholarly dispute, as O'Grady admits) that, after a clarified understanding of "Scientificity and Rationality" (her awkward title for Chapter 11), we can confidently conclude that philosophy and science were well begun by Thales. "I believe I have drawn a clear and detailed picture of a brilliant, veracious, and courageously speculative Greek. I see him as a questioner of almost everything, an investigator of nature...Thales is not the mere shadowy figure of Guthrie's perception. He is a man of substance, a man of distinction and of lasting importance" (251).O'Grady had early noted that W. K. C. Guthrie considered Thales a shadowy figure historically, made all the more so, Guthrie believed, because the legend kept expanding. For example, a sixth-century Thales as the seeker after the material archê, and so the first important physikos, is unknown before fourth-century Aristotle's Metaphysics Alpha, and by the time Euclidean theorems are attributed to Thales the tendency to foist imposing discoveries on famous persons was prevalent.This raises the major issue concerning O'Grady's exhaustively researched book. To what extent can the doxographic sources (the "A" sections of Diels's 1903Die Fragmente der Vorsokratiker), be used to interpret the Presocratics, especially if the original wording from a thinker perished (any "B" section quotations). It is clear that in the fourth century nothing in writing from Thales survived for the Lyceum to read and catalogue although its scholars clearly sought it; the repeated legetai ("it is said") of Aristotle in Metaphysics Alpha and elsewhere is decisive. It is his standard way of indicating that no written work on the matter survives to be consulted, but stories or oral accounts do.O'Grady's thesis requires that the "A" section material be exploited fully, especially to present Thales as a philosopher (29-70). Many historians will be unwilling to take the entire journey with her. Some (Harold Cherniss) would balk at the first step. The demand for confirming ipsissima verba (or "B" quotations) to reconstruct the thought of any Presocratic with real confidence (as once proposed by G. S. Kirk) threatens to exclude Thales from histories of philosophy, an unsatisfactory result. Even so, Harold Cherniss proposed that drastic solution in 1935 in his magisterial Aristotle's Criticism of Presocratric Philosophy. Presocratic philosophy, he argued, should begin with Anaximander (375).The heart of Cherniss's numbingly exhaustive argument (400 + pages) was that Aristotle's purpose in surveying his predecessors's views was never historical, but dialectical. His intent was to argue for a fourfold causality (on the grounds only four archai had been turned up by all his predecessors, starting with Thales' material cause), and to fit those predecessors's views into a theory of natural causality as he had finally formulated it in his sophisticated, [End Page 107] largely technical vocabulary. Aristotle's "historical" notices on which all later accounts must depend were, thus, never history; the problem and the solution, along with their language, were Aristotle's alone. If Theophrastus paraphrased what he found in Aristotle (McDiarmid), and if the post-Aristotelian doxographic notices were largely dependent on Theophrastus (so already Diels in 1879, in Doxographi Graeci), then any attempt to extract a philosophical Thales from the later doxographic sources (or Aristotle) is methodologically doomed from... (shrink)

Iain Atack identifies the contribution of nonviolence to political theory through connecting central characteristics of nonviolent action to fundamental debates about the role of power and violence in politics. This in turn provides a platform for going beyond historical and strategic accounts of nonviolence to a deeper understanding of its transformative potential. From Mahatma Gandhi and Martin Luther King to toppled communist regimes in Eastern Europe and pro-democracy movements in Serbia, Georgia and Ukraine, nonviolent action has played a significant (...) role in achieving social and political change in the last century. The Arab Spring revolutions, particularly those in Tunisia and Egypt, and the Occupy movement in the US and UK demonstrate that nonviolence continues to be a vital feature of many campaigns for democracy, human rights and social justice. (shrink)