Persons with serious and disabling medical conditions have traveled abroad in search of stem cell treatments in recent years. However, weak or nonexistent oversight systems in some countries provide insufficient patient protections against unproven stem cell treatments, raising concerns about exposure to harm and exploitation. The present article, the first of two, describes and analyzes stem cell tourism in Russia and India and addresses several scientific/medical, ethical, and policy issues raised by the provision of unproven stem cell-based treatments within them. (...) The distinction between treatment based on proven clinical research and "innovative treatment" is addressed and the authors conclude that the innovations at issue constitute neither. Regulatory measures need to be developed or strengthened in accord with internationally accepted standards in such countries to protect those seeking stem cell treatments. (shrink)

Clinics and hospitals around the globe are offering stem cell treatments to persons with serious conditions for whom no effective therapies are available in their home countries. Many of these treatments, which are touted as cures for such conditions as Parkinson's and Alzheimer's Diseases, multiple sclerosis, and spinal cord injuries, have not gone through clinical trials that establish their safety and efficacy. Indeed, it is unclear whether some of them even utilize stem cells. State regulation of these therapies tends to (...) be weak or nonexistent in some of the countries in which they are offered. This puts those who believe they must travel abroad for stem cell treatments at risk of injury from procedures that .. (shrink)

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients who (...) differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients who (...) differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

Aim: To examine how physicians’ life stances affect their attitudes to end-of-life decisions and their actual end-of-life decision-making.Methods: Practising physicians from various specialties involved in the care of dying patients in Belgium, Denmark, The Netherlands, Sweden, Switzerland and Australia received structured questionnaires on end-of-life care, which included questions about their life stance. Response rates ranged from 53% in Australia to 68% in Denmark. General attitudes, intended behaviour with respect to two hypothetical patients, and actual behaviour were compared between all large (...) life-stance groups in each country.Results: Only small differences in life stance were found in all countries in general attitudes and intended and actual behaviour with regard to various end-of-life decisions. However, with regard to the administration of drugs explicitly intended to hasten the patient’s death , physicians with specific religious affiliations had significantly less accepting attitudes, and less willingness to perform it, than non-religious physicians. They had also actually performed PAD less often. However, in most countries, both Catholics and Protestants reported ever having made such a decision.Discussion: The results suggest that religious teachings influence to some extent end-of-life decision-making, but are certainly not blankly accepted by physicians, especially when dealing with real patients and circumstances. Physicians seem to embrace religious belief in a non-imperative way, allowing adaptation to particular situations. (shrink)

Recently various gedankenexperiments have been formulated which argue that the assumption that “elements of reality” are Lorentz invariant cannot be reconciled with standard quantum mechanics. Two of these gedankenexperiments were subsequently analyzed using the notion of pre- and postselected quantum systems, and it was claimed that elements of reality can be made Lorentz invariant if the “product rule” of standard quantum mechanics is abandoned. In this paper we show that the apparent violations of the product rule in these gedankenexperiments are (...) not as significant as they appeared to be in the previous analysis. We conclude that the problems with Lorentz invariance which arise in these gedankenexperiments are essentially unrelated to the product rule violations. (shrink)

Willey emphasizes the social-political context as the source of problems which neo-Kantian thought had to—and largely failed to—cope with. "I believe the neo-Kantians expressed the tentative and unsuccessful efforts of a segment of the upper bourgeoisie to make peace with the proletariat and to retain an attitude of cultural community with the West". The first of these two themes refers to the rapprochement of academic philosophy and socialism which is mainly associated with "the Marburg School," above all, F. A. Lange (...) and Hermann Cohen, which led to diverse practical extensions in Karl Vorländer, Kurt Eisner, and Eduard Bernstein. (shrink)

We examine, in the context of the Einstein-Podolsky-Rosen-Bohm gedankenexperiment, problems associated with state reduction and with nonlocal influences according to different interpretations of quantum mechanics, when attempts are made to apply these interpretations in the relativistic domain. We begin by considering the significance of retrodiction within four different interpretations of quantum mechanics, and show that three of these interpretations, if applied in a relativistic context, can lead to ambiguities in their description of a process. We consider ways of dealing with (...) these ambiguities, in particular focussing on the “preferred frame” hypothesis. We then re-examine an argument involving nonlocal measurements which claimed that the preferred frame hypothesis is not tenable, and show that this argument does not in fact necessitate a rejection of the preferred frame. We then suggest that, to avoid confusion, the preferred frame could be extended to cover unitary interactions as well as state reductions. We conclude with a brief examination of a proposal that state reduction should take effect across the backward light cone of a measurement event. (shrink)

This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be permitted (...) access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

ABSTRACT This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be (...) permitted access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

: The transplantation of adult human neural stem cells into prenatal non-humans offers an avenue for studying human neural cell development without direct use of human embryos. However, such experiments raise significant ethical concerns about mixing human and nonhuman materials in ways that could result in the development of human-nonhuman chimeras. This paper examines four arguments against such research, the moral taboo, species integrity, "unnaturalness," and human dignity arguments, and finds the last plausible. It argues that the transfer of human (...) brain or retinal stem cells to nonhuman embryos would not result in the development of human-nonhuman chimeras that denigrate human dignity, provided such stem cells are dissociated. The article provides guidelines that set ethical boundaries for conducting such research that are consonant with the requirements of human dignity. (shrink)

Who blows the whistle — a loner or a well-liked team player? Which of them is more likely to lead a successful opposition to perceived organizational wrongdoing? The potential influence of co-worker pressures to conform on whistle-blowing activity or the likely effects of whistle-blowing on the group have not been addressed. This paper presents a preliminary model of whistle-blowing as an act of nonconformity. One implication is that the success of an opposition will depend on the characteristics of the whistle-blower (...) and how the complaint is pursued. Specific hypotheses and general suggestions for future research and practice are offered. (shrink)

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

Neokantismes: la marque du pluriel indique d'emblee que le mot d'ordre des annees 1865 Retour a Kant! regroupe differentes ecoles. Les auteurs dont les textes inedits en francais se trouvent ici rassembles et traduits, appartiennent en effet soit a l'ecole de Marbourg (H. Cohen, P. Natorp et E. Cassirer) soit a l'ecole de Bade (W. Windelband, H. Rickert, E. Lask, J. Cohn). Le point commun du neokantisme logique des premiers et du neokantisme axiologique des seconds consiste en une volonte (...) d'asseoir le positivisme sur un fondement philosophique respectueux de l'attitude phenomenologique. Kant apparut donc a tous ces penseurs comme science rigoureuse a condition toutefois de ne considerer le sujet transcendantal que comme une fonction logique de la pensee qui elabore la forme et le contenu de la connaissance. A condition egalement de ne pas limiter l'entreprise critique a la physique, mais de l'etendre au fondement de toutes les sciences de l'esprit. (shrink)

The New Evil Demon problem has been hotly debated since the case was introduced in the early 1980’s (e.g. Lehrer and Cohen 1983; Cohen 1984), and there seems to be recent increased interest in the topic. In a forthcoming collection of papers on the New Evil Demon problem (Dutant and Dorsch, forthcoming), at least two of the papers, both by prominent epistemologists, attempt to resist the problem by appealing to the distinction between justification and excuses. My primary aim (...) here is to critically evaluate this new excuse maneuver as a response to the New Evil Demon problem. -/- Their response attempts to give us reason to reject the idea that victims of the New Evil Demon have justification for believing as they do. I shall argue that this approach is ultimately unsuccessful, however much of value can be learned from these attempts. In particular, progress in the debate can be made by following those who advance the excuse maneuver and make explicit the connection between epistemic justification and epistemic norms. By doing so, the questions being debated are clarified, as is the methodology being used to attempt to answer them. (shrink)

As Post observes, accounting firms are unique among multinationals. They are more likely than firms in almost any other category to go abroad. They also have less choice in location as their expansion is determined largely by the desired locations of their clients. Given the widespread global presence of such firms, it can be argued that the global audit firm is uniquely at risk from variations in ethical perceptions across nations. This study extends the U.S. accounting literature on determinants of (...) cheating among accounting students to the U.K. Based on the work of Cohen et al. it develops a model that suggests that students in lower "uncertainty avoidance" countries will be both less likely to cheat, and when they do cheat, will be driven by internal rather than external mode. Our results supported the model as proposed as our results indicated that U.S. students were more likely to cheat and were more responsive to external stimuli than were the U.K. students. (shrink)

A is for Alice and astronomers arguing about acceleration -- B is for Bernard's body-exchange machine -- C is for the Catholic cannibal -- D is for Maxwell's demon -- E is for evolution (and an embarrassing problem with it) -- F is for the forms lost forever to the prisoners of the cave -- G is for Galileo's gravitational balls -- H is for Hume's shades -- I is for the identity of indiscernibles -- J is for Henri Poincaré (...) and alternative geometries -- K is for the Kritik and Kant's kind of thought experiments -- L is for Lucretius' spear -- M is for Mach's motionless chain -- N is for Newton's bucket -- O is for Olbers' paradox -- P is for Parfit's person -- Q is for the questions raised by thought experiments quotidiennes -- R is for the rule-ruled room -- S is for Salvatius' ship, sailing along its own space-time line -- T is for the time-travelling twins -- U is for the universe, and Einstein's attempts to understand it -- V is for the vexed case of the violinist -- W is for Wittgenstein's beetle -- X is for xenophanes and thinking by examples -- Y is for counterfactuals and a backwards approach to history -- Z is for Zeno and the mysteries of infinity. (shrink)

Major Philosophers of Jewish Prayer in the Twentieth Century addresses the troubling questions posed by the modern Jewish worshiper, including such obstacles to prayer as the inability to concentrate on the words and meanings of formal liturgy, the paucity of emotional involvement, the lack of theological conviction, the anthropomorphic and particularly the masculine emphasis of prayer nomenclature, and other matters. In assessing these difficultites, Cohen brings to the reader the writings on prayer of some seminal 20th century Jewish theologians. (...) These include Herman Cohen, Franz Rosenzweig, Avraham Yitzhak, Hoakohen Kook, Mordecai M. Kaplan, R. Arele, Aaron Rote, Elie Munk, Abraham J. Heschel, Jakob J. Petuchowski, Eugene B. Borowitz, and Lawrence A. Hoffman. (shrink)

John Burdon Sanderson Haldane was a giant among men. He made major contributions to genetics, population biology, and evolutionary theory. He was at once comfortable in mathematics, chemistry, microbiology and animal physiology. But it was his belief in education that led to his preparing his popular essays for publication. In his own words: "Many scientific workers believe that they should confine their publications to learned journals. I think that the public has a right to know what is going on inside (...) the laboratories, for some of which it pays." So begins Haldane's collection of essays, perhaps the most public intellectual communicating science before the writings of Stephen Jay Gould. The first part of the volume emphasizes the important developments in biology and natural science in the first quarter of the century. As such, it provides a benchmark for studies of the next three quarters of the century. In an unusual introduction, Price takes the readers through their paces, discussing the situation then and now in vitamins, oxygen want, disease controls, and the rewards of science as such. This is followed by Haldane's views on society, art, religion and economy as seen through the eyes of a politically alert major scientist. The editor provides readers unfamiliar with Haldane with a carefully rendered chronology of a life that began in 1892 and that spanned much of the present century. Despite ideas on race, class and politics that have seen better times, Haldane was truly exceptional in translating the science of his time into ideas that "everyman" could readily grasp. His predictions on what science would achieve were on target far more often than not. But even his failed predictions are perhaps the most interesting of all. They throw into sharp relief the truly novel and revolutionary developments in science over the past 75 years. J.B.S. Haldane held many positions and received many honors during his lifetime. But for most of the period covered in this volume, he was the William Dunn Reader in Biochemistry at Cambridge University. He simultaneously served as Fellow of New College, in Oxford University's Horticultural Institute. Carl A. Price served until 1999 as professor IIof plant molecular biology in the Waksman Institute of Microbiology at Rutgers, the State University of New Jersey. He also served as the editor of Plant Molecular Biology Reporter from 1983 until 1997. This is the first volume in a new series on the history and theory of science. (shrink)

We perceive relevance by virtue of inference habits, which may be expressed as Pierce's leading principles or as Toulmin's warrants. Hence relevance in a descriptive sense is a ternary relation between two statements and a set of inference rules. For a normative sense, the warrants must be properly backed. Different types of warrant to empirical generalizations, we introduce L.J. Cohen's notion of inductive support. A to empirical generalizations, we introduce L.J. Cohen's notion of inductive support. A generalization H (...) is supported by evidence E to degree i/in iff E indicates that H passes canonical test i, where there are n canonical tests. In a canonical test, one or more relevant variables, factors which may falsify H, are varied. H passes a test if it is not falsified. The tests are cumulative. Degree of support is relative to the canonical test, and may be modeled as relative to a point in a dialectical situation. A value of a variable at which H is falsified is a rebutting value. A is normatively relevant to B with respect to W iff sup[associated generalization(W), E] = i/n and for j > i, there is a presumption that the values of j are non-rebuting. (shrink)