In this article, an ethical analysis of an educational programme on renal replacement therapy options for patients and their social network is presented. The two main spearheads of this approach are: (1) offering an educational programme on all renal replacement therapy options ahead of treatment requirement and (2) a home-based approach involving the family and friends of the patient. Arguments are offered for the ethical justification of this approach by considering the viewpoint of the various stakeholders involved. Finally, reflecting on (...) these ethical considerations, essential conditions for carrying out such a programme are outlined. The goal is to develop an ethically justified and responsible educational programme. (shrink)

Terminal kidney patients are faced with lower quality of life, restricted diets and higher morbidity and mortality rates while waiting for deceased donor kidney transplantation. Fortunately, living kidney donation has proven to be a better treatment alternative (e.g. in terms of waiting time and graft survival rates). We observed an inequality in the number of living kidney transplantations performed between the non-European and the European patients in our center. Such inequality has been also observed elsewhere in this field and it (...) has been suggested that this inequality relates to, among other things, attitude differences towards donation based on religious beliefs. In this qualitative research we investigated whether religion might indeed (partly) be the explanation of the inequalities in living donor kidney transplants (LDKT) among non-European patients. Fifty patients participated in focus group discussions and in-depth interviews. The interviews were conducted following the focus group method and analyzed in line with Grounded Theory. The qualitative data analyses were performed in Atlas.ti. We found that religion is not perceived as an obstacle to living donation and that religion actually promotes helping and saving the life of a person. Issues such as integrity of the body were not seen as barriers to LDKT. We observed also that there are still uncertainties and a lack of awareness about the position of religion regarding living organ donation within communities, confusion due to varying interpretations of Holy Scriptures and misconceptions regarding the process of donation. Faith leaders play an important educational role and their opinion is influential. This study has identified modifiable factors which may contribute to the ethnic disparity in our living donation program. We argue that we need to strive for more clarity and awareness regarding the stance of religion on the issue of living donation in the local community. Faith leaders could be key figures in increasing awareness and alleviating uncertainty regarding living donation and transplantation. (shrink)

Living kidney donation provides a promising opportunity in situations where the scarcity of cadaveric kidneys is widely acknowledged. While many patients and their relatives are willing to accept its benefits, others are concerned about living kidney programs; they appear to feel pressured into accepting living kidney transplantations as the only proper option for them. As we studied the attitudes and views of patients and their relatives, we considered just how actively health care professionals should encourage living donation. We argue that (...) active interference in peoples’ personal lives is justified - if not obligatory. First, we address the ambiguous ideals of non-directivity and value neutrality in counselling. We describe the main pitfalls implied in these concepts, and conclude that these concepts cannot account for the complex reality of living donation and transplantation. We depict what is required instead as truthful information and context-relative counselling. We then consider professional interference into personal belief systems. We argue that individual convictions are not necessarily strong, stable, or deep. They may be flawed in many ways. In order to justify interference in peoples’ personal lives, it is crucial to understand the structure of these convictions. Evidence suggests that both patients and their relatives have attitudes towards living kidney donation that are often open to change and, accordingly, can be influenced. We show how ethical theories can account for this reality and can help us to discern between justified and unjustified interference. We refer to Stephen Toulmin’s model of the structure of logical argument, the Rawlsian model of reflective equilibrium, and Thomas Nagel’s representation of the particularistic position. (shrink)

This study’s objective was to understand Colombian adolescents’ experiences and preferences regarding access to sexual and reproductive health services (SRHS), either alone or accompanied. A mixed-method approach was used, involving a survey of 812 participants aged eleven to twenty-four years old and forty-five semi-structured interviews with participants aged fourteen to twenty-three. Previous research shows that adolescents prefer privacy when accessing SRHS and often do not want their parents involved. Such findings align with the longstanding tendency to frame the ethical principle (...) of autonomy as based on independence in decision-making. However, the present study shows that such a conceptualization and application of autonomy does not adequately explain Colombian adolescent participants’ preferences regarding access to SRHS. Participants shared a variety of preferences to access SRHS, with the majority of participants attaching great importance to having their parents involved, to varying degrees. What emerges is a more complex and non-homogenous conceptualization of autonomy that is not inherently grounded in independence from parental involvement in access to care. We thus argue that when developing policies involving adolescents, policymakers and health professionals should adopt a nuanced “relational autonomy” approach to better respect the myriad of preferences that Colombian (and other) adolescents may have regarding their access to SRHS. (shrink)

The paucity of research data to guide current paediatric practice has led to children being termed therapeutic orphans. This difficulty is especially pertinent to research in emergency situations, such as acute resuscitation or critical care, where accepted ethical standards for overall research, have historically created practical difficulties for researchers. The welcome establishment of organisations to support UK paediatric research is helping to ensure safer and more effective medications for children, however as the balance between protection and access at the heart (...) of the paediatric research ethical debate shifts to ever increasing access for researchers to children, it remains crucial to ensure the protection for these vulnerable participants. The fundamental protection for research subjects, namely their full informed consent before any recruitment, is not tenable in true emergency situations and so other approaches are warranted if standards are to be improved by human subjects research in such areas. Proxy, deferred and retrospective consent have all been advocated as solutions to this difficulty and this paper explores the ethical justification for these approaches and their utility in safeguarding children and families in emergency situations when traditional informed consent, as currently defined, cannot be obtained in the necessary time frame to enable research. (shrink)

1. The Commentariolum Petitionis is not in the Codex Mediceus of Cicero's correspondence with his brother Quintus, but it appears at the end of the letters to Quintus in the other manuscripts. It starts in the normal manner of a letter and is, or purports to be, a collection of tips on canvassing set in the particular context of M. Cicero's consular candidature in 64: a composition of his brother Quintus. It is printed as no. 12 in Tyrrell and Purser's (...) collection of Cicero's Letters. (shrink)

The aim of this investigation is to discuss the merits of the three radically divergent views as to the nature and function of the categories held by Kant, Ward and Alexander.

This dissertation seeks to contribute to research in the philosophy of social science. The study focuses upon select epistemological and ontological aspects of Hannah Arendt’s work from which methodological implications are drawn pertaining to sociology. Arendt, although critical of the sociology of her time, has become increasingly cited and influential for emerging sociological research and this study seeks to contribute to this by focusing upon the problem of novelty. The aim is to explore the philosophical and methodological implications of novelty (...) for social science by working through three case studies that are theoretically pivotal for social science—action, the ‘social’, and the self—in terms of novelty as expressed in Arendt’s writing. Arendt is critical of methodology and epistemology, aiming to draw her readers to ontological concerns outlined from her preoccupation with the 'world' and social reality. In this aim, Arendt seeks to distance herself from social sciences that she claims ignore human novelty in favour of reading social regularities, tendencies and similarities. Despite her disdain for method, Arendt suggests a anti-methodological 'method' (outlined in an overlooked footnote) for keeping trained upon and for dealing with novel, anomalous events. In the seed of this method lies a unique opportunity for social science to reassess and extend its methods, addressing this oversight and in so doing bring to light the novel social object as a legitimate subject of social research. (shrink)

Of the early Roman historians who wrote in Greek, A. Postumius Albinus was not necessarily alone in realizing that his Greek was not the best Greek; while, on the other hand, Cato and those who followed the new fashion of writing in Latin would have resented, we may assume, could they have foreknown, the statement of Q,. Catulus in Cicero's De Oratore that they had no literary or rather ‘oratorical’ merit; though Cato might have approved Catulus' caustic comment on Roman (...) historical writing, ‘Satis est non esse mendacem’. That an historian should not, consciously and deliberately, lie all second-century historians would no doubt have agreed; and they would have endorsed Polybius' condemnation of masquerading as history in a story whose falseness was self-evident, because it assumed, on the part of the young sons of senators at Rome, a gravitas such as no young boy could possibly possess. (shrink)

The double slit experiment for a massive scalar particle is described using intuitionistic logic with quantum real numbers as the numerical values of the particle's position and momentum. The model assigns physical reality to single quantum particles. Its truth values are given open subsets of state space interpreted as the ontological conditions of a particle. Each condition determines quantum real number values for all the particle's attributes. Questions, unanswerable in the standard theories, concerning the behaviour of single particles in the (...) experiment are answered. (shrink)

Open peer commentary on the article “Constructing Constructivism” by Hugh Gash. Upshot: Gash’s retrospective analysis suggests a number of different roles for RC over the past thirty years. We outline three of these roles and then conduct a thought experiment to argue that while RC itself could be seen as a living theory that accommodates new ideas, its strongest contributions remain when it stays true to its roots and serves as a milestone along the path of educational paradigm shifts.

‘Auctoritas’ was naturally one of Cicero's favourite concepts. In the ideal republic power lay with the people, auctoritas with the Senate . Alternatively, in a balanced state, potestas would lie with the magistrates, libertas with the people, but still auctoritas would be the property of the Senate, ‘in principum consitio’ [De rep. 2. 57).