During a pandemic, where there is widespread human infection, various and varying measures are taken that are targeted at public health objectives. During the early stages of a pandemic, these objectives may focus on containing the disease and minimizing its spread, but they may switch to mitigation as the emergent infectious disease takes hold in a population. There has been considerable debate and elucidation of the ethical principles and framework for the various responses including the need to fast track research (...) and vaccine development. However, the measures imposed during a pandemic would have unintended and untoward effect on ongoing clinical research. For example, precautionary measures, such as social distancing, may hamper ongoing clinical research, because recruitment and participation of patients and healthy volunteers is a potential source of virus spread. In this paper, we argue that a framework is needed to ensure the continuity of such research. Such a framework that considers the pertinent issues would need the ‘buy in’ of the key stakeholders (policy makers, funding agencies, institutional authorities, researchers and subjects) to ensure that the issues that are ethically relevant to pandemic planning would not be neglected or overlooked. (shrink)

Albert the Great died on November 15, 1280. It is only to be expected that the 700th anniversary of the death of one of the longest-lived philosopher-theologians of the Middle Ages should be marked by a volume of commemorative essays. Indeed, one of the more interesting features of this present work is the "Introduction," wherein the editors have located the Doctor Universalis in terms of his interests, his many and varied writings, and his companion viatores of the late twelfth and (...) the major part of the thirteenth centuries. We know he survived his most famous pupil, Thomas Aquinas, by some six years. It is perhaps more jarring to note that he may have been five years old at the death of Averroes and eleven at the death of Moses Maimonides. He went, as is said, from the decline of the golden age of Arabic and Jewish Philosophy right through to the beginnings of the decline of Scholasticism at the end of the thirteenth century. (shrink)

Rendell and Whitehead's thorough review dispels notions that culture is an exclusive faculty of humans and higher primates. We applaud the authors, but differ with them regarding the evolution of cetacean culture, which we argue resulted from the availability of abundant but spatially and temporally patchy prey such as schooling fish. We propose two examples of gene-culture coevolution: (1) acoustic abilities and acoustic traditions, and (2) transmission of environmental information and longevity.

This chapter first surveys general issues in the epistemic internalism / externalism debate: what is the distinction, what motivates it, and what arguments can be given on both sides. -/- The second part of the chapter will examine the internalism / externalism debate as regards to the specific case of the epistemology of memory belief.

Background: Discussions about medical errors facilitate professional learning for physicians and may provide emotional support after an error, but little is known about physicians’ attitudes and practices regarding error discussions with colleagues.Methods: Survey of faculty and resident physicians in generalist specialties in Midwest, Mid-Atlantic and Northeast regions of the US to investigate attitudes and practices regarding error discussions, likelihood of discussing hypothetical errors, experience role-modelling error discussions and demographic variables.Results: Responses were received from 338 participants . In all, 73% of (...) respondents indicated they usually discuss their mistakes with colleagues, 70% believed discussing mistakes strengthens professional relationships and 89% knew at least one colleague who would be a supportive listener. Motivations for error discussions included wanting to learn whether a colleague would have made the same decision , wanting colleagues to learn from the mistake and wanting to receive support . Given hypothetical scenarios, most respondents indicated they would likely discuss an error resulting in no harm , minor harm or major harm . Fifty-seven percent of physicians had tried to serve as a role model by discussing an error and role-modelling was more likely among those who had previously observed an error discussion .Conclusions: Most generalist physicians in teaching hospitals report that they usually discuss their errors with colleagues, and more than half have tried to role-model discussions. However, a significant number of these physicians report that they do not usually discuss their errors and some do not know colleagues who would be supportive listeners. (shrink)

While outcomes for children with T-cell acute lymphoblastic leukemia have improved dramatically, survival rates for patients with relapsed/refractory disease remain dismal. Prior studies indicate that glucocorticoid resistance is more common than resistance to other chemotherapies at relapse. In addition, failure to clear peripheral blasts during a prednisone prophase correlates with an elevated risk of relapse in newly diagnosed patients. Here we show that intrinsic GC resistance is present at diagnosis in early thymic precursor T-ALLs as well as in a subset (...) of non-ETP T-ALLs. GC-resistant non-ETP T-ALLs are characterized by strong induction of JAK/STAT signaling in response to interleukin-7 stimulation. Removing IL7 or inhibiting JAK/STAT signaling sensitizes these T-ALLs, and a subset of ETP T-ALLs, to GCs. The combination of the GC dexamethasone and the JAK1/2 inhibitor ruxolitinib altered the balance between pro- and anti-apoptotic factors in samples with IL7-dependent GC resistance, but not in samples with IL7-independent GC resistance. Together, these data suggest that the addition of ruxolitinib or other inhibitors of IL7 receptor/JAK/STAT signaling may enhance the efficacy of GCs in a biologically defined subset of T-ALL.Leukemia advance online publication, 30 May 2017; doi:10.1038/leu.2017.136. (shrink)

My thesis is on the intersection of epistemology and the philosophy of religion. Contemporary religious epistemology asks the question of how, if at all, can religious belief be rationally justified. I focus on a relatively new tradition that responds to this question known as Reformed Epistemology, as advanced by Alvin Plantinga. Reformed Epistemologists argue that belief in God can be rational, reasonable, and justified without appeal to evidence as was traditionally thought. Plantinga argues that religious belief stems from an innate (...) faculty which produces properly basic beliefs that need not rest on any other beliefs for their justification. My aim is to critically examine these claims. My thesis begins in section I with a discussion of Plantinga’s early attacks on classical foundationalism and Evidentialism, that is, the view that being rational means according one's belief with the evidence. His early goal is to discredit the Evidentialist objection by rebutting the flawed epistemological system he argues it presupposes. In so doing, Plantinga attempts to loosen the canons of basicality to include the belief in God as properly basic. -/- In section II I then discuss Plantinga’s notion of warrant, which is his term for justification – the hallmark difference between true belief and knowledge. After examining the tenability of Plantinga’s concept of what makes belief warranted, I examine how successfully he specifically applies this notion of justification to religious belief. Plantinga’s contention is that religious belief can enjoy enough warrant so that if the belief is true, it will constitute knowledge. In examining this claim I evaluate in section III Plantinga’s evolutionary argument against naturalism, his Aquinas/Calvin model in section IV, potential rationality defeaters in section V and in section VI the larger question of the internalism / externalism debate and its influence on these central issues. (shrink)

An edition based upon the Elwes translation, consisting of selections from Parts III, IV, and V of the original. The text has been prepared in such a way that the mathematical method of Spinoza has been obscured by a more literary arrangement.--J. E. B.

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid wheat genome. Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection. Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of (...) ESTs into contigs. These contigs plus singletons were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5′ and 3′ sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics. (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)

OBJECTIVES: To investigate the need for hospital clinical ethics committees by studying the frequency with which ethical dilemmas arose, the perceived adequacy of the process of their resolution, and the teaching and training of staff in medical ethics. DESIGN: Interviews with individuals and three multidisciplinary teams; questionnaire to randomly selected individuals. SETTING: Two major London children's hospitals. RESULTS: Ethical dilemmas arose frequently but were resolved in a relatively unstructured fashion. Ethical concerns included: the validity of consent for investigations and treatment; (...) lack of children's involvement in consent; initiation of heroic or futile treatments; resource allocation. Staff expressed the need for a forum which would provide consultation on ethical issues, develop guidelines for good ethical practice, undertake teaching and training, and provide ethical reflection outside the acute clinical setting. CONCLUSION: Multidisciplinary, accountable and audited clinical ethics committees with predominantly advisory, practice development and educational roles could provide a valuable contribution to UK clinical practice and perhaps in other countries that have not developed hospital clinical ethics committees. (shrink)

This chapter explores the opportunities and limitations of the ideal of transparency in responsible innovation, by consulting the virtual case of "The Circle", a company which appears in Dave Eggers' novel The Circle. The Circle is a high-tech company with the main purpose of being responsive to societal needs. They want to eradicate unethical behaviour in society, enhance public health and make a positive impact on the environment. The ultimate goal of The Circle is to reach 100% full transparency in (...) the world, which is impossible without any societal desirability. In first instance, it is free choice of people to accept and embrace the products and services of The Circle, who invest resources in keeping customers happy and in raising awareness about the dangers of privacy. The chapter concludes that The Circle meets the requirements regarding the outcomes of responsible innovation, at least to a certain extent, while at the same time, one feels unease about certain activities they undertake. (shrink)