Clinical Ethics Consultations are an important tool for physicians in solving difficult cases. They are extremely common in North America and to a lesser extent also present in Europe. However, there is little data on this practice in Poland. We present results of a survey of 521 physicians practising in Poland concerning their opinion on CECs and related practices. We analysed the data looking at such issues as CECs’ perceived availability, use of CECs, and perceived usefulness of such support. Physicians (...) in our study generally encounter hard ethics cases, even—surprisingly—those who do not work in hospitals. Most physicians have no CEC access, and those that do still do not employ CECs. However, physicians perceive this form of support as useful—even more so among actual users of CECs. We compared these findings with similar studies from other European countries and the North America. We point out peculiarities of our results as compared to those in other countries, with some possible explanations. We hope the results may encourage regulatory debate on the need to formally introduce CECs into the Polish healthcare system. (shrink)

According to UNESCO guidelines, one of the four forms of bioethics committees in medicine are the Hospital Ethics Committees. The purpose of this study was to evaluate how the above guidelines are implemented in real practice. There were 111 hospitals selected out of 176 Polish clinical hospitals and hospitals accredited by Center of Monitoring Quality in Health System. The study was conducted by the survey method. There were 56 hospitals that responded to the survey. The number of HECs members fluctuated (...) between 3 and 16 members, where usually 5 members were part of the board committee. The composition of the HECs for professions other than physicians was diverse and non-standardized. Only 55 % of HECs had a professional set of standards. 98 % of HECs had specific tasks. 62 % of HECs were asked for their expertise, and 55 % prepared <6.88 % of the opinions were related to interpersonal relations between hospital personnel, patients and their families with emphasis on the interactions between superiors and their inferiors or hospital staff and patients and their families. Only 12 % of the opinions were reported by the respondents as related to ethical dilemmas. In conclusion, few Polish hospitals have HECs, and the structure, services and workload are not always adequate. To ensure a reliable operation of HECs requires the development of relevant legislation, standard operating procedures and well trained members. (shrink)

The Polish equivalents of Research Ethics Committees are Bioethics Committees (BCs). A questionnaire study has been undertaken to determine their situation. The BC is usually comprised of 13 members. Nine of these are doctors and four are non-doctors. In 2006 BCs assessed an average of 27.3 ± 31.7 (range: 0–131) projects of clinical trials and 71.1 ± 139.8 (range: 0–638) projects of other types of medical research. During one BC meeting an average of 10.3 ± 14.7 (range: 0–71) projects of (...) medical research were assessed (2006). The amendment of Polish laws according with Directive 2001/20/EC caused a percentage increase in BCs which assessed less than 20 projects per year (16% vs. 33% or 42% in 2003 vs. 2005 or 2006 respectively, p < 0,05). The results confirm the usefulness of the current practice of creating BCs by medical universities, medical institutes and regional chambers of physicians and dentists but rationalization of the workload for individual BCs is necessary. (shrink)

Biological research with legitimate scientific purpose that may be misused to pose a biological threat to public health and/or national security is termed dual use. In Poland there are adequate conditions for conducting experiments that could be qualified as dual use research, and therefore, a risk of attack on Poland or other countries exists. Optimal solutions for limiting such threats are required, and the national system of biosecurity should enable early, reliable, and complete identification of this type of research. Scientists (...) should have a fundamental role in this process, their duty being to immediately, upon identification, report research with dual use potential. An important entity in the identification system of dual use research should also be the Central Register of Biological and Biomedical Research, which gathers information about all biological and biomedical research being conducted in a given country. Publishers, editors, and review committees of journals and other scientific publications should be involved in evaluating results of clinical trials. The National Council of Biosecurity should be the governmental institution responsible for developing a system of dual use research threat prevention. Its role would be to develop codes of conduct, form counsel of expertise, and monitor the problem at national level, while the Dual Use Research Committee would be responsible for individual cases. In Poland, current actions aiming to provide biological safety were based on developing and passing an act about genetically modified organisms (GMO’s) and creating a GMO Committee. Considering experiences of other nations, one should view these actions as fragmentary, and thus insufficient protection against dual use research threats. (shrink)

The Helsinki Declaration is a very important document regarding the protection of patients’ rights in clinical trials and one of the fundamental sources of operational principles for every ethics committee. Although they have been updated, the international guidelines for ethics committees continually fail to address certain issues pertaining to the protection of patients’ rights in clinical trials. These issues include, most significantly, the method of electing ethics committees (a free, secret ballot should be preferred to direct appointment), the avoidance of (...) conflict of interest during the election of ethics committee members, and the necessary insurance coverage for the participants of clinical trials. Polish law should, on the other hand, be developed in such way as to not limit the effectiveness of ethics committees in protecting patients’ rights in clinical trials. The ideal solution would be to draft a uniform law concerning not only clinical trials, but all medical experiments. The opinions of experts who have been reviewing medical research projects for several years may prove to be especially valuable in this setting. (shrink)

Although Directive 2001/20/EC of the European Parliament and of Council of 4 April 2001 on the approximation of the laws regulations and administrative provisions of the Member States relating to the implementation of good clinical practice in the conduct of clinical trials on medicinal products for human use does not contain an exception for emergency situations, and requires the informed consent of a legal representative in all cases where research is conducted on legally competent individuals who are unable to give (...) informed consent, in Poland, emergency research can be conducted without consent. Polish regulations on emergency research can hardly be treated as a result of intentional legislative policy. Our provisions arise from multiple and sophisticated interpretations of different regulations that govern medical experiments on human subjects and clinical trials. These interpretations can be summarized as follows: There are two categories of medical experiments: therapeutic and non-therapeutic experiments. Emergency research without consent may be conducted in the category of therapeutic experiment only.. Emergency research may be conducted without consent if there is a situation of great urgency in which the research subject’s life is in danger and there is no possibility of obtaining immediate consent from the research subject him or herself, or from his or her legal representative or guardianship court, and the research subject has not refused to give consent for the participation in an emergency therapeutic experiment. The legal representative or guardianship court shall be provided with all the relevant information concerning subject’s participation in an experiment as soon as possible. All projects of emergency research with intent to be done without the research subject’s consent must be approved by an independent bioethics committee. Because these five requirements seem to provide insufficient protection for a subject’s autonomy and rights it is necessary to add to them two other conditions: the emergency research could not be conducted using other research participants capable of giving informed consent; and informed consent for continued participation in the emergency research shall be obtained from either the participant him or herself or the legally authorized representative as soon as possible. A consolidated single Act that will govern all aspects of medical experiments on human subjects, including emergency research, should be prepared and enacted as soon as possible. (shrink)

The paper reports results of the very first survey-based study on the prevalence, frequency and nature of ethical or other non-medical difficulties faced by Polish physicians in their everyday clinical practice. The study involved 521 physicians of various medical specialties, practicing mainly in inpatient healthcare. The study showed that the majority of Polish physicians encounter ethical and other non-medical difficulties in making clinical decisions. However, they confront such difficulties less frequently than their foreign peers. Moreover, Polish doctors indicate different circumstances (...) as a source of the experienced problems. The difficulties most often reported relate to (i) patients (or their proxies) requests for medically non-indicated interventions; (ii) problems with communication with patients (or their proxies) due to the patients’ negative attitude, unwillingness to cooperate, or aggression; and (iii) various difficulties with obtaining informed consent. Polish physicians report difficulties associated with disagreements among care givers or scarcity of resources less frequently than doctors from other countries. The study’s findings provide support for the thesis that a significant portion of Polish physicians still follow a traditional, paternalistic, and hierarchical model of healthcare practice. Instead of promoting patient’s empowerment, engagement, and rights, they often consider these ideas as a threat to physicians’ professional authority and autonomy. The study leads to the conclusion that due to insufficient training in medical ethics, communication skills, and medical law, many Polish physicians lack the knowledge and competence necessary to adequately respond to challenges posed by modern healthcare practice. (shrink)

Kuala Lumpur is a diverse city representing many different religions and nationalities. Recent government policy has actively promoted unity and cohesion throughout the city; and the country of Malaysia, with the implementation of a programme called 1Malaysia. In this book, the authors investigate the aims of this programme – predominantly to unify the Malaysian society – and how these objectives resonate in the daily spatial practices of the city’s residents. -/- This book argues that elements of urban infrastructure could work (...) as an essential mediator ‘beyond community’, allowing inclusive social structures to be built, despite cultural and religious tensions existing within the city. It builds on the premise of an empirical study which explores the ways in which different communities use the same spaces, supported through the implementation of a theoretical framework which looks at both Western and Islamic conceptualisations of the notion of community. Through the analysis of Kuala Lumpur, this book contributes towards the creation of more inclusive places in multi-ethnic, multi-cultural and multi-religious communities across the world. (shrink)

The author recounts the dramatic life of Warsaw’s population during the uprising against the Germans. After miraculously escaping death in a mass execution,Czarkowski teamed up with several other men and lived the hard life of a refugee among the city’s ruins. He and his companions continuously risked death, both from the hands of Nazi execution squads as well as in the buildings, methodically demolished by the occupant as the city was razed to the ground in revenge for the insurgency.

Referring to basic Weberian notions of rationalization and secularization, I try to find a more accurate sense of the term “secularization”, intending to describe adequately the position of religion in modernity. The result of this query is—or at least should be—a new, original conceptualization of religion as one of finite provinces of meaning within one paramount reality of the life-world, as defined by Alfred Schutz. I proceed by exposing a well known, major oversimplification of the Weberian concept of secularization, very (...) well outlined in Peter Berger’s The sacred canopy, in order to point to the genuine, much more differentiated position of Max Weber in this matter (especially from the period of Foundations of social economic and Economy and society), and, consequently, to return to the roots of Berger’s thought: phenomenological sociology of Alfred Schutz, an attempt to assure the philosophical foundations of Weber’s sociological theory. At a closer glimpse, transformation of religion in the modern process of rationalization does not consist—according to Weber—in eliminating religion and thus depriving society of the religious source of meaning, but in parallel emancipation of many different domains of rationality, including religion itself. Using Schutz’s analysis of the social world as a complex structure of many different final provinces of meaning, I describe religion as such a province and show what does the process of rationalization of this province consist and what it should consist in: a complex, ongoing exchange of cognitive relevances and contents, combined with growing autonomy of many different sub-worlds. Schutz’s theory of symbol, rooted in Edmund Husserl’s description of constitution of complex objects in mono- and polythetic acts of consciousness, moves the analysis to the epistemological level, pointing to a chance of intensifying our cognitive relation to reality through increasing interpenetration of various sub-universes of meaning. (shrink)

Purpose of the article is to present in two parts the selected aspects of application of monetary policy in the euro area pre and post 2008 as well as insitutional adaptations brought by the EU legislator. Methodology/methods In order to better explain these points, the article relies partially on a comparison with the framework and application of the monetary policy by the Federal Reserve as well as on a historic method when outlining the influence of definition of financial stability from (...) the ECB/eurosystem towards other prominent central banks. Scientific aim The article presents selected aspects of the monetary policy in the part of the EU where single currency was introduced in order to outline state of the art governance structure as well as a certain institutional creativity in application of powers conferred upon the central banks by the Treaty on the Functioning of the European Union and Protocol on the Statute of the European System of Central Banks and of the European Central Bank. The goal is to prove the hypothesis of robustness of the framework and present the limits that can only be pushed further by the legislative power. The conclusions confirm on the one hand that the framework of monetary policy based on strong institutional safeguards such as legislative power and independence is very resilient and can prove efficient and creative enough to stabilise an innovative monetary system, however, on the other hand, validate the hypothesis that certain adaptations can only be performed on the basis of a legislative adaptations. (shrink)

Purpose of the article is to present in two parts the selected aspects of application of monetary policy in the euro area pre and post 2008 as well as insitutional adaptations brought by the EU legislator. Methodology/methods In order to better explain these points, the article relies partially on a comparison with the framework and application of the monetary policy by the Federal Reserve as well as on a historic method when outlining the influence of definition of financial stability from (...) the ECB/eurosystem towards other prominent central banks. Scientific aim The article presents selected aspects of the monetary policy in the part of the EU where single currency was introduced in order to outline state of the art governance structure as well as a certain institutional creativity in application of powers conferred upon the central banks by the Treaty on the Functioning of the European Union and Protocol on the Statute of the European System of Central Banks and of the European Central Bank. The goal is to prove the hypothesis of robustness of the framework and present the limits that can only be pushed further by the legislative power. The conclusions confirm on the one hand that the framework of monetary policy based on strong institutional safeguards such as legislative power and independence is very resilient and can prove efficient and creative enough to stabilise an innovative monetary system, however, on the other hand, validate the hypothesis that certain adaptations can only be performed on the basis of a legislative adaptations. (shrink)

The cognitive purpose of the research presented in the article is to identify the propensity for pro-social and altruistic behavior among first-year military students in three simulated situations of need for help to other people. It raised the question contained in the main research problem: to what extent do military students at universities tend to behave in a pro-social and altruistic way in situations that pose a threat to the other people’s life and health, and what is the relationship between (...) these behaviors and socialization in the civil environment? At the outset, the hypothesis was adopted that the candidates for professional soldiers show a higher propensity for this type of behavior. For its verification, the population of the first-year military students during their basic training was assumed as a research area. The study covered 246 people selected randomly from among military students in the first year of studies of the command profile of all military specialties and the medical profile. The selection of the research sample based on first-year students during the basic training aimed to identify the impact of environmental factors on the tendency to altruistic and pro-social behavior in two different groups of candidates for professional soldiers. (shrink)

This book develops a new approach to naturalizing phenomenology. The author proposes to integrate phenomenology with the mechanistic framework that offers new methodological perspectives for studying complex mental phenomena such as consciousness. While mechanistic explanatory models are widely applied in cognitive science, their approach to describing subjective phenomena is limited. The author argues that phenomenology can fill this gap. He proposes two novel ways of integrating phenomenology and mechanism. First, he presents a new reading of phenomenological analyses as functional analyses. (...) Such functional phenomenology delivers a functional sketch of a target system and provides constraints on the space of possible mechanisms. Second, he develops the neurophenomenological approach in the direction of dynamic modeling of experience. He shows that neurophenomenology can deliver dynamical constraints on mechanistic models and thus inform the search for an underlying mechanism. (shrink)

According to The Consensus Gentium Argument from the premise: “Everyone believes that God exists” one can conclude that God does exist. In my paper I analyze two ways of defending the claim that somebody’s belief in God is a prima facie reason to believe. Kelly takes the fact of the commonness of the belief in God as a datum to explain and argues that the best explanation has to indicate the truthfulness of the theistic belief. Trinkaus Zagzebski grounds her defence (...) on rationality of epistemic trust in others. In the paper I argue that the second line of reasoning is more promising and I propose its improved version. (shrink)

Descriptions of bodies within the literature of the enactive approach to cognitive science exhibit an interesting dialectical tension. On the one hand, a body is considered to be a unity which instantiates an identity, forming an intrinsic basis for value. On the other, a living body is in a reciprocally defining relationship with the environment, and is therefore immersed and entangled with, rather than distinct from, its environment. In this paper I examine this tension, and its implications for the enactive (...) approach, particularly the enactive conceptions of life and bodies. Following the lead of others, I argue that enactive cognitive science can benefit from a deeper reading and integration with extant work on the complexity and multiplicity of the living body within feminist philosophy and feminist science studies. (shrink)

A static, spherically symmetric, and asymptotically flat solution of coupled Einstein-Born-Infeld equations is presented. When the internal mass of the system is zero the resulting space-time is regular and describes static electromagnetic geon.

John L. Schellenberg, autor argumentu z ukrytości, twierdzi, że gdyby Bóg istniał, to nie istnieliby rzetelnie niewierzący. W swej najnowszej książce Jacek Wojtysiak stwierdza, że teista może odwrócić to rozumowanie i stwierdzić, że gdyby Bóg nie istniał, to nie istnieliby rzetelnie wierzący. Dochodzi on nie tylko do wniosku, że wierzący istnieją, lecz jeszcze, że można przypuszczać, iż jest ich znacznie więcej niż niewierzących. Może zatem stwierdzić istnienie wielkiego faktu wiary, wobec którego ateista jest podwójnie bezradny: po pierwsze, nie umie go (...) wyjaśnić, a po drugie – nie jest w stanie przedstawić paralelnego argumentu za ateizmem. W swoim artykule analizuję tę część książki J. Wojtysiaka, która jest poświęcona tym zagadnieniom i dochodzę do wniosku, że ateista jednak znajduje się lepszym położeniu, niż sugeruje to polski filozof. (shrink)

Can we see the expressiveness of other people's gestures, hear the intentions in their voice, see the emotions in their posture? Traditional theories of social cognition still say we cannot because intentions and emotions for them are hidden away inside and we do not have direct access to them. Enactive theories still have no idea because they have so far mainly focused on perception of our physical world. We surmise, however, that the latter hold promise since, in trying to understand (...) cognition, enactive theory focuses on the embodied engagements of a cognizer with his world. In this paper, we attempt an answer for the question What is social perception in an enactive account? In enaction, perception is conceived as a skill, crucially involving action, an ability to work successfully within the set of regularities, or contingencies that characterize a given domain. If this is the case, then social perception should be a social skill. Having thus transformed the question of what social perception is into that of what social skill is, we examine the concept of social contingencies and the manner in which social skills structure—both constrain and empower— social interaction. Some of the implications of our account for how social and physical perception differ, the role of embodiment in social interaction and the distinction between our approach and other social contingency theories are also addressed. (shrink)

ABSTRACT:Microfinance is often assumed to be an ethically progressive industry, but in recent years it has been the target of much ethical criticism. Microfinance institutions have been accused of using exploitative lending techniques and charging usurious interest rates; and critics even question the ability of microfinance to alleviate poverty. This article reviews recent research on the microfinance sector that addresses these ethical issues. We show how this research is relevant to a number of theoretical issues, such as how to define (...) poverty, how to understand exploitation, and how to balance financial and social goals in commercial organizations. We conclude by identifying a critical agenda for future research. (shrink)

History provides us with instances of various societal and economic changes that with a hindsight are interpreted as either indicating progressive or regressive trends. The present paper attempts to define what represents progress and regress by applying psychological constructs to evaluation of the psychosocial changes. Seven principles of progress are applied as criteria for interpreting various historic events. The primary condition for progress is courage to face adversity or, in the cognitive domain, ambiguity, controversy and “unknown”. An overall model of (...) Challenge-Resilience-Resourcefulness is described as the process through which progress can be achieved. (shrink)

Assuming the importance of Alfred Schutz’s “protosociology” in social theory as a given, the paper tries to explore its philosophical core, treating Schutz’s sociophenomenology as an answer to the most fundamental questions of phenomenology, such as evidence and phenomenological reduction. It analyses Schutz’s point of departure – the problematization of Max Weber’s concept of the meaning of social action and its deepening by means of Henri Bergson’s and Edmund Husserl’s notion of time – and tries to unravel the double structure (...) of consciousness, revealing increasingly its complex temporal character. Brentano’s and Husserl’s double intentionality, seeming to offer a kind of “decent realism” in modern philosophical context, in Schutz turns out to be marked by the profound pastness of reflexive consciousness, reaching the primary stream experience only by means of primary and secondary acts of remembrance, re-effectuated intersubjectively in acts of phantasying about future, thus constituting the very core of meaning, with its reference to external objects. It appears that only analysing this mode of phantasying in reference to its motives that we can solve the conundrum of realism in its modern shape. (shrink)