Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

In the preface to this book Stephen Toulmin recalls how Wittgenstein's later work appeared to his English students "as unique and extraordinary as the Tractatus had appeared to Moore." "Meanwhile," he recalls, "for our own part, we struck Wittgenstein as intolerably stupid, and he was sometimes in despair about getting us to grasp what he was talking about." Toulmin suggests that this "mutual incomprehension" was due to a "culture clash: the clash between a Viennese thinker whose whole mind had been (...) formed in a post-Kantian environment, and an audience of students who came to him with attitudes and preoccupations shaped by the neo-Humean empiricism of Moore, Russell and their associates." Engel's book is meant primarily to show that Wittgenstein's thought grows out of the Kantian philosophy, but not that it is simply derived from Kant. Rather, according to Engel, Wittgenstein was the first to see the full value of the insights of Kant and Schopenhauer. Engel bases his argument on the Blue Book. According to Engel the argument of the Blue Book comprehends two divergent theories of the origin of metaphysics. These two theories are represented in Engel's book by Ayer and Lazerowitz. For Ayer metaphysics is grounded in the inherently deceptive character of language; and the way to overcome metaphysics is but to be attentive to language. Lazerowitz, on the other hand, attempts to explain why it is that language is deceptive. Lazerowitz's argument as presented by Engel requires as a premise the proposition that the deceptions of language are not that intrinsically difficult to see through, or that metaphysical arguments are obviously "innovations." And therefore the origin of metaphysics must be sought outside of the structure of language. Lazerowitz locates the root of metaphysics in the passions, specifically, in fear--in the fear of change which is ultimately the fear of death. Engel sees each of these positions as in its way legitimate but essentially partial. Wittgenstein's thought is thus more profound than that which is derived from it. It is precisely this awareness of the necessity for both kinds of explanation that Wittgenstein, according to Engel, inherited from the tradition of Kantian metaphysics: in the first Critique's seeking both to account for the impossibility of metaphysics while, at the same time, arguing for the necessity of metaphysics as a natural disposition or arguing for the necessity of a "will to metaphysics." While Engel's argument is not as clear or thorough as it ought to be, his thesis, that Wittgenstein's work is not simply a "repudiation of our philosophical tradition, but rather is its proper twentieth-century continuation," is--in the main--convincing. The book is worth reading.--J. W. S. (shrink)

This collection of essays in moral philosophy has as its intended mark of distinction the fact that moral problems of the moment are the themes of the essays. The chapter headings indicate this contemporary concern: Abortion, Sex, Human Rights and Civil Disobedience, Criminal Punishment, Violence and Pacifism, War and Suicide and Death. There are essays by: Paul Ramsey, Philippa Foot, Jonathan Bennett, Thomas Nagel, Sara Ruddick, Richard Wassenstrom, [[sic]] John Rawls, R. M. Dworkin, William Kneale, H. L. A. Hart, J. (...) R. Lucas, Newton Carver, Jan Narveson, G. E. M. Anscombe, R. M. Hare, R. F. Holland, Mary Mothersill. One might well be inclined to agree with the editor's opposition to such philosophizing about morality which abstracts from the moral problems of one's own life. A purely theoretical approach to the study of morality would almost appear contradictory. However, it is necessary to express grave reservations about such a collection of essays as this. While the arguments of the essays are thoughtful and somewhat uncommon, the conclusions of the essays, as a rule, do not differ from "advanced" liberal opinions. In other words, the essays do not challenge students' opinions. The reading of these essays will but confirm the young in their prejudices. The problems the essays are concerned with are real problems; and it is a defect of the book that with the single exception of the chapter on Abortion no real opposing arguments are presented.--J. W. S. (shrink)

The "purpose of this book is to examine those conceptions of metaphysics prevalent in seventeenth- and eighteenth-century British philosophic thought." The book traces empiricist conceptions of metaphysics from Bacon onward to Reid and Stewart. Armstrong's treatment of Bacon is the most controversial chapter in his book. Armstrong opposes the widely held view that Bacon was essentially a mechanist. Armstrong argues that the texts usually cited to show that Bacon held the mechanical philosophy are at best ambiguous; while, on the other (...) hand, there are Bacon's clear statements on metaphysics as a science of formal causes. It is on the basis of these latter statements that Armstrong argues that Bacon's metaphysics is essentially Aristotelian. In the language of the tradition, Armstrong's interpretation of Bacon might be summed up as follows: Bacon understood metaphysics to be the science of formal causality; that is, he understood metaphysics as the science of Being as Being. Consequently, according to Armstrong, a characteristic empiricist metaphysics first appears in the thought of Hobbes. In Hobbes the mechanical philosophy is established as the science of nature, as the science of Being as Being. Metaphysics becomes defined once and for all within British Empiricism in opposition to physics or the materialist ontology. Beginning with Hobbes metaphysics is understood within British Empiricism as either epistemology or theology. This historical study should prove of interest to those who, brought up in the tradition of British Empiricism, are rediscovering the traditional questions of metaphysics.--J. W. S. (shrink)

This work is intended to be a "philosophical analysis" of certain problems encountered by the social sciences. The aim of the book is to "help redirect modern social science from some important theoretical mistakes." According to Kaplan most of our knowledge rests on common sense. It is the mark of common sense knowledge that it is not self-conscious, that it does not engage in a critique of its own possibility. The realm of the philosophy of history, of social science, and (...) of science is opened up through the attempt at "self-consciousness concerning the limits of the various processes by which knowledge is obtained." Kaplan accepts the proposition that the "framework within which knowledge occurs can never be included in knowledge itself," that the framework within which knowledge is acquired cannot be transcended. It might appear from his acceptance of this proposition that Kaplan would accept radical historicism. This is not the case. It is a primary intention of Kaplan to suggest that we can state the standpoint from which perspectival knowing exists, what it depends upon, and what it leaves out of account. Kaplan sees a measure of transcendence being achieved through the comprehension of different perspectives. However, he explicitly rejects the possibility of a true consciousness which would be the result of a single correct perspective on the world. The book has several major flaws. The greatest is the absence of sustained argument. The author fails to give evidence for the major propositions of the book. Usually a footnote to previous writings of his is offered as substitute for argument. Another major flaw of the book stems from Kaplan's understanding of what is characteristically human in the terms of systems analysis. To one not convinced in advance of the adequacy of this language to the task of understanding man, Kaplan's work will appear to suffer from an ill-conceived use of technical jargon.--J. W. S. (shrink)

The advent of moral pluralism in the post-modern age leads to a set of issues about how pluralistic societies can function. The questions of biomedical ethics frequently highlight the larger issues of moral pluralism and social cooperation. Reflection on these issues has focused on the decision making roles of the health care professionals, the patient, and the patient's family. One species of actor that has been neglected has been those institutions which are part of the public, secular realm and which (...) have a particular moral heritage. Keywords: approval, compromise, condemnation, integrity, toleration CiteULike Connotea Del.icio.us What's this? (shrink)

© 2014 Taylor Francis. The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus testing of every client presenting for services in venues where HIV prevalence is high. Because older adults have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent and ever HIV testing in a probability sample of at-risk (...) adults seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months or ever. Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis. (shrink)

Plato is one of the key ancient authors studied by both classicists and philosophers. This long-awaited new edition contains seven of the dialogues of Plato, and is the first in the five-volume complete edition of his works in the Oxford Classical Texts series. The result of many years of painstaking scholarship, the new volume will replace the now nearly 100 year old original edition, and is destined to become just as long-lasting a classic.

This paper investigates the possibilities and problems of benchmarking Corporate Social Responsibility (CSR). After a methodological analysis of the advantages and problems of benchmarking, we develop a benchmark method that includes economic, social and environmental aspects as well as national and international aspects of CSR. The overall benchmark is based on a weighted average of these aspects. The weights are based on the opinions of companies and NGO's. Using different methods of weighting, we find that the outcome of the benchmark (...) is rather robust for a sample of more than 50 large Dutch companies. (shrink)

The foreskin is a complex structure that protects and moisturizes the head of the penis, and, being the most densely innervated and sensitive portion of the penis, is essential to providing the complete sexual response. Circumcision—the removal of this structure—is non-therapeutic, painful, irreversible surgery that also risks serious physical injury, psychological sequelae, and death. Men rarely volunteer for it, and increasingly circumcised men are expressing their resentment about it.Circumcision is usually performed for religious, cultural and personal reasons. Early claims about (...) its medical benefits have been proven false. The American Academy of Pediatrics and the Centers for Disease Prevention and Control have made many scientifically untenable claims promoting circumcision that run counter to the consensus of Western medical organizations.Circumcision violates the cardinal principles of medical ethics, to respect autonomy, to do good, to do no harm, and to be just. Without a clear medical indication, circumcision must be deferred until the child can provide his own fully informed consent.In 2012, a German court held that circumcision constitutes criminal assault. Under existing United States law and international human rights declarations as well, circumcision already violates boys› absolute rights to equal protection, bodily integrity, autonomy, and freedom to choose their own religion. A physician has a legal duty to protect children from unnecessary interventions. Physicians who obtain parental permission through spurious claims or omissions, or rely on the American Academy of Pediatrics' position, also risk liability for misleading parents about circumcision. (shrink)

W. Norris Clarke, S. J.; A Curious Blindspot in the Anglo-American Tradition of Antitheistic Argument, The Monist, Volume 54, Issue 2, 1 April 1970, Pages 181–2.

Hegel’s basic position so far on the various meanings of evil as necessary and thereby intelligible directly in the development of spirit might be summed up as follows. Evil is always a necessary moment of instability which gives impetus in the movement from various meanings of particularity to various meanings of universality; from the more abstract expression of potential unity and truth to the more actualized notion and unity.

Hegel attempts both to give evil its metaphysical due and to give it intelligibility within a processive idealistic system. To accomplish these ends, he consistently employs the contrast between the natural and the free act of the subject and the contrast between the particular and the universal. He places these contrasts within the situation of an original and presupposed unity of spirit that itself is the ground of the mediation required for thinking freedom, for evil, and for ultimate reconciliation. He (...) argues for evil’s ultimate intelligibility in terms of its necessity as a consequent moment in the development of spirit from its ground; he resolves problems of evil’s penultimate irrationality in terms of its unstable contradictory elements in spirit’s history which is not yet fully concrete, a simultaneity of “ought to be” and “ought not to be” in the sense that the instability must be surpassed but not that it should never have been. The aims of this paper will be to summarize and evaluate Hegel’s efforts to give evil both significance and intelligibility within his system and to estimate if a system of progressive idealism contributes a philosophically new dimension to the problem of evil in a universe. (shrink)

This paper calculates, in a precise way, the complexity of the index sets for three classes of computable structures: the class $K_{\omega _{1}^{\mathit{CK}}}$ of structures of Scott rank $\omega _{1}^{\mathit{CK}}$ , the class $K_{\omega _{1}^{\mathit{CK}}+1}$ of structures of Scott rank $\omega _{1}^{\mathit{CK}}+1$ , and the class K of all structures of non-computable Scott rank. We show that I(K) is m-complete $\Sigma _{1}^{1},\,I(K_{\omega _{1}^{\mathit{CK}}})$ is m-complete $\Pi _{2}^{0}$ relative to Kleen's O, and $I(K_{\omega _{1}^{\mathit{CK}}+1})$ is m-complete $\Sigma _{2}^{0}$ relative to O.

This paper reports the introduction of electronic handsets, like those used on the television show 'Who Wants To Be A Millionaire?' into the teaching of philosophical logic. Logic lectures can provide quite a formidable challenge for many students, occasionally to the point of making them ill. Our rationale for introducing handsets was threefold: to get the students thinking and talking about the subject in a public environment; to make them feel secure enough to answer questions in the lectures because the (...) system enabled them to do this anonymously; and to build their confidence about their learning by their being able to see how they were progressing in relation to the rest of the students in the class. We have achieved all of these and more. Our experience has revealed that the use of handsets encourages a more dynamic form of student interaction in an environment - the lecture - that can, in the wrong hands, be utterly enervating, but they also provide an opportunity for the lecturer to respond to students' difficulties at the time when they really matter. In this paper, we discuss our case of rapid adoption, our grounds for judging it a success, and what that success seems to have depended on. (shrink)