The case of clinical trials for convalescent plasma during COVID-19 illustrates important lessons for realizing public sector approaches to biomedical research and development. These lessons, centering on mission, transparency, and spillover effects, can be translated to wider efforts to develop a “public option” for clinical trials.

This volume offers the first English language collection of academic essays on the post-Holocaust thought of Jean Améry, a Jewish-Austrian-Belgian essayist, journalist and literary author. Comprehensive in scope and multi-disciplinary in orientation, contributors explore central aspects of Améry's philosophical and ethical position, including dignity, responsibility, resentment, and forgiveness.

BackgroundThere is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality.MethodsA partially blinded, randomized, controlled multi-center study (...) was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts.ResultsSixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (−8.5%) and non-mentored (−13.9%) residents (p = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p = 0.001), understanding of manuscripts (3.73 vs 2.87; p = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p = 0.005) compared to non-mentored residents. There was no difference between groups in level of interest in peer review (3.00 vs 3.09; p = 0.72) or the quality of manuscript review assessed by the Review Quality Instrument (RQI) (3.25 vs 3.06; p = 0.50).ConclusionsWe used mentored peer review of standardized manuscripts to teach biostatistics and research methodology and introduce the peer review process to residents. Though knowledge level did not change, mentored residents had enhanced perception in their abilities to understand research methodology and manuscripts and apply study results to clinical practice. (shrink)

An electoral evaluation of a set of expert opinions proceeds by treating the experts as voters. Although this method allows us to formalise our naive views about how to take expert advice, the formalisations are plagued by paradoxes which parallel those found in literature on social aggregation devices. This parallel suggests that our naive views about taking expert advice are in as much need of revision as our naive views about deriving group preferences from individual preferences. * I am indebted (...) to Joseph Hanna for a number of criticisms and corrections to a previous draft. (shrink)

Since the publication of Roy Bhaskar'sA Realist Theory of Science in 1975,critical realism has emerged as one of the most powerful new directions in the philosophy of science and social science, offering a real alternative to both positivism and postmodernism. This reader makes accessible in one volume key readings to stimulate debate about and within critical realism, including: the transcendental realist philosophy of science elaborated inA Realist Theory of Science; Bhaskar's critical naturalist philosophy of social science; the theory of explanatory (...) critique, which is central to critical realism; and the theme of dialectic, which is central to Bhaskar's most recent writings. The volume includes extracts from Bhaskar's most important books, as well as selections from all of the other most important contributors to the critical realist program. It also includes both a general introduction and original introductions to each section. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Confucian Liberalism: Mou Zongsan and Hegelian Liberalism by Roy TsengMilan Matthiesen (bio)Confucian Liberalism: Mou Zongsan and Hegelian Liberalism. By Roy Tseng. Albany: SUNY Press, 2023. Pp. 405. Hardcover $95.00, isbn 978-1-4384-9111-0.With Confucian Liberalism, Roy Tseng sets a new landmark in the contemporary discourse on Confucian political theory. His intricate account of the political philosophy of Mou Zongsan 牟宗三 (1909–1995) and other New Confucian philosophers, in conjunction with his (...) study of T.H. Green's (1836–1882) and other British idealists' liberalism, offer a fresh and novel approach to Confucianism and liberalism alike. Throughout the eight chapters of his book, Tseng develops the concept of "Confucian liberalism." This concept stays faithful to civil liberties, but grounds democracy on an ethics of self-realization and a perfectionist ideal of the state, "where the government helps the people to 'attain accomplishment according to the individual's nature' (jiu geti er shuncheng 就個體而順成)" (p. 125). On the one hand, this framework attempts to circumvent the overbearing tendencies of traditional Confucianism, whose moral imperatives had prohibited the development of an independent sphere of politics. On the other hand, it reintroduces the Confucian concept of humaneness (ren 仁) as an answer to the lack of common meaning in modern societies. On the one hand, Tseng therefore dissociates himself from anti-Confucian liberals such as Yin Haiguang 殷海光 (1919–1969) or Zhang Foquan 張佛泉 (1907–1994), who had proclaimed the incompatibility of Confucianism and liberal values. On the other hand, he also differentiates himself from what he calls "antiliberal Confucians." Especially recently, the latter have attracted much attention by proposing a political vision opposed to the perceived foreign and "Western" concept of liberalism. Under labels such as "political Confucianism" (Jiang Qing 蔣慶), "socialist Confucianism" (Chen Lai 陳來), "politics of benevolence" (Kang Xiaoguang 康曉光), "Confucian meritocracy" (Bai Tongdong 白彤東), or "Confucian political perfectionism" (Joseph Chan 陳祖為), they have had a profound impact on the discourse of Confucian political theory. Turning toward the [End Page 1] political works of Mou Zongsan and the British idealists, Tseng neither advocates for the inherent elitism and anti-Western sentiments of antiliberal Confucianism, nor does he fully subscribe to the radically iconoclast ideals of the anti-Confucian liberals who had denied all value of tradition and saw Confucianism as a mere obstacle toward a modernized China. Another aspect of Tseng's study that stands out from the current field of research on Mou Zongsan is his reading of Mou's conceptual framework through the lens of Hegel. While many prominent researchers, e.g. Li Minghui 李明輝, point toward Mou's reliance on Kantian ideas and concepts, Tseng convincingly argues that Mou's appropriation of the idealist framework, as well as many concepts utilized by Mou, are fundamentally Hegelian, therefore warranting a shift in perspective. Confucian Liberalism is subdivided into three parts and eight chapters. Part I, titled "Confucian Ethics," introduces the reader to Mou Zongsan's moral philosophy by providing a comparative analysis of Mou, Kant, Hegel, and the British idealists, primarily represented by T.H. Green and F.H. Bradley (1846–1924). In part II, "Civil Liberalism," Tseng then moves on to elaborate on the New Confucian view of politics. Here, he pays close attention to Mou's revaluation of Confucian politics through the Hegelian framework, the notion of "civility," and the concept of "humane government." Turning again to Mou and Green, the final part, "Perfectionist Liberalism," presents the political vision of a democratic state underpinned by a strong belief that the primary task of the state is to provide an environment for the individual citizens that allows them to fully realize their moral capabilities. The third part further argues that the values upheld by New Confucianism not only do not contradict the liberal values of human dignity, tolerance, and equal respect, but are in fact able to lay a moral foundation for modern democracies that is able to overcome the weaknesses of mainstream liberalism, manifested in atomism, nihilism, and egoism. Chapter 1 introduces the reader to the core principles and concepts of Mou Zongsan's moral metaphysics. Following Mou's own approach, Tseng applies a comparative method in this introductory chapter, meticulously delineating the varying philosophical influences that shaped Mou's... (shrink)

Joyce's review of _Humanism, Philosophical Essays: A Collection of Essays on Pragmatism_, by Ferdinand Canning Scott Schiller, was written at a critical moment in the development of Joyce's fiction (before "The Sisters", before the essay "A Portrait of the Artist," and during Joyce's writing of his aesthetic theory. The review was published in the _Dublin Express_ on November 12, 1903. The diary entries at the end of _A Portrait of the Artist as a Young Man_ hint at the fallibilism and (...) reality of experience at the bedrock of Peircean semiotics and the revolutionary style of Joyce. Unfortunately the mocking style of Joyce's review may be why it has not received attention and perhaps why the review has not been included in a recent collection of Joyce's non-fiction writings. Joyce mocks Schiller’s style and thought, which is "prone to stylistic violations such as: vulgarity ... excessively ornate language ... pomposity ... exaggeration ... and avoiding the issue" as Joseph Porrovecchio states in a dissertation on Schiller's rhetoric. Schiller not only provoked Joyce to mock him, he also provoked Charles Peirce, the founder of pragmatism, to rename his philosophy "pragmaticism" adding an "ic" to it to differentiate it from Schiller’s use of the word. This essay shows Joyce knew about Charles Peirce, whose influence was extensive, continuing through Finnegans Wake, as discussed in Roy Benjamin’s The Triptych Vision: Joyce and Peirce. (shrink)

Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. This extension, suggested by the equivalence of PAS/E and CSD, is designed to promote additional patient autonomy at the end-of-life. Samuel LiPuma, in his article, “Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis” claims equivalence between CSD and death; his paper is seminal in the equivalency debate. Critics contend that sedation follows (...) proportionality protocols for which LiPuma’s thesis does not adequately account. Furthermore, sedation may not eliminate consciousness, and as such LiPuma’s contention that CSD is equivalent to neocortical death is suspect. We not only defend the equivalence thesis, but also expand it to include additional moral considerations. First, we explain the equivalence thesis. This is followed by a defense of the thesis against five criticisms. The third section critiques the current use of CSD. Finally, we offer two proposals that, if adopted, would broaden the use of PAS/E and CSD and thereby expand options at the end-of-life. (shrink)

Can God create a stone too heavy for him to lift? Can time have a beginning? Which came first, the chicken or the egg? Riddles, paradoxes, conundrums--for millennia the human mind has found such knotty logical problems both perplexing and irresistible. Now Roy Sorensen offers the first narrative history of paradoxes, a fascinating and eye-opening account that extends from the ancient Greeks, through the Middle Ages, the Enlightenment, and into the twentieth century. When Augustine asked what God was doing before (...) He made the world, he was told: "Preparing hell for people who ask questions like that." A Brief History of the Paradox takes a close look at "questions like that" and the philosophers who have asked them, beginning with the folk riddles that inspired Anaximander to erect the first metaphysical system and ending with such thinkers as Lewis Carroll, Ludwig Wittgenstein, and W.V. Quine. Organized chronologically, the book is divided into twenty-four chapters, each of which pairs a philosopher with a major paradox, allowing for extended consideration and putting a human face on the strategies that have been taken toward these puzzles. Readers get to follow the minds of Zeno, Socrates, Aquinas, Ockham, Pascal, Kant, Hegel, and many other major philosophers deep inside the tangles of paradox, looking for, and sometimes finding, a way out. Filled with illuminating anecdotes and vividly written, A Brief History of the Paradox will appeal to anyone who finds trying to answer unanswerable questions a paradoxically pleasant endeavor. (shrink)

The primary narrative problem of the analyst is, then, not how to tell a normative chronological life history; rather, it is how to tell the several histories of each analysis. From this vantage point, the event with which to start the model analytic narration is not the first occasion of thought—Freud's wish-fulfilling hallucination of the absent breast; instead, one should start from a narrative account of the psychoanalyst's retelling of something told by an analysand and the analysand's response to that (...) narrative transformation. In the narration of this moment of dialogue lies the structure of the analytic past, present, and future. It is from this beginning that the accounts of early infantile development are constructed. Those traditional developmental accounts, over which analysts labored so hard, may now be seen in a new light: less as positivistic sets of factual findings about mental development and more as hermeneutically filled-in narrative structures. The narrative structures that have been adopted control the telling of the events of the analysis, including the many tellings and retellings of the analysand's life history. The time is always present. The event is always an outgoing dialogue. Roy Schafer is clinical professor of psychology and psychiatry at Cornell University Medical College, adjunct professor of psychology at New York University, and a supervising and training analyst at Columbia University's Center for Psychoanalytic Training and Research. He is the author of A New Language for Psychoanalysis, Language and Insight, and Narrative Actions in Psychoanalysis: Narratives of Space and Narratives of Time. (shrink)

Roy T Cook examines the Yablo paradox--a paradoxical, infinite sequence of sentences, each of which entails the falsity of all others that follow it. He focuses on questions of characterization, circularity, and generalizability, and pays special attention to the idea that it provides us with a semantic paradox that involves no circularity.

El cuidado de sí es cuidado de lo más humano de cada uno de nosotros. La convicción nuclear que lo rige es siempre la misma: que lo humano puede intensificarse y crecer. Y que el peligro reside siempre en la degeneración. Intensificar lo humano es ir hacia lo “más humano”. En absoluto se busca la “superación” o el “más allá” de lo humano. Este artículo es un intento de relacionar la lectura que hace Foucault del tema del cuidado de sí (...) con la urgente necesidad de repensar hoy el lugar de lo educativo como lugar propio para ese cuidado. Para tal fin, se propone el concepto de altertopía educativa, como lugar, no solo de resistencia al dominio de la banalidad contextual, sino de gestación de la fuerza revolucionaria. (shrink)

There is a need for empirically based research on social and ethical challenges related to informed consent processes, particularly in studies focusing on adolescent sexual and reproductive health. In a pilot study of a school-based pregnancy prevention intervention in rural Zambia, the majority of the guardians who were asked to consent to their daughters’ participation, refused. In this paper we explore the reasons behind the low participation in the pilot with particular attention to challenges related to the community engagement and (...) informed consent process. The pilot was implemented in two schools and examined the acceptability of a package of interventions including economic support to families to keep their girls in school, pocket money for girls, youth club meetings on reproductive health, and community meetings to sensitize the community. Focus group discussions were conducted with girls who participated in the pilot, boys in their class and with parents. Individual semi-structured interviews were conducted with teachers, peer educators and community health workers involved in the coordination of the intervention as well as with religious and traditional leaders. Data were analyzed through thematic analysis. The findings indicate that inadequate use of recognized community communication channels during the community engagement process and dissemination of information about the pilot resulted in limited understanding of the pilot concept by the community. This surfaced through uncertainty and fear that the intervention may result in loss of control over daughters, worries about why money was provided unconditionally to girls, and suspicion of links to satanism. The sense of insecurity appeared to be exacerbated by low literacy levels, poverty, fear of loss of bride wealth, perceived disregard for local perceptions of social status, and scanty trust in the actors implementing the pilot. Inadequate use of locally appropriate channels in the dissemination of information created room for interpretation and facilitated development of mistrust, undermining the conditions for community engagement and actual informed consent. A key lesson learnt is the importance of taking seriously the complexity of local values and structures that may impact people’s capability to consent or not consent to a study in an informed manner. (shrink)