As a preliminary step to beginning to assess the usefulness of clinical vignettes to measure ethical sensitivity in undergraduate medical students, five clinical vignettes with seven to nine ethical issues each were created. The ethical issues in the vignettes were discussed and outlined by an expert panel. One randomly selected vignette was presented to first, second and third year students at the University of Toronto as part of another examination. The students were asked to list the issues presented by the (...) patient problem. Responses from 281 students were obtained. These students identified an average of 2.72 ethical issues per vignette. Each response was classified under the domains of autonomy, beneficence and justice. Comparisons were made between classes and between vignettes. There was considerable variation between classes and the responses to different vignettes seem to indicate that different vignettes measure the various domains in different ways. It does appear that the use of vignettes is one way to measure aspects of ethical sensitivity in medical students but more study is required to clarify exactly what is being measured. (shrink)

An instrument to assess 'ethical sensitivity' has been developed. The instrument presents four clinical vignettes and the respondent is asked to list the ethical issues related to each vignette. The responses are classified, post hoc, into the domains of autonomy, beneficence and justice. This instrument was used in 1990 to assess the ethical sensitivity of students in all four medical classes at the University of Toronto. Ethical sensitivity, as measured by this instrument, is not related to age or grade-point average. (...) Sensitivity increases between the 1st and 2nd year and then decreases throughout the rest of undergraduate medical training, such that the 4th-year students identify fewer issues than those entering medical school. Students expressing a career choice of family medicine identify more issues than their peers. Several problems with the use of the instrument and the interpretation of the data were found. Nonetheless, these findings, if reproducible, are important and their meaning needs further discussion. (shrink)

The purpose of the work was to produce a framework to guide the development of meritorious clinical trial proposals. The framework consists of essential features of rigourous methodology, ethical acceptability, and a component referred to as "community context". These three domains were woven together in a checklist format under the headings of general, scientific and ethical considerations. Since texts concerning clinical trial methodology do not integrate ethics criteria and ethics guidelines do not provide detailed scientific criteria in obvious and practical (...) ways, we outline a more contemporary and comprehensive set of guidelines. (shrink)

Biobanks are increasingly being created specifically for research purposes. Concomitantly, we are seeing significant and evolving shifts in research ethics in relation to biobanking. Three discrete shifts are identified in this article. The first extends the ethical focus beyond the protection of human subjects to the promotion of broader community benefits of research utilizing biobanked resources, and an expectation that these benefits will be shared. The second involves the evolution of the traditional consent paradigm for future research uses of biobanks (...) resources that are not in contemplation at the time of donation. The third involves a move away from single project management to more dynamic governance accountability to research participants and the public. These shifts may take different local and institutional forms but share common recognizable elements. (shrink)

Objective: There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this. -/- Methods: We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to (...) Consider” (P2C) document, and convened a national expert panel to review and critique the P2C. -/- Results: We developed the P2C to aid informaticists designing an advanced query tool for an electronic health record (EHR) system in Indianapolis. The P2C consists of six questions (“Points”) that frame important ethical issues, apply accepted principles of bioethics and Fair Information Practices, comment on how questions might be answered, and address implications for patient care. -/- Discussion: The P2C is intended to clarify whatis at stake when designers try to accommodate potentially competing ethical commitments and logistical realities. The P2C was developed to guide informaticists who were designing a query tool in an existing EHR that would permit patient granular control. While consideration of ethical issues is coming to the forefront of medical informatics design and development practices, more reflection is needed to facilitate optimal collaboration between designers and ethicists. This report contributes to that discussion. (shrink)

For nearly two decades, the process of reviewing the ethical merit of research involving human subjects has been based on the application of principles initially described in the U.S. National Commission's Belmont Report, and later articulated more fully by Beauchamp and Childress in their Principles of Biomedical Ethics. Recently, the use of ethical principles for deliberating about moral problems in medicine and research, referred to in the pejorative sense as “principlism”, has come under scrutiny. In this paper we argue that (...) these principles can provide a foundation for the source of ethical appraisal of human research, but are not themselves wholly adequate for this purpose. Therefore, we further propose that (1) principles should be understood as heuristics that can be “specified” as described by DeGrazia (1992), and (2) that the principle‐based approach should be supplemented by formally incorporating “sensitivity to context” into the evaluation of clinical trials. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Ethical, Legal, and Social Implications Research Program at the National Human Genome Research InstituteEric M. Meslin (bio), Elizabeth J. Thomson (bio), and Joy T. Boyer (bio)Organizers of the Human Genome Project (HGP) understood from the beginning that the scientific activities of mapping and sequencing the human genome would raise ethical, legal, and social issues that would require careful attention by scientists, health care professionals, government officials, and (...) the public. The establishment of the ELSI (ethical, legal, and social implications) programs at the National Human Genome Research Institute (NHGRI) and the Department of Energy (DOE) was thought to be vital to the success of the HGP in the United States. It also provided a novel approach to the simultaneous study of ethical, legal, and social issues and basic scientific issues. Eric Juengst, the first director of the ELSI program, described its origins in a previous issue of the Kennedy Institute of Ethics Journal (Juengst 1991). Now in its seventh year, the ELSI program has accomplished much. This article summarizes the evolution and goals of the ELSI program at NHGRI, outlines the program’s current research priorities with examples of activities within each priority area, and provides a look to the future, including the initiation of a strategic planning process.Evolution and Goals of the ELSI Research ProgramThe HGP’s “genomic” goals are unique: to map and sequence the entire human genome—some 3 billion base pairs that make up approximately 80–100,000 genes—and the genomes of related model organisms by the year 2005. This goal was particularly ambitious since, when it was proposed, the technologies for mapping and sequencing had yet to be developed. When the HGP was first established, its organizers also elaborated a set of ELSI goals, which they saw as vital to the success of the genome project. The original ELSI goals were: (1) to anticipate and address the implications of the HGP for individuals and society and (2) to examine the ELSI consequences of mapping and sequencing the human genome in order to stimulate public discussion. To meet these goals, the NHGRI created its ELSI research program in 1990. Along with mapping, sequencing, [End Page 291] and mammalian genetics, ELSI was one of four original branches in the NHGRI Division of Extramural Research that funded research in those areas. Although the individual “branches” no longer exist, the mechanisms for funding research remain much the same. While the overall goals of the program have not changed, the specific ways of achieving the goals have continued to evolve. The importance of the ELSI program lies not in the collection of a full set of data that will be valuable in and of itself, but in the value of using and interpreting this new set of information.Early on, the NHGRI described a set of somewhat more specific goals: (1) to develop a program to help understand the ethical, legal, and social implications of the human genome project and (2) to identify and define the major issues of concern and develop policy options to address them. These more specific goals have been largely met. As the most recent biennial NHGRI Progress Report notes, “a robust ELSI research and education program has been established, many of the most urgent ELSI issues have been identified, and many policy options to address these issues have been proposed” (NCHGR 1995, p. 21). Between 1990 and 1996, ELSI provided more than $32.5 million in funding through 128 research and education grants in more than 30 states and in Canada (Table 1). The ELSI research budget is unique in that when originally created, it was specifically tied to the amount of money provided for the overall NHGRI budget. The NHGRI originally devoted 3 percent of its extramural budget to fund ELSI projects, but in FY 1991, it increased the ELSI budget to 5 percent, a figure that remains today. Table 2 lists the expenditures for each fiscal year since 1990 and the cumulative expenditures to date. The ELSI research budget at NHGRI this year will be about $7 million. When other sources of funding—e.g., co-funding arrangements with other institutes and agencies and the funding of ELSI... (shrink)

Despite extensive discussion of naïve realism in the wider philosophical literature, those influenced by the phenomenological movement who work in the philosophy of perception have hardly weighed in on the matter. It is thus interesting to discover that Edmund Husserl’s close philosophical interlocutor and friend, the early twentieth-century phenomenologist Johannes Daubert, held the naive realist view. This article presents Daubert’s views on the fundamental nature of perceptual experience and shows how they differ radically from those of Husserl’s. The author argues, (...) in conclusion, that Daubert’s views are superior to those of Husserl’s specifically in the way that they deal with the phenomenon of perceptual constancy. (shrink)

Levinas is usually discussed as a philosopher wrestling with the nature of our experience of others, ethical obligation, and the divine. Unlike other phenomenologists, such as Husserl and Heidegger, he is not often mentioned in discussions about issues in philosophy of mind. His work in that area, especially on perception, is underappreciated. He gives an account of the nature of perceptual experience that is remarkable both in how it departs from that of others in the phenomenological tradition and for how (...) it fits in among presently available views about the nature of perceptual experience, namely, as a form of naïve realism. (shrink)

This book covers a remarkable amount of ground and has become something of a classic. Besides the Discourse and the Meditations, it contains Private Thoughts, the third set of Objections and Replies, most of the Regulae, parts of the Principia and the Dioptrics, together with crrespondence with Elizabeth, Princess Palatine, Mersenne and others.

A number of philosophers have held that we visually experience objects’ occluded parts, such as the out-of-view exterior of a voluminous, opaque object. That idea is supposed to be what best explains the fact that we see objects as whole or complete despite having only a part of them in view at any given moment. Yet, the claim doesn’t express a phenomenological datum and the reasons for thinking we do experience objects’ occluded parts, I argue, aren’t compelling. Additionally, I anticipate (...) and reply to attempts to salvage the idea by appeal to perceptual expectation and amodal completion. Lastly, I address potential concerns that the only way to capture the phenomenal character of perceiving voluminous objects is to say experience outstrips what’s in view, providing a description of such experience without any implication of that idea. (shrink)

This bilingual edition of the Remarks on the Philosophy of Psychology presents the first English translation of an essential body of Wittgenstein's work. It elaborates Wittgenstein's views on psychological concepts such as expectation, sensation, knowing how to follow a rule, and knowledge of the sensations of other persons. It also shows strong emphasis on the "anthropological" aspect of Wittgenstein's thought.

One key difference between perceptual experience and thought is the distinctly sensory way perception presents things to us. Some philosophers nevertheless suggest this sensory phenomenal character does not exhaust the way things are made manifest to us in perceptual experience. Edmund Husserl maintains that there is also a significant non‐sensory side to perception's phenomenal character. We may experience, for instance, an object's facing surface in a sensory mode and, as part of the same perceptual experience, also that object's out‐of‐view surface (...) in a non‐sensory mode. To the extent that perceptual experience makes things available to us in a non‐sensory mode, Husserl calls it inadequate. Here, I reconstruct four arguments for the conclusion that perceptual experience is inadequately found in various of Husserl's writings and critically evaluated them. My aim is both to showcase the variety and sophistication of Husserl's reasons for thinking perceptual experience is inadequate and to problematize that idea. (shrink)

European Journal of Philosophy, Volume 30, Issue 2, Page 755-777, June 2022.

Wijsgerig-antropologische beschouwing, mede geïnspireerd door de hedendaagse Franse filosofie en de psychoanalyse, over de liefde als grond en bestemming van mens en wereld.

1. De jezuïten -- 4. Een zwerm getuigen -- 5.-6. De filosofie van Leuven -- 7. Op zoek naar zijn en zin -- 8. Katholieken en hun filosofie.

The relation of genetic phenomenology and the project of phenomenological reduction is the primary concern of this paper. Despite Husserl’s occasional loose references to “the” reduction, performing the reduction actually refers to numerous interrelated techniques. I want here to delve into these intricacies with the aim of determining the place of genetic phenomenology within the whole of phenomenological technique. It will be necessary to both state in general terms what the aim of the reduction is and what the different “ways” (...) to the reduction are before highlighting their inadequacy for dealing with genetic matters, which then brings us face to face with the underexplored possibility that there might be a peculiar novel from of reduction or transformation of the reduction that is needed to deal with genesis on properly transcendental ground. Following this line of thought, I attempt to elaborate a way into genetic phenomenology, which, I suggest, begins to appear most clearly in Husserl’s later reflections on “abnormal” forms of consciousness. (shrink)

For nearly two decades, the process of reviewing the ethical merit of research involving human subjects has been based on the application of principles initially described in the U.S. National Commission's Belmont Report, and later articulated more fully by Beauchamp and Childress in their Principles of Biomedical Ethics. Recently, the use of ethical principles for deliberating about moral problems in medicine and research, referred to in the pejorative sense as “principlism”, has come under scrutiny. In this paper we argue that (...) these principles can provide a foundation for the source of ethical appraisal of human research, but are not themselves wholly adequate for this purpose. Therefore, we further propose that (1) principles should be understood as heuristics that can be “specified” as described by DeGrazia (1992), and (2) that the principle‐based approach should be supplemented by formally incorporating “sensitivity to context” into the evaluation of clinical trials. (shrink)