SummaryThe dichotomy between ‘scientific’ and ‘practical’ approaches to guideline development is false and divisive. Instead we should concentrate on developing mechanisms to develop and implement valid guidelines to improve patient care. The development of valid guidelines requires considerable expertise and is time consuming and expensive. It is most efficiently done at a regional or national level. The implementation of valid guidelines requires local action including the identification and modification of valid guidelines and a coordinated evidence-based implementation strategy (Grimshaw & (...) class='Hi'>Eccles 1998). (shrink)

Objective Cluster randomised trial (CRT) investigators face challenges in seeking informed consent from individual patients (cluster members). This study examined associations between reporting of patient consent in healthcare CRTs and characteristics of these trials. Study design Consent practices and study characteristics were abstracted from a random sample of 160 CRTs performed in primary or hospital care settings that were published from 2000 to 2008. Multivariable logistic regression was used to examine associations between reporting of patient consent and methodological characteristics, as (...) well as publication features such as date and journal of publication. Results 82 (53.8%) of 160 studies reported obtaining informed consent from individual patients. Reporting of patient consent was independently and positively associated with: smaller cluster size, the evaluation of experimental interventions targeted at patients, data collection from individual patients, publication later than 2004 and publication in higher-impact journals. Conclusions Reporting of consent practices in published CRTs should be improved. Consent practices in published CRTs appear to be related to the type of interventions under study, as well as journal impact and trends in research ethics practices. These findings will inform best practices in trial conduct and ethics review, remediation of errors in consent practices and ethics review and the development of regulatory guidance for CRTs. (shrink)

Owing to unique features of their design, cluster randomized trials complicate the interpretation of standard ethics guidelines. The recently published Ottawa statement on the ethical design and conduct of cluster randomized trials provides researchers and research ethics committees with detailed guidance on the design, conduct and review of cluster trials. The Ottawa statement sets out 15 recommendations, including guidance on the justification of study design, the need for research ethics committee review, the identification of research participants, obtaining informed consent, the (...) role of gatekeepers in protecting cluster interests, the assessment of benefits and harms, and the protection of vulnerable participants. (shrink)

Owing to unique features of their design, cluster randomized trials complicate the interpretation of standard ethics guidelines. The recently published Ottawa statement on the ethical design and conduct of cluster randomized trials provides researchers and research ethics committees with detailed guidance on the design, conduct, and review of cluster trials. The Ottawa statement sets out 15 recommendations, including guidance on the justification of study design, the need for research ethics committee review, the identification of research participants, obtaining informed consent, the (...) role of gatekeepers in protecting cluster interests, the assessment of benefits and harms, and the protection of vulnerable participants. (shrink)

In the face of a perceived lack of widespread understanding of the theoretical issues underlying the development, dissemination and implementation of clinical guidelines, the Royal College of General Practitioners Guidelines Group developed a 2-day course aimed at teaching the theory in these areas. The course was targeted at potential opinion formers and ran on six occasions. Postal questionnaire assessment of the course revealed high levels of satisfaction with all aspects of the course and high levels of reported use of the (...) knowledge gained. Further developments of the course are discussed. (shrink)

The Human Psyche is an in-depth exploration of dualist-interactionism, a concept Sir John Eccles developed with Sir Karl Popper in the context of a wide...

Physical and chemical processes may act upon the mind; and when we are writing a difficult letter, our mind acts upon our body and, through a chain of physical...

Sir John Eccles, a distinguished scientist and Nobel Prize winner who has devoted his scientific life to the study of the mammalian brain, tells the story of...

A long-standing theme in discussion of perception and thought has been that our primary cognitive contact with individual objects and events in the world derives from our perceptual contact with them. When I look at a duck in front of me, I am not merely presented with the fact that there is at least one duck in the area, rather I seem to be presented withthisthing (as one might put it from my perspective) in front of me, which looks to (...) me to be a duck. Furthermore, such a perception would seem to put me in a position not merely to make the existential judgment that there is some duck or other present, but rather to make a singular, demonstrative judgment, that that is a duck. My grounds for an existential judgment in this case derives from my apprehension of the demonstrative thought and not vice versa. (shrink)

On Inception is a translation of Martin Heidegger's Gesamtausgabe 70. This work belongs to the crucial period, before and during WWII, when Heidegger was at work on a series of treatises that begins with "Contributions to Philosophy" and includes "The Event" and "The History of Beyng." These works are difficult, even hermetic, but represent a crucial development in Heidegger's thinking. On Inception deepens the investigation underway in the other volumes of the series and provides a unique perspective on Heidegger's (...) thinking of Being and of Event. Here, Heidegger asks, with a greater insistence than anywhere else in his work, what it might mean to think of being as event, and not as presence. Event cannot be thought without the sense of a beginning - an inception - and so, Heidegger insists, we must try to think of being as inception, as fundamentally inceptive. On Inception pursues rigorously the difficult and puzzling implications of this speculation. It does not merely extend work already undertaken but also opens doors onto wholly other pathways. (shrink)

Is it OK to lie to Siri? Is it bad to mistreat a robot for our own pleasure? Under what condition should we grant a moral status to an artificial intelligence (AI) system? This paper looks at different arguments for granting moral status to an AI system: the idea of indirect duties, the relational argument, the argument from intelligence, the arguments from life and information, and the argument from sentience. In each but the last case, we find unresolved issues with (...) the particular argument, which leads us to move to a different one. We leave the idea of indirect duties aside since these duties do not imply considering an AI system for its own sake. The paper rejects the relational argument and the argument from intelligence. The argument from life may lead us to grant a moral status to an AI system, but only in a weak sense. Sentience, by contrast, is a strong argument for the moral status of an AI system—based, among other things, on the Aristotelian principle of equality: that same cases should be treated in the same way. The paper points out, however, that no AI system is sentient given the current level of technological development. (shrink)

Over the past three decades, the philosophy of biology has emerged from the shadow of the philosophy of physics to become a respectable and thriving philosophical subdiscipline. The authors take a fresh look at the life sciences and the philosophy of biology from a strictly realist and emergentist-naturalist perspective. They outline a unified and science-oriented philosophical framework that enables the clarification of many foundational and philosophical issues in biology. This book will be of interest both to life scientists and philosophers.

We provide a battery of examples of delusions against which theoretical accounts can be tested. Then, we identify neuropsychological anomalies that could produce the unusual experiences that may lead, in turn, to the delusions in our battery. However, we argue against Maher’s view that delusions are false beliefs that arise as normal responses to anomalous experiences. We propose, instead, that a second factor is required to account for the transition from unusual experience to delusional belief. The second factor in the (...) aetiology of delusions can be described superficially as a loss of the ability to reject a candidate for belief on the grounds of its implausibility and its inconsistency with everything else that the patient knows. But we point out some problems that confront any attempt to say more about the nature of this second factor. (shrink)

The relation between body and mind is one of the oldest riddles that has puzzled mankind. That material and mental events may interact is accepted even by the law: our mental capacity to concentrate on the task can be seriously reduced by drugs. Physical and chemical processes may act upon the mind; and when we are writing a difficult letter, our mind acts upon our body and, through a chain of physical events, upon the mind of the recipient of the (...) letter. This is what the authors of this book call the 'interaction of mental and physical events'. We know very little about this interaction; and according to recent philosophical fashions this is explained by the alleged fact that we have brains but no thoughts. The authors of this book stress that they cannot solve the body mind problem; but they hope that they have been able to shed new light on it. Eccles especially with his theory that the brain is a detector and amplifier; a theory that has given rise to important new developments, including new and exciting experiments; and Popper with his highly controversial theory of 'World 3'. They show that certain fashionable solutions which have been offered fail to understand the seriousness of the problems of the emergence of life, or consciousness and of the creativity of our minds. In Part I, Popper discusses the philosophical issue between dualist or even pluralist interaction on the one side, and materialism and parallelism on the other. There is also a historical review of these issues. In Part II, Eccles examines the mind from the neurological standpoint: the structure of the brain and its functional performance under normal as well as abnormal circumstances. The result is a radical and intriguing hypothesis on the interaction between mental events and detailed neurological occurrences in the cerebral cortex. Part III, based on twelve recorded conversations, reflects the exciting exchange between the authors as they attempt to come to terms with their opinions. (shrink)

Martin Heidegger's Contributions to Philosophy reflects his famous philosophical "turning." In this work, Heidegger returns to the question of being from its inception in Being and Time to a new questioning of being as event.

What exactly is hope and how does it influence our decisions? In How We Hope, Adrienne Martin presents a novel account of hope, the motivational resources it presupposes, and its function in our practical lives. She contends that hoping for an outcome means treating certain feelings, plans, and imaginings as justified, and that hope thereby involves sophisticated reflective and conceptual capacities. Martin develops this original perspective on hope--what she calls the "incorporation analysis"--in contrast to the two dominant philosophical (...) conceptions of hope: the orthodox definition, where hoping for an outcome is simply desiring it while thinking it possible, and agent-centered views, where hoping for an outcome is setting oneself to pursue it. In exploring how hope influences our decisions, she establishes that it is not always a positive motivational force and can render us complacent. She also examines the relationship between hope and faith, both religious and secular, and identifies a previously unnoted form of hope: normative or interpersonal hope. When we place normative hope in people, we relate to them as responsible agents and aspire for them to overcome challenges arising from situation or character. Demonstrating that hope merits rigorous philosophical investigation, both in its own right and in virtue of what it reveals about the nature of human emotion and motivation, How We Hope offers an original, sustained look at a largely neglected topic in philosophy. (shrink)

Sir John Eccles, a distinguished scientist and Nobel Prize winner who has devoted his scientific life to the study of the mammalian brain, tells the story of how we came to be, not only as animals at the end of the hominid evolutionary line, but also as human persons possessed of reflective consciousness.

A ‘lottery belief’ is a belief that a particular ticket has lost a large, fair lottery, based on nothing more than the odds against it winning. The lottery paradox brings out a tension between the idea that lottery beliefs are justified and the idea that that one can always justifiably believe the deductive consequences of things that one justifiably believes – what is sometimes called the principle of closure. Many philosophers have treated the lottery paradox as an argument against the (...) second idea – but I make a case here that it is the first idea that should be given up. As I shall show, there are a number of independent arguments for denying that lottery beliefs are justified. (shrink)

Martin Heidegger is one of the most important and influential philosophers of the 20th Century. A major figure in the development of phenomenology, his work also profoundly influenced many of the intellectual movements that followed in his wake, from Sartre's Existentialism to Derrida's deconstructionism. Towards the Definition of Philosophy brings together two seminal lectures that mark a breakthrough moment in Heidegger's thought and introduces the major themes that he would develop in his opus Being and Time.

Sir John Eccles, a distinguished scientist and Nobel Prize winner who has devoted his scientific life to the study of the mammalian brain, tells the story of how we came to be, not only as animals at the end of the hominid evolutionary line, but also as human persons possessed of reflective consciousness.

A landmark discussion between two great thinkers, vital to an understanding of twentieth-century philosophy and intellectual history.

This paper proposes a view of time that takes passage to be the most basic temporal notion, instead of the usual A-theoretic and B-theoretic notions, and explores how we should think of a world that exhibits such a genuine temporal passage. It will be argued that an objective passage of time can only be made sense of from an atemporal point of view and only when it is able to constitute a genuine change of objects across time. This requires that (...) passage can flip one fact into a contrary fact, even though neither side of the temporal passage is privileged over the other. We can make sense of this if the world is inherently perspectival. Such an inherently perspectival world is characterized by fragmentalism, a view that has been introduced by Fine in his ‘Tense and Reality’ (2005). Unlike Fine's tense-theoretic fragmentalism though, the proposed view will be a fragmentalist view based in a primitive notion of passage. (shrink)

Martin Heidegger's Nietzsche's Second Untimely Meditation presents crucial elements for understanding Heidegger's thinking from 1936 to 1940. Heidegger offers a radically different reading of a text that he had read decades earlier, showing how his relationship with Nietzche's has changed, as well as how his understandings of the differences between animals and humans, temporality and history, and the Western philosophical tradition developed. With his new reading, Heidegger delineates three Nietzschean modes of history, which should be understood as grounded in (...) the structure of temporality or historicity and also offers a metaphysical determination of life and the essence of humankind. Ullrich Hasse and Mark Sinclair offer a clear and accessible translation despite the fragmentary and disjointed quality of the original lecture notes that comprise this text. (shrink)