Currently, health systems research is reviewed by the same ethical standards as clinical research, which has recently been argued in the literature to be an inappropriate standard of evaluation. The issues unique to HSR warrant a different review by research ethics committees, as it does not impose the same risks to study participants as other types of clinical or public health research. However, there are limited tools and supporting documents that clarify the ethical considerations. Therefore, there is a need for (...) additional reflection around ethical review of HSR and their consideration by RECs. The purpose of this paper is to review, understand, and synthesize the current state of literature and practice to inform these deliberations and the larger discourse on ethics review guidelines for HSR. This paper presents a review of the literature on ethics of HSR in the biomedical, public health, and implementation research to identify ethical considerations specific to HSR; and to identify examples of commonly available guidance and/or tools for the ethical review of HSR studies. Fifteen articles were identified on HSR ethics issues, and forty-two international academic institutions were contacted, no institution had special ethical guidelines for reviewing HSR) about their HSR ethics review guidelines. There appears to be a clear gap in the current health research ethics discourse around health systems research ethics. This review serves as a first step towards a larger dialogue on the topic. (shrink)
Given that health systems research involves different aims, approaches, and methodologies as compared to more traditional clinical trials, the ethical issues present in HSR may be unique or particularly nuanced. This article outlines eight pertinent ethical issues that are particularly salient in HSR and argues that the ethical review process should be better tailored to ensure more efficient and appropriate oversight of HSR with adequate human protections, especially in low- and middle-income countries. The eight ethical areas we discuss include the (...) nature of intervention, types of research subjects, units of intervention and observation, informed consent, controls and comparisons, risk assessment, inclusion of vulnerable groups, and benefits of research. HSR involving human participants is necessary to ensure health systems strengthening and quality of care and to guide public policy intelligently. Health systems researchers must carefully define their intent and goals and openly clarify the values that may influence the premises and design of protocols. As new types of population-level research activities become more commonplace, it is critical that institutional review board and research ethics committee review processes evolve to evaluate these research protocols in ways that address the nuanced features of these studies. (shrink)
Listening to someone from some distance in a crowded room you may experience the following phenomenon: when looking at them speak, you may both hear and see where the source of the sounds is; but when your eyes are turned elsewhere, you may no longer be able to detect exactly where the voice must be coming from. With your eyes again fixed on the speaker, and the movement of her lips a clear sense of the source of the sound will (...) return. This ‘ventriloquist’ effect reflects the ways in which visual cognition can dominate auditory perception. And this phenomenological observation is one what you can verify or disconfirm in your own case just by the slightest reflection on what it is like for you to listen to someone with or without visual contact with them. (shrink)
Using as a springboard a three-way debate between theoretical physicist Lee Smolin, philosopher of science Nancy Cartwright and myself, I address in layman’s terms the issues of why we need a unified theory of the fundamental interactions and why, in my opinion, string and M-theory currently offer the best hope. The focus will be on responding more generally to the various criticisms. I also describe the diverse application of string/M-theory techniques to other branches of physics and mathematics which render the (...) whole enterprise worthwhile whether or not “a theory of everything” is forthcoming. (shrink)
We regularly wield powers that, upon close scrutiny, appear remarkably magical. By sheer exercise of will, we bring into existence things that have never existed before. With but a nod, we effect the disappearance of things that have long served as barriers to the actions of others. And, by mere resolve, we generate things that pose significant obstacles to others' exercise of liberty. What is the nature of these things that we create and destroy by our mere decision to do (...) so? The answer: the rights and obligations of others. And by what seemingly magical means do we alter these rights and obligations? By making promises and issuing or revoking consent When we make promises, we generate obligations for ourselves, and when we give consent, we create rights for others. Since the rights and obligations that are affected by means of promising and consenting largely define the boundaries of permissible action, our exercise of these seemingly magical powers can significantly affect the lives and liberties of others. (shrink)
Twentieth century philosophers introduced the distinction between “objective rightness” and “subjective rightness” to achieve two primary goals. The first goal is to reduce the paradoxical tension between our judgments of what is best for an agent to do in light of the actual circumstances in which she acts and what is wisest for her to do in light of her mistaken or uncertain beliefs about her circumstances. The second goal is to provide moral guidance to an agent who may be (...) uncertain about the circumstances in which she acts, and hence is unable to use her standard moral principle directly in deciding what to do. This paper distinguishes two important senses of “moral guidance”; proposes criteria of adequacy for accounts of subjective rightness; canvasses existing definitions for “subjective rightness”; finds them all deficient; and proposes a new and more successful account. It argues that each comprehensive moral theory must include multiple principles of subjective rightness to address the epistemic situations of the full range of moral decision-makers, and shows that accounts of subjective rightness formulated in terms of what it would reasonable for the agent to believe cannot provide that guidance. (shrink)
A large body of literature agrees that persons with schizophrenia suffer from a Theory of Mind deficit. However, most empirical studies have focused on third-person, egocentric ToM, underestimating other facets of this complex cognitive skill. Aim of this research is to examine the ToM of schizophrenic persons considering its various aspects, to determine whether some components are more impaired than others. We developed a Theory of Mind Assessment Scale and administered it to 22 persons with a DSM-IV diagnosis of schizophrenia (...) and a matching control group. Th.o.m.a.s. is a semi-structured interview which allows a multi-component measurement of ToM. Both groups were also administered a few existing ToM tasks and the schizophrenic subjects were administered the Positive and Negative Symptoms Scale and the WAIS-R. The schizophrenic persons performed worse than control at all the ToM measurements; however, these deficits appeared to be differently distributed among different components of ToM. Our conclusion is that ToM deficits are not unitary in schizophrenia, which also testifies to the importance of a complete and articulated investigation of ToM. (shrink)
We argue that thoughts are structures of concepts, and that concepts should be individuated by their origins, rather than in terms of their semantic or epistemic properties. Many features of cognition turn on the vehicles of content, thoughts, rather than on the nature of the contents they express. Originalism makes concepts available to explain, with no threat of circularity, puzzling cases concerning thought. In this paper, we mention Hesperus/Phosphorus puzzles, the Evans-Perry example of the ship seen through different windows, and (...) Mates cases, and we believe that there are many additional applications. (shrink)
In his article ‘Saints and Heroes’, Urmson argues that traditional moral theories allow at most for a threefold classification of actions in terms of their worth, and that they are therefore unsatisfactory. Since the conclusion of his argument has led to the widespread use of the term ‘acts of supererogation’, and since I do not believe that such acts exist, I propose to argue that the actions with which he is concerned not only can, but should, be contained within the (...) traditional classification. (shrink)
There is an ancient and ambiguous philosophical doctrine that perception is passive. This can mean that the mind contributes nothing to the content of our sensory experience: its power of perception is a mere receptivity. In this sense the principle has often been questioned, and is indeed doubtful on empirical grounds, given one reasonable interpretation of what it would be for the mind to make such a contribution.
R. M. Adams’s essay, “Must God Create the Best?” can be interpreted as offering a theodicy for God’s creating morally less perfect beings than he could have created. By creating these morally less perfect beings, God is bestowing grace upon them, which is an unmerited or undeserved benefit. He does so, however, in advance of the free moral misdeeds that render them undeserving. This requires that God have middle knowledge, pace Adams’s version of the Free Will Theodicy, of what would (...) result from his actualization of possible free persons. It is argued that God’s possession of such middle knowledge negates the freedom of created beings, since God completely determines every action of every created person. And since they are not free, they cannot qualify as morally unmeritorious or undeserving. And, with that, Adams’s theodicy of grace-in-advance collapses. (shrink)
Theaetetus, asked what knowledge is, replies that geometry and the other mathematical disciplines are knowledge, and so are crafts like cobbling. Socrates points out that it does not help him to be told how many kinds of knowledge there are when his problem is to know what knowledge itself is, what it means to call geometry or a craft knowledge in the first place—he insists on the generality of his question in the way he often does when his interlocutor, asked (...) for a definition, cites instead cases of the concept to be defined. (shrink)
Is God's foreknowledge compatible with human freedom? One of the most attractive attempts to reconcile the two is the Ockhamistic view, which subscribes not only to human freedom and divine omniscience, but retains our most fundamental intuitions concerning God and time: that the past is immutable, that God exists and acts in time, and that there is no backward causation. In order to achieve all that, Ockhamists distinguish ‘hard facts’ about the past which cannot possibly be altered from ‘soft facts’ (...) about the past which are alterable, and argue that God's prior beliefs about human actions are soft facts about the past. (shrink)
The theory of personal identity should illuminate and be illuminated by the theory of personality, of which it is a part. I believe that Locke's theory succeeds in this more than that of any other great philosopher, and the modifications which it may need are not fundamental ones. The problems raised by Butler and Flew can be made to disappear.
Our research is based on a rather large "library" of various works by M. Drahomanov, which contains his views on religion. Among them: Paradise and Progress, From the History of Relations Between Church and State in Western Europe, Faith and Public Affairs, Fight for Spiritual Power and Freedom of Conscience in the 16th - 17th Centuries,, "Church and State in the Roman Empire", "The Status and Tasks of the Science of Ancient History," "Evangelical Faith in Old England," "Populism and Popular (...) Progress in Austrian Rus, Austrian-Russian Remembrance," "Pious The Legend of the Bulgarians "," The Issues of Religious Freedom in Russia, "" On the Brotherhood of the Baptist or the Baptist in Ukraine, "" The Foreword, " Shevchenko, Ukrainianophiles and Socialism "," Wonderful thoughts about the Ukrainian national affair "," Zazdri gods "," Slavic variants of one Gospel legend "," Resurrection of Christ ", etc. (shrink)
In the years 1878 and 1879 the American physicist Alfred Marshall Mayer published his experiments with floating magnets as a didactic illustration of molecular actions and forms. A number of physicists made use of this analogy of molecular structure. For William Thomson they were a mechanical illustration of the kinetic equilibrium of groups of columnar vortices revolving in circles round their common centre of gravity . A number of modifications of Mayer's experiments were described, which gave configurations which were more (...) or less analogous to Mayer's arrangements. It was Joseph John Thomson who, in publications between 1897 and 1907, used Mayer's results to obtain a good deal of insight into the general laws which govern the configuration of the electrons in his atomic model. This article is mainly concerned with Mayer's experiments with floating magnets and their use by a number of physicists. Through his experiments Mayer made a significant, although small, contribution to the theory of atomic structure. (shrink)
I had a strange dream, or half-waking vision, not long ago. I found myself at the top of a mountain in the mist, feeling very pleased with myself, not just for having climbed the mountain, but for having achieved my life's ambition, to find a way of answering moral questions rationally. But as I was preening myself on this achievement, the mist began to clear, and I saw that I was surrounded on the mountain top by the graves of all (...) those other philosophers, great and small, who had had the same ambition, and thought they had achieved it. And I have come to see, reflecting on my dream, that, ever since, the hard-working philosophical worms have been nibbling away at their systems and showing that the achievement was an illusion. True, their skeletons, indigestible to worms, remained, and were surprisingly similar to one another. But I was led to think again about what one can, and what one cannot, achieve in this direction. (shrink)
In the intellectual autobiography that opens this book, Chisholm divides philosophers into “drones” and “commentators,” placing himself in the first group. As a drone, Chisholm proposed solutions to philosophical problems and asked his students and colleagues to try to refute him. He reports that they often did, sending him back to the drawing board. Chisholm’s wry self-description says much about his manner as well as his method. A more pretentious philosopher might have spoken of his dogged search for philosophical truth (...) in an age when many have come to disparage that quest. (shrink)
This article explores the vast body of English language works on Hinduism published since 1981 by Voice of India—an influential right-wing Hindu publishing house headquartered in New Delhi, but contributed to by Indians at “home” and in diasporic communities, as well as Europeans and North Americans. Focus on the construction of the Hindu “Self” and the non-Hindu “Other” shows the manner in which European thought, primarily represented by the contributions of colonial-era British and German indologists, but bolstered by evangelicals, Utilitarians (...) and Arabo-Islamicists from the same era, has become an important feature of postcolonial forms of Hinduism. In particular, the influence of fin de siècle German indologist Paul Deussen, mediated by such colonial-era Hindu thinkers as Swami Dayananda, Swami Vivekananda, Sri Aurobindo Ghose and Mahatma Gandhi, not only defines Voice of India's theology, but leads to the construction of a Hindu Self that is the personification of “Aryan godliness” and a non-Hindu Other that is essentialized as a “Semitic Demon.” Although closely associated with and often serving the political initiatives of the Sangh Parivar, the authors of this theology have been kept at arm's length by the organization for reasons of political expediency. Both the growing network of contributors to and consumers of this view, and its periodic use by the Sangh Parivar, insure that it represents a significant development in the ideology of Hindutva. (shrink)
Moral theories which, like those of Plato, Aristotle and Aquinas, give a central place to the virtues, tend to assume that as traits of character the virtues are mutually compatible so that it is possible for one and the same person to possess them all. This assumption—let us call it the compatibility thesis—does not deny the existence of painful moral dilemmas: it allows that the virtues may conflict in particular situations when considerations associated with different virtues favour incompatible courses of (...) action, but holds that these conflicts occur only at the level of individual actions. Thus while it may not always be possible to do both what would be just and what would be kind or to act both loyally and honestly, it is possible to be both a kind and a just person and to have both the virtue of loyalty and the virtue of honesty. (shrink)
Many philosophers have declared that everything which exists is a particular. There is a weak interpretation of this doctrine which I believe to be a true proposition, and a strong one which I believe to be false.