Medicine in the twenty-first century is increasingly reliant on research to guarantee the safety and efficacy of medical interventions. As a result, the need to understand the ethical issues that research generates is becoming essential. This volume introduces the principal areas of concern in research on human subjects, offering a framework for understanding research ethics, and the relationship between ethics and compliance. Research Ethics brings together leading scholars in bioethics and the topics covered include the unique concerns that arise in (...) specific areas of research such as gene therapy and stem cell research. Individual chapters also address the ethical issues that occur when conducting research with specific populations such as infants or adolescents, and the volume looks at important emerging questions in human subjects research, namely financial conflicts of interest and the interpretation of scientific data. (shrink)

The last two decades have witnessed intense debate over the ethical legitimacy of placebo controlled trials. Most of the arguments for and against the use of PCTs turn on one of the following issues: the compatibility of the obligations of clinicians and researchers with PCTs, the scientific merit of PCTs, and the influence of patients' and subjects' perceptions, ability to consent, expectations, and rights on the permissibility of PCTs. I introduce each of these categories and assess the principal arguments in (...) each group. I argue that, although some of the arguments against PCTs have limitations, they do inform the debate in significant ways by pointing to important constraints on PCTs. Those concerning patients' and subjects' perceptions, capacity to consent, expectations, and rights are particularly instructive. They do not, for the most part, sustain an absolute prohibition of PCTs, but they do suggest types of PCTs that are inappropriate and they indicate issues that must be addressed when PCTs are conducted. I argue that we should look to the reasonableness and permissibility of informed refusals of care to evaluate the extent to which a trial is a legitimate PCT ; to determine which potential subjects should be considered eligible to enroll in a PCT ; and to inform the language that should be used in describing the study as part of the informed consent process. (shrink)

Bioethical decision-making depends on presuppositions about the function and goal of bioethics. The authors in this issue of The Journal of Medicine and Philosophy share the assumption that bioethics is about resolving cases, not about moral theory, and that the best method of bioethical decision-making is that which produces useful answers. Because we have no universally agreed upon background moral theory which can serve as the basis for bioethical decision-making, they try to move bioethics away from theory. For them, a (...) good method of bioethical decision-making is one which resolves cases in ways that are justifiable to the parties involved, not necessarily in ways that bring us ‘close’ to the right and the true. The authors consider how the move away from theory and toward actual cases is best accomplished. In particular, the debate in this issue is about specification, specified principlism, and casuistry. (shrink)

Issues of institutional identity and integrity in Roman Catholic health care institutions have been addressed at the level of individual institutions as well as by organizations of Catholic health care providers and at various levels in the Church hierarchy. The papers by Carol Taylor, C.S.F.N, Thomas Shannon, Kevin O’Rourke, O.P., Gerard Magill in this volume provide a significant contribution to concerns of Roman Catholic health care institutions as they face the challenges of providing health care in a secular, pluralistic, market-driven (...) economy. One way to understand institutional integrity is as a measure of the coherence between what an institution identifies as its commitments (its stated moral character), what an institution does (its manifest moral character) and an institution’s fundamental moral commitments (its deep moral character). The essays in this volume support this model of integrity. Although it is not their explicit focus, the four essays together provide a vision of institutional integrity for Catholic health care institutions. Each author focuses on one of the three central aspects of integrity: what one identifies as one’s commitments (Taylor), how one's actions reflect one’s values (Shannon and Magill), and what one is or what one values at a deep level (O’Rourke). I will offer a brief overview of the ways in which the integrity of Catholic health care institutions has been addressed. Then I will consider the four essays and show how each offers an analysis of one of the three critical elements of integrity. (shrink)

This article addresses the impact of the potential conflict between the roles of physicians who are both clinicians and researchers on the recruitment of persons into research trials. It has been proposedthat a physician breaches inter-role confidentiality when he or she uses information gathered in his or her clinical role to inform patients about trials for which they may be eligible and that clinician-researchers should adopt a model of preliminary consent to be approached about research prior to commencing a clinical (...) relationship. This article argues that even if we grant the legitimacy of inter-role confidentiality (which is open to question), there are circumstances in which other obligations physicians bear override the obligation of inter-role confidentiality. Moreover, it is argued that the practice of preliminary consent is morally suspect and that such consent cannot be deemed valid. The article concludes with a series of recommendations of ways in which the legitimate concern regarding the conflicting roles of clinician-researchers can be addressed in the recruitment stage of research. (shrink)

Issues in bioethics often turn, at least in part, on the law and regulatory requirements. Consisting of chapters that address particular bioethics topics from the law’s perspective, this fascinating book includes: an introduction to the American legal system papers identifying the principal ways in which the law influences discussions and decisions concerning each of the topics highlighted supplemental papers on certain areas that address the influence and status of the law in countries other than the United States. Covering traditional topics (...) in bioethics, such as determinations of death and health care decisions for vulnerable groups, this study also explores emerging areas such as conflicts of interest in research, genetics, and privacy and confidentiality in the electronic age. Incisive and thought-provoking, this volume provides readers with a rich context for understanding the intersection between the law on bioethics and the central issues in bioethics. (shrink)

Medicine in the twenty-first century is increasingly reliant on research to guarantee the safety and efficacy of medical interventions. As a result, the need to understand the ethical issues that research generates is becoming essential. This volume introduces the principal areas of concern in research on human subjects, offering a framework for understanding research ethics, and the relationship between ethics and compliance. Research Ethics brings together leading scholars in bioethics and the topics covered include the unique concerns that arise in (...) specific areas of research such as gene therapy and stem cell research. Individual chapters also address the ethical issues that arise when conducting research with specific populations such as infants or adolescents, and the volume looks at important emerging issues in human subjects research, namely financial conflicts of interest and the interpretation of scientific data. (shrink)

: Four principal arguments have been offered in support of requiring public and private third-party payers to help fund medical research: (1) many of the costs associated with clinical trial participation are for routine care that would be reimbursed if delivered outside of a trial; (2) there is a need to promote scientific research and medical progress and lack of coverage is an impediment to enrollment; (3) to cover the costs of trials expands health care and treatment options for the (...) sick; and (4) it is beneficial for private insurers to cover the costs associated with cancer clinical trials because doing so makes such companies more attractive to consumers. Although many see third-party-payer coverage as a victory for patients and for the future of research, requiring coverage of services provided in a trial beyond those that would be provided to a comparable patient outside the research context raises a number of concerns. (shrink)

This chapter contains sections titled: The Conceptual Geography Some Teleological Approaches to Distributing Health Care Hypothetical Contractor Theory Libertarian Approaches: Autonomy by Default Conclusion.

ABSTRACT In establishing National Bioethics Organisations (NBOs), liberal democracies seek to acknowledge the diversity of strongly held ethical positions and the imperative to engage in public debate about important bioethical decisions. NBOs are typically given a range of responsibilities, including contributing to and stimulating public debate; providing expert opinion on relevant issues for policy deliberations; and developing public policy. The state is now found to have an interest in areas previously thought to be a matter of individual choice. NBOs can (...) provide one way of opening up public debate to allow the diversity of views to be heard in a manner that is well‐informed, articulate and responsive to both expert and ‘lay’ public views. We draw on debates in political theory about democratic decision‐making and on the policy making roles of some key NBOs. We are particularly interested in examining the capacity of NBOs to meet the democratic ideal of effective participation by the public, or citizenry, especially by those who are directly affected by the policies, in the development of effective public policy. We provide a basic framework for policy development involving NBOs that can begin to meet this ideal, a process of ‘contested deliberation’. (shrink)

Este artigo tem por objetivo investigar, no contexto da Primeira República, as tensões entre dois projetos educacionais implementados por confissões religiosas que, por meio da formação das elites, disputavam a hegemonia ideológico-cultural da sociedade brasileira, a saber, o protestante, na sua versão metodista, e o católico. Palavras-chave: Metodistas; Católicos; Educação. ABSTRACT This article aims at investigating in the context of the First Republic, the tensions between the two educational projects implemented by the religious groups who, through the formation of the (...) elite, disputed the ideological and cultural hegemony in Brazilian society that is the protestant project in its Methodist form and the catholic project. Key words: Methodists; Catholics; Education. (shrink)

One of the most characteristic features of Comparative Literature in terms of methodological practice is that of operating in “in between” spaces. Not only does this feature suggest the comparative approach as something which originates through movement, thus making it imperative for the researcher to deal with the notion of mobility, it also characterizes many of the concepts with which it operates. Considering the possibility, as well as the fertility, of practicing this methodology in the analysis and critique of contemporary (...) visual art, we understand that it fits the analysis of any enterprise regarding the in-betweens of visual and verbal texts. These fundamental aspects were elected for a comparative analysis of two visuals artists whose œuvres operate in in-between spaces between the visual and the verbal as much as between the self and the Other. José Leonilson (Brazil 1957-1993) and Louise Bourgeois (France/EUA 1911-2010) reveal, through a comparative analysis, creative and constitutive actions which elaborate a space we could best understand through the image of a seaside landscape where the line we try to draw to divide the saltwater from the sand never stands. But, in what manners could the constituted poetic space created by them be of significance for a broader spectrum than the literary interest? In our understanding, Leonilson’s and Bourgeois’s poetics operate through a silent hearing of the Other, might that be their loved ones, the stone or cloths. This conceptual notion, required for the creative action, thus establishes a particular notion of balance between them and the Other. It is this precise aspect that also operates the mobility of the notion of love through their œuvre, and through the election of personal emotional narratives as the thriving force for creation. And what could be more needed nowadays, here as elsewhere, than considering together with Leonilson’s and Bourgeois’ images that love shall be the perpetual moving space that at times nears, and later distances us from each other? (shrink)

Coordination between speakers in dialogue requires balancing repetition and change, the old and the new. Interlocutors tend to reuse established forms, relying on communicative precedents. Yet linguistic interaction also necessitates adaptation to changing contexts or dynamic tasks, which might favor abandoning existing precedents in favor of better communicative alternatives. We explored this tension using a maze game task in which individual participants and interacting pairs had to describe figures and their positions in one of two possible maze types: a regular (...) maze, in which the grid‐like structure of the maze is highlighted, and an irregular maze, in which specific parts of the maze are salient. Participants repeated this task several times. Both individuals and interacting pairs were affected by the different maze layouts, initially using more idiosyncratic description schemes for irregular mazes and more systematic schemes for regular mazes. Interacting pairs, but not individuals, abandoned their unsystematic initial descriptions in favor of a more systematic approach, which was better adapted for repeated interaction. Our results show communicative conventions are initially shaped by context, but interaction opens up the possibility for change if better alternatives are available. (shrink)

O presente trabalho focaliza o fenômeno dos longos litígios em Varas de Família, com o objetivo de discutir a inscrição do judiciário na trama conjugal. Ressalta-se que alguns casais, mesmo após o divórcio, ficam aprisionados numa dinâmica de repetição que atua por meio do litígio, representado nas ..

As one tries to grasp love and its images within José Leonilson's production, a multiplicity of aspects and meanings are seen that also relate to Louise Bourgeois's oeuvre in regard to the interest in human relations. Through a comparative approach to both artists' poetics, an understanding is created that love is not a simplistic action and all the words read in or applied to their visual discourse must be considered within a wide range of love in visual and literary images. (...) Keywords: literature and visual arts / love / creativity / Bourgeois, Louise / Leonilson, José / word and image. (shrink)

Este trabalho tem como ponto de partida os índices de reprovação nas disciplinas de Teoria Literária, gerando, consequentemente, a necessidade de suprir uma lacuna anterior à aquisição de conhecimentos específicos: auxiliar os alunos universitários a ler e verdadeiramente compreender diferentes tipos de textos para, então, elaborarem posicionamentos críticos, sejam orais ou escritos. Sendo assim, este artigo baseia-se no conceito de letramento como uso efetivo e competente da tecnologia escrita, isto é, como um instrumento de interação com os outros, de aquisição (...) de conheci-mento, imersão no imaginário, no estético, etc. (Soares, 2007). E, tendo em vista que o letramento é apresentado também pelos PCN (2011) como elemento chave no processo de inclusão social, torna-se cada vez mais premente a necessidade de flexibilizar as estratégias de sala de aula, de modo a atingir inclusive um público universitário. Portanto, este artigo apresenta-se como uma análise e defesa do uso de textos da área dos estudos literários, como uma estratégia para melhorar e acelerar o processo de letramento entre estudantes do curso de Letras. A partir de uma abordagem liguística pragmática, e tendo como aporte teórico as obras de Philippe Perrenoud, Cipriano Luckesi, e Magda Soares, este trabalho também se configura como um relato de experiência interdisciplinar de sala de aula, com alunos do curso de Letras da Universidade Federal do Pampa, no Brasil, em uma das cidades sele-cionadas pelo Programa Nacional de Desenvolvimento da Educação. (shrink)

O artigo visa a analisar como a Psicologia tem encarado os desafios colocados pelo desempenho escolar. Discute os princípios e as ferramentas q ue têm orientado as práticas psicológicas no campo do fracasso escolar. Faz um debate acerca da interface Psicologia e Educação, partindo dos princípios da ..

A teoria pedagógica comporta muitos fenômenos que o educador deve compreender e levar em consideração, dentre eles, a crise. Alguns educadores exercem dignamente o seu ofício. Mesmo diante das situações mais adversas, eles podem ser considerados resilientes. Resiliência é o nome dado à capacidade concreta das pessoas de não só superarem situações críticas, mas também de utilizá-las em seus processos de desenvolvimento pessoal. Os estudos sobre o tema se propõem a enfatizar a promoção de processos educativos que facilitem ou tornem (...) as pessoas mais resistentes e maduras para enfrentar as dificuldades que ocorrem em sua vida. A inclusão da espiritualidade como um fator de favorecimento da resiliência parece ser o de desafiar o futuro numa perspectiva de superação, considerando as adversidades como obstáculos que poderão favorecer o amadurecimento pessoal, através da ampliação da visão de mundo e do estabelecimento de novas formas de equilíbrio. Acredita-se que um professor resiliente poderá mais facilmente manter-se firme em sua tarefa de educar, transcendendo as questões meramente pedagógicas, buscando desenvolver a integralidade na prática formativa, sobretudo porque possui mais possibilidades de vivenciar a sua própria multidimensionalidade. Este texto tem como finalidade estudar a importância da espiritualidade no favorecimento de uma postura resiliente no educador. (shrink)

Nursing education is a dynamic process that is constantly changing. Currently, we want the profile of a professional who not only has technical-scientific skills, but also adopts a critical-reflexive and humanistic approach based on ethics. O aprender a cuidar em Enfermagem perpassa por questões que vão além do saber teórico, exigindo outras formas de agir, no que tange à formação e prática apoiadas na humanização. This study aimed to understand the senses of humanization in the teacher-student relationship during the supervised (...) internships in Tertiary Health Care services of a graduation. Nursing course in the interior of Pernambuco. This study aimed to understand the senses of humanization in the teacherstudent relationship during the supervised internships in Tertiary Health Care services of a graduation. Nursing course in the interior of Pernambuco. And as specific objectives: To investigate what is the perception about human relationship between teacher and student during supervised internships; identify how the relationship between teachers and students is developed during such activities and; To analyze how this relationship can affect and or impact on the development and performance of pairs. We emphasize that the study was approved by the Research Ethics Committee, with the Certificate of Presentation for Ethical Appreciation of n. 05009218.4.0000.5208. The research in question was characterized by a qualitative approach, of an exploratory nature and to obtain the data, we conducted semistructured and audio-recorded interviews, from March to May 2019, with seven supervising professors from a Private Higher Education Institution in Agreste de Pernambuco, who fallowed the Supervised Internships in the Tertiary Care to Health. Data analysis took place from the perspective of Bardin and the obtained results showed that both teachers and students understood and recognized that a humanized relationship, in the context of supervised internships, is based on respect for beliefs, values and principles, aiming at the comprehensiveness of the human being. Besides, the studies show us that the type of relationship established between this binomial can impact in various ways on the development of its activities. This research made it possible to identify and understand the meanings of humanization in the teacher-student relationship during the exercise of Supervised Internship, through a practice based on the integrality of being. Keywords: Human Formation. Nursing. Humanization. Education. Supervised Internship. (shrink)

O artigo faz uma reflexão crítica dos impactos da pandemia para as crianças da Educação Infantil no Brasil. Delineia algumas concepções de criança e infância nos discursos normativos, apontando possibilidades que valorizem a experiência infantil.

This article aims to explore a sapiential response to the question of the inner experience of the conflict between the voluntary and the involuntary, which Ricœur alludes to in the first volume of his _Philosophy of the Will_. I take as my starting point Ricœur’s reference in the conclusion to the three pieces of advice given by Descartes to achieve contentment, which Ricœur equates with the virtues of decision, effort and consent. Building on Ricœur’s assertion that we receive the life (...) of the involuntary into the heart of freedom through attention, I seek to explore how attention can help reconcile the conflicting relationship between the voluntary and the involuntary in everyday experience. I do so by proposing a rereading of these three virtues in the light of the practical mediation of attention. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Response to Anthony J. Palmer, “Music Education for the Twenty-First Century: A Philosophical View of the General Education Core”Ana Lcuía FregaI would like to discuss three themes related to Tony Palmer's paper: (1) my agreement with the content of his paper in general, (2) some remarks on elements of what he deals with, including notions about the concept or a vision of what music education should be in the (...) USA and in the rest of the world and an approach to training music teachers at university level in the USA and in the rest of the world, and (3) my personal conclusions.Music is a particular medium of expression, irreplaceable, not interchangeable with any other. It is also a natural medium of human communication. We do not think or propose that schools should create musicians, but that they should aid in the improvement of all humankind.1This quotation of mine allows me to introduce my general agreement with the main content of the first part of Palmer's paper. Neither of us argues against the importance of teaching music within the general system of education. We both promote this and work to make this a fact in our different parts of the world.We both view the tasks known as "music education" as a part of the teaching of the humanities as a way to maintain a certain level of civilization and of a culture; that is, to keep alive the rich tradition in each culture, to develop skills, to listen to, perform, and create music, and to become acquainted with the wealth of masterpieces.Also, as I have said,"I can only give what I have," and "a teacher does not teach what he/she knows but what he/she is."2 I agree with Palmer on the relevance and importance of the task of music educators. There should be a correlation between the school's mission and the quality of the training for prospective teachers for them. This is consistent with Palmer's thinking about the university task when training future music teachers.George Steiner articulated some of the difficulties, limitations, and new possibilities brought into university classrooms by the technology of the global village when he wrote:[Those artifacts] determine a new way to organize human knowledge and to connect contemporary research with previous books. All taxonomies are essentially [End Page 194] philosophical, any library... represents a formalized vision of how the world is structured, and what are the optimum views about both the human mind and the phenomenological whole.3He also adds, "We will not be able to avoid the illusion-and so it is when talking about Humanities-that knowledge is cumulative, that there is an improvement and an unavoidable teleology needed when expressing sentiments and ideas."4By introducing Steiner's ideas, I am opening a line of critical thinking about a kind of "universalization" of both Palmer's concept of whatmusiceducationmeans as well as whether and then how there should be a world-wide dissemination of the training model that he describes for music teachers. I have doubts about the underlying assumptions of these notions and their feasibility.The examples Palmer gives of listening would require an inordinate amount of time and effort. Although this may be a valuable expenditure of resources in some parts of the world, in other parts the focus would be better directed elsewhere. In some places many people do not complete their basic education, do not have access to good nutrition, and have not acquired basic language and communication skills. The big question is, "What should we really teach them?"My point here is that if Michael Murphy's model is indeed an inspiring framework, it may be useful for people belonging to a part of the so-called First World only. Palmer's work should be understood with that consideration in mind. Africa, Latin America, and the Arab world are certainly not looking for these kinds of skills from the music taught at the general level if there happens to be any music taught at all in schools.Multiculturalism is another significant issue in Palmer's paper. I understand the... (shrink)

Este artículo reflexiona sobre la segregación socio-espacial en contextos urbanos, comprendiéndola como una dimensión particular de los procesos de estructuración social en las ciudades capitalistas. Concretamente, se aborda el caso de la ciudad de Córdoba (Argentina). Se parte del supuesto de que el crecimiento urbano por expansión que se registra durante la década del `80, es el resultado de un doble proceso de larga duración. Por un lado, políticas de desarrollo urbano que buscan incrementar la productividad y atraer inversiones privadas (...) que re-cualifiquen espacios estratégicos de la ciudad. Por otro lado, y subsidiario del proceso anterior, la progresiva ocupación diferencial del área periférica de acuerdo a posiciones y condiciones de clase. Se concluye que la suburbanización que se registra en la ciudad forma parte de una política general de (re)valorización urbana orientada hacia el capital privado, y que ya desde los primeros años de la transición democrática pueden observarse en Córdoba incipientes marcas de una periferia segmentada en términos de clase. La estrategia metodológica articula el análisis de datos provenientes de fuentes secundarias (indicadores urbanos, socio-demográficos y habitacionales) con el abordaje cualitativo de intervenciones urbanas y marcos normativos sancionados a mediados de la década del ’80. (shrink)

El insigne filósofo alemán del Siglo XVII, Gottfried Wilhelm Leibniz, plantea el origen del mal como privación. Postula la existencia del mal metafísico, el mal moral y el mal físico. Este ensayo se refiere, básicamente al mal metafísico, que es el principal y la causa de que existan los otros dos. Se tomará en consideración el planteamiento del origen del mal en autores como San Agustín, Descartes, y el del Bayle, se hará referencia a autores antiguos como Aristóteles y se (...) tomarán en cuenta también los planteamientos de los autores contemporáneos a Leibniz como Spinoza y Hobbes. El origen del mal metafísico como limitación o privación en la criatura como algo inevitable porque ésta no es Dios, corresponde a una línea de pensamiento cristiano que se encuentra en San Agustín, Santo Tomás y Descartes, principalmente. En estos filósofos, encontramos el origen del mal en el status ontológico de la criatura. Lo que es propio de Leibniz es justificar este mundo como el mejor de los mundos partiendo de los mundos posibles que había en el entendimiento de Dios, de los cuales Dios escoge el mejor. (shrink)

RESUMO Este ensaio tem como escopo averiguar como o dialogismo se presentifica no texto literário, especificamente em excertos do capítulo Um certo capitão Rodrigo, da obra O tempo e o vento, de Érico Verissimo. Tenciona-se examinar, na materialidade do texto, que procedimentos enunciativo-discursivos foram mobilizados na encenação dialógica da verdade e do pensamento, configurados tal como uma sátira menipeia, e de que forma as categorias da percepção carnavalesca de mundo dessacralizam e submetem ao riso o discurso do poder. ABSTRACT This (...) essay aims to ascertain how dialogism manifests in a literary work. For that purpose, we will focus specifically on some excerpts taken from the chapter A Certain Captain Rodrigo of the novel Time and the Wind, by Érico Veríssimo. We intend to examine, in the materiality of the text, which utterative-discursive procedures were used in the dialogical staging of truth and thought present in the Menippean satire and how the authoritarian discourse is desecrated and subjected to laughter by the categories of the carnivalesque worldview. (shrink)

ABSTRACT This essay aims to investigate a few chronotopes that organize the narrative of Incidente em Antares [Incident in Antares], by Erico Verissimo. In particular, it intends to examine how political polarization and oblivion are constitutive elements of the novel and, for that reason, chronotopic. The first being a motif of chronotopic nature and occupies a permanent place in the (fictionalized) life organization of the society. The second leads to the epilogue of the narrative and reveals the modus operandi and (...) modus vivendi of the actors. Modes that, in turn, establish a relationship with the oblivion and deceit chronotopes related today to fake news. The research intends to understand the vision of man and the world carved in the Verissian universe, if they are still present in society 50 years after the publication of the work or if they have undergone transformations. (shrink)