Introduction No consent for health and medical research is appropriate when the criteria for a waiver of consent are met, yet some ethics committees and data custodians still require informed consent. Methods A single-blind parallel-group randomised controlled trial: 1129 families of children born at a South Australian hospital were sent information explaining data linkage of childhood immunisation and hospital records for vaccine safety surveillance with 4 weeks to opt in or opt out by reply form, telephone or email. A subsequent (...) telephone interview gauged the intent of 1026 parents (91%) in relation to their actions and the sociodemographic differences between participants and non-participants in each arm. Results The participation rate was 21% (n=120/564) in the opt-in arm and 96% (n=540/565) in the opt-out arm (χ2 (1 df) = 567.7, p<0.001). Participants in the opt-in arm were more likely than non-participants to be older, married/de facto, university educated and of higher socioeconomic status. Participants in the opt-out arm were similar to non-participants, except men were more likely to opt out. Substantial proportions did not receive, understand or properly consider study invitations, and opting in or opting out behaviour was often at odds with parents' stated underlying intentions. Conclusions The opt-in approach resulted in low participation and a biased sample that would render any subsequent data linkage unfeasible, while the opt-out approach achieved high participation and a representative sample. The waiver of consent afforded under current privacy regulations for data linkage studies meeting all appropriate criteria should be granted by ethics committees, and supported by data custodians. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12610000332022. (shrink)
The second volume in the Pittsburgh Series in the Philosophy of Science, this collection of papers covers a wide range of topics: the development of Newton's First Law comes under scrutiny in papers by Hanson and Ellis; Putnam attempts to clarify certain conceptual issues at the foundations of quantum theory; David Hawkins discusses the relation of teleology and thermodynamics from a neo-Aristotelian viewpoint; Morrison examines certain topics in astronomy; empiricism is studied by Feyerabend from a number of aspects, and (...) is found wanting; finally, Rescher looks at the connections of ethical principles and scientific research, with special reference to the goals, means, and standards of proof, and the dissemination of results of the latter. On the whole, a worthy successor to the first volume, just as certain to raise interest within diverse areas of philosophy.—P. J. M. (shrink)
Preface Introduction Christopher J. Berry: Adam Smith: Outline of Life, Times, and Legacy Part One: Adam Smith: Heritage and Contemporaries 1: Nicholas Phillipson: Adam Smith: A Biographer's Reflections 2: Leonidas Montes: Newtonianism and Adam Smith 3: Dennis C. Rasmussen: Adam Smith and Rousseau: Enlightenment and counter-Enlightenment 4: Christopher J. Berry: Adam Smith and Early Modern Thought Part Two: Adam Smith on Language, Art and Culture 5: Catherine Labio: Adam Smith's Aesthetics 6: James Chandler: Adam Smith as Critic 7: (...) Michael C. Amrozowicz: Adam Smith: History and Poetics 8: C. Jan Swearingen: Adam Smith on Language and Rhetoric: The Ethics of Style, Character, and Propriety Part Three: Adam Smith and Moral Philosophy 9: Christel Fricke: Adam Smith: The Sympathetic Process and the Origin and Function of Conscience 10: Duncan Kelly: Adam Smith and the Limits of Sympathy 11: Ryan Patrick Hanley: Adam Smith and Virtue 12: Eugene Heath: Adam Smith and Self-Interest Part Four: Adam Smith and Economics 13: Tony Aspromourgos: Adam Smith on Labour and Capital 14: Nerio Naldi: Adam Smith on Value and Prices 15: Hugh Rockoff: Adam Smith on Money, Banking, and the Price Level 16: Maria Pia Paganelli: Commercial Relations: from Adam Smith to Field Experiments Part Five: Adam Smith on History and Politics 17: Spiros Tegos: Adam Smith: Theorist of Corruption 18: David M. Levy & Sandra J. Peart: Adam Smith and the State: Language and Reform 19: Fabrizio Simon: Adam Smith and the Law 20: Edwin van de Haar: Adam Smith on Empire and International Relations Part Six: Adam Smith on Social Relations 21: Richard Boyd: Adam Smith, Civility, and Civil Society 22: Gavin Kennedy: Adam Smith on Religion 23: Samuel Fleischacker: Adam Smith and Equality 24: Maureen Harkin: Adam Smith and Women Part Seven; Adam Smith: Legacy and Influence 25: Spencer J. Pack: Adam Smith and Marx 26: Craig Smith: Adam Smith and the New Right 27: Tom Campbell: Adam Smith: Methods, Morals and Markets 28: Amartya Sen: The Contemporary Relevance of Adam Smith. (shrink)
A terminally ill man requests that his life be brought to a peaceful end by the doctor overseeing his care. The doctor, an atheist, regretfully declines. The patient, unsatisfied by the answer and increasingly desperate for relief, presses the doctor for an explanation. During the ensuing dialogue the philosophical, ethical and emotional arguments brought to bear by both the doctor and the patient are dissected.
The motives behind the author’s decision to resuscitate a patient are examined. This is prompted by the realisation that he ignored the man’s apparent wish not to be saved for fear of criticism from both relatives and colleagues. The way in which decisions are made when the interests of the doctor and the patient clash are briefly explored. Self interest may play a more significant role than is commonly accepted.
This is an imagined dialogue between the ghost of a young suicide and an old schoolfriend. The living discussant, a doctor now, regrets that he did not realise how deeply troubled his friend was, and wants to know if and in what way he could have dissuaded the depressed schoolboy from his irrevocable decision. The ghost, however, confident in death, free from mental anguish, challenges the doctor’s presumptions. What right does he, does society have, to stop, detain, dissuade, and “cure” (...) those who wish to kill themselves? The issues of sanity, free will, and societal judgment are explored in an encounter that can never take place, but which sheds light on the thought processes of the suicidal. (shrink)
Recognising a diminution in his emotional response to patients’ deaths, the author analyses in detail his internal reactions in an attempt to understand what he believes is a common phenomenon among doctors. He identifies factors that may erode the connection between patient and physician: an instinct to separate oneself from another’s suffering, professional unease in the case of therapeutic failure, the atrophying effect of perceived hopelessness, insincerities in the establishment of the initial relationship, and an inability to imbue the sedated (...) or unconscious patient with human qualities. He concludes that recognition of these negative influences, without necessarily changing behaviours that are natural, may be a first step towards protecting doctors against what might be an otherwise insidious process of dehumanisation. (shrink)
According to the thesis of divine ‘middle knowledge’, first propounded by the Jesuit theologian Luis de Molina in the sixteenth century, subjunctive conditionals stating how free agents would freely respond under counter-factual conditions may be straightforwardly true, and thus serve as the objects of divine knowledge. This thesis has provoked considerable controversy, and the recent revival of interest in middle knowledge, initiated by Anthony Kenny, Robert Adams and Alvin Plantinga in the 1970s, has led to two ongoing debates. One is (...) a theoretical debate over the very intelligibility of middle knowledge;1 the other is a practical debate over its philosophical and theological utility.2. (shrink)
In ‘Omniprescient Agency’ David P. Hunt challenges an argument against the possibility of an omniscient agent. The argument – my own in ‘Agency and Omniscience’ – assumes that an agent is a being capable of intentional action, where, minimally, an action is intentional only if it is caused, in part, by the agent's intending. The latter, I claimed, is governed by a psychological principle of ‘least effort’, namely, that no one intends without antecedently feeling that deliberate effort is needed (...) to achieve desired goals, such effort has a chance of success, and it is yet contingent whether the effort will be expended and the goals realized. The goals can be anything from immediate intentional doings, tryings or basic actions, to remote and perhaps unlikely consequences of actions, e.g. global justice. The thrust of the principle is that it would be impossible for a wholly rational self-aware agent to intend without a background presumption of an open future as concerns the desired state and the means to it. But this presumption embodies a sense of contingency which, in turn, requires an acknowledged ignorance about what the future holds, otherwise the future would appear closed relative to present knowledge with the desired state presented as either guaranteed or ruled out . Regardless whether this self-directed attitude is accurate, it follows that intentional action precludes complete knowledge of one's present and future. Consequently, no omniscient or omniprescient being can be an agent. (shrink)
The principle that One cannot deliberate over what one already knows is going to happen, when suitably qualified, has seemed to many philosophers to be about as secure a truth as one is likely to find in this life.Fortunately, poses little restriction on human deliberation, since the conditions which would trigger its prohibition seldom arise for us: our knowledge of the future is intermittent at best, and those things of which we do have advance knowledge are not the sorts of (...) things over which we would deliberate in any case. But matters appear to stand otherwise with an all-knowing agent such as God is traditionally conceived to be; for what an omniprescient deity ‘already knows is going to happen’ is everything that is going to happen; and if He cannot deliberate over such things, there is nothing over which He can deliberate. (shrink)
The paper that follows continues a discussion with Tomis Kapitan in the pages of this journal over the compatibility of divine agency with divine foreknowledge. I had earlier argued against two premises in Kapitan's case for omniscient impotence: that intentionally A-ing presupposes prior acquisition of the intention to A, and that acquiring the intention to A presupposes prior ignorance whether one will A. In response to my criticisms, Kapitan has recently offered new defences for these two premises. I show in (...) reply why neither defence succeeds in rehabilitating the case against omniscient agency. (shrink)
In "Omniprescient Agency" (Religious Studies 28, 1992) David P. Hunt challenges an argument against the possibility of an omniscient agent. The argument—my own in "Agency and Omniscience" (Religious Studies 27, 1991)—assumes that an agent is a being capable of intentional action, where, minimally, an action is intentional only if it is caused, in part, by the agent's intending. The latter, I claimed, is governed by a psychological principle of "least effort," viz., that no one intends without antecedently feeling that (...) (i) deliberate effort is needed to achieve desired goals, (ii) such effort has a chance of success, and (iii) it is yet contingent whether the effort will be expended and the goals realized. The goals can be anything from immediate intentional doings, tryings or basic actions, to remote and perhaps unlikely consequences of actions, e.g., global justice. The thrust of the principle is that it would be impossible for a wholly rational self-aware agent to intend without a background presumption of an open future as concerns the desired state and the means to it. But this presumption embodies a sense of contingency which, in turn, requires an acknowledged ignorance about what the future holds, otherwise the future would appear closed relative to present knowledge with the desired state presented as either guaranteed (necessary) or ruled out (impossible). Regardless whether this self-directed attitude is accurate, it follows that intentional action precludes complete knowledge of one's present and future. Consequently, no omniscient or omniprescient being can be an agent. (shrink)
Wittgenstein's Method: Neglected Aspects By Gordon Baker. Oxford: Blackwell, 2004 pp. 328. £40.00 HB.. Wittgenstein's Copernican Revolution: The Question of Linguistic Idealism By Ilham Dilman. Basingstoke: Palgrave, 2002. pp. 240. £52.50 HB. Wittgenstein: Connections and Controversies By P. M. S. Hacker. Oxford: Oxford University Press,. pp. 400. £45.00 HB; £19.99 PB. Wittgenstein's Philosophical Investigations: An Introduction By David G. Stern. Cambridge: Cambridge University Press, 2004. pp. 224. £40.00 HB; £10.99 PB.