ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

A new technique for proving realisability results is presented, and is illustrated in detail for the simple case of arithmetic minus induction. CL is a Gentzen formulation of classical logic. CPQ is CL minus the Cut Rule. The basic proof theory and model theory of CPQ and CL is developed. For the semantics presented CPQ is a paraconsistent logic, i.e. there are non-trivial CPQ models in which some sentences are both true and false. Two systems of arithmetic minus induction are (...) introduced, CL-A and CPQ-A based on CL and CPQ, respectively. The realisability theorem for CPQ-A is proved: It is shown constructively that to each theorem A of CPQ-A there is a formula A *, a so-called “realised disjunctive form of A ”, such that variables bound by essentially existential quantifiers in A * can be written as recursive functions of free variables and variables bound by essentially universal quantifiers. Realisability is then applied to prove the consistency of CL-A, making use of certain finite non-trivial inconsistent models of CPQ-A. (shrink)

In a recent article, ‘Why lockdown of the elderly is not ageist and why levelling down equality is wrong’, Savulescu and Cameron argue that a selective lockdown of older people is not ageist because it would treat people unequally based on morally relevant differences. This response argues that a selective lockdown of older people living in long-term care homes would be unjust because it would allow the expansive liberties of the general public to undermine the basic liberties of older people, (...) and because it would discriminate on the basis of extrinsic disadvantages. (shrink)

The paraconsistent system CPQ-ZFC/F is defined. It is shown using strong non-finitary methods that the theorems of CPQ-ZFC/F are exactly the theorems of classical ZFC minus foundation. The proof presented in the paper uses the assumption that a strongly inaccessible cardinal exists. It is then shown using strictly finitary methods that CPQ-ZFC/F is non-trivial. CPQ-ZFC/F thus provides a formulation of set theory that has the same deductive power as the corresponding classical system but is more reliable in that non-triviality is (...) provable by strictly finitary methods. This result does not contradict Gödel's incompleteness theorem because the proof of the deductive equivalence of the paraconsistent and classical systemss use non-finitary methods. (shrink)

It is shown that logical contradictions are derivable from natural translations into first order logic of the description and background assumptions of the Soros Game, and of other games and social contexts that exhibit conflict and reflexivity. The logical structure of these contexts is analysed using proof-theoretic and model-theoretic techniques of first order paraconsistent logic. It is shown that all the contradictions that arise contain the knowledge operator K. Thus, the contradictions do not refer purely to material objects, and do (...) not imply the existence of inconsistent, concrete, physical objects, or the inconsistency of direct sensory experience. However, the decision-making of rational self-interested agents is stymied by the appearance of such intensional contradictions. Replacing the rational self-interest axioms with axioms for an appropriate moral framework removes the inconsistencies. Rational moral choice in conflict-reflexive social contexts then becomes possible. (shrink)

This paper is motivated by the search for a natural and deductively powerful extension of classical set theory. A theory of properties U is developed, based on a system of relevant logic related to RQ. In U the set {a, b, c,...} is identified with the property [x: x=a x=b x=c...]. The universe of all sets V, is identified with the property of being a hereditary set. The main result is that relevant implication collapses to material implication for sentences with (...) quantifiers restricted to V. This demonstrates the naturalness of the system. However, an aparent lack of deductive power leads to the conclusion that the best extension of classical set theory is to be found in intensional theories with the unrestricted comprehension schema based on weak relevant logics. The author has obtained similar collapses of to for these systems. (shrink)

In this paper we consider a natural generalization of the Principle of Instantial Relevance and give a complete characterization of the probabilistic belief functions satisfying this principle as a family of discrete probability functions parameterized by a single real δ ∊ [0, 1).

We consider the problem of induction over languages containing binary relations and outline a way of interpreting and constructing a class of probability functions on the sentences of such a language. Some principles of inductive reasoning satisfied by these probability functions are discussed, leading in turn to a representation theorem for a more general class of probability functions satisfying these principles.

Volume 20, Issue 5, June 2020, Page 36-37.

BackgroundEarly in the COVID-19 pandemic, the urgent need to discover effective therapies for COVID-19 prompted questions about the ethical problem of randomization along with its widely accepted solution: equipoise. In this scoping review, uses of equipoise in discussions of randomized controlled trials of COVID-19 therapies are evaluated to answer three questions. First, how has equipoise been applied to COVID-19 research? Second, has equipoise been employed accurately? And third, do concerns about equipoise pose a barrier to the ethical conduct of COVID-19 (...) RCTs?MethodsGoogle Scholar and Pubmed were searched for articles containing substantial discussion about equipoise and COVID-19 RCTs. 347 article titles were screened, 91 full text articles were assessed, and 48 articles were included. Uses of equipoise were analyzed and abstracted into seven categories.Results and discussionApproximately two-thirds of articles used equipoise in a way that is consistent with the concept. They invoked equipoise to support RCTs of specific therapies, RCTs in general, and the early termination of RCTs after achieving the primary outcome. Approximately one-third of articles used equipoise in a manner that is inconsistent with the concept. These articles argued that physician preference, widespread use of unproven therapies, patient preference, or expectation of therapeutic benefit may undermine equipoise and render RCTs unethical. In each case, the purported ethical problem can be resolved by correcting the use of equipoise.ConclusionsOur findings highlight the continued relevance of equipoise as it supports the conduct of well-conceived RCTs and provides moral guidance to physicians and researchers as they search for effective therapies for COVID-19. (shrink)

The aim of this study is to explore how nurses perceive patient participations of patients over 75 years old undergoing hemodialysis treatment in dialysis units, and of their next of kin. Ten nurses told stories about what happened in the dialysis units. These stories were analyzed with critical discourse analysis. Three discursive practices are found: (1) the nurses’ power and control; (2) sharing power with the patient; and (3) transferring power to the next of kin. The first and the predominant (...) discursive practice can be explained with an ideology of paternalism, in which the nurses used biomedical explanations and the ethical principle of benefice to justify their actions. The second can be explained with an ideology of participation, in which the nurses used ethical narratives as a way to let the patients participate in the treatment. The third seemed to involve autonomous decision-making and the ethical principle of autonomy for the next of kin in the difficult end-of-life decisions. (shrink)

We have identified a sample of 53 societies outside of the classical Himalayan and Marquesean area that permit polyandrous unions. Our goal is to broadly describe the demographic, social, marital, and economic characteristics of these societies and to evaluate some hypotheses of the causes of polyandry. We demonstrate that although polyandry is rare it is not as rare as commonly believed, is found worldwide, and is most common in egalitarian societies. We also argue that polyandry likely existed during early human (...) history and should be examined from an evolutionary perspective. Our analysis reveals that it may be a predictable response to a high operational sex ratio favoring males and may also be a response to high rates of male mortality and, possibly, male absenteeism. Other factors may contribute, but our within-polyandry sample limits analysis. (shrink)

Big Ideas for Little Kids includes everything a teacher, a parent, or a college student needs to teach philosophy to elementary school children from picture books. Written in a clear and accessible style, the book explains why it is important to allow young children access to philosophy during primary-school education. Wartenberg also gives advice on how to construct a "learner-centered" classroom, in which children discuss philosophical issues with one another as they respond to open-ended questions by saying whether they agree (...) or disagree with what others have said. (shrink)

Arguing that psychologists and their predecessors have invariably relied on metaphors in articulation, the contributors to this volume offer a new "key" to understanding a critically important area of human knowledge by specifying the major metaphors.

The relations between reason, motivation and value present problems which, though ancient, remain intractable. If values are objective and rational how can they move us and if they are dependent on our contingent desires how can they be rational? E. J. Bond makes a bold attack on this dilemma. The widespread view among philosophers today is that judgements contain an irreducible element of personal commitment. To this Professor Bond proposes an account of values as objective and value judgements as true (...) or false, employing a distinction between grounding and motivating reasons to establish their connection with action. He defines and tests his position against a number of recent theories, providing in the process forceful criticism of Williams, Wiggins, Foot, Narveson and Nagel, among others. A distinctive contribution to the subject, it will stimulate interest and worthwhile debate among philosophers, while also serving as an introduction to this vital topic. (shrink)

A dialogue between a foreign philosopher and a powerful statesman outline Plato's reflections on the family, the status of women, property rights, and criminal law.

Email archives are important historical resources, but access to such data poses a unique archival challenge and many born-digital collections remain dark, while questions of how they should be effectively made available remain. This paper contributes to the growing interest in preserving access to email by addressing the needs of users, in readiness for when such collections become more widely available. We argue that for the content of email to be meaningfully accessed, the context of email must form part of (...) this access. In exploring this idea, we focus on discovery within large, multi-custodian archives of organisational email, where emails’ network features are particularly apparent. We introduce our prototype search tool, which uses AI-based methods to support user-driven exploration of email. Specifically, we integrate two distinct AI models that generate systematically different types of results, one based upon simple, phrase-matching and the other upon more complex, BERT embeddings. Together, these provide a new pathway to contextual discovery that accounts for the diversity of future archival users, their interests and level of experience. (shrink)

В статье философия характеризуется на основе дискурсной парадигмы анализа: как текст, интеллектуальная деятельность и коммуникация. Характеризуются два равнозначных аспекта философского дискурса - когнитивный и коммуникативный. Обсуждается феномен философских контроверз, специфика философского спора, выразительные (знаковые) средства философского дискурса, роль мировоззренческого дискурса в современной общественно-политической ситуации в стране.

Background: Despite an increase in health research conducted in Africa, there are still inadequate human resources with research ethics training and lack of local long-term training opportunities in research ethics. A research ethics training program named United States-Mali Research Ethics Training Program (US-Mali RETP) was established through a partnership between the George Washington University Milken Institute School of Public Health (GWSPH), USA and University of Sciences, Techniques & Technologies of Bamako (USTTB), to address the critical need for improved bioethics training, (...) leadership, and policy in Mali. Methods: The aims of the capacity building programme are achieved by leveraging US and Africa-based expertise to strengthen research ethics education and capacity through: (1) intensive faculty development to design ethics training curricula; (2) development of a research ethics specialization within the existing Masters of Public Health program (MPH); and (3) establishing professional development courses through short-term training workshops and webinars to address research and professional needs in ethics. Results: The program will strengthen USTTB’s capacity of research ethics by training at least 15 MPH students over 5 years to prepare the next generation of ethics researchers. During the first two years of the program, a new ethics training curricula was developed, two cohorts of Master’s students were enrolled, and a series of webinars and workshops were conducted with participation of Malian and international researchers. Conclusions: US-Mali RETP will promote a sustainable bioethics enterprise at USTTB, and enable dissemination of research ethics training to increase health research capacity in Mali. (shrink)

Although the equally pervasive and abstract concept of space has generated a vast body of disciplines, time, and the related idea of "becoming" (transforming, ...

About 6% of women in the world live in countries that ban all abortions, and 34% in countries that only allow abortion to preserve maternal life or health. In the USA, over the last decades—even before Dobbs v. Jackson Women’s Health Organization overturned the federal right to abortion—various states have sought to restrict abortion access. Often times, this legislation has been advanced based on legislators’ personal moral values. At the bedside, in contrast, provision of abortion care should adhere to the (...) normative principles of medical ethics and reproductive justice, centreing patients and their individual reproductive intentions and desires. Abortion regulations, through their influence on patients and providers, may facilitate or impede such ethical care at the bedside. In this paper, we present a framework to model how abortion legislation should fit into the patient–provider relationship and to clarify the dynamics by which legislation may affect healthcare encounters. Our proposed framework serves as a tool to analyse the ethical impact of abortion regulations. We propose a model for assessing abortion policies based not on legislators’ or advocates’ individual moral claims, but on the shared, normative framework of clinical medical ethics. Through contrasting case studies, we demonstrate how a robust normative ethical framework can recentre patients and their reproductive needs. Our model is one way to account for—and safeguard—patients’ diverse viewpoints and needs in the development of abortion policy, and it can serve to ground narratives for advocacy by healthcare workers and their professional organisations. (shrink)