This paper examines the concept of ‘openness with patients’ from the stand-point of the limitations of biomedical ethics. Initially we review contemporary critiques of bioethics and, in particular, of principlism; we relate how other; somewhat neglected, forms of medical ethics can yield useful information and provide moral guidance.The main section of the paper then shows how a bioethical approach to openness misses the social context in our example, the viewpoints of patients; we present some of the increasing wealth of research (...) evidence which points towards patients wanting more information and a greater degree of openness.Finally we put forward that a principlist’s objection to active encouragement of openness might be based on the risk of infringing upon the ‘right not to know’. We reject this by arguing how rights can be trumped. (shrink)

This paper examines the concept of ‘openness with patients’ from the stand-point of the limitations of biomedical ethics. Initially we review contemporary critiques of bioethics and, in particular, of principlism; we relate how other; somewhat neglected, forms of medical ethics can yield useful information and provide moral guidance. The main section of the paper then shows how a bioethical approach to openness misses the social context in our example, the viewpoints of patients; we present some of the increasing wealth of (...) research evidence which points towards patients wanting more information and a greater degree of openness. (shrink)

The goal of improving public health involves the use of different tools, with the law being one way to influence the activities of institutions and individuals. Of the regulatory mechanisms afforded by law to achieve this end, criminal law remains a perennial mechanism to delimit the scope of individual and group conduct. However, criminal law may promote or hinder public health goals, and its use raises a number of complex questions that merit exploration. This examination of the interface between criminal (...) law and public health brings together international experts from a variety of disciplines, including law, criminology, public health, philosophy and health policy, in order to examine the theoretical and practical implications of using criminal law to improve public health. (shrink)

Este manuscrito apresenta um ponto de vista sobre o conhecimento da origem do cosmos. A ciência afirma que o Universo teve um começo com o tempo, mas também declara que nenhuma lei natural pode ser aplicada no tempo inicial. Considerando que se trata de algo exclusivo da ciência divina, sugere-se então a instrumentalidade da fé para se conhecer aquilo que de fato é relevante sobre o início da história.

Séculos de intenso trabalho no discurso da origem da vida levaram a ciência a nenhuma descoberta significativa. As teorias mais progressivas se estagnaram no problema central da origem da informação genética, inimaginavelmente distante de qualquer concepção humana. Aparentemente o Criador reservou para si o conhecimento absoluto deste extraordinário acontecimento. Mas há algo surpreendente nessa investigação que está ao alcance do homem.

A study was undertaken of the views of users of two genitourinary medicine (GUM) clinics in England on unlinked anonymous testing (UAT) for HIV. The UAT programme measures the prevalence of HIV in the population, including undiagnosed prevalence, by testing residual blood (from samples taken for clinical purposes) which is anonymised and irreversibly unlinked from the source. 424 clinic users completed an anonymous questionnaire about their knowledge of, and attitudes towards, UAT. Only 1/7 (14%) were aware that blood left over (...) from clinical testing may be tested anonymously for HIV. A large majority (89%) said they would agree to their blood being tested, although 74% wanted the opportunity to consent. These findings indicate broad support for UAT of blood in a group of patients whose samples are included in the HIV surveillance programme. The findings suggest the need for greater attention to be given to the provision of information and, if replicated in a larger survey, may justify a reappraisal of UK policy on UAT. (shrink)

This article critically engages with Mandeville et al.'s case discussion of using social networking services for the purposes of contact tracing in infectious disease outbreaks. It will be argued that their discussion may be overstating the utility of such approaches, while simultaneously underestimating the ethical concerns that arise from this method of contact tracing. The article separates between ethical and technological concerns and suggests that due to the particular design of networking sites such as Facebook and the usage patterns of (...) subscribers, the positive effect of contact tracing through such services may be overstated. At the same time, using social networking sites raises serious concerns regarding the privacy of patients and the ownership of information posted online. (shrink)

The similarity of documents in a large database of published Fractals articles was examined for redundancy. Three different text matching techniques were used on publisheds to identify redundancy candidates, and predictions were verified by reading full text versions of the redundancy candidate articles. A small fraction of the total articles in the database was judged to be redundant. This was viewed as a lower limit, because it excluded cases where the concepts remained the same, but the text was altered substantially.Far (...) more pervasive than redundant publications were publications that did not violate the letter of redundancy but rather violated the spirit of redundancy. There appeared to be widespread publication maximization strategies. Studies that resulted in one comprehensive paper decades ago now result in multiple papers that focus on one major problem, but are differentiated by parameter ranges, or other stratifying variables. This ‘paper inflation’ is due in large part to the increasing use of metrics (publications, patents, citations, etc) to evaluate research performance, and the researchers’ motivation to maximize the metrics. (shrink)

Sarah A. Mattice develops a comparative intervention in contemporary metaphilosophy. Drawing on resources from hermeneutics, cognitive linguistics, aesthetics, and Chinese philosophy, she explores how philosophical language is deeply intertwined with the definition and practice of the discipline.

The ability to reason independently from one's own goals or beliefs has long been recognised as a key characteristic of the development of formal operational thought. In this article we present the results of a study that examined the correlates of this ability in a group of 10-year-old children ( N = 61). Participants were presented with conditional and relational reasoning items, where the content was manipulated such that the conclusion to the arguments were either congruent, neutral, or incongruent with (...) beliefs, and either logically valid or logically invalid. Participants also received a measure of working memory capacity (the counting span task) and a measure of inhibitory control (the stop signal task). Indices of belief bias and logical reasoning on belief-based problems were predicted independently by both measures. In contrast logical reasoning on belief neutral problems was predicted by working memory alone. The findings suggest that executive functions play a key role in the development of children's ability to decontextualise their thinking. (shrink)

Die demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im deutschen Gesundheitswesen in Zukunft weiter verschärfen. Soll nicht nur kurzfristig akuten Sparzwängen ausgewichen werden, steht – wie in verschiedenen Ländern bereits geschehen – auch Deutschland auf Dauer eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Eines der seit einiger Zeit häufig öffentlich zitierten Kriterien der Verteilung von Mitteln in der Gesundheitsversorgung ist die Eigenverantwortung von Patienten. Deren Berücksichtigung in der Allokation (...) von Ressourcen birgt allerdings zahlreiche Probleme. Der vorliegende Beitrag untersucht die gerechtigkeitstheoretischen Grundlagen und die praktischen Probleme bzw. die möglichen Konsequenzen von Eigenverantwortung als Verteilungskriterium im Gesundheitswesen. Auf der Grundlage eines alternativen gerechtigkeitstheoretischen Vorschlags werden drei Möglichkeiten skizziert, Eigenverantwortung von Patienten im deutschen Gesundheitswesen in gerechter Weise stärker zu betonen. (shrink)

The use of placebo in clinical trials has been repeatedly challenged as being unacceptable from an ethical point of view. The present paper responds to this criticism by taking up the issue in the light of the pertinent provisions of the Helsinki Declaration. Examples from different therapeutic areas are given that highlight the importance of placebo in situations in which its use is acceptable according to the Declaration. Particular emphasis is given to the question of active control trials, which, under (...) conditions of low assay sensitivity, may become an ethically less acceptable approach than the use of a placebo control. (shrink)

Este artigo contém um estudo sobre a Ciência a partir do ponto de vista bíblico, por meio da fé na revelação divinamente inspirada. A Bíblia revela a origem e a plenitude da Ciência no ato da criação do Universo e a apresenta como uma dádiva especial de Deus aos homens. As Escrituras também demonstram que a Ciência genuína existe para glorificar a Deus, sendo a sua instrumentalidade uma forma excelente de comunicação divina.

This paper examines some of the possible legal implications of the production, marketing and use of expert systems. The relevance of a legally useful definition of expert systems, comprising systems designed for use both by laymen and professionals, is related to the distinctions inherent in the legal doctrine underlying provision of goods and provision of services. The liability of the sellers and users of, and contributors to, expert systems are examined in terms of professional malpractice as well as product liability. (...) A recurring theme indicates that legislators may be inclined to restrict possibilities of liability suits in order to avoid disincentives to the creation of expert systems. (shrink)

Socrates op de markt, Filosofie in bedrijf was first published in the Netherlands in 1997 and reprinted in 1999.1 It was translated into German and published in Germany in late 2000. The book covers the need today for Socratic dialogue, its methods, its uses and related concepts. These include elenchus (the refutation of what one thought one knew); maieutics (Socratic midwifery making latent knowledge conscious); the relationship of knowledge to feeling, virtue and the formation of personality; and the distinction between (...) three types of knowledge: scientific (episteme), professional (techne) and practical wisdom (phronesis). Our extracts — the first in English — set out Kessels’ arguments for using Socratic dialogue today, his account of its unique role in organisational learning, and a case history: a dialogue with a top management team in which elenchus plays a signal part as they seek to define a policy for handling redundancies. (shrink)

Contemporary scholarship interprets Sergej Bulgakov’s sophiology as an engagement of Orthodox theology with the modern world and as being on its way to becoming a political theology. In this paper I undertake a re-evaluation of the kind of engagement sophiology was and was intended to be, and of the kind of world it was destined for. It will be argued that sophiology was not so much a political-theological engagement with the world concentrating on the relation of religion and politics or (...) state and church, but rather an economic-theological engagement in the tradition of oikonomia theology that tried to understand the world in its relation to and as part of divine oikonomia. Furthermore, the world sophiology promotes engagement with is not only the real contemporary world, or the sociological ideal type of modernity, but primarily the world as such, this secular and human world over and against the divine and transcendent world. (shrink)

Biomedicine is a global enterprise constructed upon the belief in the universality of scientific truths. However, despite huge scientific advances over recent decades it has not been able to formulate a specific and universal definition of death: In fact, in its attempt to redefine death, the concept of death appears to have become immersed in ever increasing vagueness and ambiguity. Even more worrisome is that bioethics, in the form of principlism, is also endeavouring to become a global enterprise by claiming (...) neutrality. It appears that the discourse within both disciplines have similarly manipulated the boundaries of death to include the “dying”. This paper argues that the redefinition of death debate in biomedicine reveals a concept of personhood which is profoundly western in origin and which is in accordance to the concept adhered to within principlism. Biomedicine and bioethics do not appear to acknowledge the limitations of their own world view and hence lack an understanding of their applicability and appropriateness in diverse social and cultural contexts; a situation which adds credence to claims as to the hegemonic and imperialistic nature of all such global enterprises. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:NEWMAN'S PSYCHOLOGICAL DISCOVERY: THE ILLATIVE SENSE (V. Continued) 15. The Universals. A long and vehement dispute once raged about the reality of universals. Are they only mental creations, forged by the human brain, without any reality outside them, or have they some independent existence apart from their mental reality? Anyhow, there was an apparent contradiction between die universal character of our ideas and the individual character of concrete things. (...) The Scholastics solved this problem by drawing clear distinctions. An idea is an abstraction; as soon as it becomes applicable to a number of objects or things in the same sense, it is a universal idea. The "direct universal" (universale directum seu metaphysicum) as such has no existence apart from our minds, because an existing thing is always bound up with concrete, determining, individualizing notes, and it is these very circumstances or accidents which are ignored by the mind as it strips the thing of its individual characteristics. When the mind reflects on this "direct universal," i.e., on the abstract essence of the thing, it sees that this is to be found in many more things and that it is identical in all those things, and in this way the "reflex or logical universal" is formed (universale reflexum seu logicum). This same essence or quiddity is not really different from the thing itself, but the mind makes abstraction of all accidents, and this foundation makes it possible to apply this idea in die same sense to all other beings of the same kind, whether they are actually existing or not. In other words the universal as a universal has only reality in the mind but it has a foundation or a ground in the thing itself. Newman was not so well acquainted with Scholasticism that he knew and mastered the solution of the problem. As a matter of fact he approached it from quite another angle. Hence when scholastically trained minds read some of his statements on universals, they may feel shocked. They sound very curious, they seem incon418 DR. ZENO, O.F.M. CAP.419 sistent with each other, they apparenüy imply a negation of the objective reality of universals. This makes it necessary to compare the texts and to explain his meaning. a. Newman Inconsistent. We should never lose sight of the fact that Newman had no intention at all to enter the province of philosophy in the restricted sense of the word. "I am only contemplating the mind as it moves in fact, by whatever hidden mechanism,"1 that is what could be put as a heading to every page of the Grammar of Assent. And when he virtually deals with metaphysics, he wants us to consider his statements as hypotheses, or as propositions stated only by the way, and in this department he always wishes "to speak under correction." This explains how he could refer to the universale metaphy sicum and the universale directum in a very correct way without realizing he was teaching Scholastic doctrine. As far as I know, it is Professor Walgrave who has first drawn attention to this fact,2 when he dealt with Newman's alleged conceptualism. Newman states that "even one act of cruelty, ingratitude, generosity or justice reveals to us at once intensive the immutable distinction between those qualities and their contraries; that is, in that particular instance and pro bac vice."3 The same holds for the opposites: right and wrong, true and false, just and unjust, beautiful and deformed.4 In one experience, therefore, he sees a thing as an immutable, absolute quiddity, which objectively and in the same sense belongs to all possible things of the same kind, although the mind does not yet explicidy confirm this universal applicability. The contemplated quality remains limited to the particular case; but in its absoluteness it is stripped of all individual, changeable and concrete characteristics. This is the metaphysical universal of the Scholastics. But Newman also mentions the logical universal when he says: "As we form our notion of whiteness from the actual sight of snow, a lily or a cloud, so, after experiencing the sentiment of approbation which arises in us on the sight of certain... (shrink)

Central to the concept of a learning organization is the ability to set up dialogues or conversational inquiries. But the techniques to accomplish this have nowhere in the literature been adequately described. This reduces the concept of a leaming organization to an unattainable ideal. These techniques were for ages, in the form of dialectic, an important instrument for investigation, until they were replaced by the formation of scientific theories. But several fundamental organizational problems cannot be solved by scientific knowledge. Therefore (...) dialectic remains a necessary instrument to start and structure processes of collective leaming. (shrink)