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)

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)

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.

This article intervenes in a critical debate about the use of consent to distinguish sex from rape. Drawing from critical contract theories, it argues that sexual consent is a cruel optimism that often operates to facilitate, rather than alleviate, sexual violence. Sexual consent as a cruel optimism promises to simplify rape allegations in the popular cultural imagination, confounds the distinction between victims and agents of sexual violence, and establishes certainty for potential victimizers who rely on it to convince themselves and (...) others that their partners implicitly or explicitly agreed to sex. In each of these cases, the power of consent rests in its tendency to obscure sexual violence in a set of questions around victimhood and agency, rather than to clarify whether or when it has occurred. Following in the critical contract tradition, this article argues that the optimistic attachment to the clarifying power of consent helps to explain the persistent commitment to better sexual consent as a ‘solution’ to the problems of rape and sexual violence, and that this ‘solution’ is insufficient to the task. (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 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)

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)

Most liberal political theorists of education argue that it is better to teach students to tolerate diversity, than to protect the potentially illiberal commitments of some members of the political communities. In fact, neither approach is wholly satisfying, yet they remain the focus of much political theorizing about education. This article suggests that this misguided focus is, in part, a consequence of a focus, by liberal political theorists of education, upon the 1987 Mozert v. Hawkins court case. Mozert raised serious (...) questions about the nature of toleration in liberal society, but from an educational standpoint, the Mozert case led political theorists to consider what curricular content is appropriate for liberal political education, rather than on the practices that democratic citizens must cultivate. I turn to Hannah Arendt to offer a critical account of the liberal responses to Mozert and then call for a theory of democratic education that fosters practices of democratic decision-making and has, as its aim, not merely to foster respect for diversity, but to allow future citizens to practice critical engagement with diversity. (shrink)

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)

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 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.

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)

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)

This volume contains an array of essays that reflect, and reflect upon, the recent revival of scholarly interest in the self and consciousness. Various relevant issues are addressed in conceptually challenging ways, such as how consciousness and different forms of self-relevant experience develop in infancy and childhood and are related to the acquisition of skill; the role of the self in social development; the phenomenology of being conscious and its metapsychological implications; and the cultural foundations of conceptualizations of consciousness. Written (...) by notable scholars in several areas of psychology, philosophy, cognitive neuroscience, and anthropology, the essays are of interest to readers from a variety of disciplines concerned with central, substantive questions in contemporary social science, and the humanities. (shrink)

When thought overwhelms the mind, the mind uses the body and the world. Several studies reveal ways that people alone or together use gesture and marks on paper to structure and augment their thought for comprehension, inference, and discovery. The studies show that the mapping of thought to gesture or the page is more direct than the arbitrary mapping to language and suggest that these forms of visual/spatial/action representation are used to “translate” language into mental representations. It is argued that (...) actions in space create patterns in the world that reflect abstractions, that the actions are incorporated into gestures and the patterns into diagrams, a network that integrates gesture, action, the designed world, and abstraction dubbed spraction. (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)