Risk–benefit assessment is a routine requirement for research ethics committees that review and oversee biomedical research with human subjects. Nevertheless, it remains unclear how to weigh and balance risks to research participants against the social benefits that flow from generating biomedical knowledge. In this article, we address the question of whether there are any reasonable criteria for defining the limit of permissible risks to individuals who provide informed consent for research participation. We argue against any a priori limit to permissible (...) research risks. However, attention to the uncertainty of potential social benefit that can be derived from any particular study warrants caution in exposing prospective research participants to a substantial likelihood of serious harm. (shrink)

Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the (...) underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured. (shrink)

Although established in the law and current practice, the determination of death according to neurological criteria continues to be controversial. Some scholars have advocated return to the traditional circulatory and respiratory criteria for determining death because individuals diagnosed as ‘brain dead’ display an extensive range of integrated biological functioning with the aid of mechanical ventilation. Others have attempted to refute this stance by appealing to the analogy between decapitation and brain death. Since a decapitated animal is obviously dead, and ‘brain (...) death’ represents physiological decapitation, brain dead individuals must be dead. In this article we refute this ‘decapitation gambit.’ We argue that decapitated animals are not necessarily dead, and that, moreover, the analogy between decapitation and the clinical syndrome of brain death is flawed. (shrink)

Despite strong growth in scientific investigation of the placebo effect, understanding of this phenomenon remains deeply confused. We investigate critically seven common conceptual distinctions that impede clear understanding of the placebo effect: (1) verum/placebo, (2) active/inactive, (3) signal/noise, (4) specific/nonspecific, (5) objective/subjective, (6) disease/illness, and (7) intervention/context. We argue that some of these should be eliminated entirely, whereas others must be used with caution to avoid bias. Clearing away the conceptual underbrush is needed to lay down a path to understanding (...) and harnessing placebo effects in clinical medicine. (shrink)

Предназначена для филологов, преподавателей, аспирантов, студентов, а также для всех интересующихся проблемами речевой коммуникации.

Der Beschreibung der zeitlichen Entwicklung lebender Systeme kann eine reine Differentialanalyse nicht genügen. In solchen Fällen muss man sich an Stelle der gewöhnlichen Differentialgleichungen der integraldifferentiellen, bezw. der Integralgleichungen bedienen. Zur leichteren Veranschaulichung der mathematischen Darstellung betrachtet Verfasser zuerst diejenigen Systeme, deren innerer Zustand sich durch ein einziges Parameterc bestimmen lässt. Die zeitliche Entwicklung eines leblosen Systems dieser Klasse werde durch die Differentialgleichung $$\frac{{dc}}{{dt}} = kf...$$ dargestellt, wot=Zeit, undk eine Funktion der äusseren Parameterα, Β, γ. ist. Im Falle eines jeden (...) Systems sind die äusseren Parameterα, Β, γ. charakteristische individuelle Funktionen der Zeit. Misst manc am. Zeitpunktt, so lässt sich die Zukunft des Systems vermittelst der Gleichung berechnen, wenn die zukünftigen Werte der äusseren Parameter gegeben sind. Solche Systeme nennt Verfasser nicht-historische Systeme. Im Falle der lebenden Systeme werde die zeitliche Entwicklung durch die Integral-differentialgleichung $$\frac{{dc}}{{dt}} = k_1 f_1 + \mathop \smallint \limits_{t - \lambda }^t k_2 f_2 dt........$$ dargestellt, wof 1 undf 2 Funktionen des Zustandsparametersc, undk 1 undk 2 Funktionen der äusseren Parameter sind. Das Zeitintegral erstreckt sich auf das vergangene Zeitintervalt-λ →t, woλ einen positiven endlichen konstanten Wert besitzt. Diese Systeme nennt Verfasser historische Systeme. Setzt manH für das darin enthaltene Integralglied, so verwandelt sich die Gleichung in: $$\frac{{dc}}{{dt}} = k_1 f_1 + H..........$$ Misst man nunc am Zeitpunktt, so kann man in diesem Fall die Zukunft des Systems ohne Kenntnis des historischen GliedsH nicht berechnen. Das Vorkommen des historischen IntegralgliedsH nennt Verfasser Chronoholismus. Man kann deshalb die historischen Systeme auch chronoholistische Systeme nennen. Die biologische Interpretation dieser Betrachtungsweise wird vom Verfasser diskutiert, und die Gleichung auf Systeme mit erblichen Eigenschaften ausgedehnt. Es werden zuletzt Systeme mit vielen Zustandsparametern in gewissen einfachen Fällen kurz behandelt. L'analyse différentielle ne suffit pas, selon l'avis de de l'auteur, pour la description de l'évolution des systèmes vivants au cours des temps. Il faut utiliser dans ces cas les équations intégro-différentielles ou intégrales. Pour faciliter le traÎtement mathématique, on peut considérer d'abord les systèmes dont l'état intérieur est défini par un seul paramètrec. L'évolution d'un système inanimé de cette classe se laisse décrire par l'équation différentielle $$\frac{{dc}}{{dt}} = k f,...........$$ oùt=temps, etk est une fonction déterminée des paramètres extérieurs α,Β, γ. Si l'on connaÎtc à un temps donnét, l'état du système à un temps futurt′ se laisse prévoir au moyen de l'équation, quand les valeurs des paramètres extérieurs dans l'intervallet → t∼' sont fixées. L'auteur appelle les systèmes de cette classe des systèmes non-historiques. Pour les systèmes vivants, il faut se servir, selon l'avis de l'auteur, des équations intégro-différentielles. Pour les systèmes définis par un seul paramètrec, on peut se servir, par exemple, de l'équation $$\frac{{dc}}{{dt}} = k_1 f_1 + \mathop \smallint \limits_{t - \lambda }^t k_2 f_2 dt........$$ où k1 et k2 sont des fonctions déterminées des paramètres extérieurs. L'intégrale s'étend sur l'intervallet-λ→ t où λ est positif et constant. En indiquant le terme intégral par le symboleH, on peut écrire $$\frac{{dc}}{{dt}} = k_1 f_1 + H..........$$ La connaissance de c à un temps donnét ne laisse pas prévoir l'état du système à un temps futurt′ sans connaissance du terme historiqueH, quand mÊme les paramètres α, Β, γ,..., seraient des fonctions déterminées du temps dans l'intervallet→t′. L'auteur appelle l'existence du terme intégral historiqueH le chronoholisme. On peut appeler les systèmes de cette classe des systèmes historiques ou chronoholistiques. L'interprétation biologique de cette faÇon de traÎter les systèmes vivants est discutée par l'auteur, qui étend l'équation pour le faire représenter aussi les propriétés héréditaires des Êtres vivants. Quelques cas de systèmes dont l'état intérieur est défini par plusieurs paramètres et plusieurs phases sont traités brièvement. (shrink)

Reviewed Works:G. Priest, R. Routley, Graham Priest, Richard Routley, Jean Norman, First Historical Introduction. A Preliminary History of Paraconsistent and Dialethic Approaches.Ayda I. Arruda, Aspects of the Historical Development of Paraconsistent Logic.G. Priest, R. Routley, Systems of Paraconsistent Logic.G. Priest, R. Routley, Applications of Paraconsistent Logic.G. Priest, R. Routley, The Philosophical Significance and Inevitability of Paraconsistency.

Initially, we perceive an indefinite extension imprecisely, a spread C ; this perception can be visual, aural, or tactile.

SummaryIntense, sustained nursing lengthens inter-birth intervals and is causally linked with low natural fertility. However, in traditional settings, the effects of such nursing on fertility are difficult to disentangle from those of nutrition. Results from an prospective, direct observational study of reproductive function in well-nourished Amele women who nurse intensively and persistently but who also have high fertility are here presented. Endocrine measures show that ovarian activity resumes by median 11·0 months postpartum. Median duration of postpartum amenorrhoea is 11·3 months, (...) time to next conception is 19·0 months, and the inter-birth interval is 28·0 months. Average life time fertility is 6·8. High fertility in Amele women is due both to refractoriness of reproductive function to suckling stimuli, and to maintenance of equivalent age-specific fertility rates across the reproductive life span. (shrink)

Contra Lewis, it is argued that the correspondence theory is a genuine rival theory of truth: it goes beyond the redundancy theory; it competes with other theories of truth; it is aptly summarized by the slogan 'truth is correspondence to fact'; and it really is a theory of truth.

International medical travel occurs when patients cross national borders to purchase medical goods and services. On occasion, physicians in home countries will be the last point of domestic contact for patients seeking healthcare information before they travel abroad for care. When this is the case, physicians have a unique opportunity to inform patients about their options and help guide them towards ethical practices. This opportunity brings to the fore an important question: What role should physicians in more-developed home countries play (...) in promoting or constraining international medical travel towards less-developed destination countries? In our view, critical attention to the decision spaces of patients—defined by the personal circumstances, socio-cultural cues, and legal constraints that inform decision-making—is a useful starting point for evaluating the proper response of physicians to various forms of international medical travel. (shrink)