This is the twenty-sixth volume in the Library of Living Philosophers, a series founded by Paul A. Schilpp in 1939 and edited by him until 1981, when the editorship was taken over by Lewis E. Hahn. This volume follows the design of previous volumes. As Schilpp conceived this series, every volume would have the following elements: an intellectual autobiography of the philosopher, a series of expository and critical articles written by exponents and opponents of the philosopher's thought, replies to these (...) critics and commentators by the philosopher, and as nearly complete a bibliography of the published work of the philosopher as possible. (shrink)
A compilation of all previously published writings on philosophy and the foundations of mathematics from the greatest of the generation of Cambridge scholars that included G.E. Moore, Bertrand Russell, Ludwig Wittgenstein and Maynard Keynes.
Health research initiatives worldwide are growing in scope and complexity, particularly as they move into the developing world. Expanding health research activity in low- and middle-income countries has resulted in a commensurate rise in the need for sound ethical review structures and functions in the form of Research Ethics Committees (RECs). Yet these seem to be lagging behind as a result of the enormous challenges facing these countries, including poor resource availability and lack of capacity. There is thus an urgent (...) need for ongoing capacity and resource development in these regions in general, and in Africa in particular. Similarly, there is a need for research and initiatives that can identify existing capacity and funding and indicate the areas where this needs to be developed.This discussion paper argues that the Mapping African Research Ethics Capacity (MARC) project is a timely initiative aimed at identifying existing capacity. MARC provides a platform and tool on the Council on Health Research for Development's (COHRED) Health Research website (HRWeb), which can be used by RECs and key stakeholders in health research in Africa to identify capacity, constraints and development needs. MARC intends to provide the first comprehensive interactive database of RECs in Africa, which will allow for the identification of key relationships and analyses of capacity. The potential of MARC lies in the mapping of current ethical review activity onto capacity needs. This paper serves as a starting point by providing a descriptive illustration of the current state of RECs in Africa. (shrink)
The growing importance of health systems research has opened debate about appropriate ethical frameworks and guidelines for the ethical review and conduct of health systems research. In this article we consider a detailed proposal from Hyder et al. and consider it in relation to the conventional criteria for ethics review of clinical research outlined by Emanuel et al. and argue that the Emanuel criteria can be usefully applied to the review of health systems research to supplement the Hyder et al. (...) proposals. We argue further that health systems researchers and reviewers would benefit from many of the debates that have characterized the ethics of clinical research over the past three decades. (shrink)
Listening to someone from some distance in a crowded room you may experience the following phenomenon: when looking at them speak, you may both hear and see where the source of the sounds is; but when your eyes are turned elsewhere, you may no longer be able to detect exactly where the voice must be coming from. With your eyes again fixed on the speaker, and the movement of her lips a clear sense of the source of the sound will (...) return. This ‘ventriloquist’ effect reflects the ways in which visual cognition can dominate auditory perception. And this phenomenological observation is one what you can verify or disconfirm in your own case just by the slightest reflection on what it is like for you to listen to someone with or without visual contact with them. (shrink)
This article reports on qualitative research conducted in KwaZulu-Natal, South Africa, among researchers and gate-keepers of health facilities in the province. Results suggest disparate but not irreconcilable perceptions of the social value of research in provincial health facilities. This study found that researchers tended to emphasize the contribution of research to the generation of knowledge and to the health of future patients while gate-keepers of health facilities tended to emphasize its contribution to the healthcare system and to current patients. Furthermore, (...) relations between research stakeholders were perceived to be somewhat fragile, making it difficult for stakeholders to achieve consensus about the social value of research, as well as on ways to maximize value. Interventions to negotiate a shared perspective on the social value of research would appear to be warranted, and the findings of this study suggest some focus areas for such intervention. (shrink)
This paper examines the commonplace assertion that utilitarianism allows for and even, at times, requires the punishment of the innocent. It traces the origins of this doctrine to the writings of the British Idealists and the subsequent development of what is called the post-utilitarian paradigm which posits various justifications for punishment such as retribution, deterrence and reform, finds all of them inadequate, and then, with the addition of other ideas, reconciles them. The idea of deterrence is falsely depicted as the (...) utilitarian contribution to the theory of punishment, while deterrence in fact is one of several elements in the utilitarian theory. The mistake comes from ignoring the pain-pleasure dimension of Benthamite utilitarianism and from regarding the principle of utility itself as the sole criterion of action in a ‘top-down’ fashion. (shrink)
My topic is personal identity, or rather, our identity. There is general, but not, of course, unanimous, agreement that it is wrong to give an account of what is involved in, and essential to, our persistence over time which requires the existence of immaterial entities, but, it seems to me, there is no consensus about how, within, what might be called this naturalistic framework, we should best procede. This lack of consensus, no doubt, reflects the difficulty, which must strike anyone (...) who has considered the issue, of achieving, just in one's own thinking, a reflective equilibrium. The theory of personal identity, I feel, provides a curious contrast. On the one side, it seems highly important to know what sort of thing we are, but, on the other, it is hard to find any answer which has a ‘solid’ feel. (shrink)
We argue that neuroeconomics should be a mechanistic science. We defend this view as preferable both to a revolutionary perspective, according to which classical economics is eliminated in favour of neuroeconomics, and to a classical economic perspective, according to which economics is insulated from facts about psychology and neuroscience. We argue that, like other mechanistic sciences, neuroeconomics will earn its keep to the extent that it either reconfigures how economists think about decision-making or how neuroscientists think about brain mechanisms underlying (...) behaviour. We discuss some ways that the search for mechanisms can bring about such top-down and bottom-up revision, and we consider some examples from the recent neuroeconomics literature of how varieties of progress of this sort might be achieved. (shrink)
Every body cell of an animal or human being contains the same complete set of genes. In theory any of these cells can be used to start a new embryo. The technique has been employed in the case of frogs. The nucleus is taken out of a body cell of a frog and implanted in an enucleated frog's egg. The resulting egg cell is stimulated to develop into a normal frog, and will be an exact copy of that frog which (...) provided the nucleus with all the genetic information. In normal sexual reproduction, two parents each contribute half their genes, but in the case of cloning, one parent passes on all his or her genes. (shrink)
In this essay, Hegel attempted to show how Fichte’s Science of Knowledge was an advance from the position of Kant in the Critique of Pure Reason, and how Schelling (and incidentally Hegel himself) had made a further advance from the position of Fichte.
Health research initiatives worldwide are growing in scope and complexity, particularly as they move into the developing world. Expanding health research activity in low- and middle-income countries has resulted in a commensurate rise in the need for sound ethical review structures and functions in the form of Research Ethics Committees. The urgent need for continued capacity development in Africa has necessitated research initiatives to identify existing capacity. This discussion paper describes the mapping of RECs in Africa through MARC project, second (...) phase and discusses the findings. MARC provides a platform and tool on COHRED's Health Research HRWeb, which can be used by RECs and key stakeholders in health research in Africa to identify capacity, constraints and development needs. (shrink)
BackgroundAfrica continues to bear a disproportionate share of the global HIV/AIDS, tuberculosis (TB) and malaria burden. The development and distribution of safe, effective and affordable vaccines is critical to reduce these epidemics. However, conducting HIV/AIDS, TB, and/or malaria vaccine trials simultaneously in developing countries, or in populations affected by all three diseases, is likely to result in numerous ethical challenges.MethodsIn order to explore convergent ethical issues in HIV/AIDS, TB and malaria vaccine trials in Africa, the Ethics, Law and Human Rights (...) Collaborating Centre of the WHO/UNAIDS African AIDS Vaccine Programme hosted a consultation on the Convergent Ethical Issues in HIV/AIDS, TB and Malaria Vaccine Trials in Africa in Durban, South Africa on the 10-11 February 2009.ResultsKey cross cutting ethical issues were prioritized during the consultation as community engagement; ancillary care obligations; care and treatment; informed consent; and resource sharing.ConclusionThe consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields. (shrink)
Background The intervention reported in this paper was a follow up to an empirical study conducted in Malawi with the aim of assessing trial participants’ understanding of randomisation, double-blinding and placebo use. In the empirical study, the majority of respondents (61.1%; n= 124) obtained low scores (lower than 75%) on understanding of all three concepts under study. Based on these findings, an intervention based on a narrative which included all three concepts and their personal implications was designed. The narrative used (...) daily examples from the field of Agriculture because Malawi has an agro-based economy. Methods The intervention was tested using a sample of 36 women who had been identified as low scorers during the empirical study. The 36 low scorers were randomly assigned to control (n=18) and intervention arms ( n =18). The control arm went through a session in which they were provided with standard informed consent information for the microbicide trial. The intervention arm went through a session in which they were provided with a narrative in ChiChewa, the local language, with the assistance of a power point presentation which included pictures as well as discussions on justification and personal implications of the concepts under study. Results The findings on the efficacy of the intervention suggest that the 3 scientific concepts and their personal implications can be understood by low literacy populations using simple language and everyday local examples. The findings also suggest that the intervention positively impacted on understanding of trial procedures under study, as 13 of the 18 women in the intervention arm, obtained high scores (above 75%) during the post intervention assessment and none of the 18 in the control arm obtained a high score. Using Fischer’s exact test, it was confirmed that the effect of the intervention on understanding of the three procedures was statistically significant (p=0.0001). Conclusions Potential trial participants can be assisted to understand key clinical trial procedures, their justification and personal implications by using innovative tailored local narratives. (shrink)
This article considers Bentham's response to the criticism of utilitarianism that it allows for and may even require the sacrifice of some members of society in order to increase overall happiness. It begins with the contrast between the principle of utility and the contrasting principle of sympathy and antipathy to show that Bentham regarded the main achievement of his principle as overcoming the subjectivity he found in all other philosophical theories. This subjectivism, especially prevalent in theories of rights, might well (...) lead to the sacrifice of the individual. The principle of utility was presented as an ‘objective’ theory that avoided the difficulties of other moral and political theories. The article also considers the importance of universally applicable ends, such as security and equality, as part of the principle of utility, and especially Bentham's view of maximizing pleasure as being a distributive rather than an aggregative idea. The article concludes by criticizing H. L. A. Hart's interpretation of the role of equality and rights in Bentham and John Stuart Mill, and argues that Mill's doctrine of moral rights builds on foundations originally established by Bentham, foundations which would preclude the sacrifice of individuals. (shrink)
William Perm summarized the Magna Carta thus: “First, It asserts Englishmen to be free; that's Liberty. Secondly, they that have free-holds, that's Property.” Since at least the seventeenth century, liberals have not only understood liberty and property to be fundamental, but to be somehow intimately related or interwoven. Here, however, consensus ends; liberals present an array of competing accounts of the relation between liberty and property. Many, for instance, defend an essentially instrumental view, typically seeing private property as justified because (...) it is necessary to maintain or protect other, more basic, liberty rights. Important to our constitutional tradition has been the idea that “[t]he right to property is the guardian of every other right, and to deprive a people of this, is in fact to deprive them of their liberty.” Along similar lines, it has been argued that only an economic system based on private property disperses power and resources, ensuring that private people in civil society have the resources to oppose the state and give effect to basic liberties. Alternatively, it is sometimes claimed that only those with property develop the independent characters that are necessary to preserve a regime of liberty. But not only have liberals insisted that, property is a means of preserving liberty, they have often conceived of it as an embodiment of liberty, or as a type of liberty, or indeed as identical to liberty. This latter view is popular among contemporary libertarians or classical liberals. Jan Narveson, for instance, bluntly asserts that “Liberty is Property,” while John Gray insists that “[t]he connection between property and the basic liberties is constitutive and not just instrumental.”. (shrink)
In Morals By Agreement, David Gauthier concludes that under certain conditions it is rational for an agent to be disposed to choose in accordance with a fair cooperative scheme rather than to choose the course of action that maximizes his utility. This is only one of a number of important claims advanced in that book. In particular, he also propounds a distinctive view concerning what counts as a fair cooperative arrangement. The thesis concerning the rationality of adopting a cooperative disposition (...) is, however, logically independent of his substantive view of a fair cooperative scheme and is itself central to the project as a whole. Gauthier's concern is to establish that certain moral principles are those that fully rational, self-interested persons would agree to take as regulative of their dealings with one another – that a contractarian approach, in this sense, can provide an adequate basis for a theory of morality. (shrink)
BackgroundA recent paper presents an argument and mechanism for the possible stopping of clinical trials early based on opportunity costs.DiscussionAlthough we agree that the costs and opportunity costs of clinical trials need to be reduced wherever possible, we raise concerns about the motivation and mechanism for stopping clinical trials early raised by Lavery et al.SummaryWe argue that there are already enough acceptable criteria and actors in the clinical trials arena to justify early stoppage of clinical trials, and argue that factors (...) other than efficacy need to be carefully considered, especially in developing country contexts. (shrink)
Some of the commentators on Intricate Ethics complain of my method. One finds the main ideas ‘Kammouflaged’ because the relevant causal distinctions are so fine-grained and the cases that illustrate them so numerous. Some say that they do not have the intuitions about many cases that I have, that I concoct dubious and ad hoc distinctions and invest them with moral significance; I am Ptolemaic in that new crystalline spheres and epicycles are constantly being added in an attempt to fix (...) the appearances. (shrink)
Accessing research participants within some social institutions for research purposes may involve a simple single administrative event. However, accessing some institutions to conduct research on their data, personnel, clients or service users can be quite complex. Research ethics committee chairpersons frequently field questions from researchers wanting to know when and why gatekeeper permission should be sought. This article examines the role and influence of gatekeepers in formal and organisational settings and explores pragmatic methods to improve understanding and facilitation of this (...) process. Conscientious and well-informed negotiations with gatekeepers are required in order to honour the ethical obligations to conduct appropriate stakeholder engagement before and during research, along with respect for the autonomy of institutions and their employees/clients/service recipients. Provision must be made to identify explicit and implicit gatekeepers to initiate and build collaborative networks that could best support the research process. Careful mutually respectful access agreements which consider the needs and vulnerabilities of both the gatekeeper and the researcher can improve the quality of the scientific data collected. Strategic planning in the research process must take these sometimes complex processes of gatekeeper permission into careful account. (shrink)
Background HIV molecular epidemiology is increasingly recognized as a vital source of information for understanding HIV transmission dynamics. Despite extensive use of these data-intensive techniques in both research and public health settings, the ethical issues associated with this science have received minimal attention. As the discipline evolves, there is reasonable concern that existing ethical and legal frameworks and standards might lag behind the rapid methodological developments in this field. This is a follow-up on our earlier work that applied a predetermined (...) analytical framework to examine the perspectives of a sample of scientists from the fields of epidemiology, public health, virology and bioethics on key ethical issues associated with HIV molecular epidemiology in HIV network research. Methods Fourteen in-depth interviews were conducted with scientists from the fields of molecular epidemiology, public health, virology and bioethics. Inductive analytical approaches were applied to identify key themes that emerged from the data. Results Our interviewees acknowledged the potential positive impact of molecular epidemiology in the fight against HIV. However, they were concerned that HIV phylogenetics research messages may be incorrectly interpreted if not presented at the appropriate level. There was consensus that HIV phylogenetics research presents a potential risk to privacy, but the probability and magnitude of this risk was less obvious. Although participants acknowledged the social value that could be realized from the analysis of HIV genetic sequences, there was a perceived fear that the boundaries for use of HIV sequence data were not clearly defined. Conclusions Our findings highlight distinct ethical issues arising from HIV molecular epidemiology. As the discipline evolves and HIV sequence data become increasingly available, it is critical to ensure that ethical standards keep pace with biomedical advancements. We argue that the ethical issues raised in this study, whether real or perceived, require further conceptual and empirical examination. (shrink)
A preliminary study aimed at investigating the potential impact of relationships on decision-making process and autonomy of women was conducted in Harare, Zimbabwe. The majority of women surveyed (87.6%) were prepared to consult their husbands, whereas only 46.6% said they would consult their relatives prior to participation in health research. Only 6.2% and 11.3% were prepared to keep their participation secret from their husbands their relatives, respectively. Overall, 58.6% were rated as autonomous, 22.5% partially autonomous, and 18.9% were rated as (...) not autonomous. Age, educational level, employment status, and marital status of respondents were significantly associated with autonomous decision-making process. (shrink)
Following the practice of human beings everywhere historians distinguish the real or most significant cause of an occurrence or state of affairs from ‘less important considerations’, ‘precipitating circumstances’, or ‘mere conditions’. I shall term claims that some phenomenon is most basically to be attributed to some one of the factors causally necessary for its occurrence attributive causal explanations or causal attributions and discuss here the extent to which moral convictions are constitutive of them.