In this article, we discuss Beauchamp and Childress’s treatment of the issue of moral status. In particular, we introduce the five different perspectives on moral status that Beauchamp and Childress consider in Principles of Biomedical Ethics and explain their alternative to those perspectives, raise some critical questions about their approach, and offer a different way to think about one of the five theories of moral status that is more in line with what we believe some of its leading advocates affirm.

Introduction to the Institutional Logics Perspective -- Precursors to the Institutional Logics Perspective -- Defining the Inter-institutional System -- The Emergence, Stability and Change of the Inter-institutional System -- Micro-Foundations of Institutional Logics -- The Dynamics of Organizational Practices and Identities -- The Emergence and Evolution of Field-Level Logics -- Implications for Future Research.

Essential Philosophy of Psychiatry is a concise introduction to the growing field of philosophy of psychiatry. Divided into three main aspects of psychiatric clinical judgement, values, meanings and facts, it examines the key debates about mental health care, and the philosophical ideas and tools needed to assess those debates, in six chapters. In addition to outlining the state of play, Essential Philosophy of Psychiatry presents a coherent and unified approach across the different debates, characterized by a rejection of reductionism and (...) an emphasis on the ineliminability of uncodified skilled judgement. The first part, Values, outlines the debate about whether diagnosis of mental illness is essentially value-laden and argues that the prospects for reducing illness or disease to plainly factual matters are poor. It also explains the important role of skilled contextual judgement, rather than a principles-based deduction, in ethical judgement. The second part, Meanings, examines the central role of understanding and a shared first person perspective, both against attempts to reduce meaning to basic information-processing mechanisms and to explain away the difficulties of understanding psychopathology in recent models of delusion. The third part, Facts, shows the importance of uncodified clinical judgements, both in assessing the validity of psychiatric taxonomy and in the application of Evidence Based Medicine. Despite advances in the codifaction of practice and operationalism of diagnosis, an element of judgement remains in the assessment both of what, at one level, is good evidence for diagnosis and treatment and what, at a higher level, is good evidence for the validity of classification overall. (shrink)

Mass literacy, mass communication, and the Internet have all increased the amount of information available. But false knowledge still abounds. Taking cues from Sir Thomas Browne, the English Renaissance skeptic, this title examines a host of contemporary errors in thinking and offers a powerful explanation of why they occur.

According to the recovery model, mental healthcare should be aimed towards a conception of recovery articulated by a patient or service user in accord with his or her own specific values. The model thus presupposes and emphasises the agency of the patient and opposes paternalism. Recent philosophical work on the relations between respect, self-respect, self-esteem, shame, and agency suggests, however, two ways in which mental illness itself can undermine self-respect, promote shame and undermine agency, suggesting a tension within the recovery (...) model. I argue, however, that this is a tension rather than a fatal flaw by distinguishing between paternalist and non-paternalist clinical responses to this failure of agency. (shrink)

Francis Bacon, lawyer, statesman, and philosopher, remains one of the most effectual thinkers in European intellectual history. We can trace his influence from Kant in the 1700s to Darwin a century later. The Advancement of Learning , first published in 1605, contains an unprecedented and thorough systematization of the whole range of human knowledge. Bacon’s argument that the sciences should move away from divine philosophy and embrace empirical observation would forever change the way philosophers and natural scientists interpret their (...) world. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.4 (2003) 361-367 [Access article in PDF] Psychopathology and Two Kinds of Narrative Account of the Self Tim Thornton Keywords self, narrative, reductionism, embodiment, Dennett, Strawson, McDowell The self plays an important role in psycho pathology. Conditions such as dementia raise the question of how much loss of memory and awareness there can be before there is, if ever, also a loss of the (...) self. Syndromes such as Dissociative Identity Disorder (DID) or Multiple Personality Disorder (MPD) raise the possibility of a fragmentation of one self into a number of selves. Depersonalization disorder suggests a kind of diminution both of the sense of self and the reality of the world. Symptoms such as thought insertion suggest a different kind of fragmentation of the coherence of thought within a self.At the same time there is something prima facie paradoxical about the very idea of the fragmentation or loss of self. It seems to be one thing for a self to suffer loss, quite another to think of the self as being lost. Although the experiences or beliefs had or entertained by a self might be disordered or chaotic, how can a self be anything other than whole and seem real and whole to itself?The narrative approach to the self looks like a tool purpose built to shed light on some aspects of psychopathology. The papers in this issue have examined its application to four revealing case histories and questioned its effectiveness in accounting for features of psychopathology. But in this short note I wish to stand back from the particular cases discussed in previous papers and to shed light on the general approach by setting out two contrasting versions of it. Crudely put, the first forges a connection between the concepts of self and personality; the second between the concepts of self and person. I will use the contrast between these two to draw some general lessons for the philosophy of psychopathology. Dennett's Austere Narrative Account I will start with Dennett's influential version of a narrative account of the self. His central idea is that the very idea of a self should be understood as dependent on a particular kind of interpretative strategy. Roughly, this contrasts with the idea that it is a more basic datum calling out for notice prior to adopting a specific theoretical perspective.Dennett suggests an analogy with centers of gravity both to outline the consequences of this view for the reality of selves, and the connection between the self and the interpretative strategy involved. [End Page 361] A center of gravity is just an abstractum. It's just a fictional object. But when I say it's a fictional object, I do not mean to disparage it; it's a wonderful fictional object, and it has a perfectly legitimate place within serious, sober, echt physical science. (Dennett 1992) The concept of a center of gravity is deployed within a branch of physics to describe and predict the behavior of physical systems acting under physical forces. It is the theoretical context that determines the nature of centers of gravity; at the same time, they contribute to that broader context. Dennett stresses that they are abstract or calculation-bound theoretical objects to contrast with objects that are also theoretically posited but causally interactive, such as microphysical particles (Dennett 1987, 53).Dennett has also used the analogy with abstracta to account for mental states such as beliefs, desires, and other propositional attitudes, which he suggests are ascribed using a particular interpretative strategy: the "Intentional Stance" (Dennett 1987, 13-42). The suggestion is that by showing the necessity of adopting that stance to make sense of human behavior he can defend a form of objectivity about mental states even while rejecting the industrial-strength realism that requires identifying mental states with physical, and thus causally interactive, internal states.Selves are given similar treatment. Like centers of gravity or mental states, they are theoretical, even fictional, entities articulated within an interpretative theoretical stance: A self is also an abstract object, a theorist's fiction... (shrink)

Despite its authors’ intentions, the four principles approach to medical ethics can become crudely algorithmic in practice. The first section sets out the bare bones of the four principles approach drawing out those aspects of Beauchamp and Childress’s Principles of biomedical ethics that encourage this misreading. The second section argues that if the emphasis on the guidance of moral judgement is augmented by a particularist account of what disciplines it, then the danger can be reduced. In the third section, I (...) consider how much the resultant picture diverges from Beauchamp and Childress’s actual position. (shrink)

The author attempts a "correct analysis of what 'the moral point of view' is only in so far as it is necessary to do this in order to discuss the problem of its 'justification'." he discusses the views of kurt baier and philippa foot. He concludes that foot and baier have not been able to answer "the so-Called fundamental question of ethics" because it is a "pseudo-Question"; that the rationality of a decision between "moral duty and enlightened self-Interest" rests on (...) whether the "agent accepts or rejects the moral point of view"; and that it is "what a person most wants to do," not what is in his or her best interest, "that provides the ultimate basis for the rational justification of an action." (staff). (shrink)

For good or for ill, we have animal bodies. Through them, we move around, eat and drink, and do many other things besides. We owe much – perhaps our very lives – to these ever-present animals. But how exactly do we relate to our animals? Are we parts of them, or they of us? Do we and these living animals co-inhere or constitute or coincide? Or what? Animalism answers that we are identical to them. There are many objections to animalism, (...) and a dizzying array of rival views. In this article, we do not propose to evaluate those objections and rivals. We will instead present a new argument for that view. The argument begins with the fact that we have emotions. (shrink)

KEYWORDS: Validity, reliability, values, taxonomy, clas- sification, McDowell.

Aristotle’s claim that poetry is ‘a more philosophic and better thing’ than history (Poet 9.1451b5-6) and his description of the ‘poetic universal’ have been the source of much scholarly discussion. Although many scholars have mined Poetics 9 as a source for Aristotle’s views towards history, in my contribution I caution against doing so. Critics of Aristotle’s remarks have often failed to appreciate the expository principle which governs Poetics 6-12, which begins with a definition of tragedy and then elucidates the terms (...) of that definition by means of a series of juxtapositions. The juxtaposition between poetry and history is one such instance which seeks to elucidate what sort of plot exemplifies a causal unity such that the events of a play unfold with likelihood or necessity. Within that context, Aristotle compares history and poetry in order to elucidate the object of poetic mimesis rather than criticize history as a discipline. Viewing Aristotle as antagonistic towards history fails to appreciate the expository structure of the Poetics and obscures the resource which history provides to the poet, a point which I explore by considering what Aristotle would have thought of an ‘historical’ tragedy like Aeschylus’ Persians. (shrink)

THE AUTHOR ARGUES THAT THE HUMEAN "A PRIORI" ATTACK ON MIRACLES IS INTENDED TO SHOW THE INCOHERENCE OF THE NOTION OF A WELL-ATTESTED MIRACULOUS EVENT (NOT THE INCOHERENCE OF THE CONCEPT OF A MIRACLE). THOUGH THIS TYPE OF ATTACK CAN BE PRESENTED IN A POWERFUL FORM, IT SUFFERS FROM AN UNDULY NARROW ASSUMPTION CONCERNING THE NATURE OF EVIDENCE AND EXPLANATION, FOR IT "IS" POSSIBLE TO DESCRIBE CIRCUMSTANCES IN WHICH IT WOULD BE REASONABLE TO CONCLUDE THAT A MIRACLE HAS OCCURRED. HOWEVER, (...) WE CAN KNOW ON "A POSTERIORI" GROUNDS THAT THE PROBABILITY OF THESE CIRCUMSTANCES EVER HAVING OBTAINED IS EXTREMELY REMOTE. FINALLY, IT IS ARGUED THAT (UNLESS THE DESIGN ARGUMENT IS SOUND) WELL-ATTESTED MIRACLES ARE, NEVERTHELESS, THE ONLY POSSIBLE GROUNDS WHICH COULD JUSTIFY A REASONABLE BELIEF IN THE EXISTENCE OF A PERSONAL GOD. (shrink)

[opening paragraph] -- Clark: The `astonishing hypothesis' which you put forward in your book, and which you obviously feel is very controversial, is that `You, your joys and sorrows, your memories and ambitions, your sense of personal identity and free will are, in fact, no more than the behaviour of a vast assembly of nerve cells. As Lewis Carroll's Alice might have phrased it: `You're nothing but a pack of neurons'.' But it seems to me that this is not so (...) astonishing a statement for a scientist to make. Isn't this what reductionist science has always believed? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Evidence-Based Medicine and EvaluativismTim Thornton (bio)KeywordsPhilosophy, psychiatry, values, causalThe rise of evidence-based medicine (EBM) in psychiatry has brought, in its train, a concentration on the validity of psychiatric taxonomy to augment the previous focus on reliability (in the medical sense of inter-subject agreement). This is not surprising. If EBM is to be a trustworthy guide to future events, such as patient recovery, it must be based on projectible (...) predicates (Goodman 1983). Not all the predicates that apparently fit past observations would produce true predictions for the future. Furthermore, there is reason to think that employing projectible predicates goes a long way to satisfy the (widespread if contested) aim of being based on a nomological science (Papineau 1986). Thus, the successful implementation of EBM within psychiatry requires the successful articulation of a valid psychiatric taxonomy.This connection helps to explain why fears about the application of EBM to psychiatry often turn on fears about the application of the criteriological model of diagnosis to individuals. In her commentary in this issue, Gloria Ayob has examined some of the arguments concerning the application of EBM to individuals. In this brief commentary, I examine a different potential source of disquiet focused on the underlying nature of psychiatric taxonomy.Dimensions for Psychiatric TaxonomyIn their recent paper, Peter Zachar and Kenneth Kendler suggest a number of different dimensions according to which rival conceptions of psychiatric taxonomy can be mapped. These include (1) causalism–descriptivism, (2) essentialism– nominalism, (3) objectivism–evaluativism, (4) internalism–externalism, (5) entities–agents, and (6) categories–continua (2007, 557). At the heart of the objectivism-evaluativism dimension is the question:Is deciding whether or not something is a psychiatric disorder a simple factual matterY (objectivism), or does it inevitably involve a value-laden judgment (evaluativism)?(Zachar and Kendler 2007, 558)Objectivists argue that the concept of disorder is a simple or plain factual matter by contrast with an evaluation. The apparently evaluative connotations of disorder, they argue, can either be reduced to, or explained away in, more basic terms, which are not themselves essentially evaluative. Thus, for example, the attempt to explain disorder in statistical terms is a form of objectivism. The more plausible attempt to explain disorder through the idea of a biological or proper function is also usually presented as a form of objectivism. (The most famous proponent of a biological approach, however, Jerome Wakefield, adds to an objectivist-aspiring core an explicit value in the form of harm [End Page 175] [Wakefield 1999].) Whether or not it can be successful as a form of objectivism, in addition to whether an analysis in biological terms is possible, depends on whether the account of function can fully discharge any initial evaluative or normative assumptions.There seems to be good evidence that current psychiatric taxonomy, at least, contains values. John Sadler, for example, makes a powerful case for this in his substantial work Values and Psychiatric Diagnosis (2005). Sadler, furthermore, addresses in some detail a further set of questions concerning the kinds and nature of the values involved. I outline just one further question about the nature of values involved.Zachar and Kendler contrast the presence of values with objectivism. Objectivity has at least two relevant senses reflecting contrasts with two senses of subjectivity. It—objectivity—might mean requiring no special subject for the conception and framing of relevant judgments. (This mirrors primary, by contrast with secondary qualities, and Williams' idea of an absolute conception [Williams 1978]). Or, it might mean disciplining and providing a contrast between correctness and incorrectness, or truth and falsity, for the relevant judgments. This contrasts with subjective whimsy.Although it seems relatively straight forward that the conception and framing of value judgments requires that subjects have a particular kind of mind, that still leaves open the other issue. Are value judgments disciplined by anything or does the "truth" of a value judgment collapse back into its being sincerely made?Evaluativism in Psychiatric Taxonomy and EBMThis question relates to the application of EBM to psychiatry in this way. On a disciplined account, psychiatric taxonomy can aim to get right the mixture or, better, the compound of simple facts and values... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Ambiguities of Mild Cognitive ImpairmentTim Thornton (bio)Keywordsclassification, disease, mild cognitive impairment, normative, valuesCorner and Bond's paper (2006) raises some key ethical questions about the classification and diagnosis of mild cognitive impairment (MCI). In this commentary, I wish to revise some of the general issues about the classification of mental disorder raised by this particular classificatory concept. The central issue raised is the connection between the pathologic status (...) of a condition and what I term the plain facts about the frequency and nature of its symptoms.There are a number of ethical questions raised by applying the label of MCI. Centrally, perhaps, is the concern, illustrated by the case vignettes, that a diagnosis carries negative repercussions that might outweigh the more narrowly medical advantages of an early diagnosis. But although that concern may be appropriate, such ethical complications are a danger of any psychiatric classification or diagnosis, even the most well grounded. Any psychiatric diagnosis can carry a danger of stigma, for example.What seems to make such ethical concerns more serious in this case—at least to a philosopher outsider—is the implicit further concern that MCI is not a real, objective, or, to use a more medical term, valid category or classification. If it is not valid, then any negative connotations of the diagnosis will not be outweighed by medical technological achievements. In other words, the further ethical issues are given much greater weight if the question of validity is not satisfactorily resolved.The question of the reality, objectivity, or validity of MCI can be divided into two issues:1. Is MCI a real, objective, or valid feature of psychological phenomenology?2. Is MCI a real, objective, or valid psychological illness, disease, or pathology?A condition might be a real, objective, or valid feature of psychological phenomenology without being a real illness. It might be some other aspect of human living. Szasz (1960) suggests that this is the case with mental illness (he might more properly say "so-called mental illness") as a whole. But, less controversially, the unusual ability to calculate, mentally and in a flash, the date of future Easter Sundays is a genuine feature of human living—some people possess the ability even if most do not—without either it, or its lack, being an illness. Being real as an illness is a very specific kind of being. It is this, I suggest, that raises difficulties in the case of MCI by contrast with the easier question of whether something is a genuine feature of human living in some other way. [End Page 21]From "normal" and "normative" to "correct" and "incorrect"Corner and Bond (2006) usefully suggest that the question of whether MCI is real is made more difficult by an ambiguity in the sense of the word normal. They suggest that although "physiologic and cognitive decline is assumed to be a normal experience" this still leaves "boundary problems" about "distinguishing normal aging from disease" (Corner and Bond 2006, 3–4). Thus, if the symptoms of MCI are continuous with the ordinary phenomena of physiologic and cognitive decline, then they might also be merely normal. But this does not settle the status of MCI because normal can mean either "normative, that is, usual; or it can mean nonpathologic" (Corner and Bond 2006, 4).On the assumption that MCI is at least continuous with phenomena that are normal, then its symptoms might be normal in the sense of usual but nevertheless pathologic: an inevitable illness. Or they might be usual and nonpathologic, that is, merely a feature of aging that, although regrettable, lacks the connotations of illness (e.g., the appropriateness, if not the possibility, of treatment). (In principle on the assumption in play—that the symptoms of MCI are normal—they might be unusual but nonpathologic akin, for example, to an improved ability to solve crosswords with age that might affect a small lucky proportion of the population. Perhaps such a crossword puzzler might be reassured by their doctor: "Well that is very unusual but there is no need to worry: it is not a symptom of any illness. You are perfectly normal.")Thus the question "Is MCI normal... (shrink)

This paper is an attempt to highlight significant developments in the history of philosophy in schools in Australia. We commence by looking at the early years when Laurance Splitter visited the Institute for the Advancement for Philosophy for Children (IAPC). Then we offer an account of the events that led to the formation of what is now the Federation of Australasian Philosophy in Schools Associations (FAPSA), the development and production of a diverse range of curriculum and supporting materials for philosophy (...) in schools, the making of the Australasian journal, and more recent events. Our purpose is to create further interest in exploring this complex and rich history. This will achieve a better understanding of the possible future directions for classroom practice and research. (shrink)

This paper reports the findings from an interconnected set of experiments designed to assess children’s knowledge of the semantic interactions between negation and quantified NPs. Our main finding is that young children, unlike adults, systematically interpret these elements on the basis of their position in overt syntax. We argue that this observation can be derived from an interplay between fundamental properties of universal grammar and basic learning principles. We show that even when children’s semantic knowledge appears to differ from that (...) of adults, the observed differences.. (shrink)

In this paper, I relate values-based practice (VBP) to clinical judgment more generally. I consider what claim, aside from the fundamental difference of facts and values, lies at the heart of VBP. Rather than, for example, construing values as subjective, I argue that it is more helpful to construe VBP as committed to the uncodifiability of value judgments. It is a form of particularism rather than principlism, but this need not deny the reality of values. Seen in this light, however, (...) VBP is part of a broader conception of clinical judgment that can be compared with Kant’s conception of reflective judgment. This is a useful way of marking similarities between a number of issues raised in philosophy, which can inform a better understanding of clinical judgment. (shrink)

At first glance, it looks like Aristotle can’t make up his mind about the ethical or moral status of non-human animals in his ethical treatises. Somewhat infamously, the Nicomachean Ethics claims that “there is neither friendship nor justice towards soulless things, nor is there towards an ox or a horse” (EN 8.11.1161b1–2). Since Aristotle thinks that friendship and justice are co-extensive (EN 8.9.1159b25–32), scholars have often read this passage to entail that humans have no ethical obligations to non-human animals. By (...) contrast, although the Eudemian Ethics denies that non-human animals can participate in “primary” friendships, EE 7.2 claims that “the other kinds of friendship are also found among animals; and it is evident that utility is present to some extent among them both in relation to humankind, in the case of tame animals, and in relation to each other” (EE 7.2.1236b3–11). Does the Nicomachean account of non-human animals contradict that of the Eudemian Ethics? Ultimately, I believe the Nicomachean account is consistent with the Eudemian account. Nonetheless, I argue that Aristotle’s treatment of non-human animals differs significantly in the two texts. My chapter explores this difference in greater detail and considers the ramifications of such a difference for our understanding of Aristotle’s place in the philosophical tradition concerning the ethical status of non-human animals. (shrink)

Here is a question as intriguing as it is brief: what are we? The animalist’s answer is equal in brevity: we are animals. This stark formulation of the animalist slogan distances it from nearby claims—that we are essentially animals, for example, or that we have purely biological criteria of identity over time. Is the animalist slogan—unburdened by modal or criterial commitments—still interesting, though? Or has it lost its bite? In this article we address such questions by presenting a positive case (...) for the importance of animalism and applying that case to recent critiques. (shrink)

In her “Saving the Appearances in Plato’s Cave,” Dr. Adriel M. Trott argues that “the philosopher’s claim to true knowledge always operates within the realm of the cave.” In order to probe her claim, I challenge her to make sense of “politics in the cave,” namely the status and practices of two categories of people in the cave: “woke” cave dwellers (namely, those who recognize shadows as shadows but have not left the cave) and “woke” puppeteers (namely, philosophers ruling within (...) the cave). (shrink)

Bradley's metaphysical views, akin to those of Hegel, with a special emphasis on the internal relations of the Absolute are developed at length in Appearance ...

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

Person Centred Medicine is a substantial and contentious view of healthcare that carries both ontological and epistemological presuppositions. This chapter examines two key aspects: that the person is a central, basic irreducible element in ontology and that person-level knowledge is both important and possible. Some reasons for holding both of these are sketched.

BackgroundConcurrent with efforts to establish national and regional biorepositories in Africa is widespread endorsement of ethics committees as stewards of the interests of individual donors and their communities. To date, ethics training programs for IRB members in Botswana have focused on ethical principles and international guidelines rather than on the ethical dimensions of specific medical technologies and research methodologies. Little is known about the knowledge and concerns of current and prospective IRB members in Botswana with respect to export, reuse, storage, (...) and benefit-sharing of biospecimens.MethodsThis qualitative study examined perspectives of IRB members in Botswana about the collection and use of biospecimens in research. Forty-one IRB members representing five committees in Botswana participated in discussions groups in March 2013. Transcriptions of audiotapes and field notes were analyzed to identify issues of concern that might be alleviated through education and capacity-building, and areas that required ongoing discussion or additional regulatory guidance.ResultsAreas of concern included lack of understanding among patients and providers about the use of biospecimens in clinical care and research; reuse of biospecimens, particularly issues of consent, ownership and decision-making; export of specimens and loss of control over reuse and potential benefits; and felt need for regulatory guidance and IRB-member training. Local belief systems about bodily integrity and strong national identity in the construct of benefits may be at odds with initiatives that involve foreign biorepositories or consider such collections to be global public goods.ConclusionEducation is needed to strengthen IRB-member capacity to review and monitor protocols calling for the collection and use of biospecimens, guided by clear national policy on priority-setting, partnerships, review, and oversight. Engagement with local stakeholders is needed to harmonize fundamentally different ways of understanding the human body and community identity with the aims of contemporary biomedicine. (shrink)

This is the first critical edition since the nineteenth century of Bacon's principal philosophical work in English, The Twoo Bookes of Francis Bacon. Of the proficience and advancement of Learning, divine and humane - traditionally known as The Advancement of Learning.

This article presents a review of the literature, summarizes current initiatives, and provides a heuristic for assessing the effectiveness of a range of institutional review board collaborative strategies that can reduce the regulatory burden of ethics review while ensuring protection of human subjects, with a particular focus on international research. Broad adoption of IRB collaborative strategies will reduce regulatory burdens posed by overlapping oversight mechanisms and has the potential to enhance human subjects protections.

First published in 1876, this forceful and vigorous classic of English moral philosophy, written in opposition to Utilitarianism by one of England's most eminent philosophers, is now available for the first time since 1977.

BackgroundEthical and regulatory guidance on the collection and use of human biospecimens for research forms an essential component of national health systems in Sub-Saharan Africa, where rapid advances in genetic- and genomic-based technologies are fueling clinical trials involving HBS and the establishment of large-scale biobanks.MethodsAn extensive multi-level search for publicly available ethics regulatory guidance was conducted for each SSA country. A second review documented active trials listed in the WHO International Clinical Trials Registry Platform as of January 2015 in which (...) HBS collection was specified in the protocol. Findings were combined to determine the extent to which countries that are study sites for HBS-related research are supported by regulatory guidance language on the collection, use, ownership and storage of biospecimens.ResultsOf the 49 SSA countries, 29 had some form of national ethics guidance, yet only 17 provided language relating to HBS-related research, with specific guidance on consent, ownership, reuse, storage, and export/import/transfer. Ten countries accounted for 84 % of the active clinical trials involving the collection of HBS in SSA. All except one of these countries were found to have some national guidance in the form of regulations, codes of ethics, and/or standard operating procedures; however, only seven of the ten offered any language specific to HBS.ConclusionsDespite the fact that the bulk of registered clinical trials in SSA involving HBS, as well as existing and proposed sites for biorepositories under the H3Africa Initiative, are currently situated in countries with the most complete ethics and regulatory guidance, variability in the regulations themselves may create challenges for planned and future pan-African collaborations and may require legislative action at the national level to revise. Countries in SSA that still lack regulatory guidance on HBS will require extensive health system strengthening in ethics governance before they can be full participants in the modern research enterprise. (shrink)

[opening paragraph] -- Clark: The `astonishing hypothesis' which you put forward in your book, and which you obviously feel is very controversial, is that `You, your joys and sorrows, your memories and ambitions, your sense of personal identity and free will are, in fact, no more than the behaviour of a vast assembly of nerve cells. As Lewis Carroll's Alice might have phrased it: `You're nothing but a pack of neurons'.' But it seems to me that this is not so (...) astonishing a statement for a scientist to make. Isn't this what reductionist science has always believed? (shrink)