Chater & Loewenstein argue for a shift in focus from individual- to structural-level approaches to societal ills. This is valid and important but overlooks the barriers inherent in the current US partisan context. Psychology can be applied to help people of mixed allyship join together, to effectively and quickly force institutions and corporations to accept structural change.

Smajdor addresses the problem of inferior clinical outcomes among adults with impairments of capacity to give informed consent (AWIC). She notes that AWIC are generally excluded from clinical trials to protect them against harms and avoid exploitation and claims there is a causal link between involvement in clinical trials and favourable outcomes. She argues, given this link, that we should increase AWIC representation in clinical trials and can justifiably do so by recognising the capacity of AWIC to assent. AWIC form (...) a diverse group, with multiple aetiologies, including, for example, Down syndrome, traumatic brain injury and dementia. In some cases, the inability to consent may fluctuate so that the same person could be AWIC only at certain times. Yet despite these differences, the group has a shared unmet need. We agree with Smajdor that AWIC outcomes should be improved, but question whether simply increasing representation in clinical trials is sufficient to achieve this. We identify the following points: 1. AWIC are under-represented in clinical trials. There is evidence of widespread exclusion of AWIC in clinical trials within the UK and abroad and it is often a specific exclusion criterion.1 2. AWIC have worse clinical outcomes and a lower life expectancy. The life expectancy …. (shrink)

Recruiting adolescents into smoking cessation studies is challenging, particularly given institutional review board (IRB) requirements for research conducted with adolescents. This article provides a brief review of the federal regulations that apply to research conducted with adolescents, and describes researchers' experiences of seeking IRB approval for youth cessation research. Twenty-one researchers provided information. The most frequently reported difficulty involved obtaining parental consent. Solutions to commonly reported problems with obtaining IRB approval are also identified. Waivers of parental consent can facilitate recruitment (...) of youths into studies; however, researchers must ensure that their protocols comply with federal regulations when requesting a waiver. (shrink)

Although Ludwik Fleck is today recognized as one of the pioneers of the historical sociology of science, his historical and epistemological writings, most of them dating from the 1930s, long remained practically unknown. They were rediscovered following the mention of Fleck's principal work, the monographGenesis and Development of a Scientific Fact(1935) in the preface of Kuhn'sThe Structure of Scientific Revolutions(1962), and thanks to the efforts of W. Baldamus (1977) and his student T. Schnelle (1982) and of the editors of the (...) English translation of Fleck's book, R. K. Merton and T. J. Trenn. Fleck's work was studied by several scholars and was the subject of two meetings: “Colloquium Ludwik Fleck” (Hamburg, 1981) organized by L. Schaffer and T. Schnelle, and a symposium organized by R. S. Cohen (Berlin, 1984). Some of the papers presented at these meetings were published in Cohen and Schnelle 1986. Today, more than fifty years after the publication of his principal study, Fleck is on his way to becoming a “classic” of the sociology of science and of epistemology. (shrink)

Michael J. Zimmerman explores whether and how our ignorance about ourselves and our circumstances affects what our moral obligations and moral rights are. He rejects objective and subjective views of the nature of moral obligation, and presents a new case for a 'prospective' view.

In this work I attempt to articulate a principle or set of principles that can guide violent revolution, or emancipatory violence, and yet still prevent the end-stage backlash that generally follows; e.g., the Terror's culmination in which the originators are the targets of the Terror.

Much has been published about the ethical issues encountered by clinicians in genetics/genomics, but those experienced by clinical laboratory scientists are less well described. Clinical laboratory scientists now frequently face navigating ethical problems in their work, but how they should be best supported to do this is underexplored. This lack of attention is also reflected in the ethics tools available to clinical laboratory scientists such as guidance and deliberative ethics forums, developed primarily to manage issues arising within the clinic.We explore (...) what ethical issues are being experienced by clinical scientists, how they think such issues could be best analysed and managed, and whether their practice might be enhanced by more situated approaches to ethics deliberation and practice such as ethical preparedness. From thematic analysis of cases presented by clinical scientists at a specially convened meeting of the UK Genethics Forum, we derived three main ethical themes: (1) the redistribution of labour and responsibilities resulting from the practice of genomic medicine; (2) the interpretation and certainty of results and (3) the proposal that better standardisation and consistency of ethical approaches (for example, more guidelines and policy) could resolve some of the challenges arising.We argue that although standardisation is important for promoting shared understandings of good (including ethical) practice, supplementary approaches to enhance and sustain ethical preparedness will be important to help clinical scientists and others in the recently expanded genetic/genomic medicine environment foster quality ethical thinking. (shrink)

Jian Zhou,* Weiqiang Ju,* Xiaopeng Yuan, Xiaofeng Zhu, Dongping Wang, Xiaoshun HeOrgan Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China *These authors contributed equally to this work: Hyperosmolar nonketotic hyperglycemic coma is a serious, rare complication induced by methylprednisolone pulse therapy for acute rejection after orthotopic liver transplantation. Herein, we report an unusual case of a 58-year-old woman who experienced acute rejection at 30 months after OLT, only one case in which HNKHC resulted in MP (...) pulse therapy for acute rejection in all 913 recipients in our center. The general morbidity of HNKHC was 1.09‰ in this study. HNKHC is characterized by rapid onset, rapid progression, and a lack of specific clinical manifestations. High-dose MP management was a clear risk factor. The principle of treatment included rapid rehydration, low-dose insulin infusion, and correcting disorders of electrolytes and acidosis. In conclusion, clinicians considering MP pulse therapy after OLT should be alert to the occurrence of HNKHC. Keywords: liver transplantation, complications, hyperosmolar nonketotic hyperglycemic coma, methylprednisolone pulse therapy, principle of treatment. (shrink)