The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)

The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)

Bolzano hat seine Wahrscheinlichkeitslehre in 15 Punkten im § 14 des zweiten Teils seiner Religionswissenschaft sowie in 20 Punkten im § 161 des zweiten Bandes seiner Wissenschaftslehre niedergelegt. (Ich verweise auf die Religionswissenschaft mit 'RW II', auf die Wissenschaftslehre mit 'WL II'.) In der RW II (vgl. p. 37) ist seine Wahrscheinlichkeitslehre eingebettet in seine Ausführungen "Über die Natur der historischen Erkenntniß, besonders in Hinsicht auf Wunder", und die Lehrsätze, die er dort zusammenstellt, dienen dem ausdrücklichen Zweck, mit mathematischem Rüstzeug (...) Lehrmeinungen entgegentreten zu können, gemäß denen Wundererzählungen keine Glaubwürdigkeit zukommen könne. In der WL II (vgl. p. 171) führt Bolzano im großen und ganzen dieselben Lehrsätze an wie in der RW II, entwickelt nun aber die Wahrscheinlichkeitslehre innerhalb seiner Lehre von den Sätzen an sich. Dabei orientiert er sich zwar durchaus an den Lehrsätzen in den damaligen "Schriften über die Wahrscheinlichkeitsrechnung" (vg. WL II, p. 190), korrigiert aber dort, wo es ihm nötig erscheint (vgl. WL II, pp. 187–191), und leistet so im Grunde eine Reformulierung des elementaren Teils der Wahrscheinlichkeitslehre seiner Zeit innerhalb seiner logischen Theorie von den Sätzen an sich. — Ich bezwecke hier keine historische Studie über Bolzanos Wahrscheinlichkeitslehre, obwohl es von Interesse sein mag, herauszuschälen, worin Bolzano mit welchen Wahrscheinlichkeitstheoretikern seiner Zeit übereinstimmt, und worin nicht, insbesondere welche Schwächen von Bolzanos Wahrscheinlichkeitslehre Schwächen aller damaligen Wahrscheinlichkeitslehren waren. Eine wichtige systematische Studie über Bolzanos Wahrscheinlichkeitslehre bestünde — wie von Berg (1962, pp. 148-149) ansatzweise begonnen — in einer exakten Rekonstruktion seiner Wahrscheinlichkeitslehre innerhalb eines konsistenten logischen Systems der Sätze an sich. Ich werde im folgenden etwas bei weitem Bescheideneres, doch möglicherweise durchaus Fruchtbares versuchen, nämlich die Lehrsätze von Bolzanos Wahrscheinlichkeitslehre in die Sprache einer heutigen Wahrscheinlichkeitstheorie zu übersetzen und die übersetzten Lehrsätze dort herzuleiten, soweit dies möglich ist. Man könnte dann in einem zweiten Schritt, der hier nicht mehr unternommen wird, untersuchen, inwieweit jene Thesen, die den Herleitungstest überstanden haben, jenen Zweck erfüllen, den Bolzano ihnen ursprünglich zugedacht hat: als mathematisches Rüstzeug für seine Argumentationen gegen die Auffassung zu dienen, Wundererzählungen könnten nicht glaubwürdig sein. (shrink)

The protection of human subjects in biomedical research relies on two principal mechanisms: assessing and comparing the risks and potential benefits of proposed research, and obtaining potential subjects' informed consent. While these have been discussed extensively in the literature, no attention has been paid to whether the processes should be different when the objective of an experimental biomedical intervention is to improve individual appearance, performance, or capability rather than to prevent, cure, or mitigate disease . This essay examines this question (...) in order to ensure that subjects in biomedical enhancement research receive adequate protection. (shrink)

There are two critical steps in determining whether a medical experiment involving human subjects can be conducted in an ethical manner: assessing risks and potential benefits and obtaining potential subjects’ informed consent. Although an extensive literature on both of these aspects exists, virtually nothing has been written about human experimentation for which the objective is not to prevent, cure, or mitigate a disease or condition, but to enhance human capabilities. One exception is a 2004 article by Rebecca Dresser on preimplantation (...) genetic modification — one of the most controversial enhancement technologies — in which she states, “Under existing research ethics principles, it would be unethical for investigators to perform modifications exposing embryos expected to develop into healthy children to significant risk in exchange for a possible physical or mental enhancement.” But Dresser does not explain why such an experiment would be unethical under existing principles, and her conclusion is not self-evident. (shrink)

The United States, along with other nations and international organizations, has developed an elaborate system of ethical norms and legal rules to govern biomedical research using human subjects. These policies govern research that might provide direct health benefits to participants and research in which there is no prospect for participant health benefits. There has been little discussion, however, about how well these rules would apply to research designed to improve participants’ capabilities or characteristics beyond the goal of good health. When (...) mentioned at all in the literature, this so-called enhancement research, as opposed to research aimed at diagnosing, preventing, curing, or treating illnesses or medical conditions, is usually dismissed without explanation. (shrink)

Selection on grandparental investment is more complex than Coall & Hertwig (C&H) propose. Patterns of investment are subject to an intergenerational conflict over how resources should be distributed to maximize fitness. Grandparents may be selected to distribute resources unevenly, while their descendants will be selected to manipulate investment in their own favor. Here we outline the evolutionary basis of this conflict.

PurposeThe purpose of this study is to describe the implementation and outcomes of an Eye Movement and Desensitization Reprocessing treatment-program for women with posttraumatic stress disorder after childbirth.MethodsA prospective cohort-study with pre- and post-measurements was carried out in the setting of an academic hospital in the Netherland. Included were women who gave birth to a living child at least 4 weeks ago, with a diagnosis of PTSD, or severe symptoms of PTSD combined with another psychiatric diagnosis. All received up to (...) 8 sessions of EMDR-therapy. The posttraumatic stress disorder Checklist for DSM-5 was administered before and after treatment. Trauma history was assessed before treatment with the Life Events Checklist for the DSM-5, the Childhood Trauma Questionnaire and the Childbirth Perception Scale. Descriptive statistics were used.ResultsForty-four women were referred, 26 met the inclusion criteria. After treatment, none of the women met the criteria for diagnosis of PTSD after on average 5 weekly sessions of EMDR- therapy. These outcomes are promising, as they were achieved in women with relatively high levels of psychiatric comorbidity and high rates of previous mental health treatment.ConclusionImplementing an EMDR-treatment program for women with PTSD after childbirth in the setting of an academic hospital is feasible and effective. Key factors for success include a close collaboration between the relevant hospital departments and a thorough case conceptualization addressing the etiology of the PTSD. (shrink)

Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

This thought-provoking book discusses the concept of progress in economics and investigates whether any advance has been made in its different spheres of research. The authors look back at the history, successes and failures of their respective fields and thoroughly examine the notion of progress from an epistemological and methodological perspective. The idea of progress is particularly significant as the authors regard it as an essentially contested concept which can be defined in many ways – theoretically or empirically; locally or (...) globally; or as encouraging or impeding the existence of other research traditions. The authors discuss the idea that for progress to make any sense there must be an accumulation of knowledge built up over time rather than the replacement of ideas by each successive generation. Accordingly, they are not concerned with estimating the price of progress, reminiscing in the past, or assessing what has been lost. Instead they apply the complex mechanisms and machinery of the discipline to sub-fields such as normative economics, monetary economics, trade and location theory, Austrian economics and classical economics to critically assess whether progress has been made in these areas of research. -/- Bringing together authoritative and wide-ranging contributions by leading scholars, this book will challenge and engage those interested in philosophy, economic methodology and the history of economic thought. It will also appeal to economists in general who are interested in the advancement of their profession. (shrink)

I wish to thank Klaus Kühnle who streamlined in [8] several of my definitions and proofs concerning the subject matter of this paper. Some ideas and results arose from discussions with Klaus Leeb. Jan Johannsen discovered some mistakes in an earlier version.

My reason for bringing up the familiar matter of phenomenalism is both critical and historical. Almost to a man those who have been interested in arguing for or against phenomenalism have assumed that Berkeley was a phenomenalist. Now if Berkeley's doctrine is appropriately named “phenomenalism,” then it is a phenomenalism of a quite different stripe from the twentieth century variety, though many who have described his doctrine as phenomenalism have not sufficiently stressed the difference.

We agree with Barsalou's claim about the importance of perceptual symbols in a theory of abstract concepts. Yet we maintain that the richness of many abstract concepts arises from the metaphorical mapping of recurring patterns of perceptual, embodied experience to provide essential structure to these abstract ideas.

Although the theory of definability had many important antecedents—such as the descriptive set theory initiated by the French semi-intuitionists in the early 1900s—the main ideas were first laid out in precise mathematical terms by Alfred Tarski beginning in 1929. We review here the basic notions of languages, explicit definability, and grammatical complexity, and emphasize common themes in the theories of definability for four important languages underlying, respectively, descriptive set theory, recursive function theory, classical pure logic, and finite-universe logic. We review (...) the history of previous studies of the similarities and differences in the theories of definability of the first three of these four languages. A seminal role leading toward unification of the theories has been played by the separation principles introduced by Nikolai Luzin in 1927. Emphasizing analogies and driving toward further unification embracing finite-universe logic we concentrate on a simple example—the first and second separation principles for existential-universal first-order sentences . Using this as a test case for the fundamental problem of how to “finitize” arguments in classical pure logic to the finite-universe case, we are led to the analogous negative solution by using the theory of certain special graphs: a graph is - special for any positive integers m , n , p , q iff it is bipartite with m red points and n blue points and for every p -tuple of red points there is a blue point to which they are all connected . As an aside we introduce for further study a natural “Ramseyesque” increasing sequence A of positive integers, where A is the least positive integer n for which an -special graph exists. (shrink)

Recently a growing number of biologists have begun to consider the causal role that processes of embryonic development may play in evolution. This constitutes a reunion of these phenomena which had been linked in the nineteenth century through Haeckel's biogenetic law. This reunion may result in a new subdiscipline of biology, if there is a set of unique concepts and methods which tie the various research approaches together. Such concepts as bauplan, canalization, and developmental constraint, may serve in such a (...) capacity. The methods employed must combine comparative and experimental analyses, with special attention paid to the range of variation in developmental events within each taxon. These concepts and methods are also applicable to the problem of how development evolved, thus the evolution of development may also be considered part of the reunion. The reunion is discussed in terms of the potential participation of various schools of thought found in the current literature. (shrink)

The purpose of this brief introduction is to describe the origin of the papers here presented and to acknowledge the help of some of the many individuals who were involved in the preparation of this volume. Of the eighteen papers, nine stem from the annual fall colloquium of the Depart ment of Philosophy at the University of Western Ontario held in London, Ontario from November 10 to November 12, 1967. The colloquium was entitled 'Philosophical Logic'. After some discussion, the editors (...) decided to retain that title for this volume. Von Wright's paper 'On the Logic and Ontology of Norms' is printed here after some revision. A. R. Anderson commented on the paper at the colloquium, but his comments here are based upon the revised version of the von Wright paper. The chairman of the session at which von Wright's paper was read and discussed was T. A. Goudge. Aqvist's paper 'Scattered Topics in Interrogative Logic', and Belnap's comments, 'Aqvist's Cor rections-Accumulating Question-Sequences', are printed as delivered. The chairman of the Aqvist-Belnap session was R. E. Butts. Wilfrid Sellars' paper 'Some Problems about Belief' is printed as delivered at the col loquium, but 'Quantifiers, Beliefs, and Sellars' by Ernest Sosa is a revision of his comments at the colloquium. That session was chaired by G. D. W. Berry. Ackermann's paper 'Some Problems oflnductive Logic', as well as Skyrms' comments, are printed as delivered. (shrink)

For each regular cardinal κ, we set up three systems of infinitary type logic, in which the length of the types and the length of the typed syntactical constructs are $\Sigma _{}$, the global system $\text{g}\Sigma _{}$ and the τ-system $\tau \Sigma _{}$. A full cut elimination theorem is proved for the local systems, and about the τ-systems we prove that they admit cut-free proofs for sequents in the τ-free language common to the local and global systems. These two results (...) follow from semantic completeness proofs. Thus every sequent provable in a global system has a cut-free proof in the corresponding τ-systems. It is, however, an open question whether the global systems in themselves admit cut elimination. (shrink)

We propose the beginnings of an intuitionistic propopsitional dynamic logic, and describe several serious open problems.