This article unfolds in three stages. First, it locates the emergence of modern conceptions of social justice in industrializing Europe, and especially in the discovery of the “social,” which provided a particular idiom for the liberal democratic politics for most of the twentieth century. Second, the article links this particular conception of the social to the political rationalities of the postwar welfare state and the identity of the social citizen. Finally, the article discusses the myriad ways in which this legacy (...) of the social and social justice has been disrupted, although not yet fully displaced, by the economic orthodoxies and individualization that inform the contemporary neoliberal governing project in Canada. The result, the article concludes, has been the institutionalization of insecurity, which demands the renewal of a social way of seeing and a politics of social justice on local and global scales. (shrink)

Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)

Houston, Texas, is a major U.S. city with, like many, a growing aging population. The purpose of this study and ultimate book chapter is to explore the views and perceptions of long-term care (LTC) residents, family members and health care providers. Individuals primarily in independent living and group residential settings were interviewed and studied. Questions emphasized the concepts of personal autonomy, dignity, quality and location of care and decision making. Although a small sample of participants were involved, consistency was noted. (...) Keeping the elderly in caring and loving home situations (theirs or family) was most preferred. Personal choice and independence were emphasized by residents, but family members needed to act as advocates. We also noted that the legal system emphasizes family control over individual decision making as competency declines with aging. Optimal personal decision making in the residents' best interest also became more difficult with loss of individual mental capacity. (shrink)

This article examines the Canadian case, focusing on the ways in which the political rationalities that have informed the Canadian variants of post-war social liberalism and neoliberalism have opened and then closed spaces for the articulation and institutionalization of gender-based equality claims-making. The article recounts how the Canadian welfare state underwrote a unique gender equality infrastructure inside the state and a thick field of gender organizations in civil society and later how this potent political and symbolic node of social liberalism (...) became a critical field of contestation for those promoting neoliberal political rationalities. The article describes a protracted war of position in which the gendered politics and identities of the 20th century have been displaced and marginalized, but not fully consumed by neoliberal idioms, representations and policy interventions. (shrink)

Tversky and Koehler's support theory attempts to explain why probability judgments are affected by the manner in which formally similar events are described. Support theory suggests that as the explicitness of a description increases, an event will be judged to be more likely. In the present experiment, experienced decision-makers from large, international accounting firms were given case-specific information about an audit client and asked to provide a series of judgments regarding the perceived likelihood of events. Unpacking a hypothesis into four (...) formally equivalent hypotheses more than doubled its perceived likelihood. These results are largely consistent with support theory, extending its generalizability to applied contexts involving business professionals. Further, the paper finds that task-specific factors, a previously untested area, can also affect support theory interpretations. (shrink)

BACKGROUND: Many published accounts of clinical trials report no differences between the treatment arms, while being underpowered to find differences. This study determined how the authors of these reports interpreted their findings. STUDY DESIGN: We examined 54 reports of surgical trials chosen randomly from a database of 110 influential trials conducted in 2008. Seven that reported having adequate statistical power were excluded from further analysis, as were the 32 that reported significant differences between the treatment arms. We examined the remaining (...) 15 to see whether the authors interpreted their negative findings appropriately. Appropriate interpretations discussed the lack of power and/or called for larger studies. RESULTS: Three of the 7 trials that did not report an a priori power calculation offered inappropriate interpretations, as did 3 of the 8 trials that reported an a priori power < 0.90. However, we examined only a modest number of trial reports from 1 year. CONCLUSIONS: Negative findings in underpowered trials were often interpreted as showing the equivalence of the treatment arms with no discussion of the issue of being underpowered. This may lead clinicians to accept new treatments that have not been validated. (shrink)

Given a sequence {a n } in (0,1) converging to a rational, we examine the model theoretic properties of structures obtained as limits of Shelah-Spencer graphs G(m, m -αn ). We show that in most cases the model theory is either extremely well-behaved or extremely wild, and characterize when each occurs.

Ulf Schmidt, writing on “Medical Ethics and Nazism” in the recently published Cambridge World History of Medical Ethics, states:In 1920, the lawyer Karl Binding and the psychiatrist Alfred Hoche published their tract Permission for the Destruction of Life Unworthy of Life. … Their positivistic theory was a combination of legal norms and medical arguments that granted the state fundamental rights while overriding the rights of individuals. The traditional moral belief system that advocated care and compassion for the weak and unproductive (...) was radically called into question. The book was written in the wake of World War I; readers were asked to compare the “battlefields littered with.. (shrink)

Originally published in 1948, this book contains an edited version of The Tree of Commonwealth, which was written by Edmund Dudley while imprisoned in the Tower of London in 1509 prior to his execution for treason the following year. Brodie notes any variations between manuscripts and provides a brief biography of Dudley and the impact of his famous text on later monarchs. This book will be of value to anyone with an interest in Tudor history or the history of (...) English statesmanship. (shrink)

section 1. Medical ethics -- section 2. Technology -- section 3. Social and business issues -- section 4. Ritual -- section 5. Women -- section 6. Israel -- section 7. Kashrut -- section 8. Jewish identity and marriage -- section 9. Shabbat and holiday.

There has been a growing concern over establishing norms that ensure the ethically acceptable and scientifically sound conduct of clinical trials. Among the leading norms internationally are the World Medical Association's Declaration of Helsinki, guidelines by the Council for International Organizations of Medical Sciences, the International Conference on Harmonization's standards for industry, and the CONSORT group's reporting norms, in addition to the influential U.S. Federal Common Rule, Food and Drug Administration's body of regulations, and information sheets by the Department of (...) Health and Human Services. There are also many norms published at more local levels by official agencies and professional groups.Any account of international standards should cover both scientific and ethical norms at once – the two are conceptually intertwined. Recent sources recognize that “[s]cientifically unsound research on human subjects is unethical in that it exposes research subjects to risks without possible benefit.”. (shrink)

This chapter contains sections titled: Of Greek Gods, the Judaeo‐Christian God, and the Sea A Ship Bound for India Beyond the Pillars of Hercules.

The evaluation of the European Moral Case Deliberation Outcomes project (Euro-MCD) has resulted in a revised evaluation instrument, knowledge about the content of MCD (moral case deliberation), and the perspectives of those involved. In this paper, we report on a perspective that has been overlooked, the facilitators’. We aim to describe facilitators’ perceptions of high-quality moral case deliberation and their Euro-MCD sessions. The research took place in Norway, Sweden, and the Netherlands using a survey combined with interviews with 41 facilitators. (...) Facilitators’ perceived that attaining a high-quality MCD implies fostering a safe and respectful atmosphere, creating a wondering mode, being an attentive authority, developing moral reflective skills, reaching a common understanding, and ensuring organisational prerequisites for the MCD sessions. Our central conclusion is that efforts at three levels are required to attain a high-quality MCD: trained and virtuous facilitator; committed, respectful participants; and organizational space. Furthermore, managers have a responsibility to prepare MCD participants for what it means to take part in MCD. (shrink)

This essay is composed of five stories written by practicing physicians about their patients. Each clinical story describes a challenging ethical condition–potential abuse of medical power, gravely ill and probably over-treated newborns, iatrogenic narcotic addiction, deceived dying people. Rather than singling out one ethical conflict to resolve or adjudicate, the authors attempt, through literary methods, to grasp the singular experiences of their patients and to act according to the deep structures of their patients' lives. Examining these five stories with simple (...) literary tools–attention to narrative frames, time, plot, and desire–reveals the mechanisms through which acts of writing and reading contribute to clinical clarity and ethical actions. (shrink)

Background: Clinical ethics support instruments aim to support healthcare professionals in dealing with moral challenges in clinical practice. CURA is a relatively new instrument tailored to the wishes and needs of healthcare professionals in palliative care, especially nurses. It aims to foster their moral resilience and moral competences. Aim: To investigate the effects of using CURA on healthcare professionals regarding their Moral Resilience and Moral Competences. Design: Single group pre-/post-test design with two questionnaires. Methods: Questionnaires used were the Rushton Moral (...) Resilience Scale measuring Moral Resilience and the Euro-MCD, measuring Moral Competences. Respondents mainly consisted of nurses and nurse assistants who used CURA in daily practice. Forty-seven respondents contributed to both pre- and post-test with 18 months between both tests. Analysis was done using descriptive statistics and Wilcoxon signed rank tests. This study followed the SQUIRE checklist. Ethical considerations: This study was approved by the Institutional Review Board of Amsterdam UMC. Informed consent was obtained from all respondents. Results: The total Moral Resilience score and the scores of two subscales of the RMRS, that is, Responses to Moral Adversity and Relational Integrity, increased significantly. All subscales of the Euro-MCD increased significantly at posttest. Using CURA more often did not lead to significant higher scores on most (sub) scales. Conclusion: This study indicates that CURA can be used to foster moral resilience and moral competences of healthcare professionals. CURA therefore is a promising instrument to support healthcare professionals in dealing with moral challenges in everyday practice. (shrink)

Volume 20, Issue 10, October 2020, Page 65-66.

This study investigated potential risk factors (coping, perfectionism and self-regulation) for substantial injuries in contemporary dance students using a prospective cohort design, as high-quality studies focusing on mental risk factors for dance injuries are lacking. Student characteristics (age, sex, BMI, educational program and history of injury) and psychological constructs (coping, perfectionism and self-regulation) were assessed using the Performing artist and Athlete Health Monitor (PAHM), a web-based system. Substantial injuries were measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on (...) Health Problems and recorded on a monthly basis as part of the PAHM system. Univariate and multivariate logistic regression analyses were conducted to test the associations between potential risk factors (i.e. student characteristics and psychological constructs) and substantial injuries. 99 students were included in the analyses. During the academic year 2016-2017, 48 students (48.5%) reported at least one substantial injury. Of all factors included, coping skills (OR: 0.91; 95% CI: 0.84–0.98), age (OR: 0.67; 95% CI: 0.46–0.98) and BMI (OR: 1.38; 95% CI: 1.05–1.80) were identified as significant risk factors in the multivariate analysis. The model explained 24% of the variance in the substantial injury group. Further prospective research into mental risk factors for dance injuries with larger samples sizes is needed to develop preventive strategies. Yet, dance schools could consider including coping skills training as part of injury prevention programs and, perhaps, providing special attention to younger dancers and those with a higher BMI through transitional programs to assist them in managing the stress they experience throughout their (academic) career. (shrink)

In 1979, James S. and Jean M. Goodwin and Albert V. Vogel published the first of what became a series of articles that studied current patterns of placebo use. They surveyed 60 house officers and 37 nurses in a New Mexico teaching hospital. Only five of the 1900 patients hospitalized during the study period had received a placebo. Their subjects underestimated the pain relief provided by placebos and believed that a positive placebo response showed that the pain was psychogenic and (...) not “real.” The few patients who were prescribed placebos tended to be those whom the staff most disliked. A few other studies published during the 1980s showed similar results.Fast forward now to 2010.... (shrink)

La parution récente en français du livre de M. Denton : “Evolution. Une théorie en crise” , qui traite des theories explicatives actuelles de l'évolution, nous amine à rappeler les caracteres généraux des grandes theories biologiques et à présenter une critique sommaire du livre en question.La science West pas une simple accumulation de connaissances. Le scientifique ne doit pas se contenter de decrire et de mesurer des faits. Son but eat d'essayer de les relier et de construire des théories qui (...) tentent de nous faire comprendre le “reel”, objet de ses recherches.Cependant, la nature du matériel biologique — c'est-à-dire les espèces vivantes et les catégories qu'on y a reconnues, classe ou ordre par exemple — est si complexe qua la biologie actuelle est fort loin encore Wavoir réalisé une synthèse qui ressemble, méme très approximativement, à la classification de Mendéleiev pour les éléments chimiques.Malgré cette complexité, les biologques ont réussi à construire la th6orie du fait de l'evolution et ils proposent aujourd'hui une théorie explicative de cette évolution qui, bien qua critiquée, est incontestablement bien étayee. Nous allons essayer de définir la structure des grandes théories biologiques; ensuite nous analyserons sommairement quelques-unes des critiques qui sont adressees aux theories de l'évolution.Considering the publication in French version of Michael Denton's book, Evolution : A Theory in crisis , in which he critizes the synthetical theory of the biological evolution, we thought it useful to point out the main errors of argumentation contained in that book by first referring to the characteristics of general biological theories.In biology, there exist elementary theories - such as that dealing with the extinction of giant Reptiles - and general theories - such as the chromosomic theory of heredity and the explanatory theory of evolution. The latter generally consist of a group of elementary theories imbricated so that they form a whole like a jig-saw puzzle. An example is provided by the synthetic theory of evolution that can be defined in 20 propositions divided into two categories : the propositions relating to the naturalists' observations - which correspond to descriptive concepts - and those relating to the data of the population genetics - which correspond to explanatory concepts . The general scheme of the theory is formed by a network of relations between the descriptive concepts and the explanatory concepts. There also exist other theories in general biology supported by thousands of minor facts which only together can be of proof of validity. These theories are quite reliable and cannot be questioned by facts still to be explained. Questioning can only happen if they are confronted to well-established data in nearly equal numbers.In his work, Denton does not deny the phenomenon of biological evolution, but he criticizes the syntheticians' ideas by emphasizing that no great evolutive changes can be accounted for by the complex mechanism of random mutations and selection. He goes back to a typological concept of the zoological classification in some way similar to that of Vialleton's. However, Denton agrees with the phenomenon of the biological evolution and accepts the existence of "saltations" among the great zoological groups. The arguments used by Denton merely show that he is not conversant with the complexity of sciences particularly in comparative anatomy and zoology, the teaching of which is being somehow neglected today.By giving as an example the structure of the aortic arches in Amphibians and by a summary of the variations of those structures and the evolution of the blood-circulation in Vertebrates, we proved that the typological argument is of no value. As a matter of fact, a study of the now living beings clearly shows the gradual transition - e.g. a transition by a very large number of feasible stages - from the Lower Vertebrates to the Higher Vertebrates. In particular, there have been several attempts at double circulation and there still exist many species in which the blood of the double circulation is mixed. It seems therefore obvious that the double circulation has been achieved, stage by stage, with many intermediate schemes; we are inclined, therefore, to conclude that this succession of small transformations was produced by a huge mechanism of selected small mutations.Our present-day biological knowledge includes a number of examples large enough to consider the “argument of the impossible” used by Denton is due to inadequate fossil data and not to any mysterious mechanism such as macromutations. Let us say again that the typological structures seem to occur only when the data of comparative anatomy and zoology are over-simplified. (shrink)