The U.S. Food and Drug Administration's rationale for supporting the development and approval of BiDil for heart failure specifically in black patients was based on under-powered, post hoc subgroup analyses of two relatively old trials , which were further complicated by substantial covariate imbalances between racial groups. Indeed, the only statistically significant difference observed between black and white patients was found without any adjustment for potential confounders in samples that were unlikely to have been adequately randomized. Meanwhile, because the accepted (...) baseline therapy for heart failure has substantially improved since these trials took place, their results cannot be combined with data from the more recent trial amongst black patients alone. There is therefore little scientific evidence to support the approval of BiDil only for use in black patients, and the FDA's rationale fails to consider the ethical consequences of recognizing racial categories as valid markers of innate biological difference, and permitting the development of group-specific therapies that are subject to commercial incentives rather than scientific evidence or therapeutic imperatives. This paper reviews the limitations in the scientific evidence used to support the approval of BiDil only for use in black patients; calls for further analysis of the V-HeFT I and II data which might clarify whether responses to H-I vary by race; and evaluates the consequences of commercial incentives to develop racialized medicines. We recommend that the FDA revise the procedures they use to examine applications for race-based therapies to ensure that these are based on robust scientific claims and do not undermine the aims of the 1992 Revitalization Act. (shrink)

Because of his preoccupation with the formal aspects of music and literature, Theodor W. Adorno is often regarded as the most aesthetically oriented thinker of the Frankfurt School theorists. It is Adorno’s perceived commitment to aestheticism—the study of art for art’s sake and the study of art as a source of sensuous pleasure, rather than as a vehicle for culturally constructed morality or meaning—that many scholars have criticized as hostile to genuine, concrete, substantive political, social, and ethical engagement with the (...) arts. _Adorno and Ethics_—the first issue of _New German Critique_ to be published by Duke University Press—takes issue with Adorno’s critics. These essays reconsider Adorno’s unique brand of aestheticism, revealing a “politics of aestheticism” and exploring the political and ethical dimensions of his writings. One contributor links the ethical turn taken in Adorno criticism with related developments in American poetry and poetics. Another examines Adorno’s aphorism “Gold Assay” for the ways in which it anticipates one of his seminal works, _The Jargon of Authenticity_. Focusing on Auschwitz and the testimony of its survivors, one contributor explores the impact of the Holocaust on modern philosophy and reason, a relationship that he argues Adorno never specified. Another contributor considers the figure of the animal in the writings of Kant, Adorno, and Lévinas, exploring what it might mean to live, as Adorno suggests, as “a good animal.” _Contributors_. J. M. Bernstein, Detlev Claussen, Samir Gandesha, Alexander García Düttmann, Christina Gerhardt, Martin Jay, Robert Kaufman, Michael Marder, Gerhard Richter. (shrink)

Managers vs. Owners: The Struggle for Corporate Control in American Democracy deals with a subject of profound importance: understanding the place of the modern corporation in a democratic society. This latest volume in the acclaimed Ruffin Series in Business Ethics describes how the balance between corporate power and government regulation has changed with the interests of society as a whole. The first section examines the debates over the rules that individuals or organized groups would agree to follow in their interactions (...) to accrue social advantages. The second section looks at management's point of view and tells how law promotes the need for managerial collective action and provides a vocabulary for articulating management as a profession. The authors conclude by looking at the impact of collective investor action - especially institutional investors - on the efforts by managers to preserve their autonomy. This examination of the inherent conflicts between the interests of corporate owners, the interests of the larger society, and the interests of managers who run corporations will be essential reading for students, scholars, and professionals concerned with the place of the large corporation in a democratic society. (shrink)

In six compelling chapters, this book recounts conversations that discuss what is ethical, why it does not occur more often, and how can we improve ethical conduct in our personal and public lives. The conversations include Knowing Ethical Principles, Learning How to Apply Principles in Practice, Moral Reminders, Accountability for Conduct, Addressing Structural Problems, and Ethical Vigilance. Major ethical perspectives are discussed in conversational format, as are fascinating ethical dilemmas taken from actual cases to evaluate and improve our ability to (...) identify ethical principles and make decisions that reflect concerns beyond self-interest. (shrink)

RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

The False Claims Act, 31 U.S.C. § 3729, a post-Civil War law inspired by cases of defense contracting fraud, was revitalized in 1986. Since then it has been used to sue both manufacturers and providers of pharmaceuticals. In some cases, these suits were meant to target offlabel marketing of pharmaceuticals. In 2009, the 11th Circuit rendered a decision in Hopper v. Solvay Pharmaceuticals that dramatically limits the ability of private plaintiff whistle-blowers to bring qui tam suits under the FCA for (...) such marketing. In June 2010, the Supreme Court denied certiorari, making the Circuit court decision final. The Solvay decision creates a significant barrier to certain kinds of qui tam suits, requiring the plaintiff to demonstrate the intent to market off-label, including by showing specific prescriptions that were written as a result of efforts to do so. (shrink)

The first longevity revolution began in the middle of the 19th century, accelerated through the first half of the 20th century, and led to the first and only quantum leap in human life expectancy.In the 20th century alone, life expectancy at birth in most developed nations rose by about 30 years. The first three quarters of the century were notable for gains made at younger and middle ages, and in the last quarter century, old age mortality declined. Nothing in history (...) has ever come close to the magnitude of this benefit to humanity. The rise in life expectancy occurred swiftly because the primary beneficiaries of advances in public health and... (shrink)

Distributional semantic models (DSMs) are a primary method for distilling semantic information from corpora. However, a key question remains: What types of semantic relations among words do DSMs detect? Prior work typically has addressed this question using limited human data that are restricted to semantic similarity and/or general semantic relatedness. We tested eight DSMs that are popular in current cognitive and psycholinguistic research (positive pointwise mutual information; global vectors; and three variations each of Skip-gram and continuous bag of words (CBOW) (...) using word, context, and mean embeddings) on a theoretically motivated, rich set of semantic relations involving words from multiple syntactic classes and spanning the abstract–concrete continuum (19 sets of ratings). We found that, overall, the DSMs are best at capturing overall semantic similarity and also can capture verb–noun thematic role relations and noun–noun event-based relations that play important roles in sentence comprehension. Interestingly, Skip-gram and CBOW performed the best in terms of capturing similarity, whereas GloVe dominated the thematic role and event-based relations. We discuss the theoretical and practical implications of our results, make recommendations for users of these models, and demonstrate significant differences in model performance on event-based relations. (shrink)

Gilles Deleuze is considered one of the most important French philosophers of the twentieth century. Eleanor Kaufman situates Deleuze in relation to others of his generation, such as Jean-Paul Sartre, Pierre Klossowski, Maurice Blanchot, and Claude Lévi-Strauss, and she engages the provocative readings of Deleuze by Alain Badiou and Slavoj ?i?ek. Deleuze, The Dark Precursor is organized around three themes that critically overlap: dialectic, structure, and being. Kaufman argues that Deleuze's work is deeply concerned with these concepts, even (...) when he advocates for the seemingly opposite notions of univocity, nonsense, and becoming. By drawing on scholastic thought and reading somewhat against the grain, Kaufman suggests that these often-maligned themes allow for a nuanced, even positive reflection on apparently negative states of being, such as extreme inertia. This attention to the negative or minor category has implications that extend beyond philosophy and into feminist theory, film, American studies, anthropology, and architecture. (shrink)

For decades, policy-makers in government, development banks and foundations, NGOs, researchers and students have struggled with the problem of how to protect people who are displaced from their homes and livelihoods by development projects. This book addresses these concerns and explores how debates often become deadlocked between 'managerial' and 'movementist' perspectives. Using development ethics to determine the rights and responsibilities of various stakeholders, the authors find that displaced people must be empowered so as to share equitably in benefits rather than (...) being victimized. They propose a governance model for development projects that would transform conflict over displacement into a more manageable collective bargaining process and would empower displaced people to achieve equitable results. Their book will be valuable for readers in a wide range of fields including ethics, development studies, politics and international relations as well as policy making, project management and community development. (shrink)

In this empirical paper, Jay, Stone, Meksin, Merck, Gordon and Hirst examine whether jury deliberations, in which individuals collaboratively recall and discuss evidence of a trial, shape the jurors’ memories. In doing so, Jay and colleagues provide a highly ecologically valid baseline for future investigation into why, how and when selective recall either facilitates remembering or leads to forgetting during jury deliberations. In particular, Jay et al. explore the specific social and cognitive mechanisms that might lead to either memory facilitation (...) (RIFA – Retrieval Induced Facilitation) and forgetting (RIF ‐ Retrieval Induced Forgetting) during jury deliberation. (shrink)

Despite the lack of invariance problem (the many‐to‐many mapping between acoustics and percepts), human listeners experience phonetic constancy and typically perceive what a speaker intends. Most models of human speech recognition (HSR) have side‐stepped this problem, working with abstract, idealized inputs and deferring the challenge of working with real speech. In contrast, carefully engineered deep learning networks allow robust, real‐world automatic speech recognition (ASR). However, the complexities of deep learning architectures and training regimens make it difficult to use them to (...) provide direct insights into mechanisms that may support HSR. In this brief article, we report preliminary results from a two‐layer network that borrows one element from ASR, long short‐term memory nodes, which provide dynamic memory for a range of temporal spans. This allows the model to learn to map real speech from multiple talkers to semantic targets with high accuracy, with human‐like timecourse of lexical access and phonological competition. Internal representations emerge that resemble phonetically organized responses in human superior temporal gyrus, suggesting that the model develops a distributed phonological code despite no explicit training on phonetic or phonemic targets. The ability to work with real speech is a major advance for cognitive models of HSR. (shrink)

H. Jay Dinshah, the father of the modern vegan movement in America and founder of American Vegan Society, eloquently explains ethical reasons for veganism. His daughter Anne updates and edits his pioneering writings. Over forty vegan luminaries tell how they were influenced and inspired by Jay. Together they encourage readers to explore ways to promote positive action in the world towards veganism through “dynamic harmlessness.”.

The stakeholder perspective has provided a rich forum for a variety of debates at the intersection of business and society. Scholars gathered for two consecutive years, first in North America, and then in Europe, to discuss the major issues surrounding what has come to be known as stakeholder theory, to attempt to find common ground, and to uncover areas in need of further inquiry. Those meetings led to a list of “tensions” and a call for papers for this special issue (...) to help address them. In this article, we introduce the resulting articles and provide some brief commentary on their importance. We end with a few of our own observations about the stakeholder perspective and stakeholder research. (shrink)

Philosophy of science has the potential to enhance scientific practice, science policy, and science education; moreover, recent research indicates that many philosophers of science think we ought to increase the broader impacts of our work. Yet, there is little to no empirical data on how we are supposed to have an impact. To address this problem, our research team interviewed 35 philosophers of science regarding the impact of their work in science-related domains. We found that face-to-face engagement with scientists and (...) other stakeholders was one of the most—if not the most—effective pathways to impact. Yet, working with non-philosophers and disseminating research outside philosophical venues is not what philosophers are typically trained or incentivized to do. Thus, there is a troublesome tension between the activities that are likely to lead to broader uptake of one’s work and those that are traditionally encouraged and rewarded in philosophy. We suggest several ways that philosophers of science, either as individuals or as a community, can navigate these tensions. (shrink)

Light effects on the activity of several genes have recently been exploited in studies of plant gene expression. We discuss here some examples involving nuclear genes of higher plants, with emphasis on responses mediated by the phytochrome system. Recent work has revealed considerable diversity in the responses of different genes, indicating that several different regulatory programs are probably involved. A start has been made in studies of nuclear events associated with the changes in expression. Transcriptional regulation almost certainly occurs, although (...) many details remain to be studied and effects on mRNA processing and turnover have not been ruled out. Recent in vitro mutagenesis and gene transfer experiments with the gene for the small subunit of RuBP carboxylase indicate that sequences involved in regulating the level of expression in the light are located 5′ to the gene within about 1 kb of the start of transcription. (shrink)

A definition of ?alienation? is proposed which is a rational reconstruction of the term as it is used in primarily moral contexts. Special attention is given to the Marxist tradition. It is argued that the earliest, moral form of Marx's economic determinism can be expressed in terms of the principle of the sufficiency of unalienated labor. In this connection four main kinds of alienation are distinguished. In the final section, it is argued that while ?alienation? has and should have an (...) important theoretical role in the context of moral discourse, social scientists, and in particular sociologists, would be better off if they eliminated ?alienation? from their scientific vocabulary. (shrink)

The arguments contained in books criticizing American social scientists by C. Wright Mills ( The Sociological Imagination) and Bernard Crick (The Science of American Politics) are discussed, compared and criticized. It is argued that Mills' criteria of evaluation and constructive alternatives to the tendencies he criticizes are immeasurably sounder than those found in Crick's book. An effort to supplement Mills' argument by providing a more explicit statement of its moral underpinnings is made. Finally, it is argued that though both critiques (...) have serious empirical flaws, the authors have undeniably demonstrated that important tendencies for irresponsible thought and action do exist within the American social sciences. (shrink)

The idea of human rights gained prominence at a time when the rising bourgeoisie viewed the state as the main obstacle to commercial expansion, private property as the major protection against dependency, and material scarcity as an indelible condition of society. As moral concepts are largely shaped by the social forces that call them into being, it is not surprising that the very language of rights was early tailored to suit the needs of an expanding, acquisitive, increasingly powerful segment of (...) society. (shrink)

Blair makes a strong case that fluid cognition and psychometric g are not identical constructs. However, he fails to mention the development of the prefrontal cortex, which likely makes the Gf–g distinction different in children than in adults.1 He also incorrectly states that current IQ tests do not measure Gf; we discuss several recent instruments that measure Gf quite well. (Published Online April 5 2006).

Examination of human activities and their outcomes is a basic function of philosophy. Historically such examination has tended to conform to one of two patterns.

The European Convention on Human Rights has been incorporated into UK domestic law. It gives many rights to patients within the National Health Service. This article explores the concept of patients’ right to privacy. It stresses that privacy is a basic human right, and that its respect by health professionals is vital for a patient’s physical, mental, emotional and spiritual well-being. I argue that health professionals can violate patients’ privacy in a variety of ways. For example: the right to enjoy (...) their property; the right to protect their medical and personal information as confidential; the right to expect treatment with dignity during intimate care; and the right to control their personal space and territory. Some preliminary evidence indicates that many health care practitioners, including nurses, are presently unaware of the articles of the Convention and the implications of the Human Rights Act 1998. In order to prevent litigation for breaches of patients’ privacy, it is advocated that universities and other educational institutions, the Government and NHS trusts should help to produce a clear educational strategy and protocols so that students and practitioners are well informed in this field. Although 41 European countries are presently the signatories of the European Convention on Human Rights, including the UK, it is important to stress that the principles discussed in this article are applicable world-wide. (shrink)

Written by researchers in their field, this book is about the skills beyond basic word recognition that are necessary for the processing and comprehension of spoken and written language. It offers topics such as: language and text analysis; cognitive processing and comprehension; development of literacy; literacy and schooling; and more.