Improving the treatment of life threatening emergency illness or disease requires that new or novel therapies be assessed in clinical trials. As most subjects for these trials will be incapacitated there is some controversy about they might best protected whilst still allowing research to continue. Recent European and UK clinical trials legislation, which has effectively stopped research into emergency conditions, is discussed. Possible changes to these regulations are proposed.
In ‘Wittgenstein on Language and Rules’, Professor N. Malcolm took us to task for misinterpreting Wittgenstein's arguments on the relationship between the concept of following a rule and the concept of community agreement on what counts as following a given rule. Not that we denied that there are any grammatical connections between these concepts. On the contrary, we emphasized that a rule and an act in accord with it make contact in language. Moreover we argued that agreement in judgments (...) and in definitions is indeed necessary for a shared language. But we denied that the concept of a language is so tightly interwoven with the concept of a community of speakers as to preclude its applicabilty to someone whose use of signs is not shared by others. Malcolm holds that ‘This is an unwitting reduction of Wittgenstein's originality. That human agreement is necessary for “shared” language is not so striking a thought as that it is essential for language simpliciter.’ Though less striking, we believe that it has the merit of being a true thought. We shall once more try to show both that it is correct, and that it is a correct account of Wittgenstein's arguments. (shrink)
In April 1939, G. E. Moore read a paper to the Cambridge University Moral Science Club entitled ‘Certainty’. In it, amongst other things, Moore made the claims that: the phrase ‘it is certain’ could be used with sense-experience-statements, such as ‘I have a pain’, to make statements such as ‘It is certain that I have a pain’; and that sense-experience-statements can be said to be certain in the same sense as some material-thing-statements can be — namely in the sense that (...) they can be safely counted on. When Moore later read his paper to Wittgenstein, Wittgenstein took violent exception to it, and the two entered into a heated exchange. The only known notes of this exchange are a previously unpublished verbatim record of part of it, taken by Norman Malcolm. This paper is an edition of Malcolm’s notes. These notes are valuable for both philosophical and scholarly reasons. They give us a glimpse of a sustained exchange between Wittgenstein and a real-life interlocutor; they contain a defence by Wittgenstein of the idea that a word’s use can illuminate its meaning; and they provide evidence of Wittgenstein’s philosophical engagement with the topic of certainty, and with Moore’s thought on it, long before he began to write the notes which make up On Certainty, in 1949. (shrink)
Background/Aim: The law on consent has changed in Scotland with the introduction of the Adults with Incapacity Act 2000. This Act introduces the concept of proxy consent in Scotland. Many patients in intensive care are unable to participate in the decision making process because of their illness and its treatment. It is normal practice to provide relatives with information on the patient’s condition, treatment, and prognosis as a substitute for discussion directly with the patient. The relatives of intensive care patients (...) appeared to believe that they already had the right to consent on behalf of an incapacitated adult. The authors’ aim was to assess the level of knowledge among relatives of intensive care patients of both the old and new law using a structured questionnaire.Methods: The next of kin of 100 consecutive patients completed a structured questionnaire. Each participant had the questions read to them and their answers recorded. Patients were not involved in the study.Results: Few were aware of the changes. Most thought that they previously could give consent on behalf of an incapacitated adult. Only 13% have ever discussed the preferences for life sustaining treatment with the patient but 84% felt that they could accurately represent the patient’s wishes.Conclusions: There appeared to be a lack of public awareness of the impending changes. The effectiveness of the Act at improving the care of the mentally incapacitated adult will depend largely on how successful it is at encouraging communication and decision making in advance of incapacity occurring. (shrink)
Throughout the biological and biomedical sciences there is a growing need for, prescriptive ‘minimum information’ (MI) checklists specifying the key information to include when reporting experimental results are beginning to find favor with experimentalists, analysts, publishers and funders alike. Such checklists aim to ensure that methods, data, analyses and results are described to a level sufficient to support the unambiguous interpretation, sophisticated search, reanalysis and experimental corroboration and reuse of data sets, facilitating the extraction of maximum value from data sets (...) them. However, such ‘minimum information’ MI checklists are usually developed independently by groups working within representatives of particular biologically- or technologically-delineated domains. Consequently, an overview of the full range of checklists can be difficult to establish without intensive searching, and even tracking thetheir individual evolution of single checklists may be a non-trivial exercise. Checklists are also inevitably partially redundant when measured one against another, and where they overlap is far from straightforward. Furthermore, conflicts in scope and arbitrary decisions on wording and sub-structuring make integration difficult. This presents inhibit their use in combination. Overall, these issues present significant difficulties for the users of checklists, especially those in areas such as systems biology, who routinely combine information from multiple biological domains and technology platforms. To address all of the above, we present MIBBI (Minimum Information for Biological and Biomedical Investigations); a web-based communal resource for such checklists, designed to act as a ‘one-stop shop’ for those exploring the range of extant checklist projects, and to foster collaborative, integrative development and ultimately promote gradual integration of checklists. (shrink)
Since 1995, students, researchers, and professionals have turned to The Craft of Research for clear and helpful guidance on how to conduct research and report it effectively. Now, master teachers Wayne C. Booth, Gregory G. Colomb, and Joseph M. Williams have completely revised and updated their classic handbook. The new edition will continue to help thousands of students and writers plan, carry out, and report on research to produce effective term papers, dissertations, articles, or books -- in any field, (...) at any level. (shrink)