Background: Informed consent in clinical research is mandated throughout the world. Both patient subjects and investigators are required to understand and accept the distinction between research and treatment.Aim: To document the extent and to identify factors associated with therapeutic misconception in a population of patient subjects or parent proxies recruited from a variety of multicentre trials .Patients and methods: The study comprised two phases: the development of a questionnaire to assess the quality of informed consent and a survey of patient (...) subjects based on this questionnaire.Results: A total of 303 patient subjects or parent proxies were contacted and 279 questionnaires were analysed. The median age was 49.5 years, sex ratio was 1 and 61% of respondents were professionally active. Overall memorisation of the oral or written communication of informed consent was good , and satisfaction with the process was around 70%. Therapeutic misconception was present in 70% of respondents, who expected to receive better care and ignored the consequence of randomisation and treatment comparisons. This was positively associated with the acuteness and severity of the disease.Conclusion: The authors suggest that the risk of therapeutic misconception be specifically addressed in consent forms as an educational tool for both patients and investigators. (shrink)

Pekakak adalah salah satu tokoh yang memiliki pengetahuan mendalam dan perencanaan yang cermat. Saat fajar menyingsing, ia terlihat bertengger di atas pohon. Dengan kemampuan sempurna untuk mengontrol kecepatan penerbangan miliknya, seperti kapan harus memperlambat atau mempercepat, dia dapat dengan mudah menghitung cara optimal untuk menangkap ikan.

Book Reviews Joël Boudreault, Dialogue: Canadian Philosophical Review/Revue canadienne de philosophie, FirstView Article.

We formalize what it means to have permission to say something. We adapt the dynamic logic of permission by van der Meyden (J Log Comput 6(3):465–479, 1996 ) to the case where atomic actions are public truthful announcements. We also add a notion of obligation. Our logic is an extension of the logic of public announcements introduced by Plaza ( 1989 ) with dynamic modal operators for permission and for obligation. We axiomatize the logic and show that it is decidable.

IΣ n andBΣ n are well known fragments of first-order arithmetic with induction and collection forΣ n formulas respectively;IΣ n 0 andBΣ n 0 are their second-order counterparts. RCA0 is the well known fragment of second-order arithmetic with recursive comprehension;WKL 0 isRCA 0 plus weak König's lemma. We first strengthen Harrington's conservation result by showing thatWKL 0 +BΣ n 0 is Π 1 1 -conservative overRCA 0 +BΣ n 0 . Then we develop some model theory inWKL 0 and illustrate (...) the use of formalized model theory by giving a relatively simple proof of the fact thatIΣ 1 provesBΣ n+1 to be Π n+2-conservative overIΣ n . Finally, we present a proof-theoretic proof of the stronger fact that theΠ n+2 conservation result is provable already inIΔ 0 + superexp. ThusIΣ n+1 proves 1-Con (BΣ n+1) andIΔ 0 +superexp proves Con (IΣ n )↔Con(BΣ n+1). (shrink)

Objective: The objectives of this study are to understand the current functions, structure and operation of hospital ethics committees (HECs) in Shanghai and to facilitate their improvement. Methods: (1) A questionnaire survey, (2) interviews with secretaries and (3) on-site document reviews of HECs in Shanghai were used in the study, which surveyed 33 hospitals. Results: In Shanghai, 57.56% of the surveyed hospitals established HECs from 1998 to 2005. Most HECs used bioethical review of research involving human subjects as well as (...) bioethical review or consultation regarding medical care services and administrative decision- making. Of the surveyed HECs, 14.3% did not provide any formal bioethical training to the HECs’ members and many HECs had no standard operating procedures. Some HECs had no clear definition of what was “conflict of interest” that should be considered by the HECs, while 44.4% of the HECs did not perform continuing review. Discussion: After the issues of related national regulations, more and more hospitals established HECs in Shanghai, but the functions of HECs need to be further developed and formal training on bioethics should be provided to HEC members. To assure the independence and good performance of HECs, the conflict of interest procedure, the standard operating procedures and bioethical review should be improved. Conclusion: HECs in Shanghai had developed in the preceding 10 years and they played great roles in protecting the rights and welfare of human subjects and patients; some areas need improvement. (shrink)