The widely cited Nuffield Council on Bioethics ‘Intervention Ladder’ structurally embodies the assumption that personal autonomy is maximized by non-intervention. Consequently, the Intervention Ladder encourages an extreme ‘negative liberty’ view of autonomy. Yet there are several alternative accounts of autonomy that are both arguably superior as accounts of autonomy and better suited to the issues facing public health ethics. We propose to replace the one-sided ladder, which has any intervention coming at a cost to autonomy, with a two-sided ‘Balanced Intervention (...) Ladder,’ where intervention can either enhance or diminish autonomy. We show that not only the alternative, richer accounts of autonomy but even Mill’s classic version of negative liberty puts some interventions on the positive side of the ladder. (shrink)

The Toronto experience suggests that there may be several general lessons for academic health sciences complexes to learn from the Olivieri/Apotex affair regarding the ethics, independence, and integrity of clinical research sponsored by for profit enterprises. From a local perspective, the OAA occurred when there already was a focus on the complex and changing relationships among the University of Toronto, its medical school, the fully affiliated teaching hospitals, and off campus faculty because of intertwined interests and responsibilities. The OAA became (...) a catalyst that accelerated various systemic reforms, particularly concerning academic/industry relations. In this article, the evolving governance framework for the Toronto academic health sciences complex is reviewed and these policy and process reforms discussed. These reforms have created collaborative activity among research ethics boards and contract research offices of the partner institutions, and allowed the joint university/hospital ethics centre to play a role in governance and policy, while respecting the missions and mandates of the involved institutions. Although few of the policies are dramatically innovative, what is arguably novel is the elaboration of an overarching governance framework that aims to move ethics to a central focus in the academic complex. Time alone will tell how sustainable and effective these changes are. (shrink)

The teaching of ethics in UK medical schools has recently been reviewed, from the perspective of the teachers themselves. A questionnaire survey of medical undergraduates at King’s College London School of Medicine provides useful insight into the students’ perception of ethics education, what they consider to be the value of learning ethics and law, and how engaged they feel with the subject.

The research investigates the role of leadership in the transformation of denominational structures towards a missional ecclesiology, and focusses on the Highveld Synod of the Dutch Reformed Church. It describes the missional journey of the denomination, and interprets the transformation. The theory of ‘complex leadership’ in complex systems is applied to the investigation of the impact of leadership on a denominational structure. The theory identifies three mechanisms used by leaders as enablers in emergent, self-organisation systems: Leaders disrupt existing patterns, they (...) encourage novelty, and they act as sensemakers. These insights are applied as a tool to interpret the missional transformation of a denomination. (shrink)

Background: Funding organisations and research ethics committees should play a part in strengthening attention to gender equality in clinical research. In the research policy of European Union , funding measures have been taken to realise this, but such measures are lacking in the EU policy regarding RECs.Objective: To explore how RECs in Austria, Germany, Ireland, The Netherlands and Sweden deal with gender equality issues by asking two questions: Do existing procedures promote representation of women and gender expertise in the committee? (...) How are sex and gender issues dealt with in protocol evaluation?Methods: Two RECs were selected from each country. Data were obtained through interviews with key informants and content analysis of relevant documents .Results: All countries have rules to ensure the presence of women on RECs; gender expertise is not required. Drug study protocols are carefully evaluated, sometimes on a formal basis, as regards the inclusion of women of childbearing age. The reason for excluding either one of the sexes or including specific groups of women or making a gender-specific risk–benefit analysis are investigated by some RECs. Such measures are, however, neither defined in the regulations nor integrated in review tools.Conclusions: The RECs investigated in five European member states are found to pay limited attention to gender equality in their working methods and, in particular in protocol evaluation. Policy and regulations of EU are needed to strengthen attention to gender equality in the work of RECs. (shrink)

Reprint. Originally published: Rajini's punchtantra: value statements on business and life management. Chennai: New Horizon Media, 2010.

Using historical data from the Utah Population Database, this analysis finds significant, consistent, but small adverse mortality effects for mothers after age 50 who had mostly sons. Examination of age-dependent effects indicates that this association increases with mother’s age. Additionally, mothers who had mostly daughters faced mortality risks that increased with age. Offspring sex composition did not have a significant effect on paternal mortality. Interaction analyses were conducted to examine the effect of offspring sex composition with regard to historical period, (...) residential location, socioeconomic status, and childhood survival. No other interactions were found to be statistically significant. Having mostly boys remained detrimental to maternal mortality regardless of childhood survival. (shrink)

In this sweeping survey, acclaimed science writers Paul Davies and John Gribbin provide a complete overview of advances in the study of physics that have revolutionized modern science. From the weird world of quarks and the theory of relativity to the latest ideas about the birth of the cosmos, the authors find evidence for a massive paradigm shift. Developments in the studies of black holes, cosmic strings, solitons, and chaos theory challenge commonsense concepts of space, time, and matter, and demand (...) a radically altered and more fully unified view of the universe. (shrink)

Paperback reissue of a book first published in 1991. The authors demonstrate how the materialistic and mechanistic world-view that has dominated western culture and science during the last few centuries is being challenged by the findings of modern physics, ranging from relativity to quantum physics. Includes a bibliography and an index. British-born, Davies is a well-known physicist and has written many other books including 'The Mind of God', winner of the 1992 Eureka Science Book Prize. He is currently professor of (...) mathematical physics at the University of Adelaide. Gribbin trained as an astrophysicist and is now a full-time science writer in Britain. (shrink)

The Unruh-Wald scenario for mining quantum black holes is applied to de Sitter space. The following questions are addressed: Will the generalized second law of thermodynamics be maintained for de Sitter horizons? Does the mining process allow the recovery of unlimited energy from the cosmological gravitational field? The evaporation of a black hole in de Sitter space is also investigated in the context of the second law.