Surgical devices are often marketed before there is good evidence of their safety and effectiveness. Our paper discusses the ethical issues associated with the early marketing and use of new surgical devices from the perspectives of the six groups most concerned. Health Canada, which is responsible for licensing new surgical devices, should amend their requirements to include rigorous clinical trials that provide data on effectiveness and safety for each new product before it is marketed. Industry should comply with all Health (...) Canada requirements to obtain licenses for new products. Until Health Canada requires effectiveness and safety data, industry should cooperate with physicians in appropriate studies before releasing new products and should make balanced presentations of all the available evidence. Surgeons should, before using a new surgical device, assess the evidence on its effectiveness and safety and ensure they are properly trained and competent in using the device. Surgeons should provide their patients with an evaluation of the available evidence and inform them about possible complications and the surgeon's level of experience with the new device. Patients, who should be given an honest evaluation of the available evidence, possible complications, and the surgeon's experience, should be encouraged to evaluate the evidence and information to their own satisfaction to ensure that fully informed consent is given. Health institutions, responsible for regulating practice within their walls, should review new devices for safety, effectiveness, and economic impacts, before allowing their use. They should also limit the use of new surgical devices to surgeons trained and competent in the new technology. Professional societies should provide guidance on the early adoption of new surgical devices and technologies. We urge all those involved in the development, licensing, and use of new surgical devices to aim for higher ethical standards to protect the health and safety of patients requiring surgery. The lowest acceptable ethical standard would require device manufacturers to provide surgeons with accurate and timely information on the efficacy and safety of their products, allowing surgeons and patients to evaluate the evidence (and the significance of information not yet available) before surgery. (shrink)
This study throws new light on the composition of Boyle's Free Enquiry into the Vulgarly Receiv'd Notion of Nature ; it also draws more general conclusions about Boyle's methods as an author and his links with his context. Its basis is a careful study of the extant manuscript drafts for the work, and their relationship with the published editions. Section 2 describes Boyle's characteristic method of composition from the late 1650s onwards, involving the dictation of discrete sections of text to (...) amanuenses; it also assesses the effect this had on the structure and presentation of Boyle's writings. Section 3 considers the published text section by section and indicates which parts were written when; it also surveys unpublished draft material relating to the work. Section 4 places the work in context, considering the intellectual threats that Boyle sought to confront in it, both when he initially composed it in the 1660s and when he rewrote it c. 1680. It thus anchors him more precisely than hitherto in the intellectual debates of his day. (shrink)
Das »Richtige und das Gute« (1930), das ethische Hauptwerk W. D. Ross’, enthält eine Vielzahl wichtiger moralphilosophischer Thesen und Argumente, die bis in die Gegenwart kontrovers diskutiert werden. Im Mittelpunkt steht seine pluralistische Deontologie, der zufolge sich die richtige Handlung aus einer Abwägung der in der jeweiligen Situation relevanten und unableitbaren Prima-facie-Pflichten ergibt, von denen nur ein Teil auf die Optimierung der Handlungsfolgen bezogen ist. Diese Deontologie wurde zu einem modernen Klassiker unter den normativen ethischen Theorien. Darüber hinaus stellt (...)Ross’ These, dass moralische Intuitionen eine Quelle selbstevidenten Wissens sein können, einen wichtigen Referenzpunkt in Debatten um den erkenntnistheoretischen Fundamentalismus dar. Auch für die Handlungstheorie liefert Ross einflussreiche Argumente, wenn er die Ansicht vertritt, dass Pflichten nie ein bestimmtes Motiv des Handelnden zum Gegenstand haben können. Eine zentrale Stellung nimmt für Ross die Güterlehre ein, in welcher er von vier Grundgütern, Tugend, Wissen, Lust und Gerechtigkeit, ausgeht. Wurde Ross in den ersten Jahrzehnten des 20. Jahrhunderts im damaligen Großbritannien als ein herausragender Ethiker – einer der bedeutendsten des Jahrhunderts, auf Augenhöhe mit G.E. Moore – angesehen, wandelte sich das Meinungsbild in den folgenden Jahrzehnten unter dem Einfluss besonders des Logischen Positivismus und der Philosophie Wittgensteins. In den letzten Jahrzehnten ist jedoch wieder ein wachsendes Interesse an Ross’ Ethik festzustellen. Dabei wird »Das Richtige und das Gute« bisweilen sogar mit der »Nikomachischen Ethik«, Kants »Grundlegung« und Humes »Untersuchung über die Prinzipien der Moral« verglichen. (shrink)
The advanced donation program was proposed in 2014 to allow an individual to donate a kidney in order to provide a voucher for a kidney in the future for a particular loved one. In this article, we explore the logistical and ethical issues that such a program raises. We argue that such a program is ethical in principle but there are many logistical issues that need to be addressed to ensure that the actual program is fair to both those who (...) do and do not participate in this program. (shrink)
Current debates about “Darwinizing culture” have typically focused on the validity of memetics. In this article we argue that meme-like inheritance is not a necessary requirement for descent with modification. We suggest that an alternative and more productive way of Darwinizing culture can be found in the application of phylogenetic methods. We review recent work on cultural phylogenetics and outline six fundamental questions that can be answered using the power and precision of quantitative phylogenetic methods. However, cultural evolution, like biological (...) evolution, is often far from treelike. We discuss the problems reticulate evolution can cause for phylogenetic analyses and suggest ways in which these problems can be overcome. Our solutions involve a combination of new methods for the study of cultural evolution , and the triangulation of different lines of historical evidence. Throughout we emphasize that most debates about cultural phylogenies can only be settled by empirical research rather than armchair speculation. (shrink)
Richerson et al. argue that relatively large culturalFSTvalues provide evidence for group structure and therefore scope for group selection. However, recent research on spatial patterns of cultural variation demonstrates that, as in the genetic case, apparent group structure can be a consequence of geographic clines, not group barriers. Such a pattern limits the scope for cultural group selection.
Motherese is a form of affective prosody injected automatically into speech during caregiving solicitude. Affective prosody is the aspect of language that conveys emotion by changes in tone, rhythm, and emphasis during speech. It is a neocortical function that allows graded, highly varied vocal emotional expression. Other mammals have only rigid, species-specific, limbic vocalizations. Thus, encephalization with corticalization is necessary for the evolution of progressively complex vocal emotional displays.
Beauty pageants are ubiquitous around the world, and their importance in many cultures is indisputable. This paper empirically examines those factors that contribute to beauty pageant success in a cross-national setting. Our analysis pays particular attention to the role of market liberalism, i.e., economic freedom, in the process. The results indicate that nations with higher economic freedom scores are underrepresented among Miss Universe semifinalists after controlling for other relevant determinants.