section 1. Medical ethics -- section 2. Technology -- section 3. Social and business issues -- section 4. Ritual -- section 5. Women -- section 6. Israel -- section 7. Kashrut -- section 8. Jewish identity and marriage -- section 9. Shabbat and holiday.

Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)

Tversky and Koehler's support theory attempts to explain why probability judgments are affected by the manner in which formally similar events are described. Support theory suggests that as the explicitness of a description increases, an event will be judged to be more likely. In the present experiment, experienced decision-makers from large, international accounting firms were given case-specific information about an audit client and asked to provide a series of judgments regarding the perceived likelihood of events. Unpacking a hypothesis into four (...) formally equivalent hypotheses more than doubled its perceived likelihood. These results are largely consistent with support theory, extending its generalizability to applied contexts involving business professionals. Further, the paper finds that task-specific factors, a previously untested area, can also affect support theory interpretations. (shrink)

BACKGROUND: Many published accounts of clinical trials report no differences between the treatment arms, while being underpowered to find differences. This study determined how the authors of these reports interpreted their findings. STUDY DESIGN: We examined 54 reports of surgical trials chosen randomly from a database of 110 influential trials conducted in 2008. Seven that reported having adequate statistical power were excluded from further analysis, as were the 32 that reported significant differences between the treatment arms. We examined the remaining (...) 15 to see whether the authors interpreted their negative findings appropriately. Appropriate interpretations discussed the lack of power and/or called for larger studies. RESULTS: Three of the 7 trials that did not report an a priori power calculation offered inappropriate interpretations, as did 3 of the 8 trials that reported an a priori power < 0.90. However, we examined only a modest number of trial reports from 1 year. CONCLUSIONS: Negative findings in underpowered trials were often interpreted as showing the equivalence of the treatment arms with no discussion of the issue of being underpowered. This may lead clinicians to accept new treatments that have not been validated. (shrink)

Given a sequence {a n } in (0,1) converging to a rational, we examine the model theoretic properties of structures obtained as limits of Shelah-Spencer graphs G(m, m -αn ). We show that in most cases the model theory is either extremely well-behaved or extremely wild, and characterize when each occurs.

Ulf Schmidt, writing on “Medical Ethics and Nazism” in the recently published Cambridge World History of Medical Ethics, states:In 1920, the lawyer Karl Binding and the psychiatrist Alfred Hoche published their tract Permission for the Destruction of Life Unworthy of Life. … Their positivistic theory was a combination of legal norms and medical arguments that granted the state fundamental rights while overriding the rights of individuals. The traditional moral belief system that advocated care and compassion for the weak and unproductive (...) was radically called into question. The book was written in the wake of World War I; readers were asked to compare the “battlefields littered with.. (shrink)

This article unfolds in three stages. First, it locates the emergence of modern conceptions of social justice in industrializing Europe, and especially in the discovery of the “social,” which provided a particular idiom for the liberal democratic politics for most of the twentieth century. Second, the article links this particular conception of the social to the political rationalities of the postwar welfare state and the identity of the social citizen. Finally, the article discusses the myriad ways in which this legacy (...) of the social and social justice has been disrupted, although not yet fully displaced, by the economic orthodoxies and individualization that inform the contemporary neoliberal governing project in Canada. The result, the article concludes, has been the institutionalization of insecurity, which demands the renewal of a social way of seeing and a politics of social justice on local and global scales. (shrink)

Originally published in 1948, this book contains an edited version of The Tree of Commonwealth, which was written by Edmund Dudley while imprisoned in the Tower of London in 1509 prior to his execution for treason the following year. Brodie notes any variations between manuscripts and provides a brief biography of Dudley and the impact of his famous text on later monarchs. This book will be of value to anyone with an interest in Tudor history or the history of English (...) statesmanship. (shrink)

There has been a growing concern over establishing norms that ensure the ethically acceptable and scientifically sound conduct of clinical trials. Among the leading norms internationally are the World Medical Association's Declaration of Helsinki, guidelines by the Council for International Organizations of Medical Sciences, the International Conference on Harmonization's standards for industry, and the CONSORT group's reporting norms, in addition to the influential U.S. Federal Common Rule, Food and Drug Administration's body of regulations, and information sheets by the Department of (...) Health and Human Services. There are also many norms published at more local levels by official agencies and professional groups.Any account of international standards should cover both scientific and ethical norms at once – the two are conceptually intertwined. Recent sources recognize that “[s]cientifically unsound research on human subjects is unethical in that it exposes research subjects to risks without possible benefit.”. (shrink)

This chapter contains sections titled: Of Greek Gods, the Judaeo‐Christian God, and the Sea A Ship Bound for India Beyond the Pillars of Hercules.

This essay is composed of five stories written by practicing physicians about their patients. Each clinical story describes a challenging ethical condition–potential abuse of medical power, gravely ill and probably over-treated newborns, iatrogenic narcotic addiction, deceived dying people. Rather than singling out one ethical conflict to resolve or adjudicate, the authors attempt, through literary methods, to grasp the singular experiences of their patients and to act according to the deep structures of their patients' lives. Examining these five stories with simple (...) literary tools–attention to narrative frames, time, plot, and desire–reveals the mechanisms through which acts of writing and reading contribute to clinical clarity and ethical actions. (shrink)

In 1979, James S. and Jean M. Goodwin and Albert V. Vogel published the first of what became a series of articles that studied current patterns of placebo use. They surveyed 60 house officers and 37 nurses in a New Mexico teaching hospital. Only five of the 1900 patients hospitalized during the study period had received a placebo. Their subjects underestimated the pain relief provided by placebos and believed that a positive placebo response showed that the pain was psychogenic and (...) not “real.” The few patients who were prescribed placebos tended to be those whom the staff most disliked. A few other studies published during the 1980s showed similar results.Fast forward now to 2010.... (shrink)

Family medicine has grown as a specialty from its early days of general practice. It was established as a Board Certified specialty in 1969. This growth and maturation can be traced in the philosophy of family medicine as articulated by Edmund D. Pellegrino, M.D. Long before it was popular to do so, Pellegrino supported the development of family medicine. In this essay I examine the development of Pellegrino's philosophical thought about family practice, and contrast it to other thinkers like Ian (...) McWhinney, Kerr White, Walter Spitzer, Donald Ransom, and Hebert Vandervoort. The arguments focus on whether the goals of family medicine and family practice (possibly two distinct entities) can be articulated, especially considering the definitional problems of family and community. I conclude by echoing Pellegrino's hope that family medicine can contribute a fresh alternative to isolated, individualistic and technological thinking in medicine. (shrink)

This essay grows out of my curiosity regarding the architectural details Chaucer provides for the consummation scene in book 3 of Troilus and Criseyde, in which Pandarus first brings Troilus to Criseyde through a trap door from an adjacent stewe and then, to reassure her that her reputation is not being compromised, offers the false explanation that Troilus secretly entered the house by means of a goter and a pryve wente . Among the obscure details are such matters as the (...) implied spatial relationships among the rooms and the exact nature of features like the goter and pryve wente. In trying to puzzle these things out, I have been able to supplement H. M. Smyser's influential presentation of the architecture of Pandarus's house with new information and interpretations—and with some speculations on the literary function of several of the architectural details that Chaucer gives us: the stewe, the trap door, the goter, and the pryve wente. (shrink)

[TofC cont.] Social ideals: Justice, A utilitarian theory of justice / J.S. Mill, Egalitarianism with changed motivation / G. Cohen; Equality, Multidimensional equality / M. Walzer, Equality of capacity / A. Sen; Liberty, rights, property, and self-ownership, A defense of the primacy of liberty rights / L. Lomasky, Atomism and the primacy of rights / C. Taylor -- Social institutions: Education, Educating about familial values / W. Galston, For vouchers and parental choice / M. Friedman; Family, In defense of filial (...) obligations / C.H. Sommers; Punishment, A utilitarian theory of punishment / J. Bentham. In [this book, the editors] provide students [with] a wide variety of readings covering the problems of political and social philosophy. Such topics as political obligation, democracy, rights, and justice are represented, in addition to less widely discussed subjects as the family. Both common approaches and those which are less familiar are presented, as well as recent developments in the topic area. -Back cover. (shrink)

The purpose of this essay is to argue for the necessity of an ethics of the practice of the specialist-technologist in medicine. In the first part I sketch three stages of medical ethics, each with a particular viewpoint regarding the technology of medicine. I focus on Brody's consideration of the physician's power as a example of contemporary medical ethics which explicitly excludes the specialist-technologist as a locus of development of medical ethics. Next, the philosophy of Heidegger is examined to (...) suggest an approach to the problem, and, finally, some of Levinas' contributions regarding the other are introduced to suggest a preliminary approach to a medical ethics of the specialist-technologist. (shrink)

Some patients have no chance of surviving if not treated, but very little chance if treated. A number of medical ethicists and physicians have argued that treatment in such cases is medically futile and a matter of physician discretion. This paper critically examines that position.According to Howard Brody and others, a judgment of medical futility is a purely technical matter, which physicians are uniquely qualified to make. Although Brody later retracted these claims, he held to the view that (...) physicians need not consult the patient or his family to determine their values before deciding not to treat. This is because professional integrity dictates that treatment should not be undertaken. The argument for this claim is that medicine is a profession and a social practice, and thus capable of breaches of professional integrity.Underlying professional integrity are two moral principles, one concerning harm, the other fraud. According to Brody both point to the fact that when the odds of survival are very low treatment is a violation of professional integrity.The details of this skeletal argument are exposed and explained, and the full argument is criticised. On a number of counts, it is found wanting. If anything, professional integrity points to the opposite conclusion. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:69 WILLIAM ROBERTSON AND DAVID HUME: THREE LETTERS The relationship between David Hume and his fellow Scottish historian William Robertson has always seemed one-sided. Despite the existence of fifteen letters to Robertson in the standard volumes of Hume's correspondence,1 Hume scholars have long had reason to regret the lack of a single extant letter from Robertson to Hume. None are to be found, for example, where one would most (...) expect them to be — in the Royal Society of Edinburgh, alongside the letters to Hume from various other Moderate clergymen and literati in Robertson's circle, such as Hugh Blair and Adam Ferguson. Fortunately, however, two of Robertson's letters to Hume (numbered II and III below) have now turned up where one would not expect them to be — among Robertson's own correspondence in the Robertson2 Macdonald Papers, National Library of Scotland. They are not mere drafts, such as one is accustomed to find among an author's private papers; rather, they are autograph signed letters that appear to have actually been posted. How and when they found their way back to Robertson's personal papers, and what became of the rest of Robertson's letters to Hume, are questions open to speculation. For the moment we are grateful for the letters we now have, neither of which is known to have been published before in whole or in part. Nor has Hume been identified before as the recipient of either of these letters, though internal evidence makes it clear that he was. Both letters date from the late 1760s, when Hume was living in London and Robertson was at the peak of his multi-faceted career in Edinburgh as university principal, parish minister, ecclesiastical leader, and man of letters. The first of them, dated 27 March 1767, was sent to Hume in his capacity as under- 70 secretary of state in the Northern Department (an office he held from February 1767 to January 1768). It is plainly a reply to a letter of 19 March, in which Hume had discussed three topics to which Robertson was 5 responding: Robertson's efforts to secure a military chaplaincy for a certain Scottish minister (evidently named Brodie); Conway's role in the famous dispute between Hume and Rousseau; and the public response to Adam Ferguson's newly published Essay on the History of Civil Society. In addition Robertson addresses a matter that Hume had apparently broached with him at some earlier time: the attempt to find a suitable Scottish church to which Hume might obtain a crown presentation for his nephews' tutor, the Rev. Christopher Tait. The letter concludes on a note of admiration that is characteristic not only of Robertson but of most of Hume's other "Protestant Pastors" in Scotland. The second letter to Hume, dated 31 January 1769, is chiefly concerned with the forthcoming publication of Robertson's History of Charles V and the French translation of it by J.-B.-A. Suard — subjects that had been treated in two letters from Hume to 7 Robertson of autumn 1768. It also contains a strong recommendation for a bright young Scottish writer (in both the legal and literary senses of that term) who would one day become Robertson's most vitriolic critic: Gilbert Stuart. On the personal side, there is encouragement for the now unemployed Hume to return to Edinburgh, as he was then threatening to do, after his "great glut of society" at Paris and London, and there are allusions in the closing paragraph to Hume's part in introducing his friend to polite society when Robertson had visited London to arrange the publication of Charles V in the spring of 1768. 71 To these two letters from Robertson we have prefixed a third from earlier in the same decade, one Q not actually addressed to Hume but largely about him. Robertson wrote it to their common friend Gilbert Elliot (later Sir Gilbert Elliot) on 8 March 1762, two days before the Town Council elected Robertson principal of Edinburgh University. The first paragraph deals with the principalship and relates to Hume only indirectly, as we point out in a footnote. The second paragraph, however, contains interesting... (shrink)

The Paris manuscripts made Marx’s humanism into a controversy. Louis Althusser argued that these early works were irrelevant to the mature work of Capital, while Shlomo Avineri contended that they were essential. In this book the thesis is that there is a continuous and complex development in Marx rather than Althusser’s coupure epistémologique or Avineri’s seamless web.

The Paris manuscripts made Marx’s humanism into a controversy. Louis Althusser argued that these early works were irrelevant to the mature work of Capital, while Shlomo Avineri contended that they were essential. In this book the thesis is that there is a continuous and complex development in Marx rather than Althusser’s coupure epistémologique or Avineri’s seamless web.

In lieu of an abstract, here is a brief excerpt of the content:69 WILLIAM ROBERTSON AND DAVID HUME: THREE LETTERS The relationship between David Hume and his fellow Scottish historian William Robertson has always seemed one-sided. Despite the existence of fifteen letters to Robertson in the standard volumes of Hume's correspondence,1 Hume scholars have long had reason to regret the lack of a single extant letter from Robertson to Hume. None are to be found, for example, where one would most (...) expect them to be — in the Royal Society of Edinburgh, alongside the letters to Hume from various other Moderate clergymen and literati in Robertson's circle, such as Hugh Blair and Adam Ferguson. Fortunately, however, two of Robertson's letters to Hume (numbered II and III below) have now turned up where one would not expect them to be — among Robertson's own correspondence in the Robertson2 Macdonald Papers, National Library of Scotland. They are not mere drafts, such as one is accustomed to find among an author's private papers; rather, they are autograph signed letters that appear to have actually been posted. How and when they found their way back to Robertson's personal papers, and what became of the rest of Robertson's letters to Hume, are questions open to speculation. For the moment we are grateful for the letters we now have, neither of which is known to have been published before in whole or in part. Nor has Hume been identified before as the recipient of either of these letters, though internal evidence makes it clear that he was. Both letters date from the late 1760s, when Hume was living in London and Robertson was at the peak of his multi-faceted career in Edinburgh as university principal, parish minister, ecclesiastical leader, and man of letters. The first of them, dated 27 March 1767, was sent to Hume in his capacity as under- 70 secretary of state in the Northern Department (an office he held from February 1767 to January 1768). It is plainly a reply to a letter of 19 March, in which Hume had discussed three topics to which Robertson was 5 responding: Robertson's efforts to secure a military chaplaincy for a certain Scottish minister (evidently named Brodie); Conway's role in the famous dispute between Hume and Rousseau; and the public response to Adam Ferguson's newly published Essay on the History of Civil Society. In addition Robertson addresses a matter that Hume had apparently broached with him at some earlier time: the attempt to find a suitable Scottish church to which Hume might obtain a crown presentation for his nephews' tutor, the Rev. Christopher Tait. The letter concludes on a note of admiration that is characteristic not only of Robertson but of most of Hume's other "Protestant Pastors" in Scotland. The second letter to Hume, dated 31 January 1769, is chiefly concerned with the forthcoming publication of Robertson's History of Charles V and the French translation of it by J.-B.-A. Suard — subjects that had been treated in two letters from Hume to 7 Robertson of autumn 1768. It also contains a strong recommendation for a bright young Scottish writer (in both the legal and literary senses of that term) who would one day become Robertson's most vitriolic critic: Gilbert Stuart. On the personal side, there is encouragement for the now unemployed Hume to return to Edinburgh, as he was then threatening to do, after his "great glut of society" at Paris and London, and there are allusions in the closing paragraph to Hume's part in introducing his friend to polite society when Robertson had visited London to arrange the publication of Charles V in the spring of 1768. 71 To these two letters from Robertson we have prefixed a third from earlier in the same decade, one Q not actually addressed to Hume but largely about him. Robertson wrote it to their common friend Gilbert Elliot (later Sir Gilbert Elliot) on 8 March 1762, two days before the Town Council elected Robertson principal of Edinburgh University. The first paragraph deals with the principalship and relates to Hume only indirectly, as we point out in a footnote. The second paragraph, however, contains interesting... (shrink)