Celebrates a half century of television history, from "The Howdy Doody Show" and "I Love Lucy" to "The Simpsons" and "The Sopranos," and the personalities, shows, and landmark events that changed entertainment history.

BACKGROUND: The offer of return of research results to study participants has many potential benefits. The current study examined the offer of return of research results by analyzing consent forms from 2 acute lymphoblastic leukemia studies of the 235 institutional members of the Children's Oncology Group. METHODS: Institutional review board (IRB)-approved consent forms from 2 standard-risk acute lymphoblastic leukemia studies (Children's Cancer Group [CCG] 1991 and Pediatric Oncology Group [POG] 9407) were analyzed independently by 2 reviewers. RESULTS: The authors received (...) replies from 202 of the 235 institutions that were contacted (85%). One hundred eighty-one institutions had CCG 1991 (n = 96) or POG 9905 (n = 85) protocols that were approved by an IRB. Most institutions provided contact information for the principal investigator (n = 175; 97%) and a member of the institution's research services office (n = 154; 85%). Only 5 (2.8%) institutions provided an indication of a participant's right to receive a summary of research results; most of these institutions provided details on how (n = 5) or when (n = 5) this was to occur. All of these institutions (n = 162; 89.5%) provided a specific statement offering new information that might affect a participant's decision to continue to participate in a study. Only 2 institutional consent forms offered participants the option to receive research results, and only 10 (5.5%) consent forms contained an unambiguous, specific statement offering to provide new information after the study was closed. CONCLUSIONS: Few institutional review board-approved consent forms explicitly indicate the right of research recipients to receive a summary of the results of the research in which they have participated. (shrink)

PURPOSE: The offer to return a summary of results to participants after the conclusion of clinical research has many potential benefits. The authors determined current practice and attitudes and needs of researchers in establishing programs to return results to research participants. METHODS: An Internet survey of all 236 principal investigators (PIs) of the Children's Oncology Group in May 2002 recorded PI and institutional demographics, current practice, and perceived barriers to and needs of PIs for the creation of research results programs. (...) RESULTS: One hundred fifty (63.8%) PIs responded. Few institutions (n = 5) had established, comprehensive programs to offer the return of results. PIs indicated that major impediments to the implementation of such programs are the preparation of lay summaries, time constraints, the task of contacting participants, and potential distress for the participants. PIs identified the following facilitators to the establishment of a program in their own institution: lay summaries, web site, preparation of an oncologist's summary, and financial credits. There was no clear consensus as to when the results should be shared: 30% indicated after the study was closed and 24% indicated at the time of publication of results. A substantial proportion of respondents opposed or strongly opposed the implementation of a universal offering of results to research participants. CONCLUSIONS: Few Children's Oncology Group institutions have programs that offer the return of results to research participants. Significant barriers and facilitators to this process have been identified. (shrink)

My strategy is to examine a recent trend in philosophical discussions of responsibility, a trend that tries, but I think ultimately fails, to give an acceptable analysis of the conditions of responsibility. It fails due to what at first appear to be deep and irresolvable metaphysical problems. It is here that I suggest that the condition of sanity comes to the rescue. What at first appears to be an impossible requirement for responsibility---the requirement that the responsible agent have created her- (...) or himself---turns out to be the vastly more mundane and non controversial requirement that the responsible agent must, in a fairly standard sense, be sane. (shrink)

Bioethics has paid surprisingly little attention to the special problems faced by women and to feminist analyses of current health care issues other than ...

Children do not belong to their parents. They are not property, although throughout much of history they were considered chattel. In the 21st century, it is generally agreed that children are indiv...

Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perform CEC in the United States, has (...) initiated a two‐step quality attestation process as a means to assess clinical ethics consultants and help identify individuals who are qualified to perform this role. This article describes the process. (shrink)

Randomization is the “gold standard” design for clinical research trials and is accepted as the best way to reduce bias. Although some controversy remains over this matter, we believe equipoise is the fundamental ethical requirement for conducting a randomized clinical trial. Despite much attention to the ethics of randomization, the moral psychology of this study design has not been explored. This article analyzes the ethical tensions that arise from conducting these studies and examines the moral psychology of this design from (...) the perspectives of physician-investigators and patient-subjects. We conclude with a discussion of the practical implications of this analysis. (shrink)

Background Dynamic consent has been proposed as a process through which participants and patients can gain more control over how their data and samples, donated for biomedical research, are used, resulting in greater trust in researchers. It is also a way to respond to evolving data protection frameworks and new legislation. Others argue that the broad consent currently used in biobank research is ethically robust. Little empirical research with cohort study participants has been published. This research investigated the participants’ opinions (...) of adding a dynamic consent interface to their existing study. Methods Adult participants in the Extended Cohort for E-health, Environment and DNA longitudinal cohort study who are members of the EXCEED Public and Participant Engagement Group were recruited. Four focus groups were conducted and analysed for thematic content. Discussion topics were derived from a review of the current literature on dynamic consent. Results Participants were in favour of many aspects of a dynamic consent interface, such as being able to update their information, add additional data to their records and choose withdrawal options. They were supportive provided it was simple to use and not intrusive. Participants expressed a markedly high level of trust in the study and its investigators and were unanimously happy with their current participation. No strong support was found for adding a dynamic consent interface to EXCEED. Conclusions Trust in the study researchers was the strongest theme found. Openness and good data security were needed to retain their trust. While happy to discuss dynamic consent, participants were satisfied with the current study arrangements. There were indications that changing the study might unnecessarily disturb their trust. This raised the question of whether there are contexts where dynamic consent is more appropriate than others. This study was limited by the small number of participants who were committed to the study and biased towards it. More research is needed to fully understand the potential impact of adding a dynamic consent interface to an existing cohort study. (shrink)

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration -- Clients (...) with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)

Only human beings have a rich conceptual repertoire with concepts like tort, entropy, Abelian group, mannerism, icon and deconstruction. How have humans constructed these concepts? And once they have been constructed by adults, how do children acquire them? While primarily focusing on the second question, in The Origin of Concepts , Susan Carey shows that the answers to both overlap substantially. Carey begins by characterizing the innate starting point for conceptual development, namely systems of core cognition. Representations of core (...) cognition are the output of dedicated input analyzers, as with perceptual representations, but these core representations differ from perceptual representations in having more abstract contents and richer functional roles. Carey argues that the key to understanding cognitive development lies in recognizing conceptual discontinuities in which new representational systems emerge that have more expressive power than core cognition and are also incommensurate with core cognition and other earlier representational systems. Finally, Carey fleshes out Quinian bootstrapping, a learning mechanism that has been repeatedly sketched in the literature on the history and philosophy of science. She demonstrates that Quinian bootstrapping is a major mechanism in the construction of new representational resources over the course of childrens cognitive development. Carey shows how developmental cognitive science resolves aspects of long-standing philosophical debates about the existence, nature, content, and format of innate knowledge. She also shows that understanding the processes of conceptual development in children illuminates the historical process by which concepts are constructed, and transforms the way we think about philosophical problems about the nature of concepts and the relations between language and thought. (shrink)

In this important book, Susan Hurley sheds new light on consciousness by examining its relationships to action from various angles. She assesses the role of agency in the unity of a conscious perspective, and argues that perception and action are more deeply interdependent than we usually assume. A standard view conceives perception as input from world to mind and action as output from mind to world, with the serious business of thought in between. Hurley criticizes this picture, and considers (...) how the interdependence of perceptual experience and agency at the personal level (of mental contents and norms) may emerge from the subpersonal level (of underlying causal processes and complex dynamic feedback systems). Her two-level view has wide implications, for topics that include self-consciousness, the modularity of mind, and the relations of mind to world. The self no longer lurks hidden somewhere between perceptual input and behavioral output, but reappears out in the open, embodied and embedded in its environment. Hurley traces these themes from Kantian and Wittgensteinian arguments through to intriguing recent work in neuropsychology and in dynamic systems approaches to the mind, providing a bridge from mainstream philosophy to work in other disciplines. Consciousness in Action is unique in the range of philosophical and scientific work it draws on, and in the deep criticism it offers of centuries-old habits of thought. (shrink)

Questions related to end-of-life decision making are common in clinical ethics and may be exceedingly difficult. Chief among these are the provision of cardiopulmonary resuscitation (CPR) and do-not-resuscitate orders (DNRs). To better address such questions, clarity is needed on the values of medical ethics that underlie CPR and the relevant moral framework for making treatment decisions. An informed consent model is insufficient to provide justification for CPR. Instead, ethical justification for CPR rests on the rule of rescue and on substituted (...) interest judgments. Patients’ known wishes and values are relevant, particularly in protecting them from unwanted CPR. Clinicians should rescue patients with the means at their disposal, as a prima facie moral imperative, unless there are compelling reasons to refrain. We present a moral framework for making decisions regarding CPR and DNR. (shrink)

Medication reconciliation for pediatric oncology patientparticipants enrolled in clinical trials often reveals the use of chemical complementary medicine alongside protocol therapeutic agents. Considering the blurry delineation between clinical ethics and research ethics, this paper demonstrates how complementary medicine-related protocol violations introduce ethical questions of who should be included and excluded from clinical trials and offers recommendations on how to manage physician-patient-family interactions around these challenging issues.

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...) on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

In the operating room, patient safety is of paramount importance. Medical students and junior trainees, despite their primary role as students, may play active roles in assessing patient safety and reporting suspected errors. Active consent is one layer of patient safety that is continuously assessed by several team members. This article examines an instance where patient consent may have been violated. Through the lens of trainee and senior perspectives, we discuss the ethical principles at stake and provide recommendations for medical (...) student and junior trainee involvement in patient care when an error is suspected. (shrink)

While we do not share Evans’s view that social science research is needed to shield bioethics from competitive threat, we incorporate and engage in social science research to inform our knowledge base, our clinical practice, and our contributions to the ongoing development of the field.

The ability to determine genetic predisposition to cancer represents an opportunity to expand cancer control efforts in a manner that was previously unimaginable. This possibility also forces individual patients, families, health care professionals, and society to confront difficult questions about genetic knowledge. Although genetic testing or screening for cancer risk may hold promise of cancer control benefits, this prospect also raises significant ethical and legal concerns that must inform and shape policy decisions. In “Cancer Genetic Susceptibility Testing,” Benjamin Wilfond and (...) the Cancer Genetic Screening Consortium present a status report and an ambitious agenda for future examination of ethical and policy issues in this embryonic field. The paper provides a provocative and timely discussion of some extremely vexing issues, but it also misses on several critical points. (shrink)

The nature/nurture debate is not dead. Dichotomous views of development still underlie many fundamental debates in the biological and social sciences. Developmental systems theory offers a new conceptual framework with which to resolve such debates. DST views ontogeny as contingent cycles of interaction among a varied set of developmental resources, no one of which controls the process. These factors include DNA, cellular and organismic structure, and social and ecological interactions. DST has excited interest from a wide range of researchers, from (...) molecular biologists to anthropologists, because of its ability to integrate evolutionary theory and other disciplines without falling into traditional oppositions. The book provides historical background to DST, recent theoretical findings on the mechanisms of heredity, applications of the DST framework to behavioral development, implications of DST for the philosophy of biology, and critical reactions to DST. (shrink)

Scholars have debated the role that altruistic considerations play—and should play—in recruitment and decision-making processes for clinical trials. Little empirical data are available to support their various perspectives. We analyzed 140 audiotaped pediatric informed consent sessions, of which 95 (68%) included at least one discussion of how participation in a cancer clinical trial might benefit: 1) the pursuit of scientific knowledge generally; 2) other children with cancer specifically; and 3) “the future” and other vaguely defined recipients. Clinicians initiated most (80%) (...) of these discussions of altruism. The enrollment rate of children in the clinical trial was high (83%) overall, but not higher among children whose parents were involved in an altruism-oriented discussion. These findings suggest that: (1) clinicians invoke a spectrum of altruistic considerations rather than a single monothematic notion of altruism, and (2) the effect of altruistic considerations on subsequent enrollment decisions is marginal. While further research on this topic is warranted, bioethical debate should strive to reflect the diversity of altruistic discourse in clinical research encounters and to place this discourse in the context of other, including nonaltruistic, considerations. (shrink)

It is well-known that Chatton is among the earliest and most vehement critics of Ockham’s theory of judgment, but scholars have overlooked the role Chatton’s criticisms play in shaping Ockham’s final account. In this paper, I demonstrate that Ockham’s most mature treatment of judgment not only contains revisions that resolve the problems Chatton identifies in his earlier theories, but also that these revisions ultimately bring his final account of the objects of judgment surprisingly close to Chatton’s own. Even so, I (...) argue that, at the end of the day, there remain significant differences between their respective analyses of the structure and intentionality of judicative states. (shrink)

A theory of conceptual development must specify the innate representational primitives, must characterize the ways in which the initial state differs from the adult state, and must characterize the processes through which one is transformed into the other. The Origin of Concepts (henceforth TOOC) defends three theses. With respect to the initial state, the innate stock of primitives is not limited to sensory, perceptual, or sensorimotor representations; rather, there are also innate conceptual representations. With respect to developmental change, conceptual development (...) consists of episodes of qualitative change, resulting in systems of representation that are more powerful than, and sometimes incommensurable with, those from which they are built. With respect to a learning mechanism that achieves conceptual discontinuity, I offer Quinian bootstrapping. TOOC concludes with a discussion of how an understanding of conceptual development constrains a theory of concepts. (shrink)

In this book, Susan Mendus seeks to address these important questions to assess whether this apparent tension between morality and politics is real and, if so, ...

This past July, five professional societies, whose members together provide the majority of clinical care in the United States, published a statement objecting to “inappropriate legislative interference” with the physician‐patient relationship and reiterated the importance of “putting patients’ best interests first.” Such a collective response is helpful, but given the apparently growing interest among legislators in legislating aspects of physician‐patient communications, individual physicians, too, may have to face this problem. What should a physician do when confronted with a law that (...) attempts to intervene in the doctor‐patient relationship in a way that the physician believes undercuts good medical care? (shrink)

Throughout, the emerging theory of aspect is extensively compared with alternative theories, and the book concludes with general reflections on the semantic ...

To what extent can animal behaviour be described as rational? What does it even mean to describe behaviour as rational? -/- This book focuses on one of the major debates in science today - how closely does mental processing in animals resemble mental processing in humans. It addresses the question of whether and to what extent non-human animals are rational, that is, whether any animal behaviour can be regarded as the result of a rational thought processes. It does this with (...) attention to three key questions, which recur throughout the book and which have both empirical and philosophical aspects: What kinds of behavioural tasks can animals successfully perform? What if any mental processes must be postulated to explain their performance at these tasks? What properties must processes have to count as rational? The book is distinctive in pursuing these questions not only in relation to our closest relatives, the primates, whose intelligence usually gets the most attention, but also in relation to birds and dolphins, where striking results are also being obtained. -/- Some chapters focus on a particular species. They describe some of the extraordinary and complex behaviour of these species - using tools in novel ways to solve foraging problems, for example, or behaving in novel ways to solve complex social problems - and ask whether such behaviour should be explained in rational or merely mechanistic terms. Other chapters address more theoretical issues and ask, for example, what it means for behaviour to be rational, and whether rationality can be understood in the absence of language. -/- The book includes many of the world's leading figures doing empirical work on rationality in primates, dolphins, and birds, as well as distinguished philosophers of mind and science. The book includes an editors' introduction which summarises the philosophical and empirical work presented, and draws together the issues discussed by the contributors. (shrink)

One of the most pressing ethical challenges facing phase I cancer research centres is the process of informed consent. Historically, most scholarship has been devoted to redressing therapeutic misconception, that is, the conflation of the nature and goals of research with those of therapy. While therapeutic misconception continues to be a major ethical concern, recent scholarship has begun to recognise that the informed consent process is more complex than merely a transfer of information and therefore cannot be evaluated only according (...) to how well an individual understands such information. Other components of decision-making operate independently of understanding and yet still may compromise the quality of informed consent. Notable among these components is unrealistic optimism, an event-specific belief that one has a better chance of receiving benefit than others similarly situated. In this article, we consider responses to interviews with parents who had recently completed an informed consent conference for enrolling their child in a phase I cancer clinical trial to examine how this influence manifests and how investigators might address it during informed consent. (shrink)

The Republic’s political discussion begins with the construction of two contrasting cities: a ‘healthy’ city and a ‘city with a fever’; one defined by environmentally sustainable subsistence practices and the other by ‘luxurious’ over consumption that exceeds the carrying capacity of its land. Plato’s characters proceed to cure the inflamed city of its fever, resulting in the delineation of the ideal political constitution, the Kallipolis, which recovers the virtues of the original, healthy city in an altered form. This paper develops (...) an ecological reading of the Republic, highlighting Plato’s optimism regarding humans’ ability to limit their material consumption in accordance with the limits of the natural world. The conventional interpretation of the Republic’s first city, known as ‘the city of pigs’, is reconsidered in light of new socio-ecological research on traditional resource management systems. (shrink)

I ARGUE THAT WE RECEIVE PLEASURE FROM TRAGEDIES BECAUSE WE ARE PLEASED TO FIND OURSELVES RESPONDING IN AN UNPLEASANT WAY TO HUMAN SUFFERING AND INJUSTICE. THE PLEASURE IS THUS A METARESPONSE, AND REFLECTS FEELINGS WHICH ARE AT THE BASIS OF MORALITY. THIS HELPS EXPLAIN WHY TRAGEDY IS SUPPOSED TO BE A HIGHER ART FORM THAN COMEDY, AND PROVIDES A NEW WAY OF SEEING THE RELATIONSHIP BETWEEN THE MORALITY OF AN ARTWORK AND ITS VALUE.

This work examines the evolution of law and legal method, and challenges the law's claim to neutrality by examining its role in creating and reproducing inequality between the sexes. It considers many of the current debates, and in each, the law is stated with reference to recent developments in statute and judicial decisions in the UK and other jurisdictions. The author illustrates how each issue is shaped by the current political climate and, where relevant, by the European Court. Reference is (...) also made to US and Australian case law. The book should be of interest to students studying women and the law, family law, criminal law and jurisprudcence, as well as those on criminology and sociology courses. It should also be useful to family and criminal practitioners. (shrink)