Background In this study, we examined the ethical implications of Egypt’s new clinical trial law, employing the ethical framework proposed by Emanuel et al. and comparing it to various national and supranational laws. This analysis is crucial as Egypt, considered a high-growth pharmaceutical market, has become an attractive location for clinical trials, offering insights into the ethical implementation of bioethical regulations in a large population country with a robust healthcare infrastructure and predominantly treatment-naïve patients. Methods We conducted a comparative analysis (...) of Egyptian law with regulations from Sweden and France, including the EU Clinical Trials Regulation, considering ethical human subject research criteria, and used a directed approach to qualitative content analysis to examine the laws and regulations. This study involved extensive peer scrutiny, frequent debriefing sessions, and collaboration with legal experts with relevant international legal expertise to ensure rigorous analysis and interpretation of the laws. Results On the rating of the seven different principles (social and scientific values, scientific validity, fair selection of participants, risk-benefit ratio, independent review, informed consent and respect for participants) Egypt, France, and EU regulations had comparable scores. Specific principles (Social Value, Scientific Value, and Fair selection of participants) were challenging to directly identify due to certain regulations embodying 'implicit' principles more than explicitly stated ones. Conclusion The analysis underscores Egypt's alignment with internationally recognized ethical principles, as outlined by Emanuel et al., through its comparison with French, Swedish, and EU regulations, emphasizing the critical need for Egypt to continuously refine its ethical regulations to safeguard participant protection and research integrity. Key issues identified include the necessity to clarify and standardize the concept of social value in research, alongside concerns regarding the expertise and impartiality of ethical review boards, pointing towards a broader agenda for enhancing research ethics in Egypt and beyond. (shrink)

The presence or absence of consciousness is the linchpin of taxonomy for disorders of consciousness (DOCs), as well as a focal point for end-of-life decision making for patients with DOCs. Focus on consciousness in this latter context has been criticized for a number of reasons, including the uncertainty of the diagnostic criteria for consciousness, the irrelevance of some forms of consciousness for determining a patient’s interests, and the ambiguous distinction between consciousness and unconsciousness. As a result, there have been recent (...) suggestions that perhaps consciousness ought not to play the focal role that it does in decision making for persons with DOCs, and that other considerations, such as patient and family values, ought to take center stage. In this article, I take a step back and reexamine the meaning of consciousness in the DOC taxonomy. I propose that, while consciousness in DOC taxonomy is defined as “wakeful awareness,” this definition, while clinically expedient, occasions ethical misunderstanding. Using resources from non-Western philosophy of mind, I argue that the form of consciousness that is ethically relevant in DOCs is intransitive, or pure. I contrast this pure experience with transitive consciousness to highlight why ethical conclusions ought not define consciousness solely as “wakeful awareness,” even if clinical criteria do. (shrink)

Gilbert (2015) suggests that predictive and advisory brain implants threaten autonomy. He analyzes these threats in terms of one patient's “sense of autonomy,” reporting that the patient felt more...

I characterize Nishida Kitarō’s metaethical perspective throughout his work but focus especially on his later papers, most notably his writings on kōiteki chokkan, or active intuition. These include Kōiteki Chokkan no Tachiba (published in 1935), Kōiteki Chokkan (published in 1937), as well as Nothingness and the Religious Worldview (Bashoteki Ronri to Shūkyōteki Sekaikan, published in 1945, and widely available in translation). I explore affinities between Nishida’s approach to ethics and metaethical intuitionism and sensibility theory. I then use this analysis to (...) identify a lesson that Nishida offers to contemporary metaethicists. (shrink)

For more than 20 years, Western science education has been incorporated into Tibetan Buddhist monastics’ training. In this time, there have been a number of fruitful collaborations between Buddhist monastics and neuroscientists, neurologists, and psychologists. These collaborations are unsurprising given the emphasis on phenomenological exploration of first-person conscious experience in Buddhist contemplative practice and the focus on the mind and consciousness in Buddhist theory. As such, Tibetan monastics may have underappreciated intuitions on the intersection of science, medicine, and ethics. Yet (...) despite their overlapping interests, Buddhist perspectives are largely absent in contemporary neuroethical analysis, apart from conceptual arguments for their relevance. This article attempts to fill this gap by presenting the results of eleven semi-structured interviews with Tibetan Buddhist monastics in India on three issues in neuroethics: identity and authenticity, enhancement, and disorders of consciousness. The results of this empirical study reinforce the conclusions of theoretical work on Buddhism and neuroethics while also identifying future areas of inquiry, including the importance of community, the challenges in acting from compassion, and the value of self-directed mental cultivation. (shrink)

Recent studies have explored the effectiveness of open-label placebos for a variety of conditions, including chronic pain, cancer-related fatigue and irritable bowel syndrome. OLPs are thought to sidestep traditional ethical worries about placebos because they do not involve deception: with an OLP, patients or subjects are told outright that they are not given an active substance. As deception is framed as the primary hurdle to ethical placebo use, the door is ostensibly opened to ethical studies of OLPs. In this article, (...) I suggest that even though OLPs seemingly do not involve deception, there are other ethical considerations in their clinical investigation and subsequent use. Research ethics often focusses on informed consent—of which, deception and honesty are a piece—as a means to justify research practices with human subjects. Yet, it is but one of the ethical considerations that should be taken into account. With research into placebo effects in particular, I argue that the history of clinical placebo use grounds special considerations for OLP research that go beyond respect for the autonomy of individual patients through informed consent and encompass structural concerns about the type of patient for whom a placebo has historically been thought appropriate. (shrink)

This paper argues that the concept of paternalism is currently overextended to include a variety of actions that, while resembling paternalistic actions, are importantly different. I use the example of Japanese physicians’ non-disclosures of cancer diagnoses directly to patients, arguing that the concept of maternalism better captures these actions. To act paternalistically is to substitute one's own judgement for that of another person and decide in place of that person for his/her best interest. By contrast, to act maternalistically is to (...) decide for another person based on a reasonable understanding of that person's own preferences. The concept of maternalism allows for a more thorough assessment of the moral justification of these types of actions. I conclude that it is possible, at least in principle, to justify Japanese physicians’ non-disclosures, and that this justification must be based on an understanding of these actions as maternalistic. (shrink)

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

Protestant Christian ethicist Timothy Jackson and secular feminist philosopher Eva Feder Kittay each explore the relationship between love or care and justice through the lens of human dependency. Jackson sharply prioritizes agape over justice, whereas Kittay articulates a more complex and integrated understanding of the relationship of care and distributive justice. An account of Christian love and its relation to justice must account for the gratuity, mutuality, and reciprocity that pervade human existence. Such an account must integrate provision for another's (...) basic needs, a feature of agape, with a distributive justice that fairly allocates the material prerequisites of care and the burden of caring labor. Kittay's treatment of care and justice is more adequate to the realities of human embodiment and the social organization of care than Jackson's, but neither offers a fully adequate ground for the moral personhood of all human beings, including deeply dependent persons. (shrink)

Dōgen has been described as a social reformer based on his more “enlightened” attitude towards women, inviting women students into his sangha and advocating for more egalitarian views of gender (Eido Frances Carney, Receiving the Marrow: Teachings on Dōgen by Soto Zen Women Priests (2012), p. xi). In this chapter, I describe how contemporary Western Zen women and their allies have understood Dōgen’s texts as a tool of personal and social transformation through examination of work by Zen practitioners such as (...) Greenwood’s Bow First (2018), Carney’s Receiving the Marrow (2012), Schireson’s Zen Women (2009), and Glassman and Fields’ Instructions to the Cook (1996). In particular, I posit that Zen women have expressed the practical nature of Dōgen’s philosophy for contemporary non-monastics, showing how to de-center oneself through full participation in the activity of the world. This is in contrast to self-centered preoccupation with individual enlightenment or spiritual attainment. Paradoxically, it is the fact that women have often been confined to social roles that prevent their separation from the minutiae of everyday life that allows them to embody Dōgen’s dictum to “forget the self and be actualized by myriad things.”. (shrink)

While Sigmund Freud and Maurice Merleau‐Ponty both acknowledge the role that spatiality plays in human life, neither pays any explicit attention to the intersections of race and space. It is Franz Fanon who uses psychoanalysis and phenomenology to provide an account of how the psychical and lived bodily existence of black people is racially constituted by a racist world. More precisely, as I argue in this paper, Fanon's work demonstrates how psychical and bodily spatiality cannot be adequately understood apart from (...) the environing space of the social world. For Fanon, body, psyche, and world mutually influence and constitute each other. In a raced and racist world, therefore, the lived bodily experience and the unconscious of human beings will be racially and racist‐ly constituted as well. This will show you how in psychoanalysis we take spatial ways of looking at things seriously. Sigmund Freud1 Sigmund Freud, “The Question of Lay Analysis,” in volume 20 of The Standard Edition of the Complete Psychological Works of Sigmund Freud, ed. and trans. James Strachey (London: The Hogarth Press, 1959), 195. Everything throws us back on to the organic relations between subject and space, to that gearing of the subject onto his world which is the origin of space. Maurice Merleau‐Ponty2 Maurice Merleau‐Ponty, Phenomenology of Perception, trans. Colin Smith (New York: Routledge, 1962), 251. Hence we are driven from the individual back to the social structure. If there is a [neurotic] taint, it lies not in the “soul” of the individual but rather in that of the environment. Franz Fanon3 Franz Fanon, Black Skin, White Mask, trans. Charles Lam Markmann (New York: Grove Press, 1967), 213. (shrink)

Frege's advances in the development of quantification have rarely been subjected to historical interpretation. While the characterization of existence as a second-order concept awaited the invention of the Begriffsschrift, important philosophical innovations had taken place since Kant's critique of the ontological argument. In particular, Herbart had re-conceptualized the nature of existential judgement and this was recognized and adopted by Brentano. In this light, thepossible influence of Herbart and Brentano (or their schools) upon Frege's work is elaborated and critically considered.

In his 1967 paper 'A Causal Theory of Knowing', Alvin Goldman sketched an account of empirical knowledge in terms of appropriate causal connections between the fact known and the knower's belief in that fact. This early causal account has been much criticized, even by Goldman himself in later years. We argue that the theory is much more defensible than either he or its other critics have recognized, that there are plausible internal and external resources available to it which save it (...) from many objections in the literature (in particular, objections raised by Harman, Pappas and Swain, Klein, Dretske, Goldman, Shope, Ackermann, Morawetz, and Collier). (shrink)

Henrich et al. reject the “selfishness axiom” within a narrowly-defined economic model, and are premature in claiming that they have demonstrated cross-cultural variability in “selfishness” as defined in broader evolutionary theory. We also question whether a key experimental condition, anonymity, can be maintained in the small, cohesive, social groupings employed in the study.

Henrich et al. reject the within a narrowly-defined economic model, and are premature in claiming that they have demonstrated cross-cultural variability in as defined in broader evolutionary theory. We also question whether a key experimental condition, anonymity, can be maintained in the small, cohesive, social groupings employed in the study.

In his recent book "Explaining Behavior," Fred Dretske has outlined a naturalized theory of intentionality. Several philosophers, including Dretske himself, view his theory as lending credence to the claim that mental state content should be construed widely. In this paper I argue that careful analysis of his theory reveals that this view is mistaken. In Dretske's theory, the notion of the function of a state plays a central role in the determination of content. It will be my contention that this (...) notion of function cannot be used in Dretske's theory to distinguish between the wide construal of the content of an intentional state and the narrow or individualistic construal. This inability of his notion of function to discriminate between wide content and individualistic content undermines any claim that Dretske's theory endorses wide content. Instead, we are lead to the conclusion that Dretske's theory entails pervasive content indeterminacy. (shrink)

Because many of Aquinas’s most distinctive philosophical claims are embedded in theological works, in order to see what his philosophy comes to it is necessary to do a great deal of extracting and reconstructing. A major school of interpretation, however, cautions that such efforts are misguided, since Aquinas’ philosophy and theology are inextricably bound together. We respond that some versions of this inseparability thesis are too strong to be true and the remainder too weak to stand in the way of (...) renewed efforts to identify Aquinas’ pure philosophical systems. Nonetheless, a good deal is to be learned about Aquinas (and about other religious philosophers) by pondering the inseparablist challenge to rational reconstruction. (shrink)

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)