BackgroundThe increasing emphasis on research, development and innovation for health in providing solutions to the high burden of diseases in the African Region has warranted a proliferation of studies including clinical trials. This changing public health landscape requires that countries develop adequate ethics review capacities to protect and minimize risks to study participants. Therefore, this study assessed the readiness of national ethics committees to respond to challenges posed by a globalized biomedical research system which is constantly challenged by new public (...) health threats, rapid scientific and technological advancements affecting biomedical research and development, delivery and manufacture of vaccines and therapies, and health technology transfer.MethodsThis is a descriptive study, which used a questionnaire structured to elicit information on the existence of relevant national legal frameworks, mechanisms for ethical review; as well as capacity requirements for national ethics committees. The questionnaire was available in English and French and was sent to 41 of the then 46 Member States of the WHO African Region, excluding the five Lusophone Member States. Information was gathered from senior officials in ministries of health, who by virtue of their offices were considered to have expert knowledge of research ethics review systems in their respective countries.ResultsThirty three of the 41 countries responded. Thirty of respondent countries had a national ethics review committee ; 79 % of which were established by law. Twenty-five NECs had secretarial and administrative support. Over 50 % of countries with NECs indicated a need for capacity strengthening through periodic training on international guidelines for health research ethics; and allocation of funds for administrative and secretariat support.ConclusionsDespite the existing training initiatives, the Region still experiences a shortage of professionals trained in health research ethics/ethicists. Committees continue to face various capacity needs especially for evaluating clinical trials, for monitoring ongoing research, database management and for accrediting institutional ethics committees. Given the growing number of clinical trials involving human participants in the African Region, there is urgent need for supporting countries without NECs to establish them; capacity strengthening where they exist; and creation of a regional network and joint ethical review mechanisms, whose membership would be open to all NECs of the Region. (shrink)
Background: Protecting the dignity of elderly residents of facilities and providing dignified care can be difficult. Although attempts have been made from several aspects, dignity is considered an area in which less real impact has been made in both theory and practice. Objective: The objective of this study is to characterize the concept of dignity in care for elderly subjects in residential facilities from a practical perspective through concept synthesis. Research design: This study includes in-depth interviews with residents of elderly (...) facilities and a literature review. Participants and research context: A total of 12 residents of seven facilities in three prefectures in Japan were recruited via purposive sampling, and 27 interviews were conducted. Each digitally recorded interview was transcribed verbatim. The interview data were analyzed based on hermeneutic phenomenological research. The literature was searched using PubMed, CINAHL, and Web of Science with combinations of terms such as dignity, elderly, and residential facilities and then selected according to the predefined inclusion criteria. The descriptions about dignity in the included studies were divided into codes and compared with the results of the interviews. Ethical considerations: This study was approved by the institutional review board of Nagoya University’s Graduate School of Medicine. Findings and discussion: There were 1728 data codes for the interviews from which four themes were generated. In the literature review, 3716 titles were searched, and 28 articles were selected. Combining these results, five following themes and a conceptual matrix were obtained: individual dignity not affected by others; dignified care in a narrow sense; elements of the staff side; dignity in relation to family members, friends, society, and other residents; and dignity in relation to nursing care facilities and the nursing care system. Conclusion: According to the established matrix, we must consider the role of the care system, facility, family, and society in providing care with dignity and the individual dignity to residents and dignity in daily care. (shrink)
RESUMO: Em grande medida, os estudos sobre a constituição do arcabouço teórico do lacanismo têm ocorrido ao largo do exame de sua historicidade. Essa negligência reforça o ocultamento do processo social que levou a produção lacaniana a uma profunda integração entre a formalização e a etificação da teoria. Esse processo não pode ser compreendido sem a contextualização crítica da conjuntura política que cercou a proposta e a existência da École Freudienne de Paris, fundada por Lacan, em 1964. A estreita convivência (...) com os jovens militantes dos grupos da esquerda extraparlamentar da época, notadamente os maoístas, e a assimilação de suas problematizações fizeram do pensamento lacaniano e da EFP o espaço de objetivação de um discurso movido pela paráfrase política e seus efeitos de engajamento. Este artigo pretende expor as linhas de estruturação político-social dos conceitos forjados por Lacan, em meio à instituição e à consolidação de sua Escola. ABSTRACT: To a great extent the studies of the constitution of the Lacanism theoretical framework have occurred off the examination of its historicity. This neglect strengthens the concealment of the social process that led the Lacanian production to a deep integration between the theory formalization and the theory ethification. This process can not be understood without grasping the context of the political environment that surrounded the proposal and the existence of École Freudienne de Paris, founded by Lacan in 1964. The close contact with the young militants of the extra-parliamentary left groups of the time, notably the Maoists, and the assimilation of the problems they rose made the Lacanian thought and EFP the place of objectification of a speech moved by the political paraphrase and their engagement effects. This article aims to expose the lines of political and social structure of concepts forged by Lacan through the establishment and consolidation of his School. (shrink)
In Kagaku no Sekai to Kokoro no Tetsugaku, Mr.Michio Kobayashi features on Descartes' theory of minds as "subjecitive-active consciousness", and defends it against the materialist movement. I show that Kobayashi's method has a difficulty for defending existence of our minds because Descartes didn't allow the scientific investigation of our mental experience from outside,and so cannot appropriately grasp the significance of other minds.
As Socrates argues in Cratylus, although different name-makers or name-designers (Greeks and barbarians) do not embody the name in the same syllables it must not be forgotten that they attempt to reproduce the same ideal (t´ypos). Could also Greek and barbarian names of gods, made of different letters and syllables, reproduce the same t´ypos? If one takes seriously Herodotus’ onomatological inquiry in his Egyptian lógos (The Histories II 50), one may find the optimum way to understand the scope of Plato’s (...) dialectical ‘games’ between the three speakers in Cratylus (Socrates, Hermogenes and Cratylus) and, more precisely, their «theological» implications. (shrink)
In this issue of the Hastings Center Report, Joshua Rager and Peter Schwartz suggest using opioid treatment agreements as public health monitoring tools to inform patients about “the requirements entailed by undergoing opioid therapy,” rather than as contractual agreements to alter patients’ individual behavior or to benefit them directly. Because Rager and Schwartz's argument presents suspected OTA violations as a justification to stop providing opioids yet does not highlight the broader epistemic and systemic context within which clinicians prescribe these medications, (...) their proposal may perpetuate a climate of distrust and stigmatization without correcting systemic factors that may have placed patients and others at risk in the first place. Given the context of epistemic uncertainty regarding opioid safety and efficacy, insufficient training for opioid prescribers, and inadequate patient education, I propose replacing OTAs, which have a narrow focus on patient behaviors, with opioid treatment plans, which would promote mutual, collaborative, and shared decision-making on the most appropriate pain management program. An OTP can be ethically justified as a tool to prevent and treat iatrogenic addiction under a specific paradigm—one that adopts a default position of professional epistemic humility and holds all collaborative parties accountable in chronic pain management. (shrink)
There was a time, in the late 1970s and 1980s, when great feats were expected of recombinant DNA biotechnology, some verging on the miraculous. According to both business enthusiasts and sober analysts like the U.S. Congressional Office of Technology Assessment, the new techniques of gene splicing would not only lift the drug industry out of its deep scientific and economic rut (characterized by long-declining introduction rates of genuinely novel medicines), but rejuvenate the American manufacturing sector (Chase 1979; Chemical Week 1987; (...) OTA 1984). Once freed by policy interventions to promote academic-industry collaboration, such as the 1980 Bayh-Dole Act, lifesaving drugs locked up in ivory towers would .. (shrink)