In the Netherlands fertility doctors increasingly formulate protocols, which oblige patients to quit their unhealthy lifestyle before they are admitted to IVF procedures. We argue that moral arguments could justify parenting protocols that concern all future parents. In the first part we argue that want-to-be parents have moral responsibilities towards their future children to prevent them from harm by diminishing or eliminating risk factors before as well as during the pregnancy. This is because of the future children's potential to become (...) of a certain type, more specifically: a person that will be the want-to-be parents' child. Want-to-be parents intend to become pregnant and therefore have an additional moral reason to diminish the risks. Also, people who become pregnant unintentionally have the responsibility to prevent their children from harm, unless they become pregnant due to contraception failure. All people not wanting to become pregnant should use contraception methods carefully.In the second part of this paper we translate the want-to-be parents' responsibilities into practice. We distinguish four determinants of risk factors: modifiability, chance, severity and effort. We examine some evidence-based risk factors based on these variables and deduce levels of responsibility.In conclusion, formulating informal requirements for want-to-be parents is morally required and therefore also for want-to-be parents in need of medical assistance. The protocols developed by fertility doctors in the Netherlands could be seen as the precursor for a general, informal Parenting Protocol that could be developed on the basis of an extended and thoroughly debated risk-responsibility analysis. (shrink)

This qualitative research study with a content analysis approach aimed to explore families’ experiences of an organ donation request after brain death. Data were collected through 38 unstructured and in-depth interviews with 14 consenting families and 12 who declined to donate organs. A purposeful sampling process began in October 2009 and ended in October 2010. Data analysis reached 10 categories and two major themes were listed as: 1) serenity in eternal freedom; and 2) resentful grief. The central themes were peace (...) and honor versus doubt and regret. The findings indicated that the families faced with an organ donation request of a brain-dead loved one experienced a lasting effect long after the patient's demise regardless of their decision to donate or refusal to donate. In conclusion, this study highlights the importance of family support and follow-up in an efficient healthcare system aimed at developing trust with the families and providing comfort during and after the final decision. (shrink)

A work ethic is people's attitude to work—imprinted in a complex of moral values and norms, embodied in categories and examples of the culture, and expressed in human behavior, above all in the sphere of labor activity. In my understanding, a work ethic is a component part of the socioeconomic genotype of a society. A SEG is a kind of information mechanism of "social inheritance" that ensures the reproduction of the structure and principles of a particular social system's functioning, regulation, (...) and learning process. It comprises a system of values, a set of motivations, and a paradigm of economic management and administration, and in its manifest form it is reflected in the contours of the regulation and administration of socioeconomic processes, including legal, administrative, economic, and moral norms and incentives. A SEG itself is based on the system of social interests and on the particular society's culture. (shrink)

Incommensurability between successive scientific theories—the impossibility of empirical evidence dictating the choice between them—was Thomas Kuhn's most controversial proposal. Toward defending it, he directed much effort over his last 30 years into formulating precise conditions under which two theories would be undeniably incommensurable with one another. His first step, in the late 1960s, was to argue that incommensurability must result when two theories involve incompatible taxonomies. The problem he then struggled with, never obtaining a solution that he found entirely satisfactory, (...) was how to extend this initial line of thought to sciences like physics in which taxonomy is not so transparently dominant as it is, for example, in chemistry. This paper reconsiders incommensurability in the light of examples in which evidence historically did and did not carry over continuously from old laws and theories to new ones. The transition from ray to wave optics early in the nineteenth century, we argue, is especially informative in this regard. The evidence for the theory of polarization within ray optics did not carry over to wave optics, so that this transition can be regarded as a prototypical case of discontinuity of evidence, and hence of incommensurability in the way Kuhn wanted. Yet the evidence for classic geometric optics did carry over to wave optics, notwithstanding the fundamental conceptual readjustment that Fresnel's wave theory required. (shrink)

Thomas S. Kuhn's singular voice was stilled by cancer on June 17, 1996, some 49 years after his initial encounters with past science had drawn him into a career in the history and philosophy of science. One of the most widely-read and influential academics of the 20th century, Kuhn was educated at Harvard University, where he received an S.B. in Physics in 1943 and a Ph.D. in the subject in 1949. He remained there until 1956, first as a Junior Fellow (...) in the Society of Fellows from 1948 to 1951, when he in effect retrained himself as a historian of science, and then as an Assistant Professor of General Education and History of Science. He joined the faculty of the University of California, Berkeley, in 1956, becoming Professor of History of Science in 1961. From 1964 to 1979 he was on the faculty of the History of Science Program of Princeton University, and from 1972 to 1979 also a member of the Institute for Advanced Study. He moved to the Department of Linguistics and Philosophy of Massachusetts Institute of Technology in 1979, where he became Professor Emeritus in 1991. He was President of the History of Science Society in 1968—70 and of the Philosophy of Science Association in 1988–90. He received the George Sarton Medal of the History of Science Society in 1982 and the John Desmond Bernal Award of the Society for the Social Studies of Science in 1983. (shrink)

F.-W. von Herrmann was a close associate of Heidegger during the final four years of the philosopher’s life. During that time, he not only had many conversations with him, but was also granted access to many writings just now appearing in the Gesamtausgabe. As a result of his proximity to Heidegger, as well as to his writings, von Herrmann seems in a unique position to provide an authoritative account of Heidegger’s work.

This excellent work defends the radical nature of Husserl’s transcendental phenomenology from those who want to turn it into a kind of realism. The influence of such "revisionists" "is so strong at present that the historical Husserl threatens to vanish from sight completely". Husserl, de Boer insists, eventually defined consciousness as absolute being which constitutes the world within itself. "Husserl’s entire development becomes incomprehensible when this idealism is denied". According to de Boer, Franz Brentano convinced the young Husserl that the (...) aim of philosophy was to find a way of anchoring norms in the face of relativism and historicism. Brentano sought to use scientific methodology to found a descriptive psychology which could in turn form the basis for normative sciences. Like Brentano, Husserl was taken with the idea of developing a "rigorous science" of consciousness which would help provide rational a priori values in the face of the irrational world-views so prevalent in the first part of the century. Husserl’s turn away from his early empiricism and naturalism and his eventual adoption of transcendental idealism follows from his attempt to solve three problems in Brentano’s work: 1) the relation between things in themselves and the immanent intentional object; 2) the method for founding a priori truths; 3) the naturalistic attitude inherent in Brentano’s view that positivistic-genetic psychology and phenomenological psychology have equal value in the study of consciousness. Husserl solved the second problem with the notion of the intuition of essences. He solved the first and third problems with the discovery of transcendental idealism in 1908. De Boer maintains that the denial of the thing in itself, which is still presupposed in the naturalistic standpoint operating in Logische Untersuchungen, "is the most important step of all in Husserl’s development". The notion of the thing in itself is common to the naturalistic-dogmatic belief that on the one hand there is a realm of objects independent of consciousness and that on the other hand there is consciousness which has some experience of those objects. In LU, Husserl simply suspended the question of the relation of the thing in itself to consciousness because he still regarded the latter as a kind of island within the "real" world, to which natural science alone has direct access. Despite the fact that LU rejected the naturalizing of ideas, LU continued to regard consciousness in a naturalistic way. Only the "Copernican revolution" of transcendental idealism enabled Husserl to see that the foundation of all being is absolute mind or consciousness. Because consciousness "constitutes" reality in a creative and productive sense, there is no point in speaking of a "thing in itself." Husserl’s transcendental reduction does not deny "reality," but merely rejects the naturalistic tendency to absolutize it. (shrink)

This collection reconsiders the notion of life and conceptualizes those forms of life which have been excluded from modern philosophy, such as post-Anthropocene life, the life of non-human animals and the life of inorganic objects"-- Provided by publisher.

Thank you so much for the invitation to be here with you. It is always a pleasure to be with people who understand, believe in, and know the importance of public health. Those of us who work in the legislative arena know how infrequent it is to have dialogue and conversation with people who really have a good, tangible, hands-on working knowledge of health care, and particularly of public health.The notion of public health is an interesting one. It will range—if (...) you talk to people in the legislature or out of the legislature—from just complete ignorance to total unawareness of what we mean by the words “public health.” When you talk to individuals like us in this room, we find a mixture of definitions, a mixture of understandings, and a mixture of appreciation as to what public health really is. (shrink)

Thank you so much for the invitation to be here with you. It is always a pleasure to be with people who understand, believe in, and know the importance of public health. Those of us who work in the legislative arena know how infrequent it is to have dialogue and conversation with people who really have a good, tangible, hands-on working knowledge of health care, and particularly of public health.The notion of public health is an interesting one. It will range—if (...) you talk to people in the legislature or out of the legislature—from just complete ignorance to total unawareness of what we mean by the words “public health.” When you talk to individuals like us in this room, we find a mixture of definitions, a mixture of understandings, and a mixture of appreciation as to what public health really is. (shrink)

BackgroundPreprint usage is growing rapidly in the life sciences; however, questions remain on the relative quality of preprints when compared to published articles. An objective dimension of quality that is readily measurable is completeness of reporting, as transparency can improve the reader’s ability to independently interpret data and reproduce findings.MethodsIn this observational study, we initially compared independent samples of articles published in bioRxiv and in PubMed-indexed journals in 2016 using a quality of reporting questionnaire. After that, we performed paired comparisons (...) between preprints from bioRxiv to their own peer-reviewed versions in journals.ResultsPeer-reviewed articles had, on average, higher quality of reporting than preprints, although the difference was small, with absolute differences of 5.0% [95% CI 1.4, 8.6] and 4.7% [95% CI 2.4, 7.0] of reported items in the independent samples and paired sample comparison, respectively. There were larger differences favoring peer-reviewed articles in subjective ratings of how clearly titles and abstracts presented the main findings and how easy it was to locate relevant reporting information. Changes in reporting from preprints to peer-reviewed versions did not correlate with the impact factor of the publication venue or with the time lag from bioRxiv to journal publication.ConclusionsOur results suggest that, on average, publication in a peer-reviewed journal is associated with improvement in quality of reporting. They also show that quality of reporting in preprints in the life sciences is within a similar range as that of peer-reviewed articles, albeit slightly lower on average, supporting the idea that preprints should be considered valid scientific contributions. (shrink)

Restrictive visitation policies produce inequities in healthcare that have meaningful consequences for patients’ health and well-being. There is a surplus of existing literature exploring the consequences of reduced visitation in the setting of pediatric patients lacking decision-making capacity, but relatively little scholarship addressing visitation restriction for less vulnerable adults possessing capacity. Here, we present the case of a patient who suffered serious complications of childbirth, during the delivery of her healthy newborn, leading to prolonged hospitalization. During her treatment course, she (...) was subsequently denied visitation with her newborn, who had been discharged from the hospital, and this had detrimental effects on her recovery. Hospital policies restricting visitation during the COVID-19 pandemic were intended to reduce the risk of disease exposure for both patients and staff, despite conflicting evidence demonstrating this benefit. In contrast, they often have negative effects on patient stress, mood, and physical recovery. The sequelae of this US-based case study argue the need for more holistic hospital visitation policies, placing a specific lens on adult patients receiving a visitation from their newborn children. (shrink)

To date, our knowledge of Rift Valley fever disease spread and maintenance is still limited, as flooding, humid weather and presence of biting insects such as mosquitoes, have not completely explained RVF outbreaks. We propose a model that includes livestock, mosquitoes and ticks compartments structured according to their questing and feeding behaviour in order to study the possible role of ticks on the dynamics of RVF. To quantify disease transmission at the initial stage of the epidemic, we derive an explicit (...) formula of the basic reproductive number, $$R_0$$ R 0. Using the concept of Metzler matrix, we state necessary conditions for global asymptotic stability of the disease-free equilibrium. Results suggest that although host-ticks interactions may serve as disease reservoirs or disease amplifiers, the Aedes reproductive number should be kept under unity if disease post-epizootics activities are to be controlled. Results of both local and global sensitivity analysis of selected model parameters indicate that $$R_0$$ R 0 is more sensitive to the ticks attachment and detachment rates, probability of transmission from ticks to host and from host to ticks, length of infection in livestock and ticks death rate. Furthermore, when comparing the mean value of $$R_0$$ R 0 with that from previous studies which did not include ticks we found that our $$R_0$$ R 0 is very much larger resulting in an increase in the exponential phase of an outbreak. These findings suggest that if ticks are capable of transmitting the virus, they may be contributing to disease outbreaks and endemicity. (shrink)

BackgroundAs a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were (...) exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk.DiscussionIn the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics.SummaryAn honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)

The purpose of this study is to examine the importance that real patients attach to their right to withdraw from an on-going feasibility randomised trial (RCT) evaluating types and timings of breast reconstruction (two parallel trials) following mastectomy for breast cancer. Our results show that, while some respondents appreciated that exercising the right to withdraw would defeat the scientific objective of the trial, some patients with a surgical preference consented only given the knowledge they could withdraw if they were not (...) allocated to their preferred treatment. (shrink)

This essay summarizes key insights across the essays in the Hastings Center Report's special report “Time to Rebuild: Essays on Trust in Health Care and Science.” These insights concern trust and trustworthiness as distinct concepts, competence as a necessary but not sufficient input to trust, trust as a reciprocal good, trust as an interpersonal as well as structural phenomena, the ethical impermissibility of seeking to win trust without being trustworthy, building and borrowing trust as distinct strategies, and challenges to trustworthiness (...) posed by the contingent nature of science. Together, these insights stand to advance an area of research that we believe has been historically stymied by conceptual confusion and a long‐standing insistence on treating trust as a purely instrumental good. (shrink)

BackgroundAccurate reporting on sex and gender in health research is integral to ensuring that health interventions are safe and effective. In Canada and internationally, governments, research organizations, journal editors, and health agencies have called for more inclusive research, provision of sex-disaggregated data, and the integration of sex and gender analysis throughout the research process. Sex and gender analysis is generally defined as an approach for considering how and why different subpopulations (e.g., of diverse genders, ages, and social locations) may experience (...) health conditions and interventions in different or similar ways.The objective of this study was to assess the extent and nature of reporting about sex and/or gender, including whether sex and gender analysis (SGA) was carried out in a sample of Canadian randomized controlled trials (RCTs) with human participants.MethodsWe searched MEDLINE from 01 January 2013 to 23 July 2014 using a validated filter for identification of RCTs, combined with terms related to Canada. Two reviewers screened the search results to identify the first 100 RCTs that were either identified in the trial publication as funded by a Canadian organization or which had a first or last author based in Canada. Data were independently extracted by two people from 10% of the RCTs during an initial training period; once agreement was reached on this sample, the remainder of the data extraction was completed by one person and verified by a second.ResultsThe search yielded 1433 records. We screened 256 records to identify 100 RCTs which met our eligibility criteria. The median sample size of the RCTs was 107 participants (range 12–6085). While 98% of studies described the demographic composition of their participants by sex, only 6% conducted a subgroup analysis across sex and 4% reported sex-disaggregated data. No article defined “sex” and/or “gender.” No publication carried out a comprehensive sex and gender analysis.ConclusionsFindings highlight poor uptake of sex and gender considerations in the Canadian RCT context and underscore the need for better articulated guidance on sex and gender analysis to improve reporting of evidence, inform policy development, and guide future research. (shrink)