Research using Controlled Human Infection Models is yet to be attempted in India. This study was conducted to understand the perceptions of the lay public and key opinion makers prior to the possible introduction of such studies in the country. 110 respondents from urban and rural Bangalore district were interviewed using qualitative research methods of Focus Group Discussions and In-depth Interviews. The data was analyzed using grounded theory. Safety was a key concern of the lay public, expressed in terms of (...) fear of death. The notion of infecting a healthy volunteer, the possibility of continued effects beyond the study duration and the likelihood of vulnerable populations volunteering solely for monetary benefit, were ethical concerns. Public good outcomes such as effective treatments, targeted vaccines and prevention of diseases was necessary justification for such studies. However, the comprehension of this benefit was not clear among non-medical, non-technical respondents and suggestions to seek alternatives to CHIMs repeatedly arose. There was a great deal of deflection—with each constituency feeling that people other than themselves may be ideally suited as participants. Risk takers, those without dependents, the more health and research literate, financially sound and those with an altruistic bent of mind emerged as possible CHIM volunteers. While widespread awareness and advocacy about CHIM is essential, listening to plural voices is the first step in public engagement in ethically contentious areas. Continued engagement and inclusive deliberative processes are required to redeem the mistrust of the public in research and rebuild faith in regulatory systems. (shrink)

Dưới đây là một số quan sát từ dữ liệu giao dịch trái phiếu sơ cấp từ hệ thống thông tin trực tuyến của Sở Giao dịch Chứng khoán Hà Nội (HNX). HNX đảm nhiệm chức năng giao dịch sơ cấp tập trung đối với thị trường trái phiếu chính phủ.

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to (...) payment: reimbursement, wage payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated. (shrink)

Controlled human infection model (CHIM) studies involve the intentional exposure of healthy research volunteers to infectious agents. These studies contribute to knowledge about the cause or development of disease and to the advancement of vaccine research. But they also raise ethical questions about the kinds of risks that should be permissible and whether limits should be imposed on research risks in CHIM studies. Two possible risk thresholds have been considered for CHIM studies. The first suggests constraining ethically (...) permissible risks according to a minimal risk threshold and the second endorses a higher risk threshold that excludes irreversible or fatal infections. I argue that neither of these thresholds is persuasive and situate questions about risk thresholds in CHIM studies within a broader debate about permissible risks in research. I argue that risks in CHIM studies should be constrained according to limits on research risks that do not offer corresponding benefits in all studies rather than developing a unique risk threshold for CHIM studies. I then propose five recommendations for the ethical assessment of risk in CHIM studies. (shrink)

Implicit in feminist and other critiques of ideal theorizing is a particular view of what normative theory should be like. Although I agree with the rejection of ideal theorizing that oppression theorists (and other theorists of justice) have advocated, the proposed alternative of nonideal theorizing is also problematic. Nonideal theorizing permits one to address oppression by first describing (nonideal) oppressive conditions, and then prescribing the best action that is possible or feasible given the conditions. Borrowing an insight from the "moral (...) dilemmas debate"— namely that moral wrongdoing or failure can be unavoidable—I suggest that offering (only) action-guidance under non-ideal conditions obscures the presence and significance of unavoidable moral failure. An adequate normative theory should be able to issue a further, non-action-guiding evaluative chim, namely that the best that is possible under oppressive conditions is not good enough, and may constitute a moral failure. I find exclusively action-guiding nonideal theory to be both insufficiently nonidealizing (because it idealizes the moral agent by falsely characterizing the agent as always able to avoid moral wrongdoing) and meanwhile too strongly adapted to the nonideal (because normative expectations are lowered and detrimentally adapted to options that, while the best possible, are still unacceptable). (shrink)

We largely agree with Grimwade et al ’s1 conclusion that challenge trial participants may ethically be paid, including for risk. Here, we add further arguments, clarify some points from the perspective of economics and indicate areas where economists can support the development of a framework for ethically justifiable payment. Our arguments apply to carefully constructed and monitored controlled human infection model trials that have been appropriately reviewed and approved. Participants in medical studies perform a service. Outside the domain of research (...) participation, there is nearly universal agreement that workers providing a service should be compensated fairly, and that work involving more discomfort and risk should be compensated more generously. Accordingly, labour regulations impose floors, not caps on compensation. Caps, even if intended to protect against undue inducement, also raise concerns about illegal price-fixing that disadvantages workers. Such limits on payment for egg donors have successfully been challenged in court.i Moreover, caps on compensation may harm everyone at risk of infection, not just potential participants. Insufficient compensation may impede the recruitment of enough suitable subjects, for example, when representativeness of the subject sample is required. Delays in vaccine development not only prolong disruption of social, educational and economic activity but also lead to excess infections and deaths. Unlike paid CHIM participants, individuals exposed to such infection do not accept it voluntarily, are not compensated for it, and are unlikely to receive the level of medical supervision afforded to closely monitored CHIM participants. Payment caps can lead to attempts to circumvent the regulation. For example, many countries …. (shrink)

There have been repeated attempts in the history of comparative biology to provide a mechanistic account of morphological homology. However, it is well-established that homologues can develop from diverse sets of developmental causes, appearing not to share any core causal architecture that underwrites character identity. We address this challenge with a new conceptual model of Character Identity Mechanisms. ChIMs are cohesive mechanisms with a recognizable causal profile that allows them to be traced through evolution as homologues despite having a diverse (...) etiological organization. Our model hypothesizes that anatomical units at different levels of organization—cell types, tissues, and organs—have level-specific ChIMs with different conserved parts, activities, and organization. Relying on a methodology of conceptual engineering, we show how the ChIM concept advances our understanding of the developmental basis of morphological characters, while forging an important link between comparative and mechanistic biology. (shrink)

Grimwade et al highlight the current lack of a universal, standardised approach to the payment of participants taking part in controlled human infection model studies.1 As they discuss, payment for these studies is controversial, with many voicing arguments for and against higher payments, particularly for those studies which involve significant burdens to the participant. The main concerns about overpayment relate to the concepts of undue inducement or coercion, whereas underpayment raises concern about exploitation and unfair treatment. In many healthy volunteer (...) trials compensation for travel, time and inconvenience are generally accepted as fair payment, but payment for risk is less accepted, with a belief that non-therapeutic studies should only incur minimal risks, so payment for risk should not be necessary.2 This paper argues that payment for risk should be included for CHIM studies. Their findings among members of the UK public and CHIM experts from a variety of centres suggest that there is support for greater risks being associated with higher payments for participants. The amount of compensation offered by a trial has to be approved by an ethics committee/institutional review board, and some research suggests that IRB members have concerns about higher payments being offered, with only approximately one-third agreeing that payment should be offered for risk.3 Without agreement and clear guidance for calculating compensation for these types of trial, there is bound to be …. (shrink)

When payment is offered for controlled human infection model research, ethical concerns may be heightened due to unfamiliarity with this study design as well as perceptions—and misperceptions—regarding risk. Against this backdrop, we commend Grimwade et al 1 for their careful handling of the relevant issues, coupling empirical and conceptual approaches. We agree with foundational elements of the authors’ analysis, including the acceptability of payment for research risk.1 However, in our view, it is preferable to treat payment for risk as a (...) discretionary incentive to achieve adequate recruitment and retention, rather than compensation owed as a matter of fairness. Grimwade et al 1 note that although their ‘Payment for Risk Model’ was ‘created specifically in the context of CHIM research, it has the potential to inform payment in other areas of medical research.’ We agree and would go further: we do not need a special payment framework for CHIMs because there is nothing so novel about them compared with other types of research as to demand a distinct approach. Any successful payment framework must address the following ethical issues: preserving informed consent ; treating participants fairly ; encouraging adequate recruitment and retention; avoiding deception by participants; and preserving public trust.2 Some of these issues may have particular salience in the context of CHIMs, but this study design does not demand consideration of entirely distinct ethical factors when evaluating offers of payment.2 We also agree with Grimwade et al 1 about several other key points.2 Given the burdens involved and …. (shrink)

This article aims to review the concept of ‘Sokhyung(贖刑)’ as an example of a pluralistic interpretation of ‘Heumhul(欽恤)’ in The Book of Documents in the 18th and 19th centuries, and compared and reviewed the interpretation of The Book of Documents by Jeong Yak-yong(丁若鏞) and Shim Dae-yoon(沈大允). Sokhyung is to replace the original sentence by paying property after the sentence is confirmed. It is a specific application example of Heumhul, which means careful and lenient application of punishment. In The Book of (...) Documents, the discussion related to Sokhyung is presented in Chapter 11 of Soonjeon(舜典) and Yeohyung(呂刑). Seojipjeon(書集傳) written by Chae Chim(蔡沈) became the standard for interpreting Sokhyung, and he opposed Sokhyung because it was not fair. At this time, Sokhyung has the meaning of ‘commutation’, and in this respect, Sokhyung takes on the character of Heumhul in that it is a lenient application of the law. Scholars of the Joseon Dynasty generally tended to follow the views of Chae Chim, but a new interpretation trend emerged in the 18th and 19th centuries. Jeong Yak-yong was in favor of the system of Sokhyung on the grounds that the body was preserved by carrying out Sokhyung. At this time, Sokhyung has a meaning of Heumhul in that it is a method of carefully applying punishment and plays a role in realizing the Virtue that likes to save lives(好生之德). Shim Dae-yoon opposed the system of Sokhyung, but did not fully agree with Chae Chim's view. He argued that Sokhyung has the character of applying the law leniently and plays a role of promising that the punishment will disappear(刑期無刑), but criticized the system of Sokhyung in that it interferes with the discretionary application of the law(權衡). (shrink)

Significant attention has been given both to the ethics of Controlled Human Infection Model research and the ethics of payment for research participation. However, comparatively little attention has been given to the ethics of paying for participation specifically in CHIM research. Grimwade et al should be commended for thoughtfully addressing this topic and especially for the empirical data collection informing their work, which is too often lacking in discussions of payment for research participation. In what follows I will discuss (...) three relatively subtle factors that, I believe, make a difference to the ethical analysis of paying for research participation and raise what I intend to be constructive questions about the extent to which the survey instrument employed by the authors captures them. The authors focus on payment for risk in CHIM research. They correctly stress that compensating participants for risk is controversial and that “many general guidelines warn against paying for the risk in medical research”. While not all guidance documents share this scepticism,1 compensating for risk raises thorny issues and uncertainty over the topic among IRBs and regulatory bodies is likely to hinder the practice. Part of the difficulty in assessing payment for research risks stems from the way in which subtle variances in background assumptions influence the ethical assessment, which also complicates empirical attempts to measure attitudes on the topic. Most importantly, it is crucial to be precise about background assumptions concerning whether participants are protected from bearing the financial burdens of research risks that eventuate in actual harms. Protective mechanisms …. (shrink)

Hồ Mạnh Tùng và Hồ Mạnh Toàn đều là các nhà nghiên cứu trẻ trong lĩnh vực khoa học xã hội ở độ tuổi dưới 30. Mặc dù mới tham gia nghiên cứu khoa học chưa lâu, nhưng 2 anh em nhà họ Hồ đã có thành tích khoa học ấn tượng.

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 115 analytical surveys of important Rousseau themes (though their connection with the main theme is sometimes weak) : Rousseau's attitude to love, his philosophy of language, his notion of a Golden Age and Terrestrial Paradise, and his views of personal immortality. Chapter 4 ("L'amour et le pays des chim~res") shows Rousseau recoiling from love fulfillment, "rejet6 dans I'imaginaire par l'~chec de sa passion," finding satisfaction only (...) in the imagination (hence his fear of "soiling the purity" of the beloved, with some strange consequences for his concept of personality). The chapter on Rousseau's philosophy of language is detailed and richly documented, as all these chapters are; it shows him struggling to free the theory from the grip of sensualism, and anticipating in intuitive flashes some very modern notions. Chapter 5 goes to the roots of Rousseau's almost delirious happiness when he finds Paradise in an isle that is both symbol and incarnation of attunement with vegetative nature (Freudians may see a good deal more in this). The last chapter brings together the texts on personal immortality, the certainty of which Rousseau derived from his personal need for compensatory justice, while admitting that there was no objective proof of it. Eigeldinger works strictly from the sources. Some naive expressions, an occasional lack of technique in handling the texts, a tendency towards poetic language and enthusiastic overstatement are easily compensated by his sensitivity, intellectual curiosity, and conscientiousness. His results are not unfamiliar, but it is good to have such rich material brought together and so well presented in these compact chapters. This is not an academic exercise but a work of love, and it is none the worse for it. GR~con SEBBA Emory University Kants These iiber das Sein. By Martin Heidegger. (Frankfurt a. M.: Vittorio Klostermann, 1962. Pp. 36. Paper, DM 3.80.) This little essay continues the "destruction of the history of ontology" which Heidegger originally projected as the second part of Sein und Zeit but never published under that title. The "destruction," as Heidegger readers are aware, is by no means an attempt to repudiate the metaphysical tradition of the West. Its aim instead is to re-think the question of being on a more fundamental level--to focus on the ground of being, being as such (Das Sein), rather than on this or that mode of being or on the totality of what is (Das Seiende). Hence Heidegger's claim that he is laying the groundwork for something that has never really been undertaken previously in Western thought, namely, "fundamental ontology." In Kant und alas Problem der Metaphysik (1929), Heidegger repudiated the NeoKantian interpretation of the Critique of Pure Reason by insisting that the thrust of that work is primarily ontological, not epistemological. Focusing his analysis on Kant's transcendental deduction of the categories and the doctrine of schematism in the first edition of the Critique, Heidegger argued that the transcendental imagination must stand at the center of ontological knowledge and that its subordination to the understanding in the second edition constitutes a "recoil" on Kant's part from his earlier and deeper insights. Moreover, Heidegger found in Kant the seeds of his own doctrine of temporality as the basis of human being, knowing, and acting--a doctrine from which once again Kant "recoiled." 116 HISTORY OF PHILOSOPHY These themes are echoed in the present essay, but a different portion of the Critique comes under scrutiny. In his discussion of the ontological proof for the existence of God, Kant writes: 'Being' is evidently not a real predicate, i.e., it is not a concept of something which could be added to the concept of a thing. It is simply [bloss] the placing [Position] of a thing, or of certain determinations in it. (A598,B626) Heidegger, armed with an impressive correlation of texts, finds in this passage a negative and an affirmative thesis. The negative thesis denies to being the character of a "real" predicate, but does not deny that it is a predicate in some sense. By "real" we are to understand, not actual, but having a reference to things. Thus interpreted, the negative thesis asserts that being is not... (shrink)