A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women9s Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial (...) protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. (shrink)

A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U (...) test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education, being employed and younger age group are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea, Drowsiness and Surgical Wound Pain. Patients ranked Heart Attack, Death and Stroke as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist, instead of letting the doctor decide or deciding for themselves. Discussion with the anaesthetist is the preferred medium of communication compared to reading a pamphlet or watching a video. Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship. (shrink)

Physicians have developed a number of implicit and explicit approaches to complex medical decisions. Decision analysis is an explicit, quantitative method of clinical decision making that involves the separation of the probabilities of events from their relative values, or utilities. Its use can help physicians make difficult choices in a manner that promotes true patient participation. Decision analysis also provides a framework for the incorporation of data from multiple sources and for the assessment of the impact of uncertain data on (...) the final decision. Although this approach is imperfect, it represents a significant advance in clinical decision making. (shrink)

An assessment is made of Rudolf Otto's criticisms of Friedrich Schleiermacher's claim that religious feeling is to be interpreted as essentially involving a feeling of absolute dependence. Otto's criticisms are divided into two kinds. The first suggest that a feeling a dependence, even an absolute one, is the wrong sort of feeling to locate at the heart of religious consciousness. It is argued that this criticism is based on misinterpretations of Schleiermacher's view, which is in fact much closer to Otto's (...) than the latter appreciated. The second kind of criticism suggests that the feeling of absolute dependence cannot play the foundational role assigned to it by Schleiermacher, since it is itself a secondary response. It is argued not only that Otto provides no justification for this criticism, but that Otto's own position is incoherent unless Schleiermacher's view is accepted. (shrink)

The Problem of Perception offers two arguments against direct realism--one concerning illusion, and one concerning hallucination--that no current theory of ...

В книге дается анализ основных характерных признаков русской философии, позволяющие выделить ее как нечто особенное из общего контекста философских культур.

A. D. Smith; VI*—The Self and the Good, Proceedings of the Aristotelian Society, Volume 85, Issue 1, 1 June 1985, Pages 101–118, https://doi.org/10.1093/aristot.

In its infancy the British Association for the Advancement of Science derived a good deal of its inspiration from the writings of Francis Bacon. But the pursuit of Baconian policies brought with it attendant dangers which critics from Charles Dickens to the Times were not slow to magnify. Although the situation was further complicated by the sensitiveness of institutional Christianity at the start of Victoria's reign, some of the hazards which the Association endured had to be accepted simply as consequences (...) of the attempt to provide a secure platform for British science. (shrink)

Jack and Jill have both applied for the same entry-level position at a local university. After interviewing the leading candidates, the members of the hiring committee agree that both Jack and Jill have all the necessary qualifications for appointment to the position. Both have the required education and training. Both have strong letters of recommendation from their Ph.D. supervisors and from their current employers. Both are similarly experienced and both are potentially capable of making important future contributions to their chosen (...) discipline. The members of the hiring committee also agree that Jack and Jill are superior to all other applicants for the position. In short, in the judgment of the hiring committee, they are the two best qualified candidates and both meet their potential employer's expectations concerning a successful applicant. Yet neither Jack nor Jill is clearly superior to the other. (shrink)

Eduard Norden, in the second half of his Agnostos Theos, has maintained with great learning and ingenuity the thesis that predications in the style ‘Thou art ,’ ‘I am ,’ are due to Oriental influence; purely Greek religious language does not go beyond ‘Thou dost ,’ ‘We are indebted to thee for .’ This view appears to be substantially correct. To Oriental influence we may, I think, trace also the custom of stringing together a series of brief predications in or (...) of the second person, for the most part not connected by conjunctions, and producing the effect of a rapid fire of assertions. The earlier Greek examples are not, as a rule, asyndetic. In the Hellenistic age and later we see the other style, as in Catullus 34. 13: ‘tu Lucina dolentibus Iuno dicta puerperis, tu potens Triuia et notho es dicta lumine luna, tu cursu dea menstruo … exples’ 61. 51: ‘te suis tremulus parens inuocat, tibi uirgines zonula soluunt sinus, te timens cupida nouus captat aure maritus’; in Lucretius' proem; in Ovid, Met. IV. 17: ‘tibi enim inconsumpta iuuenta est, tu puer aeternus, tu formosissimus alto conspiceris caelo, tibi cum sine cornibus adstas, uirgineum caput est’; in the invocation of Apollo at the end of the first book of Statius' Thebaid; in Capaneus' prayer to his strong right arm : ; in the Orphic hymns, II. 10-, though they consist mostly of accumulations of epithets; in Menander Rhetor περ πιδειкν : περ [al. Θοραι], περ σ Θνδες, παρ σοкα σελνη τν ετνα λαμβνει; in Valerius Maximus VI. (shrink)

The paper examines a single, apparently simple argument for the existence of incompatibilities between the virtues as traits of character. This argument appeals not to empirical truths about human psychology or human nature but to the possibility of conflict between the exercise of different virtues in action. There are, for example, situations in which we can exercise the virtue of truthfulness only at the expense of not exercising the virtue of tact, as when we are asked a question to which (...) the straightforward answer will pain our questioner. The person who in these situations would give a straightforward answer possesses the virtue of truthfulness to a higher degree than the person who would respond more evasively, whereas the latter person possesses the virtue of tact to a higher degree than the former. But since the two responses are mutually exclusive, it follows that the degree to which we possess the virtue of truthfulness must, at least in some measure, correlate inversely with the degree to which we possess the virtue of tact. And similarly for many other pairs of virtues. My paper focusses on the two cardinal assumptions of this argument, viz., (i) that sometimes the exercise of one virtue can conflict with the exercise of another, and (ii) that the degree to which a person possesses a virtue correlates directly with the extent of its exercise, and defends both assumptions against a variety of objections which allege that, in different ways, they are insensitive to the complexity of the virtues. (shrink)

Ausgehend von einer postulierten Abstammung der verschiedenen Gymnospermengruppen und der Angiospermen von Progymnospermen werden die Semophylesen der Samenanlagen und deren „Hüll- und Schutzorganen” eingehend besprochen. Das innere Integument ist phylogenetisch wohl aus verwachsenen sterilen Megasporangien entstanden, das aussere ist das Homologon der Cupula der Samenfarnen und ein Achsengebilde.Die dritte Hülle — die interseminalen Schuppen bei den Bennettiteen, die Chlamys bei den Chlamydospermen, die Fruchtknotenwand bei einigen Angiospermengruppen wie Pandanaceen und Cyperaceen, und der Arillus bei Angiospermen mit karpellaten Gynoezien — ist (...) wahrscheinlich aus reduzierten Samenanlagen hervorgegangen. Die vierte, aus sterilen brakteenartigen Phyllomen entstanden, hat in verschiedenen Kombinationen mit fertilen Achsen, die karpellaten Fruchtknoten der Angiospermen gebildet.Die Herkunft der Blütenpflanzen von chlamydospermen- und bennettiteen-ähnlichen Vorfahren wird sehr wahrscheinlich da Übergänge zwischen den „nackten” Samenanlagen vomGnetum-Typ und sogenannten pseudomonomeren Griffeln von Angiospermen vorliegen.En basant la phylogénie de plusieurs groupes de Gymnospermes et d'Angiospermes sur une descente des Progymnospermes du Devonien Supérieur , les sémophylèses des ovules et de ses couches protectrices ont été discuté.Le tégument interne très probablement représente une groupe de mégasporanges stériles fusés, le tégument externe est l'homologue des cupules des ptéridospermes et d'origine axillaire. La troisième couche — les écailles interséminales chez les Bennettitales, la chlamys chez les Chlamydospermes, le paroi de l'ovaire chez quelques Angiospermes comme les Pandanacées, les Piperacées..., l'arille de l'ovule dans les ovaires carpellaires des Angiospermes — est probablement l'homologue d'un nombre d'ovules steriles. La quatrième couche, constituée de phyllomes steriles, s'est associée avec des axes ovulifères en formant les pistils carpellaires des Angiospermes. L'origine des Angiospermes des ancêtres d'un type Chlamydosperme-Bennettitale est indiqué par la morphologie transitoire de quelques ovaires soi-disant „pseudo-monomères” liant les ovules „nues” du typeGnetum avec les pistils du type des Piperacées, Chloranthacées etc. (shrink)