Objective:To evaluate the effect of an intervention on the understanding and use of DNR orders by physicians; to assess the impact of understanding the importance of involving competent patients in DNR decisions.Design:Prospective clinical interventional study.Setting:Internal medicine department (70 beds) of the hospital of La Chaux-de-Fonds, Switzerland.Participants:Nine junior physicians in postgraduate training.Intervention:Information on the ethics of DNR and implementation of new DNR orders.Measurements and main results:Accurate understanding, interpretation, and use of DNR orders, especially with respect to the patients’ involvement in the (...) decision were measured. Junior doctors writing DNR orders had an extremely poor understanding of what DNR orders mean. The correct understanding of the definition of a DNR order increased from 31 to 93% (p<0.01) after the intervention and the patients’ involvement went from 17% to 48% (p<0.01). Physicians estimated that 75% of their DNR patients were mentally competent at the time of the decision.Conclusion:An intervention aimed at explaining the ethical principles and the definition of DNR orders improves understanding of them, and their implementation, as well as patient participation. Specific efforts are needed to increase the involvement of mentally competent patients in the decision. (shrink)

Objectives To evaluate whether the requirement of “minimal risk and burden” for paediatric research without direct benefit to the subjects compromises the ability to obtain data necessary for improving paediatric care. To provide evidence-based reflections on the EU recommendation that allows for a higher level of risk. Design and setting Systematic analysis of the approval/rejection decisions made by the Dutch Central Committee on Research involving Human Subjects (CCMO). Review methods The analysis included 165 proposals for paediatric research without direct benefit (...) that were reviewed by the CCMO between January, 2000, and July, 2007. A separate, in-depth analysis of all drug studies included 18 early phase drug studies and nine other drug studies without direct benefit. Results 11 out of 165 studies were definitively rejected because the CCMO did not regard the risk and/or burden to be minimal. In three of these 11 cases (including two early phase drug studies) the requirement of minimal risk and burden was cited as the only reason for rejection. Four other early phase drug studies also involved risks and/or burdens that were not regarded to be minimal but were nevertheless approved. Conclusions The requirement of minimal risk and burden, aiming to protect research subjects, occasionally leads to rejection of protocols. Early phase drug studies relatively often do not comply with the requirement. Committees may find ways to approve important studies that formally should be rejected, but that is not a desirable solution. The regulatory framework should be revised to make such occasional exceptions to the requirement legitimate and transparent. (shrink)

Multilingual dictionary of philosophical terms.

Critical study of of the addresses of Sir Muhammad Iqbal, 1877-1938 from philosophical and religious point of view.

Рассматривается понимание как специфически человеческий способ существования, как первичный, исходный опыт освоения человеком мира, в котором отсутствует субъект-объективная разделенность, лежащая в основе познавательного отношения. Для специалистов.

Islam; customs and practices; Islamic ethics; Islamic law.

Contributed articles on psychological aspect of Hindu philosophical system.

WHAT do we mean by saying that a being, God for example, is omniscient? One way of answering this question is to translate ‘God is omniscient’ into some slightly more formalised language than colloquial English, e.g. one with variables of a number of different types, including variables replaceable by statements, and quantifiers binding thes.

Author's answers to questions on Buddhist philosophy, posed to him by some foreign scholars.

Sufficient texts show that for aristotle the universal notion expresses the same real thing as the particular, Though in a different way. His grounds for a universal so conceived are twofold. First, In every sensible thing there is a basic formal principle that, Though individual, Brings each instance into formal identity with all the other instances. Secondly, In human intellectual cognition there is an active principle that raises knowledge above the status of photographing or registering or cataloguing, And actualizes what (...) was only potential in the real thing. In knowing sensible things universally, The human intellect is able to grasp the concrete thing as characterized by a formal nature, Thereby knowing it in a way that holds equally for all other instances. Though patently incomplete, This conception of the universal is free from internal contradictions. It provides a framework for fruitful discussion, And remains a challenge. (shrink)