This book is composed of seven essays on diverse ethical themes. C. H. Hamburg's essay on the task of the contemporary psychoanalyst in giving criteria for judging psychic health, Louise Roberts' discussion of "better" as a primitive ethical term, and R. C. Whittmore's "Does the Neo-intuitionist theory of obligation rest on a mistake?" are the most valuable.--A. J. S.

William Burnside was one of the three most important algebraists who were involved in the transformation of group theory from its nineteenth-century origins to a deeper twentieth-century subject. Building on work of earlier mathematicians, they were able to develop sophisticated tools for solving difficult problems. His works are of enormous historical importance; they remain also a source of inspiration and information. The works of his contemporaries, such as Klein, Frobenius, Schur, have been published as also have the works of his (...) immediate successors such as Phillip Hall. All of Burnside's papers are reproduced here, organized chronologically and with a detailed bibliography. Walter Feit has contributed a foreword, and a collection of introductory essays are included to provide a commentary on Burnside's work and set it in perspective along with a modern biography that draws on archive material. This is the first reference volume of Burnside's collected papers, enhanced by a series of critical essays on his work, and is important for group theorists and historians and philosophers of mathematics and fills the gap in this area of literature. (shrink)

Recent policy in relation to clinical research proposals in the UK has distinguished between two types of review: scientific and ethical. This distinction has been formally enshrined in the recent changes to research ethics committee structure and operating procedures, introduced as the UK response to the EU Directive on clinical trials. Recent reviews and recommendations have confirmed the place of the distinction and the separate review processes. However, serious reservations can be mounted about the science/ethics distinction and the policy of (...) separate review that has been built upon it. We argue here that, first, the science/ethics distinction is incoherent, and, second, that RECs should not only be permitted to consider a study’s science, but that they have anobligation do so. (shrink)

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

The major periods of Rimbaud's life are seen as parts of a whole, united by the theme of a necessary and hopeless struggle for an impossible adequacy--as man, as poet, as trader. Hackett effectively presents the case that Rimbaud is the greatest French poet after Baudelaire.--A. J. S.

In a modern democratic society appearance has great importance. This is especially true of the dress code in health care sphere. More recently, changing your appearance by getting tattoos and body modifications has been decried by different generations in the medical community. However, what is significance of appearance of a medical officer during epidemiological instability around the world? The response to this question was given in our study. The objectives of the study are: to interrogate the attitude of medical university (...) students to medical officers with tattoos as well as to identify medical students who are "exposed" to the fashionable trend of tattoos and body modifications. To implement these objectives, the study involved 106 medical students of various levels of degree and faculties of Rostov state medical University. The results of the study showed that the majority of medical students has not resorted to changes in their appearance, although tattoos and body modifications did not avoid the community of medical students. (shrink)

Background: The traditional approach to resolving ethics concerns may not address underlying organisational issues involved in the evolution of these concerns. This represents a missed opportunity to improve quality of care “upstream”. The purpose of this study was to understand better which organisational issues may contribute to ethics concerns. Methods: Directed content analysis was used to review ethics consultation notes from an academic children’s hospital from 1996 to 2006 (N = 71). The analysis utilised 18 categories of organisational issues derived (...) and modified from published quality improvement protocols. Results: Organisational issues were identified in 68 of the 71 (96%) ethics consult notes across a range of patient settings and reasons for consultation. Thirteen of the 18 categories of organisational issues were identified and there was a median of two organisational issues per consult note. The most frequently identified organisational issues were informal organisational culture (eg, collective practices and approaches to situations with ethical dimensions that are not guided by policy), policies and procedures (eg, staff knows policy and/or procedural guidelines for an ethical concern but do not follow it) and communication (eg, communication about critical information, orders, or hand-offs repeatedly does not occur among services). Conclusions: Organisational issues contribute to ethical concerns that result in clinical ethics consults. Identifying and addressing organisational issues such as informal culture and communication may help decrease the recurrence of future similar ethics concerns. (shrink)

Summary This paper presents an analysis and discussion of the opinions of two generations of Asian parents with regard to their young children's education. A large number of parents (n = 200) were interviewed during 1970-1974 and a smaller number (n = 40) during 1995 to ascertain their views on a variety of topics relating to their children's early education. The findings are discussed in a qualitative way and reveal the increasing satisfaction of Asian parents with their children's education. A (...) higher proportion of the mothers of the 1990s help their children with homework, read them stories and are generally more participatory in their children's education compared with the 1970s group. The second generations are concerned with the lack of facilities for the teaching of mother tongues in schools. These and other findings are discussed within the changing lifestyles of second-generation Asians. (shrink)

This book introduces Robert Corrington’s “ecstatic naturalism,” a new perspective in understanding “sacred” nature and naturalism, and explores what can be done with this philosophical thought. This is an excellent resource for scholars of Continental philosophy, philosophy of religion, and American pragmatism.

In A Professor's Duties, distinguished philosopher Peter J. Markie adds to the expanding discussion of the ethics of college teaching. Part One concentrates on the obligations of individual professors, primarily with regard to issues about what and how to teach. Part Two expands Professor Markie's views by providing a selection of the most significant previously published writings on the ethics of college teaching.

The idea that there is a fundamental difference in value between persons and things, and that respecting this difference is an important moral requirement, has strong intuitive appeal. Kantian ethics is unique in placing this requirement at the center of a moral system and in explicating the conditions for complying with it. Unlike challenges to Kantian ethics that focus on tragic cases that pit respect for one person against respect for another, this paper focuses on the question of how we (...) can respect the value distinction between persons and things under conditions of uncertainty. After exploring why decision making under uncertainty is a neglected topic among Kantians and demonstrating how uncertainty challenges our ability to comply with this norm, we propose a notion of morally insignificant risk within a framework that allows agents to navigate real-world decisions involving material benefit and some risk to dignity without violating the Kantian’s core commitments. We conclude by exploring some of the challenges facing this approach. (shrink)

Bioethicists often draw sharp distinctions between hope and states like denial, self-deception, and unrealistic optimism. But what, exactly, is the difference between hope and its more suspect cousins? One common way of drawing the distinction focuses on accuracy of belief about the desired outcome: Hope, though perhaps sometimes misplaced, does not involve inaccuracy in the way that these other states do. Because inaccurate beliefs are thought to compromise informed decision making, bioethicists have considered these states to be ones where intervention (...) is needed either to correct the person’s mental state or to persuade the person to behave differently, or even to deny the person certain options. In this article, we argue that it is difficult to determine whether a patient is really in denial, self-deceived, or unrealistically optimistic. Moreover, even when we are confident that beliefs are unrealistic, they are not always as harmful as critics contend. As a result, we need to be more permissive in our approach to patients who we believe are unrealistically optimistic, in denial, or self-deceived—that is, unless patients significantly misunderstand their situation and thus make decisions that are clearly bad for them, we should not intervene by trying to change their mental states or persuade them to behave differently, or by paternalistically denying them certain options. (shrink)

The precautionary principle is often invoked in relation to pregnant women and may be one of the underlying reasons for their continuous underrepresentation in clinical research. The principle is appealing, because potential fetal harm as a result of research participation is considered to be serious and irreversible. In our paper, we explore through conceptual analysis whether and if so how the precautionary principle should apply to pregnant women. We argue that the principle is a decision-making strategy underlying risk-benefit decisions in (...) clinical research, which can be applied to pregnant women. However, the current application is a strong one, leading to the promotion of absolute exclusion or, less often, absolute inclusion of pregnant women. In order to change this paralyzing situation, a shift toward weak precautionary thinking is necessary. Instead of automatic extreme precaution, a balance will be found between harms and potential benefits of including pregnant women in clinical research. (shrink)

The sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public, patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Difficult (...) decisions were made rapidly; flexibility and reconsideration were necessary not only because the intensity and severity of infection varied over time and by locale but also because knowledge of the disease and understanding of its treatment grew. Here we discuss the ethical challenges in decision-making and competing ethical tensions during the pandemic in an effort to advance future preparedness. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)