Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

Nous invitons ici à une véritable promenade intellectuelle qui nous conduit à creuser l'histoire de la pensée et du penser en Islam pour y retrouver des rationalistes invétérés et endurcis dont le souci fut de défendre la raison au prix de leur foi : ce sont les rationalistes qu'on appelle communément " Mu'tazila ". Très tôt, ce mouvement prit une dimension rationnelle en développant au sein de l'Islam les thèses critiques et philosophiques les plus inattendues d'une religion. Cette histoire des (...) idées que nous voulons parcourir nous mènera au " siècle des lumières en Islam " même si l'expression est quelque peu contestée par certains intellectuels musulmans qui pensent à un manque de considération pour les nouveaux penseurs de l'Islam comme si le moment de la bonne pensée n'est pas le leur. On peut leur donner raison. L'histoire ne bégaie pas toujours. Elle est parfois infidèle. Telle est malheureusement l'histoire de l'Islam. Une histoire d'hybridation et parfois d'infidélité au texte. Apparue comme une religion de salut et de raison, son image est ternie aujourd'hui par ceux qui, au prix du glaive, substituent la modernisation de la pensée islamique à une islamisation violente de la modernité. (shrink)

Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

D. A. T. Gasking; Mr. Williams on the a Priori1, Analysis, Volume 6, Issue 5-6, 1 September 1939, Pages 69–78, https://doi.org/10.1093/analys/6.5-6.69.

Revisiting African philosophy’s classic questions, D. A. Masolo advances understandings of what it means to be human—whether of African or other origin. Masolo reframes indigenous knowledge as diversity: How are we to understand the place and structure of consciousness? How does the everyday color the world we know? Where are the boundaries between self and other, universal and particular, and individual and community? From here, he takes a dramatic turn toward Africa’s current political situation and considers why individual rights and (...) freedoms have not been recognized, respected, demanded, or enforced. Masolo offers solutions for containing socially destructive conduct and antisocial tendencies by engaging community. His unique thinking about community and the role of the individual extends African philosophy in new, global directions. (shrink)

It is argued that organ donation from a patient to the patient's physician is ethically dubious because donation decisions will be inappropriately influenced and the negative public perceptions will result in more harm than good. It is suggested that to protect the perception of the physician–patient relationship, avoid cynicism about medicine’s attitude to patient welfare and maintain trust in the medical profession, a new professional boundary should be established to prevent physicians from receiving organs for transplantation donated by their patients.

D. A. Lloyd Thomas; VIII—Political Decision Procedures1, Proceedings of the Aristotelian Society, Volume 70, Issue 1, 1 June 1970, Pages 141–160, https://doi.or.

Signals to the brain from the flows of energy around the body, varied primarily by declining amounts of food energy in the stomach, can explain the pattern of meals in the laboratory rat, the differences between dark and light phases, and the development of obesity ion the rat wioth VMH lesions but normal sating.

The evolution of internation relationships is studied by means of a mathematical model based on a popular rule of triadic interaction: the friend of my friend is my friend, the friend of my enemy is my enemy, the enemy of my enemy is my friend, the enemy of my friend is my enemy. The rule is shown to lead to the formation and preservation of unipolar and bipolar configurations of nations, with the strengths of relationships, both friendly and conflictual, intensifying (...) through time. These results confirm speculations originally made in static, graph theoretic studies of the balancing of relationships within individuals, small groups and systems of nations. (shrink)

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.

The following article is a response to the position paper of the Hastings Center, “Ethical Challenges of Chronic Illness”, a product of their three year project on Ethics and Chronic Care. The authors of this paper, three prominent bioethicists, Daniel Callahan, Arthur Caplan, and Bruce Jennings, argue that there should be a different ethic for acute and chronic care. In pressing this distinction they provide philosophical grounds for limiting medical care for the elderly and chronically ill. We give a critical (...) survey of their position and reject it as well as any attempt to characterize the physician-patient relationship as a commercial contract. We emphasize, as central features of good medical practice, a commitment to be the patient's agent and a determination to acquire and be guided by knowledge. These commitments may sometimes conflict with efforts to have the physician serve as an instrument of social and economic policies limiting medical care. (shrink)

Kn. 1. O tvorcheskom puti i ideakh S. N. Bulgakova.

Migrations driven by ethnic, religious, and other forms of social conflict have been common in the past quarter-century, and have in Africa led many to seek refuge and to expect hospitality abroad. This leads to a concern for pluralist ethics, for many receiving refuge abroad expect that they will be able to live by their thoughts and beliefs, creating enclaves of cultural difference. But difference exists in all communities: cultural homogeneity does not exist except in the conservative imagination. Nevertheless, a (...) sameness – the sameness of the value of every person – remains within this plurality. The sameness is conceived in distinct ways in the Natural Law tradition that yields liberalism, in the Golden Rule, in Kant's categorical imperative, and in the Luo culture of Eastern Africa. The Luo precept Luoro remb dhano is compared with these other ethical cosmopolitan wellsprings in this essay. (shrink)