ABSTRACT This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be (...) permitted access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

Purpose This paper aims to analyze some of the epistemically pernicious effects of the use of the internet and social media. In light of this analysis, it introduces the concept of epistemic pornography and argues that epistemic agents both can and should avoid consuming and sharing epistemic pornography. Design/methodology/approach The paper draws on research on epistemic virtue, cognitive biases, social media use and its epistemic consequences, fake news, paternalistic nudging, pornography, moral philosophy, moral elevation and moral exemplar theory to analyze (...) the epistemically pernicious effects of the internet and social media. Findings There is a growing consensus that the internet and social media activate and enable human cognitive biases leading to what are here called “failures of epistemic virtue.” Common formulations of this problem involve the concept of “fake news,” and strategies for responding to the problem often have much in common with paternalistic “nudging.” While fake news is a problem and the nudging approach holds out promise, the paper concludes that both place insufficient emphasis on the agency and responsibility of users on the internet and social media, and that nudging represents a necessary but not sufficient response. Originality/value The essay offers the concept of epistemic pornography as a concept distinct from but related to “fake news” – distinct precisely because it places greater emphasis on personal agency and responsibility, and following recent literature on moral elevation and moral exemplars, as a heuristic that agents might use to economize their efforts at resisting irrational cognitive biases and attempting to live up to their epistemic duties. (shrink)

Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5-6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor (...) evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation. (shrink)

As the title suggests, Breeur’s project is to discuss three key ideas: lies, stupidity, and imposture. The book is organized into two parts of two chapters each, followed by an appendix. The individual chapters and sub-sections are well-written and philosophically sophisticated. However, the reader will be disappointed if they expect a sustained analysis of the relations among the book’s titular ideas or a unified account of their role in the breakdown of respect for truth more broadly. Breeur’s approach is more (...) episodic, laying out valuable considerations and enticing formulations, but often breaking off before spelling out their full implications or connecting them to previous discussions in the book. His discussion clearly opens up these additional avenues of thought, but the task of going down them is left largely to the reader. This review briefly takes up each of Breeur’s themes: lies, stupidity, and imposture. (shrink)

A central frustration of recent political discourse is the consistent reduction of politically relevant factual and critical speech to mere expression of partisan commitment. Partisans of “the other side”—members of the other tribe—are viewed as de facto wrong, because partisans, even when their speech invokes mere facts or purportedly shared political principles. Ideally, democratic political discourse operates along at least two central dimensions: a dimension of shared factual, historical, and political assumptions, and a more contested dimension of interpretation, prioritization, and (...) evaluation that results in diverse and often competing understandings of what is good, and so of what is best to collectively pursue. Debates among advocates of competing conceptions of the good and partisans of diverse world views identifiable in terms of the second dimension are, on this picture, constrained and grounded by the shared factual and political commitments of the first, thus ensuring a meaningful basis for ongoing political engagement. While there is little reason to think this ideal has ever been perfectly realized, in recent political discourse statements that events have occurred, drugs are effective, or transparency is important in political conduct cannot seem to get uptake except as mere expressions of political partisanship any more than an actor on stage trying to convince her audience of the danger of a real fire that has broken out in the theater can get uptake for this claim except as an expression in a theatrical performance. In both cases, the real content and discursive intent of speech is undermined by the context in which it occurs. In the case of the actor on stage, the appropriate rules for uptake and interpretation are being followed, just to unfortunate effect. However, in the case of political discourse something seems to be wrong with the rules for uptake and interpretation that have come to dominate in many quarters. This essay relies on recent discussions of silencing and epistemic injustice to introduce the ideas of partisan silencing and hyper-partisan silencing in an attempt to say more precisely what has gone wrong with the rules for uptake and interpretation in political discourse. It then relies on Hannah Arendt’s analyses of truth and lies in politics to connect these phenomena to underlying features of political action and speech. Conditions of partisan and hyperpartisan silencing turn out to be a natural, if not inevitable, consequence of the relationship of truth-telling and deception to political action itself as Arendt understands this. Finally, the essay elaborates on two suggestive passages from Arendt’s 1967 essay “Truth and Politics” to propose potential strategies for resisting conditions of hyperpartisan silencing. Because hyper-partisan silencing itself imposes a certain discursive logic, there are kinds of political speech and action that might succeed in being understood as sincere and so in being persuasive—even in the face of hyper-partisan silencing—precisely because they challenge the assumptions that underpin this discursive logic itself. (shrink)

I present an annotated development of the basic ideas of the Geneva School approach to the foundations of physics and the structures which emerge as mathematical representations of the physically dual notions of state and property.

Recent studies using functional magnetic resonance imaging of patients in a vegetative state have raised the possibility that such patients retain some degree of consciousness. In this paper, the ethical implications of such findings are outlined, in particular in relation to decisions about withdrawing life-sustaining treatment. It is sometimes assumed that if there is evidence of consciousness, treatment should not be withdrawn. But, paradoxically, the discovery of consciousness in very severely brain-damaged patients may provide more reason to let them die. (...) Although functional neuroimaging is likely to play an increasing role in the assessment of patients in a vegetative state, caution is needed in the interpretation of neuroimaging findings. (shrink)

Full text of erratum: "In the article by D.J. Buller, on p. 278, the y-axis label to Fig. IIb was incorrect. Instead of 'Percentage choosing "Eats cassava root" and "Tattoo," it should have read: 'Percentage choosing "Eats cassava root" and "No tattoo."' We apologise to readers for this error.".

Introduction: Variation across research ethics boards in conditions placed on access to medical records for research purposes raises concerns around negative impacts on research quality and on human subject protection, including privacy.Aim: To study variation in REB consent requirements for retrospective chart review and who may have access to the medical record for data abstraction.Methods: Thirty 90-min face-to-face interviews were conducted with REB chairs and administrators affiliated with faculties of medicine in Canadian universities, using structured questions around a case study (...) with open-ended responses. Interviews were recorded, transcribed and coded manually.Results: Fourteen sites required individual patient consent for the study to proceed as proposed. Three indicated that their response would depend on how potentially identifying variables would be managed. Eleven sites did not require consent. Two suggested a notification and opt-out process. Most stated that consent would be required if identifiable information was being abstracted from the record. Among those not requiring consent, there was substantial variation in recognising that the abstracted information could potentially indirectly re-identify individuals. Concern over access to medical records by an outside individual was also associated with requirement for consent. Eighteen sites required full committee review. Sixteen allowed an external research assistant to abstract information from the health record.Conclusions: Large variation was found across sites in the requirement for consent for research involving access to medical records. REBs need training in best practices for protecting privacy and confidentiality in health research. A forum for REB chairs to confidentially share concerns and decisions about specific studies could also reduce variation in decisions. (shrink)

Multiple -conclusion logic extends formal logic by allowing arguments to have a set of conclusions instead of a single one, the truth lying somewhere among the conclusions if all the premises are true. The extension opens up interesting possibilities based on the symmetry between premises and conclusions, and can also be used to throw fresh light on the conventional logic and its limitations. This is a sustained study of the subject and is certain to stimulate further research. Part I reworks (...) the fundamental ideas of logic to take account of multiple conclusions, and investigates the connections between multiple - and single - conclusion calculi. Part II draws on graph theory to discuss the form and validity of arguments independently of particular logical systems. Part III contrasts the multiple - and the single - conclusion treatment of one and the same subject, using many-valued logic as the example; and Part IV shows how the methods of 'natural deduction' can be matched by direct proofs using multiple conclusions. (shrink)

Presumably it is common ground that this verb has in addition to the basic sense ‘recognize’ the derivative sense ‘oread’, and that one must judge from the context whether reading to one or more other people, or private reading, is meant. The reading of the text of a law to a jury at an orator's request is marked by the circumstances themselves as public reading; so is the reading of the Athenian decree to the Mitylenaeans in Thucydides. When Theaetetus answers (...) in the affirmative the question whether he has read the book of Protagoras which contains the statement that man is the measure of all things (); or when it is asked ‘Why is it that some people, if they begin to read, are overcome by sleep even against their will, whereas others wishing to be overcome by sleep are kept awake by taking up a book?’ Evidently what is intended is reading in the privacy of one's own room. When Socrates in the Phaedo says that he heard a person reading from Anaxagoras and eagerly took the book home to read, both senses are found within a few pages. (shrink)

The letter sent by the Royal Society to the London optician, John Marshall, in 1694, commending his new method of grinding, has been reprinted, and referred to, in recent years. However, there has been no comprehensive analysis of the method itself, the letter and the circumstances in which it was written, nor the consequences for trade practices. The significance of the approval by the Royal Society of this innovation and the use of that approbation by John Marshall and other practitioners (...) are examined. Gaps in existing accounts of Marshall's method are partly remedied by supplementing surviving written materials with accounts of contemporary, and present-day, trade practices based on his method. The reasons why Marshall and his contemporaries failed to record his method and specify his improvements are discussed. The reactions of the Spectacle Makers' Company and its more prominent members, both to the innovation itself and to the Royal Society's letter, are analysed. The impact of the new technique on contemporary and later opticians is described. (shrink)

The author, a regional health authority administrator, argues that `ownership' is a side issue in legal and moral arguments over confidentiality of medical records. Nor is it practicable, he argues, for doctors alone to control all access to the medical records. He proposes the principle of `custodianship' of confidential information, to be accepted by an institution as a whole, as a possible way of resolving the problem. In commentaries on this and the following article an academic lawyer and a practising (...) physician respond. (shrink)