This theory accords to volitions the status of basic mental actions, maintaining that these are spontaneous exercises of the will--a "two-way" power which ...

Unhealthy lifestyle contributes significantly to the burden of disease. Scarce medical resources that could alternatively be spent on interventions to prevent or cure sufferings for which no one is to blame, are spent on prevention or treatment of disease that could be avoided through individual lifestyle changes. This may encourage policy makers and health care professionals to opt for a criterion of individual responsibility for medical suffering when setting priorities. The following article asks whether responsibility-based reasoning should be accepted as (...) relevant for fair and legitimate healthcare rationing. The luck-egalitarian argument that inequalities in health expectancies that derive from unchosen features of people’s circumstances are unjust and should be compensated, while inequalities that reflect personal choices of lifestyle may not, is discussed. It seems that while a backward-looking interpretation of individual responsibility cannot be relevant as a criterion of priority setting, a forward-looking conception of responsibility may be approved.Within all modern societies healthcare authorities are facing difficult priority setting problems. Various criteria for rationing medical intervention have been proposed due to scarcity of resources. Until now, individual responsibility for medical suffering has been given little attention in the public or in academic debate. This is about to change. As Alexander Cappelen and Ole Norheim have pointed out in a recent article in this journal, unhealthy lifestyle contributes increasingly to the burden of disease. A better understanding of the responsibility argument is important for the assessment of policies aimed at meeting this challenge.1 In this article the following question is addressed: should responsibility-based arguments be accepted as relevant to meeting healthcare rationing fairly and legitimately? I will argue that while a backward-looking conception of individual responsibility should not be endorsed, a forward-looking notion of responsibility may be approved. (shrink)

E. J. Lowe; Coinciding objects: in defence of the ‘standard account’, Analysis, Volume 55, Issue 3, 1 July 1995, Pages 171–178, https://doi.org/10.1093/analys/5.

We analyse the system of ethical review of human research in the Baltic States by introducing the principle of equivalent stringency of ethical review, that is, research projects imposing equal risks and inconveniences on research participants should be subjected to equally stringent review procedures. We examine several examples of non-equivalence or asymmetry in the system of ethical review of human research: (1) the asymmetry between rather strict regulations of clinical drug trials and relatively weaker regulations of other types of clinical (...) biomedical research and (2) gaps in ethical review in the area of non-biomedical human research where some sensitive research projects are not reviewed by research ethics committees at all. We conclude that non-equivalent stringency of ethical review is at least partly linked to the differences in scope and binding character of various international legal instruments that have been shaping the system of ethical review in the Baltic States. Therefore, the Baltic example could also serve as an object lesson to other European countries which might be experiencing similar problems. (shrink)

In this paper, I first of all define various kinds of ontological dependence, motivating these definitions by appeal to examples. My contention is that whenever we need, in metaphysics, to appeal to some notion of existential or identity-dependence, one or other of these definitions will serve our needs adequately, which one depending on the case in hand. Then I respond to some objections to one of these proposed definitions in particular, namely, my definition of (what I call) essential identity-dependence. Finally, (...) I show how a similar approach can be applied in the theory of truthmaking, by offering an account of the truthmaking relation which defines it in terms of a type of essential dependence. I also say why I think that this approach is preferable to one which treats the truthmaking relation as primitive. More generally, my view is that accounts of dependence or ‘grounding’ which treat these notions as primitive are less satisfactory than my own position, which is that in all cases a suitable definition is forthcoming if we look hard enough. (shrink)

Background Informed consent is a requirement for all research. It is not, however, clear how much information is sufficient to make an informed decision about participation in research. Information on an online questionnaire about childhood development was provided through an unfolding electronic participant sheet in three levels of information. Methods 552 participants, who completed the web-based survey, accessed and spent time reading the participant information sheet (PIS) between July 2008 and November 2009. The information behaviour of the participants was investigated. (...) The first level contained less information than might be found on a standard PIS, the second level corresponded to a standard PIS, and the third contained more information than on a standard PIS. The actual time spent on reading the information provided in three incremental levels and the participants' evaluation of the information were calculated. Results 77% of the participants chose to access the first level of information, whereas 12% accessed the first two levels, 6% accessed all three levels of information and 23% participated without accessing information. The most accessed levels of information were those that corresponded to the average reading times. Conclusion The brief information provided in the first level was sufficient for participants to make informed decisions, while a sizeable minority of the participants chose not to access any information at all. This study adds to the debate about how much information is required to make a decision about participation in research and the results may help inform the future development of information sheets by providing data on participants' actual needs when deciding about questionnaire surveys. (shrink)

De Vries' mutation theory has not stood the test of time. The supposed mutations of Oenothera were in reality complex recombination phenomena, ultimately explicable in Mendelian terms, while instances of large-scale mutations were found wanting in other species. By 1915 the mutation theory had begun to lose its grip on the biological community; by de Vries' death in 1935 it was almost completely abandoned. Yet, as we have seen, during the first decade of the present century it achieved an enormous (...) popularity. As this paper has tried to suggest, one of the principal reasons for this was that de Vries' theory served as a banner around which a whole crowd of disaffected Darwinians or anti-Darwinians could rally. However, not all of those who favored de Vries did so for quite the same reasons. Underlying the multitude of views ran several common threads: a dissatisfaction with current Darwinian theory born out of misunderstanding natural selection, a general misunderstanding of the nature of species, and a prejudice against speculative, nontestable theories in biology.Supporters of de Vries were not the only opponents of Darwinism, nor was the mutation theory the only alternative to natural selection. In the early twentieth century a number of theories had been proposed to explain away the problems which Darwin had left unsolved. There was the idea of orthogenesis, championed by the American paleontologists Cope, Osborn and others; organic selection (or orthoplasy) was championed by M. M. Baldwin and C. Lloyd Morgan; there were the concepts of convergent evolution proposed by Hermann Friedmann, the theory of physiological selection by John George Romanes, and the concepts of reproductive divergence by H. M. Vernon. Virtually none of these men either accepted or were strong supporters of the de Vriesian theory, for each had his own particular ‘ism” to advocate as the major factor in evolution. The existence of a large number of such theories, each purporting to be the explanation, was characteristic of evolutionary theory at the turn of the century. It is to a large extent the emphasis on such fragmentary concepts that retarded development of the comprehensive theory of evolution which emerged in the 1920's and 1930's. For the historian, however, a study of these alternative theories is instructive in trying to understand the inherent difficulties which Dawwinian theory posed to biologists at the time. De Vries' mutation theory serves historically as a mirror to reflect the critical mood of a generation hostile to the theory of natural selection.It has often been claimed that it was impossible to understand the mechanism of natural selection until it could be placed in genetic and mathematical terms. It is certainly true that great strides have been made in population genetics and the treatment of evolutionary concepts with mathematical tools in the last forty years. But the very people who developed the genetical and mathematical approach to evolution were already convinced of the essential correctness of Darwinian theory before they started. Advances in an understanding of Mendelian heredity aided greatly in solving one important issue for evolutionists: the origin of variations. And the rigor with which selection acted could best be studied by observing changes in gene frequencies (calculated mathematically) over a number of generations. But as this paper has shown, two of the basic problems which biologists faced in evaluating Darwinian theory at the turn of the century-the nature of species, and the criteria of what constituted an acceptable explanation in biological science-could not be answered directly by mathematics. What mathematical and genetical theory did do was to help convince the skeptics of the validity of the Darwinian proposition.The change in explanatory criteria which many hailed as de Vries' most important contribution to evolutionary theory seems to have been part of a general emergence of twentieth-century biology from the domination of theorizers in the nineteenth. It also marked the emergence of America from the domination of biological, and particularly evolutionary, influence of Europeans. The change occurred in three areas: in the kinds of questions asked: testable versus non-testable; in the kind of data sought: quantitative versus qualitative; and in the kinds of theories proposed: analytical and reductive—the attempt to see complex processes in terms of simpler components-as opposed to synthetic and speculative. Although ultimately wrong in his idea, de Vries and his theories rode high on the wave of “experimentalism” which was the harbinger of a new era in evolutionary theory. (shrink)

Clinical diagnostic medicine is an experimental science based on observation, hypothesis making, and testing. It is an use dynamic process that involves observation and summary, diagnostic conjectures, testing, review, observation and summary, new or revised conjectures, i.e. it is an iterative process. It can then be said that diagnostic hypotheses are also ‘observation-laden’. My aim is to enlarge on the strategies of medical diagnosis as these are meshed in training and clinical experience—that is, to describe the patterns of reasoning used (...) by experienced clinicians under different diagnostic circumstances and how these patterns of inquiry allow further insight into the evaluation and treatment of patients. I do not aim to present a theory and illustrate it with examples; I wish rather am to let a realistic example, similar to actual clinical scenarios, direct the exposition. To this end, I introduce an account of medical diagnosis—briefly comparing and contrasting it to other accounts—in order to focus on discussing the process of diagnosis through a detailed clinical case. (shrink)

This paper assesses several prominent recent attacks on the view that epistemic justification is conceptually prior to knowledge. I argue that this view—call it the Received View (RV)—emerges from these attacks unscathed. I start with Timothy Williamson’s two strongest arguments for the claim that all evidence is knowledge (E>K), which impugns RV when combined with the claim that justification depends on evidence. One of Williamson’s arguments assumes a false epistemic closure principle; the other misses some alternative (to E>K) explanations of (...) a putative fact about the evidence a particular subject has. Next, I neutralize each of Jonathan Sutton’s three recent arguments to the conclusion that any justified belief constitutes knowledge. Finally, I consider a recent analysis of justification due to Alexander Bird, according to which justified belief is possible knowledge. I argue that Bird’s analysis delivers neither a sufficient nor (more importantly) a necessary condition for justification. [Word count: 149]. (shrink)

Tsc question of the date of Ctesibius has been much obscured of late years by those German scholars1 who assert that Ctesibius the pneumatic and hydraulic engineer mentioned by Vitruvius IX. 8. 2 is distinct and separate from Κτησίβιος Κτησίβιος μηΧανικός who is mentioned by Athenaeus Mechanicus , Philo of Byzantium , and Hedylus ap. Athenaeum Naucratitam Deipn. XI., p. 497, d-e = Anthologia Graeca ed. Cougny, Paris , 1890, Vol. III., p. 298, n. 67.

OBJECTIVES: To analyse the attitudes of medical personnel towards terminally ill patients and their right to be fully informed. DESIGN: Self-administered questionnaire composed of 56 closed questions. SETTING: Three general hospitals and eleven health centres in Granada (Spain). The sample comprised 168 doctors and 207 nurses. RESULTS: A high percentage of medical personnel (24.1%) do not think that informing the terminally ill would help them face their illness with greater serenity. Eighty-four per cent think the patient's own home is the (...) best place to die: 8.9% of the subjects questioned state that the would not like to be informed of an incurable illness. CONCLUSION: In our opinion any information given should depend on the patient's personality, the stage of the illness and family circumstances. Our study confirms that a hospital is not the ideal environment for attending to the needs of the terminally ill and their families. (shrink)

This study focuses on the spatialization and institutionalization of social networks of Russian women who migrated to Turkey via marriage in the last 30 years. Specifically, it investigates how and why their social networks have been changing at the local and transnational levels. We conducted in-depth interviews with 56 women between 2014−2021. Our extensive analysis indicates that despite their newly established status via marriages, the Russian women have weak ties with the locals regardless of the migration period, preferring mostly to (...) engage with other Russian women in Turkey. Even if the different migrant associations established by Russian migrants in Turkey do not actually aim this, they create an effect that increases the social distance with the host society and serves to strengthen the connection between the migrants. Also, unlike pioneer migrants, newer marriage migrants have established strong transnational ties with others living overseas, regardless of their gender or ethnic identity. Further, this study reveals that the migrant women's subjectivity, their spouses’ benefit-oriented negotiation styles, and the state's diaspora policy all shape the women's social networks at different levels. (shrink)

E. H. Gombrich’s bestselling history of the world for young readers tells the story of mankind from the Stone Age to the atomic bomb, focusing not on small detail but on the sweep of human experience, the extent of human achievement, and the depth of its frailty. The product of a generous and humane sensibility, this timeless account makes intelligible the full span of human history. In forty concise chapters, Gombrich tells the story of man from the stone age to (...) the atomic bomb. In between emerges a colorful picture of wars and conquests, grand works of art, and the spread and limitations of science. This is a text dominated not by dates and facts, but by the sweep of mankind’s experience across the centuries, a guide to humanity’s achievements and an acute witness to its frailties. (shrink)

Marjorie Shostak's ethnography, Nisa: The Life and Words of a !Kung Woman, is analyzed as a case study of feminist social science. Three principles of feminist research are suggested as standards for evaluation. After discussion of the principles and analysis of the text, I raise a criticism of the principles as currently sketched. The entire project is framed by the question of how best to resolve conflict between researcher and participant accounts.