In the United States of America, the years from 1880 to 1915 were a period of rapid urbanization, combined in some areas with intense industrialization. This paper explores the creation in cities of the new industrial heartland of new institutions of higher learning. The case studies chosen illustrate varying responses to local needs for scientific and technical expertise, and illuminate how new concepts of higher education in the United States helped to shape the emergent connection between science and industry.

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

H. G. Liddell & R. Scott, A Greek-English Lexicon, rev. and aug. by Sir H. S. Jones. with the ass. of R. McKenzie, Oxford, Clarendon Press, 1940. ῥυθμός , Ion. ῥυσμός (v. infr. 111, IV), ὁ : (ῥέω) :— A. any regular recurring motion (“πᾶς ῥ. ὡρισμένῃ μετρεῖται κινήσει” Arist.Pr.882b2) : I. measured motion, time, whether in sound or motion, Democr.15c ; = ἡ τῆς κινήσεως τάξις, Pl.Lg.665a, cf. 672e ; “ὁ ῥ. ἐκ τοῦ ταχέος (...) - Études grecques (...) et latines. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

Bioethicists have long been concerned that seriously ill patients entering early phase (‘phase I’) treatment trials are motivated by therapeutic benefit even though the likelihood of benefit is low. In spite of these concerns, consent forms for phase I studies involving seriously ill patients generally employ indeterminate benefit statements rather than unambiguous statements of unlikely benefit. This seeming mismatch between attitudes and actions suggests a need to better understand research ethics committee members’ attitudes toward communication of potential benefits and risks (...) of early phase studies to potential subjects. We surveyed the members of two U.S. research ethics committees using a phase I gene transfer study scenario, and compared the results to a previous survey of potential subjects’ perceptions and attitudes toward benefit and risk for the same protocol. The results show that there is indeed a gap between the subjects’ perceptions and the committee members’ views on what is appropriate to be communicated to research subjects. This discrepancy is the product of both the commonly assumed optimism of the subjects and to a “protective pessimism” of the research ethics committee members. We discuss this discrepancy using “frameworks of trust” and demonstrate the need to incorporate these frameworks into the existing model of informed consent. (shrink)

The “learning health care system” is being heralded as offering great potential for improving the quality and cost-worthiness of medical care by closely integrating the care of patients with the accumulation of aggregate data that can guide evidence-based medicine. By using electronic medical records, routine patient care and administrative data will be available for systematic observational studies. With the aid of these electronic medical records, quality-improvement studies of institutional practices and pragmatic, comparative effectiveness randomized trials of individual treatments could become (...) standard features of the medical care environment in the LHS. In this.. (shrink)

Donors to biobanks are typically asked to give blanket consent, allowing their donation to be used in any research authorized by the biobank. This type of consent ignores the evidence that some donors have moral, religious, or cultural concerns about the future uses of their donations – concerns we call “non-welfare interests”. The nature of non-welfare interests and their effect on willingness to donate to a biobank is not well understood. In order to better undersand the influence of non-welfare interests, (...) we surveyed a national sample of the US population using a probability-based internet panel. Logistic regression models assessed the demographic and attitudinal characteristics associated with participants’ willingness to give consent for unspecified future uses of their donation when presented with 7 research scenarios that raised possible non-welfare interest concerns. Most people had non-welfare interests that significantly affect their willingness to donate to a biobank using blanket consent. Some non-welfare interests are associated with subgroups but others are not. A positive attitude toward biomedical research in general was associated with increased willingness to donate, while concerns about privacy and being African American were associated with decreased willingness. Non-welfare interests matter and can diminish willingness to donate to a biobank. Our data suggest that trust in research promotes willingness to donate. Ignoring non-welfare interests could erode this trust. Donors’ non-welfare interests could be accommodated through greater transparency and easier access to information about the uses of donations. (shrink)

Heterogeneity within MDD has hampered identification of biological markers (e.g., intermediate phenotypes, IPs) that might increase risk for the disorder or reflect closer links to the genes underlying the disease process. The newer characterizations of dimensions of MDD within Research Domain Criteria (RDoC) domains may align well with the goal of defining IPs. We compare a sample of 25 individuals with MDD compared to 29 age and education matched controls in multimodal assessment. The multimodal RDoC assessment included the primary IP (...) biomarker, positron emission tomography (PET) with a selective radiotracer for 5-HT1A ([11C]WAY-100635), as well as event-related functional MRI with a Go/No-go task targeting the Cognitive Control network, neuropsychological assessment of affective perception, negative memory bias and Cognitive Control domains. There was also an exploratory genetic analysis with the serotonin transporter (5-HTTLPR) and monamine oxidase A (MAO-A) genes. In regression analyses, lower 5-HT1A binding potential (BP) in the MDD group was related to diminished engagement of the Cognitive Control network, slowed resolution of interfering cognitive stimuli, one element of Cognitive Control. In contrast, higher/normative levels of 5-HT1A BP in MDD (only) was related to a substantial memory bias toward negative information, but intact resolution of interfering cognitive stimuli and greater engagement of Cognitive Control circuitry. The serotonin transporter risk allele was associated with lower 1a BP and the corresponding imaging and cognitive IPs in MDD. Lowered 5HT 1a BP was present in half of the MDD group relative to the control group. Lowered 5HT 1a BP may represent a subtype including decreased engagement of Cognitive Control network and impaired resolution of interfering cognitive stimuli. Future investigations might link lowered 1a BP to neurobiological pathways and markers, as well as probing subtype-specific treatment targets. (shrink)

Argumentation as the public exchange of reasons is widely thought to enhance deliberative interactions that generate and justify reasonable public policies. Adopting an argumentation-theoretic perspective, we survey the norms that should govern public argumentation and address some of the complexities that scholarly treatments have identified. Our focus is on norms associated with the ideals of correctness and participation as sources of a politically legitimate deliberative outcome. In principle, both ideals are mutually coherent. If the information needed for a correct deliberative (...) outcome is distributed among agents, then maximising participation increases information diversity. But both ideals can also be in tension. If participants lack competence or are prone to biases, a correct deliberative outcome requires limiting participation. The central question for public argumentation, therefore, is how to strike a balance between both ideals. Rather than advocating a preferred normative framework, our main purpose is to illustrate the complexity of this theme. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

In this article I draw together what is a largely neglected account of the hermeneutic thrust of Mead’s late writings. In particular, I argue that Mead’s philosophy of the present also amounts to a theory of interpretation. In an open dialogue with a number of Hans-Georg Gadamer’s most fundamental concepts, I demonstrate how Mead’s notion of emergence in the present of both past and future neatly aligns with Gadamer’s philosophical hermeneutics. I will trace the foundation of this common ground by (...) highlighting the pivotal influence of Wilhelm Dilthey on both Gadamer and the young Mead. Then, I will draw out the consequences this mutual influence has on the critique of the methodological historicist tradition. Throughout I demonstrate several missed opportunities by Hans Joas at providing a philosophical hermeneutic account of Mead’s work. It is my intention to display how together the traditions of philosophical hermeneutics and pragmatism inform one another. (shrink)

Background Most jurisdictions that allow euthanasia and assisted suicide (AS) regulate it through the medical profession. However, the extent and nature of how medicine should be involved are debated. Swiss AS practice is unusual in that it is managed by lay AS organizations that rely on a law that permits AS when done for nonselfish reasons. Physicians are not mentioned in the law but are usually called upon to prescribe the lethal medications and perform capacity evaluations.Methods We analyzed in-depth interviews (...) of 23 Swiss AS experts including ethicists, lawyers, medical practitioners, and senior officials of AS organizations for their views on AS.Results Although there was agreement on some issues (e.g., need for better end-of-life care), the interviewees’ preferred model for AS, and the nature of preferred medical involvement, varied, which we categorized into five types: preference for AS practice as it occurred prior to lay AS organizations; preference for the current lay model; preference for a modified lay model to increase autonomy protections while limiting medical AS normalization; preference for various types of more medicalized models of AS; and, ambivalence about any specific model of medical involvement. The rationales given for each type of model reflected varying opinions on how medicine’s role would likely impact AS practice and demonstrated the experts’ attitudes toward those impacts.Conclusion The dynamics within the Swiss AS regime, as reflected in the varying views of Swiss AS experts, shed light on the dilemmas inherent to medical scope and involvement in AS, which may have implications for debates in other jurisdictions. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

A liberalism which scorns all individualism is fundamentally misguided. This is the chief thesis of this paper. To argue for it, I look closely at some key concepts. The concepts of morislity and individualism are crucial. I emphasize Dewey on the "individuality of the mind" and a Deweyan discussion of language, communication, and community. The thesis links individualism and liberalism, and since appeals to liberalism have broader appeal in the present context of discussions, I start with consideration of liberalism. The (...) aim is to dispute overly restrictive conceptions and explore a broader perspective. To bring the argument to a close, attention turns first to Dewey on value inquiry, to Dewey's "democratic individualism" (cf. Dewey 1939, 179), and to the concept of moral community. Disputing the acquisitiveness of utilitarian influences in classical liberalism, a Deweyan argument from the nature of moral community supports re-emphasis on individualism in contemporary liberal thought. (shrink)

Brian Wormald provides a fundamental reappraisal of one of the most complex and innovative figures of the late-Elizabethan and Jacobean age. In the centuries since his death, Francis Bacon (1561-1626) has been perceived and studied as a promoter and prophet of the philosophy of science--natural science--but he saw himself also as a clarifier and promoter of what he called "policy" or the study and improvement of the structure and function of civil states. Mr. Wormald shows that Bacon was concerned equally (...) with the knowledge of the world of nature and with that of policy. The junction between the two enterprises was effected by his work in history; and in the end it was Bacon's conception and practice of history that provided the answer to his efforts to advance policy and natural philosophy. (shrink)

SummaryThis paper argues that the influence of language on science, philosophy and other field is mediated by communicative practices. Where communications is more restrictive, established linguistic structures exercise a tighter control over innovations and scientifically motivated reforms of language. The viewpoint here centers on the thesis that argumentation is crucial in the understanding and evaluation of proposed reforms and that social practices which limit argumentation serve to erode scientific objectivity. Thus, a plea is made for a sociology of scientific belief (...) designed to understand and insure social‐institutional conditions of the possibility of knowledge and its growth. A chief argument draws on work of Axelrod concerning the evolution of cooperation. (shrink)

There are many advantages and disadvantages to central locations. These have shown themselves in the long course of European history. In times of peace, there are important economic and cultural advantages (to illustrate: the present area of the Czech Republic was the richest country in Europe between the two World Wars). There are cross-currents of trade and culture in central Europe of great advantage. For, cultural cross-currents represent a potential benefit in comprehension and cultural growth. But under threat of large-scale (...) conflict, these locations have proved extremely dangerous. Historically, Germany and Austria may be regarded as having had two chief models of their relationships to Europe. In the Holy Roman Empire, Germany was at the center of an aspiring “universalistic” European cosmopolitanism. (In some ways similar to the present situation of the European Union.) Austria maintained a great multi¬cultural empire, until it was destroyed in the First Word War. Generally, middle-European powers have promoted the integration of European diversity, when peace and stability have been plausible objectives. But when European diversity has declined toward ethnic or national conflict, Germany has drawn away from Europe and into itself, seeking inner unity and distinctness to protect it against possible combinations of enemies. This is true of central Europe generally, in degree, but interest often centers on Germany. Generally, central Europe is a cultural pressure cooker. (shrink)

gedanken von zeitloser Aktualitat werden in den Dialogen uber das Alter und die Freundschaft beruhmten Personlichkeiten aus Roms grosser Vergangenheit in den Mund gelegt. Die kleinen Schriften sind mit ihrer vollendeten Sprache wahre Perlen im philosophischen Werk Ciceros. Herausgegeben von M. Faltner, mit einer Einfuhrung von G. Fink. ".

Reconciliation of semantic holism with interpretation of individual expressions is advanced here by means of a relativization of sentence meaning to object language theories viewed as idealizations of belief-systems. Fodor's view of the autonomy of the special sciences is emphasized and this is combined with detailed replies to his recent criticisms of meaning holism. The argument is that the need for empirical evidence requires a holistic approach to meaning. Thus, semantic realism requires semantic holism. -/- .

This paper is the expository and evaluative introduction to my new edition of Emerson's Society and Solitude, Twelve Chapters.

Arthur S. Eddington, FRS, (1882–1944) was one of the most prominent British scientists of his time. He made major contributions to astrophysics and to the broader understanding of the revolutionary theories of relativity and quantum mechanics. He is famed for his astronomical observations of 1919, confirming Einstein’s prediction of the curving of the paths of starlight, and he was the first major interpreter of Einstein’s physics to the English-speaking world. His 1928 book, The Nature of the Physical World, here re-issued (...) in a critical, annotated edition, was largely responsible for his fame as a public interpreter of science and has had a significant influence on both the public and the philosophical understanding of 20th-century physics. In degree, Eddington’s work has entered into our contemporary understanding of modern physics, and, in consequence, critical attention to his most popular book repays attention. Born at Kendal near Lake Windermere in the northwest of England into a Quaker background, Eddington attended Owens College, Manchester, and afterward Trinity College, Cambridge, where he won high mathematical honors, including Senior Wrangler. He became Plumian Professor of Astronomy at Cambridge in 1913 and in 1914 Director of the Cambridge Observatory. Eddington was a conscientious objector during the First World War. By the end of his career, he was widely esteemed and had received honorary degrees from many universities. He was elected president of the Royal Astronomical Society (1921–1923), and was subsequently elected President of the Physical Society (1930–1932), the Mathematical Association (1932), and the International Astronomical Union (1938–1944). Eddington was knighted in 1930 and received the Order of Merit in 1938. During the 1930s, his popular and more philosophical books made him a well known figure to the general public. Philosophers have found his writings of considerable interest, and have debated his themes for nearly a hundred years. (shrink)