Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present a (...) case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)

Individuals with autistic spectrum disorder (ASD) display diverse deficits in social, cognitive and behavioral functioning. To date, there has been mixed findings on the profile of executive function deficits for high-functioning adults (IQ >70) with ASD. A conceptual distinction is commonly made between “cold” and “hot” executive functions. Cold executive functions refer to mechanistic higher-order cognitive operations (e.g., working memory), whereas hot executive functions entail cognitive abilities supported by emotional awareness and social perception (e.g., social cognition). This study aimed to (...) determine the independence of deficits in hot and cold executive functions for high-functioning adults with ASD. Forty-two adults with ASD (64% male, aged 18-66 years) and 40 age and gender matched controls were administered The Awareness of Social Inference Test (TASIT; emotion recognition and social inference), Letter Number Sequencing (working memory) and Hayling Sentence Completion Test (response initiation and suppression). Between-group analyses identified that the ASD group performed significantly worse than matched controls on all measures of cold and hot executive functions (d =.54-1.5). Hierarchical multiple regression analyses revealed that the ASD sample performed more poorly on emotion recognition and social inference tasks than matched controls after controlling for cold executive functions and employment status. The findings also indicated that the ability to recognise emotions and make social inferences was supported by working memory and response initiation and suppression processes. Overall, this study supports the distinction between hot and cold executive function impairments for adults with ASD. Moreover, it advances understanding of higher-order impairments underlying social interaction difficulties for this population which, in turn, may assist with diagnosis and inform intervention programs. (shrink)

Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient’s values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge (...) the information needs of the individual patient. The aim of this paper is to describe ‘core information sets’ which are defined as a minimum set of consensus-derived information about a given procedure to be discussed with all patients. Importantly, they are intended to catalyse discussion of subjective importance to individuals. The model described in this paper applies health services research and Delphi consensus-building methods to an idea orginally proposed 30 years ago. The hypothesis is that, first, large amounts of potentially-important information are distilled down to discrete information domains. These are then, secondly, rated by key stakeholders in multiple iterations, so that core information of agreed importance can be defined. We argue that this scientific approach is key to identifying information important to all stakeholders, which may otherwise be communicated poorly or omitted from discussions entirely. Our methods apply systematic review, qualitative, survey and consensus-building techniques to define this ‘core information’. We propose that such information addresses the ‘reasonable patient’ standard for information disclosure but, more importantly, can serve as a spring board for high-value discussion of importance to the individual patient. The application of established research methods can define information of core importance to informed consent. Further work will establish how best to incorporate this model in routine practice. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

Christian philosophers have engaged naturalism in three main ways: direct refutation; systematic comparison; and sustained development of compelling alternative accounts. While all of these options have value, I argue that it is, and especially, that are most likely to win converts, and that we are witnessing an encouraging strategic shift in that direction. Options and bring Christian philosophers into closer dialogue with their naturalistic counterparts, building mutual respect and a greater opportunity for Christian philosophers to gain a full and fair (...) hearing. This points to a bright future for Christian philosophy. (shrink)

These rhetorical texts by Apuleius, second-century Latin writer and author of the famous novel Metamorphoses or Golden Ass, have not been translated into English since 1909. They are some of the very few Latin speeches surviving from their century, and constitute important evidence for Latin and Roman North African social and intellectual culture in the second century AD, a period where there is increasing interest amongst classicists and ancient historians. They are the work of a talented writer who is being (...) increasingly viewed as the major literary artist of his time in Latin. (shrink)

What are the responsibilities of a business towards the city in which it operates? The Professor of Business Ethics at Nijenrode University, the Netherlands Business School suggests three practical ways of identifying them. This article is the substance of a paper which he delivered as Chairman of the European Business Ethics Network at its 1992 Conference in Paris.

The authors argue that while meaning holism makes massive error possible, it does not, as Donald Davidson fears, threaten interpretability. Thus they hold, in opposition to Davidson, that meaning holism need not be constrained by an account of meaning according to which in the methodologically most basic cases the content of a belief is given by the cause of that belief. What ensures interpretability, they maintain, is not that speakers' beliefs are in the main true, but rather that beliefs have (...) the contents they do because of events others can in principle identify and describe. (shrink)

This article reviews recent developments within a number of academic disciplines pointing toward an increasing importance of imagination for understanding morality and cognition. Using elements from hermeneutics and metaphor theory, it works toward a framework for a more context-sensitive understanding of human agency, especially focusing on moral deliberation and change. The analytic framework is used to analyze the story of a patient making tough decisions in the context of prenatal diagnosis. We show how a relatively stable outlook on the world, (...) here called the “baseline of choice,” is challenged by unexpected events and how imaginative processes enter into the active creation of a new moral order. The ensuing interpretation is then placed within a broader philosophical landscape. John Dewey’s notion of “dramatic rehearsal” is put forward as one particularly promising way of understanding moral imagination, deliberation, and decision-making. (shrink)

Unlike nonhuman primates, thousands of bird species have articulatory capabilities that equal or surpass those of humans, and they develop their vocalizations through vocal imitation in a way that is very similar to how human infants learn to speak. An understanding of how speech mechanisms have evolved is therefore unlikely to yield key insights into how the human brain is special.

Lanczos, C. Einstein's path from special to general relativity.--Balazs, N. L. The acceptability of physical theories: Poincaré versus Einstein.--Ellis, G. F. R. Global and non-global problems in cosmology, by G. F. R. Ellis and D. W. Sciama.--Ehlers, J. The geometry of free fall and light propagation, by J. Ehlers, F. A. E. Pirani and A. Schild.--Trautman, A. Invariance of Lagrangian systems.--Penrose, R. The geometry of impulsive gravitational waves.--Exact solutions of the Einstein-Maxwell equations for an accelerated charge.--Taub, A. H. Plane-symmetric similarity (...) solutions for self-gravitating fluids.--Robinson, I. Equations of motion in the linear approximation, by I. Robinson and J. R. Robinson.--Florides, P. W. Rotating bodies in general relativity.--Chandrasekhar, S. A limiting case of relativistic equilibrium.--Israel, W. The relativistic Boltzmann equation.--Thompson, W. B. The self-consistent test-particle approach to relativistic kinetic theory. (shrink)

Chris Tucker's paper on the hiddenness argument seeks to turn aside a way of defending the latter which he calls the value argument. But the value argument can withstand Tucker's criticisms. In any case, an alternative argument capable of doing the same job is suggested by his own emphasis on free will.

* This is a fragment of J. L. Schellenberg’s paper “Divine Hiddenness and Human Philosophy” originally published in Adam Green and Eleonore Stump, Hidden Divinity and Religious Belief, 23–25, 28. Reprinted by permission of the author.

The late John L. Mackie, formerly of University College, Oxford.

In many places and times, and for many people, God's existence has been rather less than a clear fact. According to the hiddenness argument, this is actually a reason to suppose that it is not a fact at all. The hiddenness argument is a new argument for atheism that has come to prominence in philosophy over the past two decades. J. L. Schellenberg first developed the argument in 1993, and this book offers a short and vigorous statement of its central (...) claims and ideas. Logically sharp but so clear that anyone can understand, the book addresses little-discussed issues such as why it took so long for hiddenness reasoning to emerge in philosophy, and how the hiddenness problem is distinct from the problem of evil. It concludes with the fascinating thought that retiring the last of the personal gods might leave us nearer the beginning of religion than the end. (shrink)

1. Causal knowledge is an indispensable element in science. Causal assertions are embedded in both the results and the procedures of scientific investigation. 2. It is therefore worthwhile to investigate the meaning of causal statements and the ways in which we can arrive at causal knowledge.

J.L. Schellenberg offers a path to a new kind of religious outlook. Reflection on our early stage in the evolutionary process leads to skepticism about religion, but also offers a new answer to the problem of faith and reason, and the possibility of a new, evolutionary form of religion.

In Part 1 of this book, the first full-length treatment of its topic, J. L. Schellenberg argues that when we notice how.