Introduction: Uncertainty is omnipresent in cancer care, including the ambiguity of diagnostic tests, efficacy and side effects of treatments, and/or patients' long-term prognosis. During second opinion consultations, uncertainty may be particularly tangible: doubts and uncertainty may drive patients to seek more information and request a second opinion, whereas the second opinion in turn may also affect patients' level of uncertainty. Providers are tasked to clearly discuss all of these uncertainties with patients who may feel overwhelmed by it. The aim of (...) this study was to explore how oncologists communicate about uncertainty during second opinion consultations in medical oncology.Methods: We performed a secondary qualitative analysis of audio-recorded consultations collected in a prospective study among cancer patients who sought a second opinion in medical oncology. We purposively selected 12 audio-recorded second opinion consultations. Any communication about uncertainty by the oncologist was double coded by two researchers and an inductive analytic approach was chosen to allow for novel insights to arise.Results: Seven approaches in which oncologists conveyed or addressed uncertainty were identified: specifying the degree of uncertainty, explaining reasons of uncertainty, providing personalized estimates of uncertainty to patients, downplaying or magnifying uncertainty, reducing or counterbalancing uncertainty, and providing support to facilitate patients in coping with uncertainty. Moreover, oncologists varied in their choice of words/language to convey uncertainty.Discussion: This study identified various approaches of how oncologists communicated uncertain issues during second opinion consultations. These different approaches could affect patients' perception of uncertainty, emotions provoked by it, and possibly even patients' behavior. For example, by minimizing uncertainty, oncologists may consciously steer patients toward specific medical decisions). Future research is needed to examine how these different ways of communicating about uncertainty affect patients. This could also facilitate a discussion about the desirability of certain communication strategies. Eventually, practical and evidence-based guidance needs to be developed for clinicians to optimally inform patients about uncertain issues and support patients in dealing with these. (shrink)

Paper-based privacy policies fail to resolve the new changes posed by electronic healthcare. Protecting patient privacy through electronic systems has become a serious concern and is the subject of several recent studies. The shift towards an electronic privacy policy introduces new ethical challenges that cannot be solved merely by technical measures. Structured Patient Privacy Policy (S3P) is a software tool assuming an automated electronic privacy policy in an electronic healthcare setting. It is designed to simulate different access levels and rights (...) of various professionals involved in healthcare in order to assess the emerging ethical problems. The authors discuss ethical issues concerning electronic patient privacy policies that have become apparent during the development and application of S3P. (shrink)

The study presents the broad outlines for a relationalist interpretation of the Indian epistemological doctrine svataḥ prāmāṇya. Due to the inadequacy of the main western interpretations thereof, the paper’s approach can be considered an inference to the best explanation. Its main part is devoted to the typologization of various epistemological doctrines based on the svataḥ prāmāṇya principle in terms of strong and weak disjunctivism. Three paradigm cases of strong disjunctivism and a special variety of weak disjunctivism have thus been identified (...) in Indian epistemology, which allowed to draw a conclusion that strong disjunctivism constituted one of its general paradigms. (shrink)

LANGUAGE NOTE | Document text in English ; abstract also in Chinese. The cultural differences between East and West, as well as the differences in attitudes on bioethical issues, are hot topics in the international bioethics community. Scandals in biomedical research in recent years have further increased the prominence and importance of these issues. For example, high-profile cases involving head transplant experimentation and gene-edited babies have provoked international outrage, criticism, and condemnation. Among the responses, there have been reflections on the (...) issue of “why China?” Some researchers blame cultural differences, while others argue that there is a lack of rigorous research ethics oversight in the country. In “The Real Problem With Human Head Transplantation,” it is argued that China “is a country that has a history of taking positions on bioethical issues that diverge from most commonly accepted conceptions of medical and research ethics.” (Abstract taken from first paragraph of document) 當下一系列的生物醫學醜聞以及人們對其多元的反應，突顯了更深入的跨文化生命倫理研究的重要性，以加深多元文化和宗教的理解，促進長期共存和繁榮。作為對Tham文章的拓展，本文駁斥了跨文化生命倫理比較研究中將 中國文化和西方文化的簡單二元對立傳統，提出應警惕兩種錯誤傾向：沙文主義和種族中心主義傾向以及不可通約傾向。. (shrink)

Recognized in his day as a man of letters equaling Rousseau and Voltaire in France and rivaling Samuel Johnson, David Hume passed from favor in the Victorian age--his work, it seemed, did not pursue Truth but rather indulged in popularization. Although Hume is once more considered as one of the greatest British philosophers, scholars now tend to focus on his thought rather than his writing. To round out our understanding of Hume, M. A. Box in this book charts the interrelated (...) development of Hume's literary ambitions, theories of style, and compositional practice from his Treatise in 1739 through the Enquiries. In so doing, Box makes the case for Hume's career-long concern with the presentational modes of reaching an audience for his philosophical writings. Hume reacted to the popular failure of his masterpiece, A Treatise of Human Nature, Box suggests, by self-consciously exploring strategies in his subsequent works for agreeably bringing his readership to participate in the act of philosophizing. Combining a sensitive grasp of the ways Restoration period and eighteenth-century writers conceived the relations between rhetoric and philosophy with sound readings of particular texts, Box shows how Hume's literary concerns went beyond matters of style to involve persona, structure, and doctrine. While this book helps explain long-standing ambiguities surrounding Hume, especially by pointing out the tension between his created persona and his own voice, it also serves as an excellent introduction to his philosophy. (shrink)

Open peer commentary on the article “Second-Order Science: Logic, Strategies, Methods” by Stuart A. Umpleby. Upshot: This article argues that we do not need a new scientific method or a “second-order science” to deal with the facts that the individual characteristics of observers may affect the nature and quality of their observations and that the application of scientific theories may affect the systems they describe. It also argues that Umpleby has not given us good reason to think that we do.

Для широкого круга читателей (слушателей, аспирантов, преподавателей) интересующихся данной проблемой.

Das Grab des Königs Ninetjer in Saqqara: Architektonische Entwicklung frühzeitlicher Grabanlagen in Ägypten. By Claudia M. Lacher-Raschdorff. Deutsches Archäologisches Institut Kairo, Archäologische Veröffentlichungen, vol. 125. Wiesbaden: Harrassowitz Verlag, 2014. Pp. 295, 44 pls., plans. €247.

GEORGE BOOLE died one hundred years ago. This essay from Cork is intended as commemorative of a great man, for too long forgotten in the College he served so well.