The legal requirements and justifications for collecting patient-identifiable data without patient consent were examined. The impetus for this arose from legal and ethical issues raised during the development of a population-based disease register. Numerous commentaries and case studies have been discussing the impact of the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. But uncertainty still remains about the legal requirements for processing patient-identifiable data without patient consent for research purposes. This is (...) largely owing to ignorance, or misunderstandings of the implications of the common law duty of confidentiality and section 60 of the Health and Social Care Act 2001. The common law duty of confidentiality states that patient-identifiable data should not be provided to third parties, regardless of compliance with the DPA1998. It is an obligation derived from case law, and is open to interpretation. Compliance with section 60 ensures that collection of patient-identifiable data without patient consent is lawful despite the duty of confidentiality. Fears regarding the duty of confidentiality have resulted in a common misconception that section 60 must be complied with. Although this is not the case, section 60 support does provide the most secure basis in law for collecting such data. Using our own experience in developing a disease register as a backdrop, this article will clarify the procedures, risks and potential costs of applying for section 60 support. (shrink)

Recent publications on digital health technologies highlight the importance of ‘responsible’ use. References to the concept of responsibility are, however, frequently made without providing clear definitions of responsibility, thus leaving room for ambiguities. Addressing these uncertainties is critical since they might lead to misunderstandings, impacting the quality and safety of healthcare delivery. Therefore, this study investigates how responsibility is interpreted in the context of using digital health technologies, including artificial intelligence (AI), telemonitoring, wearables and mobile apps. We conducted a scoping (...) review with a systematic search in PubMed, Web of Science, Embase, CINAHL and Philosopher’s Index. A total of 34 articles were included and categorized using a theoretical framework of responsibility aspects, and revealed two main findings. First, we found that digital health technologies can expand and shift existing ‘role responsibilities’ among caregivers, patients and technology. Second, moral responsibility is often equated with liability or accountability, without clear justification. Articles describe new ways in which physicians can be held accountable, particularly in the context of AI, and discuss the emergence of a ‘responsibility gap’ where no-one can be fully responsible for AI-generated outcomes. The literature also shows that m-Health technologies can increase patients’ accountability for their own health. However, there was limited discussion in the reviewed literature on whether these attributions of accountability are appropriate. We conclude with implications for practice and suggestions for expanding the theoretical framework of moral responsibility, recommending further study on responsibility of collectives and artificial entities, and on the role of virtue in digital health. (shrink)

Long‐term potentiation (LTP) in the hippocampus is accompanied by a number of changes on both sides of the synapse. It is now generally considered that the trigger for initiating LTP is the entry of calcium into the postsynaptic area through the NMDA‐associated channel while the mechanism(s) underlying the maintenance of LTP are less well understood and probably involve contributions from both sides of the synapse.

The role of metalinguistic ability in L2 development is seriously underestimated. It may be seen both (1) as a means of initiating or boosting the flow of primary linguistic data and (2) as a generator of substitute knowledge (derived, but epistemologically distinct from domain-specific knowledge) that may compete with or compensate for perceived gaps in the learners current underlying competence. It cannot serve as a simple means of distinguishing the rival theoretical positions.

This study discusses how perceptions of ethics are formed by certified public accountants (CPAs). Theologians are used as a point of comparison. When considering CPA ethical dilemmas, both subject groups in this research project viewed confidentiality and independence as more important than recipient of responsibility and seriousness of breach. Neither group, however, was insensitive to any of the factors presented for its consideration. CPA reactions to ethical dilemmas were governed primarily by provisions of the CPA ethics code; conformity to that (...) code may well be evidence of higher stage moral reasoning. (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)

Problems concerning future populations help us better understand what it is for one possible future, or world, to be morally better than another. The repugnant conclusion challenges traditional forms of consequentialism, including utilitarianism. A key issue is whether, per the traditional view, we make things morally better by creating additional people whose lives are worth living and by creating nonidentical better-off people in place of less well-off but distinct people. Or can we, instead, make things morally better only by making (...) things better for some particular person or another? Is the structure of morality aggregative in nature or instead person-affecting in nature? While the latter, non-traditional view may tempt us, it also seems to give rise to the nonidentity problem and various inconsistency objections. Can those problems be resolved? Questions raised by Parfit and others decades ago remain unsettled today but as critical as ever. (shrink)

Many contemporary logicians acknowledge a plurality of logical theories and accept that theory choice is in part motivated by logical evidence. However, just as there is no agreement on logical theories, there is also no consensus on what constitutes logical evidence. In this paper, I outline Jean Piaget’s psychological theory of reasoning and show how he used it to diagnose and solve one of the paradoxes of material implication. I assess Piaget’s use of psychology as a source of evidence for (...) logical theory in light of reservations raised by psychologism, and I highlight some ramifications for exceptionalism and anti-exceptionalism about logic by considering his use of psychology as logical evidence in the framework of genetic epistemology, Piaget’s research programme. I conclude that Piaget’s psychological theory of reasoning not only plausibly serves as a source of evidence for logical theory but also makes a strong case for anti-exceptionalism about logic. (shrink)

There is a theistic argument which is discussed at least twice in the Hume corpus, both times rather perfunctorily. This perfunctoriness has carried over to some of his commentators, who are not always clear as to what the argument is or about the force of Hume’s comments on it. On page 23 of A Letter from a Gentleman to his Friend in Edinburgh Hume calls it “the metaphysical Argument a priori” and in Part 9 of Dialogues concerning Natural Religion simply (...) “the argument a priori”.1 It is the argument of Demea. (shrink)

Jan Narveson has articulated a deeply held, widely shared intuition regarding what moral law has to say about bringing additional people into existence: while we are “in favour of making people happy,” we are “neutral about making happy people.” Various formulations of the Narvesonian intuition (closely related to the person-affecting intuition or restriction) have been widely criticized. This present paper outlines an off-the-beaten-path alternate construction of the intuition—the existence condition—and argues that that particular construction has the resources to avoid some (...) of those criticisms. But still other considerably more widely recognized alternate constructions have been offered as well. Thus John Broome outlines what he calls the neutrality intuition. While Broome finds the underlying intuition “strongly attractive,” he nonetheless argues that the neutrality intuition itself leads us quickly into inconsistency. Wlodek Rabinowicz disagrees. On his view, Broome’s inconsistency argument shows, not that the neutrality intuition is false, but rather that it doesn’t follow, from the fact that the outcome, or possible future or world, that includes the additional person is neither better nor worse than the (otherwise similar) world that excludes that person, that the one world is exactly as good as the other. The better view, according to Rabinowicz, is that, on occasion, and specifically when the coming into existence of additional people is at stake, the one world is incommensurate with the other. What is called the principle of trichotomy is, in other words, false. Difficulties arise, however, when we try to reject that seemingly compelling conceptual principle. This present paper concludes with the argument that the availability of the existence condition—which, together with certain other uncontroversial moral principles and a handful of conceptual principles, forms the existential approach—shows that we can maintain the most intuitive parts of neutrality intuition while avoiding both Broome’s inconsistency worry and Rabinowicz’s commitment to incommensurability. Incommensurability may be correct on other grounds—but not, this present paper argues, on the grounds provided by Broome’s inconsistency argument. (shrink)

Metabolism is a criterion of life. Three senses are distinguished. The weakest allows strong A-Life: virtual creatures having physical existence in computer electronics, but not bodies, are classes as 'alive'. The second excludes strong A-Life but allows that some non-biochemical A-Life robots could be classed as alive. The third, which stresses the body's self-production by energy budgeting and self-equilibrating energy exchanges of some (necessary) complexity, excludes both strong A-Life and living non-biochemical robots.