Background The post-trial period is the time period after the end of study drug administration. It is unclear whether post-trial arrangements for patient surveillance are routinely included in study protocols and consents, and whether research ethics boards (REB) consider the post-trial period. Objectives The objective was to determine whether trial protocols and consent forms reviewed by the REB describe procedures for post-trial period surveillance. Methods An observational study of protocols of randomised trials of chronic therapies for cardiac conditions, approved by (...) the REB of two academic institutions affiliated with the University of Toronto in Canada (University Health Network and Mount Sinai Hospital) from 1995 to 2007. Plans for patient surveillance in the post-trial period described in the protocol or in the consent form before and after REB approval were recorded. Results 42 studies were identified including 18 heart failure and 15 coronary artery disease trials. Only four studies planned a clinical visit after trial termination, and an additional three planned a telephone contact after trial completion. Five trials submitted consent forms to the REB with a discussion of the post-trial period. Conclusions The majority of protocols and consent forms did not discuss plans for post-trial period surveillance. The post-trial period and the REB approval process could be improved by systematic follow-up being described in the protocol and consent form. The small number of trial protocols evaluated in the study may impair the degree to which the results can be generalised. (shrink)

Recently, the concept of "gender identity" has enjoyed a great deal of attention in gender metaphysics. This seems to be motivated by the goal of creating trans-inclusive theory, by explaining trans people's genders. In this paper, we aim to unmotivate this project. Notions of "gender identity" serve important pragmatic purposes for trans people, such as satisfying the curiosity of non-trans people, and, relatedly, securing our access to important goods like legal rights and medical care. However, we argue that this does (...) not mean that "gender identity" is a metaphysically substantial thing that deserves extensive theoretical attention. There are reasons to be skeptical of such a concept. We trace the history of "gender identity," primarily to identify its roots in trans-antagonistic medical theory and its connections to the problematic "wrong-body" model--a legacy that has pathologized and flattened trans experience. Moreover, we argue that trans people primarily use "gender identity" to explain ourselves to non-trans people, rather than to discuss ourselves among ourselves. Thus, we urge theorists to resist the urge to substantiate gender identity. Instead, we encourage the development of new and better concepts, ones that attend to the lived realities of trans community and the flourishing gender terms and practices that are constructed there. If these lived realities are taken seriously, there is no need to “explain” trans people’s genders; we can simply see them as they are. (shrink)

‘Banality of evil’ was a concept introduced by Hannah Arendt in order to characterize a new form of wickedness embodied in people as Adolf Eichmann and others nazis criminals. Arendt thougt that this perverseness was very awey from the one of ‘radical evil’, a notion built by Kant and employed by Arendt herself in former works. This article seeks to point out that concepts of radical evil and banality of evil are closer than Arendt recognizes.

The sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public, patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Difficult (...) decisions were made rapidly; flexibility and reconsideration were necessary not only because the intensity and severity of infection varied over time and by locale but also because knowledge of the disease and understanding of its treatment grew. Here we discuss the ethical challenges in decision-making and competing ethical tensions during the pandemic in an effort to advance future preparedness. (shrink)

Since the 1930s, scientists studying the neurological disease scrapie had assumed that the infectious agent was a virus. By the mid 1960s, however, several unconventional properties had arisen that were difficult to reconcile with the standard viral model. Evidence for nucleic acid within the pathogen was lacking, and some researchers considered the possibility that the infectious agent consisted solely of protein. In 1982, Stanley Prusiner coined the term `prion' to emphasize the agent's proteinaceous nature. This infectious protein hypothesis was denounced (...) by many scientists as `heretical'.This essay asks why the concept of an infectious protein was considered controversial. Some biologists justified their evaluation of this hypothesis on the grounds that an infectious protein contradicted the `central dogma of molecular biology'. Others referred to vague theoretical constraints such as molecular biology's `theoretical structure' or `framework'. Examination of the objections raised by researchers reveals exactly what generalizations were being challenged by a protein model of infection.This two-part survey of scrapie and prion research reaches several conclusions: (1) A theoretical framework is present in molecular biology, exerting its influence in hypothesis formation and evaluation; (2) This framework consists of several related, yet separable, generalizations or `elements', including Francis Crick's Central Dogma and Sequence Hypothesis, plus notions concerning infection, replication, protein synthesis, and protein folding; (3) The term `central dogma' has stretched beyond Crick's original 1958 definition to encompass at least two other `framework elements': replication and protein synthesis; and (4) From the study of scrapie and related diseases, biological information has been delineated into at least two classes: sequential and what I call `conformational'.In Part I of this essay, a brief review of the central dogma, as outlined by both Francis Crick and James Watson, will be given. The developments in scrapie research from 1965 to 1972 will then be traced. This section will summarize many of the puzzling, non-viral-like properties of the scrapie agent. Alternative hypotheses to the viral explanation will also be presented, including early versions of a protein-only hypothesis. Part II of this essay will follow the developments in scrapie and prion research from the mid 1970s through 1991. The growing prominence of a protein-only model of infection will be balanced by continued objections from many researchers to a pathogen devoid of nucleic acid. These objections will help illuminate those generalizations in molecular biology that were indeed challenged by a protein-only model of infection. (shrink)

We show that the analysis of Keisler’s order can be localized to the study of φ-types. Specifically, if is a regular ultrafilter on λ such that and M is a model whose theory is countable, then is λ+-saturated iff it realizes all φ-types of size λ.

Many philosophers maintain that works of art, in particular films and novels, cannot function as thought experiments. Most who claim this make their case by setting the bar for what can count as a philosophical thought experiment very high. It is argued here not that these positions are necessarily mistaken, but that there is a large gray area that is seldom acknowledged between what counts as a philosophical thought experiment narrowly defined and what counts as “being used to illustrate a (...) philosophical point,” where the fiction is imported into an already complete external argument. I contend that these are not the only alternatives available, that intuition pumps and variant case arguments provide better grounds for comparison than has been acknowledged, and that there are uses to which filmic illustrations in particular may be put that make distinctive and cognitive contributions of their own. In the course of making this case, it is stressed both that emotional response has clearly cognitive aspects and that many thought experiments with lower stakes rely on eliciting emotional response. (shrink)