Should there be a female age limit on public funding for assisted reproductive technology (ART)? The question bears significant economic and sociopolitical implications and has been contentious in many countries. We conceptualise the question as one of justice in resource allocation, using three much-debated substantive principles of justice—the capacity to benefit, personal responsibility, and need—to structure and then explore a complex of arguments. Capacity-to-benefit arguments are not decisive: There are no clear cost-effectiveness grounds to restrict funding to those older women (...) who still bear some capacity to benefit from ART. Personal responsibility arguments are challenged by structural determinants of delayed motherhood. Nor are need arguments decisive: They can speak either for or against a female age limit, depending on the conception of need used. We demonstrate how these principles can differ not only in content but also in the relative importance they are accorded by governments. Wide variation in ART public funding policy might be better understood in this light. We conclude with some inter-country comparison. New Zealand and Swedish policies are uncommonly transparent and thus demonstrate particularly well how the arguments we explore have been put into practice. (shrink)

At the forefront of international concerns about global legislation and regulation, a host of noted environmentalists and business ethicists examine ethical issues in consumption from the points of view of environmental sustainability, economic development, and free enterprise.

Introduction No consent for health and medical research is appropriate when the criteria for a waiver of consent are met, yet some ethics committees and data custodians still require informed consent. Methods A single-blind parallel-group randomised controlled trial: 1129 families of children born at a South Australian hospital were sent information explaining data linkage of childhood immunisation and hospital records for vaccine safety surveillance with 4 weeks to opt in or opt out by reply form, telephone or email. A subsequent (...) telephone interview gauged the intent of 1026 parents (91%) in relation to their actions and the sociodemographic differences between participants and non-participants in each arm. Results The participation rate was 21% (n=120/564) in the opt-in arm and 96% (n=540/565) in the opt-out arm (χ2 (1 df) = 567.7, p<0.001). Participants in the opt-in arm were more likely than non-participants to be older, married/de facto, university educated and of higher socioeconomic status. Participants in the opt-out arm were similar to non-participants, except men were more likely to opt out. Substantial proportions did not receive, understand or properly consider study invitations, and opting in or opting out behaviour was often at odds with parents' stated underlying intentions. Conclusions The opt-in approach resulted in low participation and a biased sample that would render any subsequent data linkage unfeasible, while the opt-out approach achieved high participation and a representative sample. The waiver of consent afforded under current privacy regulations for data linkage studies meeting all appropriate criteria should be granted by ethics committees, and supported by data custodians. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12610000332022. (shrink)

Listening to someone from some distance in a crowded room you may experience the following phenomenon: when looking at them speak, you may both hear and see where the source of the sounds is; but when your eyes are turned elsewhere, you may no longer be able to detect exactly where the voice must be coming from. With your eyes again fixed on the speaker, and the movement of her lips a clear sense of the source of the sound will (...) return. This ‘ventriloquist’ effect reflects the ways in which visual cognition can dominate auditory perception. And this phenomenological observation is one what you can verify or disconfirm in your own case just by the slightest reflection on what it is like for you to listen to someone with or without visual contact with them. (shrink)

Christian universalism, or the theory of universal salvation, is increasingly popular among religious thinkers. A small group of scholars has put forward the contentious claim that Kierkegaard was a universalist, despite that he refers in places to the idea of eternal damnation as essential to Christianity. This paper examines the evidence both for and against the view that Kierkegaard was a universalist and concludes that despite Kierkegaard’s occasional references to the importance of the idea of eternal damnation to Christianity, there (...) is reason to believe that Kierkegaard may have been a universalist, both in terms of the substance of his thought, including two unequivocal statements in his journals that he believed everyone would eventually be saved and in terms of his rhetorical style which prioritizes the effect his writings would have on the reader over the literal truth of the views they present. (shrink)

A long-standing theme in discussion of perception and thought has been that our primary cognitive contact with individual objects and events in the world derives from our perceptual contact with them. When I look at a duck in front of me, I am not merely presented with the fact that there is at least one duck in the area, rather I seem to be presented withthisthing (as one might put it from my perspective) in front of me, which looks to (...) me to be a duck. Furthermore, such a perception would seem to put me in a position not merely to make the existential judgment that there is some duck or other present, but rather to make a singular, demonstrative judgment, that that is a duck. My grounds for an existential judgment in this case derives from my apprehension of the demonstrative thought and not vice versa. (shrink)

Bodily experience in dreams should be considered illusory to the extent that they cannot be satisfactorily explained or fruitfully investigated by appealing to brain activity alone; rather, to wholly understand the unique phenomenology of embodied selfhood in dreams, one must understand how the brain processes real-body inputs to produce the phenomenology of embodied selfhood in dreams, and why the brain responds the way it does to external stimuli during sleep.

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)

In this paper I discuss Hume’s theory of pride and the ‘remarkable mechanism’ of sympathy. In the first part of the paper I outline the ways in which Hume’s theory can accommodate the sense in which the passions are directed on things or possess intentionality while still holding to his view that passions are simple feelings. In the second part of the paper I consider a problem internal to Hume’s account of pride which arises in his discussion of the love (...) of fame and the functioning of sympathy; I explain how the tensions can be reconciled by recognising that Hume’s theory of sympathy is more nuanced than has commonly been recognized. In the third part I turn back to the evaluation of Hume’s theory of pride and argue that while it is unfair to complain that Hume does not make self-evaluation a central component of pride, Hume’s treatment of the idea of self in his theory of the passions is inadequate because he can make no proper room for the phenomenon of vicarious pride. (shrink)

When we dream, it is often assumed, we are isolated from the external environment. It is also commonly believed that dreams can be, at times, accurate, convincing replicas of waking experience. Here I analyse some of the implications of this view for an enactive theory of conscious experience. If dreams are, as described by the received view, “inactive”, or “cranially envatted” whilst replicating the experience of being awake, this would be problematic for certain extended conscious mind theories. Focusing specifically on (...) Alva Noë’s enactive view, according to which the vehicles of perceptual experience extend beyond the brain, I argue that dreams are a quandary. Noë’s view is that dreaming is consistent with enactivism because even if dreams are inactive and shut off from the external environment, they are not “full-blown” perceptual consciousness, and also, there is some reason to reject the inactive claim. However, this view rests on an unjustified and reductive account of dreams which is not supported... (shrink)