Increasing ethical attention and debate is focusing on whether individuals who take part in clinical trials should be given access to post-trial care. However, the main focus of this debate has been upon drug trials undertaken in low-income settings. To broaden this debate, we report findings from interviews with individuals (n = 24) who participated in a clinical trial of a closed-loop system, which is a medical device under development for people with type 1 diabetes that automatically adjusts blood glucose (...) to help keep it within clinically recommended ranges. Individuals were recruited from UK sites and interviewed following trial close-out, at which point the closed-loop had been withdrawn. While individuals were stoical and accepting of the requirement to return the closed-loop, they also conveyed varying degrees of distress. Many described having relaxed diabetes management practices while using the closed-loop and having become deskilled as a consequence, which made reverting back to pre-trial regimens challenging. Participants also described unanticipated consequences arising from using a closed-loop. As well as deskilling, these included experiencing psychological and emotional benefits that could not be sustained after the closed-loop had been withdrawn and participants reevaluating their pre- and post-trial life in light of having used a closed-loop and now perceiving this life much more negatively. Participants also voiced frustrations about experiencing better blood glucose control using a closed-loop and then having to revert to using what they now saw as antiquated and imprecise self-management tools. We use these findings to argue that ethical debates about post-trial provisioning need to be broadened to consider potential psychological and emotional harms, and not just clinical harms, that may result from withdrawal of investigated treatments. We also suggest that individuals may benefit from information about potential nonclinical harms to help make informed decisions about trial participation. (shrink)

Mixed results regarding the role of gender in moral reasoning prompted an investigation of an alternative characteristic that may be more influential in the process: sex role orientation. We present an empirical assessment of the relationship between an individual’s moral reasoning level and his/her sex role orientation, gender, and several academic factors. Our results indicate that sex role orientation is not related to moral reasoning level. Gender is related to moral reasoning in our study, women reasoning at higher levels than (...) men. We found a positive relationship between education and moral reasoning level, and moral reasoning levels differed across academic institutions. Our results also show business students have lower moral reasoning levels than students in other fields, although this result did not reach statistical significance. (shrink)

Ethics, communication skills, and the law ('practice skills') are important in all aspects of modern health care. Doctors and nurses must be sensitive to the ethical aspects of their work and understand the legal framework within which clinical decisions are made. Well developed skills of communication, with patients, their relatives and other members of the clinical team, are a key feature of good clinical practice Until recently, the important of practice skills has been relatively neglected in health care education. This (...) situation is changing. The UK General Medical Council, for example, has recently identified three aspects as part of the core of the medical course, and the move to degree courses in nursing has led to an increasing focus of practice skills in nurse education. The Oxford Practice Skills Project (OPSP) team have developed a course, within the University of Oxford Clinical School, which covers the teaching of practice skills in an integrated manner. This course is widely recognized as one of the most systematic developments of education in these areas. This manual describes the OPSP course in detail and provides teaching materials. Although developed initially for medical students, it should be helpful to all those involved in teaching ethics, communication skills, and law in health care. Each Seminar is described in detail Tutors' guides are provided Student handouts are included Contains guidelines for introducing 'practice skills' into a busy clinical curriculum Includes over forty case histories for teaching and examination Gives details of many useful sources and resources Details a variety of teaching methods together with their advantages and disadvantages Provides an ethics teaching toolkit for clinical teachers new to this area Readers are welcome to photocopy any part of this manual for their own teaching. (shrink)

The United States recognized intellectual property rights from its earliest days and included, in its constitution, a clause which expresses this, "To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries." These few words found in Article 1, Section 8, Clause 8 have grown into a massive body of laws that govern works that were unimaginable to Thomas Jefferson and his contemporaries. Our question (...) today is very simple: is the latest metamorphosis of copyright law, the Digital Millennial Copyright Act of 1998, prudent policy? Specifically, we are concerned with three issues which critics have raised regarding this act: chilling effects on fair use, suppression of innovation, and overreach. We will also touch on the criticism which stresses that the DMCA further expands a system which increasingly and unfairly favors the content industries. This will be limited to illustrating extant tensions between copyright owners and society and also the difficulties law faces in keeping pace with the current, rapid and overwhelming technological and cultural change. We rely primarily on leading cases to establish the impact on fair use and innovation or to demonstrate over reach. (shrink)

After distinguishing different species of Legal Moralism I outline and defend a modest, positive Legal Moralism, according to which we have good reason to criminalize some type of conduct if it constitutes a public wrong. Some of the central elements of the argument will be: the need to remember that the criminal law is a political, not a moral practice, and therefore that in asking what kinds of conduct we have good reason to criminalize, we must begin not with the (...) entire realm of wrongdoing, but with conduct falling within the public realm of our civic life; the need to look at the different processes of criminalization, and to ask what kinds of consideration can properly figure in those processes; the need to attend to the relationship, and the essential differences, between criminal law and other modes of legal regulation. (shrink)

Three arguments are proposed against the idea that ordinary talk about the mind constitutes a folk psychology, a sort of prescientific theory which explains human behaviour and which is ripe for replacement by a neurological or computational theory with better scientific credentials. First, not all talk of the mind is introduced to explain in the way assumed by those who think that mental talk hypothesizes inner processes to explain behaviour. Second, the individuation of the behaviour which is explained by the (...) inner processes itself requires reference to ?mental? states such as intentions or desires. Consequently the project is circular. Finally, scientific theory is a practice with a history which may be matched in the case of ordinary talk of the mind. Certainly ordinary talk of motives, intentions, and thoughts may be infected by the theorizing of economists and sociologists et al., but it is impossible that all talk of the mind should be theoretical in this way. (shrink)

The human person makes great demands on the physician and calls for unique attention. Hence the doctor-patient relationship calls for the highest ideals of kindness, patience, trustworthiness, generosity and skill. The Catholic physician brings to these demands a specific meaning: ministering to the sick is to see Christ in them and to show Him to them.

The author's motivation for constructing the calculi of this paper\nis so that time and tense can be "discussed together in the same\nlanguage" (p. 282). Two types of enriched propositional caluli for\ntense logic are considered, both containing ordinary propositional\nvariables for which any proposition may be substituted. One type\nalso contains "clock-propositional" variables, a,b,c, etc., for\nwhich only clock-propositional variables may be substituted and that\ncorrespond to instants or moments in the semantics. The other type\nalso contains "history-propositional" variables, u,v,w, etc., for\nwhich only history-propositional variables may (...) be substituted and\nthat correspond to maximally linearly ordered subsets of instants.\nThis second type is for tense logics in which time is not linear\nand where at any moment there may exist alternative future courses\nof events. Quantifiers are included in both types but only for clock-\nand history-propositional variables. However, these quantifiers are\ngiven an essentially substitutional interpretation. In addition,\nbesides each clock-propositional variable being true at exactly one\ninstant, the semantics requires that for each instant there be at\nleast one clock-propositional variable true at that instant, which\nin effect amounts to having each instant of the model "denoted" in\nthe formalism by some clock-propositional variable. Thus it is not\nsurprising that quantification over clock-propositional variables\nturns out to have a "well behaved first-order semantics" (p. 284).\n{One axiom relating history- with clock-propositions seems to need\nrevision: CKTauTbuAUabUba. Since the clock-propositional variables\nmight be true at the same instant the consequent should include an\nalternative, namely, LCab.} Besides the standard truth-functional\nand tense operators G,H,F,P, the author includes L for "it is\nalways the case that". The model-theoretic earlier-than relation\nordering instants and the semantic truth-at (an instant) relation\nare formalized by Uab and Taα (for a wff α) which\nare defined respectively as LCbPa (whenever the clock-proposition\nb is the case the clock-proposition a was the case) and LCaα\n(α is the case whenever the clock-proposition a is the case).\nBecause the future tense operators are definable in terms of U\nand T and the latter are definable in terms of L and P, the\ndual of H, the author notes that his completeness proofs can be\nrestricted to L and H as primitive and with the future tense\noperators used for other interpretations, especially Prior, A.'s\nindeterminist "it will be the case that", where time is not linear.\nThe author concludes with some rather technical observations showing\nthat "in ordinary tense logics the instants are nonstandard elements\nof the models. This provides", according to the author, "a semantic\npressure to build the instants into tense logic, so that they will\nappear as standard elements in the models" (p. 283). (shrink)

Discussions of responsibility typically focus on the person who is held responsible: what are the conditions or criteria of responsibility; what can be done to or demanded of a person who is responsible? This paper shifts focus onto those who hold, rather than those who are held, responsible: what do we owe to those whom we hold responsible? After distinguishing responsibility as answerability from responsibility as liability, it attends mainly to the former, and points out the ways in which it (...) is multiply relational: I am responsible for something to someone who has the standing to call me to account for it, under the norms of some particular practice. Responsibility as thus understood is also reciprocal: if you are to be answerable to me, I must treat you with a certain respect, attend seriously to your answer, and be ready to answer to you myself. The paper explores some of the implications of this point both for our moral dealings with each other, and for criminal law and the criminal trial. (shrink)

The literature fails to reflect general agreement over the nature of the services and procedures provided by bioethicists, and the training and core competencies this work requires. If bioethicists are to define their activities in a consistent way, it makes sense to look for common ground in shared communities of practice. We report results of a survey of the services and procedures among bioethicists affiliated with the University of Toronto Joint Centre for Bioethics (JCB). This is the largest group of (...) bioethicists working in healthcare organizations in Canada. The results suggest there are many common services and procedures of JCB bioethicists. This survey can serve as a baseline for further exploration of the work of JCB bioethicists. Common practices exist with respect to the domains of practice, individual reporting relationships, service availability within business hours and the education and training of the bioethicist. (shrink)

Study of Samayasāra, treatise on Jaina philosophy by Kundakunda.

We can gain fresh insights into aspects of criminal liability by focusing first on the prior topic of criminal responsibility, and on the relational dimensions of responsibility: responsibility is responsibility for something, to someone. We are criminally responsible as citizens, to our fellow citizens, for committing 'public' wrongs: I discuss the difficulty of giving determinate content to this idea of public wrongs, and the way in which, whereas moral responsibility is typically strict, criminal responsibility is not. Finally, I explore the (...) grounds on which defendants might deny that they are criminally responsible before the courts that seek to try them. (shrink)

Two treatises on memory which have come down to us from antiquity are Aristotle’s “On memory and recollection” and Plotinus’ “On perception and memory” ; the latter also wrote at length about memory in his “Problems connected with the soul”. In both authors memory is treated as a ‘modest’ faculty: both authors assume the existence of a persistent subject to whom memory belongs; and basic cognitive capacities are assumed on which memory depends. In particular, both theories use phantasia to explain (...) memory. Aristotle takes representations to be changes in concrete living things which arise from actual perception. To be connected to the original perception the representation has to be taken as a copy of the original experience ‑ this is the way Aristotle defines memory at the end of his investigation. Plotinus does not define memory: he is concerned with the question of what remembers. This is of course the soul, which goes through different stages of incarnation and disincarnation. Since the disembodied soul can remember, so he does not have Aristotle’s resources for explaining the continued presence of representations as changes in the concrete thing. Instead, he thinks that when acquiring a memory we acquire a capacity in respect of the object of the memory, namely to make it present at a later time. (shrink)

A categorical structure suitable for interpreting polymorphic lambda calculus (PLC) is defined, providing an algebraic semantics for PLC which is sound and complete. In fact, there is an equivalence between the theories and the categories. Also presented is a definitional extension of PLC including "subtypes", for example, equality subtypes, together with a construction providing models of the extended language, and a context for Girard's extension of the Dialectica interpretation.

The discovery of the microworld presented a serious trial for many systems of views held by mankind, including its logic. This world was found to lack the familiar solid bodies, the unchanging particles and interrelations between them, the reflection of which, in one way or another, is the logic of the macroscopic world. What elementary particle physics encountered in the microscopic world seemed illogical: the rest-mass of a particle equals zero; a part that is not smaller than the whole; a (...) particle that in diffraction experiments moved like a wave; and much else that was unusual and strange in the properties of elementary particles. One of these properties was actually so named by physicists — "strangeness.". (shrink)

R. A. Sharpe; VIII*—Art and Expertise, Proceedings of the Aristotelian Society, Volume 85, Issue 1, 1 June 1985, Pages 133–148, https://doi.org/10.1093/aristote.