Ethical arguments about caregiver responsibility and the limits of client autonomy rely on best evidence about the risks and benefits of medical interventions. But when the evidence is unclear, or when the peer-reviewed literature presents conflicting accounts of the evidence, how are clinicians and their clients to recommend or decide the best course of action? Conflicting evidence about the outcomes of home and hospital birth in the peerreviewed literature offers an opportunity to explore this question. We present the contrary evidence (...) and describe the social and cultural elements that influence the production of the science of birth, including professional, publication, and critical bias. We then consider how the science of birth has been used an misused in making ethical arguments about preferred place of birth. We conclude with a number of recommendations about the responsible use of the evidence, arguing for an “ethics of information” that can be drawn on to guide caregivers and clients in the use of evidence for clinical decision making. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

In this issue of The Journal of Clinical Ethics, we offer a variety of perspectives on the moral and medical responsibilities of professionals with regard to a woman’s choice of where she will birth her baby. The articles in this special issue focus on place of birth, but they have larger resonance for clinicians whose decisions about providing the best possible care require them to sort through evidence, consider their own possible biases and the limitations of their training, and balance (...) the wishes of their patients with the demands of colleagues, hospitals, and insurers. The articles published in this special issue of The Journal of Clinical Ethics will help those who wrestle with such dilemmas in everyday clinical decision making. (shrink)

Interactive technology assessment (iTA) provides an answer to the ethical problem of normative bias in evaluation research. This normative bias develops when relevant perspectives on the evaluand (the thing being evaluated) are neglected. In iTA this bias is overcome by incorporating different perspectives into the assessment. As a consequence, justification of decisions based on the assessment is provided by stakeholders having achieved agreement. In this article, agreement is identified with wide reflective equilibrium to show that it indeed has the potential (...) of justifying decisions. We work out several conditions for this agreement to be achievable and just. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction (Abbott) and the assignment of responsibilities (Gusfield). This (...) theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as 'intentionally taking the life of another person by a physician, upon that person's request' can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

International array of contributors, bringing together both traditional and more recent approaches to provide valuable insights into the poets’ use of language.Covers authors from Lucilius to Juvenal.Of the peoples of ancient Italy, only the Romans committed newly composed poems to writing, and for 250 years Latin-speakers developed an impressive verse literature.The language had traditional resources of high style, e.g., alliteration, lexical and morphological archaism or grecism, and of course metaphor and word order; and there were also less obvious resources in (...) the technical vocabularies of law, philosophy and medicine.The essays in this volume show how the poets in the classical period combined these elements, and so created a poetic medium that could comprehend satire, invective, erotic elegy, drama, lyric, and the grandest heroic epos. (shrink)

The setting of this epigram is the komos sequence explored by Copley in his important book. The speaker is about to set forth in the dark, since he requires some means of lighting his way. A companion offers him a torch. It is refused as unnecessary because of the flame of love which burns in his breast.

An alleged moral right to informational privacy assumes that we should have control over information about ourselves. What is the philosophical justification for this control? I think that one prevalent answer to this question—an answer that has to do with the justification of negative rights generally—will not do.

On what grounds will the rational man become a Christian? It is often assumed by many, especially non-Christians, that he will become a Christian if and only if he judges that the evidence available to him shows that it is more likely than not that the Christian theological system is true, that, in mathematical terms, on the evidence available to him, the probability of its truth is greater than half. It is the purpose of this paper to investigate whether or (...) not this is a necessary and sufficient condition for the rational man to adopt Christianity. (shrink)

In this article we show that it is possible to completely classify the degrees of r.e. bases of r.e. vector spaces in terms of weak truth table degrees. The ideas extend to classify the degrees of complements and splittings. Several ramifications of the classification are discussed, together with an analysis of the structure of the degrees of pairs of r.e. summands of r.e. spaces.

(I UNDERSTAND BY A MIRACLE, A VIOLATION OF A LAW OF NATURE BY A GOD.) A VIOLATION OF A LAW OF NATURE IS THE OCCURRENCE OF A NON-REPEATABLE COUNTER-INSTANCE TO IT. CONTRARY TO HUME’S VIEW, THERE COULD BE GOOD HISTORICAL EVIDENCE BOTH THAT A VIOLATION HAD OCCURRED AND THAT IT WAS DUE TO THE ACT OF A GOD.

Mr Olding's recent attack on my exposition of the argument from design gives me an opportunity to defend the central theses of my original article. My article pointed out that there were arguments from design of two types—those which take as their premisses regularities of copresence and those which take as their premisses regularities of succession. I sought to defend an argument of the second type. One merit of such an argument is that there is no doubt about the truth (...) of its premisses. Almost all objects in the world behave in a highly regular way describable by scientific laws. Further, any scientific explanation of such a regularity must invoke some more general regularity. The most general regularities of all are, as such, scientifically inexplicable. The question arises whether there is a possible explanation of another kind which can be provided for them, and whether their occurrence gives any or much support to that explanation. I urged that we do explain some phenomena by explanation of an entirely different kind from the scientific. We explain states of affairs by the action of agents who bring them about intentionally of their own choice. Regularities of succession, as well as other phenomena may be explained in this way. Explanation of this kind I will term intentional explanation. Intentional explanation of some phenomenon E consists in adducing an agent A who brought E about of his own choice and a further end G which, he believed, would be forwarded by the production of E. (shrink)

This book aims to provide an introduction to Aristotle's Politics, highlighting the major themes and arguments offered in the scholar's work. It begins with a discussion on what Aristotle perceives as human good, which he had described as the ethical purpose of political science, and how he views the political community, or the polis, as a community of persons formed with a view to some good purpose and a supreme entity in the sense that it is not just one aspect (...) of city-state society but is the whole of that society. The book also discusses Aristotle's arguments against the abolition of the household for the ruling class and the communism of families and property, which Plato advocates, and highlights certain inconsistencies and vulnerabilities in his arguments supporting natural slavery and on how the husband should rule over his wife and children. The book presents Aristotle's account of the relative merits of six different types of constitution and his views on the best possible constitution that will help in the realization of the polis' true purpose of achieving the good life. It ends with a discussion on Aristotle's view of political science in relation to the protection of particular constitutions against constitutional change and political disorder. (shrink)

This treatise on aesthetics criticizes various psychological theories of art, offers new theories and interpretations, and draws important inferences concerning ...

R. G. Swinburne; XIII*—Personal Identity, Proceedings of the Aristotelian Society, Volume 74, Issue 1, 1 June 1974, Pages 231–247, https://doi.org/10.1093/arist.

_Purpose._ This article reveals the importance of the analysis of the theory of generations to identify the essential characteristics of the phenomenon of youth. _Theoretical basis_ of this study is socio-philosophical anthropology, i.e. philosophical anthropology using certain methods of sociological, socio-psychological and ethnological research, as well as philosophical comprehension of the application of these methods in special sciences. _Originality._ The authors rethought the theoretical and practical potential of generational theory through its reconceptualization based on philosophical anthropology, which created an opportunity (...) to shift research attention from the attempts to identify superhistorical characteristics of youth to the identification of the essential nature of specific historical and sociocultural features of young people as representatives of a particular culture. _Conclusions._ Defining the youth phenomenon requires accounting at least three constraints that on the one hand, play a role of warnings that deter from theoretical and practical errors in the study of the youth phenomenon, and on the other hand, guidelines for identifying real, specific characteristics of youth as a social phenomenon. Limitations of theoretical and practical analysis of young people are as follows: first, the need to consider demographic data not as final, but only as initial and preliminary, such that require further substantive socio-cultural analysis; second, the inadmissibility of ignoring the cultural diversity of the manifestations of the youth phenomenon, instead the need to identify the special characteristics of youth of different ethnic, religious and other groups; third, the need to take into account the specifics of self-identification of those who identify themselves as young people as a social group. (shrink)

When travellers are overcome by cold, it is said, they lie down quite happily and die. They put up no fight for life. If they struggled, they would keep warm; but they no longer want to struggle. The cold in themselves takes away the will to fight against the cold around them.

Background Clinical papers so flawed that they are eventually retracted may put patients at risk. Patient risk could arise in a retracted primary study or in any secondary study that draws ideas or inspiration from a primary study. Methods To determine how many patients were put at risk, we evaluated 788 retracted English-language papers published from 2000 to 2010, describing new research with humans or freshly derived human material. These primary papers—together with all secondary studies citing them—were evaluated using ISI (...) Web of Knowledge. Excluded from study were 468 basic science papers not studying fresh human material; 88 reviews presenting older data; 22 case reports; 7 papers retracted for journal error and 23 papers unavailable on Web of Knowledge. Overall, 180 retracted primary papers (22.8%) met the inclusion criteria. Subjects enrolled and patients treated in 180 primary studies and 851 secondary studies were combined. Results Retracted papers were cited over 5000 times, with 93% of citations being research related, suggesting that ideas promulgated in retracted papers can influence subsequent research. Over 28 000 subjects were enrolled—and 9189 patients were treated—in 180 retracted primary studies. Over 400 000 subjects were enrolled—and 70 501 patients were treated—in 851 secondary studies which cited a retracted paper. Papers retracted for fraud (n=70) treated more patients per study (p<0.01) than papers retracted for error (n=110). Conclusions Many patients are put at risk by retracted studies. These are conservative estimates, as only patients enrolled in published clinical studies were tallied. (shrink)