Equipoise is widely regarded to be an essential prerequisite for the ethical conduct of a randomised controlled trial. There are some circumstances however, under which it is acceptable to conduct a randomised controlled trial in the absence of equipoise. Limited access to the preferred intervention is one such circumstance. In this paper we present an example of a randomised trial in which access to the preferred intervention, preschool education, was severely limited by resource constraints. The ethical issues that arise when (...) conducting randomised trials in health care are considered in the context of trials of social interventions. In health, education and social welfare, effective interventions are frequently limited due to budgetary constraints. Explicit acknowledgement of the need to ration interventions, and the use of random allocation to do this even in the absence of equipoise, would facilitate learning more about the effects of these interventions. (shrink)

This book offers an important study of Aristotle's theory of the sense-organs. It aims to answer two questions central to Aristotle's psychology and biology: why does Aristotle think we have sense-organs, and why does he describe the sense-organs in the way he does? The author looks at all the Aristotelian evidence for the five senses and shows how pervasively Aristotle's accounts of the sense-organs are motivated by his interest in form and function. The book also engages with the celebrated problem (...) of whether perception for Aristotle requires material changes in the perceiver. It argues that, surprisingly to the modern philosopher, nothing in Aristotle's description of the sense-organs requires us to believe in such changes. (shrink)

The Gouldian argument for evolutionary contingency found in Wonderful Life can be dissected into three premises: palaeontological, macro-evolutionary, and developmental. Discussions of evolutionary contingency have revolved primarily around the developmental. However, a shift in methodological practice and new palaeontological evidence subsequent to the book’s publication appears to threaten the palaeontological premise that asserts high Cambrian disparity, or, roughly, that morphological differences between the Cambrian species were high. This presents a prima facie problem: Did the Cambrian consist of enough anatomical variety (...) to fuel a different outcome upon a replay of the tape of life? I investigate the role that disparity plays in the Gouldian argument for evolutionary contingency and conclude that the reduced disparity view does not undermine the argument, per se. As for the macro-evolutionary premise, Gould never offers any explicit justification for the idea that species sorting was indiscriminate or ‘lottery-like’ (though he certainly gestures at it). Putting aside the exegetical, I consider certain empirical avenues for underwriting the macro-evolutionary premise and argue that the most plausible route is to appeal to the special status of mass extinctions, a move that is not entirely unfamiliar to macro-evolutionists. That is, mass extinctions can be good sources of contingency due to their being ‘chancy’ in at least three respects. In sum, I update the palaeontological and macro-evolutionary premises as to reconstrue the Gouldian argument for evolutionary contingency in its strongest form. (shrink)

Transplantation is a medically successful and cost-effective way to treat people whose organs have failed--but not enough organs are available to meet demand. T. M. Wilkinson explores the major ethical problems raised by policies for acquiring organs. Key topics include the rights of the dead, the role of the family, and the sale of organs.

This “Legal Briefing” column covers recent legal developments involving patient decision aids. This topic has been the subject of recent articles in JCE. It is included in the 2010 Patient Protection and Affordable Care Act. And it has received significant attention in the biomedical literature, including a new book, a thematic issue of Health Affairs, and a recent article in the New England Journal of Medicine. Moreover, physicians and health systems across the United States are increasingly integrating decision aids into (...) their clinical practice. Both federal and state laws play a significant role in promoting this expanded use. On the other hand, concerns about liability could stymie development and implementation. We categorize legal developments concerning patient decision aids into the following five sections:1. Development of decision aids2. Effectiveness of decision aids3. Federal regulation of decision aids4. State regulation of decision aids5. Legal concerns regarding decision aids. (shrink)

. Ill BERGSONS THEORY OF ART . . .141 THE PHILOSOPHY OF INTENSIVE MANIFOLDS I I CINDERS ..... 215 APPENDICES A. REFLECTIONS ON VIOLENCE . . 249 B. PLAN FOR A ...

En sus Escolios, Nicolás Gómez Dávila hace manifiesta la relación existente entre las antiguas nociones gnósticas y las pretensiones ilustradas de la modernidad. Al determinar los fundamentos del gnosticismo en un conocimiento que se eleva sobre la fe, ubica rasgos análogos en el pensamiento moderno..

Saint-Pierre's European Union, an alternative to the balance of power system and a safeguard against universal monarchy, was based on abolition of state sovereignty. Beyond the law of nations, the Union was to ensure European domination of the world and the use of the world's resources in Europe's own interest. A first step towards this goal was a universal crusade to ‘chase the Turk out of Europe and even out of Asia and Africa’. In this, Saint-Pierre followed the logic of (...) Western irenism. (shrink)