In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single (...) institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies. (shrink)

An exceptionally well-edited anthology of basic philosophic texts arranged in chronological order. Each section is preceded by a short introduction. The volumes have many unusual features, including expository sections on Zeno by G. Vlastos, and on Malebranche by W. Doney. The range of this anthology can be judged by the inclusion of the following in their entirety: Plato's Apology, Meno, Symposium, and Phaedrus; Hume's An Enquiry Concerning Human Understanding; Descartes' Meditations; and Leibniz' Monadology.--D. Z. L.

William Gerber’s study of American liberalism is a valuable compendium of the varied, changing, and often conflicting uses of that "slippery" word, liberalism, in the United States, past and present, and in antecedent Western political thought. But Gerber identifies himself as having "set his sights on trying to build an adequate definition of liberalism". The problem is introduced by chapter 1, which asks if liberalism is dying or already dead, and by chapter 2, which asks why liberalism has not brought (...) about the "millennium" it promised. Chapter 3 calls attention to the "Difficulty of Isolating the Essence of the Liberal Viewpoint" from many competing claims, and stipulates three criteria. 1) The definition should encompass only those features of liberalism with which all experts are in agreement. This requirement leads Gerber to extensive and sometimes strained marshalling of quotations showing the frequency of disagreement among liberals with regard to those beliefs commonly associated with liberalism: freedom, majority rule, improvement of society, preference for change, perfectibility, progress, etc. 2) The definition should be exclusive to liberalism and encompass no tenets shared by other than liberals. 3) The definition should be value-neutral. Understandably, these criteria result in a definition of liberalism at a high level of abstraction: "Liberalism is the belief that individuals and institutions, including governments, should so act—or refrain from acting—as to liberate as many individuals as possible from as many shackles as possible without overturning basic social machinery". In chapters 4-8 the "pedigree" of American liberalism is traced from Hammurabi, Moses, Buddha, Laotse, and Jesus to the ancient Greeks and Romans, the Enlightenment and the Glorious Revolution, to 19th century British liberalism. Chapters 6-8 examine American liberalism before 1900, from 1900 to 1945, and since World War II. Chapters 9-11 discuss the stand of liberals on political, economic, and social issues, and chapter 12 looks to the future of liberalism. (shrink)

Objective: The objectives of this study are to understand the current functions, structure and operation of hospital ethics committees (HECs) in Shanghai and to facilitate their improvement. Methods: (1) A questionnaire survey, (2) interviews with secretaries and (3) on-site document reviews of HECs in Shanghai were used in the study, which surveyed 33 hospitals. Results: In Shanghai, 57.56% of the surveyed hospitals established HECs from 1998 to 2005. Most HECs used bioethical review of research involving human subjects as well as (...) bioethical review or consultation regarding medical care services and administrative decision- making. Of the surveyed HECs, 14.3% did not provide any formal bioethical training to the HECs’ members and many HECs had no standard operating procedures. Some HECs had no clear definition of what was “conflict of interest” that should be considered by the HECs, while 44.4% of the HECs did not perform continuing review. Discussion: After the issues of related national regulations, more and more hospitals established HECs in Shanghai, but the functions of HECs need to be further developed and formal training on bioethics should be provided to HEC members. To assure the independence and good performance of HECs, the conflict of interest procedure, the standard operating procedures and bioethical review should be improved. Conclusion: HECs in Shanghai had developed in the preceding 10 years and they played great roles in protecting the rights and welfare of human subjects and patients; some areas need improvement. (shrink)

Pre-natal exposure to acute maternal trauma or chronic maternal distress can confer increased risk for psychiatric disorders in later life. Acute maternal trauma is the result of unforeseen environmental or personal catastrophes, while chronic maternal distress is associated with anxiety or depression. Animal studies investigating the effects of pre-natal stress have largely used brief stress exposures during pregnancy to identify critical periods of fetal vulnerability, a paradigm which holds face validity to acute maternal trauma in humans. While understanding these effects (...) is undoubtably important, the literature suggests maternal stress in humans is typically chronic and persistent from pre-conception through gestation. In this review, we provide evidence to this effect and suggest a realignment of current animal models to recapitulate this chronicity. We also consider candidate mediators, moderators and mechanisms of maternal distress, and suggest a wider breadth of research is needed, along with the incorporation of advanced -omics technologies, in order to understand the neurodevelopmental etiology of psychiatric risk. (shrink)

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

This paper describes a grading grid (rubric) for argumentative essays consisting of three sections: requirements, content, and mechanics. The first section of the grid verifies whether the student met the minimum requirements of the assignment, e.g. not being plagiarized, being an argumentative essay, etc. The second section of the grid evaluates the content of the essay, looking at parameters concerning whether the thesis is clear, the extent to which it is supported, whether it considers any objections or possible replies, etc. (...) The third and final section of the grid evaluates the mechanics of writing, evaluating parameters like grammar, appropriate length, etc. Finally, the paper details a number of pedagogical benefits to using grading grids and details how best to employ them in the classroom. (shrink)

Parables are not frequently found in critical thinking textbooks. And, yet, because parables are relatively simple, engaging stories, they can present various principles of good reasoning and attitudes of a critical thinker in a way that is fun and accessible to the students in our classrooms. Using two well-known parables, W. K. Clifford’s Ship Owner and John Wisdom’s Invisible Gardener, I outline how parables like these can be used in the teaching of critical thinking, and what the benefits of doing (...) so are. I also argue that the religious context in which the parables were set is not a detriment to their pedagogical value but, rather, can be an added benefit. (shrink)

Many practices available for use in health service psychology are ineffective or harmful. How we describe these practices is important to scientific discourse and science communication with policy-makers and the general public. The label “pseudoscience” is typically applied in these cases, though the meaning of pseudoscience varies widely creating a quagmire for transparent and accurate communication. To clarify this issue, we review several prominent definitions of pseudoscience as well as consider how the term is used amongst psychology scholars and science-communicators. (...) We define two additional terms adapted from the medical literature, contemporary and alternative psychotherapies and low-value practices, and discuss their strengths and limitations. Finally, we recommend the broader category of low-value practices for use due to its definitional clarity, lack of competing definitions, and potential for clarifying research programs. (shrink)

Uncertainties about how to achieve sustainable and reliable biobased value chains can be remedied by inclusion of local biomass producers. Such inclusion implies that the knowledge, values, interests and skills of these local producers are integrated into the set-up, design, development and associated distribution of risk and benefits of the specific value chain. To make sure that this inclusion is both fair and effective, capabilities of relevant actors need to be taken into account, i.e. the capabilities of biomass producers and (...) of companies and local governments. Building on these capabilities can lead to context sensitive design of biorefineries that allow for true inclusion of local stakeholders. We support this claim with reference to the case of sugarcane production in Jamaica. (shrink)

Background and objective: Code status discussions may fail to address patients’ treatment-related goals and their knowledge of cardiopulmonary resuscitation (CPR). This study aimed to investigate patients’ resuscitation preferences, knowledge of CPR and goals of care. Design, setting, patients and measurements: 135 adults were interviewed within 48 h of admission to a general medical service in an academic medical centre, querying code status preferences, knowledge about CPR and its outcome probabilities and goals of care. Medical records were reviewed for clinical information (...) and code status documentation. Results: 41 (30.4%) patients had discussed CPR with their doctor, 116 (85.9%) patients preferred full code status and 11 (8.1%) patients expressed code status preferences different from the code status documented in their medical record. When queried about seven possible goals of care, patients affirmed an average of 4.9 goals; their single most important goals were broadly distributed, ranging from being cured (n = 36; 26.7%) to being comfortable (n = 8; 5.9%). Patients’ mean estimate of survival to discharge after CPR was 60.4%. Most patients believed it was helpful to discuss goals of care (n = 95; 70.4%) and the chances of surviving inhospital CPR (n = 112; 83.0%). Some patients expressed a desire to change their code status after receiving information about survival following inhospital CPR (n = 11; 8.1%) or after discussing goals of care (n = 2; 1.5%). Conclusions: Doctors need to address patients’ knowledge about CPR and take steps to avoid discrepancies between treatment orders and patients’ preferences. Addressing CPR outcome probabilities and goals of care during code status discussions may improve patients’ knowledge and influence their preferences. (shrink)

Purpose. Philosophy of culture is an extremely multifaceted field, which includes the anthropological segment as well. In particular, we can talk about the role of man in cultural progress in a particular period of development of the society. To some extent, this problem may also apply to the theory of archetypes, which is rapidly developing today, being used not only in philosophy but also in other fields, deeply penetrated into the methodology of humanities knowledge. Therefore, we used interdisciplinary tools for (...) this study. The purpose of this work is to study the influence of personality on the development of Ukrainian culture in a global, comprehensive dimension, based on the experience and works of famous figures that carried out cultural activities in a certain historical period. In this case, we can appeal to the archetype of the Wise Old Man, which contains a set of permanent features that connect its projections with both the "foretype" and at the same time the "accumulation" of experience. Theoretical basis. Based on the work of famous researchers in the field of philosophy, anthropology, analytical psychology, ethnophilosophy, the authors note the insufficient elaboration of the topic regarding the distinction of anthropological dimensions of different cultural periods of Ukraine in chronological order. Originality. The authors of the article prove that the continuity of the accumulation of anthropocentric features in individuals gives them transcendence, elevate to the archetype of the Wise Old Man, which can be perceived as a universal process against the ethnic development background. Conclusions. As a result of the study, we can say that the role of individual key figures in the development of national culture is quite noticeable. This can be traced both at the local level and at the national level, when we should talk about individuals who in a certain period of development of society and culture were leading and became a kind of embodiment of universal experience accumulated in an individual with a certain identity, which is the "personality" required in "that place" and "that time". For this reason, we turn to the archetype of the Wise Old Man as an "invariant", a "conductor", which reflects the most realized and individualized personality in a particular chronotope. (shrink)

Purpose. Romanticism as a movement developed in Germany, where, becoming the philosophy of time in the 18th-19th centuries, spread to all European countries. The "mobility" of the Romantic doctrine, its diversity, sometimes contradictory views, attitude to man as a free, harmonious, creative person led to the susceptibility of this movement by ethnic groups, different in nature and mentality. Its ideas found a wide response in Ukraine with its "cordocentric" type of culture in the early nineteenth century. Since the peculiarity of (...) "Ukrainian Romanticism" was its "literary-centric" nature, the purpose of this study is to analyse and comprehend the place of man in the national philosophy and literature of this period. Accordingly, the main tasks of the work are as follows: to determine the main features, the nature of Ukrainian Romanticism; to trace the main vectors of comprehension and image of man in the literature of this time. Theoretical basis. The ideas of European Romanticism were creatively rethought and assimilated during the emergence of new Ukrainian literature. It provided samples of highly artistic works, unique names of talented writers – creators and thinkers, who in their works reflected the philosophy of time. Based on the works of F. Schlegel, partly E. Husserl, M. Heidegger, K. Jaspers, Romanticism in the Ukrainian humanities, in terms of philosophy, culturology, as well as at the intersection with literature, was studied by T. Bovsunivska, Y. Hrybkova, S. Efremov, N. Kalenichenko, S. Kozak, T. Komarynets, D. Nalyvayko, Y. Nakhlik, I. Ogorodnyk, V. Ogorodnyk, A. Sinitsyna, D. Chyzhevsky, M. Yatsenko, E. Kyryliuk, M. Biletsky, D. Dontsov, S. Efremov, G. Kostyuk, S. Krymsky, Y. Sherekh and others. Originality. The authors of the article prove that Romanticism in Ukraine, being "literary-centric" inherently, having absorbed the main ideas and features of European Romanticism, has its own features and vectors of formation and development. Man in this kind of movement, thanks to the means of art, appears very clearly as a spiritually rich, sensitive, vulnerable and strong person. For him or her, the highest value is freedom, the ability to make freely independent fateful decisions. Conclusions. Ukrainian writers, reflecting the philosophical ideas of Romanticism, saw in man a harmonious combination of "natural" and "social", through which he indirectly carries out his own national existence. In addition to the objective realities of the external world, in their works, Romantic writers appeal to the subjective, internal, spiritual, "ideal" world of the hero, who interacts with reality through his own system of values. At each level of development of the humanities and methodology of cognition, this allows a new reading of these works. (shrink)

A successful attempt to provide an accurate, non-technical introduction to philosophy which begins with the discussion of logic, moves to epistemology and metaphysics, then takes up political philosophy, ethics, and the philosophy of religion, and concludes with a special section on contemporary philosophy. There are references throughout to philosophers, such as Malebranche and Plotinus, who are frequently neglected in introductory texts. --D. Z. L.

In a previous work [the second and the third author, “On paraconsistent deontic logic”, Philosophia 16, 293-303 (1986)] investigated certain systems of paraconsistent deontic in order to investigate the problem of contradiction in the domain of ethics. This paper continues this line of research, studying some paraconsistent systems containing alethic and deontic modalities. This approach allows us to treat the principles of Kant (OA→ \diamond A) and Hintikka (\square A → OA) from the classical and from the paraconsistent point of (...) view, and to propose systems in which either, both, or neither of these principles is valid. (shrink)

Background The prioritization protocols for accessing adult critical care in the extreme pandemic context contain tiebreaker criteria to facilitate decision-making in the allocation of resources between patients with a similar survival prognosis. Besides being controversial, little is known about the public acceptability of these tiebreakers. In order to better understand the public opinion, Quebec and Ontario’s protocols were presented to the public in a democratic deliberation during the summer of 2022. Objectives (1) To explore the perspectives of Quebec and Ontario (...) citizens regarding tiebreakers, identifying the most acceptable ones and their underlying values. (2) To analyze these results considering other public consultations held during the pandemic on these criteria. Methods This was an exploratory qualitative study. The design involved an online democratic deliberation that took place over two days, simultaneously in Quebec and Ontario. Public participants were selected from a community sample which excluded healthcare workers. Participants were first presented the essential components of prioritization protocols and their related issues (training session day 1). They subsequently deliberated on the acceptability of these criteria (deliberation session day 2). The deliberation was then subject to thematic analysis. Results A total of 47 participants from the provinces of Quebec (n = 20) and Ontario (n = 27) took part in the online deliberation. A diverse audience participated excluding members of the healthcare workforce. Four themes were identified: (1) Priority to young patients - the life cycle - a preferred tiebreaker; (2) Randomization - a tiebreaker of last resort; (3) Multiplier effect of most exposed healthcare workers - a median acceptability tiebreaker, and (4) Social value – a less acceptable tiebreaker. Conclusion Life cycle was the preferred tiebreaker as this criterion respects intergenerational equity, which was considered relevant when allocating scarce resources to adult patients in a context of extreme pandemic. Priority to young patients is in line with other consultations conducted around the world. Additional studies are needed to further investigate the public acceptability of tiebreaker criteria. (shrink)