Background Biobank participants often do not understand much of the information they are provided as part of the informed consent process, despite numerous attempts at simplifying consent forms and improving their readability. We report the first assessment of biobank enrollees’ comprehension under an "integrated consent” process, where patients were asked to enroll in a research biobank as part of their normal healthcare experience. A number of healthcare systems have implemented similar integrated consent processes for biobanking, but it is unknown how (...) much patients understand after enrolling under these conditions. Methods: We recruited patients who enrolled in a biobank while in a healthcare setting when receiving ordinary care. We assessed knowledge of consent materials using 11 true/false questions drawn from a well-known biobank knowledge test. After reviewing the results from 114 participants, we revised the consent form and repeated the knowledge assessment with 144 different participants. Results: Participants scored poorly on the knowledge test in both rounds, with no significant differences in overall scores or individual items between the rounds. In Phase 1, participants answered 53% of the questions correctly, 25% incorrectly, and 22% “I don’t know.” In Phase 2, participants answered 53% of questions correctly, 24% incorrectly, and 23% “I don’t know.” Participants scored particularly poorly on questions about data sharing and accessing medical records. Conclusions: Enrollees under an integrated consent model had significant misunderstandings that persisted despite an attempt to improve information specifically about those topics in a consent form. These results raise challenges for current approaches that attribute misunderstanding to overly complex consent forms. They also suggest that the pressures of the clinic may compound other problems with patient understanding of biobank consent. As health systems increasingly blend research and care, they may need to rethink their approach to educating patients about participation in a biobank. (shrink)

Realists about universals face a question about grounding. Are things how they are because they instantiate the universals they do? Or do they instantiate those universals because they are how they are? Take Ebenezer Scrooge. You can say that Scrooge is greedy because he instantiates greediness, or you can say that Scrooge instantiates greediness because he is greedy. I argue that there is reason to prefer the latter to the former. I develop two arguments for the view. I also respond (...) to some concerns one might have about the view defended. I close by showing that analogous views regarding the truth of propositions and the existence of facts are supported by analogs of one of these arguments. (shrink)

This paper introduces a logical analysis of convex combinations within the framework of Łukasiewicz real-valued logic. This provides a natural link between the fields of many-valued logics and decision theory under uncertainty, where the notion of convexity plays a central role. We set out to explore such a link by defining convex operators on MV-algebras, which are the equivalent algebraic semantics of Łukasiewicz logic. This gives us a formal language to reason about the expected value of bounded random variables. As (...) an illustration of the applicability of our framework we present a logical version of the Anscombe–Aumann representation result. (shrink)

The variety DMM of De Morgan monoids has just four minimal subvarieties. The join-irreducible covers of these atoms in the subvariety lattice of DMM are investigated. One of the two atoms consisting of idempotent algebras has no such cover; the other has just one. The remaining two atoms lack nontrivial idempotent members. They are generated, respectively, by 4-element De Morgan monoids C4 and D4, where C4 is the only nontrivial 0-generated algebra onto which finitely subdirectly irreducible De Morgan monoids may (...) be mapped by noninjective homomorphisms. The homomorphic preimages of C4 within DMM constitute a proper quasivariety, which is shown to have a largest subvariety U. The covers of the variety within U are revealed here. There are just ten of them. In exactly six of these ten varieties, all nontrivial members have C4 as a retract. In the varietal join of those six classes, every subquasivariety is a variety—in fact, every finite subdirectly irreducible algebra is projective. Beyond U, all covers of [or of ] within DMM are discriminator varieties. Of these, we identify infinitely many that are finitely generated, and some that are not. We also prove that there are just 68 minimal quasivarieties of De Morgan monoids. (shrink)

In this paper I want to suggest that, while the argued philosophical distinction between logic, epistemolgoy and ontology is one of the many achievements of Aristotle, his predecessor Parmenides was in fact already operating with a theory of knowledge and an elementary propositional logic that are of abiding philosophical interest. As part of the thesis I shall be obliged to reject a number of interpretations of particular passages in his poem, including one or two currently fashionable ones. Since so much (...) turns on points of translation, I note for purposes of comparison what seem to be significant alternatives to my own in any particular instance. The line numbers are those of the DK text. (shrink)

I argue here that in the end Bourdieu's theory of practice fails to overcome the problem on which it expressly centers, namely, subject-object dualism. The failure is registered in his avowed materialism, which, though significantly "generalized," remains what it says: a materialism. In order to substantiate my criticism, I examine for their ontological presuppositions three areas of his theoretical framework pertaining to the questions of (1) human agency (as seen through the conceptual glass of the habitus), (2) otherness, and (3) (...) the gift. By scrutinizing Bourdieu's powerful and progressive social theory, with an eye to finding fault, I hope to show the need to take a certain theoretical action, one that is patently out of keeping with the usual self-presentation and self-understanding of social science. The action I have in mind is this: because the problem of subject-object dualism is in the first place a matter of ontology, in order successfully to address it there must take place a direct shift of ontological starting point, from the received starting point in Western thought to one that projects reality in terms of ambiguity that is basic. With this shift the dualism of subject and object dissolves by definition, leaving a social reality that, for reasons of its basic ambiguity, is best approached as a question of ethics before power. (shrink)

In his investigation of the concept of "Being", Aristotle relates the question of "existence" to the question "essence" and considers essence as "whatness" and quiddity. Although in his logical discussions he treats the concepts of "existence" and "whatness" separately and makes a distinction between them, but does not extend this distinction to the area of philosophical topics. But in the prepatetic Islamic system of Philosophy, explanation and distinction between "Being" and "quidity" is without doubt one of the most fundamental philosophical (...) doctrines and beliefs. In the history of Islamic philosophy, the theory of metaphysical distinction between being and essence has been attributed to Ibn Sina, but it is Farabi who for the first time has propounded clearly and decisively a two – part division between "being" and "quiddity" and has prepared the way for Avecinian philosophy. In addition to his logical distinction between "existence" and "whatness" of things he has stressed on a metaphysical distinction between them and has made this distinction the foundation of his metaphysical system. From Farabi's view, being is an inherent accident of quiddity. In this article we try to explain the concepts of "existence" and "whatness" of things and their relation as one of the most fundamental topics in prepatetic philosophy in the philosophical thought of these two great prepatetic philosophers, ie Aristotle and Farabi, with specific stress on comparing their views. (shrink)

Controversy over providing financial incentives to research participants has a long history and remains an issue of contention in both current discussions about research ethics and for institutional review bodies/human research ethics committees which are charged with the responsibility of deciding whether such incentives fall within ethical guidelines. The arguments both for and against financial incentives have been well aired in the literature. A point of agreement for many is that inducement in the form of financial incentive is permissible when (...) the risk of harm to the individual is negligible in terms of degree and probability of occurrence. In the absence of harm to the individual, encouraging more people to participate in research would appear to be a good thing in so far as it will lead to statistically more robust research outcomes, which can then be translated into better healthcare and other practice. Whilst, on the face of it, this position seems highly defensible, I will explore the possibility that it is counterproductive – that is, providing individuals with financial incentives to become research participants may have the unintended outcome of reducing participation rates in some areas of research. In exploring this idea I will draw on empirical findings from the literature on crowding-out – the hypothesis that providing monetary incentives to people can backfire by overall reducing intrinsic motivation, in this instance intrinsic motivation to behave altruistically or undertake civic duties. (shrink)

al-juzʼ 1. Kitāb al-maqūlāt wa-kitāb al-ʻibārah.

Codes of medical ethics issued by professional organizations typically contain statements affirming the importance of confidentiality between patients and health-care practitioners. Seldom, however, is the confidentiality obligation depicted as absolute. Instead, exceptions are noted, the most common of which is that health-care professionals are justified in breaching the confidence of a patient if required by law to do so. Reasons that might be given to support this exception are critically discussed in this paper. The conclusion argued for is that this (...) is not a legitimate exception to the confidentiality rule. (shrink)

In spite of their drastically different historical trajectories, the ongoing socio-political transition in the European Union (EU) and the Indian Republic (IR), two of the most complex polities in contemporary world, suggests that they aspire to combine political federalism and cultural pluralism. This is evident from their endorsing equality, identity and inclusivity as values; implementing political decentralization and facilitating differentiation between state, civil society and market. To meet the emerging challenges both the EU and the IR endorse the idea of (...) unity in diversity. The article suggests that two coping strategies, transforming cultural diversity (a fact) into cultural pluralism (a value) and decoupling the identities of citizenship and nationality are imperatives. (shrink)