In recent times, daily, ordinary medical practices have incontrovertibly been developing under the condition of complexity. Complexity jeopardizes the moral core of practicing medicine: helping people, with their illnesses and suffering, in a medically competent way. Practical wisdom (a modification of the Aristotelian phronèsis) has been proposed as part of the solution to navigate complexity, aiming at the provision of morally good care. Practical wisdom should help practitioners to maneuver in complexity, where the presupposed linear ways of operating prove to (...) be insufficient. However, this solution is unsatisfactory, because the proposed versions of practical wisdom are too individualistic of nature, while physicians are continuously operating in varying teams, and dealing with complicated technologies and pressing structures. A second point of critique is, that these versions are theory based, and thus insufficiently attuned to the actual context of everyday medical practices. Now, our proposal is to use an approach of practical wisdom that enables medical practices to counter the complexity issue and to re-invent the moral core of medical practicing as well. This implies a practice oriented approach, as thematized by practice theory, qualitative empirical research from the inside, and abduction from actual performed practical wisdom towards an apt understanding of phronèsis. (shrink)

The paper is devoted to the subject status of the discipline “Philosophy of Sociology”. Philosophy of sociology is an interdisciplinary direction focusing on the main preconditions of sociological knowledge development as well as cognitive value of sociological facts, theories and conceptions. Its subject can be divided into “philosophical foundations of sociology” and “philosophical problems of sociology”. “Sociologism” as the concept of substitution of social philosophy by sociology as a science which is better empirically oriented and is able to give more (...) exact and proved picture of social reality also poses danger to social philosophy. “Sociologism” presents a positivist attack on social philosophy. Indeed, sociology is no less speculative science than social philosophy is, which is well illustrated by a lot of divergences among its theoretical constructions and empirical data. The main functions of philosophy of sociology in the world of contemporary social-humanitarian knowledge are critical function, integrative function and axiological function. (shrink)

A multidisciplinary faculty committee designed a curriculum to shape biomedical graduate students into researchers with a high commitment to professionalism and social responsibility and to provide students with tools to navigate complex, rapidly evolving academic and societal environments with a strong ethical commitment. The curriculum used problem-based learning (PBL), because it is active and learner-centred and focuses on skill and process development. Two courses were developed: Scientific Professionalism: Scientific Integrity addressed discipline-specific and broad professional norms and obligations for the ethical (...) practice of science and responsible conduct of research (RCR). Scientific Professionalism: Bioethics and Social Responsibility focused on current ethical and bioethical issues within the scientific profession, and implications of research for society. Each small-group session examined case scenarios that included: (1) learning objectives for professional norms and obligations; (2) key ethical issues and philosophies within each topic area; (3) one or more of the RCR instructional areas; and (4) at least one type of moral reflection. Cases emphasised professional standards, obligations and underlying philosophies for the ethical practice of science, competing interests of stakeholders and oversight of science (internal and external). To our knowledge, this is the first use of a longitudinal, multi-semester PBL course to teach scientific integrity and professionalism. Both faculty and students endorsed the active learning approach for these topics, in contrast to a compliance-based approach that emphasises learning rules and regulations. (shrink)

The blackbody radiation field is studied from different points of view. The existence of zero-point fluctuations is shown to be crucial in determining the form of the thermal part of the spectrum. The notion of a continuous field is seen to be compatible with a discrete structure for its interaction: The description normally used in the quantum context does not refer to the field but to its interaction with atomic systems, which involves statistically independent elementary acts of absorption and emission. (...) The same classical field has different effects on absorption and on emission, and these are conveniently, but not necessarily, described in terms of non-commuting operators. (shrink)

In order to study early human development while avoiding the burdens associated with human embryo research, scientists are redirecting their efforts towards so-called human embryo-like structures (hELS). hELS are created from clusters of human pluripotent stem cells and seem capable of mimicking early human development with increasing accuracy. Notwithstanding, hELS research finds itself at the intersection of historically controversial fields, and the expectation that it might be received as similarly sensitive is prompting proactive law reform in many jurisdictions, including the (...) Netherlands. However, studies on the public perception of hELS research remain scarce. To help guide policymakers and fill this gap in the literature, we conducted an explorative qualitative study aimed at mapping the range of perspectives in the Netherlands on the creation and research use of hELS. This article reports on a subset of our findings, namely those pertaining to (the degrees of and requirements for) confidence in research with hELS and its regulation. Despite commonly found disparities in confidence on emerging biotechnologies, we also found wide consensus regarding the requirements for having (more) confidence in hELS research. We conclude by reflecting on how these findings could be relevant to researchers and (Dutch) policymakers when interpreted within the context of their limitations. (shrink)

Conceived as a set of preliminary explorations to a future study of the problem of meaning and reference by the author, these "inquiries" clarify some questions raised by the specialists in linguistics, caution us about other questions that seem only too easily settled, and generally show, with great abundance of detail, the status of contemporary research on language. Much like Husserl's Logical Investigations, which pioneered the study of correspondences between grammar and logic-ontology, these explorations proceed in a zigzag sometimes emphasizing (...) semiotic issues ; other times tackling important syntactic and semantic problems ; and once coming close to an ontological characterization of language and of the human subject insofar as it uses language. Two features of this work are noteworthy. The first is the abundance of documentation as shown in the multitude of notes: the efforts of Ferrater Mora will spare many hours of work for those who need a guide in "the labyrinth of language." A second feature is the virtuoso performance by the author in the manipulation of, and exemplifications from, a variety of languages. Indagaciones sobre el Lenguaje certainly deserves publication in English.--A. de L. M. (shrink)

BackgroundPublic health scholars have long called for preparedness to help better negotiate ethical issues that emerge during public health emergencies. In this paper we argue that the concept of ethical preparedness has much to offer other areas of health beyond pandemic emergencies, particularly in areas where rapid technological developments have the potential to transform aspects of health research and care, as well as the relationship between them. We do this by viewing the ethical decision-making process as a behaviour, and conceptualising (...) ethical preparedness as providing a health research/care setting that can facilitate the promotion of this behaviour. We draw on an implementation science and behaviour change model, COM-B, to demonstrate that to be ethically prepared requires having the capability, opportunity, and motivation to work in an ethically prepared way.MethodsWe use two case examples from our empirical research—one pandemic and one non-pandemic related—to illustrate how our conceptualisation of ethical preparedness can be applied in practice. The first case study was of the UK NHSX COVID-19 contact tracing application case study involved eight in-depth interviews with people involved with the development/governance of this application. The second case involved a complex case regarding familial communication discussed at the UK Genethics Forum. We used deductive qualitative analysis based on the COM-B model categories to analyse the transcripbed data from each case study.ResultsOur analysis highlighted that being ethically prepared needs to go beyond merely equipping health professionals with skills and knowledge, or providing research governance actors with ethical principles and/or frameworks. To allow or support these different actors to utilise their skills and knowledge, a focus on the physical and social opportunity is important, as is a better understanding the role of motivation.ConclusionsTo understand ethical preparedness, we need to view the process of ethical decision-making as a behaviour. We have provided insight into the specific factors that are needed to promote this behaviour—using examples from both in the pandemic context as well as in areas of health research and medicine where there have been rapid technological developments. This offers a useful starting point for further conceptual work around the notion of being ethically prepared. (shrink)

Marion Lee Sanders,1 Anthony James Langone2 1Department of Medicine, Division of Nephrology and Hypertension, University of Iowa, Iowa City, IA, 2Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA: Transplantation is the preferred treatment option for individuals with end-stage renal disease. Individuals who undergo transplantation must chronically be maintained on an immunosuppression regimen for rejection prophylaxis to help ensure graft survival. Current rejection prophylaxis consists of using a combination of calcineurin inhibitors, mTOR inhibitors, antimetabolite (...) agents, and/or corticosteroids. These agents have collectively improved the short-term outcomes of renal transplantation, but improvements in late/chronic graft loss and recipient survival have lagged significantly behind challenging the field of transplantation to develop novel prophylactic agents. There have been several clinical trials conducted within the last 5 years in an attempt to bring such novel agents to the commercial market. These trials have resulted in the US Food and Drug Administration approval of extended-release tacrolimus, as well as belatacept, which has the potential to replace calcineurin inhibitors for rejection prophylaxis. Other trials have focused on the development of novel calcineurin inhibitors, costimulation blockade, kinase inhibitors, and inhibitors of leukocyte migration. While these later agents have not been FDA-approved for use in transplantation, they remain noteworthy, as these agents explore pathways not previously targeted for allograft-rejection prophylaxis. The purpose of this review was to consolidate available clinical trial data with regard to the recent developments in rejection prophylaxis in kidney transplantation. Keywords: rejection, prophylaxis, immunosuppression, transplantation. (shrink)

The structure of Chiodi's book is based on Vuillemin's important hermeneutical thesis that existentialism is one more step in the program of the romantics to give an absolute foundation to finite reality through the establishment of necessary relations between subjectivity and being. These relations, once revealed, would dispel the facticity and contingency in which the natural world is enshrouded. The role of Heidegger in this tradition involves one further dialectical twist, since Heidegger centers all Western Philosophy, including his own, around (...) the problem of ground in the manner proposed by the romantics. The suggested dialectical twist is then Heidegger's Kehre, a step beyond the radical contingency of Dasein in Sein und Zeit. Indeed, this contingency, once reached, shows unequivocally the failure of the romantic program. The ground cannot be ontologically connected with any object nor with the subject; it is rather the necessary history of the ground that determines all categorial differentiations in the world, including the reflective differentiation of subject-objects. Thus it becomes important to distinguish Heidegger from Hegel since, in both, history and necessity are characteristics of the ground. Chiodi gets to the bottom of this matter by pointing to the transfer of negativity from the process of history to the end of history. For Heidegger what is necessary is the repeated withdrawal of the ground so that it may never be confused with that which is known in any revelation or through all of them. This move, though clear, would still leave a fundamental ambiguity in the later philosophy of Heidegger: language, which acts as messenger from the ground to the world, must reflect the superabundance of Being from the standpoint of the ground while it only reflects possibilities of being from the standpoint of the world. This is an ambiguity that Heidegger would want to maintain. Chiodi's interpretation of Heidegger as a neo-platonist totally destroys this ambiguity and with it the very delicate balance created by Heidegger between infinite meaning and the ability of finite words to dwell upon it.--A. de L. M. (shrink)

Background: As part of an ongoing Scandinavian project on the dignity of care for older people, this study is based on ‘clinical caring science’ as a scientific discipline. Clinical caring science examines how ground concepts, axioms and theories are expressed in different clinical contexts. Central notions are caring culture, dignity, at-home-ness, the little extra, non-caring cultures versus caring cultures and ethical context – and climate. Aim and assumptions: This study investigates the individual variations of caring cultures in relation to dignity (...) and how it is expressed in caring acts and ethical contexts. Three assumptions are formulated: (1) the caring culture of nursing homes influences whether dignified care is provided, (2) an ethos that is reflected on and appropriated by the caregiver mirrors itself in ethical caring acts and as artful caring in an ethical context and (3) caring culture is assumed to be a more ontological or universal concept than, for example, an ethical context or ethical person-to-person acts. Research design: The methodological approach is hermeneutic. The data consist of 28 interviews with relatives of older persons from Norway, Denmark and Sweden. Ethical considerations: The principles of voluntariness, confidentiality and anonymity were respected during the whole research process. Findings: Three patterns were revealed: dignity as at-home-ness, dignity as the little extra and non-dignifying ethical context. Discussion: Caring communion, invitation, at-home-ness and ‘the little extra’ are expressions of ethical contexts and caring acts in a caring culture. A non-caring culture may not consider the dignity of its residents and may be represented by routinized care that values organizational efficiency and instrumentalism rather than an individual’s dignity and self-worth. Conclusion: An ethos must be integrated in both the organization and in the individual caregiver in order to be expressed in caring acts and in an ethical context that supports these caring acts. (shrink)

Modern microscopic theory is employed to construct a powerful analytical algorithm that permits a clear description of characteristic features of strongly correlated quantum fluids in thermodynamic equilibrium. Using recently developed formal results we uncover an intricate relationship between strongly correlated systems and free quantum gases of appropriately defined constituents. The latter entities are precisely defined renormalized bosons or fermions. They carry all the information contained in the statistical correlations of the strongly interacting many-particle system by virtue of their effective masses. (...) The mass of such a renormalized boson or fermion depends in a specific form on temperature, bulk particle number density of the many-body system, and eventually on momentum. Due to these properties the renormalized bosons and fermions determine in particular the location and nature of the transition to non-normal phases. (shrink)

To investigate the current status of hospital clinical ethics committees (CEC) and how they have evolved in Canada over the past 20 years, this paper presents an overview of the findings from a 2008 survey and compares these findings with two previous Canadian surveys conducted in 1989 and 1984. All Canadian hospitals over 100 beds, of which at least some were acute care, were surveyed to determine the structure of CEC, how they function, the perceived achievements of these committees and (...) opinions about areas with which CEC should be involved. The percentage of hospitals with CEC in our sample was found to be 85% compared with 58% and 18% in 1989 and 1984, respectively. The wide variation in the size of committees and the composition of their membership has continued. Meetings of CEC have become more regularised and formalised over time. CEC continue to be predominately advisory in their nature, and by 2008 there was a shift in the priority of the activities of CEC to meeting ethics education needs and providing counselling and support with less emphasis on advising about policy and procedures. More research is needed on how best to define what the scope of activities of CEC should be in order to meet the needs of hospitals in Canada and elsewhere. More research also is needed on the actual outcomes to patients, families, health professionals and organisations from the work of these committees in order to support the considerable time committee members devote to this endeavour. (shrink)

Context The attitudes of medical professionals towards physician assisted dying have been widely discussed. Less explored is the level of agreement among physicians on the possibility of ‘rational suicide’—a considered suicide act made by a sound mind and a precondition of assisted dying legislation. Objective To assess attitudes towards rational suicide in a representative sample of senior doctors in England and Wales. Methods A postal survey was conducted of 1000 consultants and general practitioners randomly selected from a commercially available database. (...) The main outcome of interest was level of agreement with a statement about rational suicide. Results The corrected participation rate was 50%; 363 questionnaires were analysed. Overall 72% of doctors agreed with the possibility of rational suicide, 17% disagreed, and 11% were neutral. Doctors who identified themselves as being more religious were more likely to disagree. Some doctors who disagreed with legalisation of physician assisted suicide nevertheless agreed with the concept of rational suicide. Conclusions Most senior doctors in England and Wales feel that rational suicide is possible. There was no association with specialty. Strong religious belief was associated with disagreement, although levels of agreement were still high in people reporting the strongest religious belief. Most doctors who were opposed to physician assisted suicide believed that rational suicide was possible, suggesting that some medical opposition is best explained by other factors such as concerns of assessment and protection of vulnerable patients. (shrink)

Objectives To investigate empirically the motivations for not consenting to DNA biobanking in a Swedish population-based study and to discuss the implications. Design Structured questionnaires and semistructured interviews. Setting A longitudinal epidemiological project (PART) ongoing since 1998 in Stockholm, Sweden. The DNA-collection wave took place during 2006–7. Participants 903 individuals completed the questionnaire (participation rate 36%) and 23 were interviewed. All individuals had participated in both non-genetic waves of the project, but refused to contribute saliva samples during the DNA-collection wave. (...) Main outcome measures Motivations behind refusing to consent to DNA biobanking, with subsequent focus on participants' explanations regarding this unwillingness. Results Public refusal to consent to DNA biobanking, as revealed by the questionnaire, was mainly explained by a lack of personal relevance of DNA contribution and feelings of discomfort related to the DNA being used for purposes other than the respective study. Interviews of individuals representing the second motivation, revealed a significant mistrust of DNA biobank studies. The underlying beliefs and attitudes were associated with concerns about integrity, privacy, suspiciousness and insecurity. However, most interviewees were supportive of genetic research per se and interpreted their mistrust in the light of distressing environmental influences. Conclusion The results suggest a need for guidelines on benefit sharing, as well as trustworthy and stable measures to maintain privacy, as a means for increasing personal relevance and trust among potential participants in genetic research. Measures taken from biobanks seem insufficient in maintaining and increasing trust, suggesting that broader societal measures should be taken. (shrink)

Karl Popper’s falsificationist epistemology that all knowledge advances through a process of conjectures and refutations carries profound implications for politics and education. In this article, I first argue that, on a political level, it is necessary to establish and maintain an open society by fostering not only five core values, viz. freedom, tolerance, respect, rationalism, and equalitarianism, but also three crucial practices, viz. democracy, state interventionism, and piecemeal social engineering. Then, considering that an open society places great political, and thus (...) educational, demands upon its members, I examine the role played by education in its establishment and maintenance, focusing on its educational aims, curriculum, and pedagogy. (shrink)

Mishel Fuco not only influenced the consciousness of modern West, but changed the modus of thinking, the way of perception of many traditional notions, transformed the opinions about the reality, history, person. Philosopher’s principle research programme which attaches the entirety to his works is “archeology of knowledge” programme, the search of human knowledge’s original layers. Let us mark that all Fuco’s works in 1960s are devoted to main aim: to clear up the conditions of historical origin of different mental aims (...) and social institutions in the culture of the Modern Time. Though in the whole this common aim remained for Fuco invariable, but the level on which he realizes his research search is changing constantly and rather logically. Relations of power, and to be more exact,accumulations of power and knowledge, social and cognitive which define all the aggregate of specific possibilities of culture in each given historical period. More than that the philosopher offers the particular prospects of sight of modern society and precisely totality of power relations, its ubiquitous nature and specific productivity which produces itself in each moment in any point or rather in any attitude from one point to another. From Fuco’s point of view the power is everywhere and not because it involves everything but because it comes from everywhere. The power is productive in that degree in which it is not associated with one definite imperious instance but pierces all kinds of activity in society, putting on its indelible stamp, developing under definite angle and due to this factit causes products, produced by them. The power induces and at the same time determines the fact which appears as a result of its inducement. The thirst of supremacy, which surrounds the individual and is focused on it as on the center of its use of force, comes out as a defining sign. It should be noticed that Fuco’s conception of power is not reduced to the understanding it as anonymous impersonal net of relations, piercing all society. It is supplemented by power treatment,coming out in “designed” look of definite imperious structure or imperious institute. (shrink)

This study examines the frequency of consanguineous marriage and the coefficient of inbreeding in the United Arab Emirates. The study was conducted in Al Ain and Dubai cities between October 1994 and March 1995. A sample of 2033 married UAE females aged 15 years and over participated. The degree of consanguinity between each female and her spouse, and the degree of consanguinity between their parents were recorded. The rate of consanguinity in the present generation was high with a coefficient of (...) inbreeding of 0·0222. The commonest type of consanguineous marriage was between first cousins. Double first cousin marriages were common compared to other populations. The consanguinity rate in the UAE has increased from 39% to 50·5% in one generation. The level of consanguinity was higher in Al Ain than in Dubai. (shrink)

INDICE -/- Note biografiche Introduzione, di Riccardo Faucci -/- Parte I - Da Verri a Toniolo 1. Jeremy Bentham: Contemporary Interpretations, di M.D.A. Freeman 2. Su Helvétius, Beccaria e Bentham, di Letizia Gianformaggio 3. L'etica utilitaristica di Pietro Veti, di Vincenzo Polignano 4. ll liberismo interventista di Vincenzo Emanuele Sergio, di Anna Li Donni 5. Il concetto di " felicità pubblica, nella << Genesi del diritto penale » di Romagnosi, e il rapporto Romagnosi-Bentham, di Robertino Ghiringhelli 6. « La più (...) grande felicità per il maggior numero » all'Accademia dei Georgofili ( 18)0-1850), di Gabriella Gioli 7. Una nota su Manzoni critico dell'utilitarismo, di Maurizio Mori 8. Sul concetto di utile in Francesco Ferrara e in Maffeo Pantaleoni, di Daniela Parisi Acquaviva 9. Sul pensiero sociale cristiano di fronte all'edonismo, di Luciano Avagliano 10. Giuseppe Toniolo e il recupero cattolico dell'utile e del valore, di Anna Camaiti -/- Parte II Aspetti di storia del pensiero economico nell’età classica -/- 1. La filosofia economica di Thomas Hobbes, di Marco Bertozzi 2. Ordinamento del sapere, modelli metodologici ed economia politica in Adam Smith, di Sergio Cremaschi 3. Elementi classici nel pensiero di Adam Smith: giurisprudenza romana e morale stoica, di Gloria Vivenza 4. Il “lusso” negli economisti italiani del Settecento, di Cosimo Perrotta 5. Prezzi naturali, prezzi di mercato e legge degli sbocchi nel dibattito fra Malthus e Ricardo, di Lilia Costabile 6. Marx e la moneta, di Roberto Petrini -/- . (shrink)