Background Ethically, informed consent regarding randomised controlled trials (RCTs) should be understandable to patients. The patients can then give free consent or decline to participate in a RCT. Little is known about what patients really understand in consultations about RCTs. Methods Cancer patients who were asked to participate in a randomised trial were surveyed using a semi-standardised interview developed by the authors. The interview addresses understanding, satisfaction and needs of the patients. The sample included eight patients who participated in a (...) trial and two who declined. The data were analysed on the basis of Mayring's qualitative analysis. Results Patients' understanding of informed consent was less developed than anticipated, especially concerning key elements such as randomisation, content and procedure of RCTs. Analysing the result about satisfaction of the patients, most of the patients described their consultations as hectic and without advance notice. Health limitations due to cancer played a decisive role. However, most of the patients perceived their physician to be sympathetic. Analysing the needs of patients, they ask for a clear informed consent consultation with enough time and adequate advance notice. Conclusion This study fills an important empirical research gap of what is ethically demanded in an RCT consultation and what is really understood by patients. The qualitative approach enabled us to obtain new results about cancer patients' understanding of informed consent, to clarify patients' needs and to develop new ideas to optimise the informed consent. (shrink)

Behrendt & Young (B&Y) propose that a dysfunction in the reticular thalamic nucleus contributes to disinhibition of specific thalamic nuclei, allowing cortical attention mechanisms to engage thalamic relay neurons, causing underconstrained activation of the cortex and hallucinations. The following hypothesis challenges the notion of impaired sensory gating by providing the alternative view that hypofrontality reduces the power of incoming stimuli, causing internal drives to override consciousness, resulting in hallucinations.

Background: The increase in medical ethical regulations and bureaucracy handled by institutional review boards and healthcare institutions puts the researchers using qualitative methods in a challenging position. Method: Based on three different cases from three different research studies, the article explores and discusses research ethical dilemmas. Objectives and ethical considerations: First, and especially, the article addresses the challenges for gatekeepers who influence the informant’s decisions to participate in research. Second, the article addresses the challenges in following research ethical guidelines related (...) to informed consent and doing no harm. Third, the article argues for the importance of having research ethical guidelines and review boards to question and discuss the possible ethical dilemmas that occur in qualitative research. Discussion and conclusion: Research ethics must be understood in qualitative research as relational, situational, and emerging. That is, that focus on ethical issues and dilemmas has to be paid attention on the spot and not only at the desktop. (shrink)

Theories of truth and vagueness are closely connected; in this article, I draw another connection between these areas of research. Gupta and Belnap’s Revision Theory of Truth is converted into an approach to vagueness. I show how revision sequences from a general theory of definitions can be used to understand the nature of vague predicates. The revision sequences show how the meaning of vague predicates are interconnected with each other. The approach is contrasted with the similar supervaluationist approach.

The legal requirements and justifications for collecting patient-identifiable data without patient consent were examined. The impetus for this arose from legal and ethical issues raised during the development of a population-based disease register. Numerous commentaries and case studies have been discussing the impact of the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. But uncertainty still remains about the legal requirements for processing patient-identifiable data without patient consent for research purposes. This is (...) largely owing to ignorance, or misunderstandings of the implications of the common law duty of confidentiality and section 60 of the Health and Social Care Act 2001. The common law duty of confidentiality states that patient-identifiable data should not be provided to third parties, regardless of compliance with the DPA1998. It is an obligation derived from case law, and is open to interpretation. Compliance with section 60 ensures that collection of patient-identifiable data without patient consent is lawful despite the duty of confidentiality. Fears regarding the duty of confidentiality have resulted in a common misconception that section 60 must be complied with. Although this is not the case, section 60 support does provide the most secure basis in law for collecting such data. Using our own experience in developing a disease register as a backdrop, this article will clarify the procedures, risks and potential costs of applying for section 60 support. (shrink)

Rawlsians argue for principles of justice that apply exclusively to the basic structure of society, but it can seem strange that those who accept these principles should not also regulate their choices by them. Valid moral principles should seemingly identify ideals for both institutions and individuals. What justifies this nonintuitive distinction between institutional and individual principles is not a moral division of labor but Rawls’s dual commitments to conventionalism and constructivism. Conventionalism distinguishes the relevant ideals for evaluating institutions from those (...) for evaluating actions, while constructivism explains why this distinction is morally fundamental. (shrink)

Psychologist Eugene C. Goldfield offers an exciting new theoretical framework--based, in part, on the concept of self-organization--that promises to aid researchers in their quest to discover the underlying origins and process of behavioral development.

Patients with 'persistent vegetative state' (PVS) are often cited in the discussions of ethicists as examples of human beings who are unconscious and do not experience life, and a number of theoretical and practical recommendations have been made on that basis. This article examines the evidence and the theoretical rationale for the belief that people with PVS are unconscious and finds them wanting. This conclusion is related to the practice of the discipline of ethics.

We give a short, critical review of the issue of decoherence. We estab- lish the most general framework in which decoherence can be discussed, how it can be quantified and how it can be measured. We focus on environment induced decoher- ence and its degree of usefulness for the interpretation of quantum theory. We finally discuss the emergence of a classical world. An overall emphasis is given in pointing at common fallacies and misconceptions.

Despite the prominence of healthcare-relatedconcerns in public debate, the ground remainsinfertile for the idea of conscripting citizensinto medical research. Reluctance to entertainthe thought of a system where nearly everyonecould be selected for service might reflectuncertainty about what the project wouldinvolve. There might also be a fear that themore crucial issue is how to protect researchsubjects within current, voluntary systems. Nodoubt reluctance to explore a system ofuniversal service results from the common hopethat each of us might avoid research in anycapacity besides (...) researcher. A system of fullcivic participation might, however, avoid manyof the usual objections. Ethics regulations,including informed-consent guidelines, couldfor the most part remain in force. Though thesystem would compel people to serve, it couldremain responsive to principles of autonomy andjustice if it centered on broad publiceducation, community representation, and alottery-type selection process. The systemcould draw from the largest possiblecross-section of society, and offer conscriptsthe widest possible range of service. In thisway, a compulsory system might reconcile theexpectations about healthcare with researchneeds. (shrink)

De generationewas the last of the three works published by William Harvey during his lifetime. Although this work on generation was most ambitious, being the product of prolonged and detailed researches, it has received relatively little attention from modern writers. It is generally felt that this work, like William Gilbert'sDe mundo, departs significantly from the more pronounced empirical approach to science which characterized Harvey's first publication,De motu cordis. De generationeshows that Harvey regarded reference to teleological and vitalistic principles as necessary (...) for the solution of crucial problems in biology. In this respect he differed from his contemporaries, the iatrochemical and iatromechanical physiologists, whose non-teleological approach seems, at least superficially, to be in sympathy with the modern biological tradition. The structure and content ofDe generationeare so evidently determined by Aristotle's biological writings, that the work is used to illustrate Harvey's failure to emancipate himself from the philosophical encumbrances of antiquity. (shrink)

An appropriate combination of Quine’s ontology and Frege’s semantics is useful to emphasize the empirical entities “ethnic group” and “nation” expressed through an axiomatic system. If “cultural diversity” is taken as a primitive because it is good ethically and it is beautiful esthetically, then “internationalist nationalism” is the correct order of human society from a political point of view.

In Defense of Utilitarianism, C.L. Sheng provides a more intensive study of the Unified Utilitarian Theory , which he proposed in his previous work A New Approach to Utilitarianism . Sheng defends utilitarianism, particularly UUT, against the objections and attacks raised by nonutilitarians, showing it to be a viable ethical theory.

C. Fred Alford interviewed working people, prisoners, and college students in order to discover how people experience evil -- in themselves, in others, and in ...

The elegiac poem of eight lines discovered in the Ceramicus and published by by W. Peek is of considerable interest for the historian. Peek is surely right in maintaining that it was composed for the Athenians who fell under Tolmides at Coronea in 447 B.C., and his general exposition of the poem's meaning is convincing. The aim of this paper is to make some comments and supplements to his interpretation and then to consider some peculiarities in the thought and technique (...) of the poem. We may first set out a text and a translation:λμονες ℎοῖον γṑνα μχες ελσανες λπ[ο]φσχς δαιμονṐς ṑλσα' μ πολμοισὐν κακι χσετλελεσσε βροοῖσι δ πσι λοιπνφρζεσθαι λογṐν πιοσν ἔθκε λος. (shrink)

I Want to discuss and illustrate in this paper certain fallacies which we are all very liable to commit in our thinking about political and social questions. Perhaps “thinking” is rather too high-sounding a name to attach to the mental processes which lie behind most political talk. It is at any rate thinking of a very low grade, for a considerable proportion of such discussion in Press and Parliament and private conversation hardly rises above the intellectual level of disputes between (...) boys at a preparatory school. (shrink)