Pragmatism is a distinctive approach to clinical research ethics that can guide bioethicists and members of institutional review boards (IRBs) as they struggle to balance the competing values of promoting medical research and protecting human subjects participating in it. After defining our understanding of pragmatism in the setting of clinical research ethics, we show how a pragmatic approach can provide guidance not only for the day-to-day functioning of the IRB, but also for evaluation of policy standards, such as the one (...) that addresses acceptable risks for healthy children in clinical research trials. We also show how pragmatic considerations might influence the debate about the use of deception in clinical research. Finally, we show how a pragmatic approach, by regarding the promotion of human research and the protection of human subjects as equally important values, helps to break down the false dichotomy between science and ethics in clinical research. (shrink)

Rachlin's substantive points about the relationship between altruism and self-control are obscured by simplistic and outdated portrayals of evolutionary psychology in relation to learning theory.

The use of upper limb vibration during exercise and rehabilitation continues to gain popularity as a modality to improve function and performance. Currently, a lack of knowledge of the pathways being altered during ULV limits its effective implementation. Therefore, the aim of this study was to investigate whether indirect ULV modulates transmission along spinal and corticospinal pathways that control the human forearm. All measures were assessed under CONTROL and ULV conditions while participants maintained a small contraction of the right flexor (...) carpi radialis muscle. To assess spinal pathways, Hoffmann reflexes elicited by stimulation of the median nerve were recorded from FCR with motor response amplitudes matched between conditions. An H-reflex conditioning paradigm was also used to assess changes in presynaptic inhibition by stimulating the superficial radial nerve 37 ms prior to median nerve stimulation. Cutaneous reflexes in FCR elicited by stimulation of the SR nerve at the wrist were also recorded. To assess corticospinal pathways, motor evoked potentials elicited by transcranial magnetic stimulation of the contralateral motor cortex were recorded from the right FCR and biceps brachii. ULV significantly reduced H-reflex amplitude by 15.7% for both conditioned and unconditioned reflexes. Therefore, ULV inhibits cutaneous and H-reflex transmission without influencing corticospinal excitability of the forearm flexors suggesting increased presynaptic inhibition of afferent transmission as a likely mechanism. A general increase in inhibition of spinal pathways with ULV may have important implications for improving rehabilitation for individuals with spasticity. (shrink)

Christian health care professionals in our secular and pluralistic society often face uncertainty about the place religious faith holds in today's medical practice. Through an examination of a virtue-based ethics, this book proposes a theological view of medical ethics that helps the Christian physician reconcile faith, reason, and professional duty. Edmund D. Pellegrino and David C. Thomasma trace the history of virtue in moral thought, and they examine current debate about a virtue ethic's place in contemporary bioethics. Their proposal (...) balances theological ethics, based on the virtues of faith, hope, and charity, with contemporary medical ethics, based on the principles of beneficence, justice, and autonomy. The result is a theory of clinical ethics that centers on the virtue of charity and is manifest in practical moral decisions. Using Christian bioethical principles, the authors address today's divisive issues in medicine. For health care providers and all those involved in the fields of ethics and religion, this volume shows how faith and reason can combine to create the best possible healing relationship between health care professional and patient. (shrink)

This book updates and adds to the classic Social Movements of the Sixties and Seventies, showing how social movement theory has grown and changed.

Exploring the moral foundations of the healing relationship, Edmund D. Pellegrino and David C. Thomasma offer the health care professional a highly readable Christian philosophy of medicine. This book examines the influence religious beliefs have on the kind of person the health professional should be, on the health care policies a society should adopt, and on what constitutes healing in its fullest sense. Helping and Healing looks at the ways a religious perspective shapes the healing relationship and the ethics (...) of that relationship. Pellegrino and Thomasma seek to clarify the role of religious belief in health care by providing a moral basis for such commitment as well as a balancing role for reason. This book establishes a common ground for believers and skeptics alike in their dedication to relieve suffering by showing that helping and healing require an involvement in the religious values of patients. It clearly argues that religion provides crucial insights into medical practice and morality that cannot be ignored, even in our morally heterogeneous society. Central to the authors' message is the concept of patients' vulnerabilities and the need to help them recover not only from the disease but also from an existential assault on their personhood. They then show how this understanding can move caregivers to view their professions as vocations and thereby change the nature of health care from a business to a community of healing. Physicians, nurses, administrators, clergy, theologians, and other health professionals and church leaders will find this volume helpful for their own reflections on the role of religion in the health care ministry and for making a religious commitment integral to their professional lives. (shrink)

Varieties of Ethical Reflection brings together new cultural and religious perspectives—drawn from non-Western, primarily Asian, philosophical sources—to globalize the contemporary discussion of theoretical and applied ethics.

David Miller is the foremost exponent of the purist critical rationalist doctrine and here presents his mature views, discussing the role that logic and argument play in the growth of knowledge, criticizing the common understanding of argument as an instrument of justification, persuasion or discovery and instead advocating the critical rationalist view that only criticism matters. Miller patiently and thoroughly undoes the damage done by those writers who attack critical rationalism by invoking the sterile mythology of induction (...) and justification that it seeks to sweep away. In addition his new material on the debate on verisimilitude is essential reading for all working in this field. (shrink)

Newton’s argument for universal gravitation in the Principia eventually rested on the third “Rule of Philosophizing,” which warrants the generalization of “qualities of bodies.” An analysis of the rule and the history of its development indicate that the term ‘quality’ should be taken to include both inherent properties of bodies and relations among systems of bodies, generalized into `laws'. By incorporating law‐induction into the rule, Newton could legitimately rebuff objections to his theory by claiming that universal gravitation was justified by (...) his method even if he could not specify the cause of gravity . †To contact the author, please write to: Department of Philosophy, Duke University, 201 West Duke Building, Box 90743, Durham, NC 27708; e‐mail: david.m.miller@duke.edu. (shrink)

David Miller elegantly and provocatively reformulates critical rationalism—the revolutionary approach to epistemology advocated by Karl Popper—by answering its most important critics. He argues for an approach to rationality freed from the debilitating authoritarian dependence on reasons and justification. "Miller presents a particularly useful and stimulating account of critical rationalism. His work is both interesting and controversial... of interest to anyone with concerns in epistemology or the philosophy of science." —Canadian Philosophical Reviews.

The democratic boundary problem arises because it appears that the units within which democratic decision procedures will operate cannot themselves be constituted democratically. The study argues that setting the boundaries of democracy involves attending simultaneously to three variables: domain (where and to whom do decisions apply), constituency (who is entitled to be included in the deciding body) and scope (which issues should be on the decision agenda). Most of the existing literature has focussed narrowly on the constituency question, endorsing either (...) the All‐Affected Interests Principle or the All Subjected Principle, but neither is satisfactory as a general solution. In particular, the former fails to explain why having interests at stake in a decision necessarily gives you the right to participate in making it, and the latter, although more plausible on that count, assumes that the domain and scope issues have already been settled. To make progress, we need to bring democratic values to bear on the boundary problem. The units we favour should be those that are likely to promote political equality and solidarity among members of the demos. Although this approach will often justify existing territorial states as sites of democracy, it can also generate arguments for making boundary changes along one or other dimension. (shrink)

The paper begins by locating the issue of trade within the broader literature on international and global justice. It then sets out eight different conceptions of ‘fair trade’, and examines the principles that lie behind them. They fall into three broad categories: procedural fairness accounts, which apply principles of equal treatment to the international rules under which trade takes place; producers’ entitlement accounts, which claim that trade must be structured so that all participants are safeguarded against harms such as exploitation (...) or poverty; and fair exchange accounts, which require trade to be conducted on terms that produce a particular division of resources or benefits between the trading partners. These conceptions are partly complementary, but may on occasion pull in different directions, requiring us to reflect on the relative weights we attach to different aspects of fairness in trade. (shrink)

This article attacks the view that global justice should be understood in terms of a global principle of equality. The principle mainly discussed is global equality of opportunity – the idea that people of similar talent and motivation should have equivalent opportunity sets no matter to which society they belong. I argue first that in a culturally plural world we have no neutral way of measuring opportunity sets. I then suggest that the most commonly offered defences of global egalitarianism – (...) the cosmopolitan claim that human lives have equal value, the argument that a persons nationality is a morally arbitrary characteristic, and the more empirical claim that relationships among fellow-nationals are no longer special in a way that matters for justice – are all defective. If we fall back on the idea of equality as a default principle, then we have to recognize that pursuing global equality of opportunity systematically would leave no space for national self-determination. Finally, I ask whether global inequality might be objectionable for reasons independent of justice, and argue that the main reason for concern is the inequalities of power that are likely to emerge in a radically unequal world. (shrink)

This distinctive collection of original articles features contributions from many of the leading scholars of ancient Greek philosophy. They explore the concept of reason and the method of analysis and the central role they play in the philosophies of Socrates, Plato, and Aristotle. They engage with salient themes in metaphysics, epistemology, ethics, and political theory, as well as tracing links between each thinker’s ideas on selected topics. The volume contains analyses of Plato’s Socrates, focusing on his views of moral psychology, (...) the obligation to obey the law, the foundations of politics, justice and retribution, and Socratic virtue. On Plato’s Republic, the discussions cover the relationship between politics and philosophy, the primacy of reason over the soul’s non-rational capacities, the analogy of the city and the soul, and our responsibility for choosing how we live our own lives. The anthology also probes Plato’s analysis of logos which underlies his philosophy including the theory of forms. A quartet of reflections explores Aristotelian themes including the connections between knowledge and belief, the nature of essence and function, and his theories of virtue and grace. The volume concludes with an insightful intellectual memoir by David Keyt which charts the rise of analytic classical scholarship in the past century and along the way provides entertaining anecdotes involving major figures in modern academic philosophy. Blending academic authority with creative flair and demonstrating the continuing interest of ancient Greek philosophy, this book will be a valuable addition to the libraries of all those studying and researching the origins of Western philosophy. (shrink)

: Recent controversial decisions to terminate several large clinical trials have called attention to the need for developing a sound ethical framework to determine when trials should be stopped in light of emerging efficacy data. Currently, the fundamental rationale for stopping trials early is based on the principle that equipoise has been disturbed. We present an analysis of the ethical and practical problems with the "equipoise disturbed" position and describe an alternative ethical framework based on the principle of nonexploitation. This (...) framework acknowledges the need for balancing the dual ethical obligations of clinical research, the protection of human subjects and the generation of new medical knowledge. Based on this framework, we put forward a proposal to make early stopping guidelines more stringent under specified conditions. The temporary withholding of apparent benefits in certain circumstances is justified by achieving a fair contract with the research participants, one that protects them from undue harm and exploitation while reducing the many uncertainties surrounding new investigational treatments that arise when trials are stopped prematurely. (shrink)

Can we conceive of a market economy that fulfils the ideals of socialism? In this book, David Miller provides a comprehensive examination, from the standpoint of political theory, of an economy in which market mechanisms retain a central role, but in which capitalist patterns of ownership have been superseded.

lecting statistics about missing bindings and macros, and other errors. This guides debugging and development efforts, leading to iterative improvements in both the tools and the quality of the converted corpus. The build system thus serves as both a production conversion engine and software test harness. We have now processed the complete arχiv collection through 2006 consisting of more than 400,000 documents (a complete run is a processor-yearsize undertaking), continuously improving our success rate. We are now able to convert more (...) than 90% of these documents to XHTML+MathML. We consider over 60% to be successes, converted with no or minor warnings. While the remaining 30% can also be converted, their quality is doubtful, due to unsupported macros or conversion errors. (shrink)

‘What distinguishes science from all other human endeavours is that the accounts of the world that our best, mature sciences deliver are strongly supported by evidence and this evidence gives us the strongest reason to believe them.’ That anyway is what is said at the beginning of the advertisement for a conference on induction at a celebrated British seat of learning in 2007. It shows how much critical rationalists still have to do to make known the message of Logik der (...) Forschung concerning what empirical evidence is able to do and what it does. (shrink)

According to Avia Pasternak, citizens can be held responsible for their state’s wrongdoing if and only if they contribute to maintaining it by acting as intentional participants in its activities. I examine two specific aspects of this general claim. First, I ask whether intentional participation requires that the citizen should accept the state, in the sense of not viewing her membership as unwillingly forced upon her, and conclude that it does not. Second I explore how the claim applies in the (...) case where there has been a discontinuity in the form of the state. I argue that it is not a condition of collective liability today that the predecessor state’s subjects should have been intentional participants at the time at which the wrongdoing occurred. (shrink)

This book explores the various aspects of social justice--to each according to his rights, to each acording to his desert, and to each according to his need--comparing the writings of Hume, Spencer, and Kropotkin. Miller demonstrates that there are radical differences in outlook on social justice between societies, and that these differences can be explained by reference to features of the social structure.

Is it possible for a liberal society to have an established church? After outlining the conditions for liberal establishment, I take from David Hume a secular argument in its favour that points to the moderating effect of establishment on religious discourse and practice. I examine the claim that state support for religion violates liberal equality, and argue that, with respect to state-provided public goods generally, what matters is that the whole package should be of roughly equal benefit to each (...) citizen; it is not required that every citizen should value each distinct good. I claim that religious establishment can have valuable effects for both believers and non-believers, and thereby count as a public good. I then examine the charge that establishment always conveys a message of disparagement to those outside the favoured church, making them into second-class citizens, as both Martha Nussbaum and Cécile Laborde have claimed. Understood as a claim about the experience of minority groups, however, it is unsupported by empirical evidence. Understood as an interpretative claim about the meaning of establishment, it fails to distinguish between privileging an institution and privileging the people attached to it. Finally, I point out that religious minorities may favour an established church as a shield against the pervasive secularism of most modern liberal societies. (shrink)

Michael Walzer has argued that `distributive justice presupposes a bounded world', but what counts as a relevant boundary? The article criticizes two arguments holding that boundaries should not count at all: a negative argument that there is no relevant difference between human relationships within and across state borders and a positive argument that principles of justice must, as a matter of logic, be universal in scope. It then examines three rival accounts of the bounded scope of distributive justice : the (...) cooperative practice view, the political coercion view, and the common identity view. Although each has plausible arguments to support it, none turns out to give necessary and sufficient conditions for principles of distributive justice to apply. Importantly, however, the idea of social justice has emerged within political units that to a large extent combine the three features in question. To the extent that this overlap breaks down, we will need to develop new theories of transnational justice. (shrink)

Ethical theories normally make room both for global duties to human beings everywhere and special duties to those we are attached to in some way. Such a split-level view requires us to specify the kind of attachment that can ground special duties, and to explain the comparative force of the two kinds of duties in cases of conflict. Special duties are generated within groups that are intrinsically valuable and not inherently unjust, where the duties can be shown to be integral (...) to relationships within the group. Since nations can be shown to meet these conditions, acknowledging special obligations towards compatriots is justified. However for such partiality to be reasonable, it must be balanced against recognition of duties of global justice. These duties include duties to respect human rights and duties of fairness towards non-nationals. Weighing such duties against domestic duties of social justice is not a simple task, and the outcome should depend on the precise specification of the duty at stake. In particular, the duty to respect human rights fragments into four sub-duties whose force when set against local duties is markedly different. (shrink)

ABSTRACT The principle of nationality is widely believed to be philosophically disreputable and politically reactionary. As defined here, it embraces three propositions: national identities are properly part of personal identities; they ground circumscribed obligations to fellow‐nationals; and they justify claims to political self‐determination. To have a national identity is to think of oneself as belonging to a community constituted by mutual belief, extended in history, active in character, connected to a particular territory, and marked off from others by its members’distinct (...) traits. Such identities are inevitably partly mythical in nature, yet they answer a pressing modern need, the maintenance of solidarity in large, anonymous societies. They are allied to no particular political programme. They do not require the suppression of minority cultures within the political community. They do not justify a secessionist free‐for‐all. Nor finally does recognition of the role of sentiments in constituting national communities commit us to a subjectivist view of social obligations. Philosophers should recognise the value of these loyalties even if they cannot be rationally grounded in a strong sense. [1]. (shrink)