Despite strong growth in scientific investigation of the placebo effect, understanding of this phenomenon remains deeply confused. We investigate critically seven common conceptual distinctions that impede clear understanding of the placebo effect: (1) verum/placebo, (2) active/inactive, (3) signal/noise, (4) specific/nonspecific, (5) objective/subjective, (6) disease/illness, and (7) intervention/context. We argue that some of these should be eliminated entirely, whereas others must be used with caution to avoid bias. Clearing away the conceptual underbrush is needed to lay down a path to understanding (...) and harnessing placebo effects in clinical medicine. (shrink)

Der Beschreibung der zeitlichen Entwicklung lebender Systeme kann eine reine Differentialanalyse nicht genügen. In solchen Fällen muss man sich an Stelle der gewöhnlichen Differentialgleichungen der integraldifferentiellen, bezw. der Integralgleichungen bedienen. Zur leichteren Veranschaulichung der mathematischen Darstellung betrachtet Verfasser zuerst diejenigen Systeme, deren innerer Zustand sich durch ein einziges Parameterc bestimmen lässt. Die zeitliche Entwicklung eines leblosen Systems dieser Klasse werde durch die Differentialgleichung $$\frac{{dc}}{{dt}} = kf...$$ dargestellt, wot=Zeit, undk eine Funktion der äusseren Parameterα, Β, γ. ist. Im Falle eines jeden (...) Systems sind die äusseren Parameterα, Β, γ. charakteristische individuelle Funktionen der Zeit. Misst manc am. Zeitpunktt, so lässt sich die Zukunft des Systems vermittelst der Gleichung berechnen, wenn die zukünftigen Werte der äusseren Parameter gegeben sind. Solche Systeme nennt Verfasser nicht-historische Systeme. Im Falle der lebenden Systeme werde die zeitliche Entwicklung durch die Integral-differentialgleichung $$\frac{{dc}}{{dt}} = k_1 f_1 + \mathop \smallint \limits_{t - \lambda }^t k_2 f_2 dt........$$ dargestellt, wof 1 undf 2 Funktionen des Zustandsparametersc, undk 1 undk 2 Funktionen der äusseren Parameter sind. Das Zeitintegral erstreckt sich auf das vergangene Zeitintervalt-λ →t, woλ einen positiven endlichen konstanten Wert besitzt. Diese Systeme nennt Verfasser historische Systeme. Setzt manH für das darin enthaltene Integralglied, so verwandelt sich die Gleichung in: $$\frac{{dc}}{{dt}} = k_1 f_1 + H..........$$ Misst man nunc am Zeitpunktt, so kann man in diesem Fall die Zukunft des Systems ohne Kenntnis des historischen GliedsH nicht berechnen. Das Vorkommen des historischen IntegralgliedsH nennt Verfasser Chronoholismus. Man kann deshalb die historischen Systeme auch chronoholistische Systeme nennen. Die biologische Interpretation dieser Betrachtungsweise wird vom Verfasser diskutiert, und die Gleichung auf Systeme mit erblichen Eigenschaften ausgedehnt. Es werden zuletzt Systeme mit vielen Zustandsparametern in gewissen einfachen Fällen kurz behandelt. L'analyse différentielle ne suffit pas, selon l'avis de de l'auteur, pour la description de l'évolution des systèmes vivants au cours des temps. Il faut utiliser dans ces cas les équations intégro-différentielles ou intégrales. Pour faciliter le traÎtement mathématique, on peut considérer d'abord les systèmes dont l'état intérieur est défini par un seul paramètrec. L'évolution d'un système inanimé de cette classe se laisse décrire par l'équation différentielle $$\frac{{dc}}{{dt}} = k f,...........$$ oùt=temps, etk est une fonction déterminée des paramètres extérieurs α,Β, γ. Si l'on connaÎtc à un temps donnét, l'état du système à un temps futurt′ se laisse prévoir au moyen de l'équation, quand les valeurs des paramètres extérieurs dans l'intervallet → t∼' sont fixées. L'auteur appelle les systèmes de cette classe des systèmes non-historiques. Pour les systèmes vivants, il faut se servir, selon l'avis de l'auteur, des équations intégro-différentielles. Pour les systèmes définis par un seul paramètrec, on peut se servir, par exemple, de l'équation $$\frac{{dc}}{{dt}} = k_1 f_1 + \mathop \smallint \limits_{t - \lambda }^t k_2 f_2 dt........$$ où k1 et k2 sont des fonctions déterminées des paramètres extérieurs. L'intégrale s'étend sur l'intervallet-λ→ t où λ est positif et constant. En indiquant le terme intégral par le symboleH, on peut écrire $$\frac{{dc}}{{dt}} = k_1 f_1 + H..........$$ La connaissance de c à un temps donnét ne laisse pas prévoir l'état du système à un temps futurt′ sans connaissance du terme historiqueH, quand mÊme les paramètres α, Β, γ,..., seraient des fonctions déterminées du temps dans l'intervallet→t′. L'auteur appelle l'existence du terme intégral historiqueH le chronoholisme. On peut appeler les systèmes de cette classe des systèmes historiques ou chronoholistiques. L'interprétation biologique de cette faÇon de traÎter les systèmes vivants est discutée par l'auteur, qui étend l'équation pour le faire représenter aussi les propriétés héréditaires des Êtres vivants. Quelques cas de systèmes dont l'état intérieur est défini par plusieurs paramètres et plusieurs phases sont traités brièvement. (shrink)

Data monitoring committees often are employed to review interim findings of randomised controlled trials. Interim findings are kept confidential until the data monitoring committee finds that they provide sufficiently compelling evidence regarding efficacy, typically because they have crossed the pre-defined statistical boundaries, or they raise serious concerns about safety. While this practice is vital to maintaining the scientific integrity of controlled trials and thereby ensuring their social value, it has been criticised as unethical. Commentators argue that withholding interim findings from (...) research participants is deceptive, inconsistent with valid informed consent, and a violation of respect for participants’ autonomy. The present article examines these arguments, focusing specifically on confidential data monitoring for efficacy. This practice need not be deceptive provided its use is disclosed to prospective research participants. In addition, confidential data monitoring does not make research participants worse off than they would be in the clinical setting and represents an acceptable limitation on the options available to prospective research participants. Taken together, these considerations suggest confidential data monitoring, subject to adequate safeguards, is ethically acceptable. (shrink)

Does action always arise out of desire? G. F. Schueler examines this hotly debated topic in philosophy of action and moral philosophy, arguing that once two senses of "desire" are distinguished - roughly, genuine desires and pro attitudes - apparently plausible explanations of action in terms of the agent's desires can be seen to be mistaken. Desire probes a fundamental issue in philosophy of mind, the nature of desires and how, if at all, they motivate and justify our actions. At (...) least since Hume argued that reason "is and of right ought to be the slave of the passions," many philosophers have held that desires play an essential role both in practical reason and in the explanation of intentional action. G. F. Schueler looks at contemporary accounts of both roles in various belief-desire models of reasons and explanation and argues that the usual belief-desire accounts need to be replaced. Schueler contends that the plausibility of the standard belief-desire accounts rests largely on a failure to distinguish "desires proper," like a craving for sushi, from so-called "pro attitudes," which may take the form of beliefs and other cognitive states as well as desires proper. Schueler's "deliberative model" of practical reasoning suggests a different view of the place of desire in practical reason and the explanation of action. He holds that we can arrive at an intention to act by weighing the relevant considerations and that these may not include desires proper at all. (shrink)

Risk–benefit assessment is a routine requirement for research ethics committees that review and oversee biomedical research with human subjects. Nevertheless, it remains unclear how to weigh and balance risks to research participants against the social benefits that flow from generating biomedical knowledge. In this article, we address the question of whether there are any reasonable criteria for defining the limit of permissible risks to individuals who provide informed consent for research participation. We argue against any a priori limit to permissible (...) research risks. However, attention to the uncertainty of potential social benefit that can be derived from any particular study warrants caution in exposing prospective research participants to a substantial likelihood of serious harm. (shrink)

Initially, we perceive an indefinite extension imprecisely, a spread C ; this perception can be visual, aural, or tactile.

Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the (...) underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured. (shrink)

Although established in the law and current practice, the determination of death according to neurological criteria continues to be controversial. Some scholars have advocated return to the traditional circulatory and respiratory criteria for determining death because individuals diagnosed as ‘brain dead’ display an extensive range of integrated biological functioning with the aid of mechanical ventilation. Others have attempted to refute this stance by appealing to the analogy between decapitation and brain death. Since a decapitated animal is obviously dead, and ‘brain (...) death’ represents physiological decapitation, brain dead individuals must be dead. In this article we refute this ‘decapitation gambit.’ We argue that decapitated animals are not necessarily dead, and that, moreover, the analogy between decapitation and the clinical syndrome of brain death is flawed. (shrink)

Mechanisms that help people in their lives have existed for centuries, and every year they become not only more and more complex and perfect, but also smarter. It is impossible to imagine modern production without smart machines, but today, with the advent of robotic android robots, their participation in our private lives and, consequently, their influence on us, becomes much more obvious. After all, the robots that are increasingly taking root in our lives today, are no longer perceived by us (...) simply as mechanisms, we endow them with human properties of character and often experience different emotions in relation to them. The appearance of a robot capable of experiencing emotions can be considered a qualitatively new step in the life of a person with robots. With such robots, it will be possible to be friends with them, to look for support from them. It is expected that they will be able to brighten up the loneliness of a variety of people, including disabled people, lonely old people, to help in caring for the sick and at the same time entertain them with communication. Speaking about the relationship with robots, it is difficult not to mention such an important aspect of human communication as sex, which, on the one hand, is not only a need, as in all living beings, but also the highest form of human love and intimacy, and on the other - can exist and be satisfied completely separate from love. It is this duality of human nature that has contributed to the transformation of sex and the human body into a commodity and the development of prostitution, pornography and the use of sexual images in advertising. The emergence of android robots can radically change our lives, including the most intimate areas of life. The development of the artificial intelligence sex industry opens up a whole new era of human-machine interaction. When smart machines become not only comfortable and entertaining, but literally enter our flesh, become our interlocutors, friends and lovers who share our feelings and interests, what will be the consequences of this unprecedented intimacy between man and machine? (shrink)

Participants are often not informed by investigators who conduct randomised, placebo-controlled acupuncture trials that they may receive a sham acupuncture intervention. Instead, they are told that one or more forms of acupuncture are being compared in the study. This deceptive disclosure practice lacks a compelling methodological rationale and violates the ethical requirement to obtain informed consent. Participants in placebo-controlled acupuncture trials should be provided an accurate disclosure regarding the use of sham acupuncture, consistent with the practice of placebo-controlled drug trials.

(1926). Notes by the way. Australasian Journal of Psychology and Philosophy: Vol. 4, No. 4, pp. 247-247.