Context Physicians are regularly confronted with research that is funded or presented by industry. Objective To assess whether physicians discount for conflicts of interest when weighing evidence for prescribing a new drug. Design and setting Participants were presented with an abstract from a single clinical trial finding positive results for a fictitious new drug. Physicians were randomly assigned one version of a hypothetical scenario, which varied on conflict of interest: ‘presenter conflict’, ‘researcher conflict’ and ‘no conflict’. Participants 515 randomly selected (...) Fellows in the American College of Obstetricians and Gynecologists' Collaborative Ambulatory Research Network; 253 surveys (49%) were returned. Main object measures The self-reported likelihood that physicians would prescribe the new drug as a first-line therapy. Results Physicians do not significantly discount for conflicts of interest in their self-reported likelihood of prescribing the new drug after reading the single abstract and scenario. However, when asked explicitly to compare conflict and no conflict, 69% report that they would discount for researcher conflict and 57% report that they would discount for presenter conflict. When asked to guess how favourable the results of this study were towards the new drug, compared with the other trials published so far, their perceptions were not significantly influenced by conflict of interest information. Conclusion While physicians believe that they should discount the value of information from conflicted sources, they did not do so in the absence of a direct comparison between two studies. This brings into question the effectiveness of merely disclosing the funding sources of published studies. (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)

But a body of rigorous mathematical theory has also gradually developed, and this is the first book to present that theory.

The immunology of falciparum malaria, the lethal type of human malaria, has been transformed by two developments. First, a culture system for the asexual blood stages of Plasmodium falciparum.1 Secondly, the cloning and expression of genes coding for a large number of the protein antigens of this malaria parasite over the past two years. Data on proteins, protein antigens and epitopes of P. falciparum supplied by gene cloning techniques have been supplemented by monoclonal antibody approaches, peptide synthesis, and high‐resolution immunochemistry.

In this paper I will argue that the latter group [of Non-Humeans] is correct. My argument focuses on practical deliberation and has two parts. I will discuss two different problems that arise for the Humean Theory and suggest that while taken individually each problem appears to have a solution, for each problem the solution Humeans offer precludes solving the other problem. I will suggest that to see these difficulties we must take seriously the thought that we can only understand an (...) agent’s reasons for her action by looking at her actual or possible practical deliberation. (shrink)