This question as to whether machines can, or could, be made to think, has become familiar in recent years since the renewed outburst of interest that has taken place in the development of Cybernetics. The notion of servo–mechanisms and the like has a history in remote antiquity but the form of its fundamental question has recently taken on a new and especially acute significance.

The U.S. Food and Drug Administration's rationale for supporting the development and approval of BiDil for heart failure specifically in black patients was based on under-powered, post hoc subgroup analyses of two relatively old trials , which were further complicated by substantial covariate imbalances between racial groups. Indeed, the only statistically significant difference observed between black and white patients was found without any adjustment for potential confounders in samples that were unlikely to have been adequately randomized. Meanwhile, because the accepted (...) baseline therapy for heart failure has substantially improved since these trials took place, their results cannot be combined with data from the more recent trial amongst black patients alone. There is therefore little scientific evidence to support the approval of BiDil only for use in black patients, and the FDA's rationale fails to consider the ethical consequences of recognizing racial categories as valid markers of innate biological difference, and permitting the development of group-specific therapies that are subject to commercial incentives rather than scientific evidence or therapeutic imperatives. This paper reviews the limitations in the scientific evidence used to support the approval of BiDil only for use in black patients; calls for further analysis of the V-HeFT I and II data which might clarify whether responses to H-I vary by race; and evaluates the consequences of commercial incentives to develop racialized medicines. We recommend that the FDA revise the procedures they use to examine applications for race-based therapies to ensure that these are based on robust scientific claims and do not undermine the aims of the 1992 Revitalization Act. (shrink)

Pausanias' Description of Greece, translated into English, with Notes and Index, by Arthur Richard Shilleto. Two Vols. George Bell and Sons. 1886. 10s.Pausanias der Perieget; Untersuchungen über seine Schriftstellerei und seine Quellen, von Dr. A. Kalkmann. Berlin, Reimer. 1886. 8 Mk.

I would like to make some further clarifying remarks about the nature of learning machines, or finite automata as they are more generally known these days. It is clear from much that has recently been written on this subject that there are still many misunderstandings about their capacity and significance.

I Would like to draw attention to the basic defect in the argument used by Mr J. R. Lucas.Mr Lucas there states that Gödel's theorem shows that any consistent formal system strong enough to produce arithmetic fails to prove, within its own structure, theorems that we, as humans, can nevertheless see to be true. From this he argues that ‘minds’ can do more than machines, since machines are essentially formal systems of this same type, and subject to the limitation implied (...) by Godel's theorem. (shrink)

The adage “an ounce of prevention is worth a pound of cure” is widely used in healthcare settings and can be applied to the work of institutional clinical ethics committees. The model of clinical ethics consultation, however, is inherently reactive: a crisis or question emerges, and ethics experts are called to help. In an effort to employ a proactive component to the model of clinical ethics consultation (as well as to standardize our educational interventions), we developed ethics pocket cards. The (...) purpose of this article is to: (1) describe the rationale for using ethics pocket cards, (2) provide examples of our cards, and (3) begin a dialogue about the potential uses of ethics pocket cards. In doing so, we hope to explore how such portable, economical devices can advance the goals of ethics consultation as well as the educational aims of ethics committees. (shrink)

Professor A. D. Ritchie's remarks cannot go without some reply, since otherwise they would only have the effect of increasing the already considerable confusion on the subject of Cybernetics.

G. W. F. Hegel (1770–1831), the influential German philosopher, believed that human history was advancing spiritually and morally according to God’s purpose. At the beginning of this masterwork, Hegel writes: “What the history of Philosophy shows us is a succession of noble minds, a gallery of heroes of thought, who, by the power of Reason, have penetrated into the being of things, of nature and of spirit, into the Being of God, and have won for us by their labours the (...) highest treasure, the treasure of reasoned knowledge.” In his introduction to this Bison Book edition, Frederick C. Beiser notes the complex and controversial history of Hegel’s text. He makes a case that this English-language translation by E. S. Haldane and Frances H. Simson is still the most reliable one. (shrink)

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)