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)

Background: Moral distress occurs when constraints prevent healthcare providers from acting in accordance with their core moral values to provide good patient care. The experience of moral distress in nurses might be magnified during the current Covid-19 pandemic. Objective: To explore causes of moral distress in nurses caring for Covid-19 patients and identify strategies to enhance their moral resiliency. Research design: A qualitative study using a qualitative content analysis of focus group discussions and in-depth interviews. We purposively sampled 31 nurses (...) caring for Covid-19 patients in the acute care units within large academic medical systems in Maryland and New York City during April to June 2020. Ethical considerations: We obtained approval from the Institutional Review Board at the University of Maryland, Baltimore. Results: We identified themes and sub-themes representative of major causes of moral distress in nurses caring Covid-19 patients. These included (a) lack of knowledge and uncertainty regarding how to treat a new illness; (b) being overwhelmed by the depth and breadth of the Covid-19 illness; (c) fear of exposure to the virus leading to suboptimal care; (d) adopting a team model of nursing care that caused intra-professional tensions and miscommunications; (e) policies to reduce viral transmission (visitation policy and PPE policy) that prevented nurses to assume their caring role; (f) practicing within crisis standards of care; and (g) dealing with medical resource scarcity. Participants discussed their coping mechanisms and suggested future strategies. Discussion/Conclusion: Our study affirms new causes of moral distress related to the Covid-19 pandemic. Institutions need to develop a supportive ethical climate that can restore nurses’ moral resiliency. Such a climate should include non-hierarchical interdisciplinary spaces where all providers can meet together as moral peers to discuss their experiences. (shrink)

Background: Concerns have been expressed regarding the adequacy of ethics review systems in developing countries. Limited data are available regarding the structural and functional status of Research Ethics Committees (RECs) in the Middle East. The purpose of this study was to survey the existing RECs in Egypt to better understand their functioning status, perceived resource needs, and challenges. Methods: We distributed a self-administered survey tool to Egyptian RECs to collect information on the following domains: general characteristics of the REC, membership (...) composition, ethics training, workload, process of ethics review, perceived challenges to effective functioning, and financial and material resources. We used basic descriptive statistics to evaluate the quantitative data. Results: We obtained responses from 67% (12/18) of the identified RECs. Most RECs (10/12) have standard operating procedures and many (7/12) have established policies to manage conflicts of interests. The average membership was 10.3 with a range from 7-19. The predominant member type was physicians (69.5% of all of the REC members) with little lay representation (13.7%). Most RECs met at least once/month and the average number of protocols reviewed per meeting was 3.8 with a range from 1-10. Almost three-quarters of the members from all of the 12 RECs indicated they received some formal training in ethics. Regarding resources, roughly half of the RECs have dedicated capital equipment (e.g., meeting room, computers, office furniture, etc); none of the RECs have a formal operating budget. Perceived challenges included the absence of national research ethics guidelines and national standards for RECs and lack of ongoing training of its members in research ethics. Conclusion: Our study documents several areas of strengths and areas for improvements in the operations of Egyptian RECs. Regarding strengths, many of the existing RECs meet frequently, have a majority of members with prior training in research ethics, and have written policies. Regarding areas for improvements, many RECs should strive for a more diverse membership and should receive more financial resources and administrative support personnel. We recommend that RECs include more individuals from the community and develop a continuing educational program for its members. Institutional officials should be aware of the resource capacity needs of their RECs. (shrink)

The texts collected in this volume, which was originally published in 1969, contain Herder's most original and stimulating ideas on politics, history and language. They had for the most part not been previously available in English. In his introduction, Professor Barnard analyses the basic premises of Herder's political thought against the background of the Enlightenment. He examines Herder's concepts of language, community and culture, his theory of historical interaction, and his approach to the problem of change and progress. Finally, he (...) provides a brief comparative analysis of traditionalist thought following the French Revolution, showing how substantive writers like Burke differed from Herder despite the close similarity of political vocabulary. (shrink)

John Lachs in his paper, “Fichte’s Idealism,” suggests that he can detect in Fichte’s Wissenschaftslehre “three major lines of argument for his idealistic conclusion.” Lachs examines each of these arguments in turn and concludes that the first “appears … to have no merit.” The second has nothing to recommend it; and the third simply “begs the question.” I wish to argue that much of Lachs’ criticism simply misses its mark. First, Lachs presents each argument independently, as if it were meant (...) to stand on its own. In fact, as will become evident, Fichte regards all three as interdependent aspects of one major argument intended to demonstrate the superiority of critical idealism. Secondly, Lachs, in reconstructing two of the three arguments, ignores certain crucial passages in Fichte’s works; and thus misinterprets or, at least, misrepresents Fichte’s fundamental position. (shrink)

The first English translation of Fichte’s second set of 1804 lectures on the Wissenschaftslehre.

This essay is written on the following premises and argues for them. “Enlightenment” is a word or signifier, and not a single or unifiable phenomenon which it consistently signifies. There is no single or unifiable phenomenon describable as “the Enlightenment,” but it is the definite article rather than the noun which is to be avoided. In studying the intellectual history of the late seventeenth century and the eighteenth, we encounter a variety of statements made, and assumptions proposed, to which the (...) term “Enlightenment” may usefully be applied, but the meanings of the term shift as we apply it. The things are connected, but not continuous; they cannot be reduced to a single narrative; and we find ourselves using the word “Enlightenment” in a family of ways and talking about a family of phenomena, resembling and related to one another in a variety of ways that permit of various generalizations about them. We are not, however, committed to a single root meaning of the word “Enlightenment,” and we do not need to reduce the phenomena of which we treat to a single process or entity to be termed “the” Enlightenment. It is a reification that we wish to avoid, but the structure of our language is such that this is difficult, and we will find ourselves talking of “the French” or “the Scottish,” “the Newtonian” or the “the Arminian” Enlightenments, and hoping that by employing qualifying adjectives we may constantly remind ourselves that the keyword “Enlightenment” is ours to use and should not master us. (shrink)

This book explores the universe and its subsystems from the three lenses of evolutionary (diversifying), developmental (converging), and complex (adaptive) processes at all scales. It draws from prolific experts within the academic disciplines of complexity science, physical science, information and computer science, theoretical and evo-devo biology, cosmology, astrobiology, evolutionary theory, developmental theory, and philosophy. The chapters come from a Satellite Meeting, "Evolution, Development and Complexity" (EDC) hosted at the Conference on Complex Systems, in Cancun, 2017. The contributions will be peer-reviewed (...) and contributors from outside the conference will be invited to submit chapters to ensure full coverage of the topics. This book explores many issues within the field of EDC such as the interaction of evolutionary stochasticity and developmental determinism in biological systems and what they might teach us about these twin processes in other complex systems. This text will appeal to students and researchers within the complex systems and EDC fields.. (shrink)

It is proved that the relevance logic \ has no structurally complete consistent axiomatic extension, except for classical propositional logic. In fact, no other such extension is even passively structurally complete.

The reception history of the French Revolution in France and England is well documented among Anglophone scholars; however, the debate over the Revolution in Germany is much less well known. Fichte's Contribution played an important role in this debate. Presented here for the first time in English, Fichte's work provides a distinctive synthesis of Locke's "possessive individualism," Rousseau's general will, and Kant's moral philosophy. This eclectic blend results in an unusual rights theory that at times veers close to a form (...) of anarchism. Written in 1792–93, just before Fichte moved to Jena to develop his philosophical system in a series of works—above all the Wissenschaftslehre of 1794—the Contribution provides invaluable insight into Fichte's early development. In addition, Fichte's work predates much of Kant's political philosophy, and can shed light on the rich dialogue in German political thought in the 1790s. (shrink)

The beginning of the seventy-sixth poem of Catullus appears to cause some modern readers considerable dismay. One may instance the reactions of R. O. A. M. Lyne: ‘Our first reaction to the beginning of this poem may be one of incredulity’ ; ‘The effect of such language is to imply an outrageous and implausible self-righteousness’ ; of K. Quinn: ‘a self-righteousness that makes us feel a little uncomfortable’ ; or of G. Williams: ‘this is sheer melodrama, a deft and surprising (...) reversal of “count your blessings”’; and, further down, on ‘si vitam puriter egi’: ‘This could be simply priggish or outrageous or both, but he does not mean it as a general statement’. (shrink)

With advances in genetic technology, there are increasing concerns about the way in which genetic information may be abused, particularly in people at increased genetic risk of developing certain disorders. In a recent case in Hong Kong, the court ruled that it was unlawful for the civil service to discriminate in employment, for the sake of public safety, against people with a family history of mental illness. The plaintiffs showed no signs of any mental health problems and no genetic testing (...) was performed. This was the first case concerning genetic discrimination in common law jurisdictions, therefore the court's judgment has implications for how genetic discrimination cases may be considered in the future. The court considered it inappropriate to apply population statistics or lifetime risks to individuals while examining fitness for work. It recommended an individualised assessment of specific risks within the job, relative to other risks posed by that workplace. (shrink)

Critical scholarly edition of J. G. Fichte's Closed Commercial State.

This piece is an essay review of Wang Hui's book China from Empire to Nation-State, which is a translation of the introduction to Wang's four-volume Rise of Modern Chinese Thought. According to the reviewer, Wang studies less the modern history of China than its historicity and does so in the context of China's transition from being an empire, inhabiting a cosmos that is the product of its own self-reflection, to being one among a number of nation-states, inhabiting a number of (...) histories of their own, all of which are now simultaneously present. But the Euro-American terms empire and nation-state, which increasingly pervade Chinese perceived realities, lack precise Chinese equivalents. Meanwhile, the terms that the Chinese use in referring to the same historical transition, tianli and gongli, are obscure to the Euro-American mind. The reviewer asks whether the Chinese, now facing a plurality of histories, wonder if there may be a plurality of li, as well, or at least if there can be a li that is “universal” in the sense that it is common to them all. The problem here, the reviewer argues, in part derives from Wang's binaries being Hegelian, while the breakdown of the nation-state in Europe projects a postpolitical order in which human communities are incapable of state-based action or of determining their own li. The review ends by questioning whether China is capable of following this path and, in any case, whether Wang's vocabulary is able to encompass it. (shrink)