Making research data readily accessible during a public health emergency can have profound effects on our response capabilities. The moral milieu of this data sharing has not yet been adequately explored. This article explores the foundation and nature of a duty, if any, that researchers have to share data, specifically in the context of public health emergencies. There are three notable reasons that stand in opposition to a duty to share one’s data, relating to: (i) data property and ownership, (ii) (...) just distribution of benefits and burdens and (iii) the contemporary ethos of science. We argue each reason can be successfully met with corresponding rationale in favour of data sharing. Further support for data sharing has been echoed in policies of health agencies, funding bodies and academic institutions; in documents on the ethical conduct of biomedical research; and in discussions on the nature of public health. From this, we ascertain that sharing data is the morally sound default position. This article then highlights the key roles reciprocity and solidarity play in supporting the practice of data sharing. We conclude with recommendations to regard public health research data as a common-pool resource in order to build a framework for stable data sharing management. (shrink)

Progressive supranuclear palsy is a movement disorder with prominent tau neuropathology. Brain diseases with abnormal tau deposits are called tauopathies, the most common of which is Alzheimer's disease. Environmental causes of tauopathies include repetitive head trauma associated with some sports. To identify common genetic variation contributing to risk for tauopathies, we carried out a genome-wide association study of 1,114 individuals with PSP and 3,247 controls followed by a second stage in which we genotyped 1,051 cases and 3,560 controls for the (...) stage 1 SNPs that yielded P ≤ 10-3. We found significant previously unidentified signals associated with PSP risk at STX6, EIF2AK3 and MOBP. We confirmed two independent variants in MAPT affecting risk for PSP, one of which influences MAPT brain expression. The genes implicated encode proteins for vesicle-membrane fusion at the Golgi-endosomal interface, for the endoplasmic reticulum unfolded protein response and for a myelin structural component. © 2011 Nature America, Inc. All rights reserved. (shrink)

It is shown that the Riemannian curvature of the 3-dimensional hypersurfaces in space-time, described by the Wilson loop integral, can be represented by a quaternion quantum operator induced by the SU(2) gauge potential, thus providing a justification for quaternion quantum gravity at the Tev energy scale.

In his struggle to vindicate the religious enterprise from the charge that it is unfalsifiable and meaningless, McKinnon reduces both science and religion to distorted caricatures, ignores the centrality of the problems of evil, anguish, absurdity, and the egocentric predicament for religion, and asserts that religion and science are fundamentally one and the same. He builds his thesis on a distinction between "assertional," "self-instructional," and "ontological-linguistic" intentionality of utterances. By equivocating about whether these usages are logically independent, McKinnon holds that, (...) as "self-instructional," utterances are outside the positivist's arena. He presses the noteworthy point--that utterances sometimes are intended to report an existential stance--in such a way as to divert attention from the vast differences between religious and scientific methods and subject matter. Not content with leaving religious utterances restricted to mere reporting, McKinnon builds a case for bypassing positivistic attack under the other two usages by trading on a supposed incommensurability between particulars and universals. E.g., he holds that "God is love" must be indeterminate and unfalsifiable since both nouns are universals and since God is incomprehensible. And so it goes, a battle between straw men on a shifting field of honor for a prize of dubious worth. Notwithstanding, this is a thought provoking treatment of a difficult topic.--M. D. P. (shrink)

This extraordinarily lucid contribution to Kant scholarship leads the reader through Kant's entire system to its ultimate political payoff. Murphy takes pains to include the relevant elements of Kant's precritical and critical philosophy. As his work approaches its final topic, the philosophy of right, Murphy's style shifts smoothly from summarization and abstract elucidation toward detailed argumentation and casuistry. His presentation is fruitfully embedded in a historical context which includes : Hobbes, Leibniz, Locke, Hume, Rousseau, Mill, Hare, Hart, and Rawls. Of (...) special interest is the discussion of Kant's inaugural dissertation and his criticism of Leibnizian philosophy as presented there.--M. D. P. [[sic]]. (shrink)

Is it a mistake to use "true" or "false" in certain contexts? White sets the stage for dealing with this issue by laying out a field of usages. He develops his position by characterizing and criticizing contemporary treatments of these data, moving rapidly from case to case. His numerous summaries and conclusions, obviously based on a wider view of the material than is presented in the text, may leave the uninitiated alternately puzzled, bristling, or suspicious. While White's data are expressed (...) clearly, the goal of his arguments and his organizational principles are frequently less apparent. White's discussions of fiction and modality are of particular historic interest. Here we find Frege and Russell arguing about whether they can argue about the King of France. We meet with Aristotle's ancient problem of the future naval battle, witness latter-day skirmishes over the nature of moral language, and find Leibniz, Hume, and Kant debating the logic of necessity and contingency. Are there really different types of truth which correspond with different modalities and existence presuppositions, as White seems to assume? This question, harking back to books 5 and 6 of Plato's Republic, is passed over by White in his usage-oriented quest for the sense of "truth." Truth will suit both student and researcher alike and is to be recommended for its breadth of concern and for its 18 pages of bibliography.--M. D. P. [[sic]]. (shrink)

Lucas plays off his understandings of the problem of freedom and Gödel's Theorem, concluding that, "... a human being cannot be represented by a logistic calculus and therefore cannot be described completely in terms of physical variables, all of whose values are completely determined by the conjunction of their values at some earlier time". Lucas approaches the problem of freedom from the perspective of a computer programmer. His argument is as follows. Men can construct a logistic calculus, L, of which (...) Gödel's theorem is a theorem. Gödel's theorem is known-by-men-to-be-true, which is a fact. Facts have ontological status. Any attempt to represent this fact by a definite description must result in an infinite regress of meta-L's, for a Gödel theorem can be constructed in any meta-L powerful enough to show that Gödel's theorem is a theorem of L. Accordingly, men can do something which cannot be represented within L; men are therefore undeterminable. Lucas's position amounts to a rethinking of Fichte's position, set in the metaphor of meta-mathematical logic. However, whereas Fichte concluded that a man can choose to posit that he is free, and thereby make himself free, Lucas concludes that all men are free since some men know that Gödel's theorem is true. One question suggested by Lucas's argument is ontological, and another is epistemological. First, what is the ontological status of facts? Secondly, what is the distinction between knowing-that-p and showing-that-p? Ultimately, Lucas's demonstration pivots on equating the-completeness-of-L with knowing-the-completeness-of-L. It remains to be shown that that which is capable of knowing-that-p is governed in the act of knowing-that-p by the conditions which determine p.--M. D. P. [[sic]]. (shrink)

In 1999, da Silva, D'Ottaviano and Sette proposed a general definition for the term translation between logics and presented an initial segment of its theory. Logics are characterized, in the most general sense, as sets with consequence relations and translations between logics as consequence-relation preserving maps. In a previous paper the authors introduced the concept of conservative translation between logics and studied some general properties of the co-complete category constituted by logics and conservative translations between them. In this paper (...) we present some conservative translations involving classical logic, Lukasiewicz three-valued system L₃, the intuitionistic system Iⁱ and several para-consistent logics, as for instance Sette's system Pⁱ, the D'Ottaviano and da Costa system J₃ and da Costa's systems $\text{C}_{n}$ , 1 ≤ n ≤ ω. (shrink)

We report the results of a randomized trial to assess the impact of an innovative ethics curriculum on the knowledge and confidence of 85 medical house officers in a university hospital programme, as well as their responses to a simulated clinical case. Twenty-five per cent of the house officers received a lecture series, 25 per cent received lectures and case conferences, with an ethicist in attendance, and 50 per cent served as controls. A post-intervention questionnaire was administered. Knowledge scores did (...) not differ among the groups. Confidence regarding ethical issues was significantly greater in the aggregate intervention group compared to the control group. Confidence regarding procedural issues related to ethics was significantly higher for the EI group than for the controls. Responses to a simulated case showed that significantly fewer house officers in the EI group would intubate a patient for whom such therapy would be futile. We conclude that ethics education can have an impact on house officers' confidence and their responses to a simulated case, and that the EI was more effective than the LI. Such results have implications regarding the implementation of ethics education during residency. (shrink)

In 1885, during initial discussions of J. C. Maxwell's celebrated thermodynamic demon, Whiting (1) observed that the demon-like velocity selection of molecules can occur in a gravitationally bound gas. Recently, a gravitational Maxwell demon has been proposed which makes use of this observation [D. P. Sheehan, J. Glick, and J. D. Means, Found. Phys. 30, 1227 (2000)]. Here we report on numerical simulations that detail its microscopic phase space structure. Results verify the previously hypothesized mechanism of its paradoxical behavior. This (...) system appears to be the only example of a fully classical mechanical Maxwell demon that has not been resolved in favor of the second law of thermodynamics. (shrink)

In a recent article in this journal our unit was accused of a number of errors of judgment in applying covert video surveillance (CVS) to infants and children suspected of life-threatening abuse. The article implied, that on moving from the Royal Brompton Hospital in London to North Staffordshire Hospital, we failed to present our work to the Research Ethics Committee (REC). We did send our protocol to the REC though we did not consider that, after a total of 16 patients (...) had been documented as being the subject of life-threatening abuse, this was research. The REC in Staffordshire agreed with us. We were also accused of undertaking work that should be pursued by the Police. We agree with this. However, unlike the Metropolitan Police the Staffordshire Police would not undertake CVS. We fail to agree that 'working together' with parents is necessarily practical or safe when trying to protect children from life-threatening abuse of this kind. (shrink)

OBJECTIVES: To study the accuracy of reviewing ward notes (chart review) as a measure of the quality of care rendered to patients with "Do Not Resuscitate" (DNR) orders. DESIGN: We reviewed the charts of 19 consecutive, competent inpatients with DNR orders for evidence that the staff addressed a broad range of patient care needs called Concurrent Care Concerns (CCCs), such as withholding treatments other than resuscitation itself, and attention to patient comfort needs. We then interviewed the patient, consultant physician, house (...) officer, and primary nurse and compared the ward notes with the understandings of these staff members. SETTING: The medical service of an urban university medical centre. RESULTS: The average number of documented CCCs addressed per DNR order was 1.1. The ward notes generally agreed with the perceptions of patients, house officers, and nurses (% agreement with notes = 79%, 77%, and 82%; kappa = 0.43, 0.40, 0.50). Consultant physicians' understandings were poorly reflected in the ward notes (% agreement = 59%; kappa = 0.18). They overestimated attention to CCCs compared with the notes (P < 0.0001) and with other observers (P < 0.0001). CONCLUSION: Chart review for attention to CCCs accurately reflects the understandings of patients, house officers, and nurses, but consultant physicians report more attention to CCCs than is recorded in the ward notes or understood by other observers. Better communication regarding end-of-life care plans should be encouraged. (shrink)

Objective: Symptom improvement is often examined as an indicator of a good outcome of accessing mental health services. However, there is little evidence of whether symptom improvement is associated with other indicators of a good outcome, such as a mutual agreement to end treatment. The aim of this study was to examine whether young people accessing mental health services who meaningfully improved were more likely to mutually agree to end treatment.Methods: Multilevel multinomial regression analysis controlling for age, gender, ethnicity, and (...) referral source was conducted on N = 8,995 episodes of care [Female = 5,469, 61%; meanAge = 13.66 years] using anonymised administrative data from young people's mental health services.Results: Compared to young people with no change in mental health difficulties, those showing positive meaningful changes in mental health difficulties were less likely to have case closure due to non-mutual agreement. Similarly, they were less likely to transfer or end treatment for other reasons than by case closure due to mutual agreement.Conclusion: The findings suggest that young people accessing mental health services whose symptoms meaningfully improve are more likely to mutually agree to end treatment, adding to the evidence that symptom improvement may be appropriate to examine as an indicator of a good outcome of accessing mental health services. (shrink)

After a brief review of pragmatic arguments against emotivism, the author of this monograph proceeds to outline and criticize two conflicting concepts of the morally right in Dewey's writings. A third interpretation, involving an "interaction of the factual and the normative" is advanced as more conformable to the spirit of instrumentalism.--A. D. P. M.

Background: Demand for organisational ethics capacity is growing in health organisations, particularly among managers. The role of clinical ethicists in, and perspective on, organisational ethics has not been well described or documented in the literature. Objective: To describe clinical ethicists’ perspectives on organisational ethics issues in their hospitals, their institutional role in relation to organisational ethics, and their perceived effectiveness in helping to address organisational ethics issues. Design and Setting: Qualitative case study involving semi-structured interviews with 18 clinical ethicists across (...) 13 health organisations in Toronto, Canada. Results: From the clinical ethicists’ perspective, the most pressing organisational ethics issues in their organisations are: resource allocation, staff moral distress linked to the organisation’s moral climate, conflicts of interest, and clinical issues with a significant organisational dimension. Clinical ethicists were consulted in particular on issues related to staff moral distress and clinical issues with an organisational dimension. Some ethicists described being increasingly consulted on resource allocation, conflicts of interest, and other corporate decisions. Many clinical ethicists felt they lacked sufficient knowledge and understanding of organisational decision-making processes, training in organisational ethics, and access to organisational ethics tools to deal effectively with the increasing demand for organisational ethics support. Conclusion: Growing demand for organisational ethics expertise in healthcare institutions is reshaping the role of clinical ethicists. Effectiveness in organisational ethics entails a re-evaluation of clinical ethics training to include capacity building in organisational ethics and organisational decision-making processes as a complement to traditional clinical ethics education. (shrink)