BackgroundStudies have shown that research participants fail to appreciate the difference between research and medical care, labeling such phenomenon as a "therapeutic misconception" (TM). Since research activity involving human participants is increasing in the Middle East, qualitative research investigating aspects of TM is warranted. Our objective was to assess for the existence of therapeutic misconception amongst Egyptians.MethodsStudy Tool: We developed a semi-structured interview guide to elicit the knowledge, attitudes, and perspectives of Egyptians regarding medical research.Setting: We recruited individuals from the (...) outpatient settings (public and private) at Ain Shams University in Cairo, Egypt.Analysis: Interviews were taped, transcribed, and translated. We analyzed the content of the transcribed text to identify the presence of a TM, defined in one of two ways: TM1 = inaccurate beliefs about how individualized care can be compromised by the procedures in the research and TM2 = inaccurate appraisal of benefit obtained from the research study.ResultsOur findings showed that a majority of participants (11/15) expressed inaccurate beliefs regarding the degree with which individualized care will be maintained in the research setting (TM1) and a smaller number of participants (5/15) manifested an unreasonable belief in the likelihood of benefits to be obtained from a research study (TM2). A total of 12 of the 15 participants were judged to have expressed a TM on either one of these bases.ConclusionThe presence of TM is not uncommon amongst Egyptian individuals. We recommend further qualitative studies investigating aspects of TM involving a larger sample size distinguished by different types of illnesses and socio-economic variables, as well as those who have and have not participated in clinical research. (shrink)

1. [without special title] -- ḥeleḳ 2. Meḳorot u-ferushim.

Medical research must involve the participation of human subjects. Knowledge of patients' perspectives and concerns with their involvement in research would enhance recruitment efforts, improve the informed consent process, and enhance the overall trust between patients and investigators. Several studies have examined the views of patients from Western countries. There is limited empirical research involving the perspectives of individuals from developing countries. The purpose of this study is to examine the attitudes of Egyptian individuals toward medical research. Such information would (...) help clarify the type and extent of concerns regarding research participation of individuals from cultural, economic, and political backgrounds that differ from those in developed countries. (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)

In this paper, we empirically explore some manifestations of norms for the conduct of science. We focus on scientific research ethics and report survey results from 606 scientists who received funding in 1993 and 1994 from the Division of Molecular and Cellular Biology of the Biology Directorate of the National Science Foundation. We also report results for 91 administrators charged with overseeing research integrity at the scientists’ research institutions. Both groups of respondents were presented with a set of scenarios, designed (...) by fractional factorial methods, describing different kinds of scientific conduct that in the eyes of some would likely be unethical. Respondents then were asked to evaluate each of these scenarios for how unethical the behavior might be and what kinds of sanctions might be appropriate. We use the responses to consider the nature of consensus around norms related to the practice of science and in particular, similarities and differences between scientists and science administrators. Implications for policy are also discussed. (shrink)

Volume 20, Issue 7, July 2020, Page 101-103.

Variation in decision-making about end-of-life care among ethnic groups creates clinical conflicts. In order to understand changes in preferences for end-of-life care among Japanese who immigrate to the United States, we conducted 18 focus groups with 122 participants: 65 English-speaking Japanese Americans, 29 Japanese-speaking Japanese Americans and 28 Japanese living in Japan.Negative feelings toward living in adverse health states and receiving life-sustaining treatment in such states permeated all three groups. Fear of being meiwaku, a physical, psychological or financial caregiving burden (...) on loved ones, was a prominent concern. They preferred to die pokkuri (popping off) before they become end stage or physically frail. All groups preferred group-oriented decision-making with family. Although advance directives were generally accepted, Japanese participants saw written directives as intrusive whereas Japanese Americans viewed them mainly as tools to reduce conflict created by dying person's wishes and a family's kazoku no jo– responsibility to sustain the dying patient. These findings suggest that in the United States Japanese cultural values concerning end-of-life care and decision-making process are largely preserved. (shrink)

Bioethics is the study of ethical issues arising out of advances in the life sciences and medicine. Historically, bioethics has been associated with issues in research ethics and clinical ethics as a result of research scandals such as the Tuskegee Syphilis Study and public debates about the definition of death, medical paternalism, health care rationing, and abortion. As biomedical technologies have advanced, challenging new questions have arisen for bioethics and new sub-disciplines such as neuroethics and public health ethics have entered (...) the scene. This volume features ten original essays on five cutting-edge controversies in bioethics written by leading philosophers. I. Research Ethics: How Should We Justify Ancillary Care Duties? II. Clinical Ethics: Are Psychopaths Morally Accountable? III. Reproductive Ethics: Is There A Solution to the Non-Identity Problem? IV. Neuroethics: What is Addiction and Does It Excuse? V. Public Health Ethics: Is Luck Egalitarianism Implausibly Harsh? S. Matthew Liao and Collin O’Neil’s concise introduction to the essays in the volume, the annotated bibliographies and study questions for each controversy, and the supplemental guide to additional current controversies in bioethics give the reader a broad grasp of the different kinds of challenges in bioethics. (shrink)

Objective To determine the attitudes of Egyptian patients regarding their participation in research and with the collection, storage and future use of blood samples for research purposes. Design Cross-sectional survey. Study population Adult Egyptian patients (n=600) at rural and urban hospitals and clinics. Results Less than half of the study population (44.3%) felt that informed consent forms should provide research participants the option to have their blood samples stored for future research. Of these participants, 39.9% thought that consent forms should (...) include the option that future research be restricted to the illness being studied. A slight majority (66.2%) would donate their samples for future genetic research. Respondents were more favourable towards having their blood samples exported to other Arab countries (62.0%) compared with countries in Europe (41.8%, p<0.001) and to the USA (37.2%, p<0.001). Conclusions This study shows that many individuals do not favour the donation of a blood sample for future research. Of those who do approve of such future research, many favour a consent model that includes an option restricting the future research to the illness being studied. Also, many Egyptians were hesitant to have their blood samples donated for genetic research or exported out of the Arab region to the USA and European countries. Further qualitative research should be performed to determine the underlying reasons for many of our results. (shrink)

This paper claims that the standard characterization of the motivational role of belief should be supplemented. Beliefs do not only, jointly with desires, cause and rationalize actions that will satisfy the desires, if the beliefs are true; beliefs are also the practical ground of other cognitive attitudes, like imagining, which means beliefs determine whether and when one acts with those other attitudes as the cognitive inputs into choices and practical reasoning. In addition to arguing for this thesis, I take issue (...) with Velleman's argument that belief and imagining cannot be distinguished on the basis of motivational role. (shrink)

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)

Researchers from diverse disciplines, including organismal and cellular physiology, sports science, human nutrition, evolution and ecology, have sought to understand the causes and consequences of the surprising variation in metabolic rate found among and within individual animals of the same species. Research in this area has been hampered by differences in approach, terminology and methodology, and the context in which measurements are made. Recent advances provide important opportunities to identify and address the key questions in the field. By bringing together (...) researchers from different areas of biology and biomedicine, we describe and evaluate these developments and the insights they could yield, highlighting the need for more standardisation across disciplines. We conclude with a list of important questions that can now be addressed by developing a common conceptual and methodological toolkit for studies on metabolic variation in animals. (shrink)

Although detailed studies of code adoption and impact have already been conducted in Hong Kong, there has as yet been no critical analysis of why there has been a gap between the normative and positive factors underlying codes of ethics in Hong Kong. The purpose of this paper is to consider why Hong Kong companies adopting codes of ethics have failed to adhere closely to the best practice prescriptions for code adoption when it would likely be in their best interests (...) to do so. This paper identifies some cultural factors, such as power distance and traditional Legalist assumptions approximating Theory X, that appear to be involved in creating this gap, and offers some practical recommendations for closing the gap, which are presented in the form of hypotheses for further testing. (shrink)

Let me begin with some of the background worries that motivate the paper. First, for years I have been working on the relation of the Timaeus to the Republic guided by this triple analogy: as the demiurge is to the cosmos, so the philosopher-ruler is to the polis, so reason is to the soul or individual. The key claim is Tim. 29e: the demiurge is good and so wants to make everything it makes like it itself is, i.e., good, as (...) good as possible. I take the demiurge to be reason idealized, so I infer reason wants to make everything it makes as good as possible. This sets the stage: how is reason related to the good? (shrink)

The Dialectic of Essence offers a systematic new account of Plato's metaphysics. Allan Silverman argues that the best way to make sense of the metaphysics as a whole is to examine carefully what Plato says about ousia (essence) from the Meno through the middle period dialogues, the Phaedo and the Republic, and into several late dialogues including the Parmenides, the Sophist, the Philebus, and the Timaeus. This book focuses on three fundamental facets of the metaphysics: the theory of Forms; (...) the nature of particulars; and Plato's understanding of the nature of metaphysical inquiry. Silverman seeks to show how Plato conceives of "Being" as a unique way in which an essence is related to a Form. Conversely, partaking ("having") is the way in which a material particular is related to its properties: Particulars, thus, in an important sense lack essence. Additionally, the author closely analyzes Plato's idea that the relation between Forms and particulars is mediated by form-copies. Even when some late dialogues provide a richer account of particulars, Silverman maintains that particulars are still denied essence. Indeed, with the Timaeus's introduction of the receptacle, there are no particulars of the traditional variety. This book cogently demonstrates that when we understand that Plato's concern with essence lies at the root of his metaphysics, we are better equipped to find our way through the labyrinth of his dialogues and to better appreciate how they form a coherent theory. (shrink)

Data science, and the related field of big data, is an emerging discipline involving the analysis of data to solve problems and develop insights. This rapidly growing domain promises many benefits to both consumers and businesses. However, the use of big data analytics can also introduce many ethical concerns, stemming from, for example, the possible loss of privacy or the harming of a sub-category of the population via a classification algorithm. To help address these potential ethical challenges, this paper maps (...) and describes the main ethical themes that were identified via systematic literature review. It then identifies a possible structure to integrate these themes within a data science project, thus helping to provide some structure in the on-going debate with respect to the possible ethical situations that can arise when using data science analytics. (shrink)

Some 20 years ago Todd and colleagues proposed that rhythm perception is mediated by the conjunction of a sensory representation of the auditory input and a motor representation of the body (Todd, 1994a, 1995 ), and that a sense of motion from sound is mediated by the vestibular system (Todd, 1992a, 1993b ). These ideas were developed into a sensory-motor theory of rhythm and beat induction (Todd et al., 1999 ). A neurological substrate was proposed which might form the biological (...) basis of the theory (Todd et al., 2002 ). The theory was implemented as a computational model and a number of experiments conducted to test it. In the following time there have been several key developments. One is the demonstration that the vestibular system is primal to rhythm perception, and in related work several experiments have provided further evidence that rhythm perception is body dependent. Another is independent advances in imaging, which have revealed the brain areas associated with both vestibular processing and rhythm perception. A third is the finding that vestibular receptors contribute to auditory evoked potentials (Todd et al., 2014a, b ). These behavioral and neurobiological developments demand a theoretical overview which could provide a new synthesis over the domain of rhythm perception. In this paper we suggest four propositions as the basis for such a synthesis. (1) Rhythm perception is a form of vestibular perception; (2) Rhythm perception evokes both external and internal guidance of somatotopic representations; (3) A link from the limbic system to the internal guidance pathway mediates the “dance habit”; (4) The vestibular reward mechanism is innate. The new synthesis provides an explanation for a number of phenomena not often considered by rhythm researchers. We discuss these along with possible computational implementations and alternative models and propose a number of new directions for future research. (shrink)

If we are to understand why psychoanalysis extends ordinary psychology in the precise ways that it does, we must take account of the existence of, and the interplay between, two distinct kinds of explanatory concern: functional and idiographic. The form and content of psychoanalytic explanation and its unusual methodology can, at least in part, be viewed as emerging out of Freud's attempt to reconcile these two types of explanatory concern. We must also acknowledge the role of the background theoretical context (...) that shapes Freud's functional thinking about the mind. A neglect of the role of the background theory in shaping the extension of ordinary psychology leaves us with puzzles about the nature and direction of the psychoanalytic extension and gives rise to an unbelievable history of psychoanalysis. (shrink)

I argue that we should rethink the nature and scope of Spinoza’s “one and the same” relation. Contrary to the standard reading, the nature of this relation is not identity but a union, and its scope includes all idea-object pairs, even God and the idea of God. A crucial reason we should adopt this dual picture is that the idea of God must be one and the same as something found when Nature is conceived under each of the other attributes. (...) If “one and the same” is interpreted as a relation of identity, this requirement cannot be met. However, maintaining that God and the idea of God are one and the same not only fulfills this requirement, but also is independently motivated. I also briefly consider how the thesis that God and the idea of God are one and the same affords us with positive insights concerning the nature of this relation. (shrink)

John Hick attempts to justify evil’s existence by claiming it is necessary for the process of “soul-making,” which allows for the development of a more valuable type of moral character than a world without evil. Hick’s theodicy has ramifications for ethics as well as philosophy of religion. His theodicy commits him to a conception of virtue theory that significantly departs from the ethical theories held by many theists. An explication of Hick’s ethical theory and comparison with relevant aspects of Thomas (...) Aquinas’s ethical theory showshow Hick’s ethical theory makes this departure. At stake in this paper is whether Hick’s ethical theory and account of the virtue of love make his theodicy less plausible. (shrink)