Equipoise is advocated as a means of achieving high scientific and ethical standards in randomised trials. As used in the context of research the word describes a state of uncertainty characterised by the belief that in a trial no arm is known to offer greater harm or benefit than any other arm. Clinicians who lack personal equipoise are advised to accept clinical or communal equipoise, based on current unresolved disagreement among the medical profession. Equipoise is mainly discussed in the literature (...) as an issue for senior doctors and research directors. Limitations of professional equipoise are reviewed, and data on the neglected topic of patients' equipoise are reported using the example of breast cancer trials. In theory, a patient who gives informed and voluntary consent to enter a randomised trial has achieved the equilibrium of equipoise. In practice, equipoise among patients ranges from personal to proxy acceptance. (shrink)

This article will examine McCormick's moral epistemology both at the level of how human persons know values and disvalues, which hereinafter will be referred to as synderesis, and at the level of how human persons know the rightness and wrongness of an action, which hereinafter will be referred to as normative moral judgment. On the one hand, from this investigation it appears that McCormick operates with a dual moral epistemology, at least at the level of synderesis. This means that at (...) one point in time it appears that a significant shift may have occurred in his moral epistemology at the level of synderesis. This may also be true at the level of normative moral judgment. On the other hand, McCormick's moral epistemology may in fact be a synthesis, which is the product of development and maturity in his thought process. This article will articulate, examine, and analyse both moral epistemologies. The first moral epistemology is operative in McCormick's writing up until 1983. The second moral epistemology corresponds to McCormick's decision in 1983 to write primarily in the area of bioethics from a theological perspective. Since the year 1983 seems to be the pivotal time when these two moral epistemologies converge, I will refer to the first moral epistemology as “prior to 1983” and I will refer to the second moral epistemology as “after 1983.” Because of the numerous criticisms that surround McCormick's moral epistemology, and the ambiguity that it entails, McCormick needed to articulate his theoretical foundations clearly and develop them systematically and coherently. Numerous moral theologians called for him to do this, yet he never responded. A systematic understanding of McCormick's moral epistemology is not only necessary but crucial in examining various issues in bioethics. It is necessary because it is the basis of moral decision making. It is crucial because the life and death of individuals may hang in the balance. (shrink)

The Nuremberg Trials of leading National Socialists established the principle that individuals may be legally punished, even by death, for obeying the laws of their country. Is there then a higher law by which enacted valid positive laws may be judged, so that persons subject to such laws would be duty-bound to defy them? In recent years the theory of natural law has been revived by a number of philosophers and jurists, who however often disagree sharply among themselves about the (...) proper methods for defining and deriving natural law. Howard Kainz surveys the history of natural law from its foreshadowing in ancient Greece down to the most recent controversies. Natural Law both introduces the subject to newcomers and sheds fresh light on such figures as Plato, Aristotle, Hume, Kant, Veatch, McInerny, Grisez, and Finnis. (shrink)

The article is concerned with the question of how legal institutions are structured with the use of constitutive, institutive, consequential, and terminative rules. To that end, the regulation of international treaties as laid down in the Vienna Convention on the Law of Treaties of 1969 is analysed. This leads to the discovery of two additional categories of rules: content rules and invalidating rules. Finally, the special status of unique legal institutions is investigated. Unique legal institutions – for example, heads of (...) state, parliaments, and supreme courts – enjoy validity in a legal system to the exclusion of the validity of any other legal institution of the same category in that system. (shrink)

Context: This conceptual paper tries to tackle the advantages and the limitations that might arise from including second-order science into global climate change sciences, a research area that traditionally focuses on first-order approaches and that is currently attracting a lot of media and public attention. Problem: The high profile of climate change research seems to provoke a certain dilemma for scientists: despite the slowly increasing realization within the sciences that our knowledge is temporary, tentative, uncertain, and far from stable, the (...) public expectations towards science and scientific knowledge are still the opposite: that scientific results should prove to be objective, reliable, and authoritative. As a way to handle the uncertainty, scientists tend to produce “varieties of scenarios” instead of clear statements, as well as reports that articulate different scientific opinions about the causes and dynamics of change for this specific field of research. (shrink)

As the United States is currently prosecuting two wars, it is important to consider whether those wars, and the resulting noncombatantcasualties, can be morally justified. Such consideration can be initiated by considering some of Alan Donagan’s work in his book The Theory of Morality. In that book Donagan sets out to develop, as a philosophical system, that part of the common morality according to the Hebrew-Christian tradition, which does not depend on any theistic beliefs. According to that tradition it is (...) sometimes morally permissible to resort to war. This poses a problem because also part of the tradition is a near absolute prohibition on harming innocent people. Since innocent people die in war, there is a tension here.Donagan claims that this problem can be solved by assigning the blame for some such deaths to the aggressor, thereby permitting (some) resorts to war. This paper shows that this solution is inadequate; and defends a more plausible (and more traditional) justification for some innocent deaths. This justification is consistent with the system Donagan develops, and thus may have application in the consideration of the justification of the two wars currently being prosecuted by the United States. (shrink)

A questionnaire on the attitudes towards the functions of research ethical committees was sent to members of selected research ethical committees in Wessex and some controls. Almost all respondents felt there was a need for ethical review of research projects; 42 per cent thought there was a need for some training before joining a committee; 67 per cent thought the system could be improved and 47 per cent thought that monitoring or follow-up procedures should be adopted. Ethical committees were thought (...) to be purely advisory, as opposed to mandatory, by 33 per cent, and 63 per cent thought they should restrict their review to ethical problems as opposed to scientific or design problems. Views about the function of non-medical members ranged from 'none at all' to 'very important'. Of the 10 controls who were asked whether they would become a member of an ethical committee if asked, seven said that on balance they would and the reasons stated varied from the view that it was a 'very important committee' to the feeling that it was 'a necessary but irksome job'. (shrink)

David Lewis has argued that we can gain helpful insight to the Prisoners' Dilemmas that we face from the fact that Newcomb's Problems are easy to solve, and the fact that Prisoners' Dilemmas are nothing other than two Newcomb Problems side by side. The present paper shows that the Prisoners' Dilemmas that we face are significantly different from Newcomb Problems in that the former are iterated while the latter are not. Thus Lewis's hope that we can get insight into the (...) former from the latter is illusory. (shrink)