Increasing ethical attention and debate is focusing on whether individuals who take part in clinical trials should be given access to post-trial care. However, the main focus of this debate has been upon drug trials undertaken in low-income settings. To broaden this debate, we report findings from interviews with individuals (n = 24) who participated in a clinical trial of a closed-loop system, which is a medical device under development for people with type 1 diabetes that automatically adjusts blood glucose (...) to help keep it within clinically recommended ranges. Individuals were recruited from UK sites and interviewed following trial close-out, at which point the closed-loop had been withdrawn. While individuals were stoical and accepting of the requirement to return the closed-loop, they also conveyed varying degrees of distress. Many described having relaxed diabetes management practices while using the closed-loop and having become deskilled as a consequence, which made reverting back to pre-trial regimens challenging. Participants also described unanticipated consequences arising from using a closed-loop. As well as deskilling, these included experiencing psychological and emotional benefits that could not be sustained after the closed-loop had been withdrawn and participants reevaluating their pre- and post-trial life in light of having used a closed-loop and now perceiving this life much more negatively. Participants also voiced frustrations about experiencing better blood glucose control using a closed-loop and then having to revert to using what they now saw as antiquated and imprecise self-management tools. We use these findings to argue that ethical debates about post-trial provisioning need to be broadened to consider potential psychological and emotional harms, and not just clinical harms, that may result from withdrawal of investigated treatments. We also suggest that individuals may benefit from information about potential nonclinical harms to help make informed decisions about trial participation. (shrink)

Mixed results regarding the role of gender in moral reasoning prompted an investigation of an alternative characteristic that may be more influential in the process: sex role orientation. We present an empirical assessment of the relationship between an individual’s moral reasoning level and his/her sex role orientation, gender, and several academic factors. Our results indicate that sex role orientation is not related to moral reasoning level. Gender is related to moral reasoning in our study, women reasoning at higher levels than (...) men. We found a positive relationship between education and moral reasoning level, and moral reasoning levels differed across academic institutions. Our results also show business students have lower moral reasoning levels than students in other fields, although this result did not reach statistical significance. (shrink)

We describe and analyse how large herbivores strongly diminished a woody vegetation, dominated by the unpalatable shrub Sambucus nigra L. and changed it into grassland. Density of woody species and cover of vegetation were measured in 1996, 2002 and 2012 in the grazed Oostvaardersplassen. In 2002 and 2012 we also measured density and cover in an ungrazed control site. In 2002 we measured intensity of browsing and bark loss of Sambucus shrubs in the grazed and control sites. In the grazed (...) site the density of Sambucus and Salix spp. declined significantly between 1996 and 2012, and large areas changed into grassland. In the control site the density of Sambucus increased significantly during this period, the density of Salix spp. did not change, and the vegetation consisted of a mixture of woody species and a field layer dominated by tall herbs. In 2002 and 2012 the percentages of dead Sambucus shrubs were significantly higher in the grazed site than in the control site. In 2002 the percentages of twigs browsed and ring barked stems of Sambucus shrubs were significantly higher in the grazed site than in the control site. Our results show that debarking caused mature Sambucus shrubs to die, but that heavy browsing may have helped this process. Our results also point to a significant neighbour effect on the break down of Sambucus, suggesting that Aggregational Resistance and Associational Palatability were both active. Essential conditions for the break down of this woody vegetation were the presence of large herbivores, the low ratio between the areas of summer and winter feeding habitats and the competition amongst herbivores. Browsing may have been responsible for seedling death, as seedlings were found only in the control site and not on the old and newly established grasslands in the grazed site. (shrink)

The formation and recall of memories are fundamental aspects of life and help preserve the complex collection of experiences that provide us with a sense of identity and autonomy. Scientists have recently started to investigate pharmacological agents that inhibit or “dampen” the strength of memory formation and recall. The development of these memory-dampening agents has been investigated for the treatment of posttraumatic stress disorder (PTSD). Currently, these agents are being tested in multicenter clinical trials and will likely soon be approved (...) for the treatment of PTSD. With advancements in technology, more targeted memory-dampening techniques may be developed in the future. Accessibility to these agents will inevitably affect one's sense of identity and also one's sense of autonomy. Therefore, it is essential that the legal and ethical implications of using these agents be examined for governments and courts to appropriately address issues that may emerge. (shrink)

Graphical AbstractUnderstanding epigenetic modifications to chromatin that regulate gene expression and cell-fate decisions is now possible in single cells thanks to recent technological advances. As interdisciplinary approaches are required to derive biological principles, this workshop brought together some of Europe's leading researchers in single-cell epigenetics to share technologies and biological insights.

"The studies collected in this book are all concerned with aspects of the Platonic tradition, either in its own internal development in the Hellenistic age and the period of the Roman Empire, or with the influence of Platonism, in one or other of its forms, on other spiritual traditions, especially that of Christianity." [Book jacket].

The discovery of the microworld presented a serious trial for many systems of views held by mankind, including its logic. This world was found to lack the familiar solid bodies, the unchanging particles and interrelations between them, the reflection of which, in one way or another, is the logic of the macroscopic world. What elementary particle physics encountered in the microscopic world seemed illogical: the rest-mass of a particle equals zero; a part that is not smaller than the whole; a (...) particle that in diffraction experiments moved like a wave; and much else that was unusual and strange in the properties of elementary particles. One of these properties was actually so named by physicists — "strangeness.". (shrink)

On the basis of a communicative theory of criminal punishment, I show how mercy has a significant but limited role to play in the criminal law—in particular (although not only) in criminal sentencing. Mercy involves an intrusion into the realm of criminal law of values and concerns that are not themselves part of the perspective of criminal law: a merciful sentencer acts beyond the limits of her legal role, on the basis of moral considerations that conflict with the demands of (...) penal justice. Sometimes, however (but in a decent system of law in a decent society, rarely), that is how citizens should act. Finally, I discuss, and criticise, two attempts to find a place for mercy within a communicative conception of punishment, and argue that repentance is not an appropriate ground for leniency or mercy in sentencing. (shrink)

He then proceeds with an examination of the picture theory developed by Wittgenstein, Carnap, and Goodman, and concludes with an examination of Patricia Churchland, Ruth Millikan, Robert Cummins, and Mark Rollins. The use of the historical development of representationalism to pose a central problem in contemporary cognitive science is unique.

Objectives: This study was designed to explore the prevalence and types of stipulations required of investigators by the institutional review board of one institution over a five year period.Design: Stipulations to research proposals were documented from the minutes of the IRB meetings.Setting: Community hospital.Participants: IRB submissions.Main measurements: Number and type of IRB stipulations.Results: Nineteen research submissions were approved without any stipulations. For the remainder, the majority of stipulations related to consent forms .Conclusions: Consent forms appear to be at highest risk (...) for IRB stipulations. Being aware of high risk areas before submission of research proposals may reduce the frequency of stipulations required of investigators. (shrink)