Background The European Union aims to optimize patient protection and efficiency of health-care research by harmonizing procedures across Member States. Nonetheless, further improvements are required to increase multicenter research efficiency. We investigated IRB procedures in a large prospective European multicenter study on traumatic brain injury, aiming to inform and stimulate initiatives to improve efficiency. Methods We reviewed relevant documents regarding IRB submission and IRB approval from European neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury. (...) Documents included detailed information on IRB procedures and the duration from IRB submission until approval. They were translated and analyzed to determine the level of harmonization of IRB procedures within Europe. Results From 18 countries, 66 centers provided the requested documents. The primary IRB review was conducted centrally or locally and primary IRB approval was obtained after one, two or three review rounds with a median duration of respectively 50 and 98 days until primary IRB approval. Additional IRB approval was required in 55% of countries and could increase duration to 535 days. Total duration from submission until required IRB approval was obtained was 114 days and appeared to be shorter after submission to local IRBs compared to central IRBs. Conclusion We found variation in IRB procedures between and within European countries. There were differences in submission and approval requirements, number of review rounds and total duration. Research collaborations could benefit from the implementation of more uniform legislation and regulation while acknowledging local cultural habits and moral values between countries. (shrink)

T. J. Smiley; XII.—Entailment and Deducibility, Proceedings of the Aristotelian Society, Volume 59, Issue 1, 1 June 1959, Pages 233–254, https://doi.org/10.1093.

The standard approach to protecting privacy in healthcare aims to control access to personal information. We cannot regain control of information after it has been shared, so we must restrict access from the start. This ‘control’ conception of privacy conflicts with data-intensive initiatives like precision medicine and learning health systems, as they require patients to give up significant control of their information. Without adequate alternatives to the control-based approach, such data-intensive programmes appear to require a loss of privacy. This paper (...) argues that the control view of privacy is shortsighted and overlooks important ways to protect health information even when widely shared. To prepare for a world where we no longer control our data, we must pursue three alternative strategies: obfuscate health data, penalise the misuse of health data and improve transparency around who shares our data and for what purposes. Prioritising these strategies is necessary when health data are widely shared both within and outside of the health system. (shrink)

Some philosophers have thought that life could only be meaningful if there is no God. For Sartre and Nagel, for example, a God of the traditional classical theistic sort would constrain our powers of self-creative autonomy in ways that would severely detract from the meaning of our lives, possibly even evacuate our lives of all meaning. Some philosophers, by contrast, have thought that life could only be meaningful if there is a God. God and the Meanings of Life is interested (...) in exploring the truth in both these schools of thought, seeking to discover what God could and couldn't do to make life meaningful (as well as what he would and wouldn't do). Mawson espouses a version of the 'amalgam' or 'pluralism' thesis about the issue of life's meaning – in essence, that there are a number of different legitimate meanings of 'meaning' (and indeed 'life') in the question of life's meaning. According to Mawson, God, were he to exist, would help make life meaningful in some of these senses and hinder in some others. He argues that whilst there could be meaning in a Godless universe, there could be other sorts of meaning in a Godly one and that these would be deeper. (shrink)

An ancient doctor who advocated the therapeutic benefits of wine and passive exercise was bound to be successful. However, Asclepiades of Bithynia did far more than reform much of traditional Hippocratic therapeutic practice; he devised an extraordinary physical theory which he used to explain all biological phenomena in uniformly simple terms. His work laid the theoretical basis for the anti-theoretical medical sect called Methodism. For his trouble he was despised by his intellectual progeny and, more importantly perhaps, by Galen. None (...) of his work survives intact, but copious ancient testimonia relating to him allow us to reconstruct many details of the theory. His ideas offer us a fascinating glimpse of how Hellenistic philosophy and medicine interacted, and provide an introduction to one of the most intriguing doctrinal disputes in Greek science. (shrink)

Recent highly publicized privacy breaches in health care and genomics research have led many to question whether current standards of data protection are adequate. Improvements in de-identification techniques, combined with pervasive data sharing, have increased the likelihood that external parties can track individuals across multiple databases. This paper focuses on the communication of identifiability risks in the process of obtaining consent for donation and research. Most ethical discussions of identifiability risks have focused on the severity of the risk and how (...) it might be mitigated, and what precisely is at stake in pervasive data sharing. However, there has been little discussion of whether and how to communicate the risk to potential donors. We review the ethical arguments behind favoring different types of risk communication in the consent process, and outline how identifiability concerns can be incorporated into either a detailed or simplified method of communicating risks during the consent process. (shrink)

How do we think about animals? How do we decide what they deserve and how we ought to treat them? Subhuman takes an interdisciplinary approach to these questions, drawing from research in philosophy, neuroscience, psychology, law, history, sociology, economics, and anthropology. Subhuman argues that our attitudes to nonhuman animals, both positive and negative, largely arise from our need to compare ourselves to them.

These notes present two, hitherto largely unnoticed, conjectures by Professor R.G.M. Nisbet, relating to Martial Book 12.

Amongst other countries, the Netherlands currently allows euthanasia, provided the physician performing the procedure adheres to a strict set of requirements. In 2016, Second Chamber member Pia Dijkstra submitted a law proposal which would also allow euthanasia without the reason necessarily having any medical foundation; euthanasia on the basis of a completed life. The debate on this topic has been ongoing for over two decades, but this law proposal has made the discussion much more immediate and concrete. This paper considers (...) the moral permissibility of Pia Dijkstra’s law proposal, focusing on the ethics of the implementation Dijkstra describes in her proposal. I argue that, at present, Dijkstra’s law proposal is unsuitable for implementation, due to a number of as of yet unaddressed problems, including the possible development of an ageist stigma and undue pressure on the profession of end-of-life coordinator. Perhaps adequate responses can be conceived to address these issues. However, the existence of a radically different, yet currently equally unacceptable position regarding the implementation of euthanasia for a completed life as proposed by fellow party member Paul Schnabel suggests it may be difficult to formulate an ethically acceptable implementation for this, in principle, ethically acceptable concept. (shrink)

This major addition to Ideas in Context examines the development of natural law theories in the early stages of the Enlightenment in Germany and France. T. J. Hochstrasser investigates the influence exercised by theories of natural law from Grotius to Kant, with a comparative analysis of the important intellectual innovations in ethics and political philosophy of the time. Hochstrasser includes the writings of Samuel Pufendorf and his followers who evolved a natural law theory based on human sociability and reason, fostering (...) a new methodology in German philosophy. This book assesses the first histories of political thought since ancient times, giving insights into the nature and influence of debate within eighteenth-century natural jurisprudence. Ambitious in range and conceptually sophisticated, Natural Law Theories in the Early Enlightenment will be of great interest to scholars in history, political thought, law and philosophy. Natural Law Theories in the Early Enlightenment has been selected as the winner of the annual Morris D. Forkosch Prize for the best book in intellectual history published in 2000. (shrink)

Recent advances in synthetic biology have made it possible to revive extinct species of animals, a process known as ‘de-extinction’. This paper examines two reasons for supporting de-extinction: the potential for de-extinct species to play useful roles in ecosystems; and human valuing of certain de-extinct species. I focus on the particular case of passenger pigeons to argue that the most critical challenge for de-extinction is that it entails significant suffering for sentient individual animals. I also provide reasons to take existence (...) value, or valuing the mere the fact that a species exists, into consideration in debates over de-extinction. (shrink)

Beskow and Weinfurt (2019) present an excellent and timely discussion of how to respond to evidence that individuals do not fully understand a biobank consent form. We faced similar challenges afte...

This chapter introduces the descriptive analogue of self-location. It argues that if a language contains predicates that apply to the properties it exemplifies, and it contains reflexive expressions that identify those properties, we have the makings of self-describing sentences that do for its descriptive vocabulary what self-locating acts do for spatial vocabulary.

It is not intended as some sort of revelation on my part that Greenberg's cultural theory was originally Marxist in its stresses and, indeed in its attitude to what constituted explanation in such matters. I point out the Marxist and historical mode of proceeding as emphatically as I do partly because it may make my own procedure later in this paper seem a little less arbitrary. For I shall fall to arguing in the end with these essay's Marxism and their (...) history, and I want it understood that I think that to do so is to take issue with their strengths and their main drift.But I have to admit there are difficulties here. The essays in question ["Avant-Garde and Kitsch" and "Towards a Newer Lacoön"] are quite brief. They are, I think, extremely well written: it was not for nothing the Partisan Review described Clement Greenberg, when he first contributed to the journal early in 1939, as "a young writer who works in the New York customs house"—fine, redolent avant-garde pedigree, that! The language of these articles is forceful and easy, always straightforward, blessedly free from Marxist conundrums. Yet the price paid for such lucidity, here as so often, is a degree of inexplicitness—certain amount of elegant skirting round the difficult issues, where one might otherwise be obliged to call out the ponderous armory of Marx's concepts and somewhat spoil the low of the prose from one firm statement to another. The Marxism, in other words, is quite largely implicit; it is stated on occasion, with brittle and pugnacious finality, as the essay's frame of reference, but it remains to the reader to determine just how it works in the history and theory presented—what that history and theory depend on, in the way of Marxist assumptions about class and capital or even abase and superstructure. That is what I intend to do in this paper: to interpret and extrapolate from the texts, even at the risk of making their Marxism declare itself more stridently than the "young writer" seems to have wished. And I should admit straight away that there are several point in what follows where I am genuinely uncertain as to whether I am diverging from Greenberg's argument or explaining it more fully. This does not worry me overmuch, as long as we are alerted to the special danger in this case, dealing with such transparent yet guarded prose, and as long as we can agree that the project in general—pressing home a Marxist reading of texts which situate themselves within the Marxist tradition—is a reasonable one.22. This carelessness distinguishes the present paper from two recent studies of Greenberg's early writings, Serge Guilbaut's "The New Adventures of the Avant-Garde in America," October 15 , and Fred Orton and Griselda Pollock's "Avant-Gardes and Partisans Reviewed," Art History 3 I am indebted to both these essays and am sure that their strictures on the superficiality—not to say the opportunism–of Greenberg's Marxism are largely right. But I am nonetheless interested in the challenge offered to most Marxist, and non-Marxist, accounts of modern history by what I take to be a justified though extreme, pessimism as t the nature of established culture since 1870. That pessimism is characteristic, I suppose, of what Marxists call an ultraleftist point of view. I believe, as I say, that a version of some such view is correct and would therefore with to treat Greenberg's theory as if it were a decently elaborated Marxism of an ultraleftist kind, on which issues in certain mistaken views but which need not so issue and which might still provide, cleansed of those errors, a good vantage for a history of our culture.T. J. Clark, professor of fine arts at Harvard University, is the author of The Absolute Bourgeois: Artists and Politics in France, 1848-1851 and Image of the People: Gustave Courbet and the 1848 Revolution. His book on impressionist painting and Paris is forthcoming. (shrink)

Finding happiness within the inevitable chaos of the world is one of the hardest things you can do. It's also one of the most important. There are lots of challenges in your life, occupying space in your mind and keeping you anxious, depressed, or angry. Mental health TikToker and licensed therapist TJ Hoegh outlines his three rules for chaotic happiness, helping you rise above the fray and claim the contentedness that is yours. With evidence-based advice and more than 30 practical (...) exercises, you'll explore your own psyche, improve the quality of your relationships, and understand the impact of the outside world so you can arrive at your happiest self. (shrink)

The theme of this volume is natural beauty, landscape and the arts. The first question for a philosopher to ask is what does philosophy have to say now particularly about natural beauty. I emphasize now, because, as is well known, historically philosophers, for example, Plato and the eighteenth-century British, and especially Scottish, philosophers, were interested in the topic of beauty. At the present day there has also been some revival of interest in this subject, but when it comes to what (...) philosophers past and present have had to say about beauty, I am doubtful how much relevance it has to the question of how we should think about natural beauty. We must be careful then in an inquiry into natural beauty not to begin by taking up some question within the traditional philosophy of beauty – such as for instance whether beauty is a real quality, or whether judgments of beauty are subjective or objective – for it is difficult to see what such metaphysical lucubrations could do for the question in hand, other than offering, what is not to be underestimated, an innocent form of academic pleasure.In any case, the modern world takes a short cut with the question of beauty: everyone, unless having a distinct reason for believing the contrary, such as a specific religious faith, unhesitatingly takes it for granted that an extreme subjectivism and relativism must hold sway. (shrink)

(1984). Gender Differences in Subject Preference and Perception of Subject Importance among Third Year Secondary School Pupils in Single‐sex and Mixed Comprehensive Schools. Educational Studies: Vol. 10, No. 3, pp. 243-253.

This paper argues that the Food and Drug Administration’s (FDA) policy for health and wellness apps is ethically problematic. Currently, the FDA does not regulate health and wellness apps that are not intended for medical use. As a result of this hands‐off policy, preventing harm to consumers is left primarily to developers and app marketplaces. We argue that the FDA’s duties to prevent harm and maintain accountability to the American public require that they play a much stronger role. We also (...) discuss concerns about efficiency and fostering innovation, and argue that while they should help shape FDA regulation of health and wellness apps, they do not justify complete absence of FDA involvement. -/- . (shrink)

The celebrated western humanist tradition has its source in its early philosophical texts. In The Gift of Death, Derrida analyses the history of the emergence of ethical responsibility in the so-called Religions of the Book such as Judaism, Christianity, and Islam. While the humanist project helped itself through its conquest of the human sphere, it has served to upset the ecological balance and jeopardize sustainability. While searching for an inclusive vision for a sustainable, ethical perspective, Dōgen’s philosophy gains relevance in (...) the contemporary context. (shrink)

Johanna Knapstein,1 Daniel Grimm,1 Marcus A Wörns,1 Peter R Galle,1 Hauke Lang,2 Tim Zimmermann111st Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany; 2Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg-University, Mainz, GermanyIntroduction: Hepatitis C virus reinfection occurs universally after liver transplantation, with accelerated cirrhosis rates of up to 30% within 5 years after liver transplantation. Dual antiviral therapy with pegylated interferon-2a and ribavirin only reaches sustained virological response rates of ~30% after liver transplantation. With the approval of viral NS3/4A (...) protease inhibitors telaprevir, boceprevir, and simeprevir and the NS5B polymerase inhibitor sofosbuvir, combination therapy offers new therapeutic options for HCV-infected patients, resulting in considerably higher sustained virological response rates in the nontransplant setting. Case presentation: We report three cases of TVR-based triple antiviral therapy in HCV genotype 1 reinfected patients after liver transplantation, of whom a 57-year-old Caucasian female and a 43-year-old Caucasian male were therapy naïve, and a 49-year-old Caucasian male patient was pretreated ineffectively. After 4 weeks of therapy, viral load decreased one to three log10 and became negative in weeks 6 to 8 in the therapy naïve patients. The pretreated patient showed a negative viral load in week 4. TVR was administered over 12 weeks, 750 mg thrice daily. Doses of immunosuppression with cyclosporine were reduced four to six fold. Initial peg-IFN and RBV doses ranged from 135–180 µg/week and 800–1,200 mg/day, according to the patient's body weight. Doses of peg-IFN and RBV were adapted to 90–135 µg/week and 400–800 mg/day after 2 to 12 weeks of protease inhibitor therapy. Dual therapy was continued for 36 weeks with total treatment duration of 48 weeks in the therapy naïve patients leading to a sustained virological response 12 weeks after the end of therapy. In the pretreated patient a breakthrough was detected in week 24 and therapy was discontinued. Overall, antiviral therapy was well tolerated. Side effects included dysgeusia and anemia leading to erythropoietin application and blood transfusions. Conclusion: This case series emphasizes that triple therapy with TVR is an efficient treatment for therapy naïve HCV genotype 1 reinfected patients after liver transplantation. But therapeutic options for pretreated patients require improvement. Keyword: cyclosporine, interferon, ribavirin, hepatitis C, protease inhibitor. (shrink)