Background Biobank participants often do not understand much of the information they are provided as part of the informed consent process, despite numerous attempts at simplifying consent forms and improving their readability. We report the first assessment of biobank enrollees’ comprehension under an "integrated consent” process, where patients were asked to enroll in a research biobank as part of their normal healthcare experience. A number of healthcare systems have implemented similar integrated consent processes for biobanking, but it is unknown how (...) much patients understand after enrolling under these conditions. Methods: We recruited patients who enrolled in a biobank while in a healthcare setting when receiving ordinary care. We assessed knowledge of consent materials using 11 true/false questions drawn from a well-known biobank knowledge test. After reviewing the results from 114 participants, we revised the consent form and repeated the knowledge assessment with 144 different participants. Results: Participants scored poorly on the knowledge test in both rounds, with no significant differences in overall scores or individual items between the rounds. In Phase 1, participants answered 53% of the questions correctly, 25% incorrectly, and 22% “I don’t know.” In Phase 2, participants answered 53% of questions correctly, 24% incorrectly, and 23% “I don’t know.” Participants scored particularly poorly on questions about data sharing and accessing medical records. Conclusions: Enrollees under an integrated consent model had significant misunderstandings that persisted despite an attempt to improve information specifically about those topics in a consent form. These results raise challenges for current approaches that attribute misunderstanding to overly complex consent forms. They also suggest that the pressures of the clinic may compound other problems with patient understanding of biobank consent. As health systems increasingly blend research and care, they may need to rethink their approach to educating patients about participation in a biobank. (shrink)

Laland and colleagues have sought to challenge the proximate–ultimate distinction claiming that it imposes a unidirectional model of causation, is limited in its capacity to account for complex biological phenomena, and hinders progress in biology. In this article the core of their argument is critically analyzed. It is claimed that contrary to their claims Laland et al. rely upon the proximate–ultimate distinction to make their points and that their alternative conception of reciprocal causation refers to phenomena that were already accounted (...) for by standard theory. (shrink)

Much philosophical progress has been made in elucidating the idea of evolutionary contingency in a recent re-burgeoning of the debate. However, additional progress has been impaired on three fronts. The first relates to its characterisation: the under-specification of various contingency claims has made it difficult to conceptually pinpoint the scope to which ‘contingency’ allegedly extends, as well as which biological forms are in contention. That is—there appears to be no systematic means with which to fully specify contingency claims which has (...) led to a tendency for authors to talk past each other. Secondly, on the matter of evidence, recent research has focused on the evidential import of convergent evolution which is taken to disconfirm the evolutionary contingency thesis. However, there has been a neglect of convergent evolution’s converse: ‘evolutionary idiosyncrasies’ or the singular evolution of certain forms, which I argue is evidentially supportive of evolutionary contingency. Thirdly, evolutionary contingency has often been claimed to vary in degrees and that the debate, itself, is a matter of ‘relative significance’. However, there has been no formal method of evaluating the strength of contingency and its relative significance in a particular domain. In this paper, I address all three issues by proposing a systematic means of fully specifying contingency theses with the concept of the modal range. Secondly, I propose an account of evolutionary idiosyncrasies, investigate the explanations for their occurrences, and, subsequently, spell out their significance with respect to the evolutionary contingency thesis. Finally, having been equipped with the evidential counterpart to convergent evolution, I shall sketch a likelihood framework for evaluating, precisely on the basis of a sequence of opposing data, the strength and relative significance of evolutionary contingency in a particular domain. With this in hand, the relative observations of idiosyncrasies and convergences can be informative of the strength and relative significance of contingency in any particular domain. (shrink)

Paternalist policies in public health often aim to improve people’s well-being by reducing their options, regulating smoking offering a prime example. The well-being challenge is to show that people really are better off for having their options reduced. The distribution challenge is to show how the policies are justified since they produce losers as well as winners. If we start from these challenges, we can understand the importance of the empirical evidence that a very high proportion of smokers regret smoking. (...) In short, it is important that they regret it and important that the proportion is so high. This paper explains how, philosophically, regret can relate to well-being and it considers some of the strengths and weakness in the empirical research that the explanation brings out. The regret case for regulating smoking is indeed strong, although not as strong as the empirical researchers think. It is much weaker for paternalistic intervention in other public health problems, such as obesity and binge drinking. (shrink)

The variety DMM of De Morgan monoids has just four minimal subvarieties. The join-irreducible covers of these atoms in the subvariety lattice of DMM are investigated. One of the two atoms consisting of idempotent algebras has no such cover; the other has just one. The remaining two atoms lack nontrivial idempotent members. They are generated, respectively, by 4-element De Morgan monoids C4 and D4, where C4 is the only nontrivial 0-generated algebra onto which finitely subdirectly irreducible De Morgan monoids may (...) be mapped by noninjective homomorphisms. The homomorphic preimages of C4 within DMM constitute a proper quasivariety, which is shown to have a largest subvariety U. The covers of the variety within U are revealed here. There are just ten of them. In exactly six of these ten varieties, all nontrivial members have C4 as a retract. In the varietal join of those six classes, every subquasivariety is a variety—in fact, every finite subdirectly irreducible algebra is projective. Beyond U, all covers of [or of ] within DMM are discriminator varieties. Of these, we identify infinitely many that are finitely generated, and some that are not. We also prove that there are just 68 minimal quasivarieties of De Morgan monoids. (shrink)

In a previous paper (Duncan, T.L., Semura, J.S. in Entropy 6:21, 2004) we considered the question, “What underlying property of nature is responsible for the second law?” A simple answer can be stated in terms of information: The fundamental loss of information gives rise to the second law. This line of thinking highlights the existence of two independent but coupled sets of laws: Information dynamics and energy dynamics. The distinction helps shed light on certain foundational questions in statistical mechanics. For (...) example, the confusion surrounding previous “derivations” of the second law from energy dynamics can be resolved by noting that such derivations incorporate one or more assumptions that correspond to the loss of information. In this paper we further develop and explore the perspective in which the second law is fundamentally a law of information dynamics. (shrink)

‘Scientific dishonesty’ implies the fabrication, falsification or plagiarism in proposing, performing or reviewing research or in reporting research results. A questionnaire was given to postgraduate students at the medical faculties in Sweden who attended a course in research ethics during the academic year 2008/2009 and 58% answered (range 29%–100%). Less than one-third of the respondents wrote that they had heard about scientific dishonesty in the previous 12 months. Pressure, concerning in what order the author should be mentioned, was reported by (...) about 1 in 10 students. We suggest that all departments conducting research should have a written policy about acceptable research behaviour and that all doctoral students should be informed of the content of this policy. Participants in the research groups concerned should also be required to analyse published articles about scientific dishonesty and critically discuss what could be done about unethical conduct. (shrink)

Gametes, tissue, and organs can be taken from the dying or dead for reproduction, transplantation, and research. Whole bodies as well as parts can be used for teaching anatomy. While these uses are diverse, they have an ethical consideration in common: the claims of the people whose bodies are used. Is some use permissible only when people have consented to the use, actually wanted the use, would have wanted the use, not opposed the use, or what? The aim of this (...) article is to make progress in answering these questions. Initially I assume knowledge of people’s desires in order to test whether consent is directly required by their rights without worrying about mistaken uses against their wishes. I claim consent is not directly required by people’s rights. If we know people wanted or would want a use, their rights permit the use, but if we know they wanted or would want not to be used, their rights do not permit the use. The knowledge assumption is then dropped and the question becomes how to decide what to do when the wishes of rightholders are not known. I suggest working out what to do when wishes are known and then adjusting, on the basis of whatever evidence there is, for probability and strength of desire. There are other considerations too, for instance about default rules. The key general comment here is that, in setting rules, the costs to rightholders in not getting what they want needs to be taken into account. The final section tries to show that, in setting these rules, mistaken uses are not to be taken as worse than mistaken failure to use. (shrink)

A medical centre is an institution established for a specific purpose: to facilitate the health and health-related welfare of the medical centre's patients. Within this institution, there are a variety of professionals who act and interact to serve this purpose. Of particular interest is the interaction between physician and nurse. Generally, the nurse is thought to be under a certain obligation to implement a physician's orders unless there is good reason not to do so. This qualifier places a conflicting obligation (...) upon the nurse not to implement some physician orders. How should a judgement about which orders there is 'good reason' not to implement be made? I propose to approach this question through an analysis of the obligation the nurse has to implement the order of a physician, and the conditions under which the order does not pose such obligations. This analysis will consist of an examination of the obligation in terms of the purposive authority of the physician. For example, in the context of the medical centre, the physician's medical training qualifies her as best able to make determinations of what treatment would promote the patient's health. However, this purpose not only serves as the basis of the physician's authority, but also serves as a limitation upon the physician's authority (for example, an order which would harm the patient would not reflect the purpose for which the physician has been given authority). Thus, a philosophical investigation into the nature of the obligation to implement a physician's orders can help to clarify those occasions when a nurse should not implement an order. (shrink)

Governments can try to counter obesity through preventive regulations such as sugar taxes, which appear to raise costs or reduce options for consumers. Would the regulations improve the welfare of adult consumers? The regulations might improve choice sets through a mechanism such as reformulation, but the scope for such improvement is limited. Otherwise, a paternalistic argument must be made that preventive regulations would improve welfare despite reducing choice. This paper connects arguments about obesity, health, and choice to a philosophically plausible (...) view of welfare. On the negative side, two errors to avoid are failing to see the limited value of health and thinking that findings of irrationality would alone settle arguments about welfare. On the positive side, preventive regulations could make people better-off if welfare is the satisfaction of preferences and if preventive regulations could better satisfy preferences by overcoming certain forms of irrationality. The leading evidence is from widespread attempts to lose weight. However, at least for the United States, most adults are not trying to lose weight, and that casts doubt on whether they would benefit from preventive regulations. If they would not, that seems a strong albeit not decisive reason against these regulations. (shrink)

In his investigation of the concept of "Being", Aristotle relates the question of "existence" to the question "essence" and considers essence as "whatness" and quiddity. Although in his logical discussions he treats the concepts of "existence" and "whatness" separately and makes a distinction between them, but does not extend this distinction to the area of philosophical topics. But in the prepatetic Islamic system of Philosophy, explanation and distinction between "Being" and "quidity" is without doubt one of the most fundamental philosophical (...) doctrines and beliefs. In the history of Islamic philosophy, the theory of metaphysical distinction between being and essence has been attributed to Ibn Sina, but it is Farabi who for the first time has propounded clearly and decisively a two – part division between "being" and "quiddity" and has prepared the way for Avecinian philosophy. In addition to his logical distinction between "existence" and "whatness" of things he has stressed on a metaphysical distinction between them and has made this distinction the foundation of his metaphysical system. From Farabi's view, being is an inherent accident of quiddity. In this article we try to explain the concepts of "existence" and "whatness" of things and their relation as one of the most fundamental topics in prepatetic philosophy in the philosophical thought of these two great prepatetic philosophers, ie Aristotle and Farabi, with specific stress on comparing their views. (shrink)

Byzantine Empire; economic and social conditions; history.

« Mais pourquoi diable les humains, sur leur petite planète bleue, s’intéressent-ils à ce point à moi, qui ne suis qu’un extraterrestre? » : telle est la question que pose un E. T. parmi tant d’autres, depuis l’espace intersidéral, à une autrice de science-fiction qui a transformé ce genre littéraire qu’est le space opéra et à un astrophysicien qui est aussi le président du plus grand festival de sciences et de science-fiction en France : les Utopiales à Nantes.

This book argues that whiteness is not only a visual orientation; it is a way of hearing. Inspired by the understandings of race and whiteness in the existential writings of Fanon, Beauvoir, Sartre, W.E.B. Du Bois, and Angela Davis, this book introduces students to the notion of the white sonic gaze.

The elite theory of Max Weber has recently been rediscovered by political scientists and political theorists who have sought to explore both the heuristic and the normative potential of plebiscitary leader democracy. Notwithstanding the merits of this wave of studies, this paper argues that attention should be shifted from Weber's context-specific defence of plebiscitary leadership in post-WWI Germany to his broader conception of charisma as an attempt to grasp the enigma of significant social and political change. Contemporary democratic theory, this (...) paper contends, can fruitfully draw on Weber to sink into the antinomies and ambiguities of a transformative democratic politics. (shrink)

al-juzʼ 1. Kitāb al-maqūlāt wa-kitāb al-ʻibārah.

Codes of medical ethics issued by professional organizations typically contain statements affirming the importance of confidentiality between patients and health-care practitioners. Seldom, however, is the confidentiality obligation depicted as absolute. Instead, exceptions are noted, the most common of which is that health-care professionals are justified in breaching the confidence of a patient if required by law to do so. Reasons that might be given to support this exception are critically discussed in this paper. The conclusion argued for is that this (...) is not a legitimate exception to the confidentiality rule. (shrink)

An important contribution to the foundations of probability theory, statistics and statistical physics has been made by E. T. Jaynes. The recent publication of his collected works provides an appropriate opportunity to attempt an assessment of this contribution.

Externalism holds that the content of our utterances and thoughts are determined partly by the environment. Here, I offer an argument which suggests that externalism is incompatible with a natural view about ontological commitment--namely, the Quinean view that such commitments are fixed by the range of the variables in your theory. The idea in brief is that if Oscar mistakenly believes that water = XYZ, the externalist ontologically commits Oscar to two waterish kinds, whereas the Quinean commits him to one (...) such kind (albeit a metaphysically impossible kind). The penultimate section addresses a variety of objections to the argument. (shrink)

In spite of their drastically different historical trajectories, the ongoing socio-political transition in the European Union (EU) and the Indian Republic (IR), two of the most complex polities in contemporary world, suggests that they aspire to combine political federalism and cultural pluralism. This is evident from their endorsing equality, identity and inclusivity as values; implementing political decentralization and facilitating differentiation between state, civil society and market. To meet the emerging challenges both the EU and the IR endorse the idea of (...) unity in diversity. The article suggests that two coping strategies, transforming cultural diversity (a fact) into cultural pluralism (a value) and decoupling the identities of citizenship and nationality are imperatives. (shrink)