Protein splicing is an extraordinary post‐translational reaction that removes an intact central “spacer” domain (Sp) from precursor proteins (N‐Sp‐C) while splicing together the N‐ and C‐domains of the precursor, via a peptide bond, to produce a new protein (N‐C). All of the available data on protein splicing fit a model in which these intervening sequences excise at the protein level via a self‐splicing mechanism. Several proteins have recently been discovered that undergo protein splicing, and in two such cases, the excised (...) spacer protein is an endonuclease. Such endonucleases are capable of conferring genetic mobility upon the intervening sequences that encodes them. These intervening sequences define a new family of mobile genetic elements that are translated yet remain phenotypically silent by excising at the protein rather than the RNA level. (shrink)

Design patterns are generalized solutions to frequently recurring problems. They were initially developed by architects and computer scientists to create a higher level of abstraction for their designs. Here, we extend these concepts to cell biology to lend a new perspective on the evolved designs of cells' underlying reaction networks. We present a catalog of 21 design patterns divided into three categories: creational patterns describe processes that build the cell, structural patterns describe the layouts of reaction networks, and behavioral patterns (...) describe reaction network function. Applying this pattern language to the E. coli central metabolic reaction network, the yeast pheromone response signaling network, and other examples lends new insights into these systems. (shrink)

Abstract Context: Established in 1997, Summa Health System’s Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management. How these services affect one another has thus far been (...) unclear. Objectives: This study describes EC consults: types, reasons, recommendations and utilization, and investigates the impact the PCCS may have on EC consult requests or recommendations. Methods: Retrospective reviews of 100 EC records explored trends and changes in types of consults, reasons for consults, and EC recommendations and utilization. Results: There were 50 EC consults each in the 6 years pre- and post-PCCS. Differences found include: (1) a decrease in number of reasons for consult requests (133–62); (2) changes in top two reasons for EC consult requests from ‘Family opposed to withdrawing life-sustaining treatment (LST)’ and ‘Patient capacity in question’ to ‘Futility’ and ‘Physician opposed to providing LST’; (3) changes in top two recommendations given by the EC from ‘Emotional Support for Patient/Family’ and ‘Initiate DNR Order’ to ‘Comfort Care’ and ‘Withdraw Treatment.’ Overall, 88% of recommendations were followed. Conclusion: PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined. Content Type Journal Article Pages 1-16 DOI 10.1007/s10730-011-9170-9 Authors Jessica Richmond Moeller, Department of Psychiatry and Behavioral Sciences, Akron General Medical Center, 400 Wabash Ave, Akron, OH 44307, USA Teresa H. Albanese, Health Services Research and Education Institute, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Kimberly Garchar, Kent State University, 6000 Frank Ave., N.W, North Canton, OH 44720, USA Julie M. Aultman, Department of Family and Community Medicine, Northeast Ohio Medical University, P.O. Box 95, Rootstown, OH 44272, USA Steven Radwany, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Dean Frate, Internal Medicine, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737. (shrink)

A core symptom of anxiety disorders is the tendency to interpret ambiguous information as threatening. Using EEG and BOLD-MRI, several studies have begun to elucidate brain processes involved in fear-related perceptual biases, but thus far mainly found evidence for general hypervigilance in high fearful individuals. Recently, multi-voxel pattern analysis (MVPA) has become popular for decoding cognitive states from distributed patterns of neural activation. Here, we used this technique to assess whether biased fear generalization, characteristic of clinical fear, is already present (...) during the initial perception and categorization of a stimulus, or emerges during the subsequent interpretation of a stimulus. Individuals with low spider fear (LSF, n = 20) and high spider fear (HSF, n = 18) underwent functional MRI scanning while viewing series of schematic flowers morphing to spiders. In line with previous studies, individuals with high fear of spiders were behaviorally more likely to classify ambiguous morphs as spiders than individuals with low fear of spiders. Univariate analyses of BOLD-MRI data revealed stronger activation towards spider pictures in high fearful individuals compared to low fearful individuals in numerous areas. Yet, neither average activation, nor support vector machine classification (i.e. a form of MVPA) matched the behavioral results - i.e., a biased response towards ambiguous stimuli - in any of the regions of interest. This may point to limitations of the current design, and to challenges associated with classifying emotional and neutral stimuli in groups that differ in their judgment of emotionality. Improvements for future research are suggested. (shrink)

Aworkshop was held August 26–28, 2015, by the Earth- Life Science Institute (ELSI) Origins Network (EON, see Appendix I) at the Tokyo Institute of Technology. This meeting gathered a diverse group of around 40 scholars researching the origins of life (OoL) from various perspectives with the intent to find common ground, identify key questions and investigations for progress, and guide EON by suggesting a roadmap of activities. Specific challenges that the attendees were encouraged to address included the following: What key (...) questions, ideas, and investigations should the OoL research community address in the near and long term? How can this community better organize itself and prioritize its efforts? What roles can particular subfields play, and what can ELSI and EON do to facilitate research progress? (See also Appendix II.) The present document is a product of that workshop; a white paper that serves as a record of the discussion that took place and a guide and stimulus to the solution of the most urgent and important issues in the study of the OoL. This paper is not intended to be comprehensive or a balanced representation of the opinions of the entire OoL research community. It is intended to present a number of important position statements that contain many aspirational goals and suggestions as to how progress can be made in understanding the OoL. The key role played in the field by current societies and recurring meetings over the past many decades is fully acknowledged, including the International Society for the Study of the Origin of Life (ISSOL) and its official journal Origins of Life and Evolution of Biospheres, as well as the International Society for Artificial Life (ISAL). (shrink)

Empirical research pertaining to cardiopulmonary resuscitation (CPR), clinician behaviors related to do-not-resuscitate (DNR) orders and substituted judgment suggests potential contributions to medical ethics. Research quantifying the likelihood of surviving CPR points to the need for further philosophical analysis of the limitations of the patient autonomy in decision making, the nature and definition of medical futility, and the relationship between futility and professional standards. Research on DNR orders has identified barriers to the goal of patient involvement in these life and death (...) discussions. The initial data on surrogate decision making also points to the need for a reexamination of the moral basis for substituted judgment, the moral authority of proxy decision making and the second-order status of the best interests standard. These examples of empirical research suggest that an interplay between empirical research, ethical analysis and policy development may represent a new form of interdisciplinary scholarship to improve clinical medicine. (shrink)

First published in 2005. Routledge is an imprint of Taylor & Francis, an informa company.

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

Investigation of neural and cognitive processes underlying individual variation in moral preferences is underway, with notable similarities emerging between moral- and risk-based decision-making. Here we specifically assessed moral distributive justice preferences and non-moral financial gambling preferences in the same individuals, and report an association between these seemingly disparate forms of decision-making. Moreover, we find this association between distributive justice and risky decision-making exists primarily when the latter is assessed with the Iowa Gambling Task. These findings are consistent with neuroimaging studies (...) of brain function during moral and risky decision-making. This research also constitutes the first replication of a novel experimental measure of distributive justice decision-making, for which individual variation in performance was found. Further examination of decision-making processes across different contexts may lead to an improved understanding of the factors affecting moral behaviour. (shrink)

Although in modern times and clinical settings, we rarely see the old characteristics of tribal shamanism such as deep trances, out-of-body experiences, and soul retrieval, the archetypal dreams, waking visions and active imagination of modern depth psychology represents a liminal zone where ancient and modern shamanism overlaps with analytical psychology. These essays explore the contributors' excursions as healers and therapists into this zone. The contributors describe the many facets shamanism and depth psychology have in common: animal symbolism; recognition of the (...) reality of the collective unconscious; and healing rituals that put therapist and patient in touch with transpersonal powers. By reintroducing the core of shamanism in contemporary form, these essays shape a powerful means of healing that combines the direct contact with the inner psyche one finds in shamanism with the self-reflection and critical awareness of modern consciousness. The essays draw from the contributors' experiences both inside and outside the consulting room, and with cultures that include the Lakota Sioux, and those of the Peruvian Andes and the Hawaiian Islands. The focus is on those aspects of shamanism most useful and relevant to the modern practice of depth psychology. As a result, these explorations bring the young practice of analytical psychology into perspective as part of a much more ancient heritage of shamanistic healing. Contributors: Margaret Laurel Allen, Norma Churchill, Arthur Colman, Lori Cromer, Patricia Damery, C. Jess Groesbeck, Pansy Hawk Wing, June Kounin, Carol McRae, Pilar Montero, Jeffrey A. Raff, Janet S. Robinson, Meredith Sabini, Dyane N. Sherwood, Sara Spaulding-Phillips, Bradley A. Te Paske and Louis M. Vuksinick. (shrink)

Gareth Evans'' proposal, as amended by Steven Neale –that a definite pronoun with a quantifiedantecedent that does not bind it has the sense ofa definite description – has been challenged inthe singular case by appeal to counter-examplesinvolving failure of the uniqueness condition forthe legitimacy of a singular description. Thischallenge is here extended to the plural.Counter-examples are provided by cases in which aplural description `the Fs'' does not denote,despite the propriety of the use of `they'' or`them'' it is to replace, because (...) of failure ofcumulativeness. A noncumulative predicate isnot distributive, and conditions for thelegitimacy of `the Fs'' designed to accommodatenondistributive `Fs'' are given in the context ofa two sorted theory with generalized quantifiers.Failure of cumulativeness is not to be confusedwith failure of maximality as Neale and othersdefine it. If not all Fs are Gs, `The Fs are Gs''is false; but it does not follow that `the Fs'' isillegitimate; and if `Fs'' is distributive. it isso only if there are no Fs. These differencesgranted, I give a partial defense of theEvans–Neale proposal from deficiencies in analternative based on the views of P. T.Geach. (shrink)

Calls for the expansion of ethics education in the business and accounting curricula have resulted in a variety of interventions including additional material on ethical cases, the code of conduct, and the development of new courses devoted to ethical development [Lampe, J.: 1996]. The issue of whether ethics should be taught has been addressed by many authors [see for example: Hanson, K. O.: 1987; Huss, H. F. and D. M. Patterson: 1993; Jones, T. M.: 1988–1989; Kerr, D. S. and L. (...) M. Smith : 1995; Loeb, S. E.: 1988; McDonald, G. M. and G. D. Donleavy: 1995]. The question addressed in this paper is not whether ethics should be taught but whether accounting students can reason more ethically after an intervention based on a discrete and dedicated course on accounting ethics. The findings in this paper indicate that a discrete intervention emphasising dilemma discussion has a positive and significant effect on students’ moral reasoning and development. The data collected from interviews suggest that the salient influences on moral judgement development include: learning theories of ethics particularly Kohlberg’s theory of cognitive moral reasoning and development; peer learning; and moral discourse. The implications from the findings in this study suggest that moral reasoning is responsive to particular types of ethics intervention and educators should carefully plan their attempts to foster moral judgement development. (shrink)

A notable feature of paradox is recognition that seemingly contradictory terms are inextricably intertwined and interrelated—holding out the hope that something new can be learned from the cognitive tension contained within. Aram has characterized the central concern of the business and society field as the paradox of interdependent relations. Our study argues that this and related paradoxes can be addressed by engaging with others and trying to gain shared insight via an interactive, developmental, exploratory sensemaking process that can inform the (...) governance of stakeholder networks. We advocate multistakeholder learning dialogues (MSLDs) as a means for both scholars and practitioners to construct meanings that can guide joint efforts to cope with messy problems that help shape complex, paradoxical relationships within stakeholder networks. (shrink)

This study explores the value of traditional ethnographic methods in sociology for the study of human-animal and animal-animal interactions and culture. Itargues that some measure of human-animal intersubjectivity is possible and that the method of participant observation is best suited to achieve this. Applying ethnographic methods to human-cat and cat-cat relationships in a no-kill cat shelter, the study presents initial findings; it concludes that the social structure of the shelter is the product of interaction both between humans and cats and (...) cats and cats and that the observed structure represents, to a large degree, choices made by the cats. The study also concludes that, within the cat community of the shelter, a distinctive cat culture has emerged, which represents the cats' adaptation to the particular conditions of shelter life. Specifically, the shelter allows for the emergence of higher order needs and goals that stress affection, friendship, and social cohesion among the cats rather than territoriality and conflict. The study further argues that traditional animal researchers have mistaken the relative equality of cat colonies for a lack of social structure, as opposed to a different structure from that found in sharply ranked nonhuman animal communities. (shrink)

In retrospect, I think I was right to compose Natural Supernaturalism by relying on taste, tact, and intuition rather than on a controlling method. A book of this kind, which deals with the history of human intellection, feeling, and imagination, employs special vocabularies, procedures, and modes of demonstration which, over many centuries of development, have shown their profitability when applied to matters of this sort. I agree with Booth that these procedures, when valid, are in a broad sense rational, and (...) subject to analysis and some degree of definition. But the rules underlying such a discourse are complex, elusive, unsystematic, and subject to innovative modification; they manifest themselves in the intuitive expertise of the historian; and the specification of these rules should not precede, but follow practice. . . . After the fact, nevertheless, a book like Natural Supernaturalism is subject to close critical inquiry about its methods and rationale. I am grateful to Booth for opening up such an inquiry, and for doing so in a way that is not only disarming, but seems to me to be the most promising of useful results. That is, instead of adopting a prosecutorial stance, demanding: "Justify the rationality and probative force of what you have done; it looks dammed suspicious to me," he has adopted the friendly tactic of saying: "Your book, in my experience of it, has yielded discoveries that I want to call knowledge, by methods, however deviant from standard rubrics of valid reasoning, that it seems irrational to call non-rational. Let's set out to clarify what these methods are, and to see what grounds we can find for the claim that they provide warranted knowledge." M.H. Abrams' contributions to Critical Inquiry are "The Deconstructive Angel" and "Behaviorism and Deconstruction: A Comment on Morse Peckham's 'The Infinitude of Pluralism'". (shrink)

This brief reply gives a few references and clarifies some points in order to emphasize that a number of Professor Seedhouse's assertions are debatable and that his criticism of slovenly scholarship and his unbridled ad hominem argumentation are out of place and easily refuted.

In the first Critique Kant introduced the analytic/synthetic distinction and illustrated it with theoretical propositions. As his main aim in that work was to justify synthetic a priori propositions, Kant was able to bring his central questions into relief and discuss the methodology of their solution by contrasting synthetic propositions, such as: “Every event has a cause” with analytic propositions, such as: “Every effect has a cause.” Consequently, few commentators have any difficulty in stating as propositions the propositions Kant is (...) justifying in the first Critique or in pointing out the difficulty of justifying such propositions. (shrink)

Informed consent has become one of the central problems in medical ehtics. At first sight, it would seem that no argument can be made against a person's right to be fully aware of the extent, course, and implications of his medical condition. It seems equally obvious that it is the patient's right to participate in, influence, or fully and solely assume the decisions of medical actions that should be undertaken or withheld with regard to his disease. Nevertheless, there are circumstances (...) in which these commonly held assumptions about a patient's rights may not apply. It is the purpose of this report to describe a case where informed consent was deliverately not sought, and to discuss the ethical issues involved. (shrink)

Scientific chemical production on a commercial scale was evident in Britain in the early nineteenth century. One of the first palaeotechnic chemical industries was the manufacture of synthetic alkali. By 1823 a well-defined pattern of soda production had emerged. An understanding of this initial distribution is important as those areas associated with the early growth of the synthetic alkali industry showed a remarkable continuity of inorganic chemical production for the remainder of the century. The paper attempts to consider those factors (...) which contributed to this selective regional response, and in doing so, a number of interesting factors of location are revealed. (shrink)

Clinicians' work depends on sincere and complete disclosures from their patients; they honour this candidness by confidentially safeguarding the information received. Breaching confidentiality causes harms that are not commensurable with the possible benefits gained. Limitations or exceptions put on confidentiality would destroy it, for the confider would become suspicious and un-co-operative, the confidant would become untrustworthy and the whole climate of the clinical encounter would suffer irreversible erosion. Excusing breaches of confidence on grounds of superior moral values introduces arbitrariness and (...) ethical unreliability into the medical context. Physicians who breach the agreement of confidentiality are being unfair, thus opening the way for, and becoming vulnerable to, the morally obtuse conduct of others. Confidentiality should not be seen as the cosy but dispensable atmosphere of clinical settings; rather, it constitutes a guarantee of fairness in medical actions. Possible perils that might accrue to society are no greater than those accepted when granting inviolable custody of information to priests, lawyers and bankers. To jeopardize the integrity of confidential medical relationships is too high a price to pay for the hypothetical benefits this might bring to the prevailing social order. (shrink)

The hopes and fears expressed in the debate on human enhancement are not always based on a realistic assessment of the expected possibilities. Discussions about extreme scenarios may at times obscure the ethical and policy issues that are relevant today. This paper aims to contribute to an adequate and ethically sound societal response to actual current developments. After a brief outline of the ethical debate concerning neuro-enhancement, it describes the current state of the art in psychopharmacological science and current uses (...) of psychopharmacological enhancement, as well as the prospects for the near future. It then identifies ethical issues regarding psychopharmacological enhancements that require attention from policymakers, both on the professional and on the governmental level. These concern enhancement research, the gradual expansion of medical categories, off-label prescription and responsibility of doctors, and accessibility of enhancers on the Internet. It is concluded that further discussion on the advantages and drawbacks of enhancers on a collective social level is still needed. (shrink)

Palabras claves. Métodos estadísticos, pruebas de hipótesisResumen. Se presentan de forma simple, breve y por medios de los ejemplos prácticos, los métodos estadísticos que sirven para demostrar la representatividad de una, dos o varias muestras basada en los parámetros poblacionales . Se indican la manera de reducir el tamaño del error experimental para aclarar el efecto significativo de los grupos o muestras bajo el interés . Además, se demuestran la forma de eliminar el efecto de las variables auxiliares o colaterales (...) causante del ruido o error en la estadística . También se nota el uso del modelo ANOVA Anidada para indicar la forma de segmentar la ANOVA en varias partes y de esta manera poder contestar preguntas más complejas. Finalmente, se describen e explican la forma de optimizar los recursos en la conducción de los experimentos y descubrir el efecto de la interacción entre las variables .Keywords. Hypothesis testing, statistical methods. Statistical methods that serve to represent, based upon population parameters of mean and variance, for one, tow or various samples taken from study populations are discussed. Ways to reduce the amount of experimental error in order to clarify the real effect of the treatments are demonstrated . The use of Covariance Analysis to show the pure effect of treatment free from the effect of collateral variables is also indicated. Nested ANOVA that allows division of ANOVA in several parts in order to answer complex questions is described and explained. Finally, the utility of Factorial Analysis for optimization of resource use as well as the illustration of interaction effects are noted and analyzed. (shrink)

Aldous Huxley’s Brave New World is a famous dystopia, frequently called upon in public discussions about new biotechnology. It is less well known that 30 years later Huxley also wrote a utopian novel, called Island. This paper will discuss both novels focussing especially on the role of psychopharmacological substances. If we see fiction as a way of imagining what the world could look like, then what can we learn from Huxley’s novels about psychopharmacology and how does that relate to the (...) discussion in the ethical and philosophical literature on this subject? The paper argues that in the current ethical discussion the dystopian vision on psychopharmacology is dominant, but that a comparison between Brave New World and Island shows that a more utopian view is possible as well. This is illustrated by a discussion of the issue of psychopharmacology and authenticity. The second part of the paper draws some further conclusions for the ethical debate on psychopharmacology and human enhancement, by comparing the novels not only with each other, but also with our present reality. It is claimed that the debate should not get stuck in an opposition of dystopian and utopian views, but should address important issues that demand attention in our real world: those of evaluation and governance of enhancing psychopharmacological substances in democratic, pluralistic societies. (shrink)

The term "interest" lacks a precise antonym. In English, we have "disinterested" and "uninteresting," but we want for a term that denotes robust opposition to interest. The same appears to hold true in every other language (as far as we know). Interest's missing antonym reflects not merely a widespread lexical oversight, but a misrecognition of interest's complete and exact meaning. More importantly, the idea that interest has no opposite expresses a certain refusal to acknowledge the power of the impulse to (...) extinguish interest, for the self and for others. Why then do we foreclose interest's possibility, degrade our (and others') capacities to experience interest, and destroy interest's objects? Why do we decline what interest proffers - which includes creative and subjective being, thinking, and relating - in favor of more primitive modes of survival, thoughtlessness, and nonbeing? Why do relationships - with ourselves, with others, with objects - toward which genuine interest draws us seem sometimes, if not often, unbearable? These questions are difficult. Their answers, even more so. Misinterest: Essays, Pensées, and Dreams attempts to approach them in an honest way, without making them fascinating, mysterious, boring, obscurantist, or fascinatingly mysteriously boringly obscurantist. Outwardly, Misinterest is concerned with dreams and forgetting and Eros and soaring dogs and groups and suicidal suburban teenagers and sex and jury duty and Nazis and fathers and hatred and holy parrots and fundamentalists and plagues and other things that may or may not be interesting. Ultimately, however, it seeks, like Jules Renard, "en restant exact" (in remaining true/real), to shed light on the establishment of misinterest, missingness, and mystery where and when they need not be, and, thus, on the psychic, familial, and political forces that compel us not to be when and where we ought. (shrink)

Classical medicine operates in a climate of rational discourse, scientific knowledge accretion and the acceptance of ethical standards that regulate its activities. Criticism has centred on the excessive technological emphasis of modern medicine and on its social strategy aimed at defending exclusiveness and the privileges of professional status. Alternative therapeutic approaches have taken advantage of the eroded public image of medicine, offering treatments based on holistic philosophies that stress the non-rational, non-technical and non-scientific approach to the unwell, disregarding traditional diagnostic (...) categories and concentrating on enhancing subjective comfort and well-being, but remaining oblivious to the organic substrate of disease. This leads to questionable ethics in terms of false hopes and lost opportunities for effective therapy. (shrink)

A number of recent publications by the philosopher David Seedhouse are discussed. Although medicine is an eminently ethical enterprise, the technical and ethical aspects of health care practices can be distinguished, therefore justifying the existence of medical ethics and its teaching as a specific part of every medical curriculum. The goal of teaching medical ethics is to make health care practitioners aware of the essential ethical aspects of their work. Furthermore, the contention that rational bioethics is a fruitless enterprise because (...) it analyses non-rational social events seems neither theoretically tenable nor to be borne out by actual practice. Medical ethics in particular and bioethics in general, constitute a field of expertise that must make itself understandable and convincing to relevant audiences in health care. (shrink)

Clinical and research practices designed by developed countries are often implemented in host nations of the Third World. In recent years, a number of papers have presented a diversity of arguments to justify these practices which include the defence of research with placebos even though best proven treatments exist; the distribution of drugs unapproved in their country of origin; withholding of existing therapy in order to observe the natural course of infection and disease; redefinition of equipoise to a more bland (...) version, and denial of post-trial benefits to research subjects. These practices have all been prohibited in developed, sponsoring countries, even though they invariably have pockets of poverty where conditions comparable to the Third World prevail. Furthermore, the latest update of the Declaration of Helsinki clearly decries double ethical standards in research protocols. Under these circumstances, it does not seem appropriate that First World scholars should propose and defend research and clinical practices with less stringent ethical standards than those mandatory in their own countries. Recent years have witnessed frequent reports of less stringent ethical standards being applied to both clinical and research medical practices, for the most part in the field of drug trials and drug marketing, initiated by developed countries in poorer nations. Still more unsettling, a number of articles have endorsed the policy of employing ethical norms in these host countries, which would be unacceptable to both the legislations and the moral standards of the sponsor nations. Also, these reformulations often contravene the Declaration of Helsinki or one of its updates. This paper is not so much concerned with the actual practices, which have been subjected to frequent scrutiny and publicly decried when gross misconduct occurred. Rather, my concern relates to the approval and support such practices have found in the literature on bioethics from authors who might be expected to use their energy and scholarship to explore and endorse the universalisability of ethics rather than to develop ad hoc arguments that would allow exceptions and variations from accepted moral standards. To this purpose, issue will be taken with arguments in three fields: medical and pharmaceutical practices, research strategies, and local application of research results. (shrink)

In this remarkably accessible, concise, and engaging introduction to moral philosophy, Steven M. Cahn brings together a rich, balanced, and wide-ranging collection of fifty readings on ethical theory and contemporary moral issues. He has carefully edited all the articles to ensure that they will be exceptionally clear and understandable to undergraduate students. The selections are organized into three parts--Challenges to Morality, Moral Theories, and Moral Problems--providing instructors with flexibility in designing and teaching a variety of ethics courses. Each reading is (...) followed by study questions. The third edition of Exploring Ethics provides more coverage of contemporary problems, featuring new selections on euthanasia, capital punishment, animal rights, affirmative action, academic ethics, the trolley problem, and the meaning of life. A Companion Website at www.oup.com/us/cahn offers a password-protected Instructor's Manual--containing a test bank, key terms with definitions, reading summaries, and PowerPoint lectures--and self-quizzes, vocabulary flashcards, and useful links for students. (shrink)

Supererogatory acts are considered by some to be part of medicine, whereas others accept supererogation to be a gratuitous virtue, to be extolled when present, but not to be demanded. The present paper sides with those contending that medicine is duty-bound to benefit patients and that supererogation/altruism must per definition remain outside and beyond any role-description of the profession. Medical ethics should be bound by rational ethics and steer away from separatist views which grant exclusive privileges but also create excessive (...) demands, way beyond what physicians perform or are willing and able to offer. (shrink)

Featuring nine new articles chosen by coeditor, Steven M. Cahn, the third edition of E. D. Klemke's The Meaning of Life offers twenty-two insightful selections that explore this fascinating topic. The essays are primarily by philosophers but also include materials from literary figures and religious thinkers. As in previous editions, the readings are organized around three themes. In Part I the articles defend the view that without faith in God, life has no meaning or purpose. In Part II the selections (...) oppose this claim, defending instead a nontheistic, humanistic alternative--that life can have meaning even in the absence of theistic commitment. In Part III the contributors ask whether the question of the meaning of life is itself meaningful. The third edition adds substantial essays by Moritz Schlick, Joel Feinberg, and John Kekes as well as selections from the writings of Louis P. Pojman, Emil L. Fackenheim, Robert Nozick, Susan Wolf, and Steven M. Cahn. The only anthology of its kind, The Meaning of Life: A Reader, Third Edition, is ideal for courses in introduction to philosophy, human nature, and the meaning of life. It also offers general readers an accessible and stimulating introduction to the subject. (shrink)

As out-of-hospital emergencies become more commonplace, so does the call for a “doctor in the house”. New York City paediatrician Mitchell Rubin has responded to numerous such crises over the past 25 years. He explores reactions on all sides of this peculiar physician–victim relationship, his growing concerns and fears, and possible reasons why many doctors hesitate to act. His thoughts and experiences instigate the discussion about the need for a universal system of Good Samaritan physician respondersWhile flying to Italy last (...) spring, the pilot’s voice came over the loudspeaker: “Is there a doctor on board”? How many times have I heard this request in the last 25 years? A passenger had fainted. As I began caring for her, the pilot asked me, “Should we take the plane down?”. Surprised to be given this responsibility, I took my best guess and answered “no”. After a stressful landing, while I gave oxygen to the prostrate woman, we were met by an ambulance on the tarmac. The woman was appreciative and gracious, the pilot scarcely offered thanks, and I began my vacation exhausted.Having been trained as a paediatrician, I have responded to nearly two dozen “Good Samaritan” scenarios, where a person was injured or became critically sick in a public setting. Perhaps I have had more than my fair share, but I wonder if this is an important and mounting phenomenon. With America growing older and more and more people with serious, chronic illnesses remaining active in the community, we should not be surprised to see increasing numbers of out-of-hospital emergencies. And, as this becomes more commonplace, I become less and less certain of the role I—and other physicians like me—should have.When I was young, cocky and fearless, the call to meet an emergency was exciting. Shortly after training, an …. (shrink)

We are each the product of our development. The nature of the developmental process by which each of us was formed is described from gametogenesis to neonatality. The varied influences upon that process and their relative balance and patterns of interaction are then considered. In particular, the relative importance of epigenetic and genetic factors is discussed. It is concluded that development is a continuous process involving epigenetic/genetic interactions throughout. The contemporary emphasis on the genetic basis for human individuality is reviewed (...) critically. (shrink)

The information about patients being murdered by Lodz ambulance doctors using pancuronium bromide , published in the Gazeta Wyborcza,1 was repeated in the international press—for example, in the British Medical Journal.2 The account of a Gazeta Wyborcza reporter who had been working as an undercover stretcher bearer and witnessed the reported events, does not prove that any murder was committed. It was the media that presented the information in a negative light. So far the police have not charged anybody with (...) murder. The ambulance workers and doctors who were selling information about the dead to funeral parlours have been detained.Although it has not been proved that any patients were murdered in Lodz, the way the matter was treated by the media could lead one …. (shrink)

Resumen. Se presentan los conceptos básicos de muestreo secuencial en sus cinco modalidades,incluyendo muestreo secuencial de tipo estándar, usando solo una densidad crítica, por una precisiónfija, por medio de presencia-ausencia y finalmente de tipo temporal. Se notan un ejemplo real para cadacaso. Se nota y se explica la importancia de la distribución de los datos y los pertinentes ecuaciones. Sepresentan a través de ejemplos reales las ecuaciones para estimar el tamaño óptimo de la muestra paracada uno de las cinco modalidades (...) del muestreo secuencial. Se enfatiza la ventaja económica de estetipo de muestreo.Palabras clave: Distribución de los datos, muestreo secuencial, tamaño óptimo de la muestra. Fundamental concepts of sequential sampling in all its types including standard sequentialsampling, sequential sampling using only one critical density, fixed precision sequential sampling,presence-absence sequential sampling, and time sequential sampling are highlighted. A real caseexample for each of the five sequential samplings is given. The relevance of data distribution forsequential sampling along with corresponding equations is provided and explained. Equations to assessthe optimal sample size for each case are noted and exemplified. The economic advantages of sequentialsampling in stressedKeywords: Data distribution, sample size, sequential sampling. (shrink)

Problem solving is an essential part of every scientific discipline. It has two components: (1) problem identification and formulation, and (2) the solution to the formulated problem. One can solve a problem on its own using ad hoc techniques or by following techniques that have produced efficient solutions to similar problems. This requires the understanding of various algorithm design techniques, how and when to use them to formulate solutions, and the context appropriate for each of them. Algorithms: Design Techniques and (...) Analysis advocates the study of algorithm design by presenting the most useful techniques and illustrating them with numerous examples -- emphasizing on design techniques in problem solving rather than algorithms topics like searching and sorting. Algorithmic analysis in connection with example algorithms are explored in detail. Each technique or strategy is covered in its own chapter through numerous examples of problems and their algorithms. Readers will be equipped with problem solving tools needed in advanced courses or research in science and engineering. (shrink)