Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...) literacy in their treatment decisions. Specifically, the article will examine the potential of shared decision-making to bridge gaps in knowledge, increase patient adherence to treatment, and improve health outcomes in low health literacy patient populations. Leveling barriers to treatment information for disadvantaged populations should be a public health imperative, especially if it can be shown to improve health outcomes and reduce health disparities. (shrink)

The National Anti-Vivisection Hospital opened to patients in 1903, the only district hospital in London not financed by state-controlled funds, which refused it support because of its principles. For three decades the hospital treated the local poor and conscientious objectors to vivisection, who were assured that staff pledged not to experiment on animals or patients. After an overambitious building program, the hospital ran into financial difficulties, and the King’s Fund refused to help unless all references to antivivisection were removed (...) from its statutes. Thus it reopened as Battersea General in 1935, continuing to serve the borough until 1972. (shrink)

The volume presents essays on the philosophical explanation of the relationship between body and soul in antiquity from the Presocratics to Galen. The title of the volume alludes to a phrase found in Plato, Aristotle and Plotinus, referring to aspects of living behaviour involving both body and soul, and is a commonplace in ancient philosophy, dealt with in very different ways by different authors.

We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)

Plutarch in his Life of Agis describes the plots by which Lysandrus the ephor contrived to depose King Leonidas II. He meant to use against him one of the Spartan laws which forbade a member of the royal houses from begetting children by a foreign woman, and another by which he who went out of Sparta with a view to settling abroad was liable to the death penalty. But though apparently a case could be made out against Leonidas under (...) these charges, Lysandrus did not simply proceed with the prosecution. After instructing confederates who would bring the case, he with his fellow ephors ‘waited for the sign’. What this meant Plutarch explains in these words: στι δ τοινδε· δι' τν1 ννα1 λαβντες ο οροι νκτα καθαρν κα σληνον, σιωπ καθζονται πρς τν ορανν ποβλποντες. ν ον κ μρους τινς ες τερον μρος στρ διξ, κρνουσι τος βασιλες, ς περ τ θεον ξαμαρτνοντας, κα καταπαουσι τς ρχς, μχρις ν κ Δελν ἢ λυμπας χρησμς λθτος λωκσι τν βασιλων βοηθν. (shrink)

The prospect of using cell-based interventions to treat neurological conditions raises several important ethical and policy questions. In this target article, we focus on issues related to the unique constellation of traits that characterize CBIs targeted at the central nervous system. In particular, there is at least a theoretical prospect that these cells will alter the recipients' cognition, mood, and behavior—brain functions that are central to our concept of the self. The potential for such changes, although perhaps remote, is cause (...) for concern and careful ethical analysis. Both to enable better informed consent in the future and as an end in itself, we argue that early human trials of CBIs for neurological conditions must monitor subjects for changes in cognition, mood, and behavior; further, we recommend concrete steps for that monitoring. Such steps will help better characterize the potential risks and benefits of CBIs as they are tested and potentially used for treatment. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

Contents: Stephen White: Opuscula and Opera in the Catalogue of Theophrastus' Works Han Baltussen: Theophrastean Echoes? The De Sensibus in the Platonic and Aristotelian Tradition Pamela M. Huby: Arabic Evidence about Theophrastus' De Sensibus Todd Ganson: A Puzzle Concerning the Aristotelian Notion of a Medium of Sense-Perception Istvan M. Bodnar: Theophrastus' De igne: Orthodoxy, Reform and Readjustment in the Doctrine of Elements Georg Wohrle: Ps-Aristoteles De Coloribus -aA Theophrastean Opusculum? David Sider: On On Signs - R.A.H. King: Nutrition and (...) Fatigue Amneris Roselli: Greek Medical Theories of Fatigue Sabine Vogt: Theophrast, De Vertigine Armelle Debru: La sueur des corps: le De sudore de Theophraste face a la tradition medicale John Dillon: Theophrastus' Critique of the Old Academy in the Metaphysics H. Takahashi: Syriac Fragments of Theophrastean Meteorology and Mineralogy Index Contributors and Editors. (Franz Steiner 2002). (shrink)

Some stalwarts are included in any and every collection of readings for students on political and social thought. Among these reliable standbys are Plato, Aristotle, Aquinas, Machiavelli, Hobbes, Locke, Rousseau, Bentham, Mill, Hegel, Marx, Lenin, and Mao Tse-tung. They are all here, marshaled and arrayed in judicious selections, well introduced. But something new has been added in this anthology. You will find in it selections from William F. Buckley, Jr., and Eldridge Cleaver, from Michael Harrington and Frantz Fanon, from Herbert (...) Marcuse and Martin Luther King, Jr., from H. L. A. Hart and Gregory Vlastos, and from others who were or are alive in the latter half of our century. The quality of the material presented is excellent. The final selection, for example, is a first-rate analysis of the notion of a "just war" by Donald A. Wells. The editors, in their general introduction, discuss such questions as what the foundation of political obligation is, how social and political institutions are or may be evaluated, how the ideals of a society are systematized, and what the nature and justification of social change are. A bibliography, a topical syllabus, and an index are usefully provided. This book of readings can confidently be recommended for use as the basic text of a historical or analytical course in political and social philosophy.—W. G. (shrink)

We shall argue that there is adequate moral justification for capital punishment with linkage, that is, with linkage to keeping non-murderers from dying. We present the argument with two aims in mind. The first is to question the conventional wisdom, seldom challenged even by proponents of capital punishment, that being an abolitionist is closely connected to having a civilized respect for human life. This conventional wisdom, we hope to show, is somewhat off the mark. To this end we exhibit structural (...) similarities between so-called lifeboat dilemmas and the public's relationship to a murderer. In a lifeboat dilemma one must choose between saving this life or that, since the lifeboat will not hold both persons. Now if this life were an innocent's and that one a murderer's, a choice to save the latter would not be met with accusations of callousness towards human life. We hope to project everyone's intuitions about this case onto the more baffling case of a society's relationship to the murderers and dying innocents in its midst. (shrink)

Philosophy of history is not a subject which has hitherto attracted much attention in this country. Preoccupation with the methods and achievements of the natural sciences, and distaste for the sort of rationale of history as a whole which Hegel and others offered under the title in the early nineteenth century, have served to make most British philosophers accord its problems only the most casual recognition. It is therefore all the more interesting to find an English writer of unusual powers (...) both of argument and expression, who was himself an historian of distinction in his special field, devoting a large part of his philosophical thinking to the problems of historical knowledge and their wider implications. Unfortunately, R. G. Collingwood was not able to begin the major work on philosophy of history, to writing which, as we are told in the introduction to the present book, he had looked forward for twenty-five years, until his powers were seriously affected by bad health, and he did not live to complete it. But though the full results of his thinking on the subject are lost, we are now able, thanks to the skilful work of his friend Professor T. M. Knox, to study what is in effect an extensive interim report on it. Professor Knox has produced The Idea of History largely on the basis of lectures which Collingwood prepared in 1936, supplemented by two essays already published which date from the same period and a certain amount of material from the unfinished Principles of History written in 1939. (shrink)

Even though for Hegel the historian rethinks, positions not as past but as necessary stages in his own philosophical development, the history of philosophy remains external to philosophy proper since a genius could work out from the beginning the stages in the Idea's progress. Hegel's critical history allocates space according to philosophical, not historical considerations, saying little about historical contexts. Non-Hegelians also emphasize assessment more than narration, and all historians of the arts and sciences must make judgments of both importance (...) and value. The history of philosophy, however, has become more historical; assessment requires understanding a philosopher's meaning through his historical situation. (shrink)

Translated from the Danish by Walter Lowrie, David Swenson, and Alexander Dru The Danish philosopher Kierkegaard is one of the master thinkers of the modern age, a defining influence on existentialism and on twentieth-century theology, and this brilliantly tailored selection from his vast and varied writings--made by the great English poet W.H Auden--is a perfect introduction to his work. Auden's inspired and incisive response to a thinker who had done much to shape his own beliefs is a fundamental reading of (...) an author whose spirit remains as radical as ever more than 150 years after he wrote. (shrink)

Hume's explicit pronouncements about truth are few and unenlightening. In a well-known passage near the beginning of Book III of the Treatise he writes that ‘Reason is the discovery of truth or falsehood. Truth or falsehood consists in an agreement or disagreement either to the real relations of ideas, or to real existence and matter of fact.’ Hume's main concern in this passage, however, is not with the concept of truth, but with his thesis that moral distinctions are not derived (...) from reason: he introduces his reference to truth only with a view to showing that our ‘passions, volitions and actions … being original facts and realities, complete in themselves,’ are not susceptible of the agreement and disagreement spoken of, and therefore cannot be said to be true or false, in conformity with or contrary to reason. The account of truth given here is not elaborated, and perhaps not even thought to need elaboration. Similarly with another passage a few pages earlier in which Hume says that ‘Truth is of two kinds, consisting either in the discovery of the proportions of ideas, considered as such, or in the conformity of our ideas of objects to their real existence’. Here again his interest is not in truth itself but in ‘curiosity, or the love of truth,’ the passion which, Hume says, ‘was the first source of all our inquiries’. Hume seems to take it for granted that nothing more needs to be said about what it is to discover ‘the proportions of ideas, considered as such,’ or about the circumstances in which we can speak of there being ‘conformity’ or the lack of it between our ideas of objects and their real existence. So far as he is concerned the central point to grasp is the distinction between propositions which have to do with relations of ideas and those which express, or purport to express, matters of fact. Once this distinction is clear, the nature of truth is supposed to be plain. (shrink)

The question I want to discuss is that of the sense and respects in which morality is strictly a matter for the individual. To hear some people talk you would think that it is wholly so. Not only do I have to make my own moral decisions; I have in a way to make them on my own terms, in so far as the rules I take to govern my actions are rules I have freely accepted, or at the least (...) not positively repudiated. In law I can be bound by statutes which I regard as abhorrent or even of whose content I am ignorant ; that a similar situation should obtain in morals is commonly treated as absurd. If I see nothing wrong with a certain practice, such as premarital sex or drug-taking, I can’t be brought morally to book for indulging in it. Morals is not solely a matter of personal taste, for the nature of moral judgment is such that the moral agent legislates not just for himself but for all who are similarly situated; equally, however, it is not something which can be externally enforced. There are no objective moral principles, plain for all to see, against which to measure moral error, and though there is fairly widespread agreement among the respectable that some forms of conduct are morally admirable and others morally deplorable, we are under no obligation to respect these “conventions.” A man’s only true obligation here is to follow his conscience and thus do what he takes to be right, in the light of the best information about the situation he can get. (shrink)