Background In April 2019, our hospital transitioned to an electronic patient record system and patient portal. MyGOSH enables young people aged 12 years or older and their parents to access results, documentation, appointments, and to communicate with their care team. Aims A focus group was conducted to explore the ethical and legal considerations of young people and their parents using a patient portal from the perspective of hospital Ethics Committee members. Participants and research context Members of the hospital Paediatric Bioethics (...) Centre were recruited. Written informed consent was provided by all participants. Research design The focus group discussion was recorded, transcribed verbatim and analysed using thematic analysis. Ethical considerations Health Research Authority Research Ethics Committee Approval was granted by London Southeast REC. Results Four themes, and sub-themes, were identified: granting access – complexities of assessing competence/capacity, exclusion from MyGOSH due to non-disclosure of diagnosis, and truth-telling; inequalities resulting in inequities – complexities of inequity in access; responding to change – providing support and managing expectations; engagement, empowerment and understanding – data safety, empowering young people to take ownership of their health data, a one-size fits all system may not meet the needs of all families, and early engagement with young people/parents. Discussion Giving families portal access can increase engagement, empowering them to be more involved in care, yet poses challenges for all. Complexities exist in the assessment for portal access, and supporting and managing user expectations whilst providing an equitable service. Conclusions Ongoing support is required for all stakeholders following patient portal implementation to navigate the ethical and legal complexities, and to promote equity and portal utility for patient benefit. (shrink)

Background: The law and literature about children’s consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to “want” to have the surgery. Refusal of heart transplantation by 6-year-olds is accepted. Research question: What are possible reasons to explain (...) the differences between theories and practices about the ages when children begin to be informed about elective heart surgery, and when their consent or refusal begins to be respected? Research design, participants and context: Research methods included reviews of related healthcare, law and ethics literature; observations and conversations with staff and families in two London hospitals; audio-recorded semi-structured interviews with a purposive sample of 45 healthcare professionals and related experts; interviews and a survey with parents and children aged 6- to 15-years having elective surgery (not reported in this paper); meetings with an interdisciplinary advisory group; thematic analysis of qualitative data and co-authorship of papers with participants. Ethical considerations: Approval was granted by four research ethics committees/authorities. All interviewees gave their informed written consent. Findings: Interviewees explained their views and experiences about children’s ages of competence to understand and consent or refuse, analysed by their differing emphases on informed, signified or voluntary consent. Discussion: Differing views about children’s competence to understand and consent are associated with emphases on consent as an intellectual, practical and/or emotional process. Conclusion: Greater respect for children’s practical signified, emotional voluntary and intellectual informed consent can increase respectful understanding of children’s consent. Nurses play a vital part in children's practitioner-patient relationships and physical care and therefore in all three elements of consent. (shrink)

Linguists, biological anthropologists, and cognitive scientists come together in this book to explore the origins and early evolution of phonology, syntax, and semantics. They consider the nature of pre- and proto-linguistic communication, the internal and external triggers that led to its transformation into language, and whether and how language may be considered to have evolved after its inception. Evidence is drawn from many domains, including computer simulations of language emergence, the songs of finches, problem-solving abilities in monkeys, sign language, and (...) the structure of languages today. (shrink)

This chapter discusses Kuhn’s conception of the history of science by focussing on two respects in which Kuhn is an historicist historian and philosopher of science. I identify two distinct, but related, aspects of historicism in the work of Hegel and show how these are also found in Kuhn’s work. First, Kuhn held tradition to be important for understanding scientific change and that the tradition from which a scientific idea originates must be understood in evaluating that idea. This makes Kuhn (...) a historicist in a sense we may call conservative. Secondly, Kuhn held that there is a pattern to the development of science. In the light of the fact that he held scientific change to be law-like, we can call this second aspect of Kuhn’s historicism determinist. I discuss the relationship of Kuhn’s historicist historiography to the philosophical purposes he had for his history of science, namely to refute a conception of scientific progress as driven towards increasing truth by something like ‘the scientific method’. I argue that while this determinism refutes certain positivist conceptions of scientific change, it also requires internalism—the view that the causes of scientific change come from within science, not from outside. Consequently, Kuhn’s historiography of science contrasts with that implicit in much of post-Kuhnian science studies. (shrink)

Aan de hand van het meesterwerk van Bach reflecteert Kessels op zijn eigen leven. Hij verbindt de wendingen, kenteringen, harmonie en disharmonie uit Bachs muziek aan episodes uit zijn persoonlijke geschiedenis. Het gevolg van Kessels' zoektocht is dat de lezer onwillekeurig ook over het eigen leven gaat nadenken. Het ogenschijnlijk particuliere project van 'Het welgetemperde gemoed' krijgt zo een universele zeggingskracht.0Kessels laat zien hoe hij streeft naar harmonie en verzoening van tegenstellingen, zich verdiept in de klassieke filosofie, de ideeënleer ontdekt (...) en zich als filosoof op de markt begeeft om het 'ideeënkijken' in praktijk te brengen. Hij is een denker die doener wil zijn, een gespletene die een geheel wil worden, een sterveling die het goddelijke zoekt. Hij wil zelf muziek worden, het eigen gemoed en dat van anderen temperen, zoals Bach het getemperde klavier laat klinken. Maar uiteindelijk blijkt dat het zuivere ideaal nooit te realiseren is: mensen zijn nu eenmaal zot en troebel. Muziek kan alleen een spiegel zijn. (shrink)

Studies of epistemic communities and collaborative research in the social sciences have deepened the understanding of how science works, and more specifically how the social dimensions of scientific practice both enable and impede social scientists in realizing their epistemic goals. Two types of studies of epistemic communities are distinguished: general theories of epistemic communities aim to construct accounts of theoretical change applicable to all social scientific specialties, whereas historical studies emphasize the contingencies that affect specific social scientific disciplines, subfields, or (...) institutions. Although collaborative research plays a less pronounced role in the social sciences than in the natural sciences, collaboration has enabled social scientists to investigate topics that would otherwise be difficult to investigate. (shrink)

A common reaction to crises experienced within or brought about by business is to identify a corollary ‘crisis of leadership’ and to call for better leaders. This paper supports the idea that there is a crisis of leadership – but interprets it quite differently. Specifically, I argue that the most ethically debilitating crisis is the fact that we look to leadership to solve organisational ethical ills. There is, I argue, a pressing need to conceptualise a business ethics that is not (...) constrained by the straitjacket of official hierarchy – a need to denaturalise ‘leadership’ as the normal or rightful locus of ethical regulation and renewal in business organisation. To this end, I explore a Levinasian ethico‐politics of responsibility and proximity as the basis of an alternative, anti‐sovereign, ethics of organisation. (shrink)

Roughly speaking, classical statistical physics is the branch of theoretical physics that aims to account for the thermal behaviour of macroscopic bodies in terms of a classical mechanical model of their microscopic constituents, with the help of probabilistic assumptions. In the last century and a half, a fair number of approaches have been developed to meet this aim. This study of their foundations assesses their coherence and analyzes the motivations for their basic assumptions, and the interpretations of their central concepts. (...) The most outstanding foundational problems are the explanation of time-asymmetry in thermal behaviour, the relative autonomy of thermal phenomena from their microscopic underpinning, and the meaning of probability. A more or less historic survey is given of the work of Maxwell, Boltzmann and Gibbs in statistical physics, and the problems and objections to which their work gave rise. Next, we review some modern approaches to (i) equilibrium statistical mechanics, such as ergodic theory and the theory of the thermodynamic limit; and to (ii) non-equilibrium statistical mechanics as provided by Lanford's work on the Boltzmann equation, the so-called Bogolyubov-Born-Green-Kirkwood-Yvon approach, and stochastic approaches such as `coarse-graining' and the `open systems' approach. In all cases, we focus on the subtle interplay between probabilistic assumptions, dynamical assumptions, initial conditions and other ingredients used in these approaches. (shrink)

I argue that van Fraassen’s selectionist explanation for the success of science is superior to the realists’ explanation. Whereas realists argue that our current theories are successful because they accurately reflect the structure of the world, the selectionist claims that our current theories are successful because unsuccessful theories have been eliminated. I argue that, unlike the explanation proposed by the realist, the selectionist explanation can also account for the failures of once successful theories and the fact that sometimes two competing (...) theories are both equally successful. (shrink)

The article examines Thomas Kuhn's work in the history of science with special attention to its relevance to subsequent developments in social epistemology. The article begins with a discussion of Kuhn's historical work, and the so-called historical turn in philosophy of science. It then examines Kuhn's views on textbook science, followed by an analysis of Kuhn's views on the relationship between the history of science and the philosophy of science. Then it discusses Kuhn's contributions to our understanding of the social (...) dimensions of scientific inquiry. Finally, it discusses his influence on the social epistemology of science and the sociology of science. (shrink)

Ultimately this book provides a theory of intergenerational justice that is both intellectually robust and practical with wide applicability to law and policy.

I examine two challenges that collaborative research raises for science. First, collaborative research threatens the motivation of scientists. As a result, I argue, collaborative research may have adverse effects on what sorts of things scientists can effectively investigate. Second, collaborative research makes it more difficult to hold scientists accountable. I argue that the authors of multi-authored articles are aptly described as plural subjects, corporate bodies that are more than the sum of the individuals involved. Though journal editors do not currently (...) conceive of the authors of multi-authored articles this way, this conception provides us with the conceptual resources to make sense of how collaborating scientists behave.Keywords: Collaborative research; Authorship; Multi-authored articles; Responsibility; Reward system; Plural subject. (shrink)

There has been a growing concern over establishing norms that ensure the ethically acceptable and scientifically sound conduct of clinical trials. Among the leading norms internationally are the World Medical Association's Declaration of Helsinki, guidelines by the Council for International Organizations of Medical Sciences, the International Conference on Harmonization's standards for industry, and the CONSORT group's reporting norms, in addition to the influential U.S. Federal Common Rule, Food and Drug Administration's body of regulations, and information sheets by the Department of (...) Health and Human Services. There are also many norms published at more local levels by official agencies and professional groups.Any account of international standards should cover both scientific and ethical norms at once – the two are conceptually intertwined. Recent sources recognize that “[s]cientifically unsound research on human subjects is unethical in that it exposes research subjects to risks without possible benefit.”. (shrink)

The literature on collective belief and collective intentionality has grown rapidly and is now quite extensive. Philosophers have applied the concepts of “collective belief” and “collective intentionality” in a variety of contexts, including political and legal contexts as well as scientific contexts, specifically to model the behavior of research teams and scientific specialties.

Without denying the importance of the postmodernist approach to the narrative form and rhetorical strategies of historiography, the author, one of Germany's ...