BackgroundStudies have shown that research participants fail to appreciate the difference between research and medical care, labeling such phenomenon as a "therapeutic misconception" (TM). Since research activity involving human participants is increasing in the Middle East, qualitative research investigating aspects of TM is warranted. Our objective was to assess for the existence of therapeutic misconception amongst Egyptians.MethodsStudy Tool: We developed a semi-structured interview guide to elicit the knowledge, attitudes, and perspectives of Egyptians regarding medical research.Setting: We recruited individuals from the (...) outpatient settings (public and private) at Ain Shams University in Cairo, Egypt.Analysis: Interviews were taped, transcribed, and translated. We analyzed the content of the transcribed text to identify the presence of a TM, defined in one of two ways: TM1 = inaccurate beliefs about how individualized care can be compromised by the procedures in the research and TM2 = inaccurate appraisal of benefit obtained from the research study.ResultsOur findings showed that a majority of participants (11/15) expressed inaccurate beliefs regarding the degree with which individualized care will be maintained in the research setting (TM1) and a smaller number of participants (5/15) manifested an unreasonable belief in the likelihood of benefits to be obtained from a research study (TM2). A total of 12 of the 15 participants were judged to have expressed a TM on either one of these bases.ConclusionThe presence of TM is not uncommon amongst Egyptian individuals. We recommend further qualitative studies investigating aspects of TM involving a larger sample size distinguished by different types of illnesses and socio-economic variables, as well as those who have and have not participated in clinical research. (shrink)

1. [without special title] -- ḥeleḳ 2. Meḳorot u-ferushim.

Medical research must involve the participation of human subjects. Knowledge of patients' perspectives and concerns with their involvement in research would enhance recruitment efforts, improve the informed consent process, and enhance the overall trust between patients and investigators. Several studies have examined the views of patients from Western countries. There is limited empirical research involving the perspectives of individuals from developing countries. The purpose of this study is to examine the attitudes of Egyptian individuals toward medical research. Such information would (...) help clarify the type and extent of concerns regarding research participation of individuals from cultural, economic, and political backgrounds that differ from those in developed countries. (shrink)

Background: Concerns have been expressed regarding the adequacy of ethics review systems in developing countries. Limited data are available regarding the structural and functional status of Research Ethics Committees (RECs) in the Middle East. The purpose of this study was to survey the existing RECs in Egypt to better understand their functioning status, perceived resource needs, and challenges. Methods: We distributed a self-administered survey tool to Egyptian RECs to collect information on the following domains: general characteristics of the REC, membership (...) composition, ethics training, workload, process of ethics review, perceived challenges to effective functioning, and financial and material resources. We used basic descriptive statistics to evaluate the quantitative data. Results: We obtained responses from 67% (12/18) of the identified RECs. Most RECs (10/12) have standard operating procedures and many (7/12) have established policies to manage conflicts of interests. The average membership was 10.3 with a range from 7-19. The predominant member type was physicians (69.5% of all of the REC members) with little lay representation (13.7%). Most RECs met at least once/month and the average number of protocols reviewed per meeting was 3.8 with a range from 1-10. Almost three-quarters of the members from all of the 12 RECs indicated they received some formal training in ethics. Regarding resources, roughly half of the RECs have dedicated capital equipment (e.g., meeting room, computers, office furniture, etc); none of the RECs have a formal operating budget. Perceived challenges included the absence of national research ethics guidelines and national standards for RECs and lack of ongoing training of its members in research ethics. Conclusion: Our study documents several areas of strengths and areas for improvements in the operations of Egyptian RECs. Regarding strengths, many of the existing RECs meet frequently, have a majority of members with prior training in research ethics, and have written policies. Regarding areas for improvements, many RECs should strive for a more diverse membership and should receive more financial resources and administrative support personnel. We recommend that RECs include more individuals from the community and develop a continuing educational program for its members. Institutional officials should be aware of the resource capacity needs of their RECs. (shrink)

In this paper, we empirically explore some manifestations of norms for the conduct of science. We focus on scientific research ethics and report survey results from 606 scientists who received funding in 1993 and 1994 from the Division of Molecular and Cellular Biology of the Biology Directorate of the National Science Foundation. We also report results for 91 administrators charged with overseeing research integrity at the scientists’ research institutions. Both groups of respondents were presented with a set of scenarios, designed (...) by fractional factorial methods, describing different kinds of scientific conduct that in the eyes of some would likely be unethical. Respondents then were asked to evaluate each of these scenarios for how unethical the behavior might be and what kinds of sanctions might be appropriate. We use the responses to consider the nature of consensus around norms related to the practice of science and in particular, similarities and differences between scientists and science administrators. Implications for policy are also discussed. (shrink)

Variation in decision-making about end-of-life care among ethnic groups creates clinical conflicts. In order to understand changes in preferences for end-of-life care among Japanese who immigrate to the United States, we conducted 18 focus groups with 122 participants: 65 English-speaking Japanese Americans, 29 Japanese-speaking Japanese Americans and 28 Japanese living in Japan.Negative feelings toward living in adverse health states and receiving life-sustaining treatment in such states permeated all three groups. Fear of being meiwaku, a physical, psychological or financial caregiving burden (...) on loved ones, was a prominent concern. They preferred to die pokkuri (popping off) before they become end stage or physically frail. All groups preferred group-oriented decision-making with family. Although advance directives were generally accepted, Japanese participants saw written directives as intrusive whereas Japanese Americans viewed them mainly as tools to reduce conflict created by dying person's wishes and a family's kazoku no jo– responsibility to sustain the dying patient. These findings suggest that in the United States Japanese cultural values concerning end-of-life care and decision-making process are largely preserved. (shrink)

Volume 20, Issue 7, July 2020, Page 101-103.

Data science, and the related field of big data, is an emerging discipline involving the analysis of data to solve problems and develop insights. This rapidly growing domain promises many benefits to both consumers and businesses. However, the use of big data analytics can also introduce many ethical concerns, stemming from, for example, the possible loss of privacy or the harming of a sub-category of the population via a classification algorithm. To help address these potential ethical challenges, this paper maps (...) and describes the main ethical themes that were identified via systematic literature review. It then identifies a possible structure to integrate these themes within a data science project, thus helping to provide some structure in the on-going debate with respect to the possible ethical situations that can arise when using data science analytics. (shrink)

Objective To determine the attitudes of Egyptian patients regarding their participation in research and with the collection, storage and future use of blood samples for research purposes. Design Cross-sectional survey. Study population Adult Egyptian patients (n=600) at rural and urban hospitals and clinics. Results Less than half of the study population (44.3%) felt that informed consent forms should provide research participants the option to have their blood samples stored for future research. Of these participants, 39.9% thought that consent forms should (...) include the option that future research be restricted to the illness being studied. A slight majority (66.2%) would donate their samples for future genetic research. Respondents were more favourable towards having their blood samples exported to other Arab countries (62.0%) compared with countries in Europe (41.8%, p<0.001) and to the USA (37.2%, p<0.001). Conclusions This study shows that many individuals do not favour the donation of a blood sample for future research. Of those who do approve of such future research, many favour a consent model that includes an option restricting the future research to the illness being studied. Also, many Egyptians were hesitant to have their blood samples donated for genetic research or exported out of the Arab region to the USA and European countries. Further qualitative research should be performed to determine the underlying reasons for many of our results. (shrink)

The Threshold of the Visible World advances a revolutionary new political aesthetic--Kaja Silverman explores the possibilities for looking beyond the restrictive mandates of the self, and the normative aspects of the cultural image-repertoire. She provides a detailed account of the social and psychic forces which constrain us to look and identify in normative ways, and the violence which that normativity implies. Accounting for these phenomena on both a conscious and an unconcious level, Silverman analyzes the psychic and textual (...) conditions under which our "field of vision" can be expanded. The title of this book is taken from Lacan's essay on the mirror stage. In that text, Lacan writes that "the mirror-image would seem to be the threshold of the visible world." He thereby suggests that the visible world has no existence as such until the infant subject has access to an image of self. Lacan intimates that the mirror provides the frame through which one relates to others within the domain of vision, stressing the priority of narcissism and the ego over all other libidinal transactions. The Threshold of the Visible World provides a psychic, social and political specification of Lacan's claim, and most particularly of its implications for the subject's relations to the social other. This is accomplished through examination of the ego, as well as two other categories at the center of Lacan's account of the mirror stage: ideality and identification. This book is an ethical-political project which leads to the re-elaboration of a number of crucial theoretical categories--Silverman offers an account of the bodily ego, of identification, of idealization, of the gaze, of the look, and of the "photographic." The Threshold of the Visible World leads as well to the formulation of a fresh model for conceptualizing sexual, racial and class "difference," and the terms under which it might be dismantled. This book thus seeks to apprehend the field of vision through the frame of a different kind of bodily ego, and discover the pleasures to be derived from corporeal transport. (shrink)

I argue that we should rethink the nature and scope of Spinoza’s “one and the same” relation. Contrary to the standard reading, the nature of this relation is not identity but a union, and its scope includes all idea-object pairs, even God and the idea of God. A crucial reason we should adopt this dual picture is that the idea of God must be one and the same as something found when Nature is conceived under each of the other attributes. (...) If “one and the same” is interpreted as a relation of identity, this requirement cannot be met. However, maintaining that God and the idea of God are one and the same not only fulfills this requirement, but also is independently motivated. I also briefly consider how the thesis that God and the idea of God are one and the same affords us with positive insights concerning the nature of this relation. (shrink)

Context Physicians are regularly confronted with research that is funded or presented by industry. Objective To assess whether physicians discount for conflicts of interest when weighing evidence for prescribing a new drug. Design and setting Participants were presented with an abstract from a single clinical trial finding positive results for a fictitious new drug. Physicians were randomly assigned one version of a hypothetical scenario, which varied on conflict of interest: ‘presenter conflict’, ‘researcher conflict’ and ‘no conflict’. Participants 515 randomly selected (...) Fellows in the American College of Obstetricians and Gynecologists' Collaborative Ambulatory Research Network; 253 surveys (49%) were returned. Main object measures The self-reported likelihood that physicians would prescribe the new drug as a first-line therapy. Results Physicians do not significantly discount for conflicts of interest in their self-reported likelihood of prescribing the new drug after reading the single abstract and scenario. However, when asked explicitly to compare conflict and no conflict, 69% report that they would discount for researcher conflict and 57% report that they would discount for presenter conflict. When asked to guess how favourable the results of this study were towards the new drug, compared with the other trials published so far, their perceptions were not significantly influenced by conflict of interest information. Conclusion While physicians believe that they should discount the value of information from conflicted sources, they did not do so in the absence of a direct comparison between two studies. This brings into question the effectiveness of merely disclosing the funding sources of published studies. (shrink)

Researchers from diverse disciplines, including organismal and cellular physiology, sports science, human nutrition, evolution and ecology, have sought to understand the causes and consequences of the surprising variation in metabolic rate found among and within individual animals of the same species. Research in this area has been hampered by differences in approach, terminology and methodology, and the context in which measurements are made. Recent advances provide important opportunities to identify and address the key questions in the field. By bringing together (...) researchers from different areas of biology and biomedicine, we describe and evaluate these developments and the insights they could yield, highlighting the need for more standardisation across disciplines. We conclude with a list of important questions that can now be addressed by developing a common conceptual and methodological toolkit for studies on metabolic variation in animals. (shrink)

Game of Thrones is a popular, award-winning television series with an eight-season run on Home Box Office, based on the Song of Fire and Ice series of books by George R.R. Martin. It depicts a morally complex political situation in a fantasy environment that has some similarities to medieval Europe. In the midst of this setting, the series advocates a cynical attitude towards politics, social structures, and religion. Most notably, the series suggests that there is no such thing as political (...) legitimacy. This chapter identifies a pattern of cynicism throughout Game of Thrones but points towards the thoughts of John Locke and Thomas Aquinas as possible alternatives to the story’s cynicism. (shrink)

This paper claims that the standard characterization of the motivational role of belief should be supplemented. Beliefs do not only, jointly with desires, cause and rationalize actions that will satisfy the desires, if the beliefs are true; beliefs are also the practical ground of other cognitive attitudes, like imagining, which means beliefs determine whether and when one acts with those other attitudes as the cognitive inputs into choices and practical reasoning. In addition to arguing for this thesis, I take issue (...) with Velleman's argument that belief and imagining cannot be distinguished on the basis of motivational role. (shrink)

Bioethics is the study of ethical issues arising out of advances in the life sciences and medicine. Historically, bioethics has been associated with issues in research ethics and clinical ethics as a result of research scandals such as the Tuskegee Syphilis Study and public debates about the definition of death, medical paternalism, health care rationing, and abortion. As biomedical technologies have advanced, challenging new questions have arisen for bioethics and new sub-disciplines such as neuroethics and public health ethics have entered (...) the scene. This volume features ten original essays on five cutting-edge controversies in bioethics written by leading philosophers. I. Research Ethics: How Should We Justify Ancillary Care Duties? II. Clinical Ethics: Are Psychopaths Morally Accountable? III. Reproductive Ethics: Is There A Solution to the Non-Identity Problem? IV. Neuroethics: What is Addiction and Does It Excuse? V. Public Health Ethics: Is Luck Egalitarianism Implausibly Harsh? S. Matthew Liao and Collin O’Neil’s concise introduction to the essays in the volume, the annotated bibliographies and study questions for each controversy, and the supplemental guide to additional current controversies in bioethics give the reader a broad grasp of the different kinds of challenges in bioethics. (shrink)

Abstract The typical explanation of an event or process which attracts the label ‘conspiracy theory’ is an explanation that conflicts with the account advanced by the relevant epistemic authorities. I argue that both for the layperson and for the intellectual, it is almost never rational to accept such a conspiracy theory. Knowledge is not merely shallowly social, in the manner recognized by social epistemology, it is also constitutively social: many kinds of knowledge only become accessible thanks to the agent's embedding (...) in an environment that includes other epistemic agents. Moreover, advances in knowledge typically require ongoing immersion in this social environment. But the intellectual who embraces a conspiracy theory risks cutting herself off from this environment, and therefore epistemically disabling herself. Embracing a conspiracy theory therefore places at risk the ability to engage in genuine enquiry, including the enquiry needed properly to evaluate the conspiracy theory. (shrink)

McKenna’s critique (rather than criticisms) of idealized approaches to epistemology is an important contribution to the literature. In this brief discussion, I set out his main concerns about more idealized approaches, within and beyond social epistemology, before turning to some issues I think he neglects. I suggest that it’s important to pay attention to the prestige hierarchy in philosophy, and to how that hierarchy can serve ideological purposes. The greater prestige of more abstract approaches plays a role in determining what (...) issues and what voices we attend to. (shrink)

Philosophers and geographers have converged on the topic of public space, fascinated and in many ways alarmed by fundamental changes in the way post-industrial societies produce space for public use, and in the way citizens of these same societies perceive and constitute themselves as a public. This volume advances this inquiry, making extensive use of political and social theory, while drawing intimate connections between political principles, social processes, and the commonplaces of our everyday environments.

Nietzsche takes moral judgments to be false beliefs, and encourages us to pursue subjective nonmoral value arising from our passions. His view that strong and unified passions make one virtuous is mathematically derivable from this subjectivism and a conceptual analysis of virtue, explaining his evaluations of character and the nature of the Overman.

Three puzzles about self-deception make this mental phenomenon an intriguing explanatory target. The first relates to how to define it without paradox; the second is about how to make sense of self-deception in light of the interpretive view of the mental that has become widespread in philosophy; and the third concerns why it exists at all. In this paper I address the first and third puzzles. First, I define self-deception. Second, I criticize Robert Trivers’ attempt to use adaptionist evolutionary psychology (...) to solve the third puzzle (existence). Third, I sketch a theory to replace that of Trivers. Self-deception is not an adaptation, but a spandrel in the sense that Gould and Lewontin give the term: a byproduct of other features of human (cognitive) architecture.Self-deception is so undeniable a fact of human life that if anyone tried to deny its existence, the proper response would be to accuse this person of it. (Allen Wood, Citation 1988 ). (shrink)

On his death in 2007, Richard Rorty was heralded by the New York Times as “one of the world’s most influential contemporary thinkers.” Controversial on the left and the right for his critiques of objectivity and political radicalism, Rorty experienced a renown denied to all but a handful of living philosophers. In this masterly biography, Neil Gross explores the path of Rorty’s thought over the decades in order to trace the intellectual and professional journey that led him to that (...) prominence. The child of a pair of leftist writers who worried that their precocious son “wasn’t rebellious enough,” Rorty enrolled at the University of Chicago at the age of fifteen. There he came under the tutelage of polymath Richard McKeon, whose catholic approach to philosophical systems would profoundly influence Rorty’s own thought. Doctoral work at Yale led to Rorty’s landing a job at Princeton, where his colleagues were primarily analytic philosophers. With a series of publications in the 1960s, Rorty quickly established himself as a strong thinker in that tradition—but by the late 1970s Rorty had eschewed the idea of objective truth altogether, urging philosophers to take a “relaxed attitude” toward the question of logical rigor. Drawing on the pragmatism of John Dewey, he argued that philosophers should instead open themselves up to multiple methods of thought and sources of knowledge—an approach that would culminate in the publication of Philosophy and the Mirror of Nature , one of the most seminal and controversial philosophical works of our time. In clear and compelling fashion, Gross sets that surprising shift in Rorty’s thought in the context of his life and social experiences, revealing the many disparate influences that contribute to the making of knowledge. As much a book about the growth of ideas as it is a biography of a philosopher, Richard Rorty will provide readers with a fresh understanding of both the man and the course of twentieth-century thought. (shrink)