Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present a (...) case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)

We propose a new approach for tracing value change. Value change may lead to a mismatch between current value priorities in society and the values for which technologies were designed in the past, such as energy technologies based on fossil fuels, which were developed when sustainability was not considered a very important value. Better anticipating value change is essential to avoid a lack of social acceptance and moral acceptability of technologies. While value change can be studied historically and qualitatively, we (...) propose a more quantitative approach that uses large text corpora. It uses probabilistic topic models, which allow us to trace values that are latent. We demonstrate the approach for five types of value change in technology. Our approach is useful for testing hypotheses about value change, such as verifying whether value change has occurred and identifying patterns of value change. The approach can be used to trace value change for various technologies and text corpora, including scientific articles, newspaper articles, and policy documents. (shrink)

For Machiavelli, religion is valued not by the importance of its founder, the content of its teachings, the truth of its dogmas or the significance of its rites. It is not the essence of what really matters but its function and importance for collective life. Religion teaches to recognize and respect political rules through the religious commandments. This collective norm could assume the outer coercive aspect of the military discipline as well as the inner persuasive character of civic and moral (...) education for the production of collective consensus. -/- Para Maquiavel, o que confere valor a uma religião não é a importância de seu fundador, o conteúdo dos ensinamentos, a verdade dos dogmas ou a significação dos mistérios e ritos. Importa não a essência da religião e sim sua função e importância para a vida coletiva. A religião ensina a reconhecer e a respeitar as regras políticas a partir do mandamento religioso. Essa norma coletiva pode assumir tanto o aspecto coercivo exterior da disciplina militar ou da autoridade política quanto o caráter persuasivo interior da educação moral e cívica para a produção do consenso coletivo. (shrink)

One of the Machiavelli's most famous and innovative thesis states that good laws arise from social conflicts, according to the Roman Empire example of the opposition between plebs and nobles. Conflicts are able to bring about order in virtue of the characteristic constrictive force of necessity, which prevents the ambition to prevail. Nonetheless, law does not neutralize the conflict; just give it a regulation. So, law is subjected to history, to the continuous change, which means that it is potentially corruptible. (...) On this account, Machiavelli says that a State can only maintain its authority through a continuous return to the originary moment, viz. to the revival of the experiences of "fear", "terror" and "punishment" lived in the originary event of the foundation. For that reason, in the origin of law is also the violence, whose combined function is to provide legitimacy to its exercise by the State apparatus as the only form to preserve political life from ruin.Uma das mais famosas e inovadoras teses de Maquiavel é a afirmação de que as boas leis nascem dos conflitos sociais, segundo o exemplo romano das oposições entre plebe e nobres. Os conflitos são capazes de produzir ordem por conter a força constritiva própria da necessidade, que impede a ambição de reinar. Contudo, a lei não neutraliza o conflito, mas apenas lhe dá uma ordenação. A lei está, pois, exposta à história, à contínua mudança, o que significa dizer que é potencialmente corruptível. Por causa desta possibilidade, Maquiavel afirma que um Estado somente mantém sua autoridade por meio de um retorno contínuo ao momento da origem, isto é, à revivência da experiência do "medo", do "terror" e da "punição" do acontecimento originário da fundação. Assim, na origem da lei está a violência, cuja função é proporcionar a legitimação de seu exercício pelo aparato estatal como única forma de preservar da ruína a vida política. (shrink)

This study brings light to the concepts of State and Government in the thought of Marsilio de Padua pointing out to profoundly modern institutions present in the reflection of this medieval philosopher. We attempt to show that Marsilio de Padua reflects based on Aristotle´s categories, but proposes a State and Government conception different from that common place of medieval politics as he insists on the need of the popular consent as a criterion of political legitimacy. -/- O estudo explicita os (...) conceitos de Estado e de Governo no pensamento de Marsílio de Pádua apontando as intuições profundamente modernas presentes na reflexão desse filósofo medieval. Procuramos mostrar que Marsílio reflete com categorias aristotélicas, mas propõe uma concepção de Estado e de Governo que se distancia do lugar comum da reflexão política medieval ao insistir na necessidade do consentimento dos súditos como critério de legitimidade política. (shrink)

We anticipate a further decline of patients who eventually will become brain dead. The intensive care unit (ICU) is considered a last resort for patients with severe and multiple organ dysfunction. Patients with primary central nervous system failure constitute the largest group of patients in which life-sustaining treatment is withdrawn. Almost all these patients are unconscious at the moment physicians decide to withhold and withdraw life-sustaining measures. Sometimes, however competent ICU patients state that they do not want to live anymore (...) because of the severity of their illness or the poor prognosis and ask for withdrawal of life-sustaining measures like mechanical ventilation. Do we consider the unconscious patient as potential organ donor before withdrawal of mechanical ventilation? This is paradoxically rare in the case of the conscious ICU patient. Is it practically possible and ethically feasible to obtain consent for organ donation from this group of patients? (shrink)

Esta obra es un viaje por el camino recorrido por la filosofía trascendente, que pone de relieve la pervivencia de conceptos como "sujeto", "crítica" o "reflexión". El núcleo fundamental del libro está en el estudio de la situación terminal a la que conduce el planteamiento fenomenológico husserliano y en el hallazgo de nuevos ámbitos de trascendentalidad. Puede advertirse cómo la vieja filosofía de sujeto-conciencia llega a transformarse y girar, para dar cabida a nuevos temas: la corporeidad, la intersubjetividad, el lenguaje, (...) que tradicionalmente habían sido silenciados o infravalorados. (shrink)