Vulnerable Subjects Research

Vulnerable Subjects Research PROTECTION OF VULNERABLE SUBJECTS IN CLINICAL TRIALS BACKGROUND Aim: To throw light on the state of vulnerable subjects in Clinical Research. Objective: To understand current provisions and legislations available to protect the rights of vulnerable subjects with special emphasis on plight of sex workers enrolled in anti-HIV trials. VULNERABLE SUBJECTS IN CLINICAL RESEARCH Individuals who are comparatively or entirely inept of defending their own wellbeing are termed as vulnerable research participants. When study includes such subjects additional care has to be taken to protect their rights. It is the investigator and his research team’s responsibility to ensure that these subjects are not exploited in the name of research. The study design team, sponsor, investigator must be aware of the special requirements needed for vulnerable subjects and they should develop the study protocol, informed consent form and the confidentiality agreement keeping the vulnerable subjects’ needs in mind. The different types of vulnerable subjects included in clinical trials are classified on basis of their vulnerability. Some examples are as follows: 1. Cognitive and Communicative vulnerability: This includes children and adolescents. Patient’s suffering from mental retardation, dementia and other kinds of mental illness. Enrollment of people with educational deficits and unfamiliarity with language. Stressful emergency: conditions that do not permit otherwise capable adults to implement their capabilities efficiently. 2. Juridical or institutional vulnerability: Person who is under the official authority of others (egs. Parents, guardians, warders, officers and judges) who may have their own benefits in whether the individual agrees to enroll in the study. 3. Deferential vulnerability: Influence of other people in subjects life, determine their decision to enter the trial. Existence of an informal hierarchy (egs. Relatives, friends, masters, physician) 4. Medical vulnerability: Prospective patients who have a severe medical condition, for which there are no existing efficient or satisfactory regular cure (examples: very aggressive and malignant forms of cancer, last stage AIDS and some uncommon ailments) owing to their unusual medically tricky state, misuse of these patients throughout their hope for remission or improvement is not unusual. 5. Economic vulnerability: Prospective subjects with low economic background may join trial with hope of getting income, housing and healthcare facilities. Payment for participation or free access to healthcare services might constitute unfair inducements to enroll through exploitation of these subjects. 6. Infrastructural vulnerability: Patient is tempted to enroll in trials, as they pre-suppose the availability to them of resources or facilities (egs. a rapid communication system, a reliable dietary intake, skilled healthcare professionals) 7. Social vulnerability: Refers to individuals belonging to undervalued social groups or communities.(sex workers)[R. Colombo, The Most Vulnerable Subjects Of Biomedical Research IX General Assembly PAV – publications] EXPLOITATION OF VULNERABLE SUBJECTS THROUGH HISTORY Exploitation was rampant in the absence of regulations, laws, guidelines and codes. Escalating physician to god-like position with immense faith in them and failure to recognize vulnerable subjects has resulted in horrific incidents in history of research. These major mishaps have convinced the medical fraternity the need for developing ethical guidelines and code for research specifically for the vulnerable populations. The Nuremberg trial The 20th century will always be remembered due to the shocking and upsetting experimentation performed by Nazi doctors. During the World War II, the Nazi physicians took advantage of the prisoners of war; they carried out experiments unparalleled in their range and the level of anguish and harm. Appalling studies such as injecting the poor prisoners with gasoline and live viruses, immersing people in ice water, and forcing them to ingest poisons have gone down in the history books as the most inhuman experiments. The physicians in order to satisfy their scientific curiosity have performed these experiments which were of no use to the participants. These experiments usually resulted in the death of the participants. After the war ended, there was a huge public outburst against these experiments and 23 physicians were indicted at Nuremberg for their willing participation in these experiments. Sixteen were found guilty and sentenced while seven were hanged to death. This resulted in the origin of the Nuremberg Code, which made informed consent mandatory. The Willowbrook study The Nuremberg Code unfortunately did not put to end unethical research as not every researcher honored the Code. The three year long Willowbrook study is another example where vulnerable patients were exploited. Willowbrook State School, an institution for mentally defective children were intentionally infect with the hepatitis virus, by being fed stools from infected persons or later by being injecting with purified virus preparations, to observe the natural history of this disease and then to test the effects o gamma globulin in preventing the disease. Researchers defended the deliberate infection of these children by stating that the bulk of them acquired the infection in any case while at Willowbrook, and possibly it would be better for them to be infected under restricted research settings. What was worse was that during the course of these studies, new inmates were admitted only if they agreed to participate in the hepatitis program! There was obviously no full disclosure ad clearly coercion and undue pressure was used to enroll vulnerable subjects like children and mentally challenged. Jewish Chronic Disease Hospital Study At the other end of life’s spectrum, came the Jewish Chronic Disease Hospital Study where live cancer cells were infused into continually ailing and incapacitated patients. These patients had been told that they were getting a skin examination. The patients were provided oral information about the test but no consent was documented. Syphilis study The most notorious example of prolonged infringement of human rights of a vulnerable faction of research participants was the long-term study of black males performed at Tuskegee by the United States Public Health Service. Initiated in the 1930s to examine the natural history of untreated syphilis, continuing until 1972, this study recruited more than 400 black men suffering from syphilis. These participants were recruited without informed consent and were mislead that a few of the measures taken in the interest of research were essentially â€Å"special complimentary treatment†. Although along the way antibiotics become available, these were not given to the patients and the study resulted in 28 deaths, 100 cases of disability, and 19 cases of congenital syphilis. The Belmont report published by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research on April 18, 1979 was one of the outcomes of the public outcry that resulted when the story of the Tuskegee study broke.[Urmila Thatte, Etical issues in clinical Research chapter 4, of Basic principles of clinical research and methodology by S K Gupta] Guidelines for ethical conduct of research in human subjects that have came into picture: Nuremberg Code, 1947 Declaration of Helsinki, 1964 The Belmont Report, 1979 International Ethical Guidelines for Biomedical Research Involving Human Subjects, 1982, 1993, 2002 The Ethics of Research related to Healthcare in Developing Countries, Nuffield council, 2002 Indian council for Medical Research Ethical Guidelines for Biomedical Research on Human subjects SPECIAL CONSIDERATIONS FOR CHILDREN Regulations that protect children, so as to prevent their exploitation are: OHRP 45 CFR 46 Subpart D FDA 21 CFR 50 Subpart D Special Considerations for Children are: Research that involves no more than minimal risk can be approved with adequate provisions for obtaining the assent of the child and permission from their parents/guardians. 45 CFR 46.404 The combination of assent by the minor subject and permission (consent) from the parents is deemed appropriate to enroll the child subject in the trial. In case of life threatening events only consent from parents would suffice, as there is expectation of direct benefit. However the child must be given full explanation of the trial. If the research presents an opening to comprehend, avoid or lessen a grave predicament affecting the health or welfare of children, but does NOT provide direct benefit to the subject or societal (indirect) benefit, than the research cannot be approved by the IRB unless HHS Secretary Approval is granted. 45 CFR 46.407 . Extremely rare- both Parent consent + child assent. When parents of the child are deceased, unknown or incompetent then the legal guardian must give is consent. Step parents, Grandparents, Adult siblings, adult Aunts or Uncles may not consent a child to research. SPECIAL CONSIDERATIONS FOR WOMEN Regulations that protect women, so as to prevent their exploitation are: OHRP 45 CFR 46 Subpart B Research studies involving pregnant women and fetuses must satisfy the following requirements to obtain IRB approval: Preclinical studies have been conducted, including studies on pregnant animals; clinical studies, that include non-pregnant women and provide data for assessing potential risks to pregnant women and fetuses 46.204(a) Risk to fetus is caused solely by interventions or procedures that hold prospect of direct benefit for the woman or the fetus or, 46.204(b) If no benefit, risk to the fetus is not greater than minimal and the research develops important biomedical knowledge not obtainable by any other means. 46.204(b) SPECIAL CONSIDERATIONS FOR PRISONERS The voluntary choice of the prisoners must not influenced by any potential advantages entailed to them due to the study, which outweighs the risks. For example, Parole decisions must not be affected for prisoners participating in the trial. The study is ethical, when the risk of participation is acceptable even to a non prisoner subject. Selections of subjects are carried out in a fair manner. When spoilt for choice, randomization techniques must be used. If necessary, adequate follow-up care must be provided to the volunteers. SPECIAL CONSIDERATIONS FOR DECISIONALLY IMPAIRED A combination of assent from the subject and permission from the concerned legal authorities constitute for the informed consent. The risk of participation would be agreeable to general volunteers too. Selection is fair and unbiased Adequate follow up is provided SPECIAL CONSIDERATIONS FOR SEX WORKERS Enrolling Sex workers in HIV vaccine trials that are ethical, valid and are not exploitative is a challenge that must be faced. Due to their nature of work, they require additional support. Sex workers are generally from the downtrodden community, they are illiterate and understanding the language in the informed consent is a major issue for them. Hence the informed consent must be in the local language and should be easily understood. The informed-consent must be prepared in such a way that it is in consultation with the community advisory and counsel board to ensure social sensitivity. Confidentiality is an important issue. These women may face physical abuse and abandonment from their clients, if they enter these trials. Supportive counseling should be provided before, during and after the test. Sex workers must not only be given male condoms but along with that they should be provided with female condoms. Proper guidance on safe sex must be dispensed. Clinical trial study team should increase awareness among the sex workers about AIDS. They should provide proper guidance to them, for prevention. Sex workers should be treated equally as general women would have been treated in a clinical trials. Study team should be sensitive towards them and not discriminate and look down upon them. CASE STUDY Health Minister, Urbain Olangnena Awono of the Cameroon government has decided that they may have to put a stop to the Tenofovir trials taking place in the port city of Douala due to various allegations by AIDS activists. The health minister had scheduled an audit for the same. The Tenofovir trial began in September 2004, Tenofovir is a established drug used for treatment of AIDS, manufactured by Gilead pharmaceuticals U.S. This trial was to determine whether Tenofovir can work as a prophylactic to prevent AIDS. The study recruited 400 sex workers free of infection. Half the women took a Tenofovir pill daily and the other half took a placebo. The study is conducted by Family Health and Insurance (FHI) with the support of U.S $ 6.5 million dollars from Bill and Melinda Gates Foundation. AIDS activists have demanded that this study be completely suspended on ethical grounds. They have said that the volunteers are vulnerable subjects and their rights have been exploited. Activists claim that the subjects have received inadequate counseling and healthcare. They have brought to notice that the sex workers are not fully informed about the risks involved in the trial. They also argue that the Study team has not promised to guarantee free healthcare if the workers become infected, which ideally every volunteer must receive. The FHI have counter attacked and cleared their stand by assuring that free medical checkups and tests have been carried out. Various tests like gynecological, medical care, HIV, pregnancy have been carried out for free. However various Activists have disregarded this claim and said that these are all false promises and haven’t been materialized. Another important issue that has been brought to notice was that, most of these sex workers were illiterate didn’t understand English and very little French, in spite of that the informed consent form were in English. However later it seen that the ICF shown to PlusNews was in French. The study team had provided 96 male condoms to sex workers. However imparting knowledge to prevent the infection of disease would be like a conflict of interest for the researchers. As the trial would be a success only if the women were exposed, become infected. The sex workers are misinformed and they feel that by taking this pill they are now vaccinated against the disease. In order to get their point across, so that the concerned authority would wake up to this injustice, AIDS activists in Paris staged a demonstration in front of the Cameroonian embassy in Paris. This demonstration got full coverage on the French T.V. This resulted in a public outcry against the trials. CRITIQUE The Tenofovir trial case study is an excellent example highlighting the profound impact media can have on the progress of the trial. The complete discontinuations of the trials prove that activists and non- governmental organizations with the help of the media can bring about change. These same activists are also involved in promoting research to combat the disease, but they can hinder the progress too. Hence researchers must be more aware about the ethical issues surrounding enrollment of sex workers. Engaging in discussion and consulting with the participant’s community before the trial begins can avoid such media spectacle. The case study rightly brings to one’s notice that lack of consultation with the support groups and community network was the biggest error on the part of the research team. Extensive discussion with community networks and a good flow of communication would bridge the gap and increase the trust of sex workers in the trials. The activists have rightly questioned why no subjects from general population have been enrolled to test safety of the drug. They have expressed concern and raised another important issue that the same trial would have provided women from Europe and U.S better benefits and adequate healthcare. The burning issue against this trial has been that since the primary outcome is HIV infection, researchers will provide inadequatecounseling to prevent infection. Since there exits a conflict of interest, sex workers will not be encouraged to have safe sex. Another important drawback of the trial has been its failure to provide sex workers with female condoms. They were provided with male condoms but negotiating for the same with their clients does not go down well with their trade. It is shocking that the sex workers were completely ignorant about the drug. They were misguided that the drug is a vaccine for AIDS, which made them more careless and prone to the disease. On the other hand, Tenofovir trials aimed at providing a prophylactic for AIDS, which would be a major breakthrough in combating this deadly disease and would definitely be of great benefit to the sex workers. Such uncontrolled and extreme protest has led to the complete discontinuation of the trial which in turn is bad news for the sex workers. The sponsor company had also promised to market this drug in Cameroon for much reduced prices. The validity of the media reports is doubtful as all the allegations made against the research team have been without any evidence. Activists instead of creating media backlash against the trial should have engaged in constructive dialogue with the research team stating their demands. CONCLUSION Clinical research has given millions of patients’ worldwide assurity that the medicine they purchase and consume, has been completely validated for its safety and efficacy. It ensures that these patients worldwide are getting the best medicine with utmost safety parameters. Investigators along with their research team bear the ultimate responsibility for their work with human subjects. They have the privilege of using human subject to advance scientific research, in turn society expects that investigators will show respect for their research subjects. Unfortunately as history has shown some scientists still continue to value their quest for knowledge and potential for personal fame and financial gain more highly then respect for basic human rights. Hence, various guidelines, regulations, codes and law have come into picture to protect the human subject. Special care and provisions must be made for subjects who are shunned from society. Sex workers live on the fringe of society and can rarely ask for their rights or support from public. In the interest of general health, to conduct trials for AIDS, this section of society must not be used as mere guinea pigs. Particular guidelines and ethical code of conduct for researchers must be drawn in order to protect these oppressed subjects. Providing them information on AIDS is not enough, they must be given free health care and female condoms. They need compassion and justice from us. REFERENCES Deanna Kerrigan et al, Environmental structural factors significantly associated with consistent condom use among female sex workers in the Dominican Republic, AIDS 2003 17:415-423 , Lippincott Williams and Wilkins. Arnaud L Fontanet et al, Protection against sexually transmitted diseases by granting sex workers in Thailand the choice of using the male or female condom: results from a randomized controlled trial, AIDS 1998, 12: 1851-1859, Lippincott Williams and Wilkins. Edward Mills et al, Media reporting of Tenofovir trials in Cambodia and Cameroon, 24 August 2005, BMC International Health and Human Rights. Edward J Mills and Sonal Singh, Health, human rights and the conduct of clinical research within oppressed populations, Globalization and health 2007, 3:10, BioMed Central Ltd. Peter H. Kilmarx et al, Protection of Human Subjects’ Rights HIV- preventive clinical trials in Africa and Asia: Experiences and Recommendations, AIDS 2001, 15 (suppl 5) : S73-S79, Lippincott Williams and Wilkins Geeta Yadav et al, Associations of sexual risk taking among Kenyan female sex workers after enrollment in an HIV – 1 prevention trial, J Acquir Immune Defic Syndr 2005; 38:329-334, Lippincott Williams and Wilkins Gielen AC, Fogarty L, OCampo P, Anderson J, Keller J, et al, Women living with HIV: Disclosure, violence, and social support, 2000, J Urban Health 77:480–491 R. Colombo, The Most Vulnerable Subjects Of Biomedical Research IX General Assembly PAV – publications. Urmila Thatte, Ethical issues in clinical Research chapter 4, of Basic principles of clinical research and methodology by S K Gupta Cynthia McGuire Dunn and Gary L. Chadwick, Protecting study volunteers in research, Third edition. Thomson Centerwatch. Ezekiel J. Emanuel, MD, PhD; David Wendler, PhD; Christine Grady, PhD, What Makes Clinical Research Ethical? , JAMA.2000;283:2701-2711. Cohen J. Cameroon Suspends AIDS Study. Science, Science Now 2005 Feb: 4. Singh JA, Mills EJ. The abandoned trials of pre-exposure prophylaxis for HIV: what went wrong? PLoS Med 2005;2: e234 Atatah C. Douala AIDS drug controversy: medical council says trials violated ethical norms. Post News Line 2005. www.postnewsline.com/2005/02/strongdouala_ai.html (accessed 15 Jan 2008). http://www.actupparis.org/article1734.html?var_recherche=tenofovir (accessed 15 Jan 2008) http://medicine.plosjournals.org/perlserv/?request=get-documentdoi=10.1371%2Fjournal.pmed.0020234ct=1SESSID=3b4fdb3c51bc2ee0983c4abb37ad4ffa (accessed 15 Jan 2008) KIPNIS K., Vulnerability in research subjects: a bioethical taxonomy, in NATIONAL BIOETHICS ADVISORY COMMISSION, Ethical and Policy Issues in Research Involving Human Participants, op. cit., vol. 2, pp. G1-G13, p. G5. http://www.academiavita.org/template.jsp?sez=Pubblicazionipag=testo/et_ricbiom/colombo/colombolang=english (accessed 15 Jan 2008) www.medscape.com/viewarticle/408956_3

politics today :: essays research papers

What is politics? Throughout history, people have participated in politics on many different levels. They may have participated through a direct democracy, in which they directly governed, or they may have participated through a representative democracy, in which they participated by electing representatives. As citizens’, people have participated in politics to attain the things they needed or wanted, the valued things. Participation in politics has been the way that people have a voice and change the things that directly affect their lives. Throughout the course of history, politics has been the competition of ideas; they decide who gets what, when, where and how. Politics is the means for attaining valued things. Although, valued things are different in every society, the means of securing those things has never changed. The competition for power, authority and influence will always be the backbone of politics. Applying power, authority and influence to the valued things that support the public good, will produce the quality of life a society desires. In the present day, citizens in the United States demand certain valued things such as welfare, education, safe streets and healthcare. Through politics, citizens can apply their power in many different ways to get the things they want. Power is the ability to get someone to do something they may or may not want to do. Through the use of or the application of coercion, persuasion, manipulation and negotiation, power is used to influence the system. It would seem as if valued things, such as safe streets and healthcare, would already be established in a society such as ours. Using safe streets as an example, it is hard to believe a person would not support safe streets. But the discussion about safe streets is not exactly whether we want them or not. The disagreement on this topic, and most political topics, is how much should be spent fiscally on achieving and maintaining safe streets. The question of how much money should be spent on what and where is usually decided by whomever or whatever has applied the most power, influence and authority. How active or inactive should the government be in getting valued things? Politics must be used as the means of answering this question. Politics should be used to attain the things that the society needs most and should represent all of the people equally. In America today, there is a general, underlying equality that has been offered to everyone.

Immanuel Kant 1724-1804 Essay

Immanuel Kant was born on April 22, 1724 in Konigsberg, East Prussia. He was the son of a saddler. At age 8, he entered the Collegium Fredericianum, a Latin school, where he remained for 8 1/2 years and studied the classics. He then entered the University of Konigsberg in 1740 to study philosophy, mathematics, and physics. The death of his father halted his university career so he became a private tutor. In 1755, he returned to Konigsburg where he later resumed his studies. In 1756, he received a degree and was made a lecturer, and in 1770 he became a professor. Kant felt he had to adhere to a very strict schedule during his years as a professor. He would get up shortly before five in the morning and spent an hour drinking tea, smoking a pipe, and thinking over his day’s work. From six to seven he prepared his lecture, which would begin at seven or eight and lasted until nine or ten. After his lecture he would devote himself to writing until the midday meal. He always had company for his midday meal and it would always last several hours because he enjoyed conversation. After the meal he would take a walk for an hour or so and his evenings were devoted to reading and reflection. He would go to bed at ten o’clock. Besides his writings, he became famous for his schedule. Kant’s most striking character trait was probably his moral earnestness and his devotion to the idea of duty. He was a sociable man and was also kindly and benevolent. He was never rich but he was careful in money matters. He regularly assisted a number of poor people. He was a sincere and loyal friend and his conduct was marked by courtesy and respect for others. For 15 years after completing his doctorate he taught at the university where he lectured on science and math, but eventually he expanded his field to cover almost all branches of philosophy. Kant was an amazing orator and was internationally famous for his lectures. His main goal in philosophical courses was to stimulate his listeners to â€Å"stand on their own feet† as he put it. He was appointed to a regular chair of philosophy at the University at the age of 46 in 1770. He was made the professor of logics and metaphysics. He came into conflict with Prussia’s government due to his unorthodox religious teachings. In 1792, the King of Prussia, Frederick William II, forbade Kant to teach or write on religious teachings. He obeyed the king’s order until William II died. In 1798, the year following his retirement from the University, Kant published a summary of his religious views. He died on February 12, 1804. During his lifetime, Kant produced many writings. Scholars usually divide his literary career into two periods: the Pre-critical period and the Critical period. During the Pre-critical period, 1747 to 1781, he wrote many non-fictional works and criticisms. Some of them were â€Å"Thoughts on the True Estimation of Living Forces†, â€Å"On Fire†, â€Å"A New Explanation of the First Principles of Metaphysical Knowledge†, and â€Å"On the Forms and Principles of the Sensible and Intelligible World†. From 1770 to 1780, he mainly worked on preparing â€Å"The Critique of Pure Reason†. The Critical period lasted from 1781 to 1794. During this period, he wrote â€Å"The Critique of Pure Reason† in 1781, and â€Å"Foundation for the Metaphysics of Ethics† in 1785. Following the critical works, Kant published â€Å"Critique of Practical Reason†, â€Å"Critique of Judgment†, and â€Å"Religion within the Limits of Mere Reason†. Three main discussions of Kant are Duty, the Formula of the End, and the Kingdom of Ethics. Kant feels that we act morally when we do our duty, however it is important to distinguish between acting according to duty and acting from duty. Acting according to duty is when someone else has imposed the duty. This is an example of heteronymous will. An example of this is Adolf Eichmann, a German nazi general of WWII, who formulated the ‘final solution’. He said that according to Kant, he acted morally, since he was following orders, as it was his duty to do so. This is wrong because Kant says that we are only acting morally if we act from duty, as dictated by our innate reason. This is an example of autonomous will. Along with duty is the difference between the Categorical Imperative and the Hypothetical Imperative. Imperatives in general are commands that dictate a particular course of action, such as â€Å"you shall clean your room. † Hypothetical Imperatives are commands that depend on my preference for a particular end, and are stated in conditional form. The Categorical Imperative, Kant argues, are moral actions based on a â€Å"supreme principle of morality† which is objective, rational, freely chosen, and it is not conditional upon one’s preferences. Therefore the Categorical Imperative can be the only possible standard of moral obligation. An example of this is two grocers in a town are John and Joe. John wants to keep his trade, so he insists on selling the best goods, giving the best service, being friendly and polite, and offering value for money. Joe does the same, not to keep his trade, but because it is what he should do. According to Kant, even though the actions are the same, John is acting immorally, according to the Hypothetical Imperative, while Joe is acting morally, according to the Categorical Imperative. For Kant, the act is not important. As long as you are acting from duty and the motive is right, the act must be right. However, the Principles of Universalisability puts a twist on this. It states that if an action is applied to everyone, and everybody did what you were about to do, it became immoral or hypocritical, and then your act would be immoral. The Formula of the End deals with ends and means. Kant states that you must not treat people as means to your own end, but as ends in themselves. It would be similar to Christianity’s ‘Golden Rule’ except for the Universalisability Principle. The example of this is suicide. The ‘Golden Rule’ does not apply in this case, because when a person commits suicide, he does not treat others in ways he would want to be treated. He does not treat them at all, because he only treats himself. The Kingdom of Ethics states that human beings, because they are rational (use reason), possess inherent value. This means that they are ends in themselves. Their value is intrinsic, not instrumental. Kant feels that no rule of conduct, which applies to all human beings, can sanction actions favoring one person over another or agree to conduct where one person treats another as a means to an end. To do so is to demean oneself and the entire human race. Kant’s ethics are founded in and based on respect for persons. In following a certain course of moral action, regardless of inclination, a person is enacting a Kingdom of Ethics. Along with ethics is the idea of good will. Kant believes that it is wrong to intentionally break a promise that you have made with a person. He feels that good will is a pure duty outlook that disregards consequences entirely. He says that a good will is a wanting, which is informed by reason. It is a wanting which stems, not from inclination, but from duty. Kant says space and time are not concepts but that they are forms of intuition. He spends a lot of time showing the fallacies that arise from applying space and time to things that are not experienced. Kant agrees with David Hume in believing passion brings man morality. He feels that reason is only the comparing of ideas, and that reason will influence us away from our influences. The cultivation of reason is required for the purpose, and the purpose leads to happiness, therefore reason is compatible with happiness. Kant believed that reason connected us directly to things-in-themselves. He feels that we possess two sources of input that can serve as such datum. These are physical sensation and the sense of moral duty. Physical sensation starts an application of reason to experience, creating the perception of phenomenal objects. The supreme rational example of this is science. The sense of moral duty begins an application of reason that produces ethics and religion. The supreme rational example of this is the â€Å"Postulates of Practical Reason† the â€Å"Ideas† of God, freedom, and immortality, which to Kant are required as conditions of the Moral Law. Kant tries to demolish all the purely intellectual proofs of the existence of God. He makes it clear that he has other reasons for believing in God that he talks about later. God, freedom, and immortality are the three ideas of reason according to Kant. The differences between reality as seen in science, and reality as seen in morality and religion show that there are points to existence that are not revealed by either one alone. The two aspects are unequal. Magnitude and religion have a much more limited rational content, returning to many of the same questions over and over again. These include the ultimate questions about the meaning of life and existence, as well as the questions on how to live. Kant was led to characterize his system as transcendental idealism, so that we have a questioned representation of things, since our moral datum does not lead to direct knowledge of things that we are able to conceive, like God. This is because we do not have the real intuition that we have of physical objects. The reality shown by morality is a matter of faith for Kant. This is an inference from the Moral Law. This way, â€Å"transcendental idealism† is different form â€Å"subjective idealism† and â€Å"objective idealism†, since they both show certainties about the ultimate nature of things. The nature of things that we cannot know about concretely is revealed in science. Kant’s theory of empirical realism stresses that phenomena are undoubtedly mental contents. He feels that it is natural and easy to infer from this a â€Å"transcendental realism where â€Å"real† objects, which are not mental objects, are things we do not experience. At the age of 69, Kant wrote an essay on religion that is considered the boldest of all his writings. He said that churches have value only in that they assist the moral development of the race. He went on to say that when mere ceremonies usurp priority over moral excellence as a test of religion, religion has disappeared. He believed that the real church is a community of people, however scattered and divided, who are united by devotion to the common moral law. He thought the creed and ritual had replaced the good life and that instead of men being bound together by religion, they are divided into a thousand sects. He went on to say that a perversion is reached when the church becomes an instrument of the government and the clergy, whose function is to console and guide a harassed humanity with religious faith and hope and charity, are made the tools of political oppression. He said that miracles cannot prove a religion because we can never rely on the testimony which supports them, and that prayer is useless as it aims at a suspension of the natural laws that hold for all experience. A priori judgments are made outside of experience. â€Å"The sky is blue† is an a posteriori judgment (made on the basis of sensory experience). â€Å"I exist† is an a priori truth, which remains unchanged even if all of our senses are deceived. Analytic statements are true based only on the meanings of words. The only thing needed to determine truth is a dictionary. Synthetic statements cannot be judged like analytic statements. â€Å"My dog has black spots† is a synthetic statement. The truth cannot be determined since my dog is not known. The truth is not dependent on word meanings, but on if it corresponds with the world. Causality is applied to perception and concepts which are applicable to perception, Kant calls Categories. There are a total of twelve Categories. Kant says that the categories are patterns of understanding by which we examine structure and understand the things that we experience. Synthetic a priori judgments consist in applying the Categories to sensory information in space and time, or the â€Å"perceptual manifold. † Application of the Categories allows people to realize physical objects as capable of casual relations and interactions with other objects. Categories cannot be applied to knowledge or things that exist apart from space and time like things-in-themselves. Kant derives the Ideas from the possible forms of logical inference. When we assume that this potentially infinite series is given in its whole, an Idea is formed. Kant recognized three Ideas. The first is of the absolute unity of the thinking subject. The second is of the absolute unity of the order of the conditions of appearance. The third is of the absolute unity of the conditions of thought in general. The first Idea provides a subject matter of speculative psychology. The second is one of speculative cosmology, while the third is one of speculative theology. These are all metaphysical knowledge of matters of fact from synthetic a priori principles. Kant’s Ideas are really all about metaphysical paradoxes (Antimony of space and time) in its entirety, an unconditioned whole. Kant believes that all these matters are open to clarification and development. He also believes that the mind produces the world it knows. To understand â€Å"The Critique†, Kant’s logical system must be understood. He divides all judgments into analytic or synthetic judgments and a priori or a posteriori judgments. Judgments about empirical matters are synthetic, which can be denied without any contradiction. A priori judgments are free from experience. All analytic judgments are a priori. Therefore judgments are split up into three classes: analytic a priori, synthetic a posteriori, and synthetic a priori. One of his points made in â€Å"The Critique† is to show how synthetic a priori judgments occur in pure mathematics and natural science. Critique is not really a criticism, but a critical analysis where Kant is not attacking â€Å"pure reason† except to show its limitations. Rather he hopes to show its possibility and to exalt it above the impure knowledge which comes to us through the distorting channels of sense. He is trying to show that knowledge is not all derived from the senses. Kant distinguished between perceiving and thinking, which are from two distinct faculties of the mind, sense and understanding. There are three types of concepts. A posteriori concepts are taken from sense perception and are applicable to it, while Ideas are free of all sense perception. From Kant we know that every event must have a cause. This is possible only on the condition that objects must be subjected to the concepts of human understanding. He said that not all knowledge is gained through experience. It is possible to gain knowledge from sense-experience. That is that you can learn by seeing things that are not experienced but rather come from logic. â€Å"The Critique of Pure Reason†, published in 1781, is a synthesis of rationalism and empiricism. In order to understand Kant’s position and orthodox teachings, we must first understand the philosophical background that he was reacting to. There were two major historical movements in the early modern period of philosophy that had a significant impact on Kant: Empiricism and Rationalism. Kant argued that both the content and method of these philosophies contained serious flaws. A central problem for philosophers in both movements was determining how we can escape from within the confines of the human mind and the immediately knowable content of our thoughts to acquire knowledge of the world outside of us. The Empiricists sought to accomplish this through the senses and a posteriori reasoning. Empiricists such as John Locke argued that human knowledge originates in our sensations or experiences. Locke argued that the mind was a blank slate, or a â€Å"Tabula Rasa†, upon which our experiences writes and that experience teaches us everything. The Rationalists attempted to use a prori reasoning to build the necessary bridge. The Rationalists, principally Descartes, approached the problems of human knowledge from another angle. The Rationalists believed that the mind was the source of knowledge and that sense-data from our experiences only trigger the knowledge already in the mind. Kant’s answer to the two positions changed the face of philosophy. Both of these in themselves, he believed, gave a one-sided view of knowledge. Kant believed that there was more to knowledge then just experience. He believed that the mind gave us knowledge through the â€Å"categories†. That experience is going to trigger the knowledge or categories that are innate to all of us. So he would say that there is nothing that we could not know or learn because we already have the categories in the mind. Kant believed that nations would not really be civilized until all standing armies are abolished. He stated that standing armies cause states to try to outdo each other with the number of armed men each has. Because of the expense of the armies, peace becomes in the long run more oppressive than a short war; and standing armies are the cause of aggressive wars undertaken in order to get rid of this burden. Kant felt that much militarism was due to the expansion of Europe into America and Africa and Asia. He believed that if democracy was established and that everyone shared in political power, the spoils of international robbery would have to be subdivided as to constitute a resistible temptation. Kant said when those who must do the fighting have the right to decide between war and peace, history will no longer be written in blood. Many philosophers were influenced by prior philosophers. Berkeley was, for Kant, the characteristic â€Å"idealist† and an empiricist. Descartes, on the other hand, was a â€Å"realist† believing that objects exist separately from us. He also thought that we could only know their essences through â€Å"clear and distinct† innate ideas. This made him a â€Å"transcendental† realist. Kant’s thoughts were mainly influenced by the rationalism of Gottfried Wilhelm von Leibniz, Christian Wolff, and the empiricism of David Hume. The reason I chose Immanuel Kant to research is because not only of his philosophical views but also because of his interests in scientific issues. He was interested in virtually every aspect of human experience. While researching him I became impressed with his views on war, especially that if we allowed the people who have to do the fighting to make the decision about war, we would have peace. I agree that sometimes the government makes the decisions that doesn’t represent what the people want. I was also impressed with his views on religion, how the churches become instruments in the hands of the government and the clergy become tools of politics. Since Kant’s thought is truly the basis of modern philosophy, it is still a main point of departure for the 21st century.

What I learned in Theater essays

What I learned in Theater essays Ok, so the only reason I joined theater class was because I needed an easy A. A blow-off class of some sort, to balance out the rest of my schedule. I got much more than that. I am taking with me a sense of self-worth, and confidence. I acquired the ability to think on my feet, and the motivation to get up and do something when faced with a new situation, not just giggle and turn red. The biggest thing, I think, is the ability to just talk to people and not be worried about what they think. After all, I cant be embarrassed after I think about some of the stuff that I did this year in front of the class. I found that I can go ahead and talk to someone I dont know, instead of just standing there, awkwardly. After spending five weeks on improvisation during the first semester, I can think on my feet. It also gives me something to do when the telemarketers call. I can think of something to say when Im talking to one of dads clients. And of course, if someone gets into a situation that they cant quite explain, I can whip up a story in no time flat, (not that I would ever get into trouble or anything). After taking the class, I never have my back to someone when Im talking. I can project, (sort of). I know what Snagglepus is talking about when he says Exit, stage right! Stage fright is no longer a big thing for me. I can play a crazy role very well. I can talk in British and Russian accents, (...Daahlink, ve must get moose and skverrl!). I can pick out bad actors/actresses in movies and shows. I have a deep respect for the theater arts. I am not much of an actress, but I love being backstage, all stressed out, trying to iron out all the last minute wrinkles before the show. Being in theater class introduced me to Theatre Club, which gave me a chance to be a part of this years production. I was glad to do everything from pinning up costumes, to re...

Assignment One Law Example

Assignment One Law Example Assignment One Law – Case Study Example Court vs. Tribunal Courts are a legal mechanism established to solve disputes and assist in interpreting the law. On the other hand, tribunals refer to an individual or an institutional granted the authority to adjudicate or settle disputes (Cownie, Bradney Burton, Mandy and Bradney, Anthony, â€Å"English Legal System in Context,† Sixth edition. (UK: Oxford University Press, 2013): 65.

Marketing in the digital era Essay Example | Topics and Well Written Essays - 2000 words

Marketing in the digital era - Essay Example Employing effective marketing mix, competitive positioning and a wider media strategy are vital. Marketers can think and utilise these strategies in achieving successful business performance. The researcher analysed the way marketers can employ a marketing strategy that meets the expectations of customers. The marketing strategy can also provide marketers various advantages including increased financial savings and continuous engagement with customers. Marketers should focus on a strategy that can enable them to increase their financial savings and maintain their position in the competitive market. The researcher examined the way marketers can differentiate products and add value to their products. They should understand the effective distribution channels and media services effective for communicating about the available products in the market. Lastly, the essay revealed the way employing CRS model, segmentation strategy and understanding the need for cultural change are crucial. Th is is because they will enable marketers to maintain their position in the market. This is because resources are scarce; thus, the marketers may end up losing opportunities in case they mismanage the resources. Barney (1995, p. 42) asserts that an industry can defeat their rivals in case it can only create a difference that it can sustain. This is through employing an effective marketing strategy that can enable them to achieve a competitive advantage.... Electronic marketing is increasing because marketers want to achieve a competitive advantage in the competitive marketing cross the globe (Ataman, Berk, Harald and Carlf 2010, p. 871). Online marketing has become commonly used in marketing of brands; thus, marketers should change their ways of thinking and acting in order to maintain their position in the competitive market. Marketers should employ effective marketing mix and expand their brands beyond the media mix in order to widen their commitment with consumers. The wider media strategy and competitive positioning strategy are effective because they provide marketers various advantages, which include increased financial savings and continuous engagement with customers. In the marketing digital era, marketers should focus on a strategy that can enable them to increase their financial savings. Resource based view of the organisation is one of the ways that can enable the firm to utilise the scarce resources effectively in achieving their demanding goals (Fahy 2000, p.98). Organisation attributes include resources and capabilities vital for achieving a competitive advantage. Therefore, marketers should utilise them effectively in order to maintain their position in the market. This is because resources are scarce; thus, the marketers may end up losing opportunities in case they mismanage the resources. Barney (1995, p. 42)Â  asserts that an industry can defeat their rivals in case it can only create a difference that it can sustain. This is through employing an effective marketing strategy that can enable them to achieve a competitive advantage. Marketers should understand that an effective strategy is built on process; thus, they should design marketing strategies basing on the available

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Why does work matter for modern societies - Essay Example The complexities of the modern world have also led to people changing their forms of production in order to fit into the world. Modernity has led to a change in labor division from the usual organizational division of labor to social divisions. Divisions of labor have changed and there is a clear varianceamid the pre modern societies and the modern societies. In the pre modern societies, labor was divided based on social units, similarity and familial basis while in the modern world it is divided based on market, state and the civil society. Work is important to the modern world since the modern world has brought about a lot of social differentiation and hence increasing structural complexity. Despite each individual participating in different careers, work holds the society together and wipes away their differences. The pre modern societies were faced with similar challenges, problems since they all belonged to similar locations, families, religion and their levels of education were equal a situation termed as mechanical solidarity. However, in the modern society, people are very different and they have to inter-depend on one another in order to survive. The modern population has different abilities and each human being can do something in a unique and better way than another. This characteristic of the modern society makes it important for every human being to work so that they may serve another human being in their area of specialty and at the same time, get services form other human beings in their different areas of specialty. The pre-modern societies were undifferentiated since they shared strong beliefs and sentiments and this characteristic is termed as collective conscience. The modern societies have a characteristic of being more differentiated due to them having less defined beliefs a nd sentiments but instead have norms and values. This characteristic of the modern society being different and in some way