I. EXECUTIVE SUMMARY The MRCT Center Post-trial Responsibilities: Continued Access to an Investigational Medicine Framework outlines a case-based, principled, stakeholder approach to evaluate and guide ethical responsibilities to provide continued access to an investigational medicine at the conclusion of a patient’s participation in a clinical trial. The Post-trial Responsibilities (PTR) Framework includes this Guidance Document as well as the accompanying Toolkit. A 41-member international multi-stakeholder Workgroup convened by the Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard University (...) (MRCT Center) developed this Guidance and Toolkit. Project Motivation A number of international organizations have discussed the responsibilities stakeholders have to provide continued access to investigational medicines. The World Medical Association, for example, addressed post-trial access to medicines in Paragraph 34 of the Declaration of Helsinki (WMA, 2013): “In advance of a clinical trial, sponsors, researchers and host country governments should make provisions for post-trial access for all participants who still need an intervention identified as beneficial in the trial. This information must also be disclosed to participants during the informed consent process.” This paragraph and other international guidance documents converge on several consensus points: • Post-trial access (hereafter referred to as “continued access” in this Framework [for terminology clarification – see definitions]) is the responsibility of sponsors, researchers, and host country governments; • The plan for continued access should be determined before the trial begins, and before any individual gives their informed consent; • The protocol should delineate continued access plans; and • The plan should be transparent to potential participants and explained during the informed consent process. -/- However, there is no guidance on how to fulfill these responsibilities (i.e., linking specific responsibilities with specific stakeholders, conditions, and duration). To fill this gap, the MRCT Center convened a working group in September of 2014 to develop a framework to guide stakeholders with identified responsibilities. This resultant Framework sets forth applicable principles, approaches, recommendations and ethical rationales for PTR regarding continued access to investigational medicines for research participants. (shrink)

This volume contains new and original papers on Martin Heidegger’s complex relation to Friedrich Nietzsche’s philosophy. The authors not only critically discuss the many aspects of Heidegger’s reading of Nietzsche, they also interpret Heidegger’s thought from a Nietzschean perspective. Here is presented for the first time an overview of not only Heidegger’s and Nietzsche’s philosophy but also an overview of what is alive – and dead – in their thinking. Many authors through a reading of Heidegger and Nietzsche deal with (...) current issues such as technology, ecology, and politics. This volume is of interest for everyone interested in Heidegger’s and Nietzsche’s thought. Contributors include: Babette Babich, Charles Bambach, Robert Bernasconi, Virgilio Cesarone, Stuart Elden, Michael Eldred, Markus Enders, Charles Feitosa, Véronique Fóti, Luanne T. Frank, Jeffery Kinlaw, Theodore Kisiel, William D. Melaney, Eric Sean Nelson, Abraham Olivier, Friederike Rese, Karlheinz Ruhstorfer, Harald Seubert, Robert Sinnerbrink, Robert Switzer, Jorge Uscatescu Barrón, Nancy A. Weston, Dale Wilkerson, Angel Xolocotzi, Jens Zimmermann. (shrink)