Futile medical interventions have virtually no chance of success. Doctors might perform such procedures because of pressure from families or patients. The doctor might also have an ulterior motive of gain or prefer to do it rather than take time to communicate with the patient about a poor prognosis. Established ways to communicate bad news to patients are not always used by managing physicians with time constraints. The SPIKES protocol method is outlined to assist in sensitive communication where further intervention (...) is futile. This review primarily explores various aspects of medical futility. It also explores strategies for effectively communicating with patients and their families regarding futility interventions. A side-effect of futile interventions is burnout in doctors and other health practitioners (HPs). The complex relationship between futility and burnout is described. (shrink)

PurposeEven low intensity exercise bouts of at least 15 min can improve feelings of energy and reduce systolic blood pressure. However, little is known about the psychological outcomes of briefer exercise bouts, particularly for modes of exercise that are more intense than level walking, and readily available to many working adults. This study assessed the effects of a 4-min bout of stair walking on FOE and feelings of fatigue.MethodsThirty-six young adult participants were randomized to either stair walking or seated control (...) groups. All participants walked on level-ground from a laboratory to a nearby stairwell and were seated for 4 min before beginning their experimental condition. Stair-walking participants walked up and down one flight of 16 stairs at their own pace for 4 min, while control participants remained seated during that time. Participants walked back to the laboratory for post-condition assessments. Measures of blood pressure, heart rate, rated perceived exertion, and the intensity of feelings of mental energy, mental fatigue, physical energy, and physical fatigue were assessed pre-and post-condition. Separate one-way ANOVAs were conducted on change scores for all variables.ResultsThe stair climbing group experienced significant increases in heart rate [F = 13.167, p < 0.001] and RPE [F = 93.844, p < 0.001] that were not observed in the seated control group. Four minutes of self-paced stair climbing resulted in small changes and non-significant differences within and between groups in blood pressure as well as FOE and FOF.ConclusionAlthough a 4-min self-paced exercise bout can convey short-term physiological health benefits, a 4-min bout of self-paced indoor stair walking in a stairwell was insufficient to lower blood pressure or change subjective FOE and fatigue in a sample that exhibited better than typical FOE and FOF at the pre-test. (shrink)

This paper brings Karl Rahner’s understanding of human ex-sistence (L. ex ‘out, forth’ and sistere ‘to stand’)—that is, human ‘standing forth’—to bear upon the phenomenon of black rage in the United States. The reason for this application is the emancipatory potential of Rahner’s transcendental realism, which basically understands human life as a dynamism at once rooted ‘in the world’ and yet called, in obediential potency, to the qualitative ‘more’. Rahner’s anthropological understanding allows for an investigation of the existential struc ture (...) and possibilities of black rage which may benefit black ex-sistence by showing how the dynamism of human life accounts for and justifies this rage as well as what liberating possibilities open up for the enraged. (shrink)

Police killings of unarmed Black people have ignited a national and international response unlike any in decades. But differing from their civil rights-oriented predecessors, today’s activists do not think that the institutions and values of liberal democracy can eradicate structural racism. They draw instead on a Black radical tradition that, Terrence L. Johnson argues, derives its force from its unacknowledged ethical and religious dimensions. We Testify with Our Lives traces Black religion’s sustained influence from SNCC to the present, reconstructing a (...) radical lived ethics of freedom and justice. Johnson demonstrates that Black Power fundamentally contests liberalism’s abstract understanding of democracy, calling instead for new embodied frameworks to achieve human flourishing and dignity. Black bodies represent the primary form of resistance against violent and oppressive regimes of white supremacy and exploitation, and the individual and collective struggles of Black life bear witness to the dogged determination to cultivate beauty, rage, and joy. Considering the writings of Audre Lorde, Toni Cade Bambara, Stokely Carmichael, Martin Luther King Jr., Malcolm X, and James Baldwin, We Testify with Our Lives makes its case through a new narrative of the evolution of Black radicalism from the civil rights movement through the Movement for Black Lives. It forges new insights into Black Power’s vital contributions to debates on ethics, transnational politics, democracy, political solidarity, and freedom—and its potent resources for the ongoing struggle to build democratic possibilities for all. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Virgil and the ModernsMichael L. HallVirgil and the Moderns, by Theodore Ziolkowski; xv & 274 pp. Princeton: Princeton University Press, 1993, $35.00.Theodore Ziolkowski’s Virgil and the Moderns is a wonderful book. Everyone interested in modern literature and the western cultural heritage should read it. Ziolkowski does much more than tell us about Virgil and his influence on modern authors and readers; he traces the Latin poet’s appeal from (...) the nineteenth century forward, focusing on different national trends and responses to the Roman past. His book is a veritable education in modern literature and cultural history.In the introductory chapter Ziolkowski situates Virgil in the twentieth century, with references to the Virgilian epigraph on the title page of Freud’s The Interpretation of Dreams (1900) and the Virgilian motto to the first volume of Toynbee’s A Study of History (1934). Ziolkowski concentrates attention, in fact, on the appeal to Roman history in many early twentieth-century historians, and he explores the various European and American reactions to the bimillennial celebrations in 1930 of Virgil’s birth. Like the Bible, the Roman past seems to speak directly to a great variety of points of view: “Roman history, properly comprehended in its broad outlines, is and remains the best teacher not only for today, but indeed for all times”; thus opined the author of Mein Kampf.Ziolkowski’s second chapter, “The Ideological Lives,” begins by observing that “every biography is ideological” and quoting Duane Reed Stuart’s comment that “Every age has tended to fashion a Virgil after its own image.” Ziolkowski tests this proposition against the many “modern” biographies of Virgil that appeared in the nineteenth and twentieth centuries, especially during the bimillennial celebrations. In Italy he finds Virgil described as “a Latin nationalist with conservative messages for the present on government and agriculture”; in France he discovers “a protofascist emerging from the bohemian life of the rive gauche of ancient Rome”; in Germany he encounters “an agrarian anima naturaliter christiana destined to become Father of the West in opposition to the rise of Nazism”; and in Latin America he sees that Virgil has become “an apostle of peace among the pagans with the providential mission to serve the generations as a pedagogue for Christ.”In the five chapters that follow, Ziolkowski shows that these various versions of Virgil’s life and influence resulted in a similar diversity of literary manifestations. In Europe, each country found a Virgil suited to its own preoccupations and prejudices. A rich and indeed overwhelming curriculum in modern literature could be constructed from the authors and texts Ziolkowski discusses in these brief surveys of works influenced by Virgil’s poetry. But although he is a deft literary critic, Ziolkowski goes further, to trace biographical and cultural influences. We discover, for example, that Gide was obsessed with the Eclogues, that it was the Georgics that Mr. Carmichael “liked to lie awake a little reading” in Woolf’s To the Lighthouse, and that Joe Paterno’s first and most enduring hero [End Page 175] was Virgil’s Aeneas, “to whom he was introduced by his high school Latin teacher at Brooklyn Prep.”I confess that my favorite parts of the book were the chapters on Virgil in Britain and the “New World.” I thought I was a pretty good student of the classics and of British and American literature, but I am ashamed to admit how much I learned from Ziolkowski’s discussions of Virgil’s influence on Virginia Woolf, T. S. Eliot, and Cyril Connolly, on Willa Cather and Robert Frost, on Archibald MacLeish, Allen Tate, and Robert Lowell. Ziolkowski is a treasure, and he has given us a rare treat in this very thoughtful study of the way our cultural inheritance is passed on and reaffirmed. As he himself remarks in the book’s final sentences on the ties that bind us to Virgil and our common past: “This reaffirmation, attained at the cost of great spiritual engagement by our intellectual predecessors, we neglect today at our peril.”Michael L. HallAlexandria, VirginiaCopyright © 1995 The Johns Hopkins University Press... (shrink)

Theft, grievances and absenteeism show the need to examine mutual loyalty and establish a‘win‐win’policy.

In teaching courses on Karl Rahner to undergraduates, I have come to appreciate the importance of finding a starting point with which students readily connect. After much thought, I begin these courses with an extended consideration of the human person. This starting point has the advantage not only of being Rahner’s but also of being one which seems attractive to students. I have found little evidence that students have to be convinced about the importance of self-concern. I am careful to (...) emphasize, however, that in Rahner’s understanding of the dynamism of conversio and reditio this starting point never allows for any form of narcissistic subjectivism. Starting with the concreteness of our lives naturally leads to other considerations which also seem attractive to students: the burden of self-responsibility, the sense of awe and wonder, the need for hope. These are among some of the concerns which I try to address when teaching Rahner. (shrink)

Rose and Schaffer (forthcoming) argue that teleological thinking has a substantial influence on folk intuitions about composition. They take this to show (i) that we should not rely on folk intuitions about composition and (ii) that we therefore should not reject theories of composition on the basis of intuitions about composition. We cast doubt on the teleological interpretation of folk judgments about composition; we show how their debunking argument can be resisted, even on the assumption that folk intuitions have a (...) teleological source; and we argue that, even if folk intuitions about composition carry no weight, theories of composition can still be rejected on the basis of the intuitions of metaphysicians. (shrink)

When some objects are the parts of another object, they compose that object and that object is composite. This article is intended as an introduction to the central questions about composition and a highly selective overview of various answers to those questions. In §1, we review some formal features of parthood that are important for understanding the nature of composition. In §2, we consider some answers to the question: which pluralities of objects together compose something? As we will see, the (...) dominant answers are all of them and none of them. In §§3-4, we examine one of the main arguments that has driven philosophers to these extreme answers: the argument from vagueness. In §5, we turn to the question of whether composition is unique: is it sometimes the case that some things compose more than one thing? Finally, in §6, we turn from the question of which composites exist to the question of which composites exist fundamentally. (shrink)

The special composition question is the question, ‘When do some things compose something?’ The answers to this question in the literature have largely been at odds with common sense, either by allowing that any two things compose something, or by denying the existence of most ordinary composite objects. I propose a new ‘series-style’ answer to the special composition question that accords much more closely with common sense, and I defend this answer from van Inwagen's objections. Specifically, I will argue that (...) the proposed answer entails the transitivity of parthood, that it is non-circular, and that it casts some light on the ancient puzzle about the Ship of Theseus. (shrink)

In this timely book L.W. Sumner addresses these issues within the wider context of palliative care for patients in the dying process.

The ancient puzzle of Dion and Theon has given rise to a surprising array of apparently implausible views. For example, in order to solve the puzzle, several philosophers have been led to deny the existence of their own feet, others have denied that objects can gain and lose parts, and large numbers of philosophers have embraced the thesis that distinct objects can occupy the same space, having all their material parts in common. In this paper, I argue for an alternative (...) approach: I claim that human beings have ordinary parts—hands, heads, feet, and so on—but no extraordinary parts, such as ‘foot-complements’, the existence of which is essential to the puzzle. I rebut three objections to this approach: an objection that it is unacceptably metaphysically arbitrary, an objection that the view is incompatible with versions of the puzzle involving decapitation, and an objection concerning masses of matter. If we can believe that there are such things as hands and feet without involving ourselves in paradox, and without accepting large numbers of co-located material objects that share all their material parts, then that is what we should do. My view is the only known alternative which allows this. (shrink)

In this chapter, I make the case for platonic realism, the thesis that there are properties that lack spatial locations. After criticizing the one-over-many argument for realism and Lewis's argument for realism, I endorse a modal argument that derives the existence of platonic properties from considerations involving necessary truth. I then defend this argument from various objections. Finally, I argue that epistemic considerations and considerations of parsimony favor a weak form of platonic realism on which there are platonic properties, but (...) each property could have had an instance, and would have been located in its instances if it had any. (shrink)

According to the traditional bundle theory, particulars are bundles of compresent universals. I think we should reject the bundle theory for a variety of reasons. But I will argue for the thesis at the core of the bundle theory: that all the facts about particulars are grounded in facts about universals. I begin by showing how to meet the main objection to this thesis (which is also the main objection to the bundle theory): that it is inconsistent with the possibility (...) of distinct qualitative indiscernibles. Here, the key idea appeals to a non-standard theory of haecceities as non-well-founded properties of a certain sort. I will then defend this theory from a number of objections, and finally argue that we should accept it on the basis of considerations of parsimony about the fundamental. (shrink)

First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

In this paper, I argue that there are universals. I begin (Sect. 1) by proposing a sufficient condition for a thing’s being a universal. I then argue (Sect. 2) that some truths exist necessarily. Finally, I argue (Sects. 3 and 4) that these truths are structured entities having constituents that meet the proposed sufficient condition for being universals.

David Lewis (1986) criticizes moderate views of composition on the grounds that a restriction on composition must be vague, and vague composition leads, via a precisificational theory of vagueness, to an absurd vagueness of existence. I show how to resist this argument. Unlike the usual resistance, however, I do not jettison precisificational views of vagueness. Instead, I blur the connection between composition and existence that Lewis assumes. On the resulting view, in troublesome cases of vague composition, there is an object, (...) which definitely exists, about which it is vague whether the relevant borderline parts compose it. (shrink)

An important figure in the natural law tradition and in the Scottish Enlightenment, Gershom Carmichael defended a strong theory of rights and drew attention to Grotius, Pufendorf, and Locke. Gershom Carmichael was a teacher and writer who played an important role in the Scottish Enlightenment of the eighteenth century. His philosophy focused on the natural rights of individuals--the natural right to defend oneself, to own the property on which one has labored, and to services contracted for with others. (...) Carmichael argued that slavery is incompatible with the rights of men and citizens, and he believed that subjects have the right to resist rulers who exceed the limits of their powers. Although he appealed to the authority of Grotius and Locke, the grounds on which he defended natural rights were distinctively his own. He drew upon the Reformed or Presbyterian theology to propose that, in respecting the natural rights of individuals, one shows one’s reverence for God’s creation. Inasmuch as all of mankind longs for lasting happiness, which can be found only in worship of or reverence for God, such reverence is the natural law which obliges all to respect the rights of all. Natural Rights includes Supplements and Observations on Pufendorf (1724), Natural Theology (1729), Logic (1722), two theses, and a manuscript on teaching, all in English for the first time. Gershom Carmichael (1672-1729) was the first professor of moral philosophy at the University of Glasgow, preceding Hutcheson, Smith, and Reid. James Moore is Professor of Political Science at Concordia University in Montreal. Michael Silverthorne is Honorary University Fellow in the School of Classics at the University of Exeter. Knud Haakonssen is Professor of Intellectual History and Director of the Centre for Intellectual History at the University of Sussex, England. (shrink)

In this paper, I develop a theory on which each of a thing’s abundant properties is immanent in that thing. On the version of the theory I will propose, universals are abundant, each instantiated universal is immanent, and each uninstantiated universal is such that it could have been instantiated, in which case it would have been immanent. After setting out the theory, I will defend it from David Lewis’s argument that such a combination of immanence and abundance is absurd. I (...) will then advocate the theory on the grounds that it accomplishes all of Lewis’s “new work” while providing a gain in parsimony and a new account of fine-grained content. I will close with a discussion of how the theory also affords a new reply to two objections to uninstantiated universals: Armstrong’s charge that they are inconsistent with naturalism, and a Benacerraf-Field-style objection about epistemic access. (shrink)

Synaesthesia is a neurodevelopmental condition characterised by anomalous sensory perceptions and associated alterations in cognitive function. This chapter summarises what is known about the familial transmission of synaesthesia and its genetic underpinnings. Early familiality studies showed evidence for a strong genetic predisposition, a highly skewed female: male ratio, and an absence of male-to-male transmission. These patterns supported an early hypothesis of a single-gene X-linked dominant mode of inheritance with male lethality. Subsequent analyses in larger samples indicated that the mode of (...) inheritance was likely to be more complex, with both the strong female skew and absence of male-to-male transmission brought into question. We review in detail the first whole genome linkage scan for auditory-visual synaesthesia and a subsequent family linkage study on coloured sequence synaesthesia. Together these results suggest linkage to five chromosomes but give no support for linkage to the X-chromosome. We discuss candidate genes within these regions and potential implications for the aetiology of synaesthesia. We also discuss the implications of these pioneering genome scans for our understanding of synaesthesia and of how different synaesthetic phenotypes may arise from different genetic predispositions interacting with other genes and with the environment. (shrink)

One of the remarkable features of recent interest in the work of Louis Althusser has been the prominence granted to Althusser’s cultural criticism. However, aside from one notable exception, Althusser’s cultural criticism has not figured prominently in discussions of his late work, and the absence of Althusser’s cultural criticism from those discussions has perhaps unwittingly obscured both the genealogy of Althusser’s late aesthetic ontology and the logic of his last texts, of ‘The Underground Current of the Materialism of the Encounter’ (...) and related writings on aleatory materialism. By tracing the genealogy of the aleatory impulse in Althusser’s cultural criticism, it is possible to show how that work resonates in Althusser’s late texts including the larger unpublished manuscript from which ‘The Underground Current of the Materialism of the Encounter’ has been drawn. This reading of the philosophy of the encounter also allows us to understand the importance of Nicolas Malebranche for Althusser’s aleatory materialism. (shrink)

Drawing on work of the past decade, this volume brings together articles from the philosophy, history, and sociology of science, and many other branches of the biological sciences. The volume delves into the latest theoretical controversies as well as burning questions of contemporary social importance. The issues considered include the nature of evolutionary theory, biology and ethics, the challenge from religion, and the social implications of biology today (in particular the Human Genome Project).