Tort claims have been studied for various reasons. Several studies have found that most tort claims are not related to negligent adverse events and most negligent adverse events do not result in tort claims. Several studies have examined the disposition of tort claims to understand the likelihood of payment once a claim has been made. Still others have proposed that tort-claims trend analysis may help administrators target their quality-improvement efforts and identify problems with quality that would not otherwise be captured.In (...) this article, we conduct a tort-claims analysis to explore areas for quality improvement, specifically for patient safety, in the Veterans Health Administration. Patient safety is an increasingly highlighted aspect of health-care delivery. Failure to assure patient safety can result in bad clinical outcomes, additional costs of care, and a negative organizational image. Filing a tort claim is one way for an individual to express concern about an organization. For our analysis, we draw from resolved tort claims in the Veterans Health Administration from fiscal years 1989 to 2000. (shrink)

Tort claims have been studied for various reasons. Several studies have found that most tort claims are not related to negligent adverse events and most negligent adverse events do not result in tort claims. Several studies have examined the disposition of tort claims to understand the likelihood of payment once a claim has been made. Still others have proposed that tort-claims trend analysis may help administrators target their quality-improvement efforts and identify problems with quality that would not otherwise be captured.In (...) this article, we conduct a tort-claims analysis to explore areas for quality improvement, specifically for patient safety, in the Veterans Health Administration. Patient safety is an increasingly highlighted aspect of health-care delivery. Failure to assure patient safety can result in bad clinical outcomes, additional costs of care, and a negative organizational image. Filing a tort claim is one way for an individual to express concern about an organization. For our analysis, we draw from resolved tort claims in the Veterans Health Administration from fiscal years 1989 to 2000. (shrink)

In the United States, physicians are Increasingly functioning In the consultative role. This change in role Is undoubtedly a result of a surge in the numbers of specialists, the relative decreasing number of primary care physicians, and the emergence of tertiary care centers as primary treatment providers. This change In the style of practicing medicine has led to role confusion In attending physician-patient-consultant relationships.

To better understand the available publications addressing ethical issues in rural health care we sought to identify the ethics literature that specifically focuses on rural America. We wanted to determine the extent to which the rural ethics literature was distributed between general commentaries, descriptive summaries of research, and original research publications. We identified 55 publications that specifically and substantively addressed rural health care ethics, published between 1966 and 2004. Only 7 (13%) of these publications were original research articles while (12) (...) 22% were descriptive summaries of research and 36 (65%) were general commentaries. The majority of publications examined (55%) were clinically focused while 27% addressed organizational ethics and 18% addressed ethical ramifications of rural health care policy at a national or community level. Our findings indicate that there are a limited number of publications focusing on rural health care ethics, suggesting a need for scholars and researchers to more rigorously address rural ethics issues. (shrink)

The purpose of this study was to assess the presence of ethics committees in rural critical access hospitals across the United States. Several studies have investigated the presence of ethics committees in rural health care facilities. The limitation of these studies is in the definition of ‘rural hospital’ and a regional or state focus. These limitations have created large variations in the study findings. In this nation-wide study we used the criteria of a critical access hospital (CAH), as defined by (...) the Medicare Rural Hospital Flexibility Program (Flex Program, 2007), to bring consistency and clarity to the assessment of the presence of ethics committees in rural hospitals. The Flex Monitoring Team conducted a national telephone survey of 381 CAH administrators throughout the United States. The survey covered a wide variety of questions concerning hospitals’ community benefit, impact activities, and whether the hospital had a formally established an ethics committee. About 230 (60%) of the respondents indicated they had a formally established ethics committee or ethics consultation program at their CAH. The prevalence of ethics committees declined as the CAH location became increasingly rural along a rural–urban continuum. Unlike CAHs, all rural Department of Veterans Affairs Medical Centers have ethics committees. The results of this study provide an understanding of the limited presence of ethics committee in rural America and the need to consider new approaches for providing ethics assistance. A virtual ethics committee network may be the most efficient and effective way of providing rural hospitals access to a knowledgeable ethics committee or consultant. (shrink)

This study examined more than 2,500 war images from U.S. television news, newspapers, news magazines, and online news sites during the first five weeks of the U.S.-led invasion of Iraq in 2003 and found that only 10% showed injury or death. The paper analyzes which media platforms were most willing to show casualties and offers insights on when journalists should use gruesome war images or keep them secret.

This study examined more than 2,500 war images from U.S. television news, newspapers, news magazines, and online news sites during the first five weeks of the U.S.-led invasion of Iraq in 2003 and found that only 10% showed injury or death. The paper analyzes which media platforms were most willing to show casualties and offers insights on when journalists should use gruesome war images or keep them secret.

This book provides a unique, cogent, engaging account of environmental determinism that has long been much needed in the classroom and beyond." -- Andrew Sluyter, Associate Professor, Louisiana State University, USA This book pulls together major critiques of contemporary attempts to explain nature-society relations in an environmentally deterministic way. After defining key terms, it reviews the history of environmental determinism's rise and fall within geography in the early twentieth century. It discusses the key reasons for the doctrine's rejection and presents (...) alternative, non-deterministic frameworks developed within geography for analyzing the roles played by the environment in human affairs. The authors examine the rise in recent decades of neo-deterministic approaches to such issues as the demarcation of regions, the causes of civilizational collapse in prehistory, today's globally uneven patterns of human well-being, and the consequences of human-induced climate change. In each case, the authors draw on the insights and approaches of geography, the academic discipline most conversant with the interactions of society and environment, to challenge the widespread acceptance that such approaches have won. The book will appeal to those working on human-environmental research, international development and global policy initiatives. William B. Meyer is Associate Professor of Geography at Colgate University, USA. He is the author of several previous books, including Human Impact on the Earth, Americans and Their Weather: A History, and The Progressive Environmental Prometheans. His research interests include urban geography, environmental history, and the history of environmental thought. Dylan M.T. Guss works in the technology investment sector. (shrink)

Ntroduction : Christianity, Christ, and Machiavelli's The prince -- Christianity's siren song -- Christ's defective political foundations -- Hope is not enough -- The prince of war -- Machiavelli's unchristian virtue -- Christ's ruinous political legacy -- The harrowing redemption of Italy -- Conclusion : Machiavelli's gospel.

Imperative sentences like Dance! do not seem to represent the world. Recent modal analyses challenge this idea, but its intuitive and historical appeal remain strong. This paper presents three new challenges for a non-representational analysis, showing that the obstacles facing it are even steeper than previously appreciated. I will argue that the only way for the non-representationalist to meet these three challenges is to adopt a dynamic semantics. Such a dynamic semantics is proposed here: imperatives introduce preferences between alternatives. This (...) characterization of meaning focuses on what function a sentence serves in discourse, rather than what that sentence refers to (e.g., a state of the world). By representing the meaning of imperatives, connectives and declaratives in a common dynamic format, the challenges posed for non-representationalism are met. (shrink)

A uniform theory of conditionals is one which compositionally captures the behavior of both indicative and subjunctive conditionals without positing ambiguities. This paper raises new problems for the closest thing to a uniform analysis in the literature (Stalnaker, Philosophia, 5, 269–286 (1975)) and develops a new theory which solves them. I also show that this new analysis provides an improved treatment of three phenomena (the import-export equivalence, reverse Sobel-sequences and disjunctive antecedents). While these results concern central issues in the study (...) of conditionals, broader themes in the philosophy of language and formal semantics are also engaged here. This new analysis exploits a dynamic conception of meaning where the meaning of a symbol is its potential to change an agent’s mental state (or the state of a conversation) rather than being the symbol’s content (e.g. the proposition it expresses). The analysis of conditionals is also built on the idea that the contrast between subjunctive and indicative conditionals parallels a contrast between revising and consistently extending some body of information. (shrink)

This paper proposes a semantics for free choice permission that explains both the non-classical behavior of modals and disjunction in sentences used to grant permission, and their classical behavior under negation. It also explains why permissions can expire when new information comes in and why free choice arises even when modals scope under disjunction. On the proposed approach, deontic modals update preference orderings, and connectives operate on these updates rather than propositions. The success of this approach stems from its capacity (...) to capture the difference between expressing the preferences that give rise to permissions and conveying propositions about those preferences. (shrink)

No existing conditional semantics captures the dual role of 'if' in embedded interrogatives — 'X wonders if p' — and conditionals. This paper presses the importance and extent of this challenge, linking it to cross-linguistic patterns and other phenomena involving conditionals. Among these other phenomena are conditionals with multiple 'if'-clauses in the antecedent — 'if p and if q, then r' — and relevance conditionals — 'if you are hungry, there is food in the cupboard'. Both phenomena are shown to (...) be problematic for existing analyses. Surprisingly, the decomposition of conditionals needed to capture the link with interrogatives provides a new analysis that captures all three phenomena. The model-theoretic semantics offered here relies on a dynamic conception of meaning and compositionality, a feature discussed throughout. (shrink)

"Provine's thorough and thoroughly admirable examination of Wright's life and influence, which is accompanied by a very useful collection of Wright's papers on evolution, is the best we have for any recent figure in evolutionary biology."—Joe Felsenstein, Nature "In Sewall Wright and Evolutionary Biology... Provine has produced an intellectual biography which serves to chart in considerable detail both the life and work of one man and the history of evolutionary theory in the middle half of this century. Provine is admirably (...) suited to his task.... The resulting book is clearly a labour of love which will be of great interest to those who have a mature interest in the history of evolutionary theory."-John Durant, ;ITimes Higher Education Supplement;X. (shrink)

In this paper, I examine various popular notions concerning the ethics of investing. I first consider and reject the absolutist view that it is always wrong to invest in evil companies and the view that what makes investments in evil companies morally objectionable is the fact that by making such investments, investors are taking steps to benefit from the wrongdoing of others. I then defend the view that what makes certain investments morally objectionable is the fact that by making such (...) investments, investors enable others to do wrong. According to this view, when weighing the purchase of a certain company's stock, investors should ask themselves the following question: Would this sort of investment, if made by many people, enable others to do wrong? If the answer to this question is yes, and if an investor nevertheless makes the investment in question, he can justifiably be accused of moral wrongdoing. (shrink)

Biodiversity and genetic resources have become the focal point of major national and international biological and political debates regarding control, ownership, access, and erosion of critical resources. While these issues are key to environmental sustainability and food security, biodiversity and genetic resources must be seen in the broader context of their inextricable relationship to cultural diversity and to humans' view of nature. Nature is assumed to be constituted socially through a wide variety of human processes described collectively as culture. Three (...) significant cultural factors, technology, science, and capitalism, are largely responsible for the secularization and homogenization of food and agriculture and the remaking of nature. These processes and forces may simultaneously and unwittingly create the problems of declines in biodiversity, cultural diversity, and food equity. Indeed, it may well be that the only way to conserve cultural biodiversity in the field is to conserve cultural diversity among peoples. This reunification of biodiversity and cultural diversity and food and agriculture will require new paradigms and institutional mechanisms that allow us to show our care for each other through our reverence for nature. (shrink)

The ArgumentMany of the epistemological issues that occupied natural philosophers of the seventeenth century were expressed visually in title-page engravings. One of those issues concerned the relative status to be accorded to evidence of the senses, as compared to knowledge gained by faith or reason. In title-page illustrations, the various arguments were often waged by a series of light metaphors: the Light of Reason, the Light of Nature, and the Lights of Sense, Scripture, and Grace. When such illustrations are examined (...) with the authors' theological views in mind, it becomes apparent that in the first half of the seventeenth century, Catholic authors favored the Light of Reason as a source of truth, while Protestant authors favored the Light of Nature. Since by the end of the century it was widely accepted by scientists of all religious persuasions that certain knowledge must be grounded in sense evidence and the direct study of nature, one might argue that in this instance Protestantism was responsible for nurturing an important development of the Scientific Revolution. However, the skewed nature of the sample and the large number of counterexamples available mitigate against taking this offshoot of the Merton thesis too seriously. (shrink)

Modern Moral Problems addresses moral quandaries that can beguile and confuse faithful Catholics. Written in a question-and-answer format, the book covers questions regarding sexuality, medical ethics, business practices, civic responsibilities, and the sacramental life of the Church. The extraordinary assortment of issuesforming a single, organized collectionis a valuable reference for anyone seeking clear and concise answers to tough moral questions. Written in a conversational tone often spliced with humor, this work by a highly respected moral theologian will be read with (...) fascination for its clarity of argument and fundamental good sense. Originally published as a monthly question-and-answer column in a magazine for priests, these selections by Msgr. William B. Smith retain a striking current topicality. Msgr. Smith often tackled matters of controversy in the Catholic Church, ones which continue to draw conflicting opinions. Interesting, informative, and eminently practical, this book conveys an overall impression that sound thinking about morality is rooted in a tradition within the Catholic Church, even when the answers to particular moral questions cannot be found in catechisms or Vatican documents. Msgr. Smith offers a clear-headed approach to the quandaries of our time precisely because of his training in traditional moral principles and his fidelity to the Catholic magisterium. This book should be in the possession of all seminarians and priests, who are bound to confront moral matters that are not so easily decided at first glance. But lay people, too, will find here rich responses to the challenging and sometimes unresolved moral questions they encounter in their own lives. (shrink)

This article updates the author’s 1982 argument that lutetium and lawrencium, rather than lanthanum and actinium, should be assigned to the d-block as the heavier analogs of scandium and yttrium, whereas lanthanum and actinium should be considered as the first members of the f-block with irregular configurations. This update is embedded within a detailed analysis of Lavelle’s abortive 2008 attempt to discredit this suggestion.

As targeted proteins that move within the cell, the steroid receptors have become very useful probes for understanding the linked phenomena of protein folding and transport. From the study of steroid receptor‐associated proteins it has become clear over the past two years that these receptors are bound to a multiprotein complex containing at least two heat shock proteins, hsp90 and hsp56. Attachment of receptors to this complex in a cell‐free system appears to require the protein unfolding/folding activity of a third (...) heat shock protein, hsp70. Like the oncogenic tyrosine kinase pp60src, steroid receptors bind to this complex of chaperone proteins at the time of their translation. Binding of the receptor to the hsp90 component of the system occurs through the hormone binding domain and is under strict hormonal control. The hormone binding domain of the receptor acts as a transferable regulatory unit that confers both tight hormonal control and hsp90 binding onto chimaeric proteins. The model of folding and transport being developed for steroid receptors leads to some general suggestions regarding the folding and transport of targeted proteins in the cell. (shrink)

The momentum of advances in biology is evident in the history of patents on life forms. As we proceed forward with greater understanding and technological control of developmental biology there will be many new and challenging dilemmas related to patenting of human parts and partial trajectories of human development. These dilemmas are already evident in the current conflict over the moral status of the early human embryo. In this essay, recent evidence from embryological studies is considered and the unbroken continuity (...) of organismal development initiated at fertilization is asserted as clear and reasonable grounds for moral standing. Within this frame of analysis, it is proposed that through a technique of Altered Nuclear Transfer, non-organismal entities might be created from which embryonic stem cells could be morally procured. Criteria for patenting of such non-organismal entities are considered. (shrink)