Clinical Ethics Consultations are an important tool for physicians in solving difficult cases. They are extremely common in North America and to a lesser extent also present in Europe. However, there is little data on this practice in Poland. We present results of a survey of 521 physicians practising in Poland concerning their opinion on CECs and related practices. We analysed the data looking at such issues as CECs’ perceived availability, use of CECs, and perceived usefulness of such support. Physicians (...) in our study generally encounter hard ethics cases, even—surprisingly—those who do not work in hospitals. Most physicians have no CEC access, and those that do still do not employ CECs. However, physicians perceive this form of support as useful—even more so among actual users of CECs. We compared these findings with similar studies from other European countries and the North America. We point out peculiarities of our results as compared to those in other countries, with some possible explanations. We hope the results may encourage regulatory debate on the need to formally introduce CECs into the Polish healthcare system. (shrink)

According to UNESCO guidelines, one of the four forms of bioethics committees in medicine are the Hospital Ethics Committees. The purpose of this study was to evaluate how the above guidelines are implemented in real practice. There were 111 hospitals selected out of 176 Polish clinical hospitals and hospitals accredited by Center of Monitoring Quality in Health System. The study was conducted by the survey method. There were 56 hospitals that responded to the survey. The number of HECs members fluctuated (...) between 3 and 16 members, where usually 5 members were part of the board committee. The composition of the HECs for professions other than physicians was diverse and non-standardized. Only 55 % of HECs had a professional set of standards. 98 % of HECs had specific tasks. 62 % of HECs were asked for their expertise, and 55 % prepared <6.88 % of the opinions were related to interpersonal relations between hospital personnel, patients and their families with emphasis on the interactions between superiors and their inferiors or hospital staff and patients and their families. Only 12 % of the opinions were reported by the respondents as related to ethical dilemmas. In conclusion, few Polish hospitals have HECs, and the structure, services and workload are not always adequate. To ensure a reliable operation of HECs requires the development of relevant legislation, standard operating procedures and well trained members. (shrink)

The Polish equivalents of Research Ethics Committees are Bioethics Committees (BCs). A questionnaire study has been undertaken to determine their situation. The BC is usually comprised of 13 members. Nine of these are doctors and four are non-doctors. In 2006 BCs assessed an average of 27.3 ± 31.7 (range: 0–131) projects of clinical trials and 71.1 ± 139.8 (range: 0–638) projects of other types of medical research. During one BC meeting an average of 10.3 ± 14.7 (range: 0–71) projects of (...) medical research were assessed (2006). The amendment of Polish laws according with Directive 2001/20/EC caused a percentage increase in BCs which assessed less than 20 projects per year (16% vs. 33% or 42% in 2003 vs. 2005 or 2006 respectively, p < 0,05). The results confirm the usefulness of the current practice of creating BCs by medical universities, medical institutes and regional chambers of physicians and dentists but rationalization of the workload for individual BCs is necessary. (shrink)

Biological research with legitimate scientific purpose that may be misused to pose a biological threat to public health and/or national security is termed dual use. In Poland there are adequate conditions for conducting experiments that could be qualified as dual use research, and therefore, a risk of attack on Poland or other countries exists. Optimal solutions for limiting such threats are required, and the national system of biosecurity should enable early, reliable, and complete identification of this type of research. Scientists (...) should have a fundamental role in this process, their duty being to immediately, upon identification, report research with dual use potential. An important entity in the identification system of dual use research should also be the Central Register of Biological and Biomedical Research, which gathers information about all biological and biomedical research being conducted in a given country. Publishers, editors, and review committees of journals and other scientific publications should be involved in evaluating results of clinical trials. The National Council of Biosecurity should be the governmental institution responsible for developing a system of dual use research threat prevention. Its role would be to develop codes of conduct, form counsel of expertise, and monitor the problem at national level, while the Dual Use Research Committee would be responsible for individual cases. In Poland, current actions aiming to provide biological safety were based on developing and passing an act about genetically modified organisms (GMO’s) and creating a GMO Committee. Considering experiences of other nations, one should view these actions as fragmentary, and thus insufficient protection against dual use research threats. (shrink)

The Helsinki Declaration is a very important document regarding the protection of patients’ rights in clinical trials and one of the fundamental sources of operational principles for every ethics committee. Although they have been updated, the international guidelines for ethics committees continually fail to address certain issues pertaining to the protection of patients’ rights in clinical trials. These issues include, most significantly, the method of electing ethics committees (a free, secret ballot should be preferred to direct appointment), the avoidance of (...) conflict of interest during the election of ethics committee members, and the necessary insurance coverage for the participants of clinical trials. Polish law should, on the other hand, be developed in such way as to not limit the effectiveness of ethics committees in protecting patients’ rights in clinical trials. The ideal solution would be to draft a uniform law concerning not only clinical trials, but all medical experiments. The opinions of experts who have been reviewing medical research projects for several years may prove to be especially valuable in this setting. (shrink)

Although Directive 2001/20/EC of the European Parliament and of Council of 4 April 2001 on the approximation of the laws regulations and administrative provisions of the Member States relating to the implementation of good clinical practice in the conduct of clinical trials on medicinal products for human use does not contain an exception for emergency situations, and requires the informed consent of a legal representative in all cases where research is conducted on legally competent individuals who are unable to give (...) informed consent, in Poland, emergency research can be conducted without consent. Polish regulations on emergency research can hardly be treated as a result of intentional legislative policy. Our provisions arise from multiple and sophisticated interpretations of different regulations that govern medical experiments on human subjects and clinical trials. These interpretations can be summarized as follows: There are two categories of medical experiments: therapeutic and non-therapeutic experiments. Emergency research without consent may be conducted in the category of therapeutic experiment only.. Emergency research may be conducted without consent if there is a situation of great urgency in which the research subject’s life is in danger and there is no possibility of obtaining immediate consent from the research subject him or herself, or from his or her legal representative or guardianship court, and the research subject has not refused to give consent for the participation in an emergency therapeutic experiment. The legal representative or guardianship court shall be provided with all the relevant information concerning subject’s participation in an experiment as soon as possible. All projects of emergency research with intent to be done without the research subject’s consent must be approved by an independent bioethics committee. Because these five requirements seem to provide insufficient protection for a subject’s autonomy and rights it is necessary to add to them two other conditions: the emergency research could not be conducted using other research participants capable of giving informed consent; and informed consent for continued participation in the emergency research shall be obtained from either the participant him or herself or the legally authorized representative as soon as possible. A consolidated single Act that will govern all aspects of medical experiments on human subjects, including emergency research, should be prepared and enacted as soon as possible. (shrink)

The paper reports results of the very first survey-based study on the prevalence, frequency and nature of ethical or other non-medical difficulties faced by Polish physicians in their everyday clinical practice. The study involved 521 physicians of various medical specialties, practicing mainly in inpatient healthcare. The study showed that the majority of Polish physicians encounter ethical and other non-medical difficulties in making clinical decisions. However, they confront such difficulties less frequently than their foreign peers. Moreover, Polish doctors indicate different circumstances (...) as a source of the experienced problems. The difficulties most often reported relate to (i) patients (or their proxies) requests for medically non-indicated interventions; (ii) problems with communication with patients (or their proxies) due to the patients’ negative attitude, unwillingness to cooperate, or aggression; and (iii) various difficulties with obtaining informed consent. Polish physicians report difficulties associated with disagreements among care givers or scarcity of resources less frequently than doctors from other countries. The study’s findings provide support for the thesis that a significant portion of Polish physicians still follow a traditional, paternalistic, and hierarchical model of healthcare practice. Instead of promoting patient’s empowerment, engagement, and rights, they often consider these ideas as a threat to physicians’ professional authority and autonomy. The study leads to the conclusion that due to insufficient training in medical ethics, communication skills, and medical law, many Polish physicians lack the knowledge and competence necessary to adequately respond to challenges posed by modern healthcare practice. (shrink)

This chapter outlines an embodied conception of noise. From an enactive and ecological perspective noise is an inevitable complement to the richness of bodily sensitivities and complex actions. The world around us, the universe, is replete, full of inexhaustible texture available to be explored at every scale at which we are capable, or can become capable, of making distinctions. Drawing on work in ecological psychology I suggest that noise is our experience of that encompassing fullness, and can be encountered in (...) a number of different ways depending on the organisation of our bodies and activities at different scales across a given period. While that fullness can be overwhelming, and create challenges for us to distinguish and coordinate effectively with the particular aspects of the world most relevant to our present concerns - noise can be intrusive and disruptive - I argue that there are significant positive aspects to the phenomenon. Noise is an inherent part of the rich messiness of the world as discussed in recent enactive work, which provides both robustness to developmental processes as well as opportunities for action that support adaptive agency. In a noisy, messy world there are always more options available to explore. (shrink)

Descriptions of bodies within the literature of the enactive approach to cognitive science exhibit an interesting dialectical tension. On the one hand, a body is considered to be a unity which instantiates an identity, forming an intrinsic basis for value. On the other, a living body is in a reciprocally defining relationship with the environment, and is therefore immersed and entangled with, rather than distinct from, its environment. In this paper I examine this tension, and its implications for the enactive (...) approach, particularly the enactive conceptions of life and bodies. Following the lead of others, I argue that enactive cognitive science can benefit from a deeper reading and integration with extant work on the complexity and multiplicity of the living body within feminist philosophy and feminist science studies. (shrink)

Can we see the expressiveness of other people's gestures, hear the intentions in their voice, see the emotions in their posture? Traditional theories of social cognition still say we cannot because intentions and emotions for them are hidden away inside and we do not have direct access to them. Enactive theories still have no idea because they have so far mainly focused on perception of our physical world. We surmise, however, that the latter hold promise since, in trying to understand (...) cognition, enactive theory focuses on the embodied engagements of a cognizer with his world. In this paper, we attempt an answer for the question What is social perception in an enactive account? In enaction, perception is conceived as a skill, crucially involving action, an ability to work successfully within the set of regularities, or contingencies that characterize a given domain. If this is the case, then social perception should be a social skill. Having thus transformed the question of what social perception is into that of what social skill is, we examine the concept of social contingencies and the manner in which social skills structure—both constrain and empower— social interaction. Some of the implications of our account for how social and physical perception differ, the role of embodiment in social interaction and the distinction between our approach and other social contingency theories are also addressed. (shrink)

Die Beiträge zur Altertumskunde enthalten Monographien, Sammelbände, Editionen, Übersetzungen und Kommentare zu Themen aus den Bereichen Klassische, Mittel- und Neulateinische Philologie, Alte Geschichte, Archäologie, Antike Philosophie sowie Nachwirken der Antike bis in die Neuzeit. Dadurch leistet die Reihe einen umfassenden Beitrag zur Erschließung klassischer Literatur und zur Forschung im gesamten Gebiet der Altertumswissenschaften.

The world of Jedi is very different from our own, that their awareness of the universe is more encompassing, richer. The Jedi call that mystical aspect of reality they perceive the Force. Jedi younglings and padawans must put their body to new uses, perform new tasks, and learn new skills in physical activities that have profound effects on the way they see the world around them. What the Jedi say more than anything else about the Force is that it flows. (...) Jedi who are able to coordinate their actions with that flow can work with the full potency of the universal relationship between all things. Jedi do not need a special Force‐organ to perceive the Force. The Force is not something Jedi just see, or hear, or taste, or touch, but rather it is something they experience on its own terms, probably using their whole body to do it. (shrink)

Enactive and ecological approaches to cognitive science both claim a “mutuality” between agents and their environments – that they have a complementary nature and should be addressed as a single whole system. Despite this apparent agreement, each offers criticisms of the other on precisely this point – enactivists claiming that ecological psychologists over-emphasise the environment, while the complementary criticism, of agent-centred constructivism, is levelled by ecological psychologists at enactivists. In this paper I suggest that underlying the confusion between the two (...) approaches is the complexity of agency, which comes in different forms, at different scales or levels of analysis. Cognitive science has not theorised the relationship between these different forms in a sufficiently disciplined manner, and a task therefore remains of finding a way to map the complex territory of agency. (shrink)

ABSTRACT The Gödel–Dummett logic and Łukasiewicz one are two main many-valued logics used by the fuzzy logic community. Our goal is a quantitative comparison of these two. In this paper, we will mostly consider the 3-valued Gödel–Dummett logic as well as the 3-valued Łukasiewicz one. We shall concentrate on their implicational-negation fragments which are limited to formulas formed with a fixed finite number of variables. First, we investigate the proportion of the number of true formulas of a certain length n (...) to the number of all formulas of such length built with exactly one variable. Then, we investigate such proportion for satisfiable formulas. Second, we generalise our investigation on formulas written with $ k\ge 1 $ k ≥ 1 variables. The primary goal of the paper is the research on the asymptotic behaviour of these fractions when the length n tends to infinity. If such limits exists, they are real numbers between 0 and 1, which are called the density of truth or the density of SAT. To compare the density of truth and the density of satisfiable formulas for both fragments of 3-valued Gödel–Dummett's and Łukasiewicz's logics we use the powerful theory of analytic combinatorics. This paper is a natural continuation of the previous brief conference note by Kostrzycka and Zaionc (2020) as well as enriched with some previous results from Kostrzycka and Zaionc (2003). In the conference note we computed analytically the density of truth and the density of SAT (with a determined precision) for 3-valued Łukasiewicz's logic restricted to a language with only one variable. In Kostrzycka and Zaionc (2003) we computed the same values for exactly the same fragment of the 3-valued Gödel–Dummett logic. This paper answers the more general questions of the existence of density of truth and density of SAT for both many-valued logics with an arbitrary finite number of variables. Therefore this paper gives an an interesting picture of two main families of finite-valued fuzzy logics problems treated quantitatively. This picture is taken from the perspective of classical logic. It shows that unexpectedly there is quantitatively a little distance between these two approaches. (shrink)

The subject of the book is a reconsideration of the internalistic model of composition of the Platonic type, and its application in the ontology of quantum theory. Nonseparability is at the centre of quantum ontology. Quantum wholes are atemporal wholes governed by internalistic logic, requiring a relativization of fundamental notions of mechanics.

Perceptual modalities have been traditionally considered the product of dedicated biological systems producing information for higher cognitive processing. Psychological and neuropsychological evidence is offered which undermines this point of view and an alternative account of modality from the enactive approach to understanding cognition is suggested. Under this view, a perceptual modality is a stable form of perception which is structured not just by the biological sensitivities of the agent, but by their goals and the set of skills or expertise which (...) they are deploying at a given time. Such a view suggests that there is no such thing as an experience that is purely visual, auditory, or otherwise modal and that our attempts to understand consciousness and the mind must be conducted within a framework that provides an account of embodied, goal-directed adaptive coping with the world. (shrink)

Dotyczy: przestrzeń, czas, ciało, kognitywistyka, fenomenologia.

The book deals with distorted humanities and social sciences and examines alternatives. The topic is analysed in a way that is ground-breaking in its global comparison of research in Central Europe, Latin America, China, Russia, Africa and India.

The author recounts the dramatic life of Warsaw’s population during the uprising against the Germans. After miraculously escaping death in a mass execution,Czarkowski teamed up with several other men and lived the hard life of a refugee among the city’s ruins. He and his companions continuously risked death, both from the hands of Nazi execution squads as well as in the buildings, methodically demolished by the occupant as the city was razed to the ground in revenge for the insurgency.

History provides us with instances of various societal and economic changes that with a hindsight are interpreted as either indicating progressive or regressive trends. The present paper attempts to define what represents progress and regress by applying psychological constructs to evaluation of the psychosocial changes. Seven principles of progress are applied as criteria for interpreting various historic events. The primary condition for progress is courage to face adversity or, in the cognitive domain, ambiguity, controversy and “unknown”. An overall model of (...) Challenge-Resilience-Resourcefulness is described as the process through which progress can be achieved. (shrink)