Discussions of both personal responsibility and the importance of trust in health-care settings are increasingly prominent in the bioethics literature. In this paper I link the two discussions and argue that health policies that include personal responsibility ought to address climates of social trust. Trust is a social good that is not always fairly distributed. Disadvantaged social groups often face default distrust. I suggest that agent-centered models in which responsibilities are negotiated do a better job of repairing social distrust than (...) authoritative models in which responsibilities are assigned . Attending to climates of trust, distrust, or antitrust is essential for addressing health inequalities. (shrink)

Objective Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians’ attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus. Design, Setting, Participants A survey of resident/fellow physicians and internal medicine (...) attendings at an academic medical center, May to August 2013. Measurements We used a 24-item, internet-based survey assessing physician-respondents’ demographic characteristics, knowledge, and attitudes regarding decisional authority for adult VA-ECMO. Qualitative narratives were also collected. Main Results A total of 179 physicians completed the survey (15 percent response rate); 48 percent attendings and 52 percent residents/ fellows. Only 32 percent of the respondents indicated that a surrogate’s consent should be required to discontinue VA-ECMO; 56 percent felt that physicians should have the right to discontinue VA-ECMO over a surrogate’s objection. Those who self-reported as “knowledgeable” about VA-ECMO, compared to those who did not, more frequently replied that there should not be presumed consent for VA-ECMO (47.6 percent versus 33.3 percent, p = 0.007), that physicians should have the right to discontinue VAECMO over a surrogate’s objection (76.2 percent versus 50 percent, p = 0.02) and that, given its cost, the use of VA-ECMO should be restricted (81.0 percent versus 54.4 percent, p = 0.005). Conclusions Surveyed physicians, especially those who self-reported as knowledgeable about VA-ECMO and/or were specialists in pulmonary/ critical care, favored a medical locus of decisional authority for VA-ECMO. VA-ECMO is complex, and the data may (1) reflect physicians’ hesitance to cede authority to presumably less knowledgeable patients and surrogates, (2) stem from a stewardship of resources perspective, and/or (3) point to practical efforts to avoid futility and utility disputes. Whether these results indicate a more widespread reversion to paternalism or a more circumscribed usurping of decisional authority occasioned by VA-ECMO necessitates further study. (shrink)

This collection of essays is a sequel to the editors' 1976 volume Studies in Nietzsche and the Classical Tradition. Philosophers, theologians, and literary historians discuss important aspects of Nietzsche's attack on Judaism and Christianity. The book contains studies of his view of biblical figures, Luther and Pascal as well as comparisons of his thought with that of Spinoza, Lessing, Heine, and Kierkegaard. Nietzsche's critique of the Old Testament, the Jewish religion of the diaspora, and historical Christianity are also investigated. Of (...) the eighteen articles included here, thirteen were prepared expressly for this volume--five were translated from German, one from French, and one from Hebrew. Contributors to this volume are: Eugen Biser, Harry Neumann, Israel Eldad, Charles Lewis, Jorg Salaquarda, Joan Stambaugh, Max L. Baeumer, Brendan Donellan, Diana Behler, Sander L. Gilman, Gerd-Gunther Grau, Josef Simon, James C. O'Flaherty, Bernd Magnus, Georges Goedert, Hans Lung, and Karl Barth. (shrink)

These fifteen essays on Nietzsche's indebtedness to the Classical Tradition were composed by scholars in the fields of philosophy, theology, German and Classics. The essays roughly cover the following epochs: the age of the Fathers of the Western Church, medieval scholasticism, the Renaissance, the Enlightenment, Weimar Classicism, Romanticism and the several other intellectual trends and movements in the nineteenth century. Collection includes three essays comparing Nietzsche's perceptions of Plato, Aristotle, and Socrates with those (respectively) of Augustine, Aquinas, and Hamann. Three (...) essays treat Nietzsche's relationship to Goethe, Schiller, and Heine. Three deal with Nietzsche and French literature or thought, one explores possible parallels between Nietzsche and Dante, another the extent of his debt to Byron. Four contributions center on Nietzsche's view of tragedy, and an older study has been expanded to show the underlying harmony of Nietzsche's conception with that of the French classical tragedians. This book affirms and fulfills the need for serious scholarship by the student of Nietzsche unable to work in German, while presenting a readable cross-section of the work being done relating Nietzsche to the intellectual tradition from which he sprang. (shrink)

This paper reports on an ongoing ARC Discovery Project that is conducting design research into learning in collaborative virtual worlds (CVW).The paper will describe three design components of the project: (a) pedagogical design, (b)technical and graphics design, and (c) learning research design. The perspectives of each design team will be discussed and how the three teams worked together to produce the CVW. The development of productive failure learning activities for the CVW will be discussed and there will be an interactive (...) demonstration of the project's CVW. (shrink)

The question I wish to explore is this: Does idealism conflict with common sense? Unfortunately, the answer I give may seem like a rather banal one: It depends. What do we mean by ‘idealism’ and ‘common sense?’ I distinguish three main varieties of idealism: absolute idealism, Berkeleyan idealism, and dualistic idealism. After clarifying what is meant by common sense, I consider whether our three idealisms run afoul of it. The first does, but the latter two don’t. I conclude that while (...) Moore’s famous common sense critique is sound against external world skepticism, against Berkeleyan idealism and dualist idealism it is unavailing. (shrink)

Nearly all Disney movies represent to people mere possibilities. One can conceive of scenarios with genies, wooden puppets coming to life, flying elephants, and mermaids. And there certainly seems to be no special problem in conceiving of a scenario where all the author's experiences are a mere dream induced by a Maleficent‐like evil genius. The problem in the present context is that the possibility of a dream‐inducing Maleficent‐like evil genius guarantees that how things appear would be no different, whether she (...) is dreaming or not. But maybe there is a difference: does it not appear to her that there is a difference between dreaming and wakefulness? The very fact that she is aware of such a distinction at all suggests the distinction is real. People prefer a real life over an experientially identical dream life, or even a more pleasurable dream life, because there is more to life than just experience. (shrink)

This book provides a conceptual basis for recognizing the classroom as an ecology of linguistic and cultural patterns that should be taken into account as part of the teacher's professional decision making. It argues that the orchestration of classroom behaviour cannot be separated from the mental ecology of metaphor and thought patterns that reflect the student's primary culture. Chapters discuss the metaphorical nature of language and thought, primary socilization, nonverbal communication, framing and social control, the classroom as an ecology of (...) power, culturally responsive supervision, and educating teachers for the 21st century - all from a cultural and linguistic point of view. (shrink)

In this volume C.A. (Chet) Bowers, whose pioneering work on education and environmental and sustainability issues is widely recognized and respected around the world, brings together a carefully curated selection of his seminal work on the ideological, cultural, and linguistic roots of the ecological crisis; misconceptions underlying modern consciousness; the cultural commons; a critique of technology; and educational reforms to address these pressing concerns. In the World Library of Educationalists, international scholars themselves compile career-long collections of what they judge to (...) be their finest pieces - extracts from books, key articles, salient research findings, major theoretical and/practical contributions - so the world can read them in a single manageable volume. Readers will be able to follow the themes and strands of their work and see their contribution to the development of a field, as well as the development of the field itself. Contributors to the series include : Michael Apple, James A. Banks, Joel Spring, William F. Pinar, Stephen J. Ball, Elliot Eisner, Howard Gardner, John Gilbert, Ivor F. Goodson, Peter Jarvis. (shrink)

This paper examines ways in which current moral values are influenced by earlier patterns of thinking carried forward in root metaphors whose meanings were often framed by the analogues settled upon in the past by thinkers who were influenced by the silences and prejudices of their culture. It is argued that such tacitly inherited metaphors reproduce the myth of the individual as a moral agent and that this both is ecologically unsustainable and undermines other important ways of understanding the individual. (...) In various ways the form of critical thinking to which it gives rise stands in the way of individuals exercising what Gregory Bateson refers to as their ?ecological intelligence? in a manner that properly takes account of the interdependent nature of cultural and natural ecologies. It is argued that if in the West (at least) a shift could be made to relying on ?ecology? as the dominant root metaphor the whole system of Western moral values would undergo a radical change to one better suited to a current Western environmental situation. (shrink)

Environmentally oriented philosophers and educational theorists are now attempting to clarify how the ideas of John Dewey can be used as the basis for changing cultural practices that contribute to the ecological crisis. Although Dewey can be interpreted as a nonanthropocentric thinker and his method of experimental inquiry can be used in eco-management projects, Dewey should not be regarded as an environmental and eco-justice philosopher—and by extension, his followers should not be regarded in this light. (1) Dewey’s emphasis on an (...) experimental mode of inquiry did not take account of the knowledge systems of other cultures—particularly cultures that are more ecologically centered. (2) Dewey’s understanding of language prevented him from recognizing how the root metaphors (meta-cognitive schemata) he took for granted were also the basis, with several exceptions, of the Industrial Revolution. (3) Dewey’s failure to understand the complex nature of tradition, including the different ways in which intergenerational knowledge is shared and renewed, makes it difficult for his followers to address a central eco-justice issue—which is to regenerate within diverse cultural communities the non-commodified forms of knowledge, skills, and relationships that enable individuals and communities to have a smaller ecological footprint. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)