Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)

Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)

Confucianism is a kind of humanism. Confucian humanism presupposes, however, a divisive act that separates human and nonhuman. This paper shows that the split between the human and the nonhuman is central to Mencius' moral psychology, and it argues that Confucianism is an anthropological machine in the sense of the term used by Giorgio Agamben. I consider the main points of early Daoist critique of Confucian humanism. A comparative analysis of Herman Melville's novella 'Bartleby the Scrivener' reveals the limitation of (...) the moral will in Mencius. Finally, I refer to an incident that recently captured the imagination of Chinese netizens, and shows the contested influence of Confucian humanism in contemporary China. (shrink)

The Aims of the Book -/- 1. To improve your skill in analyzing and evaluating arguments and presentations of the kind you find in everyday discourse (news media, discussions, advertisements), textbooks, and lectures. 2. To improve your skill in presenting arguments, reports and instructions clearly and persuasively. 3. To improve your critical instincts, that is, your immediate judgments of your attitudes toward the communications and behavior of others and yourself, so that you consistently approach them with the standards of reason (...) and the attitude of reasonableness. 4. To improve your knowledge about the facts and arguments relevant to a large number of important contemporary issues in politics, education, ethics, and several practical fields. -/- These are practical aims but not narrow practical aims: the third one, in particular, is very far-reaching and requires a whole shift of values for most of us. So this is intended to be a powerful, as well as practical, book using practical, everyday examples of the kind that a citizen, especially a citizen-student, runs into all the time. -/- The text starts with a short discussion of reasoning itself, then explores the details of this approach, and then gets down to practical procedures for improving one's reasoning skills. The discussions and examples always begin at a rather elementary level, but they get into harder material fairly quickly. If you are, or are hoping to be, a teacher or a lawyer, a scientist or an executive, what you learn here will be professional skills for you—vital professional skills. But for any citizen, they are also essential skills. (shrink)

Writing from a scientifically and philosophically informed perspective, the authors provide a critical overview of the conceptual difficulties encountered in many current neuroscientific and psychological theories.

A long-standing theme in discussion of perception and thought has been that our primary cognitive contact with individual objects and events in the world derives from our perceptual contact with them. When I look at a duck in front of me, I am not merely presented with the fact that there is at least one duck in the area, rather I seem to be presented withthisthing (as one might put it from my perspective) in front of me, which looks to (...) me to be a duck. Furthermore, such a perception would seem to put me in a position not merely to make the existential judgment that there is some duck or other present, but rather to make a singular, demonstrative judgment, that that is a duck. My grounds for an existential judgment in this case derives from my apprehension of the demonstrative thought and not vice versa. (shrink)