Some health-care institutions have ethics committees. The experience of the Ethical Issues Committee at the Royal College of Physicians is described. Ethics committees in institutions may be reactive or creative, must determine an agenda and must deal with dissent.

Following a long-term international collaboration between leaders in cosmology and the philosophy of science, this volume addresses foundational questions at the limit of science across these disciplines, questions raised by observational and theoretical progress in modern cosmology. Space missions have mapped the Universe up to its early instants, opening up questions on what came before the Big Bang, the nature of space and time, and the quantum origin of the Universe. As the foundational volume of an emerging academic discipline, experts (...) from relevant fields lay out the fundamental problems of contemporary cosmology and explore the routes toward finding possible solutions. Written for graduates and researchers in physics and philosophy, particular efforts are made to inform academics from other fields, as well as the educated public, who wish to understand our modern vision of the Universe, related philosophical questions, and the significant impacts on scientific methodology. (shrink)

Back injuries have a bad reputation. The workman looks upon them with apprehension, the insurance company with doubt, the medical examiner with suspicion, the lawyer with uncertainty. The medical examiner is faced with the difficulty of estimating the true value of the subjective symptoms in the comparative absence of physical signs. His suspicion is born of the frequent disparity between these two. This prophetic statement made almost 100 years ago highlights an ongoing problem - how people who are incapacitated by (...) painful conditions such as chronic low back pain can be evaluated consistently and equitably for purposes of disability compensation. We confronted this vexing problem when we participated in writing the chapter devoted to impairment associated with pain of the American Medical Association s Guides to the Evaluation of Permanent Impairment, 5th edition AMA Guides 5th Our purposes in this essay are to clarify several important conceptual issues associated with the assessment of pain among disability applicants, and to articulate reasons why pain should be considered in impairment and disability ratings. (shrink)

Back injuries have a bad reputation. The workman looks upon them with apprehension, the insurance company with doubt, the medical examiner with suspicion, the lawyer with uncertainty. The medical examiner is faced with the difficulty of estimating the true value of the subjective symptoms in the comparative absence of physical signs. His suspicion is born of the frequent disparity between these two. This prophetic statement made almost 100 years ago highlights an ongoing problem - how people who are incapacitated by (...) painful conditions such as chronic low back pain can be evaluated consistently and equitably for purposes of disability compensation. We confronted this vexing problem when we participated in writing the chapter devoted to impairment associated with pain of the American Medical Association s Guides to the Evaluation of Permanent Impairment, 5th edition AMA Guides 5th Our purposes in this essay are to clarify several important conceptual issues associated with the assessment of pain among disability applicants, and to articulate reasons why pain should be considered in impairment and disability ratings. (shrink)

The achievement of Immanuel Kant lies in demonstrating the law-giving power of the human intellect in the metaphysical basis of human cognition and in defence of human freedom. The power of reason was his response to the mechanical view of nature and scepticism in morals, aesthetics and religion. While reason extended over theory and practice, it was, he insisted, one reason: a unity. I advocate the unity of reason as key to understanding Kant’s philosophical project. Given his huge output, this (...) is an inevitably incomplete ambition. After an introductory chapter, comes an explication of the key role of the maxim followed by proposing a three-fold understanding of reason itself with its ideas and postulates. These extend our theoretical and practical knowledge in reason’s differing interests, albeit with conceptual difficulties in motivation and respect. Despite different faculties, theoretical and practical reason cannot conflict for there are not two reasons. One must have primacy which is shown to be the practical. The latter doctrine has implications for Kant’s rational theology and his broader world view. Morality’s supreme principle, a product of universalised reason, highlights the destiny of humankind and leads to a moral faith unique to humans. By virtue of reason, we have the will to realise our final end. The justification of reason’s unity leads to the regulative idea of a highest intelligence as a heuristic. Kant’s moral philosophy culminates in the concept of the highest good as the final end of human life. I discuss its secular and religious interpretations before concluding that, for Kant, we belong not only in the world of nature but in a noumenal world in which God and a future life may be the hope of our finite reason. (shrink)