The Mental Health Act 2007 introduced Deprivation of Liberty safeguards into the Mental Capacity Act 2005 with potentially far reaching resource implications. There appears to be no scientific data regarding the prevalence of deprivation of liberty in clinical settings such as hospitals and nursing homes. We examined how many patients across a whole Trust area in Wales were subject to some lack of capacity, how well documented this was and how many were potentially deprived of their liberty. We found that (...) no patient was deprived of their liberty, but 8% lacked capacity to make either basic or complex decisions; another 5% lacked capacity to make complex decisions. Documentation was good in mental health and community directorates, but there were gaps in documentation (not practice) in the medical and surgical directorates. Routine collection of data improved documentation regarding deprivation of liberty criteria. There is a high likelihood that senior nursing staff underestimate the number of patients who lack capacity. (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)

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)

This paper ethically analyses arising out the proposed changes to the Mental Health Act for England and Wales. It looks in particular at thea shift in philosophy that the author claims has occurred with the proposals away from rights-focused principles to more utilitarian or outcome-focused principles. It gives examples of these changes and explores itstheir consequences.

Objectives: To identify ethical attitudes about involuntary admission (known in Great Britain as formal admission) in mental health professionals and lay-people in England and Germany, especially looking at possible differences between Mental Health Professionals who are directly involved in the involuntary admission process and those who are not.Method: Three scenarios of potentially certifiable patients (known in Great Britain as sectionable patients) were presented to identify attitudes. A questionnaire asked about attitudes towards involuntary admission as well as treatment. A questionnaire analysis (...) was then performed.Results: There were similar attitudes towards involuntary admission between laypeople and mental health professionals involved in the involuntary admission process with the exception of professionals not actively involved in the involuntary admission process. Neither personal or professional experience with mental illness nor the different legal frameworks between Germany and England influenced attitudes much. Support for involuntary admission broadly increased with age.Conclusions: Psychiatrists and other mental health workers are in tune with society with regards to attitudes to involuntary admission. People involved with mentally ill patients but not in the involuntary admission process have negative attitudes towards involuntary admission. This may influence Mental Health Tribunals suggested in the new draft Mental Health Bill (2002) for England and Wales, because these Tribunals will potentially lack any involvement of professionals involved in the involuntary admission process. (shrink)

Internet usage data from around the globe show that adolescents are the most frequent Internet users, but mostly for leisure activities and maintaining social contacts. In the present study, we focused on Internet use for e-services, which could improve youth efficiency in the financial domain and bridge the online divide in youth. Specifically, we explored how societal constructs influence the use of the Internet for online shopping, e-banking and communication with providers of goods and services online. We used a representative (...) sample of adolescents from 10 countries of Southeast Europe where a great variability in Internet use is present, and where the use of e-services is generally lower than the EU average. This also allowed for meaningful cross-country comparisons. We tested a structural equation model of values predicting the use of the Internet through institutional trust which was grounded in social capital theory, cultural theory and Schwartz human values model. The model exhibited a good fit to the data but the strengths of regressional paths were rather modest. Looking into the cross-country stability of the model, however, revealed some notable differences: while the relationship between trust and use of the Internet for e-services was modest in some countries, the relationship was insignificant in other countries, where Internet usage is lower in general. This suggests that strategies aimed at leveraging e-services and digital technology potential in youth should also account for cultural specificities in the transitional economies and cultural settings with sub-optimal adoption of digital services. (shrink)

Now in a third edition, Introduction to Philosophy: Classical and Contemporary Readings is a highly acclaimed, topically organized collection that covers five major areas of philosophy--theory of knowledge, philosophy of religion, philosophy of mind, freedom and determinism, and moral philosophy. Editor Louis P. Pojman enhances the text's topical organization by arranging the selections into a pro/con format to help students better understand opposing arguments. He also includes accessible introductions to each chapter, subsection, and individual reading, a unique feature for an (...) anthology of this depth. While the book focuses on a compelling sampling of classical material--including selections from Plato, Aristotle, Descartes, Locke, Berkeley, Hume, and Kant--it also incorporates some of philosophy's best twentieth-century and contemporary work, featuring articles by Bertrand Russell, Richard Taylor, John Searle, Thomas Nagel, and others. This third edition contains an expanded glossary, more extensive section introductions, and twelve new selections: Karl Popper: "Epistemology without a Knowing Subject" Richard Rorty: "Dismantling Truth: Solidarity Versus Objectivity" Daniel Dennett: "Postmodernism and Truth" Bruce Russell: "The Problem of Evil: Too Much Suffering" David Chalmers: "Against Materialism: Can Consciousness Be Reductively Explained?" Baron Paul Henri d'Holbach: "A Defense of Determinism" Michael Levin: "A Compatibilist Defense of Moral Responsibility" Plato: Socratic Morality: "Crito" Herodotus: "Custom Is King" J. L. Mackie: "The Subjectivity of Values" Louis P. Pojman: "A Critique of Mackie's Theory of Moral Subjectivism" Thomas Nagel: "Moral Luck". (shrink)

Psychiatric practice is often faced with complex situations that seem to pose serious moral dilemmas for practitioners. Methods for solving these dilemmas have included the development of more objective rules to guide the practitioner such as utilitarianism and deontology. A more modern variant on this objective model has been 'Principlism' where 4 mid level rules are used to help solve these complex problems. In opposition to this, there has recently been a focus on more subjective criteria for resolving complex moral (...) dilemmas. In particular, virtue ethics has been posited as a more sensitive method for helping doctors to reason their way through difficult ethical issues. Here the focus is on the character traits of the practitioner. Bloch and Green advocated another way whereby more objective methods such as Principlism and virtue ethics are combined to produce what they considered sound moral reasoning in psychiatrists. This paper points out some difficulties with this approach and instead suggests that a better model of ethical judgment could be developed through the use of narratives or stories. This idea puts equal prima facie value on the patient's and the psychiatrist's version of the dilemma they are faced with. It has the potential to lead to a more genuine empathy and reflective decision-making. (shrink)

In ”Skepticism,” Peter Klein distinguishes between the “Academic Skeptic” who proposes that we cannot have knowledge of a certain set of propositions and the “Pyrrhonian Skeptic” who refrains from opining about whether we can have knowledge. Klein argues that Academic Skepticism is plausibly supported by a “Closure Principle‐style” argument based on the claim that if x entails y and S has justification for x, then S has justification for y. He turns to contextualism to see if it can contribute to (...) the discussion between one who claims that we can have knowledge about some epistemically interesting class of propositions and the Academic Skeptic. He outlines the background of Pyrrhonian Skepticism, pointing out that the Pyrrhonist withholds assent concerning our knowledge‐bearing status because reason cannot provide an adequate basis for assent. He assesses three possible patterns of reasoning, and concludes that the Pyrrhonist view, that reason cannot resolve matters concerning the nonevident, is vindicated. (shrink)

First published in 1987. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 1987. Routledge is an imprint of Taylor & Francis, an informa company.

This paper advances the research on personalization of political communication by investigating whether this process of focusing on politicians instead of political issues plays a role on Twitter. Results of a content analysis of 5,530 tweets posted in the run-up to the German federal election provide evidence that Twitter communication refers more often to politicians than to issues. However, tweets containing personal characteristics about political leaders play only a marginal role. When distinguishing among different groups of actors on Twitter (journalists, (...) politicians, citizens), we find that citizens focus more on candidates than do journalists or politicians. Investigating the impact of a televised debate on Twitter communication, we observe that this person-centered event puts the focus on individual politicians instead of issues. (shrink)

Pekakak adalah salah satu tokoh yang memiliki pengetahuan mendalam dan perencanaan yang cermat. Saat fajar menyingsing, ia terlihat bertengger di atas pohon. Dengan kemampuan sempurna untuk mengontrol kecepatan penerbangan miliknya, seperti kapan harus memperlambat atau mempercepat, dia dapat dengan mudah menghitung cara optimal untuk menangkap ikan.

By the time of his death in 2006, Sir Peter Strawson was regarded as one of the world's most distinguished philosophers. Unavailable for many years,_ Scepticism and Naturalism_ is a profound reflection on two classic philosophical problems by a philosopher at the pinnacle of his career. Based on his acclaimed Woodbridge lectures delivered at Columbia University in 1983, Strawson begins with a discussion of scepticism, which he defines as questioning the adequacy of our grounds for holding various beliefs. He then (...) draws deftly on Hume and Wittgenstein to argue that we must distinguish between 'hard', scientific naturalism; or 'soft', humanistic naturalism. In the remaining chapters the author takes up several issues in which sceptical doubts play an important role, in particular the nature of transcendental arguments and including the objectivity of moral philosophy, the mental and the physical, and the existence of abstract entities. _Scepticism and Naturalism_ is essential reading for those seeking an introduction to the work of one of the twentieth century’s most important and original philosophers. This reissue includes a substantial new foreword by Quassim Cassam and a fascinating intellectual autobiography by Strawson, which together form an excellent introduction to his life and work. (shrink)

This article aims to read feminist new materialisms (Barad), together with ‘postulated’ linguistic or cultural primacy of Queer Theory (Butler), to show how both are engaged in similar critical-ethical endeavours. The central argument is that the criticism of Barad and new materialisms misses Butler’s materialistic insights due to a narrow interpretation of Butler's alleged social-constructivist position. There is, therefore, a specific focus on where they both make similar ethical appeals. Moreover, the article relies on Adorno's negative dialectic to highlight an (...) interpretation of Barad and Butler as being part of the same dialectical movement, in which materialism and idealism fluctuate in their mutual criticisms, thus continuing the procession towards 'new knowledge' and emancipation, or freedom, through their motions back and forth. (shrink)

Reflection Principles are commonly thought to produce only strong axioms of infinity consistent with V = L. It would be desirable to have some notion of strong reflection to remedy this, and we have proposed Global Reflection Principles based on a somewhat Cantorian view of the universe. Such principles justify the kind of cardinals needed for, inter alia , Woodin’s Ω-Logic.

Differential scanning calorimetry (DSC) has been employed to investigate the glass transition activation energy E g, thermal stability and glass-forming ability (GFA) of Se90In10− x Sb x (x = 0, 2, 4, 6, 8, 10) chalcogenide glasses. DSC runs were performed at six different heating rates. Well-defined endothermic and exothermic peaks were obtained at glass transition and crystallization temperature. The dependence of glass transition temperature T g on heating rate (α), as well as composition of Sb, has been studied. From (...) the dependence of glass transition temperature on heating rate, the E g has been calculated on the basis of the Kissinger [Anal. Chem. 29 (1957) p.1702] and Moynihan [J. Phys. Chem. 78 (1974) p.267] models. Thermal stability has been monitored through the calculation of temperature differences T c–T g, the stability parameter S, and the enthalpy released during crystallization H c. The GFA has been investigated on the basis of the Hruby parameter H r, which is strong indicator of GFA. Results for GFA are in good agreement with fragility index F i calculations, indicating that Se90In6Sb4 is an excellent glass-former. (shrink)

First published in 1987. Routledge is an imprint of Taylor & Francis, an informa company.

Contributed articles presented at a National seminar.

Contributed articles presented at a National Seminar on "Teaching Philosophy in India: a Vision for the Twenty-First Century Education", held at Andhra University, during 9-11 March 1998 and sponsered by Indian Council of Philosophical Research, New Delhi.

This book is an examination of the metaphysical systems of Margaret Cavendish and Anne Conway, who share many superficial similarities. By providing a detailed analysis of their views on substance, monism, self-motion, individuation, and identity over time, as well as causation, perception, and freedom, it demonstrates the interesting ways in which their accounts differ. Seeing their systems in tandem highlights the originality of each philosopher. In addition to providing the details of their metaphysical views, the book also shows how they (...) put these views to use: for Cavendish in grounding her natural philosophy and for Conway in developing her theodicy. The account of Cavendish is more naturalistic than current interpretations. It argues that God plays no substantive role in Cavendish’s philosophy. The book provides an account of Cavendish’s matter and her biological holism. It shows how sensitive and rational matter are expressed differently in different natural kinds. It provides the first account of Cavendish’s views on individuation and identity over time and a detailed account of her views on causation, arguing that nature is the only principal cause. The book also provides an account of Conway’s spiritual substance, arguing that it is a unique type of substance. It discusses Conway’s two types of motions and causation. In addition, a detailed account of her view of motion as a mode of body, and how it is transferred, is provided. Finally, the book concludes that Conway’s metaphysics and morality are inseparable and that she holds a type of perfectionism. (shrink)

This baseline study was conducted to find out the knowledge, attitudes and practices of medical ethics among the undergraduate medical interns who did not have structured ethics curriculum in their course. A descriptive, cross-sectional study was carried out using a self-administered structured questionnaire among the medical undergraduate interns of Maharajgunj Medical Campus, the pioneer medical college of Nepal which enrols 60 students in a year. A total of 46 interns participated in the study. The most common source of knowledge on (...) ethics was lectures/seminars (35.7%) followed by experience at work (24.5%), training (21.4%) and own reading (17.3%). The main contents of Hippocratic Oath were known to 98.8% while 60.9% knew the main contents of Nepal Medical Council (NMC) code of ethics. Great majority (91.3%) regard ethics as very important in medical profession. “Doctors know the best irrespective of patients’ opinion” was disagreed by only 39.1% indicating the paternalistic attitude. However, 78.3% were in favour of adhering to the patient’s wish. None of the participant agreed to abandon confidentiality. Only about one-fourth (26.1%) claim to encounter ethical dilemma every day while the highest number (43.5%) had once in a month. To deal with the situation of ethical dilemma, majority approached to immediate supervisor followed by head of the department and colleagues. Eighty-seven percent of participating interns were involved in research activities involving human subjects. Only one of the participants had encountered the ethical issue on end-of-life and it was do-not-resuscitate consent in a terminally ill patient. On implementation of the curriculum on medical ethics focus should be - principles of biomedical ethics, sensitive ethical dilemmas like end-of-life care and practical experiences with participation in deliberations of the ethics committee. (shrink)

By the time of his death in 2006, Sir Peter Strawson was regarded as one of the world's most distinguished philosophers. Unavailable for many years,_ Scepticism and Naturalism_ is a profound reflection on two classic philosophical problems by a philosopher at the pinnacle of his career. Based on his acclaimed Woodbridge lectures delivered at Columbia University in 1983, Strawson begins with a discussion of scepticism, which he defines as questioning the adequacy of our grounds for holding various beliefs. He then (...) draws deftly on Hume and Wittgenstein to argue that we must distinguish between 'hard', scientific naturalism; or 'soft', humanistic naturalism. In the remaining chapters the author takes up several issues in which sceptical doubts play an important role, in particular the nature of transcendental arguments and including the objectivity of moral philosophy, the mental and the physical, and the existence of abstract entities. _Scepticism and Naturalism_ is essential reading for those seeking an introduction to the work of one of the twentieth century’s most important and original philosophers. This reissue includes a substantial new foreword by Quassim Cassam and a fascinating intellectual autobiography by Strawson, which together form an excellent introduction to his life and work. (shrink)

This practical and essential text, co-authored by an engineer and an ethicist, covers ethical dilemmas that any engineer might encounter on the job, emphasizing the responsibility of a practicing engineer to act in an ethical manner. To illustrate the complexities involved, the authors present characters who encounter situations that test the engineering code of ethics. The dialogue between the characters highlights different perspectives of each dilemma. As they proceed through the book, students see how the code of ethics can help (...) in decision making, as well as the implications of various decisions. The philosophical theory that supports the ethical situations encountered is presented as boxed material following each section. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

Antisthenes (c. 445- c. 365 BC), was a prominent follower of Socrates and bitter rival of Plato. In this revisionary account of his philosophy in all its aspects, P. A. Meijer claims that Plato and Aristotle have corrupted our perspective on this witty and ingenious thinker. The first part of the book reexamines afresh Antisthenes' ideas about definition and predication and concludes from these that Antisthenes never held the (in)famous theory that contradiction is impossible. The second part of the book (...) argues that Antisthenes' logical theories bear directly on his activities as an exegete of Homer and hence as a theological thinker. Part three, finally, offers innovative readings of Antisthenes' ethical fragments. (shrink)

: Burnout is a psychology syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment. The participants of this study are nurses who have been working at intensive care unit at least for one year. Data were obtained using questionnaire and processed using spearman correlation. Results indicate that are negative relationship between emotional exhaustion and depersonalization with perceived support from colleagues. However, this research finds no relationship between reduced personal accomplishment and perceived support from colleagues. Key words : Burnout, perceived support (...) from colleagues, intensive care nurses. (shrink)