Outcomes from cardiopulmonary resuscitation (CPR) remain distressingly poor. Overuse of CPR is attributable to unrealistic expectations, unintended consequences of existing policies and failure to honour patient refusal of CPR. We analyzed the CPR outcomes literature using the bioethical principles of beneficence, non-maleficence, autonomy and justice and developed a proposal for selective use of CPR. Beneficence supports use of CPR when most effective. Non-maleficence argues against performing CPR when the outcomes are harmful or usage inappropriate. Additionally, policies which usurp good clinical (...) judgment and moral responsibility, thereby contributing to inappropriate CPR usage, should be considered maleficent. Autonomy restricts CPR use when refused but cannot create a right to CPR. Justice requires that we define which medical interventions contribute sufficiently to health and happiness that they should be made universally available. This ordering is necessary whether one believes in the utilitarian standard or wishes medical care to be universally available on fairness grounds. Low-yield CPR fails justice criteria. Cardiopulmonary resuscitation should be performed when justified by the extensive outcomes literature; not performed when not desired by the patient or not indicated; and performed infrequently when relatively contraindicated. (shrink)

James questions the validity of the very tentative statement made in the final sentence of our paper. Our claim concerned the proportion of twins in Britain in the 1990s that might have arisen through subfertility treatment and was linked to the suggestion that the natural twinning rate might still be in decline. If this were true, we, like James, would regard that prospect with concern.

Although virtually all comparative research about risk perception focuses on which hazards are of concern to people in different culture groups, much can be gained by focusing on predictors of levels of risk perception in various countries and places. In this case, we examine standard and novel predictors of risk perception in seven sites among communities affected by a flood in Mexico (one site) and volcanic eruptions in Mexico (one site) and Ecuador (five sites). We conducted more than 450 interviews (...) with questions about how people feel at the time (after the disaster) regarding what happened in the past, their current concerns, and their expectations for the future. We explore how aspects of the context in which people live have an effect on how strongly people perceive natural hazards in relationship with demographic, well-being, and social network factors. Generally, our research indicates that levels of risk perception for past, present, and future aspects of a specific hazard are similar across these two countries and seven sites. However, these contexts produced different predictors of risk perception—in other words, there was little overlap between sites in the variables that predicted the past, present, or future aspects of risk perception in each site. Generally, current stress was related to perception of past danger of an event in the Mexican sites, but not in Ecuador; network variables were mainly important for perception of past danger (rather than future or present danger), although specific network correlates varied from site to site across the countries. (shrink)

MEDIEVAL LOGICS LAMBERT MARIE DE RIJK (ed.), Die mittelalterlichen Traktate De mod0 opponendiet respondendi, Einleitung und Ausgabe der einschlagigen Texte. (Beitrage zur Geschichte der Philosophie und Theologie des Mittelalters, Neue Folge Band 17.) Miinster: Aschendorff, 1980. 379 pp. No price stated. THE SEVENTEENTH CENTURY MARTA FATTORI, Lessico del Novum Organum di Francesco Bacone. Rome: Edizioni dell'Ateneo 1980. Two volumes, il + 543, 520 pp. Lire 65.000. VIVIAN SALMON, The study of language in 17th century England. (Amsterdam Studies in the Theory (...) and History of Linguistic Science, Series 111: Studies in theHistory of Linguistics, Volume 17.) Amsterdam: John Benjamins B.V., 1979.x + 218 pp. Dfl. 65. Theoria cum Praxi. Zum Verhaltnis von Theorie und Praxis im 17. und 18. Jahrhundert. (Akten des 111. Internationalen Leibnizkongress, Hannover, 12. bis 17.November 1977, Band 111: Logik, Erkenntnistheorie, Wissenschaftstheorie, Metaphysik, Theologie.) Wiesbaden: Franz Steiner Verlag, 1980. vii + 269 pp. DM 48. CLASSICAL AND NON-CLASSICAL LOGICS MICHAEL CLARK, The place of syllogistic in logical theory. Nottingham: University of Nottingham Press, 1980. ix + 151 pp. £3.00. A.F. PARKER-RHODES, The theory of indistinguishables. Dordrecht, Boston and London: D. Reidel Publishing Company, 1981. xvii + 216 pp. Dfl.90.00/$39.50. NICHOLAS RESCHER and ROBERT BRANDOM, The logic of inconsistency. Oxford:Basil Blackwell, 1980. x + 174 pp. f 11.50. MISCELLANEOUS J. ZELENY, The logic of Marx. Translated from the German by T. Carver. Oxford: Basil Blackwell, 1980. xcii + 247 pp. £12.50. FELIX KAUFMANN, The infinite in mathematics. Edited by Brian McGuinness. Introduction by E. Nagel. Translation from the German by Paul Foulkes. Dordrecht: Reidel, 1978. xvii + 235 pp. Dfl 85/$39.50 (cloth); Dfl 45/$19.95 (paper). PAMELA MCCORDUCK, Machines who think. San Francisco: W.H. Freeman and Company, 1979. xiv + 275 pp. $14.95. J. MITTELSTRASS (ed.), Enzyklopadie Philosophie und Wissenschaftstheorie Bd. 1 : A-G. Mannheim, Wien, Ziirich: Bibliographisches Institut, 1980. 835 pp. DM 128. (shrink)

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social (...) sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed. (shrink)

Did the September 11, 2001 terrorist attacks on the U.S. cause the values of teenagers in the U.S. to change? Did their previously important self-esteem and self-actualization values become less important and their survival and safety values become more important? Changes in the values of teenagers are important for practitioners, managers, marketers, and researchers to understand because high school students are our current and future employees, managers, and customers, and research has shown that values impact work and consumer-related attitudes and (...) behaviors. Further, studies that compared higher to lower performing for-profit and not-for-profit companies have found that higher performing organizations had strong values that permeated their organizations [Collins J. C., and J. I. Porras: 1994, Built to Last: Successful Habits of Visionary Companies (New York, Harper Business); O’Reilly, C. A. and J. A. Chatman: 1996, in B. M. Staw and L. L. Cummings (eds.), Research in Organizational Behavior, vol. 18 (JAI Press, Greenwhich, CT), pp. 157–200; O’Reilly, C. A.: 1989, California Management Review 31(4), 9–25; Posner, B. Z., and W. H. Schmidt: 1996, Public Personnel Management, 25(3), 277–298; Rousseau, D.: 1990, Group and Organization Studies 15(4), 448–460; Schein, E. H.: 2004, Organizational Culture and Leadership. San Francisco, Jossey Bass)]. While one study of adults found value changes, no known studies have explored if the values of teenagers also changed post-9/11. This study filled that research gap by exploring the values of a random sample of 1000 U.S. teenagers in grades 9 to 12 pre- and post-9/11, using a demographic questionnaire and the Rokeach Value Survey. The research results indicated that teenage survival, safety, and security values (a world at peace, freedom, national security, and salvation) increased in importance while their self-esteem and self-actualization values (a sense of accomplishment, inner harmony, pleasure, self-respect, and wisdom) decreased in importance, mirroring the changes for adults. The meaning of these findings for practitioners, managers, marketers and researchers was discussed. (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

The effects in a quantum-mechanical system form a partial algebra and a partially ordered set which is the prototypical example of the effect algebras discussed in this paper. The relationships among effect algebras and such structures as orthoalgebras and orthomodular posets are investigated, as are morphisms and group- valued measures (or charges) on effect algebras. It is proved that there is a universal group for every effect algebra, as well as a universal vector space over an arbitrary field.

An appropriate kind of curved Hilbert space is developed in such a manner that it admits operators of $\mathcal{C}$ - and $\mathfrak{D}$ -differentiation, which are the analogues of the familiar covariant and D-differentiation available in a manifold. These tools are then employed to shed light on the space-time structure of Quantum Mechanics, from the points of view of the Feynman ‘path integral’ and of canonical quantisation. (The latter contains, as a special case, quantisation in arbitrary curvilinear coordinates when space is (...) flat.) The influence of curvature is emphasised throughout, with an illustration provided by the Aharonov-Bohm effect. (shrink)

Deformation quantisation is applied to ordinary Quantum Mechanics by introducing the star product in a configuration space combining a Riemannian structure with a Poisson one. A Hilbert space compatible with such a configuration space is designed. The dynamics is expressed by a Hermitian Hamiltonian containing a scalar potential and a one-form potential. As a simple illustration, it is shown how a particular type of non-commutativity of the star product is interpretable as generating the Zeeman effect of ordinary Quantum Mechanics.

Classical mechanics is presented so as to render the new formulation valid for an arbitrary temporal variable, as opposed to Newton’s Absolute Time only. Newton’s theory then becomes formally identical (in a precise sense) to relativity, albeit in a three-dimensional manifold. (The ultimate difference between the two dynamics is traced to the existence of the relativistic ‘mass-shell’ condition.) A classical Lagrangian is provided for our formulation of the equations of motion and it is related to one of the known forms (...) of the corresponding relativistic Lagrangian, which is the analogue of the Polyakov Lagrangian of string theory. (shrink)

We argue that after the passage of a physician assisted death law some inequities in the health care system which prevent people from getting the medical care they need will become reasons for choosing assisted death. This raises the issue of whether there is compelling moral reason to change those inequities after the passage of an assisted death law. We argue that the passage of an assisted death law will not create additional moral reasons for eliminating inequities simply because they (...) become motives for someone to opt for assisted death. We also argue that it is not feasible to eliminate these reasons for opting for assisted death by granting a right to health care because of an intractable scarcity of medical resources. (shrink)

We investigate a possible form of Schrödinger’s equation as it appears to moving observers. It is shown that, in this framework, accelerated motion requires fictitious potentials to be added to the original equation. The gauge invariance of the formulation is established. The example of accelerated Euclidean transformations is treated explicitly, which contain Galilean transformations as special cases. The relationship between an acceleration and a gravitational field is found to be compatible with the picture of the ‘Einstein elevator’. The physical effects (...) of an acceleration are illustrated by the problem of the uniformly-accelerated harmonic oscillator. (shrink)

Supertasks recently discussed in the literature purport to display a failure ofenergy conservation and determinism in Newtonian mechanics. We debatewhether these supertasks are admissible as Newtonian systems, with Earmanand Norton defending the affirmative and Alper and Bridger the negative.

Research suggests that perceptual experience of our movements adapts together with movement control when we are the agents of our actions. Is this agency critical for perceptual and motor adaptation? We had participants view cursor feedback during elbow extension–flexion movements when they actively moved their arm, or had their arm passively moved. We probed adaptation of movement perception by having participants report the reversal point of their unseen movement. We probed adaptation of movement control by having them aim to a (...) target. Perception and control of active movement were influenced by both types of exposure, although adaptation was stronger following active exposure. Furthermore, both types of exposure led to a change in the perception of passive movements. Our findings support the notion that perception and control adapt together, and they suggest that some adaptation is due to recalibrated proprioception that arises independently of active engagement with the environment. (shrink)