OBJECTIVE: To examine the long-term effects of an innovative curriculum on medical house officers' (HOs') knowledge, confidence, and attitudes regarding medical ethics. DESIGN: Long term cohort study. The two-year curriculum, implemented by a single physician ethicist with assistance from other faculty, was fully integrated into the programme. It consisted of monthly sessions: ethics morning report alternating with didactic conferences. The content included topics such as ethics vocabulary and principles, withdrawing life support, informed consent, and justice. Identical content was offered simultaneously (...) at the largest affiliated community hospital. SETTING: A multi-hospital university training programme from July, 1992 to June, 1994. PARTICIPANTS: Thirty-nine HOs responded in 92. Thirty HOs from the same cohort responded in 94 (response rates = 83% v 71%; P = 0.19). RESULTS: The curriculum was well received, with 96% of HOs finding the sessions stimulating. Previously validated scales of knowledge and confidence were administered at baseline and at follow-up. The average knowledge score improved 14% (P < 0.001). Confidence also improved, rising from 3.3 to 3.8 on a 5-point Likert scale (P < 0.001). These findings were independent of age, gender, religion, and prior education. The only attitudinal change was an increase in the proportion of residents who thought that ethics should be a required part of residency training (57% v 80%, P = 0.05). CONCLUSION: This curriculum appears practical, popular, and effective. It should be readily transferable to other institutions. (shrink)

OBJECTIVES: To study the accuracy of reviewing ward notes (chart review) as a measure of the quality of care rendered to patients with "Do Not Resuscitate" (DNR) orders. DESIGN: We reviewed the charts of 19 consecutive, competent inpatients with DNR orders for evidence that the staff addressed a broad range of patient care needs called Concurrent Care Concerns (CCCs), such as withholding treatments other than resuscitation itself, and attention to patient comfort needs. We then interviewed the patient, consultant physician, house (...) officer, and primary nurse and compared the ward notes with the understandings of these staff members. SETTING: The medical service of an urban university medical centre. RESULTS: The average number of documented CCCs addressed per DNR order was 1.1. The ward notes generally agreed with the perceptions of patients, house officers, and nurses (% agreement with notes = 79%, 77%, and 82%; kappa = 0.43, 0.40, 0.50). Consultant physicians' understandings were poorly reflected in the ward notes (% agreement = 59%; kappa = 0.18). They overestimated attention to CCCs compared with the notes (P < 0.0001) and with other observers (P < 0.0001). CONCLUSION: Chart review for attention to CCCs accurately reflects the understandings of patients, house officers, and nurses, but consultant physicians report more attention to CCCs than is recorded in the ward notes or understood by other observers. Better communication regarding end-of-life care plans should be encouraged. (shrink)

In their simplest form, hybrid languages are propositional modal languages which can refer to states. They were introduced by Arthur Prior, the inventor of tense logic, and played an important role in his work: because they make reference to specific times possible, they remove the most serious obstacle to developing modal approaches to temporal representation and reasoning. However very little is known about the computational complexity of hybrid temporal logics.In this paper we analyze the complexity of the satisfiability problem of (...) a number of hybrid temporal logics: the basic hybrid language over transitive trees; nominal Until logic; and referential interval logic. We discuss the effects of including nominals, the @ operator, the somewhere modality E, and the difference operator D. Adding nominals to tense logic leads for several frame-classes to an increase in complexity of the satisfiability problem from PSPACE to EXPTIME. On transitive trees, however, the satisfiability problem for this language can be decided in PSPACE. Along the way we make a detour through hybrid propositional dynamic logic: we establish upper bounds for a number of temporal logics by generalizing results due to Passy and Tinchev [29] and De Giacomo [16]. We conclude with some remarks on the relevance of our results to description logic, and draw attention to the utility of the spypoint technique for proving upper and lower bounds. (shrink)

Diversity and hybridity, interaction and exchange: these terms compose the thematic focus of this issue of the journal “Der Islam”: Eastern Christianity in History and the Present: Perspectives and Obstacles. The issue features contributions to a conference held in the year 2008. Evaluating the state of research on Eastern Christianity in Germany, the participants observed that this field of academic enquiry is in danger of becoming extinct in this country. Thus, this collection of articles hopefully serves as a catalyst for (...) jumpstarting debate on Eastern Christianity in the German academic community. The study of Eastern Christian communities’ cultural identity is at the same time ineluctably intertwined with Qur‘anic Studies and Islamic History - i. e. an Islam in dialogue with, but not mimicking Jewish and Christian traditions of the Hijaz. Diversity in the Islamic-ruled world is a historical reality that has been largely ignored in the study of Islam as well. This edition of “Der Islam” therefore highlights research that considers the interaction between Muslim and non-Muslim groups, as well as the entangled development of the religious traditions, in order to better understand the socio-religious plurality of Western Asia. Interaction and exchange, however, also include moments of conflict and discrimination. As we close upon the one-year anniversary of the “Arab Spring”, the authors are reminded that it is important to consider the worsening condition of Eastern Christian communities today and their representation in Western studies as well as in the political systems they live in. (shrink)

The paper is concerned with the problem of individuation in Spinoza. Spinoza's account of individuation leads to the apparent contradiction between, on the one hand, the view that substance (God or Nature) is simple, eternal, and infinite, and on the other, the claim that substance contains infinite differentiation - determinate and finite modes, i.e. individuals. A reconstruction of Spinoza's argument is offered which accepts the reality of the contradiction and sees it as a consequence of Spinoza's way of posing the (...) problem of individuation: it is argued that Spinoza's ontology is constructed on the basis of his methodology, rather than conversely. The contradiction appears in its acutest form in Spinoza's discussion of number. The paper explains the philosophical motivation behind Spinoza's Problematik and reflects on the historical context of the contradiction to which that Problematik gives rise. (shrink)

Perhaps I should define what I mean by "ontological status" here, since much of the ensuing argument is concerned with it. I do not mean verifiability or confirmability in any reductive sense, physicalistically or phenomenologically, although it is perfectly clear that the description of how things exist requires such criteria. But to translate such criteria into ontological proofs, of the sort "what has effects, is real" is to fall prey to circularity. The alternative to such an apparently "inferred" ontology is (...) not necessarily pure, non-ontological descriptionism. Hume's suggestion was that "whatever we conceive, we conceive to be existent." In the context of Hume's conditional view of conception, such an attribution of existence to what we conceive is always probative, hypothetical. In this sense, the criteria for verifiability or confirmability also presuppose existence, even if only as the matrix in which hypothetical objects or events either do or do not have a place. If Hume's formulation is understood reflexively, then not only is what we conceive conceived to be existent, but the conception itself is conceived to be existent, since we can conceive of the fact of conceiving. This involves, of course, a distinction of levels, and the whole range of problems of metalanguages and types. For my purposes here, I shall only point out that, over the range of levels, what we conceive is neither more nor less existent than the conception itself; the empirical concept is neither more nor less existent than its extension. Existence is not a matter of degree, whatever the distinction of levels or types. Yet, there is a certain sense to the common sense appreciation that some things seem to be "more real" than others. What does break the circle of a uniform, non-modal existentiality, and makes sense out of the vaguely intuited "more real," is the hypothesis of derivative relationships between existences, i.e., the hypothesis of genetic sequence and the emergence of qualities in this sequence. In this sense, to establish the ontological status of judgment is to establish the derivative sequence of which judgment is the final term. Yet, to establish ontological status in this way, to say things are the way they have become, is to assume that genetic sequence ends, or is abolished in some instantaneous now, outside of which it is meaningless to speak of ontological status. To press this further, every genetic sequence can be differentiated into a series of "nows" each one of which paradoxically constitutes a final term in the series. As derivation has to do with coming-to-be, and apparently ends with being, in the partial sense of being constituted, so ontological status requires the additional parameter of function, as well as derivation; it requires us to speak of effects, which lie beyond the end term in any genetic sequence; to define what is also in terms of what "it" does, or what "it" becomes, or what "it" causes, or with operationism, in terms of "goings-on," without the antecedent subject-term. (shrink)

Marxist Philosophy or Marx's Philosophy? The general idea of this little book is to understand and explain why Marx will still be read in the twenty-first ...

First published in 1994. Routledge is an imprint of Taylor & Francis, an informa company.

Cette édition numérique a été réalisée à partir d'un support physique, parfois ancien, conservé au sein du dépôt légal de la Bibliothèque nationale de France, conformément à la loi n° 2012-287 du 1er mars 2012 relative à l'exploitation des Livres indisponibles du XXe siècle. Pages de début -- I -- Phénoménologies hégelienne et husserlienne Hegel et Husserl sur l'intersubjectivité Itinéraires phénoménologiques La dialectique de l'intentionnalité Essai de synthèse d'une méthode phénoménologique -- II -- Classes sociales selon Marx Imaginaire social (...) et creation des idéologies Production et classes sociales dans Le Capital L'évolution du concept de la lutte des classes dans la pensée de Marx Lesclasses sociales dans la philosophie de l'histoire de Marx Pages de fin. (shrink)

Spiritual Taxonomies and Ritual Authority recounts how philosophers of the late third century C.E. organized the spirit world into hierarchies, positioning themselves as high priests in the process. By establishing themselves as experts on sacred matters, they fortified their authority, prestige, and reputation.

Der Band gibt wichtige Impulse für die methodologische Reflexion der historischen Kulturwissenschaften. Er geht auf eine Tagung zurück, deren Thema "Dichtung und Wahrheit. Zum Verhältnis von Narration und Erklärung in den Kultur-, Geistes- und Sozialwissenschaften" war. Die Autoren greifen zum ersten Mal im kulturwissenschaftlichen Kontext Anregungen vor allem aus der Analytischen Philosophie auf und diskutieren ihren Wert für historisches und kulturwissenschaftliches Arbeiten. Im Fokus der Untersuchungen steht eine Begriffstrias, die für die Sozial-, Geistes- und Kulturwissenschaften gleichermaßen seit dem 19. Jahrhundert (...) eine große Herausforderung darstellt: Erklären, Verstehen und Erzählen. (shrink)

Der Band enthält 123 Dokumente von Marx und Engels aus dem Zeitraum von Oktober 1857 bis Dezember 1858. Dazu zählen 81 Korrespondenzen für die „New-York Tribune“ – eine der bedeutendsten US-amerikanischen Zeitungen – sowie 39 Arbeiten für das große Lexikon „New American Cyclopædia“ und drei Texte für andere Zeitungen. Sieben bisher unbekannte Texte werden hier erstmals ediert. Im Mittelpunkt der journalistischen Arbeiten steht die Kommentierung der ersten Weltwirtschaftskrise von 1857/58 und des Indischen Aufstands 1857-59, der die britische Herrschaft erschütterte. (...) Marx tritt hier als Krisenanalytiker und als Kolonialkritiker hervor. Hinzu kommen seine Artikel zum Opiumhandel, den er als internationalen Drogenhandel darstellt, zum Beginn der "Neuen Ära" in Preußen und die Kommentierung des Anschlags auf Napoleon III. Des Weiteren finden sich Berichte zu den Kämpfen im Kaukasus und zu den britischen Antiterrormaßnahmen in Irland. Der Band zeigt Marx und vor allem Engels außerdem als Autoren von Lexikonbeiträgen. Darunter finden sich umfangreiche Biografien, wie die zu Blücher und Bolivar, Militärartikel zu Artillerie und Kavallerie sowie zu großen Schlachten, wie der Schlacht bei Borodino und zum Untergang der spanischen Armada. (shrink)

The story of Sosipatra of Pergamon (4th century C.E.) as told by her biographer, Eunapius of Sardis in his Lives of the Philosophers and Sophists, is a remarkable tale. It is the story of an elite young girl from the area of Ephesus, who was educated by traveling spirits (daemons), and who grew up to lead her own philosophy school on the west coast of ancient Asia Minor. She was also a prophet of sorts, channeling divine messages to her students, (...) family, and friends, capable of mentally viewing events that were happening in other locations, and foretelling the future. This volume is the first sustained, book length, attempt to tell the story of this mysterious woman. It presents a rich contextualization of the brief, sketchy, and highly fictionalized portrait provided by Eunapius. (shrink)

Psychotherapy is commonly described as a “talking cure,” a treatment method that operates through linguistic action and interaction. The operative specifics of therapeutic language use, however, are insufficiently understood, mainly due to a multitude of disparate approaches that advance different notions of what “talking” means and what “cure” implies in the respective context. Accordingly, a clarification of the basic theoretical structure of “talking cure models,” i.e., models that describe therapeutic processes with a focus on language use, is a desideratum of (...) language-oriented psychotherapy research. Against this background the present paper suggests a theoretical framework of analysis which distinguishes four basic components of “talking cure models”: (1) a foundational theory (which suggests how linguistic activity can affect and transform human experience), (2) an experiential problem state (which defines the problem or pathology of the patient), (3) a curative linguistic activity (which defines linguistic activities that are supposed to effectuate a curative transformation of the experiential problem state), and (4) a change mechanism (which defines the processes and effects involved in such transformations). The purpose of the framework is to establish a terminological foundation that allows for systematically reconstructing basic properties and operative mechanisms of “talking cure models.” To demonstrate the applicability and utility of the framework, five distinct “talking cure models” which spell out the details of curative “talking” processes in terms of (1) catharsis, (2) symbolization, (3) narrative, (4) metaphor, and (5) neurocognitive inhibition are introduced and discussed in terms of the framework components. In summary, we hope that our framework will prove useful for the objective of clarifying the theoretical underpinnings of language-oriented psychotherapy research and help to establish a more comprehensive understanding of how curative language use contributes to the process of ther-apeutic change. (shrink)

Contrary to the prevailing view, there is not one, but at least two poetic theories in Paul Valéry: the intellectual, formalist and technical poetics Valéry is usually associated to conflicts with another poetics, which highlights sensitivity, lyricism and subjectivity. The constitutive duplicity of Valéry’s literary theory has probably something to do with the ambiguity of his relationship with Stéphane Mallarmé.

Born of a terrible insomnia--"a dizzying lucidity which would turn even paradise into hell"--this book presents the youthful Cioran, a self- described "Nietzsche still complete with his Zarathustra, his poses, his mystical clown's tricks, a whole circus of the heights." On the Heights of Despair shows Cioran's first grappling with themes he would return to in his mature works: despair and decay, absurdity and alienation, futility and the irrationality of existence. It also presents Cioran as a connoisseur of apocalypse, a (...) theoretician of despair, for whom writing and philosophy both share the "lyrical virtues" that alone lead to a metaphysical revelation. "No modern writer twists the knife with Cioran's dexterity. . . . His writing . . . is informed with the bitterness of genuine compassion."--Bill Marx, Boston Phoenix "The dark, existential despair of Romanian philosopher Cioran's short meditations is paradoxically bracing and life-affirming. . . . Puts him in the company of Nietzsche and Kierkegaard."-- Publishers Weekly, starred review "This is self-pity as epigram, the sort of dyspeptic pronouncement that gets most people kicked out of bed but that has kept Mr. Cioran going for the rest of his life."--Judith Shulevitz, New York Times Book Review Emil M. Cioran (1911-1995) is the author of numerous works, including The Fall into Time, A Short History of Decay, and Tears and Saints. (shrink)

Introduction -- Karl Marx's concept of alienation -- Objectification, alienation, and estrangement -- Other origins of alienation and objectification -- Marx's account of alienation : from early to late -- The alienated object of production : commodity fetishism -- The alienated means of production : machine fetishism -- Machines and the transformation of work -- Marx's energeticist turn -- The first law of thermodynamics -- From arbeit to arbeitskraft -- The second law of thermodynamics -- Machines in (...) the communist future -- Technology and the boundaries of nature -- Material wealth and value : the Grundrisse's fragment on machines -- The strife between technology and capital : the fall in the rate of profit -- Enjoyment not value : challenging the logic of exhaustion -- Man himself as fixed capital -- Class kinship and the redistribution of the means of production -- Machines in the capitalist reality -- Between thermodynamics and humanism : approaching capital -- Machinery as an historical category of production -- Machines, trains, and other capitalist monsters -- Rough, foul-mouthed boys : women's monstrous laboring bodies -- Wage labor and race -- Wage labor and sexuality -- Machinery and revolution -- Alienation beyond Marx -- Science and technology in Marx's excerpt notebooks -- Karl Marx and Charles Babbage -- Machines and temporality : the treadmill effect and free time -- Technophobia and technophilia -- Technophobia and twentieth-century theory. (shrink)

International in scope and featuring a diverse group of contributors, The Borders of Justice investigates the complexities of transitional justice that emerge from its “social embeddedness.” This original and provocative collection of essays, which stem from a collective research program on social justice undertaken by the Calcutta Research Group, confronts the concept and practices of justice. The editors and contributors question the relationship between geography, methodology, and justice—how and why justice is meted out differently in different places. Expanding on Michael (...) Walzer's idea of the “spheres of justice,” the contributors argue that justice is burdened with our notions of social realities and expectations, in addition to the influence of money, law, and government. Chapters provide close readings of Pascal, Plato and Marx, theories on global justice, the relationship between liberalism and multiculturalism, struggles of social injustice, and how and where we draw the borders of justice. (shrink)