There is good news, and there is bad news. The good news is that in my experience, younger physicians generally are much more concerned about the cost of clinical tests and treatments, and about justly distributing finite medical resources, than were those who practiced medicine in the fee-for-service era. The bad news has at least three components. First, with respect to medically nonbeneficial treatment in the ICU, managed care has not yet given evidence of wanting to put the brakes on (...) unrealistic family demands for aggressive medical interventions. Second, managed care is frustrating many healthcare professionals as well as patients. And third, managed care has no apparent interest in addressing, and may even have contributed to, the problem of medical indigence. Let me develop these propositions more fully. (shrink)

The use of traditional ethical methodologies is inadequate in addressing a constructed maternal–fetal rights conflict in a multicultural obstetrical setting. The use of caring ethics and a relational approach is better suited to address multicultural conceptualizations of autonomy and moral distress. The way power differentials, authoritative knowledge, and informed consent are intertwined in this dilemma will be illuminated by contrasting traditional bioethics and a caring ethics approach. Cultural safety is suggested as a way to develop a relational ontology. Using caring (...) ethics and a relational approach can alleviate moral distress in health-care providers, while promoting collaboration and trust between providers and their patients and ultimately decreasing reproductive disparities. This article examines how a relational approach can be applied to a cross-cultural reproductive dilemma. (shrink)

Name der Zeitschrift: Semiotica Jahrgang: 2016 Heft: 208 Seiten: 35-47.

Comparative analytical study on two truths according to interpretation of eminent masters Gautama Buddha and Mi-bo Gśen-rab of Bon-po sect; includes their brief biographies.

Buddist literature; explanatory commentaries on Tantra philosophy, and commentary on the Mañjuśrīnāmasaṅgīti (Praise to Manjushri).

GS 341 is one of the most familiar of Nietzsche’s writings. This article proposes a new reading that stands in contrast with most English-language Nietzsche scholarship. The text presents a communication and its reception. A ‘demon’ makes an announcement, and a hearer responds in one way or another. But there is also another narrative altogether, whose conceptual vocabulary comes from a dynamic world-view. In this an interaction of forces leads to a new situation. If the hearer is not crushed by (...) the ‘greatest weight’, there must be an inner force that counteracts its impact. I argue that what Nietzsche calls amor fati is a state that allows our drives to achieve full expression, and so makes possible a collective strength able to withstand the greatest impact. The final sentence refers to a “confirmation and sealing”. What happens is that the demon’s message makes an impression on the receptive hearer. For Nietzsche this is a working metaphor, not a turn of phrase. In a draft from this period he writes: “Let us stamp the image of eternity on our life!” That sudden and forceful act, embodying an evaluative judgement, is the event that GS 341 is all about. (shrink)

In GS, Nietzsche utters for the first time the paradoxical formula that sums up a good deal of his ethical thought: "What does your conscience say?—'You should become who you are'".1 The paradox, of course, lies in the odd juxtaposition of becoming and being: how can one become what one already is? Nietzsche repeats the formula toward the end of the original edition of GS, connecting it explicitly to the idea of self-creation: "We, however, want to become who we are—human (...) beings who are new, unique, incomparable, who give themselves laws, who create themselves!". What exactly such self-creation involves for Nietzsche, how it relates to "who we are," and whether it ultimately coheres as a... (shrink)

The importance of GS for understanding Nietzsche’s philosophy cannot be overestimated. While it can be disputed whether or not modern Nietzsche scholarship started with the revaluation of GS—as the editors claim with Giorgio Colli—the work forms an important link between the early and late writings of Nietzsche and especially Z. Klassiker Auslegen—Interpreting Classics—is a series dedicated to interpreting important works of philosophy as a whole through chapters successively discussing the individual chapters of the work. The book at hand consists of (...) two introductions—one for the volume, another one discussing the genesis of the edition of GS—and eight chapters covering each of the preface, the “Prelude in... (shrink)

In the preface to GS, Nietzsche famously exclaims, "Those Greeks were superficial—out of profundity!".1 And he attributes one aspect of this profound superficiality to the Greeks' "respect for the bashfulness [Scham] with which nature has hidden behind riddles and iridescent uncertainties". For Nietzsche, both the Greeks' shame and their respect for shame played important and healthy psychological and social roles. So, Nietzsche praises shame in the sense that "care [Scham] for one's reputation" is characteristic of noble types and a "highly (...) resourceful" emotion. However, Nietzsche also sometimes condemns shame. For example, in the last three aphorisms of Book 3 of GS, he makes... (shrink)

Genomic sequencing technologies (GS) pose novel challenges not seen in older genetic technologies, making traditional standards for fully informed consent difficult or impossible to meet. This is due to factors including the complexity of the test and the broad range of results it may identify. Meaningful informed consent is even more challenging to secure in contexts involving significant time constraints and emotional distress, such as when rapid genomic testing (RGS) is performed in neonatal intensive care units. In this article, we (...) propose that informed consent matters not for its own sake, but because obtaining it furthers a range of morally important goals, such as promoting autonomy, well‐being, and trust in medicine. These goals form the basis of a new framework [PROmoting Morally Important Consent Ends (PROMICE)] for assessing the ethical appropriateness of various informed consent models. We illustrate this framework with two examples: (a) a tiered and layered consent model for obtaining consent for GS, and (b) consent for RGS in critically ill newborns. We conclude that appropriately—rather than fully—informed consent provides the correct standard for genomic medicine and research. (shrink)

Genomic sequencing (GS) is increasingly used in paediatric medicine to aid in screening, research and treatment. Some health systems are trialling GS as a first-line test in newborn screening programmes. Questions about what to do with genomic data after it has been generated are becoming more pertinent. While other research has outlined the ethical reasons for storing deidentified genomic data to be used in research, the ethical case for storing data for future clinical use has not been explicated. In this (...) paper, we examine the ethical case for storing genomic data with the intention of using it as a lifetime health resource. In this model, genomic data would be stored with the intention of reanalysis at certain points through one’s life. We argue this could benefit individuals and create an important public resource. However, several ethical challenges must first be met to achieve these benefits. We explore issues related to privacy, consent, justice and equality. We conclude by arguing that health systems should be moving towards futures that allow for the sequential interrogation of genomic data throughout the lifespan. (shrink)

Many have claimed that ceteris paribus (CP) laws are a quite legitimate feature of scientific theories, some even going so far as to claim that laws of all scientific theories currently on offer are merely CP. We argue here that one of the common props of such a thesis, that there are numerous examples of CP laws in physics, is false. Moreover, besides the absence of genuine examples from physics, we suggest that otherwise unproblematic claims are rendered untestable by the (...) mere addition of the CP operator. Thus, “CP all Fs are Gs” when read as a straightforward statement of fact, cannot be the stuff of scientific theory. Rather, we suggest that when ``ceteris paribus'' appears in scientific works it plays a pragmatic role of pointing to more respectable claims. (shrink)

Job burnout, organizational commitment, and work environment continue to be important areas of research to be studied in the realm of company employment and employee retention. Job burnout is the state of physical and emotional exhaustion and perceiving one’s profession as dull or overwhelming. Meanwhile, organizational commitment refers to the company’s attitude towards the organization and their employees, encompassing loyalty, moral responsibility, and their willingness to work. And lastly, work environment provides opportunities for employees to establish connections, develop skills, and (...) maximize their full potential in performing tasks. For the current study, researchers utilized descriptive-correlational research design to investigate the influence of Work Environment towards the job burnout and organizational commitment of BPO agents in selected companies in Bulacan, Philippines. Hence, Danish Psychosocial Work Environment Questionnaire (DPQ), Maslach Burnout Inventory - General Survey (MBI-GS), and the Three-Dimensional Model of Organizational Commitment Scale (ACS, NCS, CCS) were employed to properly assess the study's objectives. Multiple Linear Regression Analysis was performed to analyze the collected data. Based on the analysis, findings show that work environment has no significant influence on the job burnout and organizational commitment of BPO Agents. Furthermore, the results of this study were thoroughly evaluated, leading to an in-depth discussion. Based on the findings, recommendations were made to benefit the stakeholders of the study and contributeto the existing body of knowledge. (shrink)

I provide an analysis of sentences of the form ‘To be F is to be G’ in terms of exact truth-maker semantics—an approach that identifies the meanings of sentences with the states of the world directly responsible for their truth-values. Roughly, I argue that these sentences hold just in case that which makes something F is that which makes it G. This approach is hyperintensional, and possesses desirable logical and modal features. These sentences are reflexive, transitive and symmetric, and, if (...) they are true, then they are necessarily true, and it is necessary that all and only Fs are Gs. I close by defining an asymmetric and irreflexive notion of analysis in terms of the reflexive and symmetric one. (shrink)

I provide an analysis of sentences of the form ‘To be F is to be G’ in terms of exact truth-maker semantics—an approach that identifies the meanings of sentences with the states of the world directly responsible for their truth-values. Roughly, I argue that these sentences hold just in case that which makes something F also makes it G. This approach is hyperintensional and possesses desirable logical and modal features. In particular, these sentences are reflexive, transitive, and symmetric, and if (...) they are true, then they are necessarily true, and it is necessary that all and only Fs are Gs. I motivate my account over Correia and Skiles’ [11] prominent alternative and close by defining an irreflexive and asymmetric notion of analysis in terms of the symmetric and reflexive notion. (shrink)

There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members (‘KEMRI Community Representatives’, or ‘KCRs’) linked to a (...) large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. (shrink)

A long-standing debate in group ontology and group epistemology concerns whether some groups possess mental states and/or epistemic states such as knowledge that do not reduce to the mental states and/or epistemic states of the individuals who comprise such groups (and are also states not possessed by any of the members). Call those who think there are such states inflationists. There has recently been a defense in the literature of a specific type of inflationary knowledge—viz., knowledge of facts about group (...) minds or group self-knowledge (GS-K). In this paper I address whether some groups do possess such knowledge. I argue that we have good reason to think they do not. I do so by exploring the most explicit defense of such knowledge in the literature—Lukas Schwengerer’s (2022) defense—as well as other ways of defending this thesis and arguing that such ways are problematic. In the latter part of the paper, I explain why the two most popular inflationary approaches to group knowledge simpliciter are incompatible with there being GS-K. In doing so I work to show why even inflationists should reject the view that there is inflationary group self-knowledge. (shrink)

Gideon Rosen and Robert Schwartzkopff have independently suggested (variants of) the following claim, which is a varian of Hume's Principle: -/- When the number of Fs is identical to the number of Gs, this fact is grounded by the fact that there is a one-to-one correspondence between the Fs and Gs. -/- My paper is a detailed critique of the proposal. I don't find any decisive refutation of the proposal. At the same time, it has some consequences which many will (...) find objectionable. (shrink)

Nietzsche employs the concept of pregnancy metaphorically at various points in his writings; discussing the pregnancy of philosophers (GM III 8, BGE 292), spiritual pregnancy (EH, Clever 3; GS 72) and being pregnant with thoughts or deeds (D 552). I explore how Nietzsche uses the notion of pregnancy in Dawn, arguing that it connects to the theme of self-cultivation. I employ the various associations that Nietzsche makes with pregnancy, including the unknown, selfishness, strangeness, and solitude, to elucidate Nietzsche’s understanding of (...) self-cultivation. I show how the metaphor of pregnancy, in which we do not control what we give birth to, both expresses and helps us explore the problem of what, if the self is made up of and directed by many competing drives, shapes and directs self-cultivation. I argue that Nietzsche’s deliberate references to the context of Plato’s discussion of pregnancy involve a self-conscious challenge to Plato’s concept of the philosopher, and of philosophy, and a reimagining of what they will give birth to. The appropriation of Plato’s famous metaphor thus underscores how Nietzsche’s concept and method of self-cultivation contrasts to Plato’s care for the soul and is rooted in attentiveness to the body and its drives. (shrink)

Comprehensive Biomedical Research Centre and Centre for Philosophy, Justice and Health, UCL, First Floor, Charles Bell House, 67–73 Riding House Street, London W1W 7EJ, UK. Tel.: +44 (0)20 7679 9417; Fax: +44 (0)20 7679 9426; Email: james-gs.wilson{at}ucl.ac.uk ' + u + '@' + d + ' '//--> . Abstract This paper aims to shed some light on the difficulties we face in constructing a generally acceptable normative framework for thinking about public health. It argues that there are three factors that (...) combine to make theorising about public health difficult, and which when taken together defeat simplistic top-down and bottom-up approaches to the design of public health policies. The first factor is the problem of complex systems, namely that the distribution of health both affects and is affected by the distribution of other goods. The second is the difficulty of defining the goals of public health: we still need to get clear about what we should mean by health in this context, and what the goals of public health should be. The third is that we stand in need of an account of how important health is relative to the importance of other goods that a just society should be trying to secure for its citizens. The paper argues that these problems should lead us to abandon the search for a ‘one-size fits all’ normative framework for thinking about public health. Rather, different approaches will be appropriate at different levels of abstraction. CiteULike Connotea Del.icio.us What's this? (shrink)

Cimpian et al. observed that we accept generic statements of the form ‘Gs are f’ on relatively weak evidence, but that if we are unfamiliar with group G and we learn a generic statement about it, we still treat it inferentially in a much stronger way: all Gs are f. This paper makes use of notions like ‘representativeness’, ‘contingency’ and ‘relative difference’ from psychology to provide a uniform semantics of generics that explains why people accept generics based on weak evidence. (...) The spirit of the approach has much in common with Leslie’s cognition-based ideas about generics, but the semantics will be grounded on a strengthening of Cohen’s relative readings of generic sentences. In contrast to Leslie and Cohen, we propose a uniform semantic analysis of generics. The basic intuition is that a generic of the form ‘Gs are f’ is true because f is typical for G, which means that f is valuably associated with G. We will make use of Kahneman and Tversky’s Heuristics and Biases approach, according to which people tend to confuse questions about probability with questions about representativeness, to explain pragmatically why people treat many generic statements inferentially in a much stronger way. (shrink)

Nietzsche’s imperative call, Werde, der Du bist - Become the one you are - is, to say the least, an odd sort of imperative: dissonant and yet intrinsically inspiring. Thus Alexander Nehamas in an essay on this very theme names it the “most haunting of Nietzsche’s haunting aphorisms.” 1 Expressed as it is in The Gay Science, “Du sollst der werden, der du bist” (GS 270, KSA 3, p. 519) - Thou shalt -.

ABSTRACT This paper reports on an empirical performance analysis of four modal theorem provers on benchmark suites of randomly generated formulae. The theorem provers tested are the Davis-Putnam-based procedure KSAT, the tableaux-based system KRZIS, the sequent-based Logics Workbench, and a translation approach combined with the first-order theorem prover SPASS. Our benchmark suites are sets of multi-modal formulae in a certain normal form randomly generated according to the scheme of Giunchiglia and Sebastiani [GS 96a, GS 96b]. We investigate the quality of (...) the random modal formulae and show that the scheme has some shortcomings, which may lead to mistaken conclusions. We propose improvements to the evaluation method and show that the translation approach provides a viable alternative to the other approaches. (shrink)