Using a real-life case involving an accidental discovery of misattributed paternity as a springboard for discussion, I reflect on several practical and theoretical issues surrounding truth-telling in the doctor-patient relationship. I present the moral dilemma and identify arguments in favour of and against disclosure. I then examine the theoretical difficulties in balancing conflicting reasons and in establishing what constitutes the 'truth'. I conclude that withholding the information from the patients would be ethically permissible and, more generally, that honesty is not (...) always the best policy. (shrink)

edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.

Latin is one of the best documented and most extensively studied of any language: nearly every area has been subject to continued and intense scrutiny, with ideas from recent subfields of linguistics providing a fresh look at some old topics. The Latin future imperative, the form that conveys commands for non-immediate execution, constitutes precisely such a topic in Latin linguistics: from the Roman Imperial period on, students have demarcated the usages, syntax and context-specific features associated with this form; more recently, (...) scholars have applied ideas from various linguistic subfields to achieve new insights. Given that the –toimperative is so well understood, it might come as a surprise to find that some matters pertaining to it are still debated. This paper will address four such contested areas: first, its register ; second, the form's politeness ; third, the temporal scope of the –toimperative ; and fourth, the sensitivity of the form to social factors, that is, to the identity of the speaker and the addressee. (shrink)

The medical profession’s role should be limited to advice and informationThe medical establishment’s desire to interfere with the autonomous wishes of boxers seems at odds with the principle of respect for autonomy prevalent in contemporary biomedical practice. I argue that the role of the medical profession in boxing should be solely an advisory and informational one. In addition, the distinctions made between boxing and other high risk sports often rely on an insufficient knowledge of the sport. This leads to misdirected (...) criticisms and excessive emphasis on the colourful discourse of boxing, as opposed to the practice of boxing itself. Dr Herrera’s claim in his article that boxing differs from other sports in the acceptability of its acts outside the realm of sport is refuted.1 The importance of consent as a legitimising factor is highlighted, and a number of possible solutions to improve safety within the sport are tentatively suggested.In the United Kingdom, a competent adult may legally refuse medical treatment, irrespective of the severity of his condition or the validity of his reasons. With the pre-eminence of an autonomy based model of bioethics, respecting a patient’s wishes forms an integral part of acting in his best interests. It is puzzling, then, to find that the Australian Medical Association have called for a ban on boxing on the grounds that the activity is excessively hazardous to the health of boxers. The often mentioned principle of respect for autonomy is abandoned once the person drops the privileged title of “patient”. This suggests that being a patient …. (shrink)

Quid ais has as its two main functions in Latin to express surprise (“what are you saying?”), and to get the addressee’s attention (“tell me something…”); the latter type has a commanding tone. It is proven that quid ais in Plautus has a decidedly male character; that is, he avoided giving the phrase to women. To explain this finding, it is noted that 91% of instances of quid ais in Plautus are of the second “attention-getting” type. With its imperatival force, (...) this quid ais was probably not felt to be appropriate for Plautus’ female characters whose speech is generally more polite and deferential than male speech. Indeed, in the three cases when a woman does utter the phrase, she either assumes a male role, or belongs to a type which in recent scholarship has been shown to have a “commanding” style of speech: the meretrix or the uxor dotata. (shrink)

This paper discusses the difference between the factual and the legal, both as to terms and as to statements, on the analogy of the methodologists' distinction of the observational and the theoretical. No absolute distinction exists, and pure `brute facts' do not exist in law because of the socialisation of physical world and juridification of the social world.; also, the effect of evidentiary constraints. Law/fact distinction depends on `applicability rules'. The problem of `mixed terms' is partly a matter of judicial (...) pragmatics, partly to do with the character of applicability rules, and their extensiveness. Semantic realism versus semantic instrumentalism in respect of legal terms -- the latter preferred. Tendency to abstract terms in advanced legal orders. (shrink)

Case 1 reminds us that patients have duties too, while case 2 presents an instance of justified withholding of informationHow refreshing to read these two cases! No conjoined twins, fantastical chimeras, or other incredible scenarios at the fringes of medical reality. Each case highlights the practical and theoretical difficulties that doctors face in their everyday practice.Case 1: In case 1, the patient, who had declined an HIV test, changed his mind and requested an HIV test on the request form without (...) informing the doctor. The pathologist performed the tests and returned the results to the unsuspecting doctor, who duly investigated the matter. The doctor’s anxiety at the situation, as well as the worries of the entire practice and pathology laboratory, must have been deeply unpleasant. Thus the patient, no doubt unintentionally, caused much distress by requesting the HIV test. He was, at the very least, guilty of a lack of foresight and consideration. As a minimum, he should have informed the doctor of his last minute alteration. This would have enabled the doctor to discuss the implications of the test, to organise appropriate counselling, and, most importantly, to receive the results in full knowledge of the situation.As Dr Fraser points out, the experience of case 1 reinforces the importance of taking good medical notes. Even if the patient’s refusal had been documented in the notes, however, this would not have prevented him from requesting the HIV test, and indeed other tests, on the blood form. Pharmacists may still occasionally be faced with situations when they are unsure whether the doctor prescribed 10 capsules of a drug, or 110 capsules, as the patient may have added a “1” in front of the doctor’s original prescription. Similarly, how …. (shrink)

The public revelation in 2003 that medical students perform intimate examinations without patient consent has engendered much debate in the press and scientific journals. Using this case as a springboard for discussion, I will argue that medical schools should encourage students to raise their ethical concerns and call for a change of policy making it easier for students to do so. I will also address the question of medical students’ moral obligations towards their patients, and conclude that medical students ought (...) to express their discontent when faced with unethical practices or attitudes.In early January 2003, a study appeared in the British Medical Journal revealing that nearly a quarter of rectal and vaginal examinations on anaesthetised patients were performed by medical students without patient consent.1 Although the study did not generate the firestorm of controversy many expected, it engendered much discussion on ethical issues surrounding informed consent and patient autonomy, as well as stressing the need for greater ethics training for medical students. As an ethical problem, however, the case of intimate examinations is, to my mind, relatively uninteresting. If we agree that it is wrong for doctors to perform a vaginal examination on a conscious person without their consent, then it follows that it will still be …. (shrink)

Although telephone consultations are widely used in the delivery of healthcare, they are vulnerable to breaches of patient confidentiality. Current guidelines on telephone consultations do not address adequately the issue of confidentiality. In this paper, we propose a solution to the problem: a password system to control access to patient information. Authorised persons will be offered the option of selecting a password which they will use to validate their request for information over the telephone. This simple yet stringent method of (...) access control should improve security while allowing the continuing evolution of telephone consultations. (shrink)

Artykuł porusza kwestie determinizmu oraz wolnej woli. Zagadnienie to, jak się zdaje, pomimo upływu lat nadal budzi wiele emocji i pozostaje aktualne. Pytanie o ludzką wolność jest bowiem jednym z tych, od których odpowiedzi głęboko uzależnione jest nasze pojmowanie własnej egzystencji, ogólny obraz świata, stosunek do rozmaitych koncepcji metafizycznych, a także rozumienie takich pojęć jak: moralność, sprawiedliwość, wina, odpowiedzialność czy autonomia. Z determinizmem dodatkowo łączy się egzystencjalny lęk o to, czy jesteśmy w stanie panować nad własnymi decyzjami i czy życie (...) nasze, w związku z tym, nie jest li tylko igraszką w rękach losu. Celem niniejszego artykułu, którego inspiracją była analiza pism F. Nietzschego1, jest próba uzasadnienia stanowiska odrzucającego koncepcję wolnej woli jako swego rodzaju złu dzenia panującego w ogólnoludzkiej świadomości. W związku z tym, tekst w głównej mierze koncentruje się na argumentach negujących idee wolnej woli, w mniejszym zaś stopniu na tych, które mogłyby przemawiać za jej utrzymaniem: nie uwzględnia np. zagadnień związanych z fizyką kwantową czy zasadą Heisenberga. Zamiarem moim było zabranie głosu w sporze o wolną wolę i jednoznaczne opowiedzenie się za stanowiskiem deterministycznym w taki sposób, aby sprowokować Czytelnika do własnych przemyśleń, a nawet zainspirować do napisania własnego artykułu, w którym będzie On argumentował np. za utrzymaniem koncepcji wolnej woli poprzez wskazanie na błędy w moim rozumowaniu. W tekście staram się m.in. sformułować definicję wolnej woli, przedstawić jej genezę oraz konsekwencje wynikające z przyjęcia deterministycznej wizji świata. (shrink)

The subject of this article is the role of inductive reasoning (in the meaning of induction by incomplete enumeration) in the methodology of mathematics. The following types of induction have been distinguished: I 1) induction which causes formulation of axioms of different mathematical theories; I 2) enumerative induction which causes formulation of theorems on the basis of a finite number of cases; I 3) induction concerning the range of application of mathematical symbols; I 4) induction generalising the properties of finite (...) sets to the infinite case; I 5) induction pointing to analogies between problems belonging to different domains of mathematics. Inductive reasoning should not be put against the creativity of scientists, as induction is often an important, though not always conscious part of our cognition. The concept of notional metaphor can be useful for explaining the nature of inductive reasoning. With this concept, a general scheme of inductive reasoning has been proposed, which, in the opinion of the authors, is more adequate for presenting the nature of induction than traditional approaches. (shrink)

Pascal’s Wager is one of the most interesting and original arguments for the existence of God. It does not invoke advanced metaphysical concepts; instead, it employs the methods and concepts of probability calculus. Its argumentative power mainly rests on the appropriate interpretation of the determinants of human existence, which are taken to include our cognitive, moral and physical limitations. The article discusses different aspects of Pascal’s reasoning. In particular, it examines the wager in the context of Grace as something that (...) Pascal himself believed in. (shrink)

Case presentations, esthetics, insurance considerations, communicable diseases, referral questions, dental phobia, and legal concerns all play a role in doctor-patient relationships. These topics, and many others, are the subject of this one-of-a-kind resource, designed to show dental students and practitioners how to approach patient relationships.

W pierwszej części artykułu dokonano analizy pojęcia „panteizm”. Ze względu na stosunek pojęć „bóstwo” i „byt/świat” wyróżnione zostały następujące stanowiska: 1) bóstwo jest częściowo w sobie i jest częściowo we wszystkim; 2) bóstwo jest w całości we wszystkim; 3) wszystko jest w bóstwie, bez wyczerpywania jego zakresu i treści; 4) wszystko jest w bóstwie, wyczerpując jego zakres i treść. W drugiej części artykułu przytoczono poglądy ilustrujące i pogłębiające analizy wyjściowe. Poglądy te zaczerpnięto z literatury filozoficznej, teologicznej i pięknej: z tradycji (...) pozaeuropejskich teksty Lao-tsego, Zhuangzi, Bhagawadgita, z tradycji europejskiej – klasyczne dla panteizmu fragmenty: Plotyna, Spinozy, Heraklita, Hölderlina, Novalisa, Feuerbacha i innych, w tym poetów. W końcowej części artykułu sformułowano dwie tezy zarówno podsumowujące rozważania, jak i mające inspirować dalszą dyskusję. Pierwsza teza: jeśli przyjmuje się stanowiska i, to zatraca się specyficzność panteizmu. Teza druga: należy odróżnić panteizm właściwy, wyrazisty, dojrzały myślowo, tj. stanowiska i, natomiast stanowisk i nie uznawać za panteizm. (shrink)

cz. 1. Obserwacje i przeżycia własne -- cz. 2. Spotkania z myślą współczesną -- cz. 3. W stronę fizjologii.

Vincent proposes that the extracellular cGMP found in cerebellum after glutamate receptor activation is released mainly from Purkinje cells because in these neurons the presence of guanylate cyclase has been shown using monoclonal antibodies. It is uncertain, however, whether Purkinje cells are the only source of extracellular cGMP in the cerebellum. This commentary examines the possibility that glial and cerebellar granule cells may also participate in cGMP synthesis and release, Moreover, the hypothesis of transcellular metabolism of citrulline and arginine is (...) discussed. [VINCENT]. (shrink)

The present paper aims to investigate the causes of genocidal mobilization associated with the involvement of ordinary people. I discuss the “innocent causes” of criminal choices made by perpetrators who are not leaders, sadists or radicals. To this end, I compared three total genocides, of Armenians, Jews, Romani, Tutsi and Twa, and selected partial genocides. My analysis proves that entire nations or ethnic groups may be exterminated because many people make criminal choices which are motivated by values and norms that (...) in other circumstances would be considered acceptable or even commendable. These choices are made partly due to the structural pressure of circumstances and are partly derived from dispositions shaped in the course of primary and secondary socialization. Yet, they always require the reflexive mediation of “objective” social forces. (shrink)

The dominant approach in genocide studies focuses on the intentions and motives of mass murderers. However, in many cases, natural phenomena, pathogens and machines determine the nature and course of genocidal mobilization. The aim of this article is to present the advantages of the actor-network theory in explaining genocidal mobilization, taking into account environmental factors. “Natural objects” have been selected from a rich catalogue of non-human actors. The author divides these objects into three classes, showing that pathogens and deserts are (...) of key importance in the history of collective violence. Referring to specific cases, the author identifies that adopting the assumptions and methods of ANT reveals new aspects of the genocidal process. This indicates the need for considering the politics of non-human actors, delegating morality and law, tracking consecutive translations, rejecting the division into qualitatively different micro- and macro-actors, and tracking the emergence of new actants and forms of knowledge during genocide. (shrink)

In preparing for a lecture on the ethics of surgical complications, it became apparent that confusion exists about the definition of a ‘‘surgical complication.’’ Is it, as one medical website states, ‘‘any undesirable result of surgery?’’ [1]. In the European Journal of Surgery, Veen et al. [2] provide a more elaborate definition: ‘‘every unwanted development in the illness of the patient or in the treatment of the patient’s illness that occurs in the clinic’’ [2]. An esteemed historian of science suggests (...) yet another definition in a recent volume on surgical complications: ‘‘a complication, in any sphere of endeavour, is something out of the norm, and the product of extraneous and unexpected factors’’ [3]. Such is the discrepancy in definitions that Rampersaud et al. [4] declared in 2006 that ‘‘presently, there is no clear or consistent definition of a complication in the surgical literature.’’ Much research in surgery aims to reduce the risk of surgical complications. However, until we have a stable and agreed definition of what counts as a surgical complication, we cannot reliably compare different studies to discover what best reduces the chance of surgical complications [5]. Therefore, the topic is more than mere pedantry; defining surgical complications will help us with the broader question of how to improve surgical practice. A basic PubMed search returned nearly 800 articles with the phrases ‘‘surgical complications’’ or ‘‘surgical complication’’ in the title. But unlike the sources above. (shrink)

This article aims to present polemical exchanges over capital punishment that were conducted in interwar Poland. By using the analytical method and the source texts found in the press and the minutes of the Codification Committee, the author wants to trace the evolution of views on the death penalty and its usefulness in the state policy. The opinions on the subject differed considerably which was common not only for the interwar period. Back in the 19th century, when the first statements (...) on capital punishment had been published in newspapers, they had ended with completely different conclusions. Advocates for the abolition of the death penalty had emphasized first of all its ineffectiveness as well as the doubts of a religious and moral nature, which had led to a conclusion that the state could not take away a person’s life. Whereas supporters of the death penalty had believed that, in view of the low level of civilisation development of individual communities, giving up the possibility to impose the death sentence could have contributed to an uncontrolled rise in crime rates. They had also emphasized that public opinion demanded the retaining of capital punishment and acting against it would have resulted in various manifestations of public unrest. The death penalty had not been abolished in Poland during the interwar period but the exchange of arguments during those years had laid the foundations for the future changes in that area. They occurred at the end of the 20th century. (shrink)