Who should have a right to participate in a polity’s decision-making? Although the answers to this ‘boundary problem’ in democratic theory remain controversial, it is widely believed that the enfranchisement of tourists and children is unacceptable. Yet, the two most prominent inclusion principles in the literature – Robert Goodin’s ‘all (possibly) affected interests’-principle and the ‘all subjected to law’-principle – both enfranchise those groups. Unsurprisingly, democratic theorists have therefore offered several reasons for nonetheless exempting tourists and children from the franchise. (...) In this paper, I argue that their attempts fail. None of the proposed rationales can do the job without having unacceptable implications for the voting rights of other groups. I then develop a new specification of the affected interests-view, one that avoids such problems. According to my life plan-principle, a person is entitled to participate in a polity’s decision-making if and only if its decisions will actually affect her autonomously chosen life plans, or prevent her from developing or revising plans of that kind. I show that this principle straightforwardly avoids enfranchising tourists and children, and thus improves upon its two prominent rivals. The paper ends by considering and rejecting two objections to my new principle. (shrink)

Even though the phenomenon of gentrification is ever-growing in contemporary urban contexts, especially in high income countries, it has been mostly overlooked by normative political theorists and philosophers. In this paper we examine the normative dimensions of gentrification through the lens of food. By drawing on Huber and Wolkenstein’s (Huber and Wolkenstein, Politics, Philosophy & Economics 17:378–397, 2018) work, we use food as an example to illustrate the multiple ways in which life plans can be located and to argue (...) that both existing residents and newcomers have an interest in occupancy rights. More specifically, while newcomers have an interest in moving freely to new neighbourhoods in order to purse their preferred life plans, they also have an interest in being able to continue to pursue those life plans once they have acquired them, and this requires occupancy rights and the implementation of measures aimed at regulating and slowing down gentrification. Moreover, when residents belong to already disadvantaged groups, more significant anti-gentrification measures can be implemented in order to prevent injustices from being compounded. (shrink)

When philosophers undertake to say what it is that makes life worth living, they generally display a procrustean habit of thought which the practice of philosophy itself does much to encourage. As a result, they arrive at an image of the human good that is far more controversial than they suspect. The canonical view among philosophers ancient and modern has been, in essence, that the life lived well is the life lived in accord with a rational (...) class='Hi'>plan. To me this conception of the human good seems manifestly wrong. The idea that life should be the object of a plan is false to the human condition. It misses the important truth which Proust, by contrast, discerned and made into one of the organizing themes of his great meditation on disappointment and revelation, A la recherche du temps perdu : The happiness that life affords is less often the good we have reason to pursue than the good that befalls us unexpectedly. (shrink)

Ageing has become a central topic of medical ethical debates, e.g. regarding autonomy and care in geriatric practice, the just distribution of healthcare or the implications of anti-ageing medicine. In all these debates, however, particular conceptions of ageing are tacitly presupposed. The aim of my research is to develop an explicit understanding of the relevance of ageing for ethical reasoning, providing a conceptual framework for discussing concrete medical ethical problems in a more comprehensive and reflected manner. I proceed from the (...) life course approach, assuming that our life is shaped by a time regime defined and implemented by social institutions and structures, reflected in cultural images, and internalized as an “inner clock” directing individual decisions. From the ethical viewpoint, two concepts appear particularly significant: In a deontological perspective, the idea of “age norms”, social standards of age-appropriate behavior, becomes relevant. In a teleological perspective focusing on individual flourishing and good life, the concept of life plans, comprising age-related self-images and expectations, is important. I will briefly sketch the current medical ethical debates around ageing, then delineate the life course perspective and its implications for ethical reasoning, and finally exemplify its theoretical potential regarding medical ethical controversies about long time care, resource allocation and life extension. (shrink)

Aristotle claims at Eudemian Ethics 1.2 that everyone who can live according to his own choice should adopt some goal for the good life, which he will keep in view in all his actions, for not to have done so is a sign of folly. This is an opinion shared by other ancients as well as some moderns. Others believe, however, that this view is false to the human condition, and provide a number of objections: (1) you can’t (...) class='Hi'>plan love; (2) nor life’s surprises; (3) planning a whole life is of no use since the world changes too much; (4) as do our values; and (5) planning a life is something only dreary people would do. The aim of this paper is to examine these objections, as part of a broader attempt to defend the relevance of a eudaimonistic approach to the question of how to live well. (shrink)

Background:Despite the growing body of knowledge about surrogate decision making, we know very little about the use of ethical frameworks (including ethical theories, principles, and concepts) to understand surrogates’ day-to-day experiences in end-of-life care planning for incapacitated adults.Objectives and Methods:This qualitative systematic review was conducted to identify the types of ethical frameworks used to address surrogates’ experiences in end-of-life care planning for incapacitated adults as well as the most common themes or patterns found in surrogate decision-making research.Findings:Seven research (...) papers explicitly identified ethical theories, principles, or concepts, such as autonomy, substituted judgment, and best interest standards as guidelines for the research. Surrogate decision making themes included the responsibilities and goals of being a surrogate, factors influencing surrogates’ decision making, outcomes for surrogates, and an overarching theme of “wanting to do the right thing” for their loved one and/or themselves.Discussion:Understanding the complexity of surrogates’ experiences of end-of-life care planning is beyond the scope of conventional ethical frameworks.Conclusion:Ethical frameworks that address individuality and contextual variations related to decision making may more appropriately guide surrogate decision-making research that explores surrogates’ end-of-life care planning experiences. (shrink)

How we live our lives depends on how we relate to our past, present and future. The article focusses on the relation to our future. The target of my critique is a “planning conception” that imagines the future as a realm that we can rationally plan and form in light of our ends. In the first section I present an outline of the planning conception, building on Bratman’s planning theory and Rawls’ idea of a life plan. The (...) second section highlights the attractions of the planning conception. I argue that this conception offers a prima facie intriguing view of the temporality of human life. It promises a life in which we can control the passage of time. The third section reveals severe limitations of the planning conception. I question the claim that plans are central to our self-understanding and to a good life. The planning conception tends to distort the temporality of human life with respect to past, present and future. Given this diagnosis, I sketch an alternative in the last section of the paper. I explore the temporal specifics of ways of understanding oneself as a person and argue that both the formation and the very form of these ‘ways of being’ do not follow the logic of planning. (shrink)

Es bien conocido el aprecio que desde hace tiempo tiene la Iglesia por el método ver-juzgar-actuar, sin embargo, las reflexiones de la filosofía y la sociología hacen considerar hoy la necesidad de enriquecer el momento del ver, con unos elementos fenomenológicos y hermenéuticos que lo hagan más histórico y menos objetivista y de lograr además una mayor interacción entre los tres momentos. En este sentido, la investigación propone la inserción de las historias de vida de las personas y las comunidades (...) como un camino nuevo de conocimiento de la realidad. En efecto, la realidad no sólo consiste en el hecho desnudo, sino también en el hecho tal y como lo percibe el sujeto; no sólo es suceso, sino también narración. Así, las historias de vida, y el consecuente método autobiográfico constituyen, según la investigación, un recurso vital en la planificación pastoral; no simplemente un apéndice secundario o un recurso simplemente aplicativo, sino, un momento intrínseco de la reflexión y de la experiencia teológica y pastoral. It is well-known the log lasting appreciation of the church for the method see-judge-act, however the current philosophical and sociological considerations are considering the need for an enrichment of the moment of seeing with some phenomenological and hermeneutical elements which could make it more historical and less objective and to achieve, moreover, a major interaction among the three moments. In this sense, the research proposes also the introduction of the stories of people’s lives and of the communities as a new way of awareness of reality. Indeed, reality is not only in the naked event, but also in the event as it is seen by the subject; not only the happened event, but also its narration. For this reason, the life stories and the autobiographical method are, according to the research a vital resource in the pastoral planning; not simply a secondary appendix or a applicative type, but as an intrinsic moment of the theological and pastoral reflection and experience. (shrink)

This book examines the relevance of modern medicine and healthcare in shaping the lives of elderly persons and ageing societies. Combining individual and social dimensions, Planning Later Life discusses the ethical, social, and political consequences of increasing life expectancies and demographic change in the context of biomedicine and public health. By focusing on the field of biomedicine and healthcare, the authors engage readers in a dialogue on the ethical and social implications of recent trends in dementia research and (...) care, advance healthcare planning, or the rise of anti-ageing medicine and prevention. Bringing together the largely separated debates of individualist bioethics on the one hand, and public health ethics on the other, the volume deliberately considers the entanglements of envisioning, evaluating, and controlling individual and societal futures. The process of devising and exploring the various positive and negative visions and strategies related to later life is rarely reflected systematically from a philosophical, sociological, and ethical point of view. As such, this book will be crucial to those working and studying in the life sciences, the humanities, and the social sciences, particularly in the areas of bioethics, social work, gerontology and aging studies, healthcare and social service, sociology, social policy, and geography and population studies. (shrink)

Predictive medicine presents opportunities to consider later life under conditions of illness, such as dementia. This paper examines how family caregivers (N = 27) assess the opportunity of prediction and early diagnosis of dementia for oneself based on their particular experience. Furthermore, it compares their attitudes with laypersons’ attitudes (N = 43) towards genetic testing of APOE. By this, we elaborate how much personal experience impacts anticipation and affects, but also moral attitudes towards predictive medicine. Differences in our settings (...) do not allow for direct comparison, so our analysis focuses on multiple similarities in the assessments of predictive (non-genetic vs. genetic) testing. Groups’ reasoning showed also differences influenced mainly by personal experience. Family caregivers addressed more responsibility towards family and had more hopes into medical treatments. To cope with the disease, they expressed expectations to start with medicine and care decisions as early as possible. Laypersons, however, stressed self-determination more and expressed worries about the influence of the pharmaceutical industry by referring to unnecessary medication and, implicitly, the medicalization of aging. (shrink)

Physicians and families need to interact more meaningfully to clarify the values and preferences at stake in advance care planning. The current use of advance directives fails to respect patient autonomy. This paper proposes using the family covenant as a preventive ethics process designed to improve end-of-life planning by incorporating other family members—as agreed to by the patient and those family members—into the medical care dialogue. The family covenant formulates advance directives in conversation with family members and with the (...) assistance of a physician, thereby making advance directives more acceptable to the family, and more intelligible to other physicians. It adds the moral force of a promise to the obligation of respecting a patient’s preferences about end-of-life care. These negotiations between patient, family, and physician, from early planning phases through implementation, should greatly reduce the incidence of family disagreements on what the patient would have wanted. The family covenant ensures advance directive discussions within the family, promotes and respects the autonomy of other family members, and might even spur others in the family to complete advance directives through additional covenants. The family covenant holds the potential to transform moral quagmires into meaningful moral conversation. J Am Geriatr Soc 51:1155–1158, 2003. (shrink)

This text intends to show a kind of aprproach and introduction to Deleuze's work. Based on the problem of the non-existence of consensus in the world of life, we feel the need to start thinking and formulating the concept of virtual multiplicity. Then we present a kind of guide to do so. The solution to the problem of plurality and difference is the concept of forms of life formulated and thought in acordance with Deleuze.O texto pretende mostrar um (...) tipo de abordagem e de entrada no texto deleuziano. A partir do problema do fato da não existência de consenso no mundo da vida sentiu-se a necessidade de começar a pensar e formular um conceito de formas de vida. Escolheu-se, para isto, a idéia de plano de imanência e o conceito de multiplicidade virtual de Deleuze. Apresentamos, então, uma espécie de roteiro desse percurso. É o conceito de formas de vida, articulado e pensado a partir de Deleuze, a resposta ao problema da pluralidade e da diferença. (shrink)

An emerging ethical philosophy in marketing is developing. This philosophy is based on quality-of-life studies which are becoming an important topic of research in behavioral and social sciences (basic and applied research). This paper addresses the QOL orientation in marketing from a decision-making perspective. Specifically, this paper shows how marketers can engage in strategic marketing planning guided by the QOL concept.

Explores the acquisition and use of knowledge for human purposes and the extent of our ability to shape the future through the design, regulation, and restructuring of the lives of human systems at all levels.

A number of influential reports on influenza pandemic preparedness include recommendations for extra-autonomous decisions to withdraw mechanical ventilation from some patients, who might still benefit from this technology, when demand for ventilators exceeds supply. An unintended implication of recommendations for nonvoluntary and involuntary termination of life support is that it make pandemic preparedness plans vulnerable to patients’ claims for assisted suicide and active euthanasia. Supporters of nonvoluntary passive euthanasia need to articulate why it is both morally different and morally (...) superior to voluntary active euthanasia if they do not wish to invite expansion of end-of-life options during health system catastrophe. (shrink)

What sense could it make to describe your life as ‘unlivable’? What is it not only to be alive but to have a life that you live or lead? I answer by developing a social understanding of the pursuit of meaning in life. True to other uses of ‘meaning,’ I propose, meaning in a life is communicative. If you experience your life as ‘unlivable,’ recovery can lie in this communicative dynamic: you regain the experience of (...) leading your life by letting others remind you of meanings you have communicated to them in leading it. My argument develops an analogy between two dimensions in which you project an investment – a care, concern, love, or the like – when you form an intention or plan. Intrapersonally, you project your investment as communicatively intelligible to your own future self at ‘plan’s end.’ Interpersonally, you project it as communicatively intelligible to others who might come to love this thing that you love simply because you love it, as an expression of love for you. The normativity of meaning in your life puts rational pressure on you not only to abandon investments that you cannot communicate but to experience the meaning in investments that you retain. (shrink)

PurposeAdvance directives have been criticized for failing to help physicians make decisions consistent with patients’ wishes. This pilot study sought to determine if an interactive, computer-based decision aid that generates an advance directive can help physicians accurately translate patients’ wishes into treatment decisions.MethodsWe recruited 19 patient-participants who had each previously created an advance directive using a computer-based decision aid, and 14 physicians who had no prior knowledge of the patient-participants. For each advance directive, three physicians were randomly assigned to review (...) the advance directive and make five to six treatment decisions for each of six (potentially) end-of-life clinical scenarios.From the three individual physicians’ responses, a “consensus physician response” was generated for each treatment decision (total decisions = 32). This consensus response was shared with the patient whose advance directive had been reviewed, and she/he was then asked to indicate how well the physician translated his/her wishes into clinical decisions.ResultsPatient-participants agreed with the consensus physician responses 84 percent (508/608) of the time, including 82 percent agreement on whether to provide mechanical ventilation, and 75 percent on decisions about cardiopulmonary resuscitation (CPR).Across the six vignettes, patient-participants’ rating of how well physicians translated their advance directive into medical decisions was 8.4 (range = 6.5-10, where 1 = extremely poorly, and 10 = extremely well). Physicians’ overall rating of their confidence at accurately translating patients’ wishes into clinical decisions was 7.8 (range = 6.1-9.3, 1 = not at all confident, 10 = extremely confident).ConclusionFor simulated cases, a computer-based decision aid for advance care planning can help physicians more confidently make end-of-life decisions that patients will endorse. (shrink)

Simonet, Emanuel Nicolas Cortes Advance care planning is a significant and important process of end-of-life care. It provides the opportunity for persons to express their medical treatment preferences prior to losing the capacity to decide for themselves. It also allows for the appointment of substituted decision maker to make medical decisions for persons who have lost capacity. Whilst advance care planning can be beneficial when it is used effectively, the legislative framework surrounding advance care planning is complex and confusing. (...) This brief article will summarise advance care planning, its current legislative framework in Victoria and how proposed recommendations offered by the Inquiry into end of life choices may simplify advance care planning. (shrink)

Defending Life is arguably the most comprehensive defense of the pro-life position on abortion - morally, legally, and politically - that has ever been published in an academic monograph. It offers a detailed and critical analysis of Roe v. Wade and Planned Parenthood v. Casey as well as arguments by those who defend a Rawlsian case for abortion-choice, such as J. J. Thomson. The author defends the substance view of persons as the view with the most explanatory power. (...) The substance view entails that the unborn is a subject of moral rights from conception. While defending this view, the author responds to the arguments of thinkers such as Boonin, Dworkin, Stretton, Ford and Brody. He also critiques Thomson's famous violinist argument and its revisions by Boonin and McDonagh. Defending Life includes chapters critiquing arguments found in popular politics and the controversy over cloning and stem cell research. (shrink)

According to the popular Whole Life Satisfaction theories of happiness, an agent is happy when she judges that her life fulfils her ideal life-plan. Fred Feldman has recently argued that such views cannot accommodate the happiness of spontaneous or pre-occupied agents who do not consider how well their lives are going. In this paper, I formulate a new Whole Life Satisfaction theory which can deal with this problem. My proposal is inspired by Michael Smith’s advice-model (...) of desirability. According to it, an agent is happy when a more informed and rational hypothetical version of her would judge that the agent’s actual life matches the best life-plan for her. This view turns out to be a flexible model which can avoid many problems of the previous theories of happiness. (shrink)

Eight principles to take responsibility for your life"--Provided by publisher.

Life Takes Place argues that, even in our mobile, hypermodern world, human life is impossible without place. Seamon asks the question: why does life take place? He draws on examples of specific places and place experiences to understand place more broadly. Advocating for a holistic way of understanding that he calls "synergistic relationality," Seamon defines places as spatial fields that gather, activate, sustain, identify, and interconnect things, human beings, experiences, meanings, and events. Throughout his phenomenological explication, Seamon (...) recognizes that places are multivalent in their constitution and sophisticated in their dynamics. Drawing on British philosopher J. G. Bennett's method of progressive approximation, he considers place and place experience in terms of their holistic, dialectical, and processual dimensions. Recognizing that places always change over time, Seamon examines their processual dimension by identifying six generative processes that he labels interaction, identity, release, realization, intensification, and creation. Drawing on practical examples from architecture, planning, and urban design, he argues that an understanding of these six place processes might contribute to a more rigorous place making that produces robust places and propels vibrant environmental experiences. This book is a significant contribution to the growing research literature in "place and place making studies.". (shrink)

In this article I review the principal arguments in favour of and against the UK government’s recent proposals to allow access to NHS patient records to life sciences companies as part of the NHS–Life Sciences partnership scheme.

The great urbanist Jane Jacobs details how urban planning impacts the social interactions and social networks responsible for the economic death or life of a city. How might urban planning impinge on the moral values that underlie that development? I draw on Jacobs’s work on the moral foundations of commercial society to identify two “urban values” (tolerance and innovation). I then examine how these values support the social networks and processes that facilitate urban-based innovation and how urban planning can (...) strengthen or undermine those values. I use the examples of urban planning in the 15th Ward of Syracuse, New York and of city building in the private development of Cayalá in Guatemala City to illustrate these points. (shrink)

The Second World War and its associated political events of a national and global scale brought new circumstances, which was considerably influenced the development processes of Tehran. During World War II, Iran hoped that Washington would keep Britain and the Soviet Union from seizing control of the country’s oil fields. In 1951 and 1952 Truman worked with Iranian Prime Minister, though unsuccessfully, to regain some of those lost oil rights for Iran. By the late 1950s and President Kennedy’s presidency, he (...) used aid as leverage for social reform. During the early years of 1960s, the Kennedy Administration was urging its allies in the third world to carry out necessary reforms in order to prevent popular discontent and enhance the dominant ideology of ‘modernism’. In 1968, a major piece of legislation, the Urban Development and Renewal Act, enabled the municipality to implement Tehran’s Comprehensive Plan (TCP 1968), which integrated all the elements of a 1960s’ American city such as the separation of functions, highways, suburbs, shopping centers and housing area. The export of these American cities principles can only be understood from the background of the Cold War period, in which the east and west were both competing for cultural colonization of Middle Eastern strategically important cities like Tehran. During this period, the new developments supported by the oil boom of 1970s, were built in different forms to constitute an expanding metropolis. In 1974, the second “International Congress of Architecture” with the theme of “Toward a Quality of Life” held at Persepolis and brought together all leading world architects and planners to review Iran’s progress in its professional response to the challenges posed by increasing oil revenues. This research aims to represent the export of planning as a political means of cultural colonization of the Third World during the cold war period. (shrink)

Advance care planning is a process that encourages people to identify their values, to reflect upon the meanings and consequences of serious illness, to define goals and preferences for future medical treatment and care, and to discuss these goals with family and health-care providers. Advance care planning is especially important for those who are chronically ill, as patients and their families face a variety of complex healthcare decisions. Participating in advance care planning has been associated with improved outcomes; yet, despite (...) over 25 years of public awareness campaigns, research, and interventions developed to increase participation, advance care planning completion rates for people with chronic illnesses are no different than those in the general public (approximately 25%).Advance care planning has traditionally used an individualistic approach to autonomy, which puts forward an understanding of agents as independent, rational and self-interested persons. Because this individualistic approach has been largely unsuccessful in improving advance care planning uptake, a re-examination of the philosophical underpinnings of this practice and an exploration of alternative frameworks is warranted. In offering this exploration, we briefly outline two current perspectives on autonomy: the individualistic view and the relational view as articulated by feminist philosophers. Using a critical examination of the theoretical and empirical work on this topic, we argue that the individualistic view of autonomy does not sufficiently capture the relational and social complexities of the decision-making process of advance care planning. To offer a counterpoint, we examine the relational view of autonomy and suggest that this perspective is better aligned with the process of advance care planning. Specifically, we demonstrate that a relational model of autonomy is well suited to exploring advance care planning for four main reasons: (1) it recognizes the importance of relationships, (2) it reflects the fluctuating nature of autonomy in chronic illness, (3) it recognizes vulnerability, and (4) it is consonant with empirical work examining the advance care planning process. (shrink)

As workforce aging continues through the next decade, the number of persons who will retire from long-held jobs and careers will increase. In recent years, researchers across disciplines of psychology have focused attention on the impact of the retirement process on post-retirement adjustment and well-being. One area that has received attention from investigators in both psychology and economics pertains to the impact of retirement planning on the retirement decision and post-retirement adjustment. The objective of the current review is twohreefold. The (...) first goal is to review the literature on retirement planning with attention to past conceptualizations and current theoretical specifications. Second, empirical work investigating the psychological antecedents of retirement planning is reviewed. The primary conclusion reached from this review is that, conceptually, retirement planning continues to be poorly delineated and, thereby, narrowly investigated. Empirically, cognitive antecedents of retirement planning continue to figure prominently in both workplace and retirement researches. The boundary conditions of retirement planning, as well as alternative mechanisms for adult wellbeing, are discussed. Specifically, retirement planning’s meaning amidst increasing job mobility and longer life expectancies are identified as two complementary areas for future empirical integration of work - retirement research domains. (shrink)

TWO OBJECTIONS are often levelled against Aristotle's theory of practical inference. The first is that he fails to discuss adequately the nature of reasoning about the ends of good living. Thus, while there is no shortage of examples of technical deliberation, such as how a doctor deliberates to bring about healing, we have no comparable examples of how a person of determinate character deliberates to promote the ends of that character. The second is that while Aristotle has an account of (...) how we reason to a decision to act now, he lacks a more general account of intention that can accommodate both present intention and future intention--that is, intending now to act later. The two challenges, I want to argue, are related, though often not by the objectors. Deliberation about how best to live over the course of a life requires a continuing interest in one's future self and a capacity to decide upon future ends that constrain the present and are constrained by it. An Aristotelian conception of the good life, with its intrinsic sense of completeness and unity, requires this close knit of present and future. But if this is so, then the capacity to deliberate about the future and to regulate the present in light of future plans will be particularly urgent in the case of living such a life. Deliberation about future intentions should, if anywhere, play a prominent role here. It will be a severe limitation on Aristotle's view if his account of deliberation precludes such a role for practical reason. (shrink)

We are morally obligated to plan for disaster because it affects human life and well-being. Because contemporary disasters affect the public, such planning should be public in democracies and it should not violate the basic ethical principles of normal times. Current Avian Flu pandemic planning is restricted to a response model based on scarce resources, or inadequate preparation, which gives priority to some lives over others. Rather than this model of ‘Save the Greatest Number,’ the public would be (...) more ethically served by a model of ‘Save All Who Can Be Saved,’ which is based on adequate preparation. And where events exceed adequate preparation, scarce resources should be allocated fairly. (shrink)

Background:A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population.Research aim:To identify challenges in implementing the ‘Let Me Decide’ advance care planning programme in long-term-care.Research design:This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families.Participants and research context:long-term-care residents in two nursing homes and one community hospital.Ethical considerations:The local research ethics committee granted ethical approval.Findings:Following implementation, over (...) 50% of all residents had completed some form of end-of-life care plan. Of the 70 residents who died in the post-implementation period, 14% had no care plan, 10% (with capacity) completed an advance care directive and lacking such capacity, 76% had an end-of-life care plan completed for them by the medical team, following discussions with the resident (if able) and family. The considerable logistical challenge of releasing staff for training triggered development of an e-learning programme to facilitate training.Discussion:The challenges encountered were largely concerned with preserving resident’s autonomy, avoiding harm and suboptimal or crisis decision-making, and ensuring residents were treated fairly through optimisation of finite resources.Conclusions:Although it may be too late for many long-term-care residents to complete their own advance care directive, the ‘ Let Me Decide’ programme includes a feasible and acceptable option for structured end-of-life care planning for residents with variable capacity to complete an advance care directive, involving discussion with the resident (to the extent they were able) and their family. While end-of-life care planning was time-consuming to deliver, nursing staff were willing to overcome this and take ownership of the programme, once the benefits in improved communication and enhanced peace of mind among all parties involved became apparent in practice. (shrink)

American biologists in the late nineteenth century pioneered the descriptive-comparative study of all cell divisions from zygote to gastrulation -- the cell lineage. Data from cell lineages were crucial to evolutionary and developmental questions of the day. One of the main questions was the ultimate causation of developmental patterns -- historical or mechanical. E. B. Wilson's groundbreaking lineage work on the polychaete worm Nereis in 1892 set the stage for (1) an attack on Haeckel's phylogenetic-historical notion of recapitulation and (2) (...) support for mechanistic explanations of cleavage patterns. As more lineage work -- especially Lillie's work on "Unio" and Conklin's on "Crepidula" -- became available in the mid-late 1890s, mechanism was tempered with more evolutionary, homology-based views. However, as I show by focusing on three major issues -- homology, body plans and life history -- these views were primarily based on the precocious segregation and prospective significance -- what the cell became not what it was. Even on issues like adaptation, most lineagists argued teleologically from the adult backward. Most cell lineage workers, by 1900, were to varying degrees mechanist/experimentalist and recapitulationist simultaneously. The exception was E. G. Conklin, whose views were more akin to a Darwinian evolutionist than either mechanist or recapitulationist. Lineage work eventually declined and by 1907 published accounts of new lineages had basically stopped. I argue that established workers and younger researchers stopped wanting to take on cell lineage projects because the general patterns were the same for all the spiralians while the specifics showed too much variation. It was hard to theoretically encompass or analyze the minutiae of variation in a recapitulationist or mechanist framework. The only established worker who continued to do comparative lineage studies was E. G. Conklin, perhaps because the variation could best be accommodated by Darwinian evolution. (shrink)