PURPOSE: To evaluate the effects of social support on comprehension and recall of consent form information in a study of Parkinson disease patients and their caregivers.DESIGN and METHODS: Comparison of comprehension and recall outcomes among participants who read and signed the consent form accompanied by a family member/friend versus those of participants who read and signed the consent form unaccompanied. Comprehension and recall of consent form information were measured at one week and one month respectively, using Part A of the (...) Quality of Informed Consent Questionnaire .RESULTS: The mean age of the sample of 143 participants was 71 years . Analysis of covariance was used to compare QuIC scores between the intervention group and control group . In the 1-week model, no statistically significant intervention effect was found . However, the intervention status by patient status interaction was statistically significant . In the 1-month model, no statistically significant intervention effect was found . Again, however, the intervention status by patient status interaction was statistically significant . At both time periods, intervention group patients scored higher on the QuIC than did intervention group caregivers, and control group patients scored lower on the QuIC than did control group caregivers.IMPLICATIONS: Social support played a significant role in enhancing comprehension and recall of consent form information among patients. (shrink)

Background: Thrombolytic drugs to treat an acute ischaemic stroke reduce the risk of death or major disability. The treatment is, however, also associated with an increased risk of potentially fatal intracranial bleeding. This confronts the patient with the dilemma of whether or not to take a risk of a serious side effect in order to increase the likelihood of a favourable outcome. Objective: To explore acute stroke patients’ perception of risk and willingness to accept risks associated with thrombolytic drug treatment. (...) Design: Eleven patients who had been informed about thrombolytic drug treatment and had been through the process of deciding whether or not to participate in a thrombolytic drug trial went through repeated qualitative, semistructured interviews. Results: Many patients showed a limited perception of the risks connected with thrombolytic drug treatment. Some perceived the risk as not relevant to them and were reluctant to accept that treatment could cause harm. Others seemed to be aware that treatment would mean exposure to risk. The patients’ willingness to take a risk also varied substantially. Several statements revealed ambiguity and confusion about being involved in a decision about treatment. The patients’ reasoning about risk was put into the context of their health-related experiences and life histories. Several patients wanted the doctor to be responsible for the decisions. Conclusion: Acute stroke patients’ difficulties in perceiving and processing information about risk may reduce their ability to be involved in clinical decisions where risks are involved. (shrink)

Category-specific impairments of object recognition and naming are among the most intriguing disorders in neuropsychology, affecting the retrieval of knowledge about either living or nonliving things. They can give us insight into the nature of our representations of objects: Have we evolved different neural systems for recognizing different categories of object? What kinds of knowledge are important for recognizing particular objects? How does visual similarity within a category influence object recognition and representation? What is the nature of our semantic knowledge (...) about different objects? We review the evidence on category-specific impairments, arguing that deficits even for one class of object cannot be accounted for in terms of a single information processing disorder across all patients; problems arise at contrasting loci in different patients. The same apparent pattern of impairment can be produced by damage to different loci. According to a new processing framework for object recognition and naming, the hierarchical interactive theory, we have a hierarchy of highly interactive stored representations. HIT explains the variety of patients in terms of lesions at different levels of processing and different forms of stored knowledge used both for particular tasks and for particular categories of object. Key Words: category-specific deficits; functional imaging; hierarchical models; interactive activation models; neuropsychology; object recognition; perceptual and functional knowledge. (shrink)

We summarise and respond to the main points made by the commentators on our target article, which concern: whether structural similarity can play a causal role in normal object identification and in neuropsychological deficits for living things, the nature of our structural knowledge of the world, the relations between sensory and functional knowledge of objects, and the nature of our functional knowledge about living things, whether we need to posit a “core” semantic system, arguments that can be marshalled from evidence (...) on functional imaging, the causal mechanisms by which category differences can emerge in object representations, and the nature of our knowledge about categories other than living and nonliving things. We also highlight points raised in our article that seem to be accepted. (shrink)

Background: Informed consent is regarded as a contract between autonomous and equal parties and requires the elements of information disclosure, understanding, voluntariness and consent. The validity of informed consent for critically ill patients has been questioned. Little is known about how these patients experience the process of consent.Objective: The aim of this study was to explore critically ill patients’ experience with the principle of informed consent in a clinical trial and their ability to give valid informed consent.Design: 11 stroke patients (...) who had been informed about thrombolytic treatment and had been through the process of deciding whether or not to participate in a thrombolysis trial went through repeated qualitative semistructured interviews.Results: None of the patients had any clear understanding of the purpose of the trial. Neither did they understand the principles of randomisation and voluntariness. Reasons for giving or not giving consent were trust, conceptions of benefits and risks and altruism. Several patients found it immoral to involve patients in the consent procedure and argued that this was the doctors’ responsibility. Others argued that it is a duty to question patients and perceived it as a sign of being treated with respect and dignity. A majority of the patients found the consent process vague and ambiguous.Conclusions: The results indicate that the principle of informed consent from critically ill patients cannot be seen as a contract between equal and autonomous parties. Further studies are needed to explore critically ill patients’ experiences with the process of informed consent. (shrink)

This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.

Transcranial magnetic stimulation, EEG, and behavioral studies by our group implicate spurious activation of speech perception neurocircuitry in the genesis of auditory hallucinations in schizophrenia. The neurobiological basis of these abnormalities remains uncertain, however. We review our ongoing studies, which suggest that altered cortical coupling underlies speech processing in schizophrenia and is expressed via disrupted gamma resonances and impaired corollary discharge function of self-generated verbal thought.

Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case (...) and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK.Results: Survey respondents ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision-making capacity , disagreement among caregivers and limitation of treatment at the end of life . The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct , someone capable of providing specific advice , help in weighing outcomes and clarification of the issues . Few of the types of help expected to be useful varied among countries.Conclusion: Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. (shrink)

BackgroundThere is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality.MethodsA partially blinded, randomized, controlled multi-center study (...) was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts.ResultsSixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (−8.5%) and non-mentored (−13.9%) residents (p = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p = 0.001), understanding of manuscripts (3.73 vs 2.87; p = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p = 0.005) compared to non-mentored residents. There was no difference between groups in level of interest in peer review (3.00 vs 3.09; p = 0.72) or the quality of manuscript review assessed by the Review Quality Instrument (RQI) (3.25 vs 3.06; p = 0.50).ConclusionsWe used mentored peer review of standardized manuscripts to teach biostatistics and research methodology and introduce the peer review process to residents. Though knowledge level did not change, mentored residents had enhanced perception in their abilities to understand research methodology and manuscripts and apply study results to clinical practice. (shrink)

In The Ethics of Food, Gregory E. Pence brings together a collection of voices who share the view that the ethics of genetically modified food is among the most pressing societal questions of our time. This comprehensive collection addresses a broad range of subjects, including the meaning of food, moral analyses of vegetarianism and starvation, the safety and environmental risks of genetically modified food, issues of global food politics and the food industry, and the relationships among food, evolution, and human (...) history. (shrink)

For as long as there has been anything called “the philosophy of action,” its practitioners have accounted for action in terms of an associated kind of explanation. The alternative to this approach was noticed, but not adopted, by G. E. M. Anscombe. Anscombe observed that a series of answers to the reason-requesting question “Why?” may be read in reverse order as a series of answers to the question “How?” Unlike answers to the question “Why?”, answers to the question “How?” are (...) not explanatory of what they are about: they reveal, not reasons for doing something, but ways of doing something, and they have the form of what Aristotle called a practical syllogism. The alternative to theorizing action in terms of explanation, is, thus, to theorize it in terms calculation. In exploring this alternative, I argue for three main theses: first, that (pace Anscombe) it is not a matter of indifference whether we theorize action in terms of the question “Why?” or in terms of the question “How?”; second, that the question “Why?” is a question for an observer of action (the agent already knows the answer and can learn nothing from the inquiry), whereas the question “How?” is a question for the agent—and moreover, one that the agent must answer in order to achieve any end whatsoever—so that part of what is at stake is the standpoint from which action is to be theorized; and finally, that the standpoint of the agent, revealed by the question “How?”, is prior to that of an observer. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Controversy Between Schelling and Jacobi LEWIS S. FORD SCHELLING, ALONGWITH FICHTE, has suffered the fate of being labelled one of tIegel's predecessors. Richard Kroner provides the classic expression of this viewpoint in his monumental study, Von Kant bis Hegel, which examines Schelling's thought primarily for its contribution to Hegel's final synthesis.I In English we have Josiah Royce's sympathetic and lively account of Schelling's early romantic exuberance, regarded (...) as a transitional stage in the development of German idealism. 2 But this emphasis on the early ScheUing has led to an unfortunate neglect of his work subsequent to the break with Hegel in 1807. Schelling's romanticism, so ably documented by E. D. Hirsch, Jr., 3 can only be regarded as one phase in the total sweep of his thought, for, after the break with Hegel, Schelling produced at least three major works: the essay •ber das Wesen der menschlichen Freiheit,4 wrestling with the problem of evil and human freedom, the fragmentary Weltalter, 5 which in scope and dialectical intricacy should be compared with Hegel's Logic, and the Philosophie der Mythologie und Offenbarung, 6 furnishing a fundamental critique of the whole dialectical enterprise. Save for the essay on human freedom, however, none of these works were published during his lifetinm, as Schelling withdrew from the public eye after his controversies with Hegel and Jacobi. Thus the publishing histories of Schelling and Hegel are exactly reverse. Schelling rushed into print his early speculative gropings, while Hegel suppressed his/making the Ph~nomenologic des Geistes his first major publication. Then while Hegel's Logic and Encyclopedia were being publicly acclaimed, Schelling remained silent. This accident of history is largely responsible for the illusion that Schelling is the older of the two x (Tiibingen: J. C. B. Mohr, 1921-24),2 vols. 2The Spirit of Modern Philosophy (Boston: Houghton Mifflin, 1892), Lecture VI, 164-189. Wordsworth and ScheUing, A Typological Study of Romanticism (New Haven: Yale University Press, 1960),Yale Studies in English, Vol. CXLV. 4Friedrich Wilhelm Joseph yon Sehelling, Philosophische Untersuchungen i~berdas Wesen der menschlichen Freyheit und die damit zusaramenhdngenden Gegenstdnde, 1809. Reprinted in the Sdmmtliche Werke, Erste Abtheilung, VII. Band (Stuttgart und Augsburg: J. G. Cotta, 1856), 331-416. English translation by James Gutmann: Of Human Freedom (Chicago: Open Court, 1936). 5Three fragmentary versions of the Weltalter have been published. The Urfassungen of 1811 and 1813were edited by Manfrcd SehrSter and published as a separate Naehlassband to the M~nchener Jubildumsausgabe of the collected works: Die Weltalter, Fragmente (Munich: Biederstein, Leibniz, 1946). A later version is published in S.W. I: 8, pp. 195-344,which has been translated by Frederick de Wolfe Bolman, Jr. : The Ages of the World (NewYork: Columbia University Press, 1942). 6Philosophie der Mythologie is published in S.W. II: 1-2; Philosophie der Offenbarung in S.W. II: 3-4. These essays were first collected and published by Herman Nohl in Hegels theologische Jugendschriften (Tiibingen: 1907).T. M. Knox translated them into English, with an introduction by Richard Kroner: GeorgWilhelm Friedrich Hegel, Early Theological Writings (Chicago: University of Chicago Press, 1948). [75] 76 HISTORY OF PHILOSOPHY thinkers (actually he was five years Hegel's junior), who retired from the philosophical scene after making his contribution to the Hegelian synthesis. Paul Tillich's doctoral dissertations s and Ernst Cassirer's studies in post-Kantian thought 9 made serious inroads on this conception, yet the iIInsion persisted. Their insistence on the importance of the later Schelling has been brilliantly sustained by two recent studies: Horst Fuhrmans's Schellings Philosophie der Weltalter1~and Walter Schulz's Die Vollendung des deutschen Idealismus in der Spdtphilosophie Schellings, ~ and we may hope that the conventional estimate of Schelling will be drastically revised. Fuhrmans has demonstrated that the split between the early and the later Schelling must be placed in the year 1806 when he came in contact with Franz yon Bander in Munich, who encouraged him to delve deeper into the theological and cosmological ramifications of Jacob Boehme's thought. TM The reorientation this caused is apparent in the essay on human freedom, published in 1809, but it was not fully exploited until the... (shrink)

Systematic pluralism does not purport to be a new philosophy. Rather, it is a position on positions, a discovery of something previously unrecognized in the nature of philosophical thought. Further, “since the special arts and sciences are particular embodiments of philosophic principles, a pluralism at the level of philosophy implies a similar pluralism at the level of the special arts and sciences.” Therefore, the claims of systematic pluralism are not limited to philosophy but the position has something fundamental to report (...) about all departments of human thought, resulting in the characteristic movement between levels of generality, from widest philosophical import to narrowest disciplinary application, which appears over and over again in the writings of systematic pluralists and which is well exemplified by the essays in this issue of The Monist, the first of any publication dedicated entirely to the examination of discoveries which are now over half a century old. (shrink)

The Birkhoff-Maltsev problem asks for a characterization of those lattices each of which is isomorphic to the lattice L(K) of all subquasivarieties for some quasivariety K of algebraic systems. The current status of this problem, which is still open, is discussed. Various unsolved questions that are related to the Birkhoff-Maltsev problem are also considered, including ones that stem from the theory of propositional logics.

In lieu of an abstract, here is a brief excerpt of the content:William Thomas Jones 1910–1998Charles M. YoungWilliam Thomas Jones, a friend and supporter of this journal since its inception, died on September 30, 1998, in Claremont, California, at the age of eighty-eight. Born in Natchez, Mississippi, Will was educated at Swarthmore, Oxford (as a Rhodes scholar), and Princeton. After a legendary teaching career spanning nearly fifty years, thirty-four at Pomona College and another fifteen at the California Institute of Technology, (...) Will retired in 1985. He published a host of articles and books, among them the highly regarded five-volume A History of Western Philosophy, now in its fourth edition. Will received numerous awards and honors, including Lippincott, Procter, Ford Faculty, and Guggenheim Fellowships; he was also a Phi Beta Kappa Visiting Scholar, and twice a Resident Scholar with the Rockefeller Foundation at Villa Servelloni. In 1969–70, he was President of the American Philosophical Association’s Pacific Division.In 1961, Will joined Karl Aschenbrenner, John D. Goheen, Paul O. Kristeller, Oskar Piest, Benson Mates, Ernest Moody, Richard H. Popkin, Herbert W. Schneider, and E. W. Strong (as chair) to form the Executive Committee (now Board of Directors) of the Journal of the History of Philosophy. The first issue of the JHP appeared some two years later. Will provided much valuable counsel and support in the turbulent early years of the JHP, helping in particular in securing much needed financial support from the Claremont Colleges. We join Will’s family, friends, colleagues, and students in mourning the loss of a fine historian, philosopher, and teacher.Copyright © 1999 Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:William Thomas Jones 1910–1998Charles M. YoungWilliam Thomas Jones, a friend and supporter of this journal since its inception, died on September 30, 1998, in Claremont, California, at the age of eighty-eight. Born in Natchez, Mississippi, Will was educated at Swarthmore, Oxford (as a Rhodes scholar), and Princeton. After a legendary teaching career spanning nearly fifty years, thirty-four at Pomona College and another fifteen at the California Institute of Technology, (...) Will retired in 1985. He published a host of articles and books, among them the highly regarded five-volume A History of Western Philosophy, now in its fourth edition. Will received numerous awards and honors, including Lippincott, Procter, Ford Faculty, and Guggenheim Fellowships; he was also a Phi Beta Kappa Visiting Scholar, and twice a Resident Scholar with the Rockefeller Foundation at Villa Servelloni. In 1969–70, he was President of the American Philosophical Association’s Pacific Division.In 1961, Will joined Karl Aschenbrenner, John D. Goheen, Paul O. Kristeller, Oskar Piest, Benson Mates, Ernest Moody, Richard H. Popkin, Herbert W. Schneider, and E. W. Strong (as chair) to form the Executive Committee (now Board of Directors) of the Journal of the History of Philosophy. The first issue of the JHP appeared some two years later. Will provided much valuable counsel and support in the turbulent early years of the JHP, helping in particular in securing much needed financial support from the Claremont Colleges. We join Will’s family, friends, colleagues, and students in mourning the loss of a fine historian, philosopher, and teacher.Copyright © 1999 Johns Hopkins University Press... (shrink)

LetL(K) denote the lattice (ordered by inclusion) of quasivarieties contained in a quasivarietyK and letD 2 denote the variety of distributive (0, 1)-lattices with 2 additional nullary operations. In the present paperL(D 2) is described. As a consequence, ifM+N stands for the lattice join of the quasivarietiesM andN, then minimal quasivarietiesV 0,V 1, andV 2 are given each of which is generated by a 2-element algebra and such that the latticeL(V 0+V1), though infinite, still admits an easy and nice description (...) (see Figure 2) while the latticeL(V 0+V1+V2), because of its intricate inner structure, does not. In particular, it is shown thatL(V 0+V1+V2) contains as a sublattice the ideal lattice of a free lattice with free generators. Each of the quasivarietiesV 0,V 1, andV 2 is generated by a 2-element algebra inD 2. (shrink)

How ought Christians to approach moral problems? This is a question of method in moral theology. It is also a question of who is in authority to speak on matters of morality. In this essay, the moral methodology of Richard McCormick, S.J., one of the most powerful voices in contemporary Roman Catholic theology, is explored in depth. Attention is focused on its critical details, its development over time, and in particular McCormick's use of authorities in Roman Catholicism. It is argued (...) that his ethical theory is built around one central insight: that the human person in all its facets and dimensions is the criterion of the rightness and wrongness of human actions. (shrink)

The same research proposal was submitted to 24 district health authority (DHA) research ethics committees in different parts of the country. The objective was to obtain permission for a multi-centre research project. The study of neonatal care in different types of unit (regional, subregional and district), required that four health authorities were approached in each of six widely separated health regions in England. Data were collected and compared concerning aspects of processing, including application forms, information required, timing and decision-making. The (...) key finding was that ethics committees received and processed the applications variably, reflecting individual factors and local problems. To improve consensus and facilitate multicentre studies, standard forms and instructions are suggested and the establishment of a national committee or advisory group advocated. (shrink)

Provability, Computability and Reflection.

Discusses some of the philosophical ideas about knowledge and applies them to organizational design and information processing in order to create new ideas and new ways of thinking. Explains how this can be achieved by a discussion of the issues surrounding organizational design and the impact of design on information processing. Reviews the ideas concerning the theory of knowledge proposed by rationalists, such as Descartes and empiricists, such as Locke and how these relate to other epistemological theories such as historicism (...) and pragmatism. Concludes by discussing the means by which philosophical theories of knowledge can assist towards new considerations of information processing. (shrink)

Documents as we encounter them in everyday life are complex and diverse things, whether on paper, computer disk or on the World Wide Web. They play many roles vis-à-vis human beings, and the humans engaged with them have diverse responsibilities that are not always easy to fulfil. Added to this is the issue of how a document or literary work can change and yet retain its identity, as found in maintenance, drafting and versioning of documents. This paper explores how the (...) meaning-oriented philosophy of Herman Dooyeweerd may be used to understand the complex nature of documents, to throw light on the roles, responsibilities and culture surrounding them, and to tackle issues of identity and change. (shrink)

In their “social contextual view” of emotional mimicry, authors Hess and Fischer (2022) put forward emotional mimicry as a social regulator, considering it a social act, bound to certain affiliative contexts or goals. In this commentary, we argue that the core function of mimicry is to ease predicting conspecifics’ behaviours and the environment, and that as a consequence, this often smoothens social interactions. Accordingly, we make three main points. First, we argue that there is no good reason to believe that (...) the mimicry of negative expressions is fundamentally different than the mimicry of positive or ambiguous or autonomic expressions. Second, we give examples of empirical evidence that mimicry is not always a social act. Third, we show that mimicry has primary benefits for the mimicker. As such, we will briefly summarise and elaborate on the relevant findings in these respects, and propose a comparative, multi-method and ecologically valid approach which can explain the multifaceted character of the phenomenon. (shrink)

We argue that on logical grounds the constructivist algorithms mentioned by Quartz & Sejnowski (Q&S) do not resolve the learning paradox. In contrast, a neural network might acquire a more powerful structure by means of phase transitions. The latter kind of developmental mechanism can be in agreement with the constructivist manifesto.