BackgroundMost end-of-life decisions are made by family members. Current ethical guidelines for family decision making are based on a hierarchical model that emphasizes the patient’s wishes over his or her best interests. Evidence suggests that the model poorly reflects the strategies and priorities of many families.MethodsResearchers observed and recorded 26 decision-making meetings between hospital staff and family members. Semi-structured follow-up interviews were conducted. Transcriptions were analyzed using qualitative techniques.ResultsFor both staff and families, consideration of a patient’s best interests generally took (...) priority over the patient’s wishes. Staff generally introduced discussion of the patient’s wishes for rhetorical purposes, such as persuasion. Competing moral frameworks, which de-emphasized the salience of patients’ autonomy and “right to choose,” played a role in family decision making.ConclusionsThe priority given to the patients’ wishes in the hierarchical model does not reflect the priorities of staff and families in making decisions about end-of-life care. (shrink)

Just how eternal is the Eternal Return? This article examines how Foucault's readings of Nietzsche and of Deleuze critically revise the Return so as to arrive at a concept of contingency that is itself contingent. I argue that this archaeological/genealogical rereading problematises the Return as presented in Difference and Repetition; when the Return is presented as ‘the form of change [that] does not change’, it risks returning eternally to the Same – for all its avowed affirmation of difference. By returning (...) the Return to its own historically contingent epistemic conditions of possibility, Foucault repeats Deleuze's philosophy with maximum difference. (shrink)

Volume 33, Issue 8, November 2020, Page 1096-1120.

We use tools of mathematical logic to analyse the notion of a path on a complex algebraic variety, and are led to formulate a “rigidity” property of fundamental groups specific to algebraic varieties, as well as to define a bona fide topology closely related to etale topology. These appear as criteria for ℵ1-categoricity, or rather stability and homogeneity, of the formal countable language we propose to describe homotopy classes of paths on a variety, or equivalently, its universal covering space.Technically, for (...) a variety A defined over a finite field extension of the field Q of rational numbers, we introduce a countable language L describing the universal covering space of A, or, equivalently, homotopy classes of paths in A. Under some assumptions on A source we show that the universal covering space of A is an analytic Zariski structure [26]), and present an Lω1ω)-sentence axiomatising the class containing the structure and that is stable and homogeneous over elementary submodels. The “rigidity” condition on fundamental groups says that projection of the fundamental group of a variety is the fundamental group of the projection, up to finite index and under some irreducibility assumptions, and is used to prove that the projection of an irreducible closed set is closed in the analytic Zariski structure.In particular, we define an analytic Zariski structure on the universal covering space of an Abelian variety defined over a finite extension of the field Q of rational numbers. (shrink)

Dysfunction or injury of pain-transmitting primary afferents' central pathways can result in pain. The organism as a whole responds to such injury and consequently many symptoms of neuropathic pain develop. The nervous system responds to painful events and injury with neuroplasticity. Both peripheral sensitization and central sensitization take place and are mediated by a number of biochemical factors, including genes and receptors. Correction of altered receptors activity is the logical way to intervene therapeutically. [berkley; blumberg et al.; coderre & katz; (...) dickenson; mcmahon; wiesenfeld-hallin et al.]. (shrink)

Syntax of displacing predicates -- Argument hierarchies -- Animacy and adult sentence processing -- Animacy and children's language -- Modeling displacing predicates -- Conclusions and origins.

Among the most important problems related to Russia's development, which are considered in depth in various kinds of forum and the media, both here and in the west, there is, however, an almost total absence of such a crucial strategic topic as working out an urban policy. In the meantime the crises that Russia is continually facing as it undergoes reforms are caused by the disparity between the tasks that have to be completed and the stage of civilization we are (...) at. In order to fast forward to another level we have only the strategic role of the cities, in particular the largest of them, to guide us. Without real cities with a developed urban culture no effective solution can be found to the problems we are up against, whether they are economic, cultural, social or human rights issues. (shrink)

In the study of Chinese thought, the products of the Han dynasty have historically been identified as those most antithetical to Western rationalism. In many of these narratives, the commentarial t...

Diogenes, Ahead of Print. In the study of Chinese thought, the products of the Han dynasty have historically been identified as those most antithetical to Western rationalism. In many of these narratives, the commentarial tradition and systems of complementary yin and yang receive the most attention. The present work draws on Mawangdui texts, the writings of Dong Zhongshu, the Huainanzi, and ultimately Heshanggong’s Commentary on the Daodejing to complexify this view. Within these examples one discovers divergent philosophies of opposites and (...) yin and yang that confound the notion of a monolithic and solely holistic Han cosmology. Ultimately, this paper seeks to promote Heshanggong’s Commentary as an exemplar of Eastern Han Daoist yin-yang theory that subdivides these two principles into mode and substance. Such an interpretive move explains the commentary’s valorization of yin modes but not yin substances, and yang substances but not yang modes. Furthermore, this approach unveils new insights about the relationship of the Dao and Heaven, the history of Daoism, and the varieties of correlative cosmologies in the Han. (shrink)

In the study of Chinese thought, the products of the Han dynasty have historically been identified as those most antithetical to Western rationalism. In many of these narratives, the commentarial t...

Exploring the status of feminism in this "postfeminist" age, this sophisticated meditation on feminist thinking over the past three decades moves away from the all too common dependence on French theorists and male thinkers and instead builds on a wide-ranging body of feminist theory written by women. These writings address the question "Where are we going?" as well as "Where have we come from?" As evidenced in the essays compiled here, the multiplicity of directions available to this new feminism ranges (...) from poststructuralist academic theory through cultural activism to re-readings of law, literature, and representation. Contributors include Mieke Bal, Lauren Berlant, Rosi Braidotti, Elisabeth Bronfen, Judith Butler, Rey Chow, Drucilla Cornell, Ann Cvetkovich, Jane Gallop, Beatrice Hanssen, Claire Kahane, Ranjana Khanna, Biddy Martin, Juliet Mitchell, Anita Haya Patterson, and Valerie Smith. _Feminist Consequences_, representing the forefront of international feminist thought, marks a new and long-desired stage of feminist criticism where women are themselves making theory rather than reacting to male production. (shrink)

Cancer susceptibility testing is likely to become routine in medical practice, despite many limitations and unanswered questions. These uncertainties greatly complicate the process of informed consent, creating an excellent opportunity to reconsider exactly how it should be conducted. Research with women's reactions to the availability of genetic susceptibility testing for breast cancer dramatically underscores that informed consent ought to be highly individualized, taking care to discern what patients believe about the disease and its causes and what role they want their (...) physician to play. (shrink)

This commentary draws upon the author's experience in bioethics and as a physician, ordained Rabbi, and certified Mohel (a Jewish professional qualified to perform infant male circumcisions (MC)). People's identity and adherence to a religious belief are frequently cited reasons for deciding whether to circumcise their male children. For Jewish and Muslim males, circumcision is considered essential. In this commentary, the author uses his medical, religious, and bioethical knowledge, expertise, and experience to address common arguments used in opposing nontherapeutic male (...) circumcision of minors. In these narratives, half of the parents agreed with circumcision, and half did not. The parents against circumcision cite human rights violations, security, privacy, and bodily integrity issues and refer to circumcision as genital mutilation, while those who agree argue that circumcision should be done for religious reasons to prevent health issues, promote hygiene and cleanness, avoid cancer, or for later sexual enjoyment. After evaluating the evidence, the author states that parents should be free to either consent or decline MC for a son. Though a reoccurring theme in these narratives was for mothers to leave the circumcision decision up to their male partners, the author concludes that women have considerable power regarding the decision. (shrink)