This book overviews how different special sciences could be applied in everyday life. The book was published as part of a nonfiction agricultural series written and edited in part by Nikolai Borodin (1861-1937). In the pre-revolutionary period, Borodin and fellow scholar B. Bakhmetiev visted the USA to obtain a loan and ensure the execution of order for supply of military and agricultural equipment. During the Civil War Borodin joined the White movement and Kolchak's government which sent him to the United (...) States to purchase the agricultural machinery and equipment for educational institutions in Sberia. When the Bolsheviks won the war, Borodin remained abroad. (shrink)

If Unamuno had been able to choose how to be remembered, he would have wanted him to be a poet. This book wants to do justice to that happy possibility. But above all because Unamuno was a poet in the highest sense: he was while writing the same essay as a novel, or theater, letter or verse, and he was also a poet when he passionately lived all the facets of his intense existence. His intellectual work was poetic and his (...) personal relationships, as well as his political activity, also responded to that peculiar Unamunian aesthetic in which the vital horizon is inescapably confused with the tasks of thought." --Translated from back cover. (shrink)

Purpose of the article is to establish the role of egoism in the life of a person faced with a disability situation, as a moment of self-determination in an existential crisis. I set the task to evaluate the influence of egoism and find out its significance in the prospect of the person’s further existence in the conditions of disability using the philosophical anthropology based on the meta-anthropology principle. Theoretical basis. Based on the fact that the role of egoism is perceived (...) by public opinion as a vice and entails the absorption by a person of the benefits intended for others, I find them inappropriate for a person in a situation of disability. Taking into account the concepts of ego of altruism and altruistic egoism, which partially justify the positive influence of egoism, are only a product of the symbiotic interaction of altruism and egoism. The combination of egoism with altruism cannot reveal the essence of the crisis for a person in a disability situation. In a situation of disability, a person cannot synthesize altruism, as part of the egoism symbiosis. Methodological system in the study of the positive role of egoism, the modern theory of meta-anthropology by Nazip Khamitov is used. The theory that divides the being of a person into various types is able to most fully structure the concept of egoism in the being of a person who has disability. Originality. I made an attempt to prove the positive role of egoism in a situation related to the body transformation into new conditions. The analysis of evidence of the need for the egoism development, as a function capable of actualizing a person in the formed crisis circumstances is carried out. A theory about the need for egoism to get a person out of the existential crisis situation in which he stays due to a disability situation was proposed. Conclusions. I show that taking care of oneself is a balancing factor for a person, as opposing a fatally unfair situation in which a person has received disability. Rational egoism is able to bring a person out of ultimate being and allow him to transform into a new, changed reality. (shrink)

1. Philosophy, or the nature of philosophical knowledge, is defined as darsana, which means "seeing" or "vision." Seeing is, perhaps, the best instance of what we mean by "direct experience"; in this sense, Indian philosophy is "empirical." Its empiricism is, however, an "empiricism without limits." I shall not discuss here whether "seeing," "hearing," etc., are instances of immediate experience, or of mediate knowledge. If we see with the eyes, or through them, it may be argued that seeing and hearing, etc., (...) are instances of mediate knowledge. But the motive in defining the nature of philosophical knowledge as darsana or "vision" is that Indian philosophy distrusts abstract reasoning or knowledge. Philosophy is not, according to Indian philosophy, primarily a "theory" about reality but an experience of reality: an experience verified or verifiable. The Vedänta is the "end" of knowledge in the sense that knowledge ends in experience: in direct realization. This is the meaning of the Vedäntic statement: we cannot know Brahman but we can be Brahman. The nature of ultimate reality is atarkyam, "non-logical," as the Upanisads say. This does not mean that logic should not be used as a method or that logical knowledge has no use. Logical knowledge gives knowledge of "existence" in some sense, e.g., if I say, "No statement is true," then, this statement is, at least, true: therefore it exists. Whereas philosophy as darsana is an intuition of the existent and not of existence. In a certain sense, there is no problem for Indian philosophy of the reality and proof of the external world. The Katha Upanisad says that the senses are "pierced outwards"; "therefore, they see external objects": tasmät parang pasyati. But why the expression "external world" if there is not another world in some sense? However this may be, it is an historical fact that, in its quest for the Real, Indian thought changed from the objective to the subjective method: its search for the reality of the objective universe was through its search for the inner essence of man's being. The Katha Upanisad speaks of seeing "with eyes turned within": ävratta çaksu. The conception of philosophy as darsana corresponds to Plato's definition of the Dialectic as "the eye of the soul": "not implanting eyes, for they exist already, but giving them a right direction which they have not." Philosophy as darsana is the sight of "those who have eyes to see," though not the sight of "those who see only what they want to see." Darsana as defined is "discovery": there is in it, or through it, an unveiling of Reality. Darsana is a perceptual or "intuitive" situation in which the existent is beheld "face to face"; pratyagätänamaiksat: "beheld the Atman face to face": but this relation of "face to face" cannot properly be described as an "encounter," if this means seeing another. (shrink)

Mahatma Gandhi's philosophy, which he called "an experiment with truth," was not a philosophy in which he merely interpreted or analysed things for himself. It was an experience, or experiment, in which he changed himself and his environment. In the process, Gandhi re-oriented many traditional ideas of Hindu thought and practice. He said: "I do not claim to have originated any new principle. I have simply tried in my own way to apply eternal truths to our daily life and problem." (...) He was an ordinary man who became a mahätmä, "a man of great soul": indeed, "in a beggar's garb.". (shrink)

Background In May 2020, England moved to an opt-out organ donation system, meaning adults are presumed to be an organ donor unless within an excluded group or have opted-out. This change aims to improve organ donation rates following brain or circulatory death. Healthcare staff in the UK are supportive of organ donation, however, both healthcare staff and the public have raised concerns and ethical issues regarding the change. The #options survey was completed by NHS organisations with the aim of understanding (...) awareness and support of the change. This paper analyses the free-text responses from the survey. Methods The #options survey was registered as a National Institute of Health Research (NIHR) portfolio trial [IRAS 275992] 14 February 2020, and was completed between July and December 2020 across NHS organisations in the North-East and North Cumbria, and North Thames. The survey contained 16 questions of which three were free-text, covering reasons against, additional information required and family discussions. The responses to these questions were thematically analysed. Results The #options survey received 5789 responses from NHS staff with 1404 individuals leaving 1657 free-text responses for analysis. The family discussion question elicited the largest number of responses (66%), followed by those against the legislation (19%), and those requiring more information (15%). Analysis revealed six main themes with 22 sub-themes. Conclusions The overall #options survey indicated NHS staff are supportive of the legislative change. Analysis of the free-text responses indicates that the views of the NHS staff who are against the change reflect the reasons, misconceptions, and misunderstandings of the public. Additional concerns included the rationale for the change, informed decision making, easy access to information and information regarding organ donation processes. Educational materials and interventions need to be developed for NHS staff to address the concepts of autonomy and consent, organ donation processes, and promote family conversations. Wider public awareness campaigns should continue to promote the positives and refute the negatives thus reducing misconceptions and misunderstandings. Trial registration National Institute of Health Research (NIHR) [IRAS 275992]. (shrink)

_Purpose._ The authors of this article aim to reveal how motivation and legitimacy ensure the normativity of the structuring and genesis of multiple social identity. _Theoretical basis._ Social constructivism was chosen as a research methodology. It reveals social identity as an identity constructed by its bearer on the basis of ready-made versions of social identity proposed by social groups and society. Social circles, identified by Georg Simmel, unite representatives of different social groups into a wider oneness, which can be interpreted (...) as a multiple social identity, and the motivation for its formation can be identified on the basis of Weber’s concept of legitimacy. _Originality._ Identifying the structure and genesis of a multiple social identity creates prerequisites for establishing its normative foundations, as well as for a specific analysis of the procedures for achieving its motivation and legitimacy. Georg Simmel’s concept of social virtues promotes consideration of the basic virtues of an individual as those that enable one’s to be a member of various social groups in which these virtues are manifested. _Conclusions._ The social virtues present in the social identities that are part of a multiple social identity determine not only the social status of these individuals in these social groups but also the ranking and normative significance of these groups for this individual. If the observance of virtues in a certain social group causes a higher motivation of an individual’s behavior, then this group acquires a higher legitimacy for her/him. Using the example of virtues, it is possible to search for other possible grounds for the formation of multiple social identity. Such grounds are primarily other characteristics of key social practices that support different social groups. (shrink)

Gravity was a major theme in the seventeenth century scientific discussion. Trendsetters in the renewal of natural science were Galilei and Descartes. The first required a unified theory of all phenomena of gravity ; the second provided one with his vortex-hypothesis, which explained gravity by the mechanical push of subtile bodies of the vortex. This conception was tested and generally followed by Christiaan Huygens, whereas Newton presented the laws of the so called 'attraction' by which he did not at all (...) indicate the causes of those laws of motion. Spinoza comes on the scene of polemics as a critical Cartesian. Motion (of which downward motion of heavy bodies is only one instance) was explained by Descartes, but not so the rest of bodies or the equilibrium in the power relation between opposite forces, neither the reason why in some cases the particles form a hard body. Full fledged mechanism and consistent determinism lead Spinoza to account for rest and solidity in the same way, namely by means of the pressure of small and mostly unvisible bodies in the whirling environment. This paradoxical law was acknowledged as a real and important contribution to physical science by the Dutch spinozistic Cartesians Cuffeler and Overkamp, by the mathematician De Volder, by Spinoza's younger friend Tschirnhaus and in France by Malebranche. By the end of the century it was quite normal to speak about „the gravity of the air” and to consider the gravity of gross bodies as an illusion. (shrink)

In an almost forgotten passage of the Postenor Analytics (Bk I, ch. III) Aristotle argues against 'another school', according to which it is possible to proof things 'by each other and in a circle'. His logical refutation of this opinion became so dominant in the Western philosophical tradition, that the 'vicious circle' has always deemed a crime since. A scientific demonstration has to be built on firm premisses in order to deduce conclusions from them in a straight, ongoing proces, in (...) which one does not have to return to the premisses for a reconsideration of them on the basis of their implications. Although Aristotle does not mention names, he in fact reacts against Plato and the mainstream of Greek thought, which stresses the essential circularity of human argumentation. In the first, the historical part of the treatise the roots of this circular logic are unearthed in the work of Heraclitus and Parmenides, who both defended a ring structure of their metaphysical explication of nature. Truth is described as well-rounded, because you can follow it in a circle, passing through each of its links in turn, back to your startingpoint. The association of circular motion with thought is fully present in the work of Plato, who speeks many times about the 'periforas tès dianoias' and the essential interdependance of our ideas. Not the theory of an anonymous alternative school but Aristotle's own rectilinear formal logic was the exceptional, untraditional standpoint, which, moreover, was in conflict with his explication of divine thinking as 'noèsis noèseôs'. In modern times Hegel, Nietzsche and Heidegger were the main representatives of an anti-Aristotelian attitude. All three reject the logical prohibition of the circular argument, because it is inadequate to the life of concrete scientific thinking. The path of science always turns around towards its origins and results in a correction of its fundamental hypotheses on a higher level. Circularity is considered as a hallmark of sound logical procedure, as a characteristic of excellence in human understanding. The famous 'hermeneutic circle' is interpreted as the modern equivalent of the Hegelian 'Kreislauf and the Greek ' to par'allèlôn'. In the second, the more systematic part of the text the circular nature of our cognitive and scientific behaviour is demonstrated along three different lines. Reflection on the natural language with its finite stock of words, whose meanings are structurally connected, leads us to the so called semiotical circularity. Natural language is a complex network in which circular argumentation is not only unavoidable, but even the only means of explication. We have to work with the material contained in our dictionary, in which the items are defined by each other. The second reason is constituted by the system-orientation of science. In science we try to systematize our knowledge by means of formalisations and abstractions. The development of science can be characterised as a succession of systems, in which every element gets its meaning from the whole organisation. If we accept systematicity as the arbiter of truth, our logic is anti-fundamentalistic and the path of our thought is in fact circular (or better : spiralistic). The third adstruction of our theory is afforded by the coupling, that is realised in a rational proof. We draw conclusions from the coherence of our perceptions, from the reciprocal implications of our ideas. Never any of our ideas is without the repercussions of the movements elsewhere in the field. When we proof something, we also disproof and correct our startingpoints at the same time. The tradition of the circular nature of human thinking is very old, but not antiquated. The accusation of committing a fallacy in the case of circularity in normal and in scientific thinking is unfouded. It is now the formal logicians turn to defend his claim. (shrink)

Background: There is a shortage of reports on what potential recipients of implantable cardioverter–defibrillators need to be informed about and what role they can and want to play in the decision-making process when it comes to whether or not to implant an ICD.Aims: To explore how patients with heart failure and previous episodes of malignant arrhythmia experience and view their role in the decision to initiate ICD treatment.Patients and methods: A qualitative content analysis of semistructured interviews was used. The study (...) population consisted of 31 outpatients with moderate heart failure at the time of their first ICD implantation.Setting: The study was performed at Sahlgrenska University Hospital, Göteborg, Sweden.Results: None of the respondents had discussed the alternative option of receiving treatment with anti-arrhythmic drugs, the estimated risk of a fatal arrhythmia, or the expected time of survival from heart failure in itself. Even so, very little criticism was directed at the lack of information or the lack of participation in the decision-making process. The respondents felt that they had to rely on the doctors’ recommendation when it comes to such a complex and important decision. None of them regretted implantation of the ICD.Conclusions: The respondents were confronted by a matter of fact. They needed an ICD and were given an offer they could not refuse, simply because life was precious to them. Being able to give well-informed consent seemed to be a matter of less importance for them. (shrink)

Philosophy; philosophical theology; philosophical anthropology; history.

Collaborative research practices in the field of plant genetic resources must follow the principles of fairness and equity as defined in the Convention on Biological Diversity (CBD) and in the International Treaty on Plant Genetic Resources for Food and Agriculture (ITPGRFA). In this context the concepts of fairness and equity generally refer to the substantive and procedural dimensions associated with sharing the benefits of this research. But neither term is clearly defined by these international treaties, and the meanings attributed to (...) the concepts vary among different societies. This paper looks at the question of how to account for the diversity among value systems when conducting research that implicates diverse stakeholders and respects the requirements of fairness and equity. We incorporated an auto-ethnography method developed as part of a multi-stakeholder network involved in research projects on plant genetic resources in West Africa. A theatrical device was used as a framework for testing the principles of fairness and equity, helping us to collectively identify feelings of injustice, and explore the conditions for making collaborative research practices more ethical in ways that respect the perspectives of different stakeholders. In an environment of extensive political and socio-cognitive inequality, this approach makes it possible to explain the criteria relating to interactional justice and expectations in terms of socio-political and socio-emotional benefits. It also invites us to consider the principles of fairness and equity in a framework of ethical competence that goes beyond international directives. (shrink)

Student character survey in Indonesia in 2021, on average, produced lower index numbers compared to last year’s index results. This research aims to explore the policies and content of Character Building Training (CBT), and the impact of the programme on student character. This research was qualitative, involving informants: 60 students and 8 lecturers, who were selected using purposive and snowball techniques, so that if the data were saturated, collecting the data was considered sufficient. Data were collected through observation and in-depth (...) interviews carried out from June to September 2022. Data analysis was carried out manually using the Discovering Cultural Themes model by carrying out data reduction, data display, and drawing conclusions and verification. The research results show that CBT is implemented through a cycle of CBT campaign, capacity building, and institutionalisation with a nurturing, learning, mentoring, and consulting approach. The content includes attitudes and values, skills, knowledge and moderate integrative insight, as well as amplifying tolerant, open, critical, caring, and creative behaviour, respecting differences, and polite and commendable behaviour. The CBT programme has amplified some aspects: religious character, discipline, politeness, caring for the environment, and patriotism. The greatest and dominant strengthening was in religious character and love of the country. The implication and contribution of this research is the continuation of character education for young people as an instrument to substantiate religious moderation. Contribution: This research is important theoretically and practically to contribute to the formation of character building in young people in Islamic tertiary institutions. Currently, character education is the main vision of Islamic tertiary institutions in Indonesia, which is associated with religious moderation as one of the priorities in the national medium-term development plan. (shrink)

With technological possibilities in healthcare steadily increasing, more tools for digital cognitive rehabilitation become available. Acceptance of such technological advances is crucial for successful implementation. Therefore, we examined technology acceptance specifically for this form of rehabilitation in a sample of healthcare providers involved in cognitive rehabilitation. An adjusted version of the Technology Acceptance Model questionnaire was used, including the subscales for perceived usefulness, perceived ease of use, subjective norm, and intention to use, which all contribute to actual use of a (...) specific technology. Results indicate a generally favorable attitude toward the use of digital cognitive rehabilitation and positive responses toward the TAM constructs. Only for subjective norm, a neutral mean response was found, indicating that this could pose a potential obstacle toward implementation. Potential differences between subgroups of different age, gender, and professional background were assessed. Age and gender did not affect the attitude toward digital cognitive rehabilitation. Occupational therapists showed lower scores than healthcare psychologists and physiatrists with regard to perceived usefulness, possibly linked to a difference in operational and managerial tasks. The findings of his study stimulate further implementation of digital cognitive rehabilitation, where the role of subjective norms should be specifically considered. (shrink)

It is well-documented that mathematics achievement is an important predictor of many positive life outcomes like college graduation, career opportunities, salary, and even citizenship. As such, it is important for researchers and educators to help students succeed in mathematics. Although there are undoubtedly many factors that contribute to students' success in mathematics, much of the research and intervention development has focused on variations in instructional techniques. Indeed, even a cursory glance at many educational journals and granting agencies reveals that there (...) is a large amount of time, energy, and resources being spent on determining the best way to convey information through direct, declarative instruction. The proposed project is motivated by recent calls to expand the focus of research in mathematics education beyond direct, declarative instruction. The overarching goal of the presented experiment is to evaluate the efficacy of a novel mathematics intervention designed using principles taken from the literature on non-declarative learning. The intervention combines errorless learning and structured cue fading to help second grade students improve their understanding of symbolic magnitude. Results indicate that students who learned about symbolic magnitude using the novel intervention did better than students who were provided with extensive declarative support. These findings offer preliminary evidence in favor of using learning combination of errorless learning and cue fading techniques in the mathematics classroom. (shrink)

OBJECTIVES: Life-sustaining treatment at the end of life gives rise to many ethical problems in Japan. Recent surveys of Japanese physicians suggested that they tend to treat terminally ill patients aggressively. We studied why Japanese physicians were reluctant to withhold or withdraw life-support from terminally ill patients and what affected their decisions. DESIGN AND PARTICIPANTS: A qualitative study design was employed, using a focus group interview with seven physicians, to gain an in-depth understanding of attitudes and rationales in Japan regarding (...) medical care at the end of life. RESULTS: Analysis revealed that physicians and patients' family members usually make decisions about life-sustaining treatment, while the patients' wishes are unavailable or not taken into account. Both physicians and family members tend to consider withholding or withdrawing life-sustaining treatment as abandonment or even killing. The strongest reason to start cardiopulmonary resuscitation- and to continue it until patients' family members arrive-seems to be the family members' desire to be at the bedside at the time of death. All physicians participating in our study regarded advance directives that provide information as to patients' wishes about life-sustaining treatment desirable. All expressed concern, however, that it would be difficult to forego or discontinue life-support based on a patient's advance directive, particularly when the patient's family opposed the directive. CONCLUSION: Our group interview suggested several possible barriers to death with dignity and the appropriate use of advance directives in Japan. Further qualitative and quantitative research in this regard is needed. (shrink)

Religious life; Islam; Islam and social problems; Islamic ethics; security.

Nietzsche, Friedrich Wilhelm, 1844-1900; criticism and interpretation; Human; Alienation; philosophical aspects; Philosophy, Modern; 19th century.

It was with this bitter intervention from Thrasymachus, occurring halfway through the first of its ten Books, that that work begins to come urgently alive. For the remainder of Book I the Socrates of the Dialogue asks questions and raises objections, while Thrasymachus keeps urging that in fact the just become through their very justice the victims of exploitation–the suckers!

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

The SSIS SEL Brief Scales are multi-informant measures that were developed to efficiently assess the SEL competencies of school-age youth in the United States. Recently, the SSIS SELb was translated into multiple languages for use in a multi-site study across six European countries. The purpose of the current study was to examine concurrent and predictive evidence for the SEL Composite scores from the translated versions of the SSIS SELb Scales. Results indicated that SSIS SELb Composite scores demonstrated expected positive concurrent (...) and predictive relationships with scores from the Connor-Davidson Resilience Scale and negative relationships with scores from the problem behavior scales of the Strengths and Difficulties Questionnaire. Although there were a few exceptions, these patterns generally were consistent across informants and samples providing initial validity evidence for the Composite score from the translated versions of the SSIS SELb Scales. Limitations and future research directions are discussed. (shrink)

Sufficient texts show that for aristotle the universal notion expresses the same real thing as the particular, Though in a different way. His grounds for a universal so conceived are twofold. First, In every sensible thing there is a basic formal principle that, Though individual, Brings each instance into formal identity with all the other instances. Secondly, In human intellectual cognition there is an active principle that raises knowledge above the status of photographing or registering or cataloguing, And actualizes what (...) was only potential in the real thing. In knowing sensible things universally, The human intellect is able to grasp the concrete thing as characterized by a formal nature, Thereby knowing it in a way that holds equally for all other instances. Though patently incomplete, This conception of the universal is free from internal contradictions. It provides a framework for fruitful discussion, And remains a challenge. (shrink)

Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)