"The fixed person for fixed duties, who in older societies was such a godsend, in the future ill be a public danger." Twenty years ago, a single legal metaphor accurately captured the role that American society accorded to physicians. The physician was "c- tain of the ship." Physicians were in charge of the clinic, the Operating room, and the health care team, responsible - and held accountabl- for all that happened within the scope of their supervision. This grant of responsibility (...) carried with it a corresponding grant of authority; like the ship's captain, the physician was answerable to no one regarding the practice of his art. However compelling the metaphor, few would disagree that the mandate accorded to the medical profession by society is changing. As a result of pressures from a number of diverse directions - including technological advances, the development of new health professionals, changes in health care financing and delivery, the recent emphasis on consumer choice and patients' rights - what our society expects phy- cians to do and to be is different now. The purpose of this volume is to examine and evaluate the conceptual foundations and the moral imp- cations of that difference. Each of the twelve essays of this volume assesses the current and future validity of the "captain of the ship" metaphor from a different perspective. The essays are grouped into four sections. In Section I, Russell Maulitz explores the physician's role historically. (shrink)

Some people have supposed that utility is good in itself, non-in-strumentally good, as distinct from good because conducive to other good things. And in modern versions of this view, utility often means want-satisfaction, as distinct from pleasure or happiness. For your want that p to be satisfied, is it necessary that you know or believe that p, or sufficient merely that p is true? However that question is answered, there are problems with the view that want-satisfaction is a non-instrumental good. (...) What if you want something only because you have a false belief? What if the time at which you want that p is fifty or five hundred years before the time to which p itself refers? To meet these difficulties, qualifications have to be introduced, and much has been written about how exactly these qualifications are to be framed.1 There is however what may be a rather more serious objection to the view that want-satisfaction is a non-instrumental good, or rather to the combination of that view with the principle that it is sufficient for your want that p to be satisfied simply that p is true. The objection is that this combination forces you to give undue weight to the mere acquisition of desires when you come to make judgements about changes in the value of things. It forces you to say that for any true proposition p, which initially you do not want to be true, your mere acquisition of a desire that p will, other things being equal, make the world better. Non-instrumental value can be increased merely by multiplying desires, even though everything else remains the same. Surely, however, improving the world is not as easy as that. (shrink)

Conceptualization and measurement of organizational commitment involve different dimensions that include economic, affective, as well as moral aspects labelled in the literature as: ‘continuance’, ‘affective’ and ‘normative’ commitment. This multidimensional framework emerges from the convergence of different research lines. Using Aristotle’s philosophical framework, that explicitly considers the role of the will in human commitment, it is proposed a rational explanation of the existence of mentioned dimensions in organizational commitment. Such a theoretical proposal may offer a more accurate definition of ‘affective (...) commitment’ that distinguishes feelings from rational judgments. The use of a philosophical explanation coherent with psychological findings also allows the discovery of a wider moral concept of ‘normative commitment’. (shrink)

Summary Tycho Brahe's lunar theory, mostly the work of his assistant Christian Longomontanus, published in the Progymnasmata (1602), was the most advanced and accurate lunar theory yet developed. Its principal innovations are: the introduction of equant motion for the first inequality in order to separate the determination of direction and distance; a more accurate limit for the second inequality although requiring a more complex calculation; additional inequalities of the variation and, in place of the annual inequality in Tycho's earlier theory, (...) a reduction in the equation of time; in the latitude theory a variation of the inclination of the orbital plane and an inequality of the motion of the nodes; a reduction in the range of variation of distance, parallax, and apparent diameter. Some of these were already present in Tycho's earlier lunar theory (1599), but all were changed in notable ways. Twenty years later Longomontanus published a modified version of the lunar theory in Astronomia Danica (1622), for the purpose of facilitating the calculation through new correction tables, and also explained his reasons for parts of the theory in the Progymnasmata. This paper is a technical study of both lunar theories. (shrink)

Context: Immunity includes cognitive concepts: the organism is thought to specifically recognize foreign materials and develop a memory of these encounters. Vaccines are thought to work by enhancing this immunological memory. Lymphocytes are key cells and specific antibodies are key molecules in immune recognition. Antibodies are blood proteins called “immunoglobulins.” Spontaneously formed immunoglobulins are seen as “natural” antibodies to dietary components and commensal bacteria. Immune cognition is used simply as a didactic metaphor. Problem: Do the cognitive aspects of immunology stem (...) from the activities of cells and molecules, or are they ascribed by the immunologist operating as a human observer? (1) An immense variety of immunoglobulins may bind to the same antigen with different binding energies. It is the immunologist who arbitrates the boundary between those that are specific (and declared antibodies) and those that are not. Specific antibodies serve as functional labels pasted onto natural immunoglobulins, as if they were recognizing elements. Is this “arbitration” the true cognitive event ascribed to immunoglobulins and lymphocytes? (2) A major impasse exists between progress in experimental immunology and its translation into clinical results. A proper understanding of immunological activity demands a wider view of an organism’s biology and, also, of the interference of human observers in delineating experimental realities, such as the specificity of immune recognition. Maturana’s biology of cognition and language provides one such approach. Method: Use of Maturana’s biology of cognition and language concepts to describe immunological activity. Results: A whole new understanding of immunological activity is suggested. Implications: A major change in the way of seeing is proposed that may eventually help the translation of this knowledge into clinical results. Furthermore, the immune system may also become a proper model for cognitive analyses. (shrink)

The purpose of the study is to identify a common theoretical basis for the study of human life as capital and unconditional higher value. Theoretical basis is based on the value-laden and revised structural constructivism, provided by the French philosopher and sociologist Pierre Bourdieu, critical analysis of the concepts of capital as the embodiment of social expectations, the biological concept of the value of human life, as well as the concepts of its sanctity. Originality. It is proved that one should (...) not consider the value of human life as capital only but instead takes into account its different value interpretations, especially when forming the social identity of a person. Moreover, in each of the value systems, the value of human life can be recognized as unconditional, which does not prevent the coexistence of such different value interpretations within the framework of one social identity, which then inevitably becomes a multiple social identity. Conclusions. Human life cannot be considered as a result of integrating economic expectations into the concept of "advertising" capital: first, expectations may well be inadequate; second, expectations by themselves are not directly related to capital; third, expectations do not necessarily lead to development; fourth, one should clearly distinguish between the spontaneous "expectations" and the values that express people’s strong motivation as members of social communities. The multiplicity of possible cultural conditions that affirm the unconditional value of life indicates that this unconditionality is always relevant rather than absolute. The multiple social identities could be used to add value to the protection of human life, the affirmation of multiple social identities is a means of affirming the unconditional value of human life – it is unconditional in several alternative ways. (shrink)

When do two mental items belong to the same life? We could be content with the answer -just when they have certain volitional qualities in common. An affinity is noted between that theory and Berkeley's early doctrine of the self. Some rivals of the volitional theory invoke a spiritual or physical owner of mental items. They run a risk either of empty formality or of causal superstition. Other rivals postulate a non-transitive and symmetrical relation in the set of mental items. (...) They must allow in consequence either for joint ownership of one and the same mental item, or for incompatible simultaneous decisions by one and the same person, or for new forms of death. This makes them disquieting. Another rival invokes a transitive and symmetrical relation defined in terms of co-consciousness. Even that allows for incongruous simultaneities. The volitional theory is free from such disadvantages. (shrink)

_The purpose _of this article is to find out whether philosophical and anthropological studies of human nature affect the legitimization of decisions about human life and death, using the example of a philosophical analysis of the problem of euthanasia. _Theoretical__ basis._ Philosophically and anthropologically based situational analysis in bioethics is chosen as the research methodology, which reveals the legitimation of euthanasia as a complex and highly responsible moral decision, which should be based on both the consideration of all the patient’s (...) special circumstances and the competent and adequate application of fundamental knowledge about the human being. _Originality._ From a philosophical point of view, it would be correct to legalize euthanasia, but under the condition of significantly limiting the cases of its application, clearly defining the conditions for its provision and strict control over its implementation. It is morally unacceptable to justify either murder or torture, so euthanasia appears as an attempt to avoid both at the same time. _Conclusions._ Specific solutions to practical problems often indicate the necessary direction for solving theoretical difficulties. Thus, making proper moral decisions about euthanasia requires reliance on fundamental knowledge about human beings, but at the same time it provides arguments "for" and "against" artificial termination of life. The basic principles of bioethics – autonomy, nonmaleficence, beneficence and respect for the dignity of human life – serve as criteria for making balanced ethical decisions both in theory and in practice. These principles should be complemented by a coherent ethical, legal and philosophical position on euthanasia, which is achieved through legitimation procedures. Decisive for making a decision on euthanasia should be the strong desire of the patient himself. (shrink)

Los 18 trabajos recogidos en este volumen tienen como telón de fondo una preocupación por la racionalidad occidental. Mucho se ha hablado de su crisis o de su fracaso. De ello se ha ocupado durante décadas la Escuela de Francfort, en sus distintas reencarnaciones, y, más recientemente, el pensamiento posmoderno. Lo que este libro pretende es enfrentarnos a la crisis de la razón pero desde un ángulo insólito, desde el pensamiento judío. El judaísmo hizo su experiencia de la modernidad. Sintió (...) que no tenía sitio. Algunos de los autores aquí estudiados tuvieron que plantearse, en el momento de su madurez, que había que elegir entre ser moderno o marginarse. Durante siglos, la mayoría optó por lo primero, es decir, por la asimilación. Hasta que algunos plantearon y decidieron seguir siendo judíos sin renunciar a filosofar. Con ello el judaísmo se convierte en un lugar privilegiado para valorar el pulso de la razón occidental. El judaísmo era el límite de la Ilustración. Así lo planteaban los ilustrados y así lo vivieron durante mucho tiempo los propios pensadores judíos. Hasta que les dio por pensar por sí mismos. En este libro se reconstruyen algunos de esos memorables episodios. (shrink)

Ukraine has a special geopolitical location in Europe - between East and West, South and North. The specificity of this provision is due to multi-year contacts between peoples who lived or passed through its territory, the interactions of different cultures, traditions and worldviews. As a result, there is a rather varied ethno-national and religious palette of Ukrainian population. In today's conditions of building an independent state and civil society, this can be both a positive and a negative factor. Recent events (...) and practices show that the problem of religious and ethnic renaissance has acquired a special political and spiritual significance. Different directions of Christianity, other religions, existing for centuries on the Ukrainian ethnic basis, have been influenced by a wide range of social and national life. In addition, ethno-national and religious processes took place differently in the western and eastern regions of Ukraine, in the village and in the city. (shrink)

The idea that deep brain stimulation (DBS) induces changes to personality, identity, agency, authenticity, autonomy and self (PIAAAS) is so deeply entrenched within neuroethics discourses that it has become an unchallenged narrative. In this article, we critically assess evidence about putative effects of DBS on PIAAAS. We conducted a literature review of more than 1535 articles to investigate the prevalence of scientific evidence regarding these potential DBS-induced changes. While we observed an increase in the number of publications in theoretical neuroethics (...) that mention putative DBS-induced changes to patients’ postoperative PIAAAS, we found a critical lack of primary empirical studies corroborating these claims. Our findings strongly suggest that the theoretical neuroethics debate on putative effects of DBS relies on very limited empirical evidence and is, instead, reliant on unsubstantiated speculative assumptions probablyin lieuof robust evidence. As such, this may reflect the likelihood of a speculative neuroethics bubble that may need to be deflated. Nevertheless, despite the low number of first-hand primary studies and large number of marginal and single case reports, potential postoperative DBS changes experienced by patients remain a critical ethical concern. We recommend further empirical research in order to enhance theoretical neuroethics work in the area. In particular, we call for the development of better instruments capable of capturing potential postoperative variations of PIAAAS. (shrink)

This study aims at assessing the level of knowledge, attitudes, and practices (KAP) concerning reproductive health (RH) among adolescent college-going girls in the urban and rural areas of Chittagong District, Bangladesh. A college-based cross-sectional study was conducted among college-going girls (N = 792) of four colleges attending Higher Secondary Certificate (HSC) classes (eleven/twelve classes) in Chittagong District. Data were collected using a structured and self-administered questionnaire. Chi-square (χ2) and independent-samples t-test were conducted to make the comparison between urban and rural (...) participants. Data were analyzed using IBM SPSS version 24.0. The authors’ interpretation of the findings was also informed by anthropological as well as qualitative considerations. Mothers were reported to be the key informants of reproductive health for the adolescent girls of both urban and rural areas. Besides, urban respondents were more likely than rural respondents (p <.001) to feel comfortable during the discussion on RH with mother/sister/relative; to communicate frequently with their mothers; to discuss RH issues regularly; to have prior knowledge on menstruation. Moreover, this study also found significant differences (p <.05) regarding most of the items addressing RH knowledge, attitude, and practice between adolescent girls in urban and rural areas of Bangladesh due to the existing socio-cultural disparities between the areas of residence. (shrink)

The purpose of this essay is to show that there was one person, perhaps only one, who developed a rigorously scientific cosmology nearly two thousand years ago. Cosmology is the largest of all subjects, with a long history, and the cosmology considered here is the one that endured for the longest part, nearly three-quarters, of that history. By cosmology I mean a description of the universe as a whole and of the arrangement of its principal parts. But by scientific cosmology, (...) I mean something more. For a cosmology to be considered scientific, three criteria must be met: it must be quantitative, physical, and empirical. Quantitative means that it must assign some scale of distances and sizes to its parts. Physical means that it must rest upon some kind of physical or mechanical principles, causes, for the ordering and motion of its parts. Finally, empirical means that it must either be derived from observation or, if derived theoretically, as from physical or mechanical principles, it must be confirmed by observation. I set out these criteria, which may not be exclusive or exhaustive but are surely within reason, in order to define our subject and exclude mythological or theological cosmologies, which generally meet none of the criteria, and philosophical cosmologies, as those of Plato, Aristotle, and Descartes, which may meet one or two in some way, although not rigorously, but surely do not meet all three. I am not concerned with whether the cosmology or the criteria upon which it is based are correct. Compared to our present understanding, the scale may be off by orders of magnitude, the physics may be entirely mistaken, and the observations may be inaccurate. But if all three are present I would call the cosmology scientific, and if not I would not call the cosmology scientific. (shrink)