The paper explores the ethical and psychological issues that arise when family members request that “everything possible” be done for a particular patient. The paper first illustrates this phenomenon by reviewing the well known case of Helga Wanglie. We proceed to argue that in Wanglie and similar cases family members may request futile treatments as a means of conveying that (1) the loss of the patient is tantamount to losing a part of themselves; (2) the patient should not be abandoned (...) or disvalued in any way; or (3) the patient is owed special obligations by virtue of the special relationship in which the family and the patient stand. We maintain that families can best express these important messages by caring for patients, rather than by making requests for futile interventions. Likewise, when life-sustaining measures are futile, health providers can best fulfill their professional obligations by assuring patients' dignity and comfort, rather than by applying futile interventions. (shrink)

The purpose of this study is to examine the importance that real patients attach to their right to withdraw from an on-going feasibility randomised trial (RCT) evaluating types and timings of breast reconstruction (two parallel trials) following mastectomy for breast cancer. Our results show that, while some respondents appreciated that exercising the right to withdraw would defeat the scientific objective of the trial, some patients with a surgical preference consented only given the knowledge they could withdraw if they were not (...) allocated to their preferred treatment. (shrink)

We are printing, by kind permission of the Law Commission, two sections of the report of the Law Commission on injuries to unborn children. This report was the result of a request to the Law Commission by the Lord Chancellor at the time (Lord Hailsham of Saint Marylebone) to advise on `what the nature and extent of civil liability for antenatal injury should be'. The Law Commission followed its usual practice in such circumstances of consulting various bodies and obtaining expert (...) advice on the subject and then embodying the results in a working paper (Working Paper No. 47 - injuries to unborn children) published on 19 January 1973, which preceded their report (Cmnd 5709). Meanwhile a Royal Commission is considering much wider issues of civil liability for injury (including antenatal injury) but the terms of reference for the Law Commission were much narrower and confined to the position of children injured before birth. In the section relating to the present law the report makes it clear that it is probable that liability under the common law already exists. The Scottish Law Commission has also issued a report (Cmnd 5371). They were given different terms of reference and came to somewhat different conclusions. We are printing from this long report the paragraphs discussing the medical background and the summary of recommendations. As will be evident on reading the paragraphs on the medical background to injuries to the unborn child, events are moving very rapidly, particularly in the study of congenital defects and the effects of drugs but the problems of proof present great difficulty. Other causes of injury to the unborn child are better known to the general public: for example, those following the illness, infection and disease of the mother during pregnancy, injury caused in attempted termination of pregnancy and the risks resulting from the mother's condition. The summary of the recommendations sets out very clearly the legal position of the unborn child, as the Law Commission sees it, arising from injury before birth, the final conclusion being that `legislation is desirable'. These extracts from the report, apart from their intrinsic interest, lead on to the paper by Mr Kennedy and Dr Edwards in which they set out their criticisms of it, and provide quick references to the original document. (shrink)

This mixed methods study examines how college students’ perceptions and experiences affect their understanding of academic integrity. Using qualitative and quantitative responses from the Personal and Social Responsibility Institutional Inventory, both quantitative and qualitative results demonstrate that while campuses may see a reduction in overall levels of cheating when punitive academic integrity policies are present, students may develop higher levels of personal and academic integrity through the use of more holistic and community-focused practices.

Ontology engineering is mainly done by domain experts who are specialists in their domain but have, if at all, limited knowledge in logics, computer science, or analytic philosophy. The literature on formal ontologies and biomedical ontologies is neither suited nor intended to serve as an educational resource that would help domain experts to become good ontologists. Existing educational resources focus rather on ontology tools and languages than on good practice. The purpose of the GoodOD guideline is to pave the road (...) for domain experts who want (or need) to become ontology engineers. It pursues the openly pragmatic approach that ontology engineers only need to know ontology theory to the extent which supports the (measurable) outcome of their work. The GoodOD Guideline builds upon given philosophical and methodological principles as well as preexisting tools and resources. In particular (pragmatic) scientific realism, first order logics and its subset OWL-DL (description logics), set theory, an upper-level ontology with high-level categories and a canonic set of relations, constraints which limit the freedom of choice when building coordinate expressions, the ontology editor Protégé 4, a complete DL reasoner, such as HermIT, ontology design patterns, and naming conventions. -/- Given these precepts the guideline contains all the knowledge to be acquired by a user to be able to solve ontology engineering problems in a foreseeable and non-arbitrary way. The didactic concept is to convey the skills not only by theory but also by practical examples. (shrink)

The focus of this study was to analyze the content, distribution, and comparative genome relationships of 996 chromosome bin-mapped expressed sequence tags accounting for 2266 restriction fragments on the homoeologous group 3 chromosomes of hexaploid wheat. Of these loci, 634, 884, and 748 were mapped on chromosomes 3A, 3B, and 3D, respectively. The individual chromosome bin maps revealed bins with a high density of mapped ESTs in the distal region and bins of low density in the proximal region of the (...) chromosome arms, with the exception of 3DS and 3DL. These distributions were more localized on the higher-resolution group 3 consensus map with intermediate regions of high-mapped-EST density on both chromosome arms. Gene ontology classification of mapped ESTs was not significantly different for homoeologous group 3 chromosomes compared to the other groups. A combined analysis of the individual bin maps using 537 of the mapped ESTs revealed rearrangements between the group 3 chromosomes. Approximately 232 of the consensus mapped ESTs matched sequences on rice chromosome 1 and revealed large- and small-scale differences in gene order. Of the group 3 mapped EST unigenes ∼21 and 32% matched the Arabidopsis coding regions and proteins, respectively, but no chromosome-level gene order conservation was detected. (shrink)

Pre-Implantation Genetic Diagnosis represents the first fusion of genomics and assisted reproduction and the first reproductive technology that allows prospective parents to screen and select the genetic characteristics of their potential offspring. However, for some, the idea that we can intervene in the mechanisms of human existence at such a fundamental level can be, at a minimum, worrying and, at most, repugnant. Religious doctrines particularly are likely to collide with the rapidly advancing capability for science to make such interventions. This (...) paper focuses on opinions and arguments of selected religious scholars regarding ethical issues pertaining to PGD. In-depth interviews were conducted with religious scholars from three different religious organizations in the Klang Valley, Malaysia. Findings showed that Christian scholars are very sceptical of the long-term use of PGD because of its possible effect on the value of humanity and the parent-children relationship. This differs from Islamic scholars, who view PGD as God-given knowledge in medical science to further help humans understand medical genetics. For Buddhist scholars, PGD is considered to be new medical technology that can be used to save lives, avoid suffering, and bring happiness to those who need it. Our results suggest that it is important to include the opinions and views of religious scholars when it comes to new medical technologies such as PGD, as their opinions will have a significant impact on people from various faiths, particularly in a multi-religious country like Malaysia where society places high value on marital relationships and on the traditional concepts of family. (shrink)

The review presents the International Workshop “Transcendental Turn in Contemporary Philosophy-3: Nature of Transcendental Philosophy” held in Moscow on 19-22 April, 2018. The workshop was co-sponsored by the State Academic University for the Humanities, the Russian State University for the Humanities and the Foundation for the Humanities. The review examines the main topics of the workshop, summarises the main presentations and explicates the problem area of modern interpretations of Kant and the development of transcendentalism in the twentieth and twenty-first centuries. (...) The presentations, questions and discussions centred around the main problems of transcendentalism: the differences between the phenomenon and the thing in itself, between the first and second editions of the Critique of Pure Reason, the relationship between realist and constructivist aspects of Kantian transcendentalism, the transformation of Kantian transcendental philosophy in Neo-Kantianism and phenomenology and more. (shrink)

OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

The ternary xV2O5–(40 − x)Li2O–60B2O3 glass system, where x = 1, 2, 3, 4 and 6 mol%, was prepared by normal quenching. Ultrasonic velocities and attenuation were measured at room temperature using a pulse-echo technique. Various parameters, such as elastic moduli, micro-hardness, Poisson's ratio and Debye temperature, were determined from the measured densities and velocities. The composition dependence of these parameters, in addition to the glass-transition temperature, suggested that vanadium ions were incorporated into these glasses as a network modifier, resulting (...) in the reconversion of BO4 tetrahedra to BO3 triangles by the breaking of B–O–B linkages and the formation of nonbridging oxygens (NBOs). The outcome was a reduction in network connectivity and rigidity with increasing V2O5 content. The results are explained quantitatively in terms of fractal bond connectivity, average atomic volume, network dimensionality, packing density, number of network bonds per unit volume, cross-link density and atomic ring size. The Makishima and Mackenzie model appears to be valid for the studied glasses when the fate of BO4 tetrahedra and creation of NBOs are taken into account. (shrink)

This paper proposes an empirical hypothesis that in some cases of social interaction we have an immediate perceptual access to others' minds in the perception of their embodied intentionality. Our point of departure is the phenomenological insight that there is an experiential difference in the perception of embodied intentionality and the perception of non-intentionality. The other's embodied intentionality is perceptually given in a way that is different from the givenness of non-intentionality. We claim that the phenomenological difference in the perception (...) of embodied intentionality and non-intentionality translates into an account of how, in some cases of social cognition, we perceive mental properties in the perception of embodied intentionality. The hypothesis derives support from a host of recent empirical studies in social neuroscience which demonstrate the importance of embodied engagements in understanding other minds. These studies reveal that embodied intersubjective interaction often builds on our ability to understand other minds in an immediate perceptual way not adequately investigated by theory-theory (TT) and simulation theories (ST) of mind-reading. We argue that there is a genuine, nontrivial difference in the informational content of the perception of embodied intentionality and the perception of non-intentionality which leads to a further difference in the way information is processed in the case of perception of embodied intentionality as opposed to the perception of non-intentionality. The full significance of such difference is appreciated only within an account of perception which views perception and action as tightly coupled. Thus, we propose an "action-oriented account of social perception" to develop a neurophilosophical account of the perceptual knowledge of other minds. (shrink)

The problem of the rational and the irrational has been one of the most important problems of philosophy since philosophy's birth, for what is philosophy if not meditation on the structure of the universe and of man, immersed in it: Is the universe rational, or is it at bottom irrational and hence unknowable and unpredictable? Are our means of coming to know being [bytie] rational, or can one reach the depths of being only through intuition, illumination, and so forth? Let (...) me immediately make the qualification that the questions posed are improper, for to separate the rational and the irrational is from various points of view extremely unphilosophical. Just as the one cannot exist without the many, just as there is no being without nonbeing, no left without right, no night without day, and no male without female, so there is in philosophy no rational without the irrational. To disregard or consciously reject either the rational or the irrational level of being leads to truly tragic consequences: not only is an invalid theoretical schema created that impoverishes reality, but a knowingly false idea of the universe and of man's situation in it is formed. Let us recall our, if one may call it that, most recent past. The Stalinist-Brezhnevist ideology without further ado simply forbade the irrational and commanded that the world be regarded as rational, lucid, and transparent. The powers that be taught philosophers and their ilk to "think" of being as exclusively of this world, a very simple world, each part of which was easy to describe, explain, and render comprehensible to all without exception. L. Gozman and A. Etkind have persuasively demonstrated how on the basis of such a theoretical postulate were built the corresponding moral, political, and scientific constructions, which became out-and-out caricatures . For example, the authors wrote, a "simple" person, who "had not studied in the universities," was considered the bearer of true morality and goodness. On the other hand, anything that was incomprehensible, that did not fit into a rationalistic framework, was declared an ill-intentioned muddling of a harmonious world that harbored no essential secrets. But if the world is simple and comprehensible, then all the work of scientists is a meaningless waste of the nation's money, and their discoveries and conclusions are an attempt to take people in. The broadest circulation was given to popularized scientific literature and educational lectures that helped the reader and the listener to develop the assurance that he was clear about everything, with the exception of why specialists were unable to get to the bottom of such obvious questions. (shrink)

The fate of liberalism in Russia almost automatically brings to mind the image of something tragic, of something that perished in its very prime. The fate of the theoreticians and political leaders of liberalism, from B.N. Chicherin to P.A. Stolypin and P.N. Miliukov, reflects the fate of the movement itself—disgrace, exile, violent death. The Bolshevik October Revolution can be dated as the final ruin of the liberal movement in Russia. The lifespan of Russian liberalism thus dates from the middle of (...) the nineteenth century to 1917. (shrink)

Historical study of Islam and science including hadith, theology and Islamic philosophy etc.

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)