The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)
I define serendipity as the art of making an unsought finding. And I propose an overview of my collection of serendipities, the largest yet assembled, chiefly in science and technology, but also in art, by giving a list of ‘serendipity patterns’. Although my list of ‘patterns’ is just a list and not a classification, it serves to introduce a new and possibly stimulating perspective on the old subject of serendipity. Knowledge of these ‘serendipity patterns’ might help in expecting also the (...) unexpected and in finding also the unsought. * I acknowledge A. D. de Groot, R. C. M. Noordam, B. P. van Heusden, T. Pinkster, C. J. van den Berg, T. A. F. Kuipers, A. Wegener Sleeswijk and my referee for their suggestions and I dedicate this article to T. A. van Kooten. Cases and studies of serendipidy are welcome. À propos: a travelling serendipity exhibition is available, also for ‘new democracies’: ‘Freedom of opportunity as developed by democracy is the best human reaction to divergent phenomena. We may, in fact, define ‘freedom’ as ‘the opportunity to profit from the unexpected.’ (Langmuir [1956]). (shrink)
Abstract Kohlberg's cognitive?developmental theory provides teachers with a framework for understanding the change and development of moral judgment and decision?making of their pupils. One major abuse, however, may be when teachers take the stage labels associated with the hypothesized stage levels of moral judgment as indicative of static student qualities or characteristics, by placing more emphasis on perceived and labelled qualities than on the actual moral reasoning of the student. This, it is suggested, together with some empirical examples, may obscure (...) the developmental trend of the student's moral judgment or even affect the teacher's expectations and consequently student's performance, and fails to take into account such factors as environment and interpersonal interaction. A study is reported in which curriculum consultants exposed to moral development theory were tested to determine whether they would use Kohlbergian labels of stage content or actual moral reasoning when required to make assessments. Suggestions are put forward as to how moral development theory can be more closely linked to pedagogy. (shrink)
InWord and Object W. V. Quine argues that there is no uniquely correct way to assign referents to the terms of a language; any claim about the reference of a term is implicitly relative to a manual of translation. To Rudolf Carnap this must have seemed familiar. BeforeWord and Object was written Carnap had been saying the same thing inMeaning and Necessity: under the assumption of the method of the name-relation, any claim about the reference of a term is implicitly (...) relative to what Carnap calls a conception of the name-relation. Yet Carnap is often taken to be a victim of Quine's relativistic notion of reference. Drawing on Carnap's discussion of the name-relation inMeaning and Necessity, it is argued that Carnap's and Quine's views on reference are not so far apart as is usually perceived. (shrink)
