Background and Aims Progress towards validating amyloid beta as an early indicator of Alzheimer’s disease (AD) heightens the need for evaluation of stakeholders’ perspectives of the benefits and harms of preclinical testing in asymptomatic individuals. Methods Investigators conducted and analyzed 14 semi-structured interviews with family members of patients diagnosed with AD. Results Participants reported benefits, including the potential to seek treatment, make lifestyle changes, and prepare for cognitive impairment. Participants identified harms, including social harms, adverse life decisions, and psychological harms. (...) Nine participants reported either a “positive global perspective” or a “positive global perspective (qualified).” Conclusion Results from this study characterized stakeholders’ perspectives on the potential benefits and harms of clinical use of preclinical testing for AD. Investigators used data from this study to develop a framework that contributes to ongoing discussions that will evaluate widespread adoption of preclinical testing and will inform future research. (shrink)

Objective Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians’ attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus. Design, Setting, Participants A survey of resident/fellow physicians and internal medicine (...) attendings at an academic medical center, May to August 2013. Measurements We used a 24-item, internet-based survey assessing physician-respondents’ demographic characteristics, knowledge, and attitudes regarding decisional authority for adult VA-ECMO. Qualitative narratives were also collected. Main Results A total of 179 physicians completed the survey (15 percent response rate); 48 percent attendings and 52 percent residents/ fellows. Only 32 percent of the respondents indicated that a surrogate’s consent should be required to discontinue VA-ECMO; 56 percent felt that physicians should have the right to discontinue VA-ECMO over a surrogate’s objection. Those who self-reported as “knowledgeable” about VA-ECMO, compared to those who did not, more frequently replied that there should not be presumed consent for VA-ECMO (47.6 percent versus 33.3 percent, p = 0.007), that physicians should have the right to discontinue VAECMO over a surrogate’s objection (76.2 percent versus 50 percent, p = 0.02) and that, given its cost, the use of VA-ECMO should be restricted (81.0 percent versus 54.4 percent, p = 0.005). Conclusions Surveyed physicians, especially those who self-reported as knowledgeable about VA-ECMO and/or were specialists in pulmonary/ critical care, favored a medical locus of decisional authority for VA-ECMO. VA-ECMO is complex, and the data may (1) reflect physicians’ hesitance to cede authority to presumably less knowledgeable patients and surrogates, (2) stem from a stewardship of resources perspective, and/or (3) point to practical efforts to avoid futility and utility disputes. Whether these results indicate a more widespread reversion to paternalism or a more circumscribed usurping of decisional authority occasioned by VA-ECMO necessitates further study. (shrink)

This essay considers one key aspect of Alexander Pruss’s One Body: An Essay in Christian Sexual Ethics, namely, his judgment that many, perhaps most, of the fleshly intimacies possible among human persons ought be evaluated and judged licit or illicit by their relation to the act whereby husband and wife become “one flesh.” This account of fleshly intimacies is too restrictive, indeed absurdly so, and particularly if considered according to natural lights alone and in abstraction from Christian revelation and (...) doctrine, which is what Pruss claims to do in the book. (shrink)

We propose using a bi-axial map as a heuristic for categorizing different dynamics involved in the relationship between quality and popularity. The east–west axis represents the degree to which an agent’s decision is influenced by those of other agents. This ranges from the extreme western edge, where an agent learns individually (no outside influence), to the extreme eastern edge, where an agent is influenced by a large number of other agents. The vertical axis represents how easy or difficult it is (...) for an agent to discern the relative quality of available choices. When a case study is located on the map, it becomes easier to select the range of tools to use for understanding and predicting the relation between quality and popularity. (shrink)

This handbook presents a comprehensive introduction to the core areas of philosophy of education combined with an up-to-date selection of the central themes. It includes 95 newly commissioned articles that focus on and advance key arguments; each essay incorporates essential background material serving to clarify the history and logic of the relevant topic, examining the status quo of the discipline with respect to the topic, and discussing the possible futures of the field. The book provides a state-of-the-art overview of philosophy (...) of education, covering a range of topics: Voices from the present and the past deals with 36 major figures that philosophers of education rely on; Schools of thought addresses 14 stances including Eastern, Indigenous, and African philosophies of education as well as religiously inspired philosophies of education such as Jewish and Islamic; Revisiting enduring educational debates scrutinizes 25 issues heavily debated in the past and the present, for example care and justice, democracy, and the curriculum; New areas and developments addresses 17 emerging issues that have garnered considerable attention like neuroscience, videogames, and radicalization. The collection is relevant for lecturers teaching undergraduate and graduate courses in philosophy of education as well as for colleagues in teacher training. Moreover, it helps junior researchers in philosophy of education to situate the problems they are addressing within the wider field of philosophy of education and offers a valuable update for experienced scholars dealing with issues in the sub-discipline. Combined with different conceptions of the purpose of philosophy, it discusses various aspects, using diverse perspectives to do so. Contributing Editors: Section 1: Voices from the Present and the Past: Nuraan Davids Section 2: Schools of Thought: Christiane Thompson and Joris Vlieghe Section 3: Revisiting Enduring Debates: Ann Chinnery, Naomi Hodgson, and Viktor Johansson Section 4: New Areas and Developments: Kai Horsthemke, Dirk Willem Postma, and Claudia Ruitenberg. (shrink)

The essays in this book, by a variety of leading Augustine scholars, examine not only Augustine's multifaceted philosophy and its relation to his epoch-making theology, but also his practice as a philosopher, as well as his relation to other philosophers both before and after him. Thus the collection shows that Augustine's philosophy remains an influence and a provocation in a wide variety of settings today.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: -/- The main aim of this review will be to assess the effects of changing practitioner empathy or patient expectations for all conditions. The main objective is to conduct a systematic review of randomised trials where the intervention involves manipulating either (a) practitioner empathy or (b) patient expectations, or (c) both.

Since its founding in 1943, Medievalia et Humanistica has won worldwide recognition as the first scholarly publication in America to devote itself entirely to medieval and Renaissance studies. Since 1970, a new series, sponsored by the Modern Language Association of America and edited by an international board of distinguished scholars and critics, has published interdisciplinary articles. In yearly hardbound volumes, the new series publishes significant scholarship, criticism, and reviews treating all facets of medieval and Renaissance culture: history, art, literature, music, (...) science, law, economics, and philosophy. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

English summary: It seems that reason is less a universal principle than something inherently bound to the contexts in which it appears. These contributions to a conference held on the occasion of Christoph Schwobel's 60th birthday explore the character of reason's manifold contexts: the grounding of reason in the inner word of God 's Trinitarian life as well as the disclosure of reason and and its limits in human conversation. German description: Vernunft scheint in der Gegenwart weniger ein allgemeines Prinzip (...) als eine in Kontexte eingebundene Grosse zu sein. Die Beitrage einer Tagung anlasslich von Christoph Schwobels 60. Geburtstag, gehen der Frage nach dem Charakter dieser Kontextbindung nach: der Begrundung der Vernunft im trinitarischen Gesprach wie der Erschliessung und Problematisierung der Vernunft im menschlichen Gesprach. Mit Beitragen von V. Brummer, G. van den Brink, C. Drobe, H. J. Eckstein, D.-M. Grube, J. Halfwassen, S. Heine, F. Hermanni, E. Herms, W. Harle, W. Homolka, W. Jeanrond, R. W. Jenson, D. Kelsey, A. F. Koch, A. Kupsch, V. Leppin, P.-C. Lai, P. Lo, A. Min, J. Moltmann, M. Muhling, P. Peterson, M. Sarot, F. Schweitzer, A. Torrance, J. Webster, M. Welker, M. Wendte, M. Wisse, H. Wisskirchen und L. Zak. (shrink)

The editors of this unique volume have brought together 24 leading emotion theorists with a wide variety of perspectives to address 12 fundamental questions about the subject.

The hermeneutical key to reading and interpreting the Gospel of Mark is the role which the Evangelist has given to the passion of Jesus as the primary perspective for understanding all the other traditions about Jesus incorporated in the Gospel.

Like nature itself, modern economic life is driven by relentless competition and unbridled selfishness. Or is it? Drawing on converging evidence from neuroscience, social science, biology, law, and philosophy, Moral Markets makes the case that modern market exchange works only because most people, most of the time, act virtuously. Competition and greed are certainly part of economics, but Moral Markets shows how the rules of market exchange have evolved to promote moral behavior and how exchange itself may make us more (...) virtuous. Examining the biological basis of economic morality, tracing the connections between morality and markets, and exploring the profound implications of both, Moral Markets provides a surprising and fundamentally new view of economics--one that also reconnects the field to Adam Smith's position that morality has a biological basis. Moral Markets, the result of an extensive collaboration between leading social and natural scientists, includes contributions by neuroeconomist Paul Zak; economists Robert H. Frank, Herbert Gintis, Vernon Smith, and Bart Wilson; law professors Oliver Goodenough, Erin O'Hara, and Lynn Stout; philosophers William Casebeer and Robert Solomon; primatologists Sarah Brosnan and Frans de Waal; biologists Carl Bergstrom, Ben Kerr, and Peter Richerson; anthropologists Robert Boyd and Michael Lachmann; political scientists Elinor Ostrom and David Schwab; management professor Rakesh Khurana; computational science and informatics doctoral candidate Erik Kimbrough; and business writer Charles Handy. (shrink)

This paper examines the strengths and weaknesses of one of science's most pervasive and flexible metaprinciples;optimalityis used to explain utility maximization in economics, least effort principles in physics, entropy in chemistry, and survival of the fittest in biology. Fermat's principle of least time involves both teleological and causal considerations, two distinct modes of explanation resting on poorly understood psychological primitives. The rationality heuristic in economics provides an example from social science of the potential biases arising from the extreme flexibility of (...) optimality considerations, including selective search for confirming vidence, ex post rationalization, and the confusion of prediction with explanation. Commentators are asked to reflect on the extent to which optimality is an organizing principle of nature, a set of relatively unconnected techniques of science, a normative principle for rational choice and social organization, a metaphysical way of looking at the world, or something else still. (shrink)

This exploration of a notorious mathematical problem is the work of the man who discovered the solution. Written by an award-winning professor at Stanford University, it employs intuitive explanations as well as detailed mathematical proofs in a self-contained treatment. This unique text and reference is suitable for students and professionals. 1966 edition. Copyright renewed 1994.

The problem of Time is one of the most fascinating and yet most difficult of those questions to which the human mind applies itself in philosophical thought. Dean Inge, in his Philosophy of Plotinus, has referred to this problem as ‘the hardest in metaphysics,’ and we know that “from the time of Parmenides and Zeno to that of Mr. Bradley and M. Bergson, there has been no other problem that has seemed so baffling as that of Time.”.

Because Paul has proven difficult to understand, the interpreter must pay careful attention to the language, the rhetorical structure, and the context if unnecessary difficulties are to be avoided.

The problem of Time is one of the most fascinating and yet most difficult of those questions to which the human mind applies itself in philosophical thought. Dean Inge, in his Philosophy of Plotinus, has referred to this problem as ‘the hardest in metaphysics,’ and we know that “from the time of Parmenides and Zeno to that of Mr. Bradley and M. Bergson, there has been no other problem that has seemed so baffling as that of Time.”.

This study examined the historical perspectives of eleven emergent bilingual and bilingual students at two middle schools. Data analysis revealed that the participants’ perspectives on U.S. history reflected three schematic narrative templates focused on nation-building, equality, and discrimination. The participants primarily employed the (in)equality narratives when discussing aspects of U.S. history directly linked to their identities. The findings add to the extant research on student historical perspectives and use of schematic narrative templates. The findings further suggest that engaging (emergent) bilingual (...) students in examining multiple perspectives and conducting critical history inquiry can contribute to notions of culturally and linguistically responsive social studies instruction. (shrink)

Clinical ethicists encounter the most emotionally eviscerating medical cases possible. They struggle to facilitate resolutions founded on good reasoning embedded in compassionate care. This book fills the considerable gap between current texts and the continuing educational needs of those actually facing complex ethics consultations in hospital settings. 28 richly detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of these impossibly difficult consultations. The cases are grouped together by theme to aid teaching, discussion and professional growth. The (...) cases inform any reader who has a keen interest in the choices made in real-life medical dilemmas as well as the emotional cost to those who work to improve the situations. On a more advanced level, this book should be read by ethics committee members who participate in ethics consultations, individual ethics consultants, clinicians who seek education about complex clinical ethics cases, and bioethics students. (shrink)

In his identity, words, and deeds Jesus of Nazareth provides the possibility and promise of ministry in his name.

Complex clinical ethics cases require a blend of compassion, sensitivity, and tenacity in order to navigate the hard work required of stakeholders. Each person comes to the table with rich historie...

There is as yet... no unanimity among New Testament scholars as to the extent to which, or even whether at all, the category of divine man played a part in the interpretation of Jesus in the early Christian traditions.

This study examines the effects of demographic characteristics on ethical perceptions. While earlier research has produced conflicting results regarding the predictive power of these variables, significant and definite insights were obtained with proper controls. The following predictors of ethical attitudes are examined: age, gender, marital status, education, dependent children status, region of the country and years in business, while controlling for job status. A nation-wide random sample of employees was used in obtaining a response rate of fifty-three percent (total n (...) of 423). Indices of aspects of business ethical attitudes were constructed using factor analysis. Linear multiple regression analysis indicated the significant predictive variables. Age was found to be a most-significant predictor. Older workers had stricter interpretations of ethical standards. Gender and region predicted attitudes about job-discrimination practices only, with women and persons from the Midwest most strongly opposed to the practice. All the other variables proved to be unreliable ethics predictors. (shrink)

The vulnerability of patients receiving significantly innovative neurosurgical procedures, either as research or as non-standard therapy, presents particularly potent challenges for those attempting to substantially advance clinical Neurosurgical practice in the most ethically and efficacious manner. This beginning formulation has built into it several important notions about research participation, balancing values, and clinical advancement in the context of neurological illness. For the time being, allow vulnerability to act as a placeholder for circumstances or states of being wherein the established checks (...) and balances of power and interest are no longer sufficient in promoting the just treatment of persons. Further, the phrase to substantially advance Neurosurgical practice encompasses radical innovation as well as significant research into new procedures. Finally, few of these explorations involve true randomized placebo controlled trials, but rather they enroll patients rightfully hoping for some benefit by means of undergoing the procedure.When a neurosurgeon asks me, as an ethicist, to meet with a patient who has medically refractory disease and no good standard therapy options remaining, he is asking for help concerning whether to offer, as a last chance, an unproven therapy as either innovation or research. (shrink)

Seven specific challenges in patient vulnerability related to neurosurgical advancement highlight needed augmentations for standards in innovation and research that do not unduly inhibit access to potential therapies while assuring just treatment of patients.

The essay examines the impact of thought insertion on typical conceptions of self-consciousness. Stephens and Graham have recently argued that thought insertion is compatible with the inseparability thesis, which maintains that with regard to self-consciousness subjectivity is a proper part of introspection--introspection and subjectivity are inseparable. They argue that thought insertion is an error of agency and not an error of subjectivity. The essay contends that even if they are correct in their interpretation that thought insertion is an error of (...) agency rather than subjectivity, which is unlikely, they are incorrect to maintain that it is not also an error of subjectivity. Evidence is put forth to indicate that thought insertion is, at best, a mistake of agency and subjectivity. It is concluded that thought insertion is incompatible with the inseparability thesis, and a new inseparability thesis is thereby postulated. (shrink)

Most people would agree that compulsive lying is a "sickness." In his provocative Lying, Paul Griffiths suggests that consistent truth telling might evoke a similar response. After all, isn't unremitting honesty often associated with stupidity, insanity, and fanatical sainthood? Drawing from Augustine's writings, and contrasting them with the work of other Christian and non-Christian thinkers, Griffiths deals with the two great questions concerning lying: What is it to lie? When, if ever, should or may a lie be told? Examining (...) Augustine's answers to these questions, Griffiths grapples with the difficulty of those answers while rendering them more accessible. With rhetorical savvy Augustine himself would applaud, Griffiths aims to "seduce" rather than argue his readers into agreement with Augustine. Augustine's historically significant, characteristically Christian, and undeniably radical thoughts on lying ignite Griffiths's searching discussion of this challenging and crucial topic. Marvelously erudite and energetic, Lying will draw Augustine enthusiasts, students of ethics, and anyone who is committed to living a more honest life. (shrink)

Trust is a temporary attachment between humans that pervades our daily lives. Recent research has shown that the affiliative hormone oxytocin rises with a social signal of interpersonal trust and is associated with trustworthy behavior (the reciprocation of trust). This commentary reports these results and relates them to the target article's findings for variations in affiliative-related behaviors.