Background and objective: Code status discussions may fail to address patients’ treatment-related goals and their knowledge of cardiopulmonary resuscitation (CPR). This study aimed to investigate patients’ resuscitation preferences, knowledge of CPR and goals of care. Design, setting, patients and measurements: 135 adults were interviewed within 48 h of admission to a general medical service in an academic medical centre, querying code status preferences, knowledge about CPR and its outcome probabilities and goals of care. Medical records were reviewed for clinical information (...) and code status documentation. Results: 41 (30.4%) patients had discussed CPR with their doctor, 116 (85.9%) patients preferred full code status and 11 (8.1%) patients expressed code status preferences different from the code status documented in their medical record. When queried about seven possible goals of care, patients affirmed an average of 4.9 goals; their single most important goals were broadly distributed, ranging from being cured (n = 36; 26.7%) to being comfortable (n = 8; 5.9%). Patients’ mean estimate of survival to discharge after CPR was 60.4%. Most patients believed it was helpful to discuss goals of care (n = 95; 70.4%) and the chances of surviving inhospital CPR (n = 112; 83.0%). Some patients expressed a desire to change their code status after receiving information about survival following inhospital CPR (n = 11; 8.1%) or after discussing goals of care (n = 2; 1.5%). Conclusions: Doctors need to address patients’ knowledge about CPR and take steps to avoid discrepancies between treatment orders and patients’ preferences. Addressing CPR outcome probabilities and goals of care during code status discussions may improve patients’ knowledge and influence their preferences. (shrink)

Background: Discussions about medical errors facilitate professional learning for physicians and may provide emotional support after an error, but little is known about physicians’ attitudes and practices regarding error discussions with colleagues.Methods: Survey of faculty and resident physicians in generalist specialties in Midwest, Mid-Atlantic and Northeast regions of the US to investigate attitudes and practices regarding error discussions, likelihood of discussing hypothetical errors, experience role-modelling error discussions and demographic variables.Results: Responses were received from 338 participants . In all, 73% of (...) respondents indicated they usually discuss their mistakes with colleagues, 70% believed discussing mistakes strengthens professional relationships and 89% knew at least one colleague who would be a supportive listener. Motivations for error discussions included wanting to learn whether a colleague would have made the same decision , wanting colleagues to learn from the mistake and wanting to receive support . Given hypothetical scenarios, most respondents indicated they would likely discuss an error resulting in no harm , minor harm or major harm . Fifty-seven percent of physicians had tried to serve as a role model by discussing an error and role-modelling was more likely among those who had previously observed an error discussion .Conclusions: Most generalist physicians in teaching hospitals report that they usually discuss their errors with colleagues, and more than half have tried to role-model discussions. However, a significant number of these physicians report that they do not usually discuss their errors and some do not know colleagues who would be supportive listeners. (shrink)

"Effective Weight Loss presents 25 detailed sessions of an empirically supported, cognitive-behavioral treatment package called Acceptance-Based Behavioral Treatment. The Clinician Guide is geared towards helping administer treatment, and the companion Workbook provides summaries of session content, exercises, worksheets, handouts, and assignments for patients and clients receiving the treatment"--.

The obesity epidemic is one of the most serious public health threats confronting the nation and the world. The majority of overweight individuals want to lose weight, but the overall success of self-administered diets and commercial weight loss programs is very poor. Scientific findings suggest that the problem boils down to adherence. The dietary and physical activity recommendations that weight loss programs promote are effective; however, people have difficulty initiating and maintaining changes. Effective Weight Loss presents 25 detailed sessions of (...) an empirically supported, cognitive-behavioral treatment package called Acceptance-Based Behavioral Treatment. The foundation of this approach is comprised of the nutritional, physical activity, and behavioral components of the most successful, gold-standard behavioral weight loss programs. These components are synthesized with acceptance, willingness, behavioral commitment, motivation, and relapse prevention strategies drawn from a range of therapies. ABT is based on the idea that specialized self-control skills are necessary for weight control, given our innate desire to consume delicious foods and to conserve energy by avoiding physical activity. These self-control skills revolve around a willingness to choose behaviors that may be perceived as uncomfortable, for the sake of a more valuable objective. The Clinician Guide is geared towards helping administer treatment, and the companion Workbook provides summaries of session content, exercises, worksheets, handouts, and assignments for patients and clients receiving the treatment. The books will appeal to psychologists, primary care physicians, nutritionists, dieticians, and other clinicians who counsel the overweight. (shrink)

Backround Education in ethics and professionalism should reflect the realities medical students encounter in the hospital and clinic. Method We performed content analyses on Case Observation and Assessments (COAs) written by third-year medical students about ethical and professional issues encountered during their internal medicine and paediatrics clinical clerkships. Results A cohort of 141 third-year medical students wrote 272 COAs. Content analyses identified 35 subcategories of ethical and professional issues within 7 major domains: decisions regarding treatment (31.4%), communication (21.4%), professional duties (...) (18.4%), justice (9.8%), student-specific issues (5.4%), quality of care (3.8%), and miscellaneous (9.8%). Conclusions Students encountered a wide variety of ethical and professional issues that can be used to guide pre-clinical and clinical education. Comparison of our findings with results from similar studies suggests that the wording of an assignment (specifying “ethical” issues, “professional” issues, or both) may influence the kinds of issues students identify in their experience-based clinical narratives. (shrink)

The authors discuss some of the conceptual issues that must be considered in using and understanding psychiatric classification. DSM-IV is a practical and common sense nosology of psychiatric disorders that is intended to improve communication in clinical practice and in research studies. DSM-IV has no philosophic pretensions but does raise many philosphical questions. This paper describes the development of DSM-IV and the way in which it addresses a number of philosophic issues: nominalism vs. realism, epistemology in science, the mind/body dichotomy, (...) the definition of mental disorders, and dimensional vs. categorical classification. (shrink)

El presente volumen recoge seis ensayos publicados originalmente en inglés en revistas especializadas y volúmenes colectivos a lo largo de la última década. Tratan de las consecuencias de desarrollos recientes en el análisis del conocimiento para la evaluación de los argumentos escépticos tradicionales. Los argumentos escépticos pretenden mostrar que es imposible conocer el mundo. Forman parte de la tradición filosófica occidental desde la antigüedad, y han tenido una influencia importantísima en el desarrollo de la filosofía desde entonces hasta nuestros (...) días. Sin embargo, los principales argumentos escépticos parecen descansar sobre premisas acerca de la naturaleza del conocimiento que han sido puestas en tela de juicio en la epistemología actual. Esto se debe sobre todo a los análisis externistas del conocimiento, que conciben la formación de creencias como un fenómeno natural y el conocimiento como una característica objetiva de este fenómeno. Muchos epistemólogos contemporáneos piensan que si el externismo es verdadero los argumentos escépticos carecen de valor. Los trabajos recogidos aquí consideran diversos aspectos de esta situación, estudiando en detalle la interacción entre principios externistas específicos y las líneas argumentativas principales del escepticismo. (shrink)

Posverdad y populismo forman parte de una nueva intolerancia que se extiende por todo el planeta. Ambos se apoyan en la usurpación de los hechos, ahora frecuentemente difundida en las redes sociodigitales. Posverdad es la creencia masiva en versiones y falsedades que se ajustan a los prejuicios de quienes las consideran ciertas. Populismo es el ejercicio autoritario del poder a cargo de personajes que, al considerar que encarnan la voluntad del pueblo, avasallan reglas, instituciones y derechos de la democracia. (...) Los líderes populistas reaccionaron con impericia ante la pandemia y trataron de aprovecharla para ampliar su popularidad y/o para legitimar medidas autoritarias. Posverdad, populismo y pandemia son procesos con múltiples aristas. Al describir los rasgos de cada uno, este libro quiere contribuir a su discusión. --back cover. (shrink)

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

Drawing on work of the past decade, this volume brings together articles from the philosophy, history, and sociology of science, and many other branches of the biological sciences. The volume delves into the latest theoretical controversies as well as burning questions of contemporary social importance. The issues considered include the nature of evolutionary theory, biology and ethics, the challenge from religion, and the social implications of biology today (in particular the Human Genome Project).

Herbert Marcuse examined the subjective and material conditions of radical social change and developed the "Great Refusal," a radical concept of "the protest against that which is." The editors and contributors to the exciting new volume The Great Refusal provide an analysis of contemporary social movements around the world with particular reference to Marcuse's revolutionary concept. The book also engages-and puts Marcuse in critical dialogue with-major theorists including Slavoj Žižek and Michel Foucault, among others. The chapters in this book analyze (...) different elements and locations of the contemporary wave of struggle, drawing on the work and vision of Marcuse in order to reveal, with a historical perspective, the present moment of resistance. Essays seek to understand recent uprisings-such as the Zapatistas in Mexico, the Arab Spring, and the Occupy movement-in the context of Marcuse's powerful conceptual apparatus. The Great Refusal also charts contemporary social movements against global warming, mass incarceration, police brutality, white supremacy, militarization, technological development, and more, to provide insights that advance our understanding of resistance today. Contributors include: Kevin B. Anderson, Stanley Aronowitz, Joan Braune, Jenny Chan, Angela Y. Davis, Arnold L. Farr, Andrew Feenberg, Michael Forman, Christian Fuchs, Stefan Gandler, Christian Garland, Toorjo Ghose, Imaculada Kangussu, George Katsiaficas, Douglas Kellner, Sarah Lynn Kleeb, Filip Kovacevic, Lauren Langman, Heather Love, Peter Marcuse, Martin J. Beck Matuštík, Russell Rockwell, AK Thompson, Marcelo Vieta, and the editors. (shrink)

Avec trois entretiens de Jean-Luc Nancy Cosa volante : l'art n'est ni un objet, ni un ensemble de composantes formelles, encore moins schème et substance. L'art les arts plutôt, dans leur pluralité différentielle élève la question d'une forme en formation. Cette forma formans traverse de part en part la pensée des arts de Jean-Luc Nancy où importe surtout l'approche de ce qui, dans l'art, fait sens (sensibilité, intelligence, sensation, sensualité). A travers touches, intensités, vibrations, timbres, tonalités, colorations, grains, résonances, rythmes, (...) il s'agit de voir comment les arts donnent forme au monde. Cet ouvrage explore plusieurs motifs du travail de Nancy : sa réflexion sur l'iconologie "chrétienne" au sein de sa "déconstruction du christianisme", la question de ses "étranges corps étrangers", les modalités de ses ekphraseis, sa poétique cinétique, entre autres. Trois entretiens avec le philosophe constituent des moments privilégiés de cet échange autour de la question de l'art. (shrink)

Essays devoted to the work of the late Neil Wilson, Canadian philosopher and contributor to the field of semantic analysis that emerged from the fusion of logic, pragmatism, and ontology. Many of the essays in this volume take their initial inspiration from Wilson's seminal work Substances Without Substrata.

Intensity, duration, freedom, these are the three notions which constitute the motto of bergsonian speculation and the three notions which need to be decanted in order to fully understand the philosophy of life of Bergson, which culminates in his magnum opus – L’Évolution créatrice. Thus, we will try to clarify each one of them, interconnecting them consecutively in a coherent whole of an account which, being made from the exterior – as all and any analysis of life -, still delineates (...) the method of a philosophy which has the desire to comprehend pure consciousness and what is proper of life in a strict sense, and, more precisely, life as analagous of consciousness. Intensidad, duración, libertad, son las tres nociones que forman el núcleo de la especulación bergsoniana y las tres nociones que hay que decantar para comprender, en su totalidad, la filosofía de vida de Bergson que culmina en su obra magna -L'Évolution créatrice. De este modo, se intentará esclarecer cada uno de ellos, entrelazándolos consecutivamente en un todo coherente cuya consideración, es realizada desde un exterior que -como todos y cada uno de los análisis sobre la vida-, no deja de delinear la Método por el que deben regirse todas las filosofías que pretenden comprender tanto la conciencia pura, como lo propio de la vida en sentido estricto y, más precisamente, la vida como análoga a la conciencia. (shrink)

Our interpretive resources enable us to make sense of, navigate, and communicate about our shared world. These resources not only carve the world up into categories, but also guide how we, individually and collectively, are oriented towards it. In this thesis, I examine how these resources, and the dispositions they guide, may be harmful. A vital kind of interpretive resources are frames, which equip us with unified perspectives on the world. Perspectives are suites of open-ended interpretive (inquisitive, attentional, inferential, evaluative, (...) and affective) dispositions. Frames thereby guide how we interpret, respond to, and navigate the world. I show that these perspectives are epistemically powerful and indispensable. I argue that flawed perspectives, and the distorting frames that produce them, are deeply pernicious and I examine their relationship to oppression. (shrink)

En un artículo anterior, titulado «Del Diálogo del Guerrero al Diálogo del Hogar: para una fenomenología de los celos» y en homenaje a Ricardo Sánchez Ortiz de Urbina, concluía que el amor y los celos forman el arranque mismo de la condición humana en su dimensión del exceso: no es la dualidad discreta Amor/Odio la expresión de la base y el fundamento de los afectos, sino la dualidad continua Amor/Celos. Las preguntas surgen de suyo: ¿con qué concepto quedaría vinculado (...) por continuidad y exceso el odio? ¿Y cuál es la posición que le corresponde al odio respecto del amor? A partir de un comentario de Maimónides —en el que vincula la enemistad con el odio y del que sólo el conocimiento de la verdad puede alejarnos—, argumentaré que el odio es generado por la crítica, por el saber crítico, que destruye la verdad absoluta. Y propondré un cuadro semiótico-topológico explicativo con ejemplos literarios e históricos. (shrink)

The Philosophy of Adam Smith contains essays by some of the most prominent philosophers and scholars working on Adam Smith today. It is a special issue of The Adam Smith Review, commemorating the 250th anniversary of Smith's Theory of Moral Sentiments. Introduction Part 1: Moral phenomenology 1. The virtue of TMS 1759 D.D. Raphael 2. The Theory of Moral Sentiments and the inner life Emma Rothschild 3. The standpoint of morality in Adam Smith and Hegel Angelica Nuzzo Part 2: Sympathy (...) and moral judgment 4. Smith and Rousseau in dialogue: sympathy, pitié, spectatorship and narrative Charles L. Griswold 5. Adam Smith’s concept of sympathy and its contemporary interpretations Bence Nanay 6. Smith’s ambivalence about honour Stephen Darwall 7. Sentiments and spectators: Adam Smith’s theory of moral judgment Geoffrey Sayre-McCord 8. Smith’s anti-cosmopolitanism Fonna Forman-Barzilai 9. Resentment and moral judgment in Smith and Butler Alice MacLachlan Part 3: Economics, religion, aesthetics and value theory 10. Adam Smith’s problems: individuality and the paradox of sympathy Robert Urquhart 11. Scepticism and naturalism in Adam Smith Ryan Patrick Hanley 12. Adam Smith’s solution to the paradox of tragedy Arby Ted Siraki 13. Smithian intrinsic value Patrick Frierson Memoir on Adam Smith’s life 14. Adam Smith’s smile: his years at Balliol College, 1740–6, in retrospect Ian Simpson Ross. (shrink)

Bernat argues for a unified brain-based determination of death (UBDD), noting that it “conceptually justifies” death determination both in Donation after Circulatory Determination of Death (DCDD) a...

The object of this paper is to show why recent research in the psychology of deductive and probabilistic reasoning does not have.