With the passage by virtually every state legislature of healthcare proxy laws, the medical profession increasingly can expect to rely on the participation of surrogates in making decisions on behalf of incompetent patients. Several concerns about the legitimacy of proxy decision making have been discussed in the ethical and general medical literature: the lack of concordance between the views of patients and their surrogates have been documented on multiple occasions, and cases of abuse by proxies or potential conflict of interest (...) have been reported. Another dilemma that deserves discussion arises when proxies demand withdrawal of treatment that physicians and nurses regard as essential to the wellbeing of the patient. The following case highlights this dilemma. (shrink)

Developing a reasonable approach to the medical care of older people with dementia will be essential in the coming decades. Physicians are the locus of decision making for persons with dementia. It is the responsibility of the physician to assure that the surrogate understands the nature and trajectory of the disease and then to elicit the desired goal of care. Physicians need to ascertain whether any advance directives are available, and if so, whether they apply to the situation of advanced (...) dementia. Finally, physicians should help surrogates understand how the goals of care are best translated into practice. When the goal is comfort, this is achieved by assuring dignity, minimizing suffering, and promoting caring. In general, comfort should be the default goal of care, best implemented through palliative care or hospice. (shrink)

America is aging. But even more striking than the rise in the proportion of the population over age 65 is the unprecedented number of individuals who are living into their eighties and nineties. While many people remain robust well into advanced age, the dramatic increase in the number of the oldest old has brought with it an epidemic of Alzheimer’s disease and other dementias. Dementia is a highly prevalent condition — currently 5.4 million Americans have Alzheimer’s disease, a number which (...) may rise to 16 million by 2050 if there is no breakthrough in the prevention or treatment of the disease — but it disproportionately affects those over age 85, striking between one-third and one-half of this cohort. Developing a reasonable approach to the medical care of older people with dementia will be essential in the coming decades. (shrink)

Several religious traditions are widely believed to advocate the use of life-sustaining treatment in all circumstances. Hence, many believe that these faiths would require the use of a feeding tube in patients with advanced dementia who have lost interest in or the capacity to swallow food. This article explores whether one such tradition—halachic Judaism—in fact demands the use of artificial nutrition and hydration in this setting. Traditional arguments have been advanced holding that treatment can be withheld in persons who are (...) dying, in individuals whose condition causes great suffering, or in the event that the treatment would produce suffering. Individuals with advanced dementia can be considered to be dying, often suffer as a result of their dementia, and are likely to suffer from the use of a feeding tube. Given these observations and the absence of a compelling case for distinguishing between tube feeding and other forms of medical treatment, traditional Judaism appears compatible with withholding artificial nutrition for individuals with advanced dementia. (shrink)

In light of the central role that medications play in medical progress, the declining rate of new drug development over the past decade is cause for concern . Without important breakthroughs in drug discovery, the future will not be auspicious for the many people suffering from chronic and incurable illnesses. The sluggish pace of pharmaceutical innovation has been particularly characteristic of the largest drug manufacturers, which have generally focused their energies on potential blockbuster medications, those that can generate over $1 (...) billion in annual revenue . Given Pharma’s struggles, the success of the country’s largest drug manufacturer in bringing the .. (shrink)

With great fanfare, the first baby boomer turned 65 on January 1, 2011, ushering in the new, gray society. We—I'm one of the 76 million baby boomers—were expected to transform aging: better educated, healthier, reared in an era of unprecedented prosperity, committed to individual autonomy, we would singlehandedly turn retirement from a time of decline, disability, and despair into a period of travel, adventure, and personal growth. If we did become ill, despite regular exercise, a wholesome diet, and a goodly (...) dose of vitamins, we would demand, and receive, the fruits of American technological ingenuity, vanquishing disease and perhaps even death. Concurrent with the designation of age 70 as "the new 40," we have... (shrink)

Modern gerontology has debunked the myth of old age as a period of inevitable decline. But what science has not been able to change is the reality that old age often is a time of illness and disability, particularly for the oldest old—those over age 85. The vaunted compression of morbidity hasn't happened; while the period of decline before death may have shrunk, it hasn't vanished. The trajectory in the last phase of life is rarely a precipice, with older people (...) living healthy lives until, abruptly, they fall off a cliff. Rather, it typically takes the form of a series of dips that return to an ever-lowering baseline or a slow fade.The... (shrink)

With the passage by virtually every state legislature of healthcare proxy laws, the medical profession increasingly can expect to rely on the participation of surrogates in making decisions on behalf of incompetent patients. Several concerns about the legitimacy of proxy decision making have been discussed in the ethical and general medical literature: the lack of concordance between the views of patients and their surrogates have been documented on multiple occasions, and cases of abuse by proxies or potential conflict of interest (...) have been reported. Another dilemma that deserves discussion arises when proxies demand withdrawal of treatment that physicians and nurses regard as essential to the wellbeing of the patient. The following case highlights this dilemma. (shrink)

Some recent discussions of narrative structure consider the narrative as a sequence of events, and assume that the structure is what is manifested by the relation between any given event and the event 1, or perhaps the whole sequence from the first event up to the th event in the book. In the present discussion this approach will be modified in two ways. It will be modified, later on, by considering what would be happening if the writer were revising his (...) work into the final version, out of a penultimate version which was, as it were, a next-most complex version: one to which some final "complexifying" process had not yet been applied. The other way in which the present discussion will modify that approach is that it will consider narrative not as one sequence of events but as an interrelated set of sequences. · 1. E.g., R. Barthes, "Introduction à l'analyse structurale du récit," Communications, no. 8 , pp.1-27. John Holloway, professor of Modern English at the University of Cambridge, has written The Victorian Sage, The Charted Mirror, The Story of the Night, Blake: The Lyric Poetry, and five volumes of verse, such as New Poems. He is presently completing a book on poetic modes from Milton to Hardy and coediting a four-volume series on English and Irish street ballads. His other contribution to Critical Inquiry," Supposition and Supersession: A Model of Analysis for Narrative Structure" appeared in the Autumn 1976 issue. (shrink)

Clarifying the mission of the American high school / Ernest L. Boyer--Educational goals and curricular decisions in the new Carnegie Report / John Martin Rich--Essential schools : a first look / Theodore R. Sizer--Teaching and learning : the dilemma of the American high school / Chester E. Finn, Jr.--The paideia proposal : rediscovering the essence of education / Mortimer Adler--The paideia proposal : noble amibitions, false leads, and symbolic politics / Willis D. Hawley--Cultural literacy : let's get specific / E.D. (...) Hirsch, Jr.--Cultural literacy : what every educator needs to know / Thomas H. Estes, Carol J. Gutman, and Elise K. Harrison--A blueprint for public education / John E. Chubb--Should market forces control educational decision making / Jack Tweedie--Teachers as transformative intellectuals / Henry A. Giroux--Dilemma language / Colin Lacey--Rich schools, poor schools : the persistence of unequal education / Arthur E. Wise and Tamar Gendler--Partial privatization of publice school finance / Thomas G. Fox and John Riew--Quality and equality in American education : public and Catholic schools / James S. Coleman--Oranges plus apples, Dr. Coleman, give you oranges plus apples / James Rogers--Synthesis of research on school-based management / Jane L. David--Unfulfilled promises / Betty Malen, Rodney T. Ogawa, and Jennifer Kranz--Effective high schools--What are the common characteristics? / Joseph Murphy and Philip Hallinger--Effective schools : a friendly but cautionary note / Larry Cuban--In education, magnets attract controversy / Mary Haywood Metz--Schools of choice : a path to educational quality or 'Tiers of inequity'? / Kathleen Sylvester--Interesting times / Alan H. Jones--Making a difference in educational quality through teacher education / Carolyn M. Evertson, Willis D. Hawley, and Marilyn Zlotnik--Developing a career ladder : getting down to the basics / Thomas Deering--The career ladder and lattice : a new look at the teaching career / Timothy J.L. Chandler, Stacey L. Lane, Janice M. Bibik, and Bernard Oliver--Equity, quality, and effectiveness in bilingual education / George M. Blanco--Bilingual--No! / Muriel Paskin Carrison--Multiethnic education and the quest for equality / James A. Banks--The limits of pluralism / M. Donald Thomas--The case for keeping mentally retarded children in your regular classrooms / Martin Tonn--Mainstreaming : a formative consideration / Harry N. Chandler--Reflections on three decades of eduction of the gifted / A. Harry Passow--Equity vs. excellence : an eductional drama / James J. Gallagher. (shrink)

Since the publication of Edmund Gettier's challenge to the traditional epistemological doctrine of knowledge as justified true belief, Roberts and Wood claim that epistemologists lapsed into despondency and are currently open to novel approaches. One such approach is virtue epistemology, which can be divided into virtues as proper functions or epistemic character traits. The authors propose a notion of regulative epistemology, as opposed to a strict analytic epistemology, based on intellectual virtues that function not as rules or even as skills (...) but as habits of the heart. To that end, they divide the task of clarifying and expounding their notion in the book's two parts.In the first part, Roberts and Wood examine various components that constitute their notion of regulative epistemology. The first are the epistemic goods or goals that drive the epistemic process. What is needed, claim Roberts and Wood, is an enriched notion of these goods rather than the restricted notion of justified true belief. Epistemic agents are more than calculating devices in that …. (shrink)

It is often assumed that adaptation — a temporary change in sensitivity to a perceptual dimension following exposure to that dimension — is a litmus test for what is and is not a “primary visual attribute”. Thus, papers purporting to find evidence of number adaptation motivate a claim of great philosophical significance: That number is something that can be seen in much the way that canonical visual features, like color, contrast, size, and speed, can. Fifteen years after its reported discovery, (...) number adaptation’s existence seems to be nearly undisputed, with dozens of papers documenting support for the phenomenon. The aim of this paper is to offer a counterweight — to critically assess the evidence for and against number adaptation. After surveying the many reasons for thinking that number adaptation exists, we introduce several lesser-known reasons to be skeptical. We then advance an alternative account — the old news hypothesis — which can accommodate previously published findings while explaining various (otherwise unexplained) anomalies in the existing literature. Next, we describe the results of eight pre-registered experiments which pit our novel old news hypothesis against the received number adaptation hypothesis. Collectively, the results of these experiments undermine the number adaptation hypothesis on several fronts, whilst consistently supporting the old news hypothesis. More broadly our work raises questions about the status of adaptation itself as a means of discerning what is and is not a visual attribute. (shrink)

L'esthétique, en tant que discipline philosophique traitant de l'art née au sein de la culture occidentale, n'a été introduite que tardivement dans les autres cultures, notamment asiatiques, où existaient pourtant de longue date des notions, formulées dans leurs langues pour rendre compte de l'expérience esthétique et évaluer les oeuvres artistiques. Alors, ne peut-on trouver, des résonances entre langages artistiques entre l'Asie et l'Occident? Tel est le pari qui sous-tend le recueil de textes rassemblés ici.

The research described here contributes to the extant empirical research on business ethics education by examining outcomes drawn from the literature on positive organizational scholarship (POS). The general research question explored is whether a course on ethical decision-making in business could positively influence students’ confidence in their abilities to handle ethical problems at work (i.e., moral efficacy), boost the relative importance of ethics in their work lives (i.e., moral meaningfulness), and encourage them to be more courageous in raising ethical problems (...) at work even if it is unpopular (i.e., moral courage). Specifically, the study used a rigorous quasi-experimental pretest–posttest research design with a treatment (N = 30) and control group (N = 30) to investigate whether a graduate-level course in business ethics could influence students’ levels of moral efficacy, meaningfulness, and courage. Findings revealed that participants in the business ethics treatment course experienced significant positive increases in each of the three outcome variables as compared to the control group. The largest increase was in moral efficacy, followed by moral courage, and finally, moral meaningfulness. These findings are discussed in the context of the current research on business ethics education and POS. Implications for future research are discussed. (shrink)

Thomas Reid (1710–96) is increasingly being seen as a highly significant philosopher and a central figure in the Scottish Enlightenment. This new edition of Reid's classic philosophical text in the philosophy of mind at long last gives scholars a complete, critically edited text of the Inquiry. The critical text is based on the fourth life-time edition (1785). A selection of related documents showing the development of Reid's thought, textual notes, bibliographical details of previous editions and a full introduction by the (...) editor makes this an important contribution to the study of this increasingly respected philosopher. -/- Key Features - Complete, critically edited text of the Inquiry accompanied by a judicious selection of manuscript evidence relating to its composition - Comprehensive Introduction providing an historical and philosophical account of the formation of the Inquiry - Detailed textual notes which include bibliographical details and allusions, translations, references to secondary literature and selected passages from Reid's manuscripts. (shrink)

The visual system adapts to a wide range of visual features, from lower-level features like color and motion to higher-level features like causality and, perhaps, number. According to some, adaptation is a strictly perceptual phenomenon, such that the presence of adaptation licenses the claim that a feature is truly perceptual in nature. Given the theoretical importance of claims about adaptation, then, it is important to understand exactly when the visual system does and does not exhibit adaptation. Here, we take as (...) a case study one specific kind of adaptation: visual adaptation to size. Supported by evidence from four experiments, we argue that, despite robust effects of size adaptation in the lab, (1) size adaptation effects are phenomenologically underwhelming (in some cases, hardly appreciable at all), (2) some effects of size adaptation appear contradictory, and difficult to explain given current theories of size adaptation, and (3) prior studies on size adaptation may have failed to isolate size as the adapted dimension. Ultimately, we argue that while there is evidence to license the claim that size adaptation is genuine, size adaptation is a puzzling and poorly understood phenomenon. (shrink)

An adult university hospital ethics committee evaluated a proposed TA-NRP protocol in the fall of 2018. The protocol raised ethical concerns about violation of the Uniform Determination of Death Act and the prohibition known as the Dead Donor Rule, with potential resultant legal consequences. An additional concern was the potential for increased mistrust by the community of organ donation and transplantation. The ethics committee evaluated the responses to these concerns as unable to surmount the ethical and legal boundaries and the (...) ethics committee declined to endorse the procedure. These concerns endure. (shrink)

R F Dearden; Theory and Practice in Education, Journal of Philosophy of Education, Volume 14, Issue 1, 30 May 2006, Pages 17–29, https://doi.org/10.1111/j.1467-.

This provocative collection of essays written by the influential Greek scholar E. R. Dodds between 1929 and 1971. represents the wide range of his literary and philosophical interests. Insightful and learned, the essays combine profound scholarship with the lucid humanity of a teacher awareof the special value of Greek studies in the modern world.

Розкрито сутність поняття «рейтинг». Доведено значущість рейтингової оцінки для суб’єктів фінансового ринку, зокрема для страхових компаній, потенційних страхувальників, інвесторів та кредиторів.

After presenting the major objections raised against standard formulations of the H-D method of theory testing, I identify what seems to be an important element of truth underlying the method. I then draw upon this element in an effort to develop a plausible formulation of the H-D method which avoids the various objections.

Na era das tecnologias digitais, entender vieses algorítmicos por meio das teorias da verdade ajuda a fazer perguntas cujas respostas facilitam a filtragem da informação de forma mais eficaz. O ganho é a compreensão aprofundada da realidade.

Unfortunately, many people today see the regulation of lies, disinformation, hate speech, and fake news as an infringement of free speech, at least when such speech is ‘political,’ despite the damage that such speech can do. But this very protective attitude toward speech rests on a mistaken understanding of the role of free speech in a liberal society. The right to free speech is based on the liberal value of freedom, and as such can be no broader than freedom itself. (...) And freedom has always been subject to reasonable limits in a liberal society. Indeed, while the principles of toleration and neutrality are often cited as supporting a broad interpretation of the right to free speech, they also tell us that certain limits apply to that right. We need not tolerate speech that encourages intolerance, and while government should be neutral between reasonable conceptions of the good, it need not be neutral between reasonable and unreasonable conceptions. These ideas form the framework of liberal society, and as I shall show, also provide a guide for understanding what kind of speech is protected in a liberal society and what it is not. (shrink)

R S Downie; Professions and Professionalism, Journal of Philosophy of Education, Volume 24, Issue 2, 30 May 2006, Pages 147–159, https://doi.org/10.1111/j.1467-.

Aim To study the views of people in a largely Muslim country, Kuwait, of the acceptability of a life-ending action such as physician-assisted suicide (PAS). Method 330 Kuwaiti university students judged the acceptability of PAS in 36 scenarios composed of all combinations of four factors: the patient's age (35, 60 or 85 years); the level of incurability of the illness (completely incurable vs extremely difficult to cure); the type of suffering (extreme physical pain or complete dependence) and the extent to (...) which the patient requests a life-ending procedure, euthanasia or PAS (no request, some form of request, repeated requests). In all scenarios, the patients were women who were receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. Results Five clusters were found. For 44%, PAS was always very unacceptable, no matter what the circumstances. For 23%, it was unacceptable, but less so if the patient was older or requested it repeatedly. For 16%, it was unacceptable if the patient was young but was acceptable if the patient was elderly. For 5%, it was unacceptable if the patient had extreme pain but was acceptable if completely dependent. For 11%, it was unacceptable if the patient did not request it but acceptable if she did. Conclusion The majority of the Kuwaiti university students opposed PAS either categorically or with a slight variation according to circumstances. Nonetheless, a minority approved of PAS in some cases, particularly when the patient was elderly. (shrink)