Revisionist historians of the nuclear age have long argued that it was not necessary to have used the atomic bombs in August 1945 to bring the Second World War to an end, and that a more conciliatory approach by the Truman administration towards the Soviet Union—being franker with Stalin about the bomb and giving him an assurance that it would not be used—would have created a better chance of achieving a less confrontational postwar relationship between the two powers. They have (...) also challenged the “myth” that the reason for using the bombs was to save American lives. (shrink)

The least infringement principle has been widely endorsed by public health scholars. According to this principle, public health policies may infringe upon “general moral considerations” in order to achieve a public health goal, but if two policies provide the same public health benefit, then policymakers should choose the one that infringes least upon “general moral considerations.” General moral considerations can encompass a wide variety of goals, including fair distribution of burdens and benefits, protection of privacy and confidentiality, and respect for (...) autonomy.In this article, we argue that the Center for Disease Control and Prevention's 2006 HIV screening recommendations may violate the least infringement principle. This is a concern because, although not legally binding, the Recommendations appear to have already influenced state laws and will likely continue to do so as legislative proposals continue to be passed. At a minimum, therefore, the Recommendations have important implications for HIV screening within the United States. (shrink)

Is the United States "the land of equal opportunity" or is the playing field tilted in favor of those whose parents are wealthy, well educated, and white? If family background is important in getting ahead, why? And if the processes that transmit economic status from parent to child are unfair, could public policy address the problem? Unequal Chances provides new answers to these questions by leading economists, sociologists, biologists, behavioral geneticists, and philosophers.New estimates show that intergenerational inequality in the United (...) States is far greater than was previously thought. Moreover, while the inheritance of wealth and the better schooling typically enjoyed by the children of the well-to-do contribute to this process, these two standard explanations fail to explain the extent of intergenerational status transmission. The genetic inheritance of IQ is even less important. Instead, parent-offspring similarities in personality and behavior may play an important role. Race contributes to the process, and the intergenerational mobility patterns of African Americans and European Americans differ substantially.Following the editors' introduction are chapters by Greg Duncan, Ariel Kalil, Susan E. Mayer, Robin Tepper, and Monique R. Payne; Bhashkar Mazumder; David J. Harding, Christopher Jencks, Leonard M. Lopoo, and Susan E. Mayer; Anders Björklund, Markus Jäntti, and Gary Solon; Tom Hertz; John C. Loehlin; Melissa Osborne Groves; Marcus W. Feldman, Shuzhuo Li, Nan Li, Shripad Tuljapurkar, and Xiaoyi Jin; and Adam Swift. (shrink)

Background and PurposeMany critically ill patients in intensive care units (ICUs) are unable to communicate their wishes about goals of care, particularly about the use of life-sustaining treatments. Surrogates and clinicians struggle with medical decisions because of a lack of clarity regarding patients’ preferences, leading to prolonged hospitalizations and increased costs. This project focused on the development and implementation of a tool to facilitate a better communication process by (1) assuring the early identification of a surrogate if indicated on admission (...) and (2) clarifying the decision-making standards that the surrogate was to use when participating in decision making. Before introducing the tool into the admissions routine, the staff were educated about its use and value to the decision-making process.Project and MethodsThe study was to determine if early use of a simple method of identifying a patient’s surrogate and treatment preferences might impact length of stay (LOS) and total hospital charges. A pre- and post-intervention study design was used. Nurses completed the surrogacy information tool for all patients upon admission to the neuroscience ICU. Subjects (total N=203) were critically ill patients who had been on a mechanical ventilator for 96 hours or longer, or in the ICU for seven days or longer. The project included staff education on biomedical ethics, critical communication skills, early identification of families and staff in crisis, and use of a simple tool to document patients’ surrogates and previously expressed care wishes. Data on hospital LOS and hospital charges were collected through a retrospective review of medical records for similar four-month time frames pre- and post-implementation of the assessment tool.ResultsSignificant differences were found between pre- and post-groups in terms of hospital LOS (F=6.39, p=.01) and total hospital charges (F=7.03, p=.009).ConclusionsProject findings indicate that the use of a simple admission assessment tool, supported by staff education about its completion, use, and available resources, can decrease LOS and lower total hospital charges. The reasons for the difference between the pre- and post-intervention groups remain unclear. Further research is needed to evaluate if the quality of communications between patients, their legally authorized representatives, and clinicians—as suggested in the literature—may have played a role in decreasing LOS and total hospital charges. (shrink)

Aldo Leopold was a pragmatist in the vernacular sense of the word. Bryan G. Norton claims that Leopold was also heavily influenced by American Pragmatism, a formal school of philosophy. As evidence, Norton offers Leopold's misquotation of a definition of right (as truth) by political economist, A.T. Hadley, who was an admirer of the philosophy of William James. A search of Leopold's digitised literary remains reveals no other evidence that Leopold was directly influenced by any actual American Pragmatist or by (...) Pragmatism (although he may have been indirectly influenced by Pragmatism early in his career). A 1923 reference, by Leopold, to Hadley and Hadley's putative definition of truth, cited by Norton, is dripping with irony. Leopold, as he matured philosophically, regarded a profound cultural shift from anthropocentric dominionism and consumerism to an evolutionary-ecological worldview and an associated non-anthropocentric 'land ethic' to be necessary for successful and sustainable conservation. Hadley espoused a brutal form of Social Darwinism and his philosophy, as expressed in the book of Hadley's that Norton cites, is politically reactionary, militaristic and unconcerned with conservation. Leopold's mature philosophy and Hadley's – far from consonant, as Norton claims – are diametrically opposed. (shrink)

Although the theory of definability had many important antecedents—such as the descriptive set theory initiated by the French semi-intuitionists in the early 1900s—the main ideas were first laid out in precise mathematical terms by Alfred Tarski beginning in 1929. We review here the basic notions of languages, explicit definability, and grammatical complexity, and emphasize common themes in the theories of definability for four important languages underlying, respectively, descriptive set theory, recursive function theory, classical pure logic, and finite-universe logic. We review (...) the history of previous studies of the similarities and differences in the theories of definability of the first three of these four languages. A seminal role leading toward unification of the theories has been played by the separation principles introduced by Nikolai Luzin in 1927. Emphasizing analogies and driving toward further unification embracing finite-universe logic we concentrate on a simple example—the first and second separation principles for existential-universal first-order sentences . Using this as a test case for the fundamental problem of how to “finitize” arguments in classical pure logic to the finite-universe case, we are led to the analogous negative solution by using the theory of certain special graphs: a graph is - special for any positive integers m , n , p , q iff it is bipartite with m red points and n blue points and for every p -tuple of red points there is a blue point to which they are all connected . As an aside we introduce for further study a natural “Ramseyesque” increasing sequence A of positive integers, where A is the least positive integer n for which an -special graph exists. (shrink)