Introduction Currently, The nature and scope of Clinical Ethics Protocols in Madrid are not well understood.Objectives The main objective is to describe the features of ‘guideline/recommendation’ type CEPs that have been or are being developed by existing Clinical Ethics Committees in Madrid. Secondary objectives include characterisation of those CECs that have been the most prolific in reference to CEP creation and implementation and identification of any trends in future CEP development.Methods We collected CEPs produced and in process by CECs accredited (...) in the public hospitals in Madrid, Spain, from 1996 to 2008.Results CECs developed 30 CEPs, with 10 more in process. The most common topic is refusal of treatment . If CEPs addressing terminal illness, Do-Not-Resuscitate orders and advance directives are placed into a separate ‘ethical problems at the end of life’ category, this CEP subject emerges as the most common . There is a relationship between the age of the CEC and the development of CEPs . CECs now seem to be more likely to engage in CEP development.Conclusions The CECs in Madrid, Spain, have developed a significant number of CEPs and there is a trend towards continued development. The most frequent topics are ethical problems at the end of life and refusal of treatment by the patient. (shrink)

An additional compartment of vaccinated individuals is considered in a SIS stochastic epidemic model with infection reintroduction. The quantification of the spread of the disease is modeled by a continuous time Markov chain. A well-known measure of the initial transmission potential is the basic reproduction number $$R_0$$, which determines the herd immunity threshold or the critical proportion of immune individuals required to stop the spread of a disease when a vaccine offers a complete protection. Due to repeated contacts between the (...) typical infective and previously infected individuals, $$R_0$$ overestimates the average number of secondary infections and leads to, perhaps unnecessary, high immunization coverage. Assuming that the vaccine is imperfect, alternative measures to $$R_0$$ are defined in order to study the influence of the initial coverage and vaccine efficacy on the transmission of the epidemic. (shrink)

It is unknown whether hospital-based medical professionals in Spain educate patients about advance directives. The objective of this research was to determine the frequency of hospital-based physicians’ and nurses’ engagement in AD discussions in the hospital and which patient populations merit such efforts. A short question-and-answer-based survey of physicians and nurses taking care of inpatients was conducted at a university hospital in Madrid, Spain. In total, 283 surveys were collected from medical professionals, of whom 71 per cent were female, with (...) an average age of thirty-four years. Eighty-four per cent had never educated patients about ADs because of lack of perceived responsibility, time, or general knowledge of ADs. Patient populations that warranted AD discussions included those with terminal illnesses, chronic diseases, and elderly patients. Regarding degree of AD understanding in medical professionals: 57 per cent of medical professionals claimed sufficient general knowledge of ADs, 19 per cent understood particulars regarding AD document creation, and 16 per cent were aware of AD regulatory policies. Engagement in AD discussions was considered important by 83 per cent of medical professionals, with 79 per cent interested in participating in such discussions themselves. The majority of hospital physicians and nurses do not educate their patients about ADs, despite acknowledging their importance. Patient populations of highest priority included those with terminal diseases or chronic illness or who are of advanced age. (shrink)

Presentación de la obra que realiza una exposición de las principales teorías del conocimiento y de interpretación de la subjetividad desde el inicio de la modernidad.

Este escrito surgió de la lectura del libro de M.ª Isabel Lafuente, Libertad, ley y poder. Bien común y Derechos humanos en la obra de Francisco Suárez (Editorial Académica Española, Berlín, 2022, 482 pp.), que se comenta a continuación. El foco de mi comentario en diálogo con este estudio es triple. Primeramente, señalar la importancia que la obra de Francisco Suárez (1548-1617) tuvo principalmente durante los siglos xvii-xviii y la variación de perspectiva y método que la filosofía moderna introdujo con (...) respecto al hacer de la escolástica y de la propia filosofía iusnaturalista de Suárez. En segundo lugar, indicar la recuperación y actualidad de Suárez en el presente. Y, en último lugar, ofrecer la estructura y los contenidos principales del libro de M.ª Isabel Lafuente con una breve conclusión. (shrink)

This volume reflects on questions of human rights in the context of globalization. The essays responding to this subject are rich and varied: they focus on legal acceptance as well as consequences of human rights with regard to social rights and the necessary protection of the environment connected or close to those rights. Another approach to the subject featured in the volume is the legal recognition and the consideration of human rights as moral rights. With concepts on universality, a new (...) cosmopolitism, cultural pluralism and perspectives on religious variants and technological advances the debate on human rights is concluded. Index / Indice I. The Foundation of Rights / El fundamento de los derechos: J. Rubio Carracedo: El legalismo occidental: un problema para la universalizacion de los derechos humanos J. A. Seoane: El caracter juridico de las leyes injustas M. Borowski: Classifying and qualifying properties of fundamental rights J. von Platz: Faith in reason: questioning practical reason as fact, norm, end, and function of human rights R. Cruft: Policy implications of the philosophical foundations of human rights Maria Gabriela Scataglini: Derechos humanos: otra mirada sobre la cuestion de su universalidad II. A New Cosmopolitism / Un nuevo cosmopolitismo: V. de P. Barreto: Derecho cosmopolita y derechos humanos Luis Fernando Barzotto: Reconocimiento y fraternidad A. R. Bernstein: Justifying universal human rights via Rawlsian public reason H. Khatchadourian: Democracy and the globalization of human rights Milagros Otero Parga: Derechos humanos y globalizacion Halim Bepari: Human rights and the United Nations Miracy B. S. Gustin: Rescate de los derechos humanos en situaciones adversas de paises perifericos III. Multiculturism and Pluralism of Values /Multiculturalidad y pluralismo de valores: M. Herrero / M. Saralegui: Dogmatismo politico y pluralismo religioso Berry Tholen: Migration, justice, and Europe's identity. The relevance of special ties for EU's migration policy C. M. Alvarez Chicano: Implicaciones de la inconmensurabilidad de los valores en la aplicacion de principios de orden etico y juridico L. Perez Conejo: Axiologia juridica y pluralismo de valores: algunas consideraciones sobre la nocion de 'inconmensurabilidad' S-I. Liu: Fundamental legal values and globalization with regard to historical experience in freedom of speech L. C. Amezua: Libertad natural y esclavitud voluntaria: reflexiones de F. Suarez sobre la esclavitud IV. Rights and Gender / Derechos y genero: J.M. Gil Ruiz: La violencia de genero en el contexto familiar y la agresion de la ciencia juridica A. Goiriena Lekue: El interes superior del/la nino/a, coparentalidad y neutralidad de genero en la atribucion de la guarda y custodia de los hijos e hijas P. Garcia Guevara: Las politicas de genero en los paises globalizados del 'Tercer Mundo' V. Technological Impact and New Generation Rights / Impacto tecnologico y nuevas generaciones de derechos: M. Ahteensuu: Understanding the precautionary principle in the light of the traditional weak-strong distinction: a critical comment Cristina Monero Atienza: Bases para una teoria de los derechos en el siglo XXI M. Kitahara: Personal data processing and business ethics: personal data processing and personal data protection in business A. D. Oliver Lalana: El lado empirico de la legitimidad comunicativa: sobre la publicidad organizativa del derecho de proteccion de datos en internet J. Ebbesson / M. Zamboni: Transbordering democracy? The case of environment protection Sagrario Moles Nieto: El impacto medioambiental de los cultivos transgenicos VI. Bioethics and Law / Bioetica y derecho: M. Cruz Diaz de Teran: Principios para una biojuridica global C. Faralli / S. Tugnoli: Bioethics between law and science: the Italian law on medically assisted procreation (Law No. 40, February 19, 2004) N. Zeegers: The working of power in communicative regulation: the case of research with human embryos J. A. Fernandez Suarez: La bioetica en la era de la globalizacion F. J. Blazqez Ruiz: Privacidad y discriminacion genetica: propuestas bioeticas y juridicas ante los desafios de un mundo globalizado. (shrink)

La estructura convivencial: La convivencia como problema, por V. M. González-Haba Guisado. Diálogos verdaderos y diálogos falsos, por G. D. Pire.--El hecho religioso: La libertad religiosa, fundamento de la convivencia política, por P. Lucas Verdu. La religión como sistema establecido, por F. Pérez Gutiérrez. La función del escritor, por J. Maritain.--La realidad socio-económica: Sociología del cooperativismo agrario, por A. Fernández Oubiña. La alienación internacional, por C. Herreros de las Cuevas. Salario y plusvalía, por M. Rico Lara.--Las tensiones sociales: Reflexiones sobre (...) democracia y opinión, por C. Movilla Alvarez. Participación social y personalidad, por J. Ubalde Merino. El derecho natural como técnica de racionalización, por M. M. Zorrilla Ruiz. (shrink)

The study of corporate social responsibility has been the object of much research in recent decades, although there is a need to continue investigating its benefits as a marketing tool. In the current work we adopt a multi-dimensional perspective of social responsibility, and we carry out market research to determine the perceptions of users of mobile telephone services about economic, legal, ethical and social aspects of their operating companies. With these data we determine the structure and components of the concept (...) of social responsibility. Subsequently, this is related with the overall evaluation of the service and loyalty by means of a model of structural equations, in order to determine the influence of corporate social responsibility on these concepts, and hence its benefits as a commercial tool. (shrink)

In “Imposing Risks,” Judith Thomson gives a case in which, by turning on her stove, she accidentally causes her neighbor’s death. She claims that both the following are true: (1) she ought not to have caused her neighbor’s death; (2) it was permissible for her to turn her stove on. In this paper it is argued that it cannot be that both (1) and (2) are true, that (2) is true, and that therefore (1) is false. How this is so (...) is explained, and the implications of this position regarding the relation between rights and duties is explored. (shrink)

Plato's Timaeus contains a powerful and influential myth, of the construction of the universe by a divine craftsman. A god imposes reason on necessity, to bring order from a primeval 'receptacle' of disordered matter. There results the 'child' that is the cosmos - a copy of an eternally-existing perfect model. Here eight new essays from a distinguished international cast, explore aspects of this challenging work: the principles of the mythical narrative, how the world soul and human body are formed, implications (...) for illness - mental and physical, the importance of music and harmonious proportion. Later developments are also treated: Aristotle's theory of generation, the commentary of Proclus and elements of modern evolutionary theory. (shrink)

Using in-depth interviews with forty transgender people, I explore “discursive aggression,” a term for the communicative acts used in social interaction to hold people accountable to social- and cultural-based expectations, and subsequently to reinforce inequality in everyday life. I show how these interactional affronts restore social order, are based in dominant language systems, and reflect expectations for how interactions should unfold. Gendered expectations—such as the assumption that gender is identifiable based on visual cues alone—come to life through language, are delivered (...) through discursive aggression, and become routinized micro-inequalities that people negotiate in interaction. I present five vignettes to exemplify how discursive aggression typically unfolds in interaction. In so doing, this research demonstrates the value of discursive aggression as a concept to capture a pervasive, yet under-examined, feature of everyday life and a mechanism for how power is reified in interaction. (shrink)

Some patients have no chance of surviving if not treated, but very little chance if treated. A number of medical ethicists and physicians have argued that treatment in such cases is medically futile and a matter of physician discretion. This paper critically examines that position.According to Howard Brody and others, a judgment of medical futility is a purely technical matter, which physicians are uniquely qualified to make. Although Brody later retracted these claims, he held to the view that physicians need (...) not consult the patient or his family to determine their values before deciding not to treat. This is because professional integrity dictates that treatment should not be undertaken. The argument for this claim is that medicine is a profession and a social practice, and thus capable of breaches of professional integrity.Underlying professional integrity are two moral principles, one concerning harm, the other fraud. According to Brody both point to the fact that when the odds of survival are very low treatment is a violation of professional integrity.The details of this skeletal argument are exposed and explained, and the full argument is criticised. On a number of counts, it is found wanting. If anything, professional integrity points to the opposite conclusion. (shrink)

This article explores early Greeks' cosmological speculation, showing how they explored the possibility of a “theory of everything” and human understanding of the cosmos. In the exposition of competitive cosmologies, there are three questions still unresolved: the form of most of the matter in the universe is not known; the process of beginning of the universe is not known; and whether the universe is finite or infinite is also not known. Presocratic solutions to these problems, still perplexing to the contemporaries, (...) are tackled in this article, with the addition of a note on what is called the anthropic principle, which addresses the place of human life and human observation in the whole. (shrink)

SummaryLeśniewski presented his logical systems in a way which conformed to his nominalism, so the question arises whether Leśniewski's logic can be given a natural formal semantics which, unlike current versions, avoids commitment to abstract entities. Building on hints in Wittgenstein's Tractatus, I develop the idea of a way of meaning which is the basis for what I call combinatorial semantics. I then consider whether this commits us to abstract objects or an intensional metalogic.

We discuss approaches to the study of the evolution of music (sect. R1); challenges to each of the two theories of the origins of music presented in the companion target articles (sect. R2); future directions for testing them (sect. R3); and priorities for better understanding the nature of music (sect. R4).

Clinical Ethics, Ahead of Print. ObjectiveThe purpose of this study was to assess if a relationship existed between audiologists’ perceptions of moral distress, occupational wellbeing, and patient-practitioner orientation.DesignThe Moral Distress Thermometer, Health and Safety Executive Management Standards Indicator Tool and Patient-Practitioner Orientation Scale was sent out to all audiologists registered with the professional body Audiology Australia.Study sample: A total of 43 audiologists completed the questionnaires.ResultsUsing a multiple linear regression model there was no evidence of a relationship between patient-practitioner orientation and (...) either moral distress or occupational wellbeing. However, an association between higher moral distress and lower occupational wellbeing was demonstrated. The occupational wellbeing subscales of ‘managerial support’, ‘peer support’, ‘relationships’, ‘role’, and ‘change’ were strongly associated with poorer scores on moral distress.ConclusionFor our sample of audiologists, ethical conflict appeared to be linked to reduced job satisfaction. There is a need to consider ways of providing supportive organisational structures in which ethical conflicts can be openly discussed and negotiated in order to improve occupational wellbeing in the profession. (shrink)

The Greeks and Romans have been charged with destroying the ecosystems within which they lived. In this book, however, M. D. Usher argues rather that we can find in their lives and thought the origin of modern ideas about systems and sustainability, important topics for humans today and in the future. With chapters running the gamut of Greek and Roman experience – from the Presocratics and Plato to Roman agronomy and the Benedictine Rule – Plato's Pigs brings together unlikely bedfellows, (...) both ancient and modern, to reveal surprising connections. Lively prose and liberal use of anecdotal detail, including an afterword about the author's own experiments with sustainable living on his sheep farm in Vermont, add a strong authorial voice. In short, this is a unique, first-of-its-kind book that is sure to be of interest to anyone working in Classics, environmental studies, philosophy, ecology, or the history of ideas. (shrink)