Objective To ascertain and improve the understanding and use of chaperones among the patients of an English general practice (GP). Background Doctors have long been advised to have a third party present during intimate physical examinations. Little is known about the understanding of the term in the general population in England and the consequences of this for the promotion and use of chaperones in GP. We audited the understanding and use of chaperones in an English GP. The aim of (...) the study was to increase the awareness of the availability of chaperones in our population. Methods A questionnaire was given randomly to 100 patients attending the GP surgery. Participants were asked about their awareness of and frequency of requesting a chaperone while undergoing intimate examinations. Based on the initial results, a poster was designed for the waiting room to increase awareness. Data were collected with the same questionnaire to see if the new poster altered surgery attendees understanding and likely subsequent use of chaperones. Results In the initial audit, 29% of patients were unaware of the term chaperone, and only one person (1%) had ever requested a chaperone. After the introduction of a specially designed poster, the results showed an improvement in awareness from 71% to 89%, and the likely frequency of using a chaperone increased from 1% to 4%. Conclusion There is a need to improve the understanding of the general population about chaperones if we are to see greater use of chaperones in GP. (shrink)

This paper reports a study of planning processes in the five-disc Tower of London (TOL) task in 20 younger and 20 older adult participants. A concurrent direct ''think-aloud'' method was used to obtain data on planning processes prior to moving discs in the TOL. A check was made of the effects of verbalising by comparing performance data from the experimental groups with data from control groups who did not verbalise during planning or moving. Verbalising slowed down planning and moving but (...) did not appear to distort the participants' approaches to the task. Older and younger participants did not differ in average moves taken to solve the tasks. However, older participants' planning was less complete and more error-prone than that of younger participants. The planning processes were characterised as showing a means-ends ''goal selection'' strategy. In this strategy participants (1) identify a single active goal disc at the start, (2) select moves and move sequences to enable the placing of the current goal disc in its target position, and (3) continue in this way until all discs are in their target positions. Age differences were found in the planning stage, during which there was no stimulus support and hence a substantial working memory load. During the move phase there was stimulus support and hence little loading of working memory. Age differences in moves required were not found in the move phase. As older participants tend to have depleted working memory capacity the present results suggest that working memory is heavily loaded in TOL planning but less so in the move phase of TOL. (shrink)

Conducting research in a prison setting is ethically challenging. Because history is full of unethical research conducted in prison settings, researchers are often afraid of doing research in this area. It is argued that too much emphasis has been put on the protection of prison inmates as a vulnerable population. Consequently, too little research is being conducted where the focus is on those factors which serve to make the prison population vulnerable. In this paper ethical questions, emerging when conducting (...) a study on literacy and mental health among Norwegian prison inmates, are presented and discussed. Relevant questions relate to topics which include ethical clearance of the research protocol, the consent procedure, clarification of roles and the publication of the results. The ethical questions are discussed in relation to the four principles of ‘respect for the client's rights and dignity’, ‘competence’, ‘responsibility’ and ‘integrity’ set out in the meta-code of ethics, formulated by the European Federation of Professional Psychologists Associations. The wider relationships between ethics in society, research ethics in general, and ethics when conducting research in a prison setting are also considered. (shrink)

Recognition that the Principle of Respect for Autonomy fails to work in family-centric societies such as Singapore has recently led to the promotion of relational autonomy as a suitable framework within which to place healthcare decision making. However, empirical data, relating to patient and family opinions and the practices of healthcare professionals in Confucian-inspired Singapore, demonstrate clear limitations on the ability of a relational autonomy framework to provide the anticipated compromise between prevailing family decision-making norms and adopted Western led atomistic (...) concepts of autonomy. Evidence suggests that despite a growing infusion of Western influence, there is still little to indicate any major shift to individual decision making, particularly in light of the way society and healthcare are structured. Similarly, the lack of employing a shared decision-making model and data that discredit the notion that the complex psychosocial and cultural factors that affect the decision making may be considered “content neutral” not only prevents the application of relational autonomy but questions the viability of the values behind the Principle of Respect for Autonomy. Taking into account local data and drawing upon a wider concept of personhood that extends beyond prevailing family-centric ideals along with the complex interests that are focused upon the preservation of the unique nature of personhood that arises from the Ring Theory of Personhood, we propose and “operationalize” the employing of an authoritative welfare-based approach, within the confines of best interest decision making, to better meet the current care needs within Singapore. (shrink)

After introducing and illustrating the idea of a calculus, this work develops a philosophically interesting but technical theory of the foundation of logic, in connection with propositional calculi and in relation to recent metamathematical research; then quantification theory is introduced, including material on completeness and undecidability and the theory of equality. Not just another logic text, this information-packed little treatise will probably find a place among the classical introductions to the field.--L. K. B.

This elementary introduction aims "to present a unified picture of Science"; it shows little concern for serious argument or alternative positions.--L. K. B.

The proportion of research misconduct cases among trainees in the biomedical sciences has risen, raising the question of why, and what are the responsibilities of research administrators and the research community to address this problem. Although there is no definitive research about causes, for trainees the relationship with a research mentor should play a major role in preventing actions that constitute research misconduct. Examination of the limited literature and of the number of cases closed by the US Office of Research (...) Integrity between 2009 and 2013 raises questions about the mentor-student relationship and what it should be accomplishing. But many gaps in policy and its implementation inhibit this role. There is no acknowledgement of mentorship in federal regulations and research on how to teach research integrity is woefully underdeveloped, especially for international trainees. And some institutional research integrity officers may have had little preparation for the role. (shrink)

“Would you like to contribute to XYZ charity by adding a dollar to your bill today?” Point-of-sale campaigns for fundraising are common to grocery stores, pharmacies, restaurants and warehouse clubs. Commonly referred to as ‘checkout charity,’ these fundraisers have generated over $4.1 billion in contributions for nonprofits over the past three decades. Yet little research has focused on the ethicality of this type of campaign. To address this need, we analyze the issue using behavioral ethics and normative theory. We (...) consider three stakeholder perspectives, including the nonprofit initiating the campaign, the business hosting the campaign, and the donor. Often ethical theories are seen as competing for primacy rather than being complementary perspectives in choosing the best action. We demonstrate that ethical discernment results in a richer analysis when consulting multiple frameworks. The purpose of this paper is to provide a set of ethical considerations for individuals to draw upon when devising and donating to checkout charity campaigns. This analysis will serve as a conceptual resource for scholars, practitioners, and students of nonprofit and for-profit management. (shrink)

Oocyte donation raises conflicts of interest and commitment for physicians but little attention has been paid to how to reduce these conflicts in practice. Yet the growing popularity of assisted reproduction has increased the stakes of maintaining an adequate oocyte supply and minimizing conflicts. A growing body of professional guidelines, legal challenges to professional self-regulation, and empirical research on the practice of oocyte donation all call for renewed attention to the issue. As empirical findings better inform existing conflicts and (...) their potential harms, we can better attempt to reduce these conflicts. To that end, the article first describes the nature of conflicts in oocyte donation and relevant regulations and professional guidelines. We then describe studies on conflicts at four phases of oocyte donation: recruitment, screening, stimulation, and post-stimulation monitoring. Next we consider three models for conflict reduction in medicine generally: improved professional self-regulation, outright restriction like Stark anti-referral laws, or the use of conflict mediators, like in living organ donation. We ultimately conclude that improved professional self-regulation is a reasonable starting place for oocyte donation. (shrink)

Within the past few years, managed care health insurance programs have become commonplace. With managed care programs, however, physicians are facing increasing ethical pressures. This paper examines the relationship between physicians'' behavior intentions with respect to four managed care ethical scenarios and their responses to Forsyth''s (1980) Ethics Position Questionnaire (EPQ). This is one of the first papers to compare this scale to behavioral intentions in the workplace. We provide a literature review of the ethical dilemmas that doctors face under (...) a managed care system and conduct a national random sample of general practitioners and surgeons regarding the four managed care ethical dilemmas. The results show that the doctors surveyed are significantly more idealistic than relativistic. In relating the EPQ to the ethical scenarios, however, there was no support for the proposition that ethical ideology was related to the ethical behavioral intentions. This suggests more research is needed to establish the links between ethical positions, attitudes, and behavioral intentions. Finally, there were little differences in EPQ scores by practice or demographic variables, the only significant result being that general surgeons are significantly more idealistic than family practitioners. (shrink)

In 1958, economist A. W. Phillips published an article describing what he observed to be the inverse relationship between inflation and unemployment; subsequently, the "Phillips curve" became a central concept in macroeconomic analysis and policymaking. But today's Phillips curve is not the same as the original one from fifty years ago; the economy, our understanding of price setting behavior, the determinants of inflation, and the role of monetary policy have evolved significantly since then. In this book, some of the top (...) economists working today reexamine the theoretical and empirical validity of the Phillips curve in its more recent specifications. The contributors consider such questions as what economists have learned about price and wage setting and inflation expectations that would improve the way we use and formulate the Phillips curve, what the Phillips curve approach can teach us about inflation dynamics, and how these lessons can be applied to improving the conduct of monetary policy. ContributorsLawrence Ball, Ben Bernanke, Oliver Blanchard, V. V. Chari, William T. Dickens, Stanley Fischer, Jeff Fuhrer, Jordi Gali, Michael T. Kiley, Robert G. King, Donald L. Kohn, Yolanda K. Kodrzycki, Jane Sneddon Little, Bartisz Mackowiak, N. Gregory Mankiw, Virgiliu Midrigan, Giovanni P. Olivei, Athanasios Orphanides, Adrian R. Pagan, Christopher A. Pissarides, Lucrezia Reichlin, Paul A. Samuelson, Christopher A. Sims, Frank R. Smets, Robert M. Solow, Jürgen Stark, James H. Stock, Lars E. O. Svensson, John B. Taylor, Mark W. Watson. (shrink)

The United States is one of the most charitable nations, yet comprises some of the most materialistic citizens in the world. Interestingly, little is known about how the consumer trait of materialism, as well as the opposing moral trait of gratitude, influences charitable giving. We address this gap in the literature by theorizing and empirically testing that the effects of these consumer traits on charitable behavior can be explained by diverse motivations. We discuss the theoretical implications, along with implications (...) for charitable organizations, and offer suggestions for future research. (shrink)

Background Machine learning (ML) is utilized increasingly in health care, and can pose harms to patients, clinicians, health systems, and the public. In response, regulators have proposed an approach that would shift more responsibility to ML developers for mitigating potential harms. To be effective, this approach requires ML developers to recognize, accept, and act on responsibility for mitigating harms. However, little is known regarding the perspectives of developers themselves regarding their obligations to mitigate harms.Methods We conducted 40 semi-structured interviews (...) with developers of ML predictive analytics applications for health care in the United States.Results Participants varied widely in their perspectives on personal responsibility and included examples of both moral engagement and disengagement, albeit in a variety of forms. While most (70%) of participants made a statement indicative of moral engagement, most of these statements reflected an awareness of moral issues, while only a subset of these included additional elements of engagement such as recognizing responsibility, alignment with personal values, addressing conflicts of interests, and opportunities for action. Further, we identified eight distinct categories of moral disengagement reflecting efforts to minimize potential harms or deflect personal responsibility for preventing or mitigating harms.Conclusions These findings suggest possible facilitators and barriers to the development of ethical ML that could act by encouraging moral engagement or discouraging moral disengagement. Regulatory approaches that depend on the ability of ML developers to recognize, accept, and act on responsibility for mitigating harms might have limited success without education and guidance for ML developers about the extent of their responsibilities and how to implement them. (shrink)

Dispositional forgiveness is positively associated with many facets of wellbeing and has protective implications against depression and anxiety in adolescents. However, little work has been done to examine neurobiological aspects of forgiveness as they relate to clinical symptoms. In order to better understand the neural mechanisms supporting the protective role of forgiveness in adolescents, the current study examined the middle frontal gyrus, which comprises the majority of the dorsolateral prefrontal cortex and is associated with cognitive regulation, and its relationship (...) to forgiveness and clinical symptoms in a sample of healthy adolescents. In this cross-sectional study, larger MFG volume was significantly associated with higher self-reported dispositional forgiveness scores and lower levels of depressive and anxiety symptoms. Forgiveness mediated the relationship between MFG volume and both depressive and anxiety symptom levels. The mediating role of forgiveness in the relationship between MFG volume and clinical symptoms suggests that one way that cognitive regulation strategies supported by this brain region may improve adolescent mental health is via increasing a capacity for forgiveness. The present study highlights the relevance of forgiveness to neurobiology and their relevance to emotional health in adolescents. Future longitudinal studies should focus on the predictive quality of the relationship between forgiveness, brain volume and clinical symptoms and the effects of forgiveness interventions on these relationships. (shrink)

Over the last decade, numerous interventions and techniques that aim to engender, strengthen, and expand compassion have been created, proliferating an evidence base for the benefits of compassion meditation training. However, to date, little research has been conducted to examine individual variation in the learning, beliefs, practices, and subjective experiences of compassion meditation. This mixed-method study examines changes in novice meditators’ knowledge and contemplative experiences before, during, and after taking an intensive course in CBCT®, a contemplative intervention that is (...) increasingly used for both inter- and intrapersonal flourishing. The participants in this study were Christian healthcare chaplains completing a 1-year residency in Clinical Pastoral Education who learned CBCT as part of their professional chaplaincy training curriculum. Prior to and upon completion of training, we surveyed participants to assess their beliefs about the malleability of compassion, types of engagement in compassion meditation, and perceptions of the impact of taking CBCT. We also conducted in-depth interviews with a subset of participants to gain a qualitative understanding of their subjective experiences of learning and practicing compassion meditation, a key component of CBCT. We found that participants reported increases in the extent to which they believed compassion to be malleable after studying CBCT. We also found high levels of variability of individual ways of practicing and considered the implications of this for the study of contemplative learning processes. This multi-methodological approach yielded novel insights into how compassion practice and compassion-related outcomes interrelate, insights that can inform the basic scientific understanding of the experience of learning and enacting compassion meditation as a means of strengthening compassion itself. (shrink)

Over 100 million Americans suffer from chronic pain, which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year. Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy can (...) be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions. However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women with chronic musculoskeletal pain. Functional magnetic resonance imaging data were collected pre- and post-ACT, and changes in functional connectivity were measured using Network-Based Statistics. Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire, the Chronic Pain Acceptance Questionnaire, the Center for Epidemiologic Studies Depression Scale, and the NIH Toolbox Neuro-QoLTM scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection, emotion, and cognitive control. These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies. (shrink)

This volume reaches beyond the controversy surrounding the teaching and learning of evolution in the United States, specifically in regard to the culture, politics, and beliefs found in the Southeast. The editors argue that despite a deep history of conflict in the region surrounding evolution, there is a wealth of evolution research taking place—from biodiversity in species to cultural evolution and human development. In fact, scientists, educators, and researchers from around the United States have found their niche in the South, (...) where biodiversity is high, culture runs deep, and the pace is just a little bit slower. (shrink)

These are exciting times for philosophy and psychiatry. After drifting apart for most of this century, the two disciplines, if not yet fully reconciled, are suddenly at least on speaking terms. With hindsight we may wonder why they should have ignored each other for so long. As Anthony Quinton pointed out in a lecture to the Royal Institute of Philosophy a few years ago, it is remarkable that philosophers, in a sense the experts on rationality, should have had so (...) class='Hi'>little to say about the phenomena of irrationality. There have been partial exceptions, of course. Descartes and Kant both touched on madness; and there were, notably, important philosophical influences on the development of modern psychiatry in the late nineteenth and early twentieth centuries. Yet even John Locke, who was a doctor as well as philosopher, confined himself to a fair-l y superficial distinction between what we should now call mental illness and mental defect—those with, in Locke's view, respectively too many ideas and too few. (shrink)

Replaces communal altruism with communal egoism as a way of solving problems of too much violence and too little peace in the twenty-first century.

This is one of four volumes from the same press collecting Hare’s major papers. Of the six papers in this volume, two have appeared in Mind, one in the Philosophical Review, two have appeared in special collections, and only one has not been previously published. There is brief additional material appended to some of the articles and, perhaps most important, a four page bibliography of Hare’s writings. From this bibliography one can discover which of Hare’s articles appear in each of (...) the volumes of this group and also find their original location. One might thus save the cost of a volume or two for there is little doubt, considering the size and price of these books, upon what principle the publisher of this series has decided. The articles are largely a development and defense of Hare’s views of practical reason as set forth in The Language of Morals, with particular attention to the logical forms of imperatives and ought statements, and to the forms of inference valid for each. Beyond this basic theme, the collection is not particularly unified. Two fundamental impressions, however, emerge. The first is an awareness of the enormous influence of J. L. Austin on Hare’s thinking. This is evident not only in his discussion and rejection of Austin’s distinction between locutionary and illocutionary acts, but more importantly in his constant respect for ordinary usage and his resistance to ideal formalism. The second impression is that there is much to be done to develop a logic for imperative and prescriptive inferences. These papers present some basic principles for such a development but, since they are primarily defenses against criticisms of Hare’s book, there is an ad hoc character about them. What is now required is a more complete and systematic treatment of these topics. Ordinary language analysts might here make some inroads on the domain of formal logic to recall some of that logic to philosophy. The articles collected, therefore, are valuable, particularly as they encourage further development of the overlap of logic and ethics.—K. M. (shrink)

It may be of interest to supplement the latter part of Professor Conway's article by a note applying the same standards to estimating the value of the other sources on which we have to rely for our knowledge of the Spirensian tradition. Apart from ‘L’ and Harl. 2684 Luchs used for this purpose three partially Spirensian sources: the one fourteenth-century and four fifteenth-century MSS whose archetype he called ‘R’ V, the fifteenth-century Vat. Pal. 876, and the fifteenth-century Flor. Laur. lxxxix. (...) inf. 1. The last mentioned may be dismissed as practically valueless and as supplying little more than new corruptions from an unusually contaminated intermediary. In addition to these deteriores Luchs used the Agennensis , but only for the Spirensian supplement in Book xxvi' and for the last part of Book xxx . He did not deal at all with the Spirensian textual correctors in A. (shrink)

Kurrâ’ya nispet edilen aynı kelimelerdeki edâ farklılıklarının tartışmalara sebep olmasından ötürü kıraat ihtilafı olan kelimelerde ihticâc yapılmasına gereksinim duyulmuştur. Delil getirmek manasında kullanılan ihticâc kavramı, kıraat ihtilafları için söz konusu olduğunda ise kıraat ihtilaflarının sıhhat zemininin ortaya konması kastedilmektedir. Ayrıca 2. asrın sonlarında kıraat tevcîhlerinin yapıldığı müstakil eserler ortaya çıkmakla birlikte kıraat alan yazınına ait genel telifatlarda da kıraat ihticâclarının yapıldığı görülmektedir. Kıraat müelliflerinden biri olan İbnu’l-Cezerî de Neşru’l-ḳırââti’l-‘aşr adlı eserinde zaman zaman kıraat ihticâcına yer vermektedir. Mezkûr eserdeki kıraat ihticâcları (...) hakkında tespit edilebildiği kadarıyla yapılmış tek bir çalışma bulunmaktadır. Fakat bu çalışmada, kıraatten ve bunun dışındaki disiplinlerden yeterince istifade edilmediği belirlenmiştir. Ayrıca selef ulemasının Neşru’l-ḳırââti’l-‘aşr adlı esere ihticâc konusunda etkisi özelinde bir çalışmaya da rastlanmamıştır. Buradan hareketle elinizdeki bu çalışmada, İbnu’l-Ce-zerî’nin kıraat ihticâcına dair uygulamaları Neşru’l-ḳırââti’l-‘aşr adlı eser özelinde incelenmiş, me‘âni’l-Kur’ân ve me‘âni’l-kıraat literatürlerinin ortaya çıktıkları dönem dikkate alınarak h. 2.-4. asırlarda kaleme alınan bu literatürlere ait eserlerin İbnu’l-Cezerî’ye ait kıraat tevcîhlerine etkisinin olup olmadığı araştırılmıştır. Çalışmanın neticesinde İbnu’l-Cezerî’nin yaptığı kıraat tevcîhlerinden ele alınanların bir kısmına, söz konusu üç asırda kaleme alınan me‘âni’l-Kur’ân ve me‘âni’l-kıraat telifatında ekseriyetle yer verilmediği saptanmıştır. İbnu’l-Cezerî’nin ise kıraat ihtilafının olmadığı yerlerde dahi ilgili edâ için ihticâc yaptığı müşahede edilmiştir. Buna ilaveten İbnu’l-Cezerî’nin Neşr’de yaptığı ihticâc uygulamalarının me‘âni’l-Kur’ân ve me‘âni’l-kıraat telifatında yapılan ihticâc işlemleriyle benzeştiği görülmüştür. Yine Neşr’in tevcîh eseri olmaması hasebiyle de İbnu’l-Cezerî tarafından yapılan ihticâcların ihtiyaç merkezli olarak kendini gösterdiği belirlenmiştir. (shrink)

Previous work suggests that threat-related stimuli are stored to a greater degree in working memory compared to neutral stimuli. However, most of this research has focused on stimuli with physically salient threat attributes, failing to account for how a “neutral” stimulus that has acquired threat-related associations through differential aversive conditioning influences working memory. The current study examined how differentially conditioned safe and threat stimuli are stored in working memory relative to a novel, non-associated stimuli. Participants completed a differential fear conditioning (...) task followed by a change detection task consisting of three conditions across two loads. Results revealed individuals successfully learned to distinguishing CS+ from CS– conditions during the differential aversive conditioning task. Our working memory outcomes indicated successful load manipulation effects, but no statistically significant differences in accuracy, response time, or Pashler’s K measures of working memory capacity between CS+, CS–, or N conditions. However, we observed significantly reduced RT difference scores for the CS+ compared to CS– condition, indicating greater RT differences between the CS+ and N condition vs. the CS– and N condition. These findings suggest that differentially conditioned stimuli have little impact on behavioral outcomes of working memory compared to novel stimuli that had not been associated with previous safe of aversive outcomes, at least in healthy populations. (shrink)

This article explores egg freezing experiences of women in Turkey. Since 2014, it has been legal in Turkey to use egg freezing technology for ageing women, while it was previously allowed only for disease-related purposes. In cooperation with a private fertility clinic in Istanbul, the authors conducted 21 interviews with older, single women who held either professional or managerial positions and who were undergoing or had undergone the procedure. Drawing on a qualitative analysis of these interviews, the authors explore the (...) social context in which women postpone motherhood and decide to freeze their eggs. The study also looks at the women’s emotional responses to ageing that were triggered by the experience of egg freezing and their narratives of empowerment as a result of the procedure. (shrink)

This article explores the enduring mysteries of consciousness and the afterlife, two enigmatic topics that have fascinated humanity for ages. Despite extensive scientific efforts, the existence of an afterlife remains unproven, and understanding consciousness remains a significant challenge. The research introduces innovative hypotheses through simple thought experiments with empirical evidence and robust theoretical foundations. It delves into the complexities of consciousness, its relationship with the brain, and the need for interdisciplinary approaches including philosophy. Boldly contemplating the probability of a continuous (...) consciousness after death, the study argues that existing evidence strongly supports this idea. Beyond theoretical implications, it envisions practical outcomes, suggesting that insights into these mysteries could enhance human well-being and contribute to a more harmonious world. In summary, this article embarks on a quest to shed light on age-old questions about consciousness and the high probability of the afterlife. Through fresh methodologies, it aims to provide new perspectives that could reshape our understanding of existence and inspire intellectuals to positive individual and societal advancements including peace, happiness, health, and intelligence. -/- . (shrink)

Spinoza has been appropriated as a philosophical forefather of deep ecology. I identify what I take to be the relevant components of Spinoza ’s metaphysics, which, at face value, appear to be harmonious with deep ecology’s commitments. However, there are central aspects of his moral philosophy which do not appear to be “environmentally friendly,” in particular the sentiments expressed in the Ethics IV35C1 and IV37S1. I describe environmental ethics’ treatment of these passages and then indicate what I take to be (...) a more satisfactory route toward “ecologizing Spinoza.”. (shrink)

Social media applications such as Twitter, YouTube and Facebook have attained huge popularity, with more than three billion people and organizations predicted to have a social networking account by 2015. Social media offers a rapid avenue of communication with the public and has potential benefits for communicable disease control and surveillance. However, its application in everyday public health practice raises a number of important issues around confidentiality and autonomy. We report here a case from local level health protection where the (...) friend of an individual with meningococcal septicaemia used a social networking site to notify potential contacts. (shrink)

Background and objectives: Definitions of medical futility, offered by healthcare professionals, bioethicists and other experts, have been rigorously debated by many investigators, but the perceptions of patients of futility have been explored only by a few. Patients were allowed to discuss their concerns about end-of-life care, so that their ideas about treatment futility or utility could be extrapolated by us.Methods: In this cross-sectional study, in-depth, semistructured interviews were conducted with 30 elderly people who were receiving outpatient care in a large, (...) urban Veterans Affairs medical centre in the US. Each of their healthcare providers was also interviewed. Participants were asked to consider four terms commonly used in advance directive forms and to discuss what these terms meant to them. Audiotapes of the open-ended interviews were transcribed and responses were coded and categorised by constant comparison, a commonly used qualitative method.Results: The following four factors were taken into account by the participants when discussing end-of-life interventions and outcomes: expected quality of life; emotional and financial costs of treatment; likelihood of treatment success; and expected effect on longevity.Conclusions: Although the terms “utility” or “futility” were not generally used by the participants, segments of speech indicating their perceptions of these terms were identified. Treatment was not always discussed in the same way by patients and providers, but seemed to reflect the same four concerns. Therefore, it may be fruitful for providers to focus on these concerns when discussing end-of-life treatment options with their patients. (shrink)

Faced with troubling professional decisions in his long and successful career as a psychiatrist, M. O'C. Drury turned for direction to the philosophical work of his teacher and friend, Ludwig Wittgenstein. Of particular concern to Drury were the situations in which psychiatrists were expected to differentiate between instances of madness that were religious in form and instances of genuine religious experience that, for their oddity, landed believers in psychiatric consulting rooms. In this essay we consider the special orientation Wittgenstein's philosophy (...) gave Drury, for example the way in which Drury came to understand how even his search for a principle of differentiation between madness and religion was misleading and contrary to his own practice—how it involved ‘sitting back in a cool hour and attempting to solve this problem as a pure piece of theory. To be the detached, wise, external critic’ and not see himself and his own manner of life ‘as intimately involved in the settlement of this question.’. (shrink)

Philosophical Investigations, EarlyView.

InThe Education of the Human Race, G. E. Lessing helps his readers understand why the propositions of the Old Testament are pseudo-propositions, or why they do not resemble the significant propositions of natural science but thetautologicalpropositions of mathematics and of logic. That is, the so-called propositions of the Old Testament do not teach readers whether what actually happens is this or that; rather what they teach us is to imagine expressions by substitution in such a way as to throw their (...) structure into relief. One of Lessing's most attentive readers was Wittgenstein. Or perhaps only Wittgenstein would have been able to grasp so immediately Lessing's insight that the tautological or pseudo-propositions of the Old Testament invite thinkingonlywhen readers use them to understand ‘what is the case’ in the pictures the propositions have – logically – constructed. Thus in this essay I use Wittgenstein's reading of Lessing to throw light on his work in theTractatus. Rather than take up the new logician's interest in completely analyzing expressions, Wittgenstein insists in theTractatusthat the expressions we use, even those that seem to be propositions or that contain assertions, are in fact designed to be elucidatorywithoutsaying anything about the nature of the subjects that figure in them. Wittgenstein's great insight was to see that the propositional signs of our language are able to bring something to mindwithoutsaying what is a representation of what. (shrink)