Outcomes from cardiopulmonary resuscitation (CPR) remain distressingly poor. Overuse of CPR is attributable to unrealistic expectations, unintended consequences of existing policies and failure to honour patient refusal of CPR. We analyzed the CPR outcomes literature using the bioethical principles of beneficence, non-maleficence, autonomy and justice and developed a proposal for selective use of CPR. Beneficence supports use of CPR when most effective. Non-maleficence argues against performing CPR when the outcomes are harmful or usage inappropriate. Additionally, policies which usurp good clinical (...) judgment and moral responsibility, thereby contributing to inappropriate CPR usage, should be considered maleficent. Autonomy restricts CPR use when refused but cannot create a right to CPR. Justice requires that we define which medical interventions contribute sufficiently to health and happiness that they should be made universally available. This ordering is necessary whether one believes in the utilitarian standard or wishes medical care to be universally available on fairness grounds. Low-yield CPR fails justice criteria. Cardiopulmonary resuscitation should be performed when justified by the extensive outcomes literature; not performed when not desired by the patient or not indicated; and performed infrequently when relatively contraindicated. (shrink)

Is science our most precious possession or has our culture elevated science into a false idol? Is technology a useful servant or a malign genie? These questions are at the centre of the 'science wars' currently being waged over the role and future of science and technology in our society. This balanced selection of a variety of perspectives on the hotly contested role of science and technology in contemporary society will clarify this vital debate for both specialists and non-specialists.

"... are dinosaurs social constructs? Do we really know anything about dinosaurs? Might not all of our beliefs about dinosaurs merely be figments of the paleontological imagination? A few years ago such questions would have seemed preposterous, even nonsensical. Now they must have a serious answer." At stake in the "Science Wars" that have raged in academe and in the media is nothing less than the standing of science in our culture. One side argues that science is a "social construct," (...) that it does not discover facts about the world, but rather constructs artifacts disguised as objective truths. This view threatens the authority of science and rejects science's claims to objectivity, rationality, and disinterested inquiry. Drawing Out Leviathan examines this argument in the light of some major debates about dinosaurs: the case of the wrong-headed dinosaur, the dinosaur "heresies" of the 1970s, and the debate over the extinction of dinosaurs. Keith Parsons claims that these debates, though lively and sometimes rancorous, show that evidence and logic, not arbitrary "rules of the game," remained vitally important, even when the debates were at their nastiest. They show science to be a complex set of activities, pervaded by social influences, and not easily reducible to any stereotype. Parsons acknowledges that there are lessons to be learned by scientists from their would-be adversaries, and the book concludes with some recommendations for ending the Science Wars. (shrink)

For stakeholders, such as investors and lenders, to appropriately assess a company's financial performance, the reported accounting earnings must closely reflect the economic reality of the organization's financial activity throughout the reporting period. The degree to which reported earnings capture economic reality is called earnings quality. Managers have an ethical obligation to report high quality earnings to interested stakeholders in a timely matter. Accounting research has identified conditions within an organization, such as management compensation contracts and pending litigation that can (...) impact earnings quality. We extend this line of research by exploring whether another characteristic of an organization, gender diversity in senior management, influences the quality of reported earnings. Companies with more women in senior management are found to be more profitable and have higher stock returns after initial public offerings than those with fewer women in the management ranks. Our findings suggest that the improved bottom line for companies with more women senior executives is not produced through the management of earnings or lower quality earnings. Instead, earnings quality is positively associated with gender diversity in senior management. (shrink)

Offers a critical examination of Alvin Plantinga's and Richard Swinburne's contemporary attempt to defend traditional theism within the context of analytic philosophy.

This provocative, focused, and succinct new text addresses two issues integral to the study of the philosophy of science: the rationality of science and the realism question. Students are invited to think deeply about salient issues as they explore collections of cases and examples, beginning by considering the founding document of modern science, Copernicus’s On the Revolutions of the Heavenly Spheres , and including discussions of other key readings such as Thomas Kuhn’s The Structure of Scientific Revolutions . Author Keith (...) Parsons challenges students’ thinking, offering his own views while providing a solid foundation for debate. (shrink)

In this essay I respond to the critical remarks made by Prof. Reppert in “Reply to Parsons and Lippard on the Argument from Reason” (present issue). I also provide a critique of Reppert’s original article, “The Argument from Reason,” in Philo vol. 2, no. 1 (Spring-Summer 1999).

In his book Nonbelief & Evil, Theodore Drange argues that theists are likely to deploy the “unknown purpose defense” in the face of the existence of apparently gratuitous evils. That is, they will assert that God has morally sufficient reasons for permitting apparently gratuitous evil, but that humans do not know those reasons. Drange argues that by deploying the unknown purpose defense, and by challenging atheologians to prove that God does not have such unknown morally sufficient reasons, theists can achieve (...) a stalemate with atheological challengers. I argue, however, that the epistemic burden of ascertaining whether God probably does or does not possess morally sufficient reasons for permitting evil falls asymmetrically on theists and atheists. Further, I argue that, given the failure of theodicies, the condition of nescience, the admission that we are in no position to assess whether God probably does or does not possess morally sufficient reasons for permitting ostensibly gratuitous evil, entails agnosticism about God’s existence. To escape agnosticism, theists will probably claim to have a warranted and properly basic belief in the existence and goodness of God. While I concede that theists may be doing their “epistemic best” in claiming such assurance, I argue that theists must concede that the existence of apparently gratuitous evil equally legitimizes nonbelief. (shrink)

The freedom to choose for oneself is a part of what it means to be a human being.Jackson J In England and Wales, the Mental Capacity Act 20...

Copernican questions, 2006 ; It started with Copernicus, 2014 -- Copernican questions. What was Copernicus's revolution? ; What happens when your world changes? ; Copernican questions : rationality and realism ; The plan of the book -- Is science really rational? : the problem of incommensurability. Incommensurability of standards ; Incommensurability of values ; Incommensurability of meaning ; Evaluating meaning incommensurability ; Conversion : a concluding case study -- A walk on the wild side : social constructivism, postmodernism, feminism, and (...) that old-time religion. The constructivist challenge ; Postmodernism attacks! ; Is "objectivity" what a man calls his subjectivity? ; Is science godless? -- Ascending the slippery slope : scientific progress and truth. The evils of Whig history ; Social-constructivist history ; Does science converge toward truth? ; Assessing Laudan's Critique of Convergent Realism ; Scientists' own realism ; Could we be wrong about everything? -- Truth of consequences? Electrons : real particles or convenient fictions? ; Van Fraassen's constrictive empiricism ; Do we observe through microscopes? ; But what about things that are really unobservable? ; So what really is the goal of science? -- Mysteries of methods. Induction and deduction ; Aristotle : the first methodologist ; Bacon : scientific method renovated? ; The hypothetico-deductive method ; Hume on induction ; Popper and the rejection of induction ; Inference to the Best Explanation (IBE) to the rescue? -- If you have science, who needs philosophy? The limits of science? ; The breakdown of philosophy ; Naturalizing epistemology ; Naturalizing ethics ; Philosophy in an age of science -- Science, scientism, and being human. Mind : physical or spiritual? ; Science and the human image ; Ape, angel, or neither? (shrink)

This chapter begins by defining natural theology in analytical philosophy, and next considers analytical philosophers's rejection of natural theology and the rise of analytical theism. The focus then turns to one of the most prominent arguments debated in recent discussions of natural theology, the so-called fine-tuning argument. The FTA is a sophisticated version of the traditional argument to design, one that appeals to the apparent ‘fine tuning’ of the fundamental constants of nature, such as the gravitational constant, such that even (...) a minute variation in these values would not have permitted the development in our universe of complex forms of life or, a fortiori, intelligent and sentient creatures. The chapter first presents a statement of the argument by two of its defenders – William Lane Craig and Robin Collins – and then looks at criticisms by such philosophers as Robin Le Poidevin and Graham Oppy. It concludes by asking whether the recent debates among analytic philosophers of religion have really advanced the case for natural theology. (shrink)

Shepard proposes that the human mind relies on screw displacement because of its adaptive simplicity and uniqueness. I discuss this hypothesis by assessing screw displacement with respect to (1) other plausible spatial transformations, (2) a variety of criteria for adaptive efficiency and utility, and (3) a variety of psychological conditions in which observed responses discriminate amongst alternative spatial procedures. [Shepard].

Preface for instructors -- Preface for students (you really should read it) -- What is logic about? -- Sentential logic basics -- Sentential logic proofs -- More sentential logic : contradictions, tautologies and assumptions -- Predicate logic basics -- Proofs in predicate logic -- Probability : the basic rules of life -- The theorem of Dr. Bayes -- Probability illusions : why we are so bad at inductive reasoning -- Studies have shown ... or have they? -- Inference to the (...) best explanation -- Rhetoric : the art of persuasion -- Won't get fooled again (fallacies and other foibles) -- Spin, spin, spin (or how not to be a sucker) -- Everything you know is wrong! : pseudoscience and bogus scholarship. (shrink)

Clozapine is a very effective drug with both significant benefits and significant risks in treatment-resistant schizophrenia. Informed consent is generally accepted as both desirable and necessary in order to ensure that the patient’s human rights and dignity are respected. Disclosure is a key element of informed consent. It is unclear if the adequate documentation of disclosure is standard practice before initiation of clozapine. The aim of this study was to assess the adequacy of the documentation of disclosure in consent to (...) clozapine treatment in an adult mental health service and to develop guidelines on disclosure. The method was a retrospective analysis of charts of patients given clozapine who received the drug through the pharmacy of a single North Dublin psychiatric hospital. Results show that current practice has evident gaps. The professional, ethical and legal issues are discussed. (shrink)

Knowledge about moral development and elderly persons is very limited. A hermeneutical interpretative study was conducted with healthy elderly persons in order to explore and describe their moral orientation based on the paradigms of justice and care . The types of moral reasoning, dominance, alignment and orientation were determined. All but one participant included both types of reasoning when discussing an ethical conflict. None of the men’s moral reasoning was dominated by caring, but justice dominated the reasoning of four women. (...) The implications for ethical decision-making and future research are discussed. (shrink)

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

Biological evolution provides a creative fount of complex and subtle adaptations, often surprising the scientists who discover them. However, because evolution is an algorithmic process that transcends the substrate in which it occurs, evolution’s creativity is not limited to nature. Indeed, many researchers in the field of digital evolution have observed their evolving algorithms and organisms subverting their intentions, exposing unrecognized bugs in their code, producing unexpected adaptations, or exhibiting outcomes uncannily convergent with ones in nature. Such stories routinely reveal (...) creativity by evolution in these digital worlds, but they rarely fit into the standard scientific narrative. Instead they are often treated as mere obstacles to be overcome, rather than results that warrant study in their own right. The stories themselves are traded among researchers through oral tradition, but that mode of information transmission is inefficient and prone to error and outright loss. Moreover, the fact that these stories tend to be shared only among practitioners means that many natural scientists do not realize how interesting and lifelike digital organisms are and how natural their evolution can be. To our knowledge, no collection of such anecdotes has been published before. This paper is the crowd-sourced product of researchers in the fields of artificial life and evolutionary computation who have provided first-hand accounts of such cases. It thus serves as a written, fact-checked collection of scientifically important and even entertaining stories. In doing so we also present here substantial evidence that the existence and importance of evolutionary surprises extends beyond the natural world, and may indeed be a universal property of all complex evolving systems. (shrink)

Background:Women's health has received renewed attention in the last few years including health rehabilitation options for women affected by breast cancer. Dancing has often been regarded as one attractive option for supporting women's well-being and health, but research with women recovering from breast cancer is still in its infancy. Dancing with Health is multi-site pilot study that aimed to evaluate a dance programme for women in recovery from breast cancer across five European countries.Methods:A standardized 32 h dance protocol introduced a (...) range of Latin American dances presented within a sports and exercise framework with influences from dance movement therapy. Fifty-four women (M age 53.51; SD 7.99) participated in the study who had a breast cancer diagnosis 6 weeks, no indication of metastasis, or scheduled surgery/chemotherapy/radiation treatment for the duration of the intervention. Primary outcome data was collected for anthropometric and fitness measures next to cancer-related quality of life.T-tests and Wilcoxon signed ranked tests were used to establish differences pre and post intervention. Cohen's d was also calculated to determine the effect size of the intervention.Results:Statistically significant changes were found for: (i) weight, right and left forearm circumference and hip; (ii) 6 min walking, right and left handgrip, sit-to-stand and sit-and-reach; (iii) the EORTC-QLQ C30 summary score as well as the subscales of emotional and social functioning and symptoms. In all cases the direction of change was positive, while Cohen's d calculated showed that the effect of the intervention for these parameters ranged from intermediate to large.Conclusion:Changes on the above anthropometric, fitness and quality of life measures suggest that the intervention was of value to the participating women recovering from breast cancer. Results also advocate collaborative efforts across countries to further research. (shrink)

This collection of papers by prominent feminist thinkers advances the positive feminist project of remapping the moral by developing theory that acknowledges the diversity of women.

Mood profiling has a long history in the field of sport and exercise. Several novel mood profile clusters were identified and described in the literature recently (Parsons-Smith, Terry, & Machin, 2017). In the present study, we investigated whether the same clusters were evident in an Italian language, sport and exercise context. The Italian Mood Scale (ITAMS; Quartiroli, Terry, & Fogarty, 2017) was administered to 950 Italian-speaking sport participants (659 females, 284 males, 7 unspecified; age range = 16–63 yr., M (...) = 25.03, SD = 7.62) and seeded k-means clustering methodology applied to the responses. Six distinct mood profiles were identified, termed the iceberg, inverse iceberg, inverse Everest, shark fin, surface, and submerged profiles, which closely resembled those reported among English-speaking participants (Parsons-Smith et al., 2017). Significant differences were found in the distribution of specific mood profiles across gender and age groups. Findings supported the cross-cultural generalizability of the six mood profiles and offer new research avenues into their antecedents, correlates and behavioral consequences in Italian-language contexts. (shrink)