BackgroundDecision-making in initiating life-sustaining health technology is complex and often conducted at time-critical junctures in clinical care. Many of these decisions have profound, often irreversible, consequences for the child and family, as well as potential benefits for functioning, health and quality of life. Yet little is known about what influences these decisions. A systematic review of reasoning identified the range of reasons clinicians give in the literature when initiating technology dependence in a child, and as a result helps determine the (...) range of influences on these decisions.MethodsMedline, EMBASE, CINAHL, PsychINFO, Web of Science, ASSIA and Global Health Library databases were searched to identify all reasons given for the initiation of technology dependence in a child. Each reason was coded as a broad and narrow reason type, and whether it supported or rejected technology dependence.Results53 relevant papers were retained from 1604 publications, containing 116 broad reason types and 383 narrow reason types. These were grouped into broad thematic categories: clinical factors, quality of life factors, moral imperatives and duty and personal values; and whether they supported, rejected or described the initiation of technology dependence. The majority were conceptual or discussion papers, less than a third were empirical studies. Most discussed neonates and focused on end-of-life care.ConclusionsThere is a lack of empirical studies on this topic, scant knowledge about the experience of older children and their families in particular; and little written on choices made outside ‘end-of-life’ care. This review provides a sound basis for empirical research into the important influences on a child’s potential technology dependence. (shrink)

Background There is considerable variation in the functionality of bioethical services in different institutions and countries for children in hospital, despite new challenges due to increasing technology supports for children with serious illness and medical complexity. We aimed to understand how bioethics services address bioethical concerns that are increasingly encountered in paediatric intensive care. Methods A qualitative descriptive design was used to describe clinician’s perspectives on the functionality of clinical bioethics services for paediatric intensive care units. Clinicians who were members (...) of formal or informal clinical bioethics groups, or who were closely involved with the process of working through ethically challenging decisions, were interviewed. Interviews took place online. Resulting transcripts were analysed using thematic analysis. Results From 33 interviews, we identified four themes that described the functionality of bioethics services when a child requires technology to sustain life: striving for consensus; the importance of guidelines; a structure that facilitates a time-sensitive and relevant response; and strong leadership and teamwork. Conclusions Clinical bioethics services have the potential to expand their role due to the challenges brought by advancing medical technology and the increasing options it brings for treatment. Further work is needed to identify where and how bioethics services can evolve and adapt to fully address the needs of the decision-makers in PICU. (shrink)

Following the announcement in 1949 in the USA that cortisone offered rheumatoid arthritis sufferers effective treatment for their crippling disease, the Ministry of Health came under considerable pressure from the medical profession and the public to make cortisone available in Britain. The Ministry, therefore, urged British companies to start manufacturing cortisone. Among the several pharmaceutical firms responding to the Ministry’s request, Glaxo’s expertise in the field of vitamins gave them a head start. This paper describes the varied and flexible strategy (...) that enabled Glaxo to maintain this head start, and the scientific and technical capabilities which the company subsequently built up, enabling them to dominate the market for corticosteroids in Britain.Among the drugs to emerge out of the Glaxo project to manufacture cortisone, which began in 1950 and later became a wider R&D programme on steroids, was the topical steroid Betnovate, launched in 1963, which remains a best-seller today. However, although it led to successful new products, Glaxo’s programme had limitations. The paper identifies a missed opportunity, in the shape of the biosynthetic route to steroid drugs, often considered as a milestone in the development of the new biotechnology. Whether or not this missed opportunity proved costly to the company is uncertain. However, it illustrates the role of technological path-dependence, and the importance of the integration between different scientific disciplines, in this case chemistry and biology, in pharmaceutical innovation. (shrink)

This selection consists of extracts from writings of women concerned solely with the pursuit of abstract ideas, historically contextualized. The texts, for the most part, reflect issues widely debated in their contemporary societies. Extracts from lesser-known writers are also included, providing a diversity of arguments spanning four centuries and including some notable contemporary philosophers.

A leader in the modern commentary on ethics and philosophy, Mary Warnock casts a critical eye over her life and times.

How is hope to be found amid the ethical and political dilemmas of modern life? Writer and philosopher Mary Zournazi brought her questions to some of the most thoughtful intellectuals at work today. She discusses "joyful revolt" with Julia Kristeva, the idea of "the rest of the world" with Gayatri Spivak, the "art of living" with Michel Serres, the "carnival of the senses" with Michael Taussig, the relation of hope to passion and to politics with Chantal Mouffe and Ernesto (...) Laclau. A dozen stimulating minds weigh in with their visions of a better social and political order. The result is a collaboration - of writing, of thinking, and of politics - that demonstrates more clearly than any single-authored project could how ideas encountering one another can produce the vision needed for social change. (shrink)

All religion and much philosophy has been concerned with the contrast between the ephemeral and the eternal. Human beings have always sought ways to overcome time, and to prove that death is not the end. This book consists then in an exploration of certain closely related ideas: personal identity, time, history and our commitment to the future, and the role of imagination in life.

En este libro, la autora desarrolla su concepción del juicio reflexionante inspirada en Emmanuel Kant y en Hannah Arendt para concentrarse en cómo cierto tipo de narraciones modelan nuestras nociones de lo que consideramos moral. Lara nos ofrece distintas concepciones sobre el mal en su formulación histórica mediante los ejemplos de las tragedias griegas, las diferentes concepciones sobre el mal en la obra de Shakespeare, el uso literario de la metáfora en la obra de Joseph Conrad y en narraciones fílmicas (...) que describen la crueldad humana. Lara sugiere que el aprendizaje moral es un proceso en el que intervienen las instituciones sociales, la voluntad de los individuos y de las sociedades para comprometerse a un debate abierto y con ello modelar los juicios colectivos sobre el pasado. Lara enfatiza que el juicio reflexionante se da entre un evento, una narración de dicho evento y la recepción pública de dicha narrativa. En este libro se aportan importantes métodos para la comprensión del fenómeno moral del mal, porque introducen nuevas verdades desvelatorias acerca de eventos particulares que no pueden ser simplemente captados por medio de categorías conceptuales. Lara utiliza como fuentes a Jürgen Habermas, Walter Benjamin, Primo Levi, Giorgio Agamben y Ariel Dorfman para probar la conclusión de este tipo de narraciones: la acción (de crueldad) ata de manera definitiva al perpetrador con su víctima. (shrink)

Fundamental principles : the nature of the dispute -- Types of euthanasia -- Psychiatric assisted suicide -- Neonates -- Incompetent adults -- Human life is sacred -- The slippery slope -- Medical views -- Four methods of easing death and their effect on doctors -- Looking further ahead.

The works of Mary Wollstonecraft (1759-1797) ranged from the early _Thoughts on the Education of Daughters_ to _The Female Reader_, a selection of texts for girls, and included two novels. But her reputation is founded on _A Vindication of the Rights of Woman_ of 1792. This treatise is the first great document of feminism—and is now accepted as a core text in western tradition. It is not widely known that the germ of Wollstonecraft’s great work came out of an (...) earlier and much shorter vindication—A Vindication of the Rights of Men (1790), written in the context of the issues raised by the French Revolution. This edition, which follows the model of other Broadview Editions in including a range of materials that help the reader to see the work in the context of its era out of which it emerged, is arranged chronologically, opening with Wollstonecraft’s “other vindication.” It also includes a wide range of other documents in appendices, as well as a comprehensive and authoritative introduction, chronology, and full index. (shrink)

Nature and Mortality is a challenging look at some of the major public issues of our time through the eyes of one of our most influential and probing liberal humanists. It is a frank account on where we stand today on such controversial matters as human embryology, genetic engineering, euthanasia and abortion. Warnock's views may seem like a red rag to a bull to some, but her contribution to the debate is always stimulating. Enlivened by autobiographical anecdote and some delicious (...) side-swipes, Nature and Mortality is Mary Warnock at her most perceptive, wise and entertaining. (shrink)

Western philosophical orthodoxy places many aspects of other people's lives outside the scope of our knowledge. Demonstrating an alternative to this view, however, this book argues that Jean-Paul Sartre's application of his unique psychoanalytic method to Gustave Flaubert is the culmination of his project to show that it is possible to know everything there is to know about another person. It examines how Sartre aims to revolutionize our way of thinking about others by presenting his existential psychoanalysis as the means (...) to knowledge of both ourselves and others. By so doing, it highlights how his determination to solve the longstanding philosophical conundrum about other minds drives him not only to incorporate insights from Descartes, Hegel, Husserl, Freud, Marx, and Beauvoir into his philosophy, but also to supplement and enhance his philosophy through the development and application of a new form of psychoanalysis. -/- Sartre's Existential Psychoanalysis integrates, for the first time, Sartre's psychoanalysis into his overarching philosophical project. By offering a critical interrogation of the role his psychoanalytical studies played in the development of his existentialism, Mary Edwards uncovers the overlooked philosophical significance of his existential psychoanalysis and brings it into a new and productive dialogue with current research in the fields of philosophy, psychology, and psychotherapy. (shrink)

This chapter first distinguishes between originality and creativity. True originality is rare, whether in art, science, or LEGO, because to be truly original means to have done something that no one has ever done before, and that no one could have anticipated. Most LEGO creations will not meet that condition, for with the exception of serious hobbyists who undertake massive builds, most players who make original creations are making creations that are commonplace. Painting or remolding or placing stickers on the (...) bricks counts against the spirit of LEGO creation. The chapter then discusses The LEGO Movie embodies the paradox that presents three conflicting models of creative LEGO play, illustrated by the Master Builders, Finn's father, and Emmet. The movie's creators were deliberately playing around with conflicting popular conceptions of creativity: creativity as madness, creativity as thinking outside the box, and creativity as vision. (shrink)

Fraud in Europe is complex and well organised: it crosses organisational and geographic boundaries. The policing of fraud, on the other hand, is characterised both at national and transnational levels by fragmentation and divided accountability. This paper considers the issues involved in combating fraud in European institutions and spending programmes. It discusses the roles of those bodies with transnational responsibilities such as UCLAF , the European Fraud Prevention Office and the European Court of Auditors. The paper considers the difficulties associated (...) with the Corpus Juris proposals for a single European legal area to facilitate the fight against fraud related to the European Budget. It concludes that the task of policing Europe is hampered not only by the diversity of national political and jurisprudential systems, but also by the weakness and lack of independence of the transnational institutions. (shrink)

ABSTRACTHélène Landemore's Democratic Reason offers a new justification for democracy and for broad-based citizen participation, appealing to the “emergent” intelligence of large, diverse groups. She argues that ordinary citizens should rule as directly as possible because they will make better informed, more intelligent decisions than, for example, appointed officials, councils of experts, or even elected representatives. The foundation of this conclusion is the premise that “diversity trumps ability” in a wide range of contexts. But the main support for that claim (...) is merely a series of computer experiments that are strongly biased toward that result and tell us essentially nothing about decision making in real-world political settings. Moreover, Landemore's analyses of alternative forms of rule deal only in abstract comparisons between sharply distinguished ideal types. Among other difficulties, they entirely overlook the central consideration in such comparisons: the relative ability of any decision-making process to go beyond stereotyped, intrinsic strategies and integrate multiple sources and varieties of information. In the end, Landemore's claims for the superior intelligence of broadly participatory forms are thus not supported by credible evidence. (shrink)

The unity of aesthetic and teleological judgment, the third and earlier Critiques, is based on Kant′s discovery of a “heuristic method” for applying judgments regarding sense phenomena to abstract thought, a “second attention” which enables an “idea of the whole”. Synthetic judgment, basis for cognition and human action, depends on efficacy of non-empirical insights: the transcendental standpoint, “regulative” ideas, consciousness of “ought” and the reality of freedom, universality of natural mechanism, the principle of “fortuitous” purposiveness. The activity of reflective judgment (...) in the encounter with the beautiful, sublime, living, and two paradigmatic types of explanation, inspired by Spinoza′s distinction of extensio and cogitatio, permit Kant to bridge the gap between freedom and necessity, theoretical knowledge and morality. (shrink)

Emerging research has examined individual differences in affective forecasting; however, we are aware of no published study to date linking psychopathology symptoms to affective forecasting problem...

Known as the “Mother of Tibetan Buddhism” and the “Mother of Knowledge,” Yeshe Tsogyal built upon indigenous Bön philosophy and Mahāyāna Buddhism to bring about a Buddhism that is identifiably Tibetan. I report on her life, her works and teaching. Then summarize her significance as a philosopher of Tibetan Buddhist metaphysics, epistemology and ethics. Lastly, I append portions of several writings attributed to her.

Recently, concerns have been raised about the phenomenon of 'overdiagnosis', the diagnosis of a condition that is not causing harm, and will not come to cause harm. Along with practical, ethical, and scientific questions, overdiagnosis raises questions about our concept of disease. In this paper, we analyse overdiagnosis as an epistemic problem and show how it challenges many existing accounts of disease. In particular, it raises questions about conceptual links drawn between disease and dysfunction, harm, and risk. We argue that (...) "disease" should be considered a vague concept with a nonclassical structure. On this view, overdiagnosed cases are 'borderline' cases of disease, falling in the zone between cases that are clearly disease, and cases that are clearly not disease. We then develop a précising definition of disease designed to provide practical help in preventing and limiting overdiagnosis. We argue that for this purpose, we can define disease as dysfunction that has a significant risk of causing severe harm to the patient. (shrink)

Neil Levy argues that while addicts who believe they are not addicts are self-deceived, addicts who believe they are addicts are just as self-deceived. Such persons accept a false belief that their addictive behaviour involves a loss of control. This paper examines two implications of Levy's discussion: that accurate self-knowledge may be particularly difficult for addicts; and that an addict's self-deceived belief that they cannot control themselves may aid their attempts at self-control. I argue that the self-deceived beliefs of addicts (...) in denial and of self-described addicts differ in kind. Unlike the self-deception of an addict in denial, that of the self-described addict allows them to acknowledge their behaviour. As such, it may aid an addict to develop more self-control. A paradoxical implication is that this self-deception may allow an addict more self-knowledge. (shrink)

In his justly celebrated Expert Political Judgment, Philip E. Tetlock evaluates the judgment of economic and political experts by rigorously testing their ability to make accurate predictions. He finds that ability profoundly limited, implying that expert judgment is virtually useless, if not worse. He concludes by proposing a project that would seek to improve experts' performance by holding them publicly accountable for their claims. But Tetlock's methods severely underestimate the value of expert opinion. Despite their notorious disagreements, experts have highly (...) pertinent information and advice in many areas of public policy. The main problem with experts is that political actors seize on their most extreme views in one direction or the other, and overlook their areas of general agreement and the core of relatively reliable information that they provide. (shrink)

In his justly celebrated Expert Political Judgment, Philip E. Tetlock evaluates the judgment of economic and political experts by rigorously testing their ability to make accurate predictions. He finds that ability profoundly limited, implying that expert judgment is virtually useless, if not worse. He concludes by proposing a project that would seek to improve experts' performance by holding them publicly accountable for their claims. But Tetlock's methods severely underestimate the value of expert opinion. Despite their notorious disagreements, experts have highly (...) pertinent information and advice in many areas of public policy. The main problem with experts is that political actors seize on their most extreme views in one direction or the other, and overlook their areas of general agreement and the core of relatively reliable information that they provide. (shrink)

Mary Anne Warren investigates a theoretical question that is at the centre of practical and professional ethics: what are the criteria for having moral status? That is: what does it take to be an entity towards which people have moral considerations? Warren argues that no single property will do as a sole criterion, and puts forward seven basic principles which establish moral status. She then applies these principles to three controversial moral issues: voluntary euthanasia, abortion, and the status of (...) non-human animals. (shrink)

Bryan Caplan’s The Myth of the Rational Voter turns, in two contrasting ways, on the role of experts. On the one hand, Caplan uses the opinions of economists as a benchmark for identifying error in public opinion, finding such error systematic and pervasive. On the other hand, in considering remedies, he largely discounts the ability of policymakers to use expert advice and their own expertise to resist misguided public pressure. Although Caplan’s use of expert opinion as a benchmark, in principle, (...) is acceptable, he overstates what we can conclude from that exercise with his data. There are, however, alternative grounds for a more tentative, yet broadly similar, assessment of the prevalence of error in mass opinion. (shrink)

A biography of the theologian/scientist/philosopher who became famous for his archeological research and for his efforts to reconcile religion and science through a synthesis of evolutionary theory and Christian doctrine.

Se aborda el problema de qué es una ley científica. Se analiza la concepción tradicional hempeliana sobre la posibilidad de caracterizar una forma lógica para los enunciados de ley científica, que las distinguiría de las regularidades accidentales, concluyendo que ello no es posible. Se analiza entonces el problema de cómo es posible la predicción a partir de enunciados de ley, si no hay diferencia lógica con afirmaciones de regularidad, buscando criterios que permitan el establercimiento de afirmaciones proyectables. Correlativamente se trata (...) el problema de la normatividad de un criterio de identificación de candidatos a enunciados de ley, candidatos que ya no denominamos "lawlike statements" puesto que se ha abandonado la pretensión de que lo que determina los buenos candidatos a leyes sea su forma. A lo largo del texto se analizan de modo argumentado las posiciones filosóficas más tradicionales. Las conclusiones apuntan a la posibilidad de criterios de identificación a leyes sólo parcialmente normativos. (shrink)

In June 2002, Arthur Andersen LLP became the first accounting firm in history to be criminally convicted. The repercussions were immense. From a position as one of the leading professional services firms in the world, with 85,000 staff in 84 countries and revenues in excess of $9 billion, Andersen effectively ceased to exist within a matter of months. Although Andersen’s conviction related specifically to a charge of obstructing justice, public attention focused on the audit relationship between Andersen and its major (...) client, Enron Corporation, particularly the actions (and inactions) that had allowed Enron to post spectacular year-on-year earnings and profit growth. As well as examining events leading up to the demise of Andersen, the case provides an opportunity to consider the broader controversy over accounting and corporate governance practices and, more generally, the pressures found within organisations that can foster unethical conduct. The case was prepared from public sources. (shrink)

First published in 1984, Cultural Analysis is a systematic examination of the theories of culture contained in the writings of four contemporary social theorists: Peter L. Berger, Mary Douglas, Michel Foucault, and Jürgen Habermas. This study of their work clarifies their contributions to the analysis of culture and shows the converging assumptions that the authors believe are laying the foundation for a new approach to the study of culture. The focus is specifically on culture, a concept that remains subject (...) to ambiguities of treatment, and concentrates on questions concerning the definition and content of culture, its construction, its relations with social conditions, and the manner in which it may be changing. The books demonstrates how these writers have made strides towards defining culture as an objective element of social interaction which can be subjected to critical investigation. (shrink)

Journal Name: Philologus Issue: Ahead of print.