The case presents a teenage girl, Sam*, in the end stages of a rare disease, with no proven therapeutic options and an investigational hematopoietic stem cell transplant has been offered thr...

A report of a problem-based learning project on the ethics of terminal care, offered as one of the options available to first year MB ChB students in Edinburgh University Medical School. The project formed part of the 'clinical correlation course' in the new curriculum. Six students took part under the supervision of two clinical tutors and a moral philosopher. The course was case-based and practical with students being given the opportunity over a period of eight weeks to meet patients, relatives (...) and hospital staff at a local geriatrics hospital and terminal care home. The main issue studied was the degree of choice available to patients electing to be treated at home, in hospital or in a hospice. Other issues included: pre-death, disposal of the dead, certification of death, communication with relatives and follow-up bereavement services. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:THE GREAT GATSBY: ROMANCE OR HOLOCAUST? Thomas J. Cousineau Washington College In an otherwise appreciative response to The Great Gatsby, H. L. Mencken expressed a reservation about the plot ofthe novel, which he characterized as "no more than a glorified anecdote" (Claridge 156). Writing to Edmund Wilson, Fitzgerald suggested, in turn, that what Mencken did not find in Gatsby was "any emotional backbone at the very height of it" (...) (Turnbull 342). Critics ofthe novel, however, have tended to overlook the self-evident fact that the novel's ostensible emotional center—the reunion between Gatsby and Daisy—does not possess sufficient significance to justify the classic status that has been largely accorded to Fitzgerald's novel. We need only remember Daisy's effusive appreciation ofGatsby's "beautiful shirts," or the even more telling detail that the truly "romantic" moments in Daisy and Gatsby's relationship all occurred several years earlier in Louisville and that the period of the reunion is scarcely mentioned in the novel to convince ourselves that the putative grandeur of Gatsby's dream does not adequately account for the novel's power or its lasting significance. Reading Gatsby as a novel about its hero's dream makes of it, in fact, a precarious literary achievement, one whose numerous absurdities were perceptively delineated by the English novelist L.P. Hartley, who admired Fitzgerald's literary gifts but thought that he had squandered them in Gatsby. In a 1926 review of the novel, Hartley offered the following summary of its plot: An adventurer of shady antecedents builds a palace at a New York seaside resort, entertains on a scale which Lucullus would have marveled at but could not have approved, and spends untold sums ofmoney, all to 22Thomas J. Cousineau catch the eye ofhis one time sweetheart, who lives on an island opposite, unhappily but very successfully married. At last, after superhuman feats ofostentation and display, the fly walks into the web. A train ofdisasters follows, comparable in quantity and quality with the scale ofthe Great Gatsby's prodigies of hospitality. Coincidence leaps to the helm and throws a mistress under a motor-car. The car does not stop, which, all things considered, is the most natural thing that happens in the book. An injured husband finds the Great Gatsby in suicidal mood sitting on a raft in his artificial lake and (apparently) forestalls him; anyhowthey are both discovered dead. The elder Gatsby is unearthed and gives a pathetic account ofhis son's early years. All the characters behave as though they were entitled to grieve over a great sorrow, and the book closes with the airs oftragedy. (Claridge 178) Minor inaccuracies aside, this must be among the most cogent, disabused responses that the plot of The Great Gatsby has ever received. It is such a welcome antidote to the reams of interpretation ofthe novel produced by critics who, dutifully aping Nick Carraway in this respect, have allowed their conviction as to Gatsby's "greatness" to be matched only by their equally adamant certainty as to the moral tawdriness of Tom and Daisy Buchanan. As Hartley's exasperated summary reminds us, The Great Gatsby, read as the account ofthe eponymous hero's dream, simply cannot support the weight of morally serious interpretation that it would like to invite or that so many ofits critics, in their turn, would like to bestow upon it.1 Nor do we move any closer to appreciating the greatness of Gatsby by shiftingourattention tothe growth in moral awareness thatcountless critics have attributed toNick Carraway, whose self-evaluation as "one ofthe few honest people that I have ever known" (64) should in itself arouse our suspicions.2 As we shall see, the fruits ofNick's presumed moral education The seemingly indestructible resistance to Hartley's lucidity that has been displayed by the great majority ofthe novel's critics may be observed in the chapter that Jeffrey Hart devotes to Gatsby in his recently published Smiling Through the Cultural Catastrophe. Arguing that "magical transformation" is the novel's true subject (230), Hart credits Nick with achieving an "epiphany" whereby he recognizes Gatsby's superiority to "the whole damn bunch put together" (238) and concludes that the larger... (shrink)

What role, if any, should emotions play in clinical reasoning and decision making? Traditionally, emotions have been excluded from clinical reasoning and decision making, but with recent advances in cognitive neuropsychology they are now considered an important component of them. Today, cognition is thought to be a set of complex processes relying on multiple types of intelligences. The role of mathematical logic or verbal linguistic intelligence in cognition, for example, is well documented and accepted; however, the role of emotional intelligence (...) has received less attention—especially because its nature and function are not well understood. In this paper, I argue for the inclusion of emotions in clinical reasoning and decision making. To that end, developments in contemporary cognitive neuropsychology are initially examined and analyzed, followed by a review of the medical literature discussing the role of emotions in clinical practice. Next, a published clinical case is reconstructed and used to illustrate the recognition and regulation of emotions played during a series of clinical consultations, which resulted in a positive medical outcome. The paper’s main thesis is that emotions, particularly in terms of emotional intelligence as a practical form of intelligence, afford clinical practitioners a robust cognitive resource for providing quality medical care. (shrink)

We investigate the expressive power of second-order logic over finite structures, when two limitations are imposed. Let SAA ) be the set of second-order formulas such that the arity of the relation variables is bounded by k and the number of alternations of second-order quantification is bounded by n . We show that this imposes a proper hierarchy on second-order logic, i.e. for every k , n there are problems not definable in AA but definable in AA for some c (...) 1 , d 1 . The method to show this is to introduce the set AUTOSAT of formulas in F which satisfy themselves. We study the complexity of this set for various fragments of second-order loeic. For first-order logic FOL with unbounded alternation of quantifiers AUTOSAT is PSpace complete. For first-order logic FOL n with alternation of quantifiers bounded by n , AUTOSAT is definable in AA . AUTOSAT) is definable in AA for some c 1 , d 1. (shrink)

James Earl Baumgartner (March 23, 1943–December 28, 2011) came of age mathematically during the emergence of forcing as a fundamental technique of set theory, and his seminal research changed the way set theory is done. He made fundamental contributions to the development of forcing, to our understanding of uncountable orders, to the partition calculus, and to large cardinals and their ideals. He promulgated the use of logic such as absoluteness and elementary submodels to solve problems in set theory, he applied (...) his knowledge of set theory to a variety of areas in collaboration with other mathematicians, and he encouraged a community of mathematicians with engaging survey talks, enthusiastic discussions of open problems, and friendly mathematical conversations. (shrink)