The universe, of which our domicile the planet Earth forms but a minuscule part, has an architecture that changes and has been changing in time. In other words, it has a history of evolution. Lack of experimental evidence denies us the knowledge of what the universe was like “at the time of its origin,” as discussed by Hubert Reeves in the preceding chapter. Neither do we know much about its geometry, simply because our observatories are concentrated, for all practical purposes, (...) vanishingly close to a single point in an immensity whose size can only be measured by the billions of years required by light to go from one extremity to another! (shrink)

The earth, the abode of the only form of intelligent life in the universe of which we are aware, is a minor member of a system of nine planets, 40 or so moons and about 100 billion asteroids orbiting around the Sun, an average-size member of the 100-billion-star community making up our galaxy, the Milky Way. It is the third planet to the Sun, which it orbits, following an almost circular elliptical path maintaining an average distance of 1.5×108 km, with (...) the longest and the shortest radii now being 1.53×108 km and 1.47×10 km respectively (Fig. 1). This orbit is subject to changes in its “eccentricity” (i.e., in how much it deviates from a circle) with periods of 105 and 4×10 years5 years (Fig. 2A). In addition, the elliptical orbit itself slowly rotates as shown in Fig. 2B, in what we call the precession. (shrink)

The universe, of which our domicile the planet Earth forms but a minuscule part, has an architecture that changes and has been changing in time. In other words, it has a history of evolution. Lack of experimental evidence denies us the knowledge of what the universe was like “at the time of its origin,” as discussed by Hubert Reeves in the preceding chapter. Neither do we know much about its geometry, simply because our observatories are concentrated, for all practical purposes, (...) vanishingly close to a single point in an immensity whose size can only be measured by the billions of years required by light to go from one extremity to another! (shrink)

The earth, the abode of the only form of intelligent life in the universe of which we are aware, is a minor member of a system of nine planets, 40 or so moons and about 100 billion asteroids orbiting around the Sun, an average-size member of the 100-billion-star community making up our galaxy, the Milky Way. It is the third planet to the Sun, which it orbits, following an almost circular elliptical path maintaining an average distance of 1.5×108 km, with (...) the longest and the shortest radii now being 1.53×108 km and 1.47×10 km respectively (Fig. 1). This orbit is subject to changes in its “eccentricity” (i.e., in how much it deviates from a circle) with periods of 105 and 4×10 years5 years (Fig. 2A). In addition, the elliptical orbit itself slowly rotates as shown in Fig. 2B, in what we call the precession. (shrink)

Background: The magnitude of bullying and harassment among psychiatrists is reportedly high, yet no peer-review published studies addressing this issue could be found. Therefore, it was decided to conduct a pilot study to assess the degree of the problem, the types of bullying/harassment and to provide some insights into the situation.Methods and Principal Findings: Following multiple focus group meetings, a yes/no response type questionnaire was developed to assess the degree and type of bullying and harassment experienced by psychiatrists. Over a (...) 3-month period the questionnaire was administered to a random sample of 60 psychiatrists. 57 out of the 60 psychiatrists reported harassment and bullying. Frequencies of the following response variables are presented in descending order: rumours 40% ; defamation 20% ; passing remarks 20% ; false accusations 15% ; threats 13.3% ; verbal abuse 13.3% ; unjustified complaints 13.3% ; promotion blocked 13.3% ; humiliation 13% ; bad reference given 10% ; credentials questioned 8.3% ; physical attacks 5% ; termination 5% ; derogatory remarks 1.7% and 1.7% were subjected to personal work. As a result of being subjected to harassment, 66.7% of the psychiatrists did not take any action, whereas 33.3% confronted the person they believed responsible. Asked whether the bullying and harassment caused distress, 18.3% of the psychiatrists did not report any effect, 30% reported mild distress, 40% moderate distress and severe distress was reported by 11.7%.Conclusions: It was concluded that the magnitude of bullying and harassment among psychiatrists may be quite high, as evidenced by this pilot study. There is a need for extensive systematic studies on this subject and to establish strategies to prevent and address this issue at a national and regulatory level. (shrink)

L'ouvrage ici presente appartient peut-etre a la derniere periode de la production d'Avicenne. Le Livre des directives et remarques supplee les parties perdues de La philosophie orientale, dernier grand projet avicennien, en ce sens qu'il tend a rearticuler science divine et science universelle, par raport a l'entreprise philosophique du Shifa'. Neanmoins les Directives ne sont aucunement un traite, mais plutot un recueil de notes sur des points controverses. Les liens entre les chapitres sont souvent tenus, parfois meme arbitraires, mais il (...) ressort pourtant de la des modifications importantes par rapport aux philosophes grecs. Les theories d'Avicenne sont ainsi toutes en faveur d'une pensee rationaliste et scientifique. L'avance scientifique des orientaux a, pour lui, ouvert a l'intelligence des voies nouvelles; les methodes grecques de pensee demeurent fondamentales, mais des exigences inconnues de leur temps demandent qu'elles soient depassees. (shrink)

The nature of quantum computation is discussed. It is argued that, in terms of the amount of information manipulated in a given time, quantum and classical computation are equally efficient. Quantum superposition does not permit quantum computers to ''perform many computations simultaneously'' except in a highly qualified and to some extent misleading sense. Quantum computation is therefore not well described by interpretations of quantum mechanics which invoke the concept of vast numbers of parallel universes. Rather, entanglement makes available types of (...) computation processes which, while not exponentially larger than classical ones, are unavailable to classical systems. The essence of quantum computation is that it uses entanglement to generate and manipulate a physical representation of the correlations between logical entities, without the need to completely represent the logical entities themselves. (shrink)

Objectives: Evidence based patient choice seems based on a strong liberal individualist interpretation of patient autonomy; however, not all patients are in favour of such an interpretation. The authors wished to assess whether ideals of autonomy in clinical practice are more in accordance with alternative concepts of autonomy from the ethics literature. This paper describes the development of a questionnaire to assess such concepts of autonomy.Methods: A questionnaire, based on six moral concepts from the ethics literature, was sent to aneurysm (...) patients and their surgeons. The structure of the questionnaire was assessed by factor analysis, and item reduction was based on reliability.Results: Ninety six patients and 58 surgeons participated. The questionnaire consisted of four scales. Two of the scales reflected the paternalistic and consumerist poles of the liberal individualist model, one scale reflected concepts of Socratic autonomy and of procedural independence, and the fourth scale reflected ideals of risk disclosure.Discussion: The Ideal Patient Autonomy Scale is a 14 item normative instrument. It is clearly distinct from the generally used psychological preference questionnaires that assess preferences for physician-patient roles. (shrink)

Adrian Viens, Guest Editor of this Olivieri symposium, and Julian Savulescu, the Editor of JME, set the scene for the symposium."In failing...[her] when she needed them most, it is now clear that some members of the University’s Faculty of Medicine heard her muffled cries of academic freedom from the back room, yet their response was to serve another round of drinks and turn the music up louder. With the bombshell revelations in the...affair, the plug may have been pulled on this (...) business sponsored party, and hopefully a sober re-examination of the university’s neglected role and responsibility toward independent inquiry and academic freedom can begin.1" "These guys don’t get one thing—we’re not going away. This isn’t a personal vendetta. This is something I want patients to be protected from when I’m dead, fifty years from now.2" "[The Olivieri affair is] not a mystery novel, but instead the latest skulduggery at Toronto’s Hospital for Sick Children.1" "The legal assaults which you have endured in your battle against the drug company, and in your battle against the medical establishment appear to have been fought with the type of uncommon bravery that is rarely seen. It is for this reason that our trustees have unanimously chosen to recognise you for this most prestigious award.3" "[The Olivieri affair resulted from] a fundamental misreading of the issue as a mere contractual and scientific dispute...[it is] Canada’s worst academic and research scandal in decades...[Since 1998, Olivieri has been] demoted, then restored, then harassed. She has been smeared with allegations attacking her competence, integrity, sanity and personality....4"The Olivieri affair is one of the most important events to occur in research ethics. From its dominance in the Canadian and international news media, to changes in the governance of public health, academic medicine, …. (shrink)

This paper examines the use of case studies in ethics education. While not dismissing their value for specific purposes, the paper shows the limits of their use. While agreeing that case studies are narratives, although rather thin stories, the paper argues that the claim that case studies could represent reality is difficult to sustain. Instead, the paper suggests a way of using stories in ethics teaching that could be more real for students, while also giving them a way of thinking (...) about their own professional practices. The paper shows how the method can be used to develop a more critical and reflective practice for students in the health care professions. Some immediate problems with the method are discussed. (shrink)

Informed consent enjoys an unassailable position in both clinical and research situations as a safeguard of patients’ rights. Keeping the patient involved in the decision making process is easier when there is direct communication with the individual. The Pakistani milieu offers challenges to this process because crucial decision making is often done by family members or is left entirely up to the attending physician. There seems to be a general acceptance of this shifting of focus from the individual to other (...) players. This also raises certain ethical dilemmas for physicians who may feel uncomfortable with communication which excludes the patient or in accepting a paternalistic primary decision making role. The objective of this informal qualitative study was to ascertain physicians’ perceptions regarding the process of information delivery to the patient in the Pakistani context and the various influences acting upon it. (shrink)

Parents’ freedom to choose infant male circumcision is the correct policyIndividuals and groups lobbying to have infant male circumcision prohibited or restricted often argue that the practice of routinely circumcising infants is unjustified. For instance, in this issue of the journal, John Hutson argues that it is virtually impossible to justify a policy in which the medical establishment should be able to embark on a “mass circumcision” campaign of 100% of the infant male population [see page 238].1Indeed, I would be (...) hard pressed to find anyone who could rationally disagree with this contention. However, this is because no one is currently arguing for the enactment of a policy that stipulates that all healthy male infants should be routinely circumcised . Arguments seeking to support a prohibition of “routine infant circumcision”, such as the one by Hutson, are arguing against a straw man—and a pitiful one at that.2 Such arguments only serve to misconstrue the debate and avoid engaging in the real and pressing issues concerning the legitimacy of the provision of this procedure.The questions that should be considered, and the ones which I shall be interested in discussing here, are what reasons are justifiable for allowing parents to choose to have their son circumcised? After well informed and careful deliberation should parents have the freedom to choose to have their son circumcised? These are the most relevant questions to be considered because there is a growing collection of citizens, medical practitioners, and lawyers who are currently lobbying for the practice of infant male circumcision to be outlawed—for example, there is a bioethicist who argues that the criminal law should be used …. (shrink)

This book presents and exemplifies the theory of grammar called Semantic Syntax. The grammar, which offers a syntactic theory closely connected with semantic analyses, is a direct continuation of Generative Semantics; it will re-ignite interest in that framework which flourished and promised so much in the 1960s and 1970s.

In classical Greek poetry there is a familiar distinction between verse which repeats line upon line, and that which forms patterns liable to closure at intervals, in stanzas or lyric sections. This is often equated with the distinction between spoken and sung verse, but the equation is only approximate. At an earlier stage all verse had some musical accompaniment—so much can be deduced from a number of passages in Homer, and is in any case implicit in the nature of quantitative (...) verse. By Hellenistic times it seems that, in new composition, the more complex lyric structures had died out, while of the simpler ones more and more were being taken over as spoken verse. In the fifth century—and this can probably be extended to at least the late sixth and most of the fourth—only two kinds of verse are known to have dispensed with music altogether in performance: the heroic hexameter and the iambic trimeter. (shrink)

In classical Greek poetry there is a familiar distinction between verse which repeats line upon line, and that which forms patterns liable to closure at intervals, in stanzas or lyric sections. This is often equated with the distinction between spoken and sung verse, but the equation is only approximate. At an earlier stage all verse had some musical accompaniment—so much can be deduced from a number of passages in Homer, and is in any case implicit in the nature of quantitative (...) verse. By Hellenistic times it seems that, in new composition, the more complex lyric structures had died out, while of the simpler ones more and more were being taken over as spoken verse. In the fifth century—and this can probably be extended to at least the late sixth and most of the fourth—only two kinds of verse are known to have dispensed with music altogether in performance: the heroic hexameter and the iambic trimeter. (shrink)