Although treating the elderly occasion the same kinds of ethical issues as treating other patients, specific problems do arise when making decisions for persons, once competent, who no longer can express their values. I examine the problem of decisional incapacity and offer a critique of the principles, such as substituted judgment, and the instruments, such as advance directives, living wills, other instructional directives, as well as surrogate decision-makers.

This essay explores the preferences, anticipations and expectations of the elderly regarding the role of family members in making health care decisions for them should they become decisionally incapacitated. Findings are presented from a series of in-depth interviews of men and women aged 67–91 years. Following a discussion of the uncertain legal status of familial surrogate decision-making, we argue that the family unit's autonomy is sufficient to justify the elderly's preferred reliance on their own family. Further, we suggest that social (...) and legal policy changes should facilitate, rather than impede, familial decision-making. (shrink)

The total and the sharp character of orthodox quantum logic has been put in question in different contexts. This paper presents the basic ideas for a unified approach to partial and unsharp forms of quantum logic. We prove a completeness theorem for some partial logics based on orthoalgebras and orthomodular posets. We introduce the notion of unsharp orthoalgebra and of generalized MV algebra. The class of all effects of any Hilbert space gives rise to particular examples of these structures. Finally, (...) we investigate the relationship between unsharp orthoalgebras, generalized MV algebras, and orthomodular lattices. (shrink)

The debate about constructivism in physics has led to different kinds of questions that can be conventionally framed in two classes. One concerns the mathematics that is considered for the theoretical development of physics. The other is concerned with the experimental parts of physical theories. It is unnecessary to observe that the intersection between our two classes of problems is far from being empty. In this paper we will mainly deal with topics belonging to the second class. However, let us (...) briefly mention some important problems that have been debated in the framework of our first class. For instance, the following: to what extent do the undecidability and incompleteness results of classical mathematics affect fragments of physical theories, in such way as to have a “real physical meaning”? are the mathematical arguments that seem to be essential for physics justifiable in the framework of traditional mathematical constructivism?The first question has recently been investigated by Pitowski, Penrose, da Costa, Doria, Mundici, Svozil and others. As expected by most logicians, one can construct undecidable sentences whose physical meaning seems to be hardly questionable. This happens both in classical and in quantum mechanics. (shrink)

Community energy based on a mix of distributed technologies offers a serious alternative to the current energy system. The nature of community energy and the role that such initiatives might play in the general fabric of civic life is not, however, well understood. Community energy initiatives might involve only those citizens who prefer to be actively and continuously involved in intense, democratic debate. A more robust conceptualization of community energy might, on the other hand, be guided by Benjamin Barber’s notion (...) of “strong democracy,” in which community energy initiatives would draw upon a much broader citizen base, involving people from many walks of life and from quarters not generally presumed to be part of a sustained democratic process. The history of community energy is explored and a number of case studies are presented to illustrate the problems, prospects, and limitations of a socially and technologically decentralized energy system. (shrink)

Rehabilitation For Traumatic Brain Injury (TBI) is a state-of-the-science review of the effectiveness of rehabilitation interventions.

A letter to The Times of London, May 9, 1992 protesting the Cambridge University proposal to award an honorary degree to M. Jacques Derrida.

Constructibility and complexity play central roles in recent research in computer science, mathematics and physics. For example, scientists are investigating the complexity of computer programs, constructive proofs in mathematics and the randomness of physical processes. But there are different approaches to the explication of these concepts. This volume presents important research on the state of this discussion, especially as it refers to quantum mechanics. This `foundational debate' in computer science, mathematics and physics was already fully developed in 1930 in the (...) Vienna Circle. A special section is devoted to its real founder Hans Hahn, referring to his contribution to the history and philosophy of science. The documentation section presents articles on the early Philipp Frank and on the Vienna Circle in exile. Reviews cover important recent literature on logical empiricism and related topics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Bonhoeffer the Assassin? Challenging the Myth, Recovering His Call to Peacemaking by Mark Thiessen Nation, Anthony G. Siegrist, and Daniel P. UmbelDallas J. GinglesBonhoeffer the Assassin? Challenging the Myth, Recovering His Call to Peacemaking Mark Thiessen Nation, Anthony G. Siegrist, and Daniel P. Umbel grand rapids, mi: baker academic, 2013. 272 pp. $29.99In their new book Bonhoeffer the Assassin?, Mark Thiessen Nation, Anthony G. Siegrist, and Daniel P. (...) Umbel painstakingly reread primary texts in order to challenge the widely held belief that Dietrich Bonhoeffer participated in an attempt to assassinate Adolf Hitler. Their alternative to the usual narrative of Bonhoeffer’s life holds that early in his career, long before the crisis of the Confessing Church and the rise of Nazism, Bonhoeffer made a commitment to [End Page 205] Christian pacifism that endured even through the war years and his resistance to Hitler.To argue for this alternative telling, the authors analyze Bonhoeffer’s three main “ethical” texts: the early “Barcelona lectures,” Discipleship, and finally Ethics. On their telling, while the early ethics lectures were theologically deficient, by the time that Bonhoeffer wrote Discipleship he had developed “integration,” which was “the primary theological catalyst for the ethical transition from Barcelona to Discipleship” (129). Discipleship is, they conclude, the pinnacle of Bonhoeffer’s thought, and anything that comes after it, including Ethics, cannot in any fundamental way differ from it.Alongside this diachronic analysis of Bonhoeffer’s main ethics texts, the authors emphasize two letters that Bonhoeffer wrote in 1935 and 1936. In the first, Bonhoeffer asserts that, because of his theology, he is “sometimes perceived as fanatical” (223). The second he wrote describing his “conversion experience” in 1930, in relation to the Sermon on the Mount and “Christian pacifism.” Read singly, these letters are interesting examples of Bonhoeffer’s thought and life of faith. As the authors present the argument, though, the letters comprise a unified narrative and function as an interpretive lens by which the primary texts should be understood. They think that the “fanaticism” of the first letter refers to the faith brought about in the conversion experience described in the second. The “fanaticism” letter is important because in it he asserts that, “if he were to become more ‘reasonable,’ he would have to ‘chuck [his] entire theology’” (223).Because Bonhoeffer wrote that he would have to “chuck” his theology if he made it more “reasonable,” the authors think that the theology that emerged from the conversion experience has a foundational role in his later works. Whatever Bonhoeffer wrote in Ethics, then, simply cannot disagree with the “fanaticism” that “is most fully articulated in … Discipleship” (223). Because of the importance of the “Christian pacifism” of the conversion and Discipleship, it is thus impossible—or at least highly unlikely—that Bonhoeffer participated in the assassination attempts.Bonhoeffer scholars and nonspecialists alike will find this text provocative and interesting. The conclusions, though, are finally unconvincing. For the authors, the “conversion experience” is the central key to understanding Bonhoeffer, and it is clear that they understand “Christian pacifism” to be of primary importance in the conversion, but they never tell us to what variety of Christian pacifism Bonhoeffer converted. It is very likely that Bonhoeffer’s Christian pacifism was different in kind than the Christian pacifism that the authors seem to endorse. That anachronistic reading alone renders the conclusions of the text suspect.Apart from simple historical questions, the methodology the authors use to construct their hermeneutical lens is also problematic. It is difficult to submit [End Page 206] Bonhoeffer’s entire corpus to two earlier letters that he wrote a full year apart. While readers may understand and agree that Bonhoeffer was not, in reality, an assassin (the minor claim), it will be hard to convince readers of the impassibility of his “Christian pacifism” (the major claim).Dallas J. GinglesSouthern Methodist UniversityCopyright © 2015 Society of Christian Ethics... (shrink)

The current work takes a phenomenological approach to investigating the role of guilt in a sample of persons diagnosed with Obsessive-Compulsive Disorder . The role of guilt in OCD has been frequently noted in the literature, although infrequently studied as a factor in its own right. Typically, those studying OCD have found positive correlations between questionnaire measures of guilt and self-reported symptoms of OCD. Those working with sufferers have also found that OC clients in therapy report feelings of guilt with (...) respect to their symptoms. The present work investigates, in a qualitative way, the meaning of guilt for those with OCD. The presumed role of guilt is examined descriptively, with an eye to developing a more complete understanding of the relationship between feelings of guilt and OC symptoms in a sample of sufferers. Nine participants were recruited, and were interviewed using an unstructured approach. In terms of analysis, emphasis was placed on understanding the experience of guilt and OC symptoms as both were lived by sufferers, with a focus on the personal significance of guilt for study participants. Fifteen descriptive guilt/OCD themes were derived from interviews across the nine participants. Themes revealed a variety of connections that sufferers made between feelings of guilt and symptoms of OCD. A common description of the experience was also derived. The results suggest that the role of guilt in OCD is highly interpersonal in nature, and that feelings of guilt may precede, motivate, as well as be a consequence of, OC symptoms. The role of guilt for any given sufferer may also be highly idiosyncratic. (shrink)

The Clinical Ethics Credentialing Project (CECP) was intiated in 2007 in response to the lack of uniform standards for both the training of clinical ethics consultants, and for evaluating their work as consultants. CECP participants, all practicing clinical ethics consultants, met monthly to apply a standard evaluation instrument, the “QI tool”, to their consultation notes. This paper describes, from a qualitative perspective, how participants grappled with applying standards to their work. Although the process was marked by resistance and disagreement, it (...) was also noteworthy for the sustained engagement by participants over the year of the project, and a high level of acceptance by its conclusion. (shrink)