(2013). Sickle Cell Disease and the “Difficult Patient” Conundrum. The American Journal of Bioethics: Vol. 13, No. 4, pp. 3-10. doi: 10.1080/15265161.2013.767954.

Nach Freuds anfänglichen Überlegungen hat die Verdrängung die Dissoziation als die primäre Abwehrreaktion auf ein schweres Trauma eher ersetzt als ergänzt. Dabei ist es zu einem unnötigen Schisma zwischen Traumatheorien und dem Mainstream der Psychoanalyse gekommen. Um die Rolle der Dissoziation in primitiven psychischen Zuständen wieder in den Blick zu bekommen, ist ein Verständnis der triadischen Natur des Traumas nötig, die die Faktoren der Triebökonomie, des strukturellen Konflikts und Defizits sowie der Objektbeziehung umfasst. Die Behandlungstechnik erfordert eine Beschäftigung mit verdrängten (...) Phantasien, die mit dem Trauma in Verbindung stehen, mit Objektbeziehungsmustern, die in die Bindung eingreifen, sowie mit den psychoökonomischen Problemen, die die Ich-Funktionen durcheinandergebracht haben. Eine klinische Fallstudie illustriert dies. (shrink)

We are printing, by kind permission of the Law Commission, two sections of the report of the Law Commission on injuries to unborn children. This report was the result of a request to the Law Commission by the Lord Chancellor at the time (Lord Hailsham of Saint Marylebone) to advise on `what the nature and extent of civil liability for antenatal injury should be'. The Law Commission followed its usual practice in such circumstances of consulting various bodies and obtaining expert (...) advice on the subject and then embodying the results in a working paper (Working Paper No. 47 - injuries to unborn children) published on 19 January 1973, which preceded their report (Cmnd 5709). Meanwhile a Royal Commission is considering much wider issues of civil liability for injury (including antenatal injury) but the terms of reference for the Law Commission were much narrower and confined to the position of children injured before birth. In the section relating to the present law the report makes it clear that it is probable that liability under the common law already exists. The Scottish Law Commission has also issued a report (Cmnd 5371). They were given different terms of reference and came to somewhat different conclusions. We are printing from this long report the paragraphs discussing the medical background and the summary of recommendations. As will be evident on reading the paragraphs on the medical background to injuries to the unborn child, events are moving very rapidly, particularly in the study of congenital defects and the effects of drugs but the problems of proof present great difficulty. Other causes of injury to the unborn child are better known to the general public: for example, those following the illness, infection and disease of the mother during pregnancy, injury caused in attempted termination of pregnancy and the risks resulting from the mother's condition. The summary of the recommendations sets out very clearly the legal position of the unborn child, as the Law Commission sees it, arising from injury before birth, the final conclusion being that `legislation is desirable'. These extracts from the report, apart from their intrinsic interest, lead on to the paper by Mr Kennedy and Dr Edwards in which they set out their criticisms of it, and provide quick references to the original document. (shrink)

The authors argue that there is a world within us filled with memories, perceptions, tastes, preferences, biases, and beliefs that have been encoded and are expressed on an unaware, largely non-conscious level but, nevertheless, alter the quality, substance and trajectory of our lives.

Although research has found that long-term mindfulness meditation practice promotes executive functioning and the ability to sustain attention, the effects of brief mindfulness meditation training have not been fully explored. We examined whether brief meditation training affects cognition and mood when compared to an active control group. After four sessions of either meditation training or listening to a recorded book, participants with no prior meditation experience were assessed with measures of mood, verbal fluency, visual coding, and working memory. Both interventions (...) were effective at improving mood but only brief meditation training reduced fatigue, anxiety, and increased mindfulness. Moreover, brief mindfulness training significantly improved visuo-spatial processing, working memory, and executive functioning. Our findings suggest that 4 days of meditation training can enhance the ability to sustain attention; benefits that have previously been reported with long-term meditators. (shrink)

GIS for Science presents a collection of real-world stories about modern science and a cadre of scientists who use mapping and spatial analytics to expand their understanding of the world. The accounts in this book are written for a broad audience including professional scientists, the swelling ranks of citizen scientists, and people generally interested in science and geography. Scientific data are brought to life with GIS technology to study a range of issues relevant to the functioning of planet Earth in (...) a natural sense as well as the impacts of human activity. In a race against the clock, the scientists profiled in this volume are using remote sensing, web maps within a geospatial cloud, Esri StoryMaps, and spatial analysis to document and solve an array of issues with a geographic dimension, ranging from climate change, natural disasters, and loss of biodiversity, to homelessness, loss of green infrastructure, and resource shortages. These stories present geospatial ideas and inspiration that readers can apply across many disciplines, making this volume relevant to a diverse scientific audience. See how scientists working on the world's most pressing problems apply geographic information systems--GIS. -- "Mike Goodchild". (shrink)

The lung allocation score system in the United States and several European countries gives more weight to risk of death without transplantation than to survival following transplantation. As a result, centers transplant sicker patients, leading to increased length of initial hospitalization. The care of patients who have accumulated functional deficits or additional organ dysfunction during their prolonged stay can be ethically complex. Disagreement occurs between the transplant team, patients and families, and non-transplant health care professionals over the burdens of ongoing (...) intensive intervention. These cases highlight important ethical issues in organ transplantation, including the nature and requirements of transplant informed consent, the limits of physician prognostication, patient autonomy and decision-making capacity following transplant, obligations to organ donors and to other potential recipients, and the impact of program metrics on individualized recipient care. We outline general ethical principles for the care of lung transplant recipients with prolonged hospitalization and give regulatory, research, and patient-centered recommendations for these cases. (shrink)

Can parents who choose not to vaccinate their children be held legally liable for any harm that results? The state of laboratory and epidemiological understanding of a disease such as measles makes it likely that a persuasive causal link can be established between a decision to not vaccinate, a failure to take appropriate precautions to isolate a non-vaccinated child who may have been exposed to measles from highly vulnerable persons, and a death. This paper argues that, even if a parent (...) chooses to not vaccinate a child under a state law permitting exemptions, that decision does not create complete protection against liability for the adverse consequences of that choice. (shrink)

Consider this hypothetical scenario involving a choice not to vaccinate a child. Ms. S has a niece who is autistic. The girl's parents are suspicious that there is some relationship between her autism and her Measles Mumps and Rubella vaccination. They have shared their concerns with Ms. S. She then declines to have her own daughter, Jinny S., vaccinated with the MMR vaccine. To bypass the state's mandatory vaccination requirement, Ms. S claims a state-legislated philosophical exemption, whereby she simply attests (...) to the fact that she is opposed to vaccinating her daughter due to a conscientiously held belief. At the age of four, Jinny goes on a trip by airplane to Germany with her mother. After returning to the United States, she attends daycare despite having some mild cold symptoms. Subsequently, she develops a classic measles rash, at which point her mother brings her to a pediatrician and keeps her home from daycare. (shrink)

_Philosophy and Animal Life_ offers a new way of thinking about animal rights, our obligation to animals, and the nature of philosophy itself. Cora Diamond begins with "The Difficulty of Reality and the Difficulty of Philosophy," in which she accuses analytical philosophy of evading, or deflecting, the responsibility of human beings toward nonhuman animals. Diamond then explores the animal question as it is bound up with the more general problem of philosophical skepticism. Focusing specifically on J. M. Coetzee's (...) _The Lives of Animals_, she considers the failure of language to capture the vulnerability of humans and animals. Stanley Cavell responds to Diamond's argument with his own close reading of Coetzee's work, connecting the human-animal relation to further themes of morality and philosophy. John McDowell follows with a critique of both Diamond and Cavell, and Ian Hacking explains why Cora Diamond's essay is so deeply perturbing and, paradoxically for a philosopher, he favors poetry over philosophy as a way of overcoming some of her difficulties. Cary Wolfe's introduction situates these arguments within the broader context of contemporary continental philosophy and theory, particularly Jacques Derrida's work on deconstruction and the question of the animal. _Philosophy and Animal Life_ is a crucial collection for those interested in animal rights, ethics, and the development of philosophical inquiry. It also offers a unique exploration of the role of ethics in Coetzee's fiction. (shrink)

Reform of the federal income tax system has become a perennial item on the domestic policy agenda of the United States, although there is considerable uncertainty over specifics. Indeed the recent report of the President's Advisory Panel on Federal Tax Reform recommended not one but two divergent policy directions. In Fundamental Tax Reform, top experts in tax policy discuss a wide range of issues raised by the prospect of significant tax reform, identifying the most critical questions and considering whether the (...) answers are known, unknown--or unknowable. The debates over tax reform usually concern the advantages and disadvantages of income-based taxation as opposed to any of the several alternative forms of consumption-based taxation. The book opens with chapters that discuss the strengths, weaknesses, and political feasibility of these options. Other chapters consider the effect of tax reform on businesses, especially their investment behavior, and include a discussion of possible problems in any transition to a consumption-based tax; international taxation issues arising in an era of globalization; and individual behavioral response to tax reform, including a view of the topic from the perspective of the relatively new field of behavioral economics. ContributorsRosanne Altshuler, Alan J. Auerbach, John W. Diamond, Harry Grubert, Arnold C. Harberger, Kevin A. Hassett, Thomas J. Kniesner, Laurence J. Kotlikoff, Edward J. McCaffery, Kathryn Newmark, David Rapson, Daniel Shaviro, Joel Slemrod, James P. Ziliak, George R. ZodrowDiscussants James Alm, Henry J. Aaron, Charles L. Ballard, Leonard E. Burman, Robert S. Chirinko, Robert D. Dietz, Malcolm Gillis, Roger H. Gordon, Jane G. Gravelle, Timothy S. Gunning, James M. Poterba, Thomas S. Neubig, Alan Viard, George Yin John W. Diamond is Edward and Hermena Kelly Fellow in Tax Policy and Adjunct Professor of Economics at the Baker Institute for Public Policy, Rice University. George R. Zodrow is Professor of Economics and Rice Scholar at the Baker Institute and International Research Fellow at the Centre for Business Taxation, Oxford University. (shrink)

Dans son Introduction au Tractatus de Wittgenstein, Elizabeth Anscombe considérait que le livre avait le défaut d’exclure la proposition « “Quelqu’un” n’est pas le nom de quelqu’un » qu’elle considérait comme évidemment vraie. Ce n’est pas une proposition bipolaire et sa négation n’est pas intelligible. J’examine la question de savoir si elle a raison de dire que le Tractatu s exclut de telles propositions, et je considère son exemple en relation avec d’autres propositions qui, du moins en théorie, n’ont pas (...) de négation intelligible. En considérant le cas particulier de la réponse de Frege à Benno Kerry sur le concept de ‘cheval’, j’essaie de développer une approche de la place que donne la philosophie de Wittgenstein à certains types de proposition qui n’ont pas de négation intelligible. (shrink)

The received translation and interpretation of many of the technical terms current in the textile industry of the Roman Empire are inaccurate, because lexicographers have either fought shy of being precise, or have thought that they recognized in the ancient world technical processes which originated at a much later date. The evidence is often equivocal or insufficient, but may still yield details that have been overlooked. The textile expression scutulatus, to take an example, deserves more attention than Blümner has devoted (...) to it. When it refers to the appearance of a garment, Lewis and Short, s.v. scutulatus, translate ‘diamond or lozenge-shaped, checkered’. It seems worth while to attempt a more precise translation, and, if possible, to estimate the significance in context of the goods so designated. (shrink)

This text offers major re-evaluation of Wittgenstein's thinking. It is a collection of essays that presents a significantly different portrait of Wittgenstein. The essays clarify Wittgenstein's modes of philosophical criticism and shed light on the relation between his thought and different philosophical traditions and areas of human concern. With essays by Stanley Cavell, James Conant, Cora Diamond, Peter Winch and Hilary Putnam, we see the emergence of a new way of understanding Wittgenstein's thought. This is a controversial collection, with (...) essays by highly regarded Wittgenstein scholars that may change the way we look at Wittgenstein's body of work. (shrink)

It is a landmark theorem of McKinsey and Tarski that if we interpret modal diamond as closure, then $$\mathsf S4$$ S4 is the logic of any dense-in-itself metrizable space. The McKinsey–Tarski Theorem relies heavily on a metric that gives rise to the topology. We give a new and more topological proof of the theorem, utilizing Bing’s Metrization Theorem.

Conscious experience has been said to be outside of, or alien to, physics, and unexplained in a physical world. However, it is argued here that experience is entirely expected in a physical world that can only be defined by its power to determine patterns of experience. Something physical is something with the type of causal power that can contribute to determining the content of an experience if a subject is present at the right place and time. Physical powers also interact (...) with other physical powers, distant from any given subject, to form chains, and it is these interactions that physics handles mathematically. Nevertheless, actual causation is always defined by reference to determination of experience. The apparent puzzle of why there should be a link between experience and the physical may relate in part to the fact that experience is always immediately causally proximal, always 'here and now', at least as far as we can ascertain. Proximality, and with it the potential for mentality, cuts across existential/ ontological categories. Experience also requires a concept of an intrinsic individual, in order for there to be individual points of view. The practical problem for consciousness studies is to identify intrinsically individual causal units with event domains in human brains, that can have points of view and content that could fit with human experiences, in a way consistent with current physics. It is suggested that the 'causal diamond' concept of the here and now explored by Savitt (2015) and Arthur (2019), together with principles of field theory, may provide a useful starting point. (shrink)

In 1961, at the age of nineteen, Jorge J. E. Gracia escaped from the island of Cuba by passing himself off as a Catholic seminarian. He arrived in the United States with just a few spare belongings and his mother's diamond ring secured in a hole in one of his shoes. With a Diamond in My Shoe tells the story of Gracia's quest for identity--from his early years in Cuba and as a refugee in Miami to his formative (...) role in institutionalizing the field of Latin American philosophy in the US academy. Committed to integrating into Anglo America without forgetting his roots, Gracia reflects on his struggles and successes as an immigrant and academic, bringing a philosopher's eye to bear on his personal and professional development as a leading Latinx scholar. (shrink)

The received translation and interpretation of many of the technical terms current in the textile industry of the Roman Empire are inaccurate, because lexicographers have either fought shy of being precise, or have thought that they recognized in the ancient world technical processes which originated at a much later date. The evidence is often equivocal or insufficient, but may still yield details that have been overlooked. The textile expression scutulatus, to take an example, deserves more attention than Blümner has devoted (...) to it. When it refers to the appearance of a garment, Lewis and Short, s.v. scutulatus, translate ‘diamond or lozenge-shaped, checkered’. It seems worth while to attempt a more precise translation, and, if possible, to estimate the significance in context of the goods so designated. (shrink)

This paper deals with an analysis of debris produced during the polishing of diamond. The debris is carefully collected 'as ejected' to shorten the history of the freshly removed material. Using high-resolution electron microscopy as well as electron-energy-loss spectroscopy, the structure of the material is revealed and analysed in terms of density, percentage of sp 2 hybridized carbon, and oxygen content. Debris from polishing in the so-called hard and soft directions were involved in this investigation. Overall the structure of (...) all debris is amorphous carbon. The material appears to be composed of small clusters, some nanometres in diameter, in which the graphite basal planes can be recognized. Very few and very small nanometre-sized diamond particles were found in the debris from polishing in the hard direction. The results support a polishing mechanism based on a mechanically induced transformation of diamond to graphite, after which material removal easily occurs. The well-known anisotropy observed in polishing can be explained satisfactorily on the basis of this model. Finally, in appendices, the art of polishing and the role of the black powder during preparation of the scaife are discussed. (shrink)