Evidence-based medicine has always required integration of patient values with ‘best’ clinical evidence. It is widely recognized that scientific practices and discoveries, including those of EBM, are value-laden. But to date, the science of EBM has focused primarily on methods for reducing bias in the evidence, while the role of values in the different aspects of the EBM process has been almost completely ignored.

Cardiopulmonary resuscitation is frequently performed on patients who, in retrospect, had a very low chance of survival. This is because all patients are ‘For cardiopulmonary resuscitation’ on admission to hospital by default, and delays occur before cardiopulmonary resuscitation can be ‘de-prescribed’. This article reviews the nature of potential harms caused by futile cardiopulmonary resuscitation, the reasons why de-prescription may be delayed, recent legal judgements relevant to timely do not attempt cardiopulmonary resuscitation decision making, and the possible detrimental effects of do (...) not attempt cardiopulmonary resuscitation discussions on end of life care. The moral and operational feasibility of a model in which informed consent must be obtained before cardiopulmonary resuscitation is attempted in some patient groups is then explored. (shrink)

This article aims to challenge and expand notions of health, health care and health promotion, particularly in relation to smoking, via a consideration of the autobiographical literary work of the English playwright, Simon Gray. Gray died in 2008, having written a series of reflective autobiographical books, The Smoking Diaries. Gray was a lifelong smoker, perpetually trying to give up his habit. This article introduces Gray’s diaries and their reflections on life, death, health care and smoking. It then enquires what can (...) be learned about contemporary health care practices and assumptions from Gray’s work. Finally, it reflects on the limits of views of health and health promotion when considered in the light of a fully lived life. In the life under consideration, health care risks are very differently understood to those prevalent in the medical community. Literary approaches to thinking about smoking are thus seen to place health and health care in broader, richer, and less instrumental perspectives than those that are common amongst contemporary health professionals and institutions. (shrink)

It remains unclear what is being processed in blindsight in response to faces, colours, shapes, and patterns. This was investigated in two hemianopes with chromatic and achromatic stimuli with sharp or shallow luminance or chromatic contrast boundaries or temporal onsets. Performance was excellent only when stimuli had sharp spatial boundaries. When discrimination between isoluminant coloured Gaussians was good it declined to chance levels if stimulus onset was slow. The ability to discriminate between instantaneously presented colours in the hemianopic field depended (...) on their luminance, indicating that wavelength discrimination totally independent of other stimulus qualities is absent. When presented with narrow-band colours the hemianopes detected a stimulus maximally effective for S-cones but invisible to M- and L-cones, indicating that blindsight is mediated not just by the mid-brain, which receives no S-cone input, or that the rods contribute to blindsight. The results show that only simple stimulus features are processed in blindsight. (shrink)

Any theory of practical irrationality necessarily imposes a division of labour between an account of the agent's intentional states and how these are formed, and an account of how these intentional states get applied in particular circumstances to choose a particular action. Nevertheless, questions that concern the content of the agent's beliefs and desires are still routinely lumped together with questions that deal with the way the agent chooses in the light of these beliefs and desires. This generates a number (...) of pseudoproblems. Seeks to clarify some of them, by considering the internal structure of decision theory. (shrink)

While human lives are endlessly variable, our most memorable positive moments are dominated by four elements: elevation, insight, pride, and connection. If we embrace these elements, we can conjure more moments that matter. What if a teacher could design a lesson that he knew his students would remember twenty years later? What if a manager knew how to create an experience that would delight customers? What if you had a better sense of how to create memories that matter for your (...) children? This book delves into some fascinating mysteries of experience: Why we tend to remember the best or worst moment of an experience, as well as the last moment, and forget the rest. Why 'we feel most comfortable when things are certain, but we feel most alive when they're not.' And why our most cherished memories are clustered into a brief period during our youth. Readers discover how brief experiences can change lives, such as the experiment in which two strangers meet in a room, and 45 minutes later, they leave as best friends. (What happens in that time?) Or the tale of the world's youngest female billionaire, who credits her resilience to something her father asked the family at the dinner table. (What was that simple question?) Many of the defining moments in our lives are the result of accident or luck -- but why would we leave our most meaningful, memorable moments to chance when we can create them? The Power of Moments shows us how to be the author of richer experiences."--Dust jacket flap. (shrink)

This paper proposes a new interpretation of John Stuart Mill's notion of utility, which is used to provide a utilitarian justification for an eclectic, rather than a vocational, education. Vocational education is strongly promoted in recent policy documents, which makes it important to raise the question of justification. Many existing interpretations of Mill's utilitarianism argue for a hierarchy of pleasures. Although this enables one to justify an eclectic education, it is an interpretation that could be dismissed as ‘un-utilitarian’. This paper (...) proposes an alternative interpretation of Mill's notion of utility as a hierarchy of preferences. Our interpretation not only provides grounds for justifying an eclectic or critical education, it is also consistent with utilitarianism as an ethical theory. The paper also shows how the resultant curricula will better support democracy and participation in civil society. (shrink)

Introduction -- Instrumental rationality -- Social order -- Deontic constraint -- Intentional states -- Preference noncognitivism -- A naturalistic perspective -- Transcendental necessity -- Weakness of will -- Normative ethics.

AimsSport specialization is an actual trend in youth athletes, but it can increase injury risk. The aim was to determine the eventual correlation between sports specialization and injury risk in various sports, using a biopsychosocial approach.Methods169 sport-specialized athletes completed [; overall,, ] a self-reported questionnaire regarding sociodemographic, physical-attitudinal, injuries and psychological-attitudinal To analyze data univariate and correlate analyses were used.ResultsOf 169 athletes enrolled, 53% were single-sport specialized. In team sports a high risk of having to remain at rest for up (...) to 1 month because of overuse was observed. Males who suffered direct trauma in the team group were more exposed to that type of injury, and also the type of specialization figured significantly. In addition, interoceptive awareness correlates with injury. This study shows that, even though young athletes seem to be at a high risk of becoming injured, early team sport specialization and a high performance level cannot be considered to be the only risk factors. (shrink)

Loss of the Y‐chromosome is a common feature of species with chromosomal sex determination. However, our understanding of why some lineages frequently lose Y‐chromosomes while others do not is limited. The fragile Y hypothesis proposes that in species with chiasmatic meiosis the rate of Y‐chromosome aneuploidy and the size of the recombining region have a negative correlation. The fragile Y hypothesis provides a number of novel insights not possible under traditional models. Specifically, increased rates of Y aneuploidy may impose positive (...) selection for (i) gene movement off the Y; (ii) translocations and fusions which expand the recombining region; and (iii) alternative meiotic segregation mechanisms (achiasmatic or asynaptic). These insights as well as existing evidence for the frequency of Y‐chromosome aneuploidy raise doubt about the prospects for long‐term retention of the human Y‐chromosome despite recent evidence for stable gene content in older non‐recombining regions. (shrink)

Habermas has argued that many of the endemic socio- economic problems of Western society are either symptoms or prod ucts of a 'lopsided' process of cultural rationalization, one that has emphasized instrumental forms of rationality over communicative. But other than presenting a rather general typology of lifeworld pathologies, Habermas has not done much to specify what these problems might be, nor has he provided any 'middle-range' analysis of the mechanisms through which they might be generated. This paper discusses some of (...) the ways in which, consistent with Haber mas's general framework, rational choice theory can be used for pre cisely this task. In this analysis, rational choice theory is not presented as a comprehensive theory of action, but is employed as a critical- diagnostic tool that allows the theorist to identify undesirable social interaction patterns that arise from a broader instrumentalization of the lifeworld. Key Words: critical theory • Habermas • instrumental rationality • market failure • rational choice theory. (shrink)

Moriarty argues that the Market Failures Approach to business ethics is inapplicable to “real world” problems, because it treats “market failure” as a failure to achieve Pareto efficiency. Depending upon how it is applied, Pareto efficiency is either trivially easy to satisfy or else so demanding that no real-world market could ever satisfy it. In this Commentary, I argue that Moriarty overstates these difficulties. The regulatory structure governing markets is best understood as an attempt to maximize the number of Pareto-improving (...) exchanges that occur. There is no reason to think business self-regulation cannot be guided by the same normative-conceptual framework. (shrink)

The recent renewal of interest in the philosophy of Henri Bergson has increased both recognition of his influence on twentieth-century philosophy and attention to his relationship to phenomenology. Until now, the question of Martin Heidegger’s debt to Bergson has remained largely unanswered. Heidegger’s brief discussion of Bergson in Being and Time is geared toward explaining why he fails in his attempts to think more radically about time. Despite this dismissal, a close look at Heidegger’s early works dealing with temporality reveals (...) a sustained engagement with Bergson’s thought. In The Origin of Time, Heath Massey evaluates Heidegger’s critique of Bergson and examines how Bergson’s efforts to rethink time in terms of duration anticipate Heidegger’s own interpretation of temporality. Massey demonstrates how Heidegger follows Bergson in seeking to uncover “primordial time” by disentangling temporality from spatiality, how he associates Bergson with the tradition of philosophy that covers up this phenomenon, and how he overlooks Bergson’s ontological turn in Matter and Memory. Through close readings of early major works by both thinkers, Massey argues that Bergson is a much more radical thinker with respect to time than Heidegger allows. (shrink)

Originally published in 1949. This meticulously researched book presents a comprehensive outline and discussion of Aristotle's mathematics with the author's translations of the greek. To Aristotle, mathematics was one of the three theoretical sciences, the others being theology and the philosophy of nature. Arranged thematically, this book considers his thinking in relation to the other sciences and looks into such specifics as squaring of the circle, syllogism, parallels, incommensurability of the diagonal, angles, universal proof, gnomons, infinity, agelessness of the universe, (...) surface of water, meteorology, metaphysics and mechanics such as levers, rudders, wedges, wheels and inertia. The last few short chapters address 'problems' that Aristotle posed but couldn't answer, related ethics issues and a summary of some short treatises that only briefly touch on mathematics. (shrink)

Society, based on contract and voluntary exchange, is evolving, but remains only partly developed. Goods and services that meet the needs of individuals, such as food, clothing, and shelter, are amply produced and distributed through the market process. However, those that meet common or community needs, while distributed through the market, are produced politically through taxation and violence. These goods attach not to individuals but to a place; to enjoy them, individuals must go to the place where they are. Land (...) owners, all unknowingly, distribute such services contractually as they rent or sell sites. Rent or price is the market value of such services, net after disservices, as they affect each site. By distributing occupancies to those who can pay the highest price, land owners’ interests align with those of society. Without this, tenure would be precarious—by force or favor of politicians. The 18th-century separation of land from state, so little studied by historians, permitted the development of modern property in land. This change is perhaps “the greatest single step in the evolution of Society the world has ever seen.” When land owners realize that they market community services, they will organize to produce and administer them as well, and society will be made whole. (shrink)

This book advances a novel theory of international justice that combines the orthodox liberal notion that the lives of individuals are what ultimately matter morally with the putatively antiliberal idea of an irreducibly collective right of self-governance. The individual and her rights are placed at center stage insofar as political states are judged legitimate if they adequately protect the human rights of their constituents and respect the rights of all others. Yet, the book argues that legitimate states have a moral (...) right to self-determination and that this right is inherently collective, irreducible to the individual rights of the persons who constitute them. Exploring the implications of these ideas, the book addresses issues pertaining to democracy, secession, international criminal law, armed intervention, political assassination, global distributive justice, and immigration. A number of the positions taken in the book run against the grain of current academic opinion: there is no human right to democracy; separatist groups can be morally entitled to secede from legitimate states; the fact that it is a matter of brute luck whether one is born in a wealthy state or a poorer one does not mean that economic inequalities across states must be minimized or even kept within certain limits; most existing states have no right against armed intervention; and it is morally permissible for a legitimate state to exclude all would-be immigrants. (shrink)

In the wake of intensifying debates on decolonisation and restitution in Africa and its francophone diaspora, a Facebook posting of 6 February 2020 gave an other life to a photographic portrait of the French-Italian explorer Savorgnan de Brazza taken in 1882.1 The uploaded digital scan of a photograph from nearly 140 years ago flashed up in a moment of contemporary hypervisibility, offering a visual pretext to denounce de Brazza and the effect of his interventions in Africa virtually and openly on (...) a public post, pulling the image out of the academic and archival environments it had until then mostly inhabited. (shrink)

Husserl’s early picture of explanation in the sciences has never been completely provided. This lack represents an oversight, which we here redress. In contrast to currently accepted interpretations, we demonstrate that Husserl does not adhere to the much maligned deductive-nomological (DN) model of scientific explanation. Instead, via a close reading of early Husserlian texts, we reveal that he presents a unificationist account of scientific explanation. By doing so, we disclose that Husserl’s philosophy of scientific explanation is no mere anachronism. It (...) is, instead, tenable and relevant. We discuss how Husserl and other contemporary thinkers draw theoretical inspiration from the same source—namely, Bernard Bolzano. Husserl’s theory of scientific explanation shares a common language and discusses the same themes as, for example, Phillip Kitcher and Kit Fine. To advance our novel reading, we discuss Husserl’s investigations of grounding, inter-lawful explanation, intra-mathematical explanation, and scientific unification. (shrink)

This work analyzes the centrality of law in nineteenth-century historical and institutional economics and is a prehistory to the new institutional economics of the late twentieth century. In the 1830s the 'new science of law' aimed to explain the working rules of human society by using the methodologically individualist terms of economic discourse, stressing determinism and evolutionism. Practitioners stood readier than contemporary institutionalists to admit the possibilities of altruistic values, bounded rationality, and institutional inertia into their research program. Professor Pearson (...) shows that the positive analysis of law tended to push normative discussions up from the level of specific laws to that of society's political organization. The analysis suggests that the professionalization of the social sciences - and the new science's own imprecision - condemned the program to oblivion around 1930. Nonetheless, institutional economics is currently developing greater resemblances to the now-forgotten new science. (shrink)

This paper makes a phenomenological contribution to the distinction between personal and subpersonal types of explanation. I expound the little-known fact that Husserl gives an account of personal level explanation via his exposition of our capacity to express the understanding of another’s motivational nexus when we are in the personalistic attitude. I show that Husserl’s unique exposition of the motivational nexus conveys its concrete, internally coherent, and intentional nature, involving relationships amongst the sense contents of acts of consciousness. Moreover, the (...) motivational nexus is a generative space of possibility and choice. I show that, for these reasons, motivational explanation is not causal, nor deductive nomological, nor does it reduce to subpersonal explanation. I finish with the comment that the uniqueness of personal level explanation points towards the possibility that the human sciences ought also employ types of explanations not found in natural sciences. (shrink)

Saint Augustine.--Peter Abaelard.--Saint Thomas Aquinas.--William of Ockham.