Volume 19, Issue 10, October 2019, Page 68-70.

Mayo Clinic is recognized as a worldwide leader in innovative, high-quality health care. However, the Catholic mission and ideals from which this organization was formed are not widely recognized or known. From partnership with the Sisters of St. Francis in 1883, through restructuring of the Sponsorship Agreement in 1986 and current advancements, this Catholic mission remains vital today at Saint Marys Hospital. This manuscript explores the evolution and growth of sponsorship at Mayo Clinic, defined as “a collaboration between the Sisters (...) of St. Francis and Mayo Clinic to preserve and promote key values that the founding Franciscan sisters and Mayo physicians embrace as basic to their mission, and to assure the Catholic identity of Saint Marys Hospital.” Historical context will be used to frame the evolution and preservation of Catholic identity at Saint Marys Hospital; and the shift from a “sponsorship-by-governance” to a “sponsorship-by-influence” model will be highlighted. Lastly, using the externally-developed Catholic Identity Matrix (developed by Ascension Health and the University of St. Thomas, Minnesota), specific examples of Catholic identity will be explored in this joint venture of Catholic health care institution and a secular, nonprofit corporation (Mayo Clinic). (shrink)

Volume 19, Issue 12, December 2019, Page 60-62.

Background Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians’ decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients’ ability to comprehend (...) complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Methods Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents’ perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Results Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient’s AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to “pass away in peace.” Few (17%) would forgo an AD following a family’s request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities surrounding their care while 69% agreed that costs should never impact a physician’s decision as to whether to comply with a patient’s AD. Conclusions Our findings highlight the impact, albeit small, external factors have on physician AD compliance. Most respondents based their decision on the clinical situation at hand and interpretation of the patient’s initial wishes and preferences expressed by the AD. (shrink)

Copernican questions, 2006 ; It started with Copernicus, 2014 -- Copernican questions. What was Copernicus's revolution? ; What happens when your world changes? ; Copernican questions : rationality and realism ; The plan of the book -- Is science really rational? : the problem of incommensurability. Incommensurability of standards ; Incommensurability of values ; Incommensurability of meaning ; Evaluating meaning incommensurability ; Conversion : a concluding case study -- A walk on the wild side : social constructivism, postmodernism, feminism, and (...) that old-time religion. The constructivist challenge ; Postmodernism attacks! ; Is "objectivity" what a man calls his subjectivity? ; Is science godless? -- Ascending the slippery slope : scientific progress and truth. The evils of Whig history ; Social-constructivist history ; Does science converge toward truth? ; Assessing Laudan's Critique of Convergent Realism ; Scientists' own realism ; Could we be wrong about everything? -- Truth of consequences? Electrons : real particles or convenient fictions? ; Van Fraassen's constrictive empiricism ; Do we observe through microscopes? ; But what about things that are really unobservable? ; So what really is the goal of science? -- Mysteries of methods. Induction and deduction ; Aristotle : the first methodologist ; Bacon : scientific method renovated? ; The hypothetico-deductive method ; Hume on induction ; Popper and the rejection of induction ; Inference to the Best Explanation (IBE) to the rescue? -- If you have science, who needs philosophy? The limits of science? ; The breakdown of philosophy ; Naturalizing epistemology ; Naturalizing ethics ; Philosophy in an age of science -- Science, scientism, and being human. Mind : physical or spiritual? ; Science and the human image ; Ape, angel, or neither? (shrink)

The contributors to this book draw upon their unique insights and research experience to address fundamental questions, including: What forms does the will take ...

In his notes Nietzsche refers to 'the struggle between science and wisdom exhibited in the ancient Greek philosophers'. Nietzsche's own view about 'science' (learning) was to the effect that, at its best, it should be greatly respected yet always tested by the demands of personal wisdom, an 'egotistical' quality which nevertheless transcends self-indulgence. Keith May considers the meaning and implications of Nietzsche's belief in relation to philosophy up to the time of Aristotle, and then its bearing on modern (essentially (...) nihilistic) attitudes, to which it supplies something of an antidote. This study entails a fresh reading of Nietzsche's treatment of some Presocratic thinkers, including new interpretations of Heraclitus and Parmenides, followed by independent if roughly 'Nietzschean', considerations of Socrates and Plato. Aristotle's concept of being is related to being as will to power. This leads to an analysis of Nietzsche's apprehension of the soul (named 'Ariadne') and finally to thoughts of how we might now aim to overcome the Greeks. (shrink)

Is science our most precious possession or has our culture elevated science into a false idol? Is technology a useful servant or a malign genie? These questions are at the centre of the 'science wars' currently being waged over the role and future of science and technology in our society. This balanced selection of a variety of perspectives on the hotly contested role of science and technology in contemporary society will clarify this vital debate for both specialists and non-specialists.

This chapter is concerned with an analysis of the etymology of the English term “will,” which is used to emphasize some possible sedimented assumptions with its meaning in English-speaking European and North American academic communities. It takes a look at two general philosophical approaches to the will and examines the will in early modern social theory. From here the chapter turns to anthropology to study two of the most generative approaches to willing in modern culture theory: practice theoretical and psychocultural (...) variants of anthropology. Finally, the chapter discusses the preceding chapters in terms of the four different themes that recur throughout the book. (shrink)

National water quality concerns are creating momentum for legislation that takes a proactive stance toward agricultural practices involving agrichemicals. In response, the Environmental Protection Agency has asked the states to design appropriate non-point source pollution policies. This article examines the issues involved in two ways. First, it reviews the literature on previous conservation policies and discusses the implications for stricter regulation. Second, in order to determine the public opinion context for non-point source pollution policies, it examines the responses of a (...) sample of Oklahoma rural leaders to a set of environmental, water quality, political, economic, and family farm orientation items developed in previous surveys. The analysis considers areas of agreement and disagreement related to socio-economic status, education, and extent of involvement in farming. It concludes that although Oklahoma's rural leaders are concerned about water quality problems, an environmentally-sound formulation of rural values has yet to develop. The most serious obstacle appears to be the perceived threat of environmental regulations to the variability of production agriculture. (shrink)

Offers a critical examination of Alvin Plantinga's and Richard Swinburne's contemporary attempt to defend traditional theism within the context of analytic philosophy.

This provocative, focused, and succinct new text addresses two issues integral to the study of the philosophy of science: the rationality of science and the realism question. Students are invited to think deeply about salient issues as they explore collections of cases and examples, beginning by considering the founding document of modern science, Copernicus’s On the Revolutions of the Heavenly Spheres , and including discussions of other key readings such as Thomas Kuhn’s The Structure of Scientific Revolutions . Author (...) class='Hi'>Keith Parsons challenges students’ thinking, offering his own views while providing a solid foundation for debate. (shrink)

"... are dinosaurs social constructs? Do we really know anything about dinosaurs? Might not all of our beliefs about dinosaurs merely be figments of the paleontological imagination? A few years ago such questions would have seemed preposterous, even nonsensical. Now they must have a serious answer." At stake in the "Science Wars" that have raged in academe and in the media is nothing less than the standing of science in our culture. One side argues that science is a "social construct," (...) that it does not discover facts about the world, but rather constructs artifacts disguised as objective truths. This view threatens the authority of science and rejects science's claims to objectivity, rationality, and disinterested inquiry. Drawing Out Leviathan examines this argument in the light of some major debates about dinosaurs: the case of the wrong-headed dinosaur, the dinosaur "heresies" of the 1970s, and the debate over the extinction of dinosaurs. Keith Parsons claims that these debates, though lively and sometimes rancorous, show that evidence and logic, not arbitrary "rules of the game," remained vitally important, even when the debates were at their nastiest. They show science to be a complex set of activities, pervaded by social influences, and not easily reducible to any stereotype. Parsons acknowledges that there are lessons to be learned by scientists from their would-be adversaries, and the book concludes with some recommendations for ending the Science Wars. (shrink)

This chapter begins by defining natural theology in analytical philosophy, and next considers analytical philosophers's rejection of natural theology and the rise of analytical theism. The focus then turns to one of the most prominent arguments debated in recent discussions of natural theology, the so-called fine-tuning argument. The FTA is a sophisticated version of the traditional argument to design, one that appeals to the apparent ‘fine tuning’ of the fundamental constants of nature, such as the gravitational constant, such that even (...) a minute variation in these values would not have permitted the development in our universe of complex forms of life or, a fortiori, intelligent and sentient creatures. The chapter first presents a statement of the argument by two of its defenders – William Lane Craig and Robin Collins – and then looks at criticisms by such philosophers as Robin Le Poidevin and Graham Oppy. It concludes by asking whether the recent debates among analytic philosophers of religion have really advanced the case for natural theology. (shrink)

In his book Nonbelief & Evil, Theodore Drange argues that theists are likely to deploy the “unknown purpose defense” in the face of the existence of apparently gratuitous evils. That is, they will assert that God has morally sufficient reasons for permitting apparently gratuitous evil, but that humans do not know those reasons. Drange argues that by deploying the unknown purpose defense, and by challenging atheologians to prove that God does not have such unknown morally sufficient reasons, theists can achieve (...) a stalemate with atheological challengers. I argue, however, that the epistemic burden of ascertaining whether God probably does or does not possess morally sufficient reasons for permitting evil falls asymmetrically on theists and atheists. Further, I argue that, given the failure of theodicies, the condition of nescience, the admission that we are in no position to assess whether God probably does or does not possess morally sufficient reasons for permitting ostensibly gratuitous evil, entails agnosticism about God’s existence. To escape agnosticism, theists will probably claim to have a warranted and properly basic belief in the existence and goodness of God. While I concede that theists may be doing their “epistemic best” in claiming such assurance, I argue that theists must concede that the existence of apparently gratuitous evil equally legitimizes nonbelief. (shrink)

In this essay I respond to the critical remarks made by Prof. Reppert in “Reply to Parsons and Lippard on the Argument from Reason” (present issue). I also provide a critique of Reppert’s original article, “The Argument from Reason,” in Philo vol. 2, no. 1 (Spring-Summer 1999).

Preface for instructors -- Preface for students (you really should read it) -- What is logic about? -- Sentential logic basics -- Sentential logic proofs -- More sentential logic : contradictions, tautologies and assumptions -- Predicate logic basics -- Proofs in predicate logic -- Probability : the basic rules of life -- The theorem of Dr. Bayes -- Probability illusions : why we are so bad at inductive reasoning -- Studies have shown ... or have they? -- Inference to the (...) best explanation -- Rhetoric : the art of persuasion -- Won't get fooled again (fallacies and other foibles) -- Spin, spin, spin (or how not to be a sucker) -- Everything you know is wrong! : pseudoscience and bogus scholarship. (shrink)

Boys, Boyz, Bois concerns questions of ethics, gender and race in popular American images, national discourse and cultural production by and about black men. The book proposes an ethics of masculinity, as ethnics refers to a system of morality and valuation and as ethics refers to a care of the self and ethical subject formation. The texts of analysis include recent films by black/African American filmmakers, gansta rap and hip-hop and black star persona: texts ranging from Blaxploitation and New Black (...) Cinema to contemporary music video to autobiography and the public image of Sidney Poitier. The book is a significant contribution to cultural studies and gender studies and critical race theory. What is distinctive about the book is the question of ethics as a question of race and gender. (shrink)

Gender differences in knowledge of NRM practices have long been noted in Senegal and throughout Sub-Saharan Africa. An exploration of these differences among a sample of rural Senegalese men and women shows that these differences are, in part, a function of extension agent interventions. The level of knowledge of a set of NRM technologies is associated with contact with three key types of extension agent in rural Senegal: extension team leaders, forestry agents, and women's agents. Analysis of intra-household variation in (...) levels of knowledge shows a degree of interdependence between the knowledge levels of husbands and wives for some practices. However, multi-variate analysis, controlling for personal and contextual factors, clearly demonstrates the independent impact of extension agents on gender differences in rural Senegalese NRM knowledge. It can be concluded that contact with extension agents increases knowledge of NRM practices. In particular, contact with the women's agent is a strong predictor of the level of women's NRM knowledge and, surprisingly, also contributes to the level of men's knowledge. Despite the small number of women's agents in the field, they appear to have significant positive impact on the dissemination of NRM knowledge among rural Senegalese women and men. (shrink)

BackgroundDepressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen. Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects in (...) patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.DiscussionThe use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.ConclusionWe urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine. (shrink)