Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

This book is a study of the second-edition version of the 'Transcendental Deduction', which is one of the most important and obscure sections of Kant's Critique of Pure Reason. By way of a close analysis of the B-Deduction, Adam Dickerson makes the distinctive claim that the Deduction is crucially concerned with the problem of making intelligible the unity possessed by complex representations - a problem that is the representationalist parallel of the semantic problem of the unity of the proposition. Along (...) the way he discusses most of the key themes in Kant's theory of knowledge, including the nature of thought and representation, the notion of objectivity, and the way in which the mind structures our experience of the world. (shrink)

Concentrating on the thought of Canada's major scientists, philosophers, and clerics - men such as William Dawson and Daniel Wilson, John Watson and W.D. LeSeur, G.M. Grant and Salem Bland - A Disciplined Intelligence begins by reconstructing the central strands of intellectual and moral orthodoxy prevalent in Anglo-Canadian colleges on the eve of the Darwinian revolution. These include Scottish common sense philosophy and the natural theology of William Paley. The destructive impact of evolutionary ideas on that orthodoxy and the major (...) exponents of the new forms of social evolution - Spencerian and Hegelian alike - are examined in detail. By the twentieth century the centre of Anglo-Canadian thought had been transformed by what had become a new, evolutionary orthodoxy. The legacy of this triumphant intellectual movement, British idealism, was immense. It helped to destroy Protestant denominationalism, provide the philosophical core of the social gospel movement, and constitute a major force behind the creation of the United Church of Canada. Throughout the nineteenth century and continuing into the twentieth, however, the moral imperative in Anglo-Canadian thought remained a constant presence. (shrink)

The Groningen protocol allows for the euthanasia of severely ill newborns with a hopeless prognosis and unbearable suffering. We understand the impetus for such a protocol but have moral and ethical concerns with it. Advocates for euthanasia in adults have relied on the concept of human autonomy, which is lacking in the case of infants. In addition, biases can potentially influence the decision making of both parents and physicians. It is also very difficult to weigh the element of quality of (...) life on the will to live. We feel an important line has been crossed if the international medical community consents to the active euthanasia of severely ill infants and are concerned about the extension of the policy to other at risk groups. (shrink)

One of the more intriguing figures of the first period of the Successors is Nicanor, the lieutenant and admiral of Cassander. He came into prominence when he assumed command of the Macedonian garrison at Athens, late in 319 B.c. After distinguishing himself there he took a fleet to the Bosporus, where with Antigonus' collaboration he won a decisive victory over Polyperchon's royal navy. Subsequently his aspirations became sufficiently lofty to threaten his patron's security, and Cassander took elaborate precautions to ensure (...) his arrest and condemnation. Nicanor was clearly a figure of considerable importance; yet no source even hints at his origins and family background. Can conjecture go any way to filling the gaps? (shrink)

A new theory of particles proposed in an earlier paper is now applied to explain energy. Having earlier derived the Rydberg formula for atomic spectra without using the Pauli principle, the authors now derive the photoelectric effect, deflection of light by gravitation, and Planck's law for blackbody radiation without using Planck's assumption on energy quanta or Einstein's theory of general relativity.