Background: Hospital nurses are frequently the first care givers to receive a patient’s request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses’ opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. Methods: A phone survey conducted among a random national sample of 1502 (...) French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Results: Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Conclusions: Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call “good” euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia. (shrink)
We use Homer and Sun Tzu as a background to better understand and reformulate confrontation, anger and violence in medicine, contrasting an unproductive ‘love of war’ with a productive ‘art of war’ or ‘art of strategy’. At first glance, it is a paradox that the healing art is not pacific, but riddled with militaristic language and practices. On closer inspection, we find good reasons for this cultural paradox yet regret its presence. Drawing on insights from Homer's The Iliad and The (...) Odyssey, we argue for better understanding of confrontation, anger, bullying, intimidation and violence in medicine in order to change the culture. For example, equating medicine with war is not a given condition of medicine but a convenient metaphor with historical origins and a historical trajectory. Other, non-martial metaphors, such as medicine as collaboration, may be more appropriate in an age of team-based care. Taking lessons from Homer, we suggest three key ways in which cold-hearted confrontation and anger in medicine can be transformed into productive, warm-hearted engagement: the transformation of angry impulse into reflection, moral courage and empathy. Thinking with Homer can offer an aesthetically and morally charged alternative to the current body of literature on topics, such as anger in doctors, and how this may be ‘managed’, without recourse to an instrumental economy where emotions are viewed as commodities, and emotional responses can be ‘trained’ through communication skills courses. (shrink)
We show that assuming the determinacy of all games on reals, every set of reals is Θ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\Theta $$\end{document} universally baire.
The analysis of the Helmholtz equation is shown to lead to an exact Hamiltonian system describing in terms of ray trajectories, for a stationary refractive medium, a very wide family of wave-like phenomena (including diffraction and interference) going much beyond the limits of the geometrical optics (“eikonal”) approximation, which is contained as a simple limiting case. Due to the fact, moreover, that the time independent Schrödinger equation is itself a Helmholtz-like equation, the same mathematics holding for a classical optical beam (...) turns out to apply to a quantum particle beam moving in a stationary force field, and leads to a system of Hamiltonian equations providing exact and deterministic particle trajectories and dynamical laws, and containing the laws of Classical Mechanics in the eikonal limit. (shrink)
The aim of this paper is to present the French approach to Information and Communication, and to sketch out some arguments pro and con for their amalgamation into a unique scientific body. Since its creation in 1975, the French academic field of Information-Communication has proved several advantages in the development of a new scientific corpus, but also some drawbacks. These are going to be reviewed and the question will be posed on the opportunity to generalize that model or to abandon (...) it. The research concludes that a dichotomy between information and communication is certainly not representative of the French field of information and communication; it would rather be a continuum or a multi-polar space. Furthermore it is suspected that Anglo-Saxon separation of information science from communication science is not clear either. International comparison and research program in information – communication are advocated. (shrink)
Ship design needs to respond to and attract an ever more design conscious society. However, little research has been conducted into perceptions of beauty and pleasure and how such perceptions can be usefully absorbed into ship design. Aesthetic consideration, is seen as a distraction from the bespoke nature of the ship design process and is often avoided, second guessed or left for external consultancy. The ship design discipline requires the nurturing of its own aesthetic methods, for future development, and to (...) adapt some of the aesthetic ideals found in architecture, art and design. This paper argues that philosophy can be effective in interpreting what the passenger finds attractive and pleasurable. To illustrate the philosophical approach proposed, the `Elbe SWATH’ and the `Oasis of the Seas’ are investigated and compared using theoretical resources from the culturally focused philosophy of `Functional Beauty’. Conclusions suggest that the interpretation of the end users most valued appreciations can lead to design directives that deliver subjective qualities of beauty - beauty similar to those seen in the pure aims of the Elbe SWATH’s purposeful work craft, or comparable to nature’s beauty and purity in aim. (shrink)
A rich collection of essays in honor of Msgr. Mansion, including a study of Mansion's work, several essays on Plato, studies of various aspects of Aristotle's philosophy--textual and systematic analyses of his metaphysics, logic, psychology and ethics--and some essays on the influence of Plato and Aristotle on medieval philosophy. Contributors include Diès, Wilpert, Ross, and Minio-Palaello.--A. R.
1. The “puzzle” Physical objects are coloured: roses are red, violets are blue, and so forth. In particular, physical objects have fine-grained shades of colour: a certain chip, we can suppose, is true blue (unique, or pure blue). The following sort of scenario is commonplace. The chip looks true blue to John; in the same (ordinary) viewing conditions it looks (slightly) greenish-blue to Jane. Both John and Jane are “normal” perceivers. Now, nothing can be both true blue and greenish-blue; since (...) the chip is true blue, it is not greenish-blue. Hence Jane, unlike John, is misperceiving the chip. Generalizing, the conclusion is that there is widespread misperception of fine-grained shades. According to Tye (2006), and Cohen, Hardin, and McLaughlin (2006), the previous paragraph amounts to a paradox: an apparently unacceptable conclusion has been drawn from apparently acceptable premises via apparently acceptable reasoning. (See also Hawthorne and Kovakovich 2006, 180-1.) Tye swallows the conclusion, aided by a dose of evolutionary speculation. Hardin (1988), on the other hand, rejects the first premise, and denies that physical objects are coloured. Cohen (2004) and McLaughlin (2003) claim that both Jane and John have the colour of the chip right. Our opening paragraph concealed a crucial parameter. In fact, the chip looks greenish-blue-relative-to- circumstances-C to Jane, and true-blue-relative-to-circumstances-C* to John, and the chip has both these relativized colours.1 All this ingenious philosophizing would be in vain, of course, if the conclusion of the opening paragraph were not puzzling or problematic. So, why is it supposed to be? According to Tye, the conclusion is puzzling because John and Jane are both “normal perceivers” (xx). He seems to think that it is (prima facie) plausible to assume.. (shrink)
Background: The traditional approach to resolving ethics concerns may not address underlying organisational issues involved in the evolution of these concerns. This represents a missed opportunity to improve quality of care “upstream”. The purpose of this study was to understand better which organisational issues may contribute to ethics concerns. Methods: Directed content analysis was used to review ethics consultation notes from an academic children’s hospital from 1996 to 2006 (N = 71). The analysis utilised 18 categories of organisational issues derived (...) and modified from published quality improvement protocols. Results: Organisational issues were identified in 68 of the 71 (96%) ethics consult notes across a range of patient settings and reasons for consultation. Thirteen of the 18 categories of organisational issues were identified and there was a median of two organisational issues per consult note. The most frequently identified organisational issues were informal organisational culture (eg, collective practices and approaches to situations with ethical dimensions that are not guided by policy), policies and procedures (eg, staff knows policy and/or procedural guidelines for an ethical concern but do not follow it) and communication (eg, communication about critical information, orders, or hand-offs repeatedly does not occur among services). Conclusions: Organisational issues contribute to ethical concerns that result in clinical ethics consults. Identifying and addressing organisational issues such as informal culture and communication may help decrease the recurrence of future similar ethics concerns. (shrink)
