Introduction: Previous studies have measured individuals’ willingness to share personal information stored in an electronic health record (EHR) with healthcare providers. But none have measured preferences when patients’ choices determine access by healthcare providers. -/- Methods: Patients were given the ability to control the access of doctors, nurses or other staff in a primary care clinic to personal information stored in an EHR. Patients could restrict access to all personal data or to specific types of sensitive information, and could restrict (...) access for a specific time period. Patients also completed a survey regarding their understanding and opinions regarding the process. -/- Results: Of 139 eligible patients who were approached, 105 (75.5%) were enrolled and preferences were collected from 105 of them (100%). Sixty patients (57%) did not restrict access by any providers. Of the 45 patients (43%) who chose to limit the access of at least 1 provider, 36 restricted access only to all personal information in the EHR, while 9 restricted access of some providers to a subset of the their personal information. Thirty-four (32.3%) patients blocked access to all personal information by all doctors, nurses, and/or other staff; 26 (24.8%) blocked access by all doctors and/or nurses, and 5 (4.8%) denied access to alldoctors, nurses, and staff. -/- Conclusions: A significant minority of patients chose to restrict access by their primary care providers to personal information contained in an EHR, and few chose to restrict access to specific types of information. More research is needed to identify patient goals and understanding when facing decisions of this sort, and to identify the impact of educating patients regarding information contained in the EHR and its use in clinical care. (shrink)
This paper gives an account of the debate between F.A. Hayek and J.M. Keynes in the 1930s written for the general public. The purpose of this is twofold. First, to provide the general reader with a narrative of what happened, … More ›.
Purpose: Commenting on the transcript of a lecture. Findings: The document reconstructs the development of the original 1973 lecture by Heinz von Foerster into his best-known paper, On Constructing a Reality. Many aspects of that paper can be identified as being shaped through interaction with the audience. Implications: The lecture documented here was a forerunner of a central paper in constructivism.
In the years 1878 and 1879 the American physicist Alfred Marshall Mayer published his experiments with floating magnets as a didactic illustration of molecular actions and forms. A number of physicists made use of this analogy of molecular structure. For William Thomson they were a mechanical illustration of the kinetic equilibrium of groups of columnar vortices revolving in circles round their common centre of gravity . A number of modifications of Mayer's experiments were described, which gave configurations which were more (...) or less analogous to Mayer's arrangements. It was Joseph John Thomson who, in publications between 1897 and 1907, used Mayer's results to obtain a good deal of insight into the general laws which govern the configuration of the electrons in his atomic model. This article is mainly concerned with Mayer's experiments with floating magnets and their use by a number of physicists. Through his experiments Mayer made a significant, although small, contribution to the theory of atomic structure. (shrink)
This paper charts P.A.M. Dirac’s development of his theory of the electron, and its radical picture of empty space as an almost-full plenum. Dirac’s Quantum Electrodynamics famously accomplished more than the unification of special relativity and quantum mechanics. It also accounted for the ‘duplexity phenomena’ of spectral line splitting that we now attribute to electron spin. But the extra mathematical terms that allowed for spin were not alone, and this paper charts Dirac’s struggle to ignore or account for them as (...) a sea of strange, negative-energy, particles with positive ‘holes’. This work was not done in solitude, but rather in exchanges with Dirac’s correspondence network. This social context for Dirac’s work contests his image as a lone genius, and documents a community wrestling with the ontological consequences of their work. Unification, consistency, causality, and community are common factors in explanations in the history of physics. This paper argues on the basis of materials in Dirac’s archive that — in addition — mathematical beauty was an epistemological factor in the development of the electron and hole theory. In fact, if we believe that Dirac’s beautiful mathematics captures something of the world, then there is both an epistemology and an ontology of mathematical beauty. (shrink)
Since his death in 1979, Herbert M arcuse's influence has been steadily waning. The extent to which his work is ignored in progressive circles is curious, as M arcuse was one of the most influential radical theorists of the day during the 1960s and his work continued to be a topic of interest and controversy during the 1970s. While the waning of the revolutionary movements with which he was involved helps explain M arcuse's eclipse in popularity, the lack of new (...) texts and publications has also contributed. For while there have been a large number of new translations of works by Benjamin, Adorno, and Habermas during the past decade, few new publications of untranslated or uncollected material by M arcuse have appeared, although there have been a steady stream of books on M arcuse.1 In addition, while there has been great interest in the writings of Foucault, Derrida, Baudrillard, Lyotard, and other French "postmodern," or "poststructuralist," theorists, M arcuse did not fit into the fashionable debates concerning modern and postmodern thought.2 Unlike Adorno, M arcuse did not anticipate the postmodern attacks on reason and his dialectics were not "negative." Rather he subscribed to the project of reconstructing reason and of positing utopian alternatives to the existing society -- a dialectical imagination that has fallen out of favor in an era that rejects totalizing thought and grand visions of liberation and social reconstruction. (shrink)
RésuméL'auteur montre que si l'argumentation d'Einstein paraǐt classique sur presque tous les points, elle ne l'est pas sur un point fondamental, qui est l'égalité de la vitesse de la lumière dans toutes les directions. Si l'on laisse tomber ce postulat, on retombe sur la simultanéité absolue. D'autre part, ce « classicisme » est légitime et apparaǐt au contraire comme une habileté didactique. Enfin, il montre que le point qui déroute M. Evans, c'est la relativité de la vitesse relative, qui n'existe (...) pas en physique classique.The author shows that although Einstein's argument seems classical in almost all points, it fails to be in one very important point: the equality of the velocity of light for all observers. When setting aside this postulate, one returns to the absolute simultaneity. On the other hand, this almost classical argument is perfectly valid from the relativistic point of view and appears as a didactic cleverness. The author shows finally that the point deceiving Mr. Evans is the relativity of the relative velocity, that does not exist in classical physics. (shrink)
Ethics of Richard M. Hare is widely considered as a classical example of the strong internalistic theory of motivation: he is thought to believe that having a moral motive is a sufficient condition to act accordingly. However, strong internalism has difficulties with explaining the phenomenon of acrasia and amoralism. For this reason some critics charge him with developing a false theory of moral motivation. In the article I present Hare's answer to these questions by dividing the discussion about motivation into (...) three levels: semantical, epistemological, and ontological. I also explain his concept of internal motivation and argue that his theory, contrary to what his critics assume, may be called a weak motivational internalism. (shrink)
My aim in this paper is to attempt a philosophical reading of M. Karagatsis’ novel Kitrinos Fakelos (1956), focusing my analysis on the passions and the emotions of its fictional characters, aiming at demonstrating their independence as well as the presentation of their psychography in Karagatsis’ novel where the description of the emotions caused by love is a dominant feature. In particular, I will examine the expression of desire, love (erôs) and sympathy in this novel – passions and emotions that (...) play an important role to moral life and human existence in general. I will be approaching these issues from the point of view of moral philosophy, analyzing the passions and the emotions expressed by the fictional characters in Kitrinos Fakelos, and in particular of the fictional character of Manos Tasakos. At the same time, I will attempt to show the philosophical influences that M. Karagatsis has received in his literary work, and especially in his novel Kitrinos Fakelos, by the philosophical thought of Friedrich Nietzsche. In addition, I will try to demonstrate the contrast between the Nietzschean moral model and that of both ancient and contemporary virtue ethical theory, in relation to the traditional interpretation of the work of Nietzsche’s that Karagatsis adopts, along with many of his contemporaries in Greece from the beginning of the 20th century until the 70’s at least. (shrink)
Since the beginning of the 20th Century to the present day, it has rarely been doubted that whenever formal aesthetic methods meet their iconological counterparts, the two approaches appear to be mutually exclusive. In reality, though, an ahistorical concept is challenging a historical analysis of art. It is especially Susanne K. Langer´s long-overlooked system of analogies between perceptions of the world and of artistic creations that are dependent on feelings which today allows a rapprochement of these positions. Krois’s insistence on (...) a similar point supports this analysis. - I - Unbestritten bis heute gilt, formwissenschaftliche und ikonologische Methoden scheinen sich grundsätzlich auszuschließen, da die ersteren auf ahistorischen und die letzteren auf historischen Grundlagen aufbauen. Dem entgegen soll mit diesem Beitrag gezeigt werden, wie insbesondere die Forschungen Susanne K. Langers und ergänzend diejenigen von John M. Krois eine Annäherung beider Positionen ermöglichen. (shrink)
A large body of literature agrees that persons with schizophrenia suffer from a Theory of Mind deficit. However, most empirical studies have focused on third-person, egocentric ToM, underestimating other facets of this complex cognitive skill. Aim of this research is to examine the ToM of schizophrenic persons considering its various aspects, to determine whether some components are more impaired than others. We developed a Theory of Mind Assessment Scale and administered it to 22 persons with a DSM-IV diagnosis of schizophrenia (...) and a matching control group. Th.o.m.a.s. is a semi-structured interview which allows a multi-component measurement of ToM. Both groups were also administered a few existing ToM tasks and the schizophrenic subjects were administered the Positive and Negative Symptoms Scale and the WAIS-R. The schizophrenic persons performed worse than control at all the ToM measurements; however, these deficits appeared to be differently distributed among different components of ToM. Our conclusion is that ToM deficits are not unitary in schizophrenia, which also testifies to the importance of a complete and articulated investigation of ToM. (shrink)
I present here a modal extension of T called KTLM which is, by several measures, the simplest modal extension of T yet presented. Its axiom uses only one sentence letter and has a modal depth of 2. Furthermore, KTLM can be realized as the logical union of two logics KM and KTL which each have the finite model property (f.m.p.), and so themselves are complete. Each of these two component logics has independent interest as well.
Moral theories which, like those of Plato, Aristotle and Aquinas, give a central place to the virtues, tend to assume that as traits of character the virtues are mutually compatible so that it is possible for one and the same person to possess them all. This assumption—let us call it the compatibility thesis—does not deny the existence of painful moral dilemmas: it allows that the virtues may conflict in particular situations when considerations associated with different virtues favour incompatible courses of (...) action, but holds that these conflicts occur only at the level of individual actions. Thus while it may not always be possible to do both what would be just and what would be kind or to act both loyally and honestly, it is possible to be both a kind and a just person and to have both the virtue of loyalty and the virtue of honesty. (shrink)
CQ: The Baby Bas Ross case stirred much public debate in The Netherlands since 1988 -a newborn infant with Down's syndrome whose parents refused to consent to a surgery that would have repaired an otherwise fatal congenital anomaly. Can you share your thoughts with us on this case?HD: I was the first ethicist to comment on this case because I was a friend of Dr. Molenaar, who was the final surgical decision maker for Baby Bas. A physician and I supported (...) his decision throughout the prosecution that followed. We also summarized the case in the N.T.V.G., the Dutch Magazine of Medicine. We argued In the article that parents should have the option to make nontreatment decisions. Moreover, In cases where the physician has to perform aggressive medical interventions, there certainly must be thorough and sound justification to ensure that the decision to Intervene Is in the best interest of the child.Heleen M. Dupuis, Ph.D., is Professor of Bioethics at the Leiden University School of Medicine, where she heads the Department of Metamedica and teaches in the Department of Philosophy. She is also a member of the Institutional Review Board/Ethics Committee of the Leiden University Hospital and a member of the Ethics Committee of the Royal Dutch Society of Medicine. (shrink)
Theophrasti Characteres recensuit Hermannus Diels. Oxford Classical Texts. 1909. 3s. 6d. net. Pp. xxviii + .Θεοφρστου Xαρακτxs22EFρες. The Characters of Theophrastus. An English Translation from a Revised Text. With Introduction and Notes by R. C. Jebb, M.A. A new edition. Edited by J. E. Sandys, Litt.D. Macmillan. 1909. 7s. 6d. net. c. 23×14½. Pp. xvi+229.
This essay comments on the articles by Loretta M. Kopelman and Anita Silvers. It extends their analyses and concludes that consistency and the total absence of conflict may be unavailable when one interprets and applies the Americans with Disabilities Act.
In 2011 the English Court of Protection ruled that it would be unlawful to withdraw artificial nutrition and hydration from a woman, M, who had been in a minimally conscious state for 8 years. It was reported as the first English legal case concerning withdrawal of artificial nutrition and hydration from a patient in a minimally conscious state who was otherwise stable. In the absence of a valid and applicable advance decision refusing treatment, of other life-limiting pathology or excessively burdensome (...) suffering, the judgement makes it clear that the obligation on health professionals falls strongly in favour of preserving life. Although the Court sought to limit the judgement as closely as possible to the facts of the case, it is likely to have a significant impact on life-sustaining treatment decisions for people in states of low awareness. This paper outlines the main legal features of the judgement. (shrink)
I use some ideas of Keith DeRose's to develop an (invariantist!) account of why sceptical reasoning doesn't show that I don't know that I'm not a brain in a vat. I argue that knowledge is subject to the risk-of-error constraint: a true belief won’t have the status of knowledge if there is a substantial risk of the belief being in error that hasn’t been brought under control. When a substantial risk of error is present (i.e. beliefs in propositions that are (...) false in nearby worlds), satisfying the constraint requires bringing the risk under control. This is achieved either by sensitivity, i.e. you wouldn’t have the belief if it were false, or by identifying evidence for the proposition. However, when the risk of error is not substantial (i.e. beliefs in propositions that are not false in nearby worlds), the constraint is satisfied by default. My belief that I am not a brain in a vat is insensitive and I have no evidence for it, but since it is not false in nearby worlds, it satisfies the constraint by default. (shrink)
Typical analyses of belief in conspiracy theories have it that identifying as a conspiracy theorist is irrational. However, given that we know conspiracies occur, and theories about said conspiracies can be warranted, should we really be scared of the locution 'I'm a conspiracy theorist...'?
The article responds to the objections M.D. Ashfield has raised to my recent attempt at saving epistemic contextualism from the knowability problem. First, it shows that Ashfield’s criticisms of my minimal conception of epistemic contextualism, even if correct, cannot reinstate the knowability problem. Second, it argues that these criticisms are based on a misunderstanding of the commitments of my minimal conception. I conclude that there is still no reason to maintain that epistemic contextualism has the knowability problem.
Since everything which enters into the human understanding comes there through the senses, man's first reason is a reason of the senses; this sensual reason serves as the basis of intellectual reason. Our first masters of philosophy are our feet, our hands, our eyes. Emile, 125.