Four ethical values — maximizing benefits, treating equally, promoting and rewarding instrumental value, and giving priority to the worst off — yield six specific recommendations for allocating medical resources in the Covid-19 pandemic: maximize benefits; prioritize health workers; do not allocate on a first-come, first-served basis; be responsive to evidence; recognize research participation; and apply the same principles to all Covid-19 and non–Covid-19 patients.
Medical cannabis is widely available in the USA and legalisation is likely to expand. Despite the increased accessibility and use of medical cannabis, physicians have significant knowledge gaps regarding evidence of clinical benefits and potential harms. We argue that primary care providers have an ethical obligation to develop competency to provide cannabis to appropriate patients. Furthermore, specific ethical considerations should guide the recommendation of medical cannabis. In many cases, these ethical considerations are extensions of well-established principles of beneficence and nonmaleficence, (...) which indicate that providers should recommend cannabis only for conditions that have the strongest evidence base. Additionally, the contested status of cannabis in American culture raises specific issues related to shared decision-making and patient education, as well as continuing clinical education. (shrink)
This paper argues against the continued practice of Confucian familism, even in its moderate form, in East Asian hospitals. According to moderate familism, a physician acting in concert with the patient's family may withhold diagnostic information from the patient, and may give it to the patient's family members without her prior approval. There are two main approaches to defend moderate familism: one argues that it can uphold patient's autonomy and protect her best interests; the other appeals to cultural relativism by (...) construing the principle of ‘family autonomy’ to be incommensurable with that of individual autonomy. We respond to the first approach by explaining how the familist arguments either depend on some unreasonable assumptions or simply fail to articulate. The critique of the second approach is based on our recent survey showing that there is no dichotomy of relevant values between the East and the West: we believe that the result can effectively block the familist's reliance on certain traditional or cultural values to explain their resistance to the incorporation of pluralist values. Despite our disagreement with familism, we consider the Eastern emphasis on the family to be conducive to the communication between patient, family members and medical personnel, which is indispensible to the patient's well being and autonomy. We conclude that respect for patient autonomy is perfectly consistent with the involvement of the family in making medical decision as long as the family plays a merely consultant role. (shrink)
A.1. Some philosophers, including Tarski and Russell, have concluded from a study of various versions of the Liar Paradox ‘that there must be a hierarchy of languages, and that the words “true” and “false”, as applied to statements in any given language, are themselves words belonging to a language of higher order’. In his famous essay on truth Tarski claimed that ‘colloquial’ language is inconsistent as a result of its property of ‘universality’: that is, whatever can be said at all (...) can in principle be said in it, with an extended vocabularly if necessary. Thus, in English we can talk about English expressions, what they denote, what they say, whether what they say is true or false, and so on: English contains its own metalanguage. This universality enables us to construct sentences which say of themselves that they are false, and by applying the law of excluded middle to them we easily derive a contradiction. Tarski concludes that ‘these antinomies seem to provide a proof that every language which is universal in the above sense, and for which the normal laws of logic hold, must be inconsistent’ . He then proposes to avoid such contradictions by the use of a hierarchy of languages such that statements about any one language can be made only in a different language at a higher level. (shrink)
Medications of choice, necessary supplies, and evidence-based health care now seem like luxuries. The contrast between my experience at a well-funded health unit and the Lev El Lev (“heart to heart”) African Refugee Clinic in Tel Aviv, Israel, is staggering. The complex personal, social, health, psychological, educational, and economic difficulties create a unique ethical environment for the health care provider.
The Purpose of this paper is to ask how far Locke can be said to have anticipated modern theories of number, particularly the intuitionist theory of Brouwer and Heyting. It has in mind Mr Edward E. Dawson's statement that Locke's account of number was not merely ‘a good effort in his own day’ but that ‘what Locke had to say really was quite fundamental, and a good deal of modern mathematics assumes his position, either explicitly or implicitly’. Mr Dawson thinks (...) that some of the central notions of the intuitionist theory are already present in the Essay Concerning Human Understanding , II, xvi, ‘Of Number’. We should like to examine the view. (shrink)
This paper will suggest a mapping for human dynamics to see where emerging digital technology currently and could further affect the dynamics of the human, technological and natural, and the cultural forms that define them. Emerging technology will be seen to reveal and surpass the limitations of human measures built on human abilities and perception. and the social structures that are derived from them. The formation of this conceptual mapping is based on the premise that digital technology has the ability (...) to better relay and hence refine dynamics working at points where culture is created and necessitated in our perception of a shared reality. Technology thus alleviates the layering, representation, labelling, and reification notions of culture that are based in human perceptual limitations. Information as referential will be seen against the tendency of technology to offer succinct mediation and direct actions as a format for any change and application with refined cultural constructions. The mapping presents a notion of homeostasis or more bereft of balance at the point where the proximal dynamics of the unit, that is, the individual, is closely supported by the technology with a changing orientation to the dynamics of a natural environment. The notion of a person as an individual is also reconsidered in terms of technology and how this changing definition is part of how we conceptualize a balanced world. Nonlinear mapping rendered in a complex will be introduced to align these mixed dynamics. Complex is here defined as a concurrence of dynamics evident in shifts of change that act as a whole and where each action affects the whole. As measures are revealed so, too, will be the source of notions of linearity and nonlinearity; mapping; point of view as a basis of complexity; and evolutionary theory as a function of a labeling of cultural dynamics. (shrink)
There can be no doubt that we do know one another. We know that others exist and we know a good deal about others. The question is how we know others. To say that others do not exist would be to assert a solipsism—a theory which no serious philosopher has ever maintained. Solipsism is absurd. Not because it is self-contradictory, for there is nothing self-contradictory in the notion that I alone exist having the experiences and thoughts which I do have (...) and that apart from me nothing and no one else exists. It is absurd simply because others do exist and I know this; because, that is to say, it contradicts the known evidence. This is the sole—but the adequate—ground for concluding solipsism to be absurd. Any discussion of this present problem, therefore, must begin with, the recognition of the fact that knowledge of others occurs. (shrink)