Objective To determine the attitudes of Egyptian patients regarding their participation in research and with the collection, storage and future use of blood samples for research purposes. Design Cross-sectional survey. Study population Adult Egyptian patients (n=600) at rural and urban hospitals and clinics. Results Less than half of the study population (44.3%) felt that informed consent forms should provide research participants the option to have their blood samples stored for future research. Of these participants, 39.9% thought that consent forms should (...) include the option that future research be restricted to the illness being studied. A slight majority (66.2%) would donate their samples for future genetic research. Respondents were more favourable towards having their blood samples exported to other Arab countries (62.0%) compared with countries in Europe (41.8%, p<0.001) and to the USA (37.2%, p<0.001). Conclusions This study shows that many individuals do not favour the donation of a blood sample for future research. Of those who do approve of such future research, many favour a consent model that includes an option restricting the future research to the illness being studied. Also, many Egyptians were hesitant to have their blood samples donated for genetic research or exported out of the Arab region to the USA and European countries. Further qualitative research should be performed to determine the underlying reasons for many of our results. (shrink)

This paper distinguishes four major types of futility (physiological, imminent demise, lethal condition, and qualitative) that have been advocated in the literature either in a patient dependent or a patient independent fashion. It proposes five criteria (precision, prospective, social acceptability, significant number, and non-agreement) that any definition of futility must satisfy if it is to serve as the basis for unilaterally limiting futile care. It then argues that none of the definitions that have been advocated meet the criteria, primarily because (...) their proponents have not paid sufficient attention to the problematic nature of the data supporting the use of their definitions. (shrink)

Psychoactive drugs are being prescribed to millions of Americans at an increasing rate. In many cases these drugs are necessary in order to overcome debilitating emotional problems. Yet in other instances, these drugs are used to supplant, not supplement, interpersonal therapy. The process of overcoming emotional obstacles by introspection and the attainment of self knowledge is gradually being eroded via the gratuitous use of psychoactive medication in order to rapidly attain a release from the common problems that life inevitably presents (...) us with. In this paper, I argue that Kant’s formula of humanity, which maintains that persons ought never to treat others or themselves soley as a means to an end, proscribes this. Moreover, Kant argues that we have an imperfect duty of self development, and I argue that we fail to adhere to such a duty whenever we seek to evade the process of introspection and self knowledge in favour of the expedient results that drugs may provide us with as we attempt to overcome the emotional hurdles in our lives. (shrink)

The persistent educational challenges that fractions pose call for developing novel instructional methods to better prepare students for fraction learning. Here, we examined the effects of a 24-session, Cuisenaire rod intervention on a building block for symbolic fraction knowledge, continuous and discrete non-symbolic proportional reasoning, in children who have yet to receive fraction instruction. Participants were 34 second-graders who attended the intervention (intervention group) and 15 children who did not participate in any sessions (control group). As attendance at the intervention (...) sessions was irregular (median = 15.6 sessions, range = 1–24), we specifically examined the effect of the number of sessions completed on their non-symbolic proportional reasoning. Our results showed that children who attended a larger number of sessions increased their ability to compare non-symbolic continuous proportions. However, contrary to our expectations, they also decreased their ability to compare misleading discretized proportions. In contrast, children in the Control group did not show any change in their performance. These results provide further evidence on the malleability of non-symbolic continuous proportional reasoning and highlight the rigidity of counting knowledge interference on discrete proportional reasoning. (shrink)

Sections R1 to R3 attempt to take the sting out of hostile commentaries. Sections R4 to R5 engage Berlin and Kay and the World Color Survey to correct the record. Section R6 begins the formulation of a new theory of colour as an engineering project with a technological developmental trajectory. It is recommended that the colour space be abandoned.

In this target article the following hypotheses are discussed: (1) Colour is autonomous: a perceptuolinguistic and behavioural universal. (2) It is completely described by three independent attributes: hue, brightness, and saturation: (3) Phenomenologically and psychophysically there are four unique hues: red, green, blue, and yellow; (4) The unique hues are underpinned by two opponent psychophysical and/or neuronal channels: red/green, blue/yellow. The relevant literature is reviewed. We conclude: (i) Psychophysics and neurophysiology fail to set nontrivial constraints on colour categorization. (ii) Linguistic (...) evidence provides no grounds for the universality of basic colour categories. (iii) Neither the opponent hues red/green, blue/yellow nor hue, brightness, and saturation are intrinsic to a universal concept of colour. (iv) Colour is not autonomous. (shrink)

Background: Legislation on physician-assisted suicide is being considered in a number of states since the passage of the Oregon Death With Dignity Act in 1994. Opinion assessment surveys have historically assessed particular subsets of physicians.Objective: To determine variables predictive of physicians’ opinions on PAS in a rural state, Vermont, USA.Design: Cross-sectional mailing survey.Participants: 1052 physicians licensed by the state of Vermont.Results: Of the respondents, 38.2% believed PAS should be legalised, 16.0% believed it should be prohibited and 26.0% believed it should (...) not be legislated. 15.7% were undecided. Males were more likely than females to favour legalisation . Physicians who did not care for patients through the end of life were significantly more likely to favour legalisation of PAS than physicians who do care for patients with terminal illness . 30% of the respondents had experienced a request for assistance with suicide.Conclusions: Vermont physicians’ opinions on the legalisation of PAS is sharply polarised. Patient autonomy was a factor strongly associated with opinions in favour of legalisation, whereas the sanctity of the doctor–patient relationship was strongly associated with opinions in favour of not legislating PAS. Those in favour of making PAS illegal overwhelmingly cited moral and ethical beliefs as factors in their opinion. Although opinions on legalisation appear to be based on firmly held beliefs, approximately half of Vermont physicians who responded to the survey agree that there is a need for more education in palliative care and pain management. (shrink)

This new edition of Introduction to Lattices and Order presents a radical reorganization and updating, though its primary aim is unchanged. The explosive development of theoretical computer science in recent years has, in particular, influenced the book's evolution: a fresh treatment of fixpoints testifies to this and Galois connections now feature prominently. An early presentation of concept analysis gives both a concrete foundation for the subsequent theory of complete lattices and a glimpse of a methodology for data analysis that is (...) of commercial value in social science. Classroom experience has led to numerous pedagogical improvements and many new exercises have been added. As before, exposure to elementary abstract algebra and the notation of set theory are the only prerequisites, making the book suitable for advanced undergraduates and beginning graduate students. It will also be a valuable resource for anyone who meets ordered structures. (shrink)

To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not always described. Half of the (...) guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process. (shrink)

This paper examines the challenge that psychoanalytic theory cannot be refuted. It does so by considering the theory in its orthodox Freudian form, and in the main branches into which it can be divided ? the theory of Instincts, of Development, of Psychic Structure, of Mental Economics or Defence, and of Symptom Formation. The essential character of the generalizations and concepts of these branches will just be indicated; and we shall ask of each branch whether it is possible to refute (...) it. A considerable amount of scientific enquiry has been done into the concepts and generalizations of psychoanalysis. Relevant examples of these enquiries will be noted; and the question asked whether these scientific studies have in fact done anything to refute or support the various branches of psychoanalytic theory. The general upshot will be that the challenge is both important and a mistake. (shrink)

[opening paragraph]: Buddhist inquiry into the natural world proceeds from a radically different point of departure than western science, and its methods differ correspondingly. Early pioneers of the scientific revolution, including Copernicus, Kepler, and Galileo, expressed an initial interest in the nature of physical objects most far removed from human subjectivity: such issues as the relative motions of the sun and earth, the surface of the moon, and the revolutions of the planets. And a central principle of scientific naturalism is (...) the pure objectification of the natural world, free of any contamination of subjectivity. This principle of objectivism demands that science deals with empirical facts testable by empirical methods entailing testability by third-person means; and such facts must, therefore, be public rather than private, which is to say, they must be accessible to more than one observer. (shrink)

The authors discuss some of the conceptual issues that must be considered in using and understanding psychiatric classification. DSM-IV is a practical and common sense nosology of psychiatric disorders that is intended to improve communication in clinical practice and in research studies. DSM-IV has no philosophic pretensions but does raise many philosphical questions. This paper describes the development of DSM-IV and the way in which it addresses a number of philosophic issues: nominalism vs. realism, epistemology in science, the mind/body dichotomy, (...) the definition of mental disorders, and dimensional vs. categorical classification. (shrink)

OBJECTIVES: To study the opinions of nationals (Emiratis) and doctors practising in the United Arab Emirates (UAE) with regard to informing terminally ill patients. DESIGN: Structured questionnaires administered during January 1995. SETTING: The UAE, a federation of small, rich, developing Arabian Gulf states. PARTICIPANTS: Convenience samples of 100 Emiratis (minimum age 15 years) and of 50 doctors practising in government hospitals and clinics. RESULTS: Doctors emerged as consistently less in favour of informing than the Emiratis were, whether the patient was (...) described as almost certain to die during the next six months or as having a 50% chance of surviving, and even when it was specified that the patient was requesting information. In the latter situation, a third of doctors maintained that the patient should not be told. Increasing survival odds reduced the number of doctors selecting to inform; but it had no significant impact on Emiratis' choices. When Emiratis were asked whether they would personally want to be informed if they had only a short time to live, less than half responded in the way they had done to the in principle question. CONCLUSIONS: The doctors' responses are of concern because of the lack of reference to ethical principles or dilemmas, the disregard of patients' wishes and dependency on survival odds. The heterogeneity of Emiratis' responses calls into question the usefulness of invoking norms to explain inter-society differences. In the current study, people's in principle choices did not provide a useful guide to how they said they would personally wish to be treated. (shrink)

In this text, a variety of modal logics at the sentential, first-order, and second-order levels are developed with clarity, precision and philosophical insight. All of the S1-S5 modal logics of Lewis and Langford, among others, are constructed. A matrix, or many-valued semantics, for sentential modal logic is formalized, and an important result that no finite matrix can characterize any of the standard modal logics is proven. Exercises, some of which show independence results, help to develop logical skills. A separate sentential (...) modal logic of logical necessity in logical atomism is also constructed and shown to be complete and decidable. On the first-order level of the logic of logical necessity, the modal thesis of anti-essentialism is valid and every de re sentence is provably equivalent to a de dicto sentence. An elegant extension of the standard sentential modal logics into several first-order modal logics is developed. Both a first-order modal logic for possibilism containing actualism as a proper part as well as a separate modal logic for actualism alone are constructed for a variety of modal systems. Exercises on this level show the connections between modal laws and quantifier logic regarding generalization into, or out of, modal contexts and the conditions required for the necessity of identity and non-identity. Two types of second-order modal logics, one possibilist and the other actualist, are developed based on a distinction between existence-entailing concepts and concepts in general. The result is a deeper second-order analysis of possibilism and actualism as ontological frameworks. Exercises regarding second-order predicate quantifiers clarify the distinction between existence-entailing concepts and concepts in general. Modal Logic is ideally suited as a core text for graduate and undergraduate courses in modal logic, and as supplementary reading in courses on mathematical logic, formal ontology, and artificial intelligence. (shrink)

A number of recent arguments purport to show that imprecise credences are incompatible with accuracy-first epistemology. If correct, this conclusion suggests a conflict between evidential a...