Background Various authorities recommend the participation of patients in promoting patient safety, but little is known about health care professionals' (HCPs') attitudes towards patients' involvement in safety-related behaviours. Objective To investigate how HCPs evaluate patients' behaviours and HCP responses to patient involvement in the behaviour, relative to different aspects of the patient, the involved HCP and the potential error. Design Cross-sectional fractional factorial survey with seven factors embedded in two error scenarios (missed hand hygiene, medication error). Each survey included two (...) randomized vignettes that described the potential error, a patient's reaction to that error and the HCP response to the patient. Setting Twelve hospitals in Switzerland. Participants A total of 1141 HCPs (response rate 45%). Measurements Approval of patients' behaviour, HCP response to the patient, anticipated effects on the patient–HCP relationship, HCPs' support for being asked the question, affective response to the vignettes. Outcomes were measured on 7-point scales. Results Approval of patients' safety-related interventions was generally high and largely affected by patients' behaviour and correct identification of error. Anticipated effects on the patient–HCP relationship were much less positive, little correlated with approval of patients' behaviour and were mainly determined by the HCP response to intervening patients. HCPs expressed more favourable attitudes towards patients intervening about a medication error than about hand sanitation. Conclusions This study provides the first insights into predictors of HCPs' attitudes towards patient engagement in safety. Future research is however required to assess the generalizability of the findings into practice before training can be designed to address critical issues. (shrink)

Metagenomics bears upon all aspects of microbiology, including our understanding of mitochondrial and eukaryote origin. Recently, ribosomal protein phylogenies show the eukaryote host lineage – the archaeal lineage that acquired the mitochondrion – to branch within the archaea. Metagenomic studies are now uncovering new archaeal lineages that branch more closely to the host than any cultivated archaea do. But how do they grow? Carbon and energy metabolism as pieced together from metagenome assemblies of these new archaeal lineages, such as the (...) Deep Sea Archaeal Group (including Lokiarchaeota) and Bathyarchaeota, do not match the physiology of any cultivated microbes. Understanding how these new lineages live in their environment is important, and might hold clues about how mitochondria arose and how the eukaryotic lineage got started. Here we look at these exciting new metagenomic studies, what they say about archaeal physiology in modern environments, how they impact views on host‐mitochondrion physiological interactions at eukaryote origin. (shrink)

In his article ‘God and Probability’, 1 Hugh Mellor introduced the notion of the ‘bridge-hand fallacy’, allegedly committed by those who think they can appeal to probabilities in arguments for design. I should like to give this notion another airing, partly because of its recent criticism in two interesting books - R. G. Swinburne' The Existence of God and D. J. Bartholomew's God of Chance - and partly because it seems worth asking how it fares in relation to the most (...) recent examples of design argument, namely those which appeal to the so-called ‘anthropic principle’ in cosmology. (shrink)

Does the recent success of Podemos and Syriza herald a new era of inclusive, egalitarian left populism? Because leaders of both parties are former students of Ernesto Laclau and cite his account of populism as guiding their political practice, this essay considers whether his theory supports hope for a new kind of populism. For Laclau, the essence of populism is an “empty signifier” that provides a means by which anyone can identify with the people as a whole. However, the concept (...) of the empty signifier is not as neutral as he assumes. As I show by analyzing the role of race in his theory, some subjects are constituted in a way that prevents their unmediated identification with the people. Consequently, Laclau’s view should be read as symptomatic of the problems with populist logic if its adherents are to avoid reproducing its exclusions and practice a more inclusive politics. (shrink)

Planned home birth has been considered by some to be consistent with professional responsibility in patient care. This article critically assesses the ethical and scientific justification for this view and shows it to be unjustified. We critically assess recent statements by professional associations of obstetricians, one that sanctions and one that endorses planned home birth. We base our critical appraisal on the professional responsibility model of obstetric ethics, which is based on the ethical concept of medicine from the Scottish and (...) English Enlightenments of the 18th century. Our critical assessment supports the following conclusions. Because of its significantly increased, preventable perinatal risks, planned home birth in the United States is not clinically or ethically benign. Attending planned home birth, no matter one’s training or experience, is not acting in a professional capacity, because this role preventably results in clinically unnecessary and therefore clinically unacceptable perinatal risk. It is therefore not consistent with the ethical concept of medicine as a profession for any attendant to planned home birth to represent himself or herself as a “professional.” Obstetric healthcare associations should neither sanction nor endorse planned home birth. Instead, these associations should recommend against planned home birth. Obstetric healthcare professionals should respond to expressions of interest in planned home birth by pregnant women by informing them that it incurs significantly increased, preventable perinatal risks, by recommending strongly against planned home birth, and by recommending strongly for planned hospital birth. Obstetric healthcare professionals should routinely provide excellent obstetric care to all women transferred to the hospital from a planned home birth. The professional responsibility model of obstetric ethics requires obstetricians to address and remedy legitimate dissatisfaction with some hospital settings and address patients’ concerns about excessive interventions. Creating a sustained culture of comprehensive safety, which cannot be achieved in planned home birth, informed by compassionate and respectful treatment of pregnant women, should be a primary focus of professional obstetric responsibility. (shrink)

B L Curtis; Learning and Intentionality, Journal of Philosophy of Education, Volume 5, Issue 1, 30 May 2006, Pages 105–121, https://doi.org/10.1111/j.1467-9752.

B L Curtis; Learning and Intentionality, Journal of Philosophy of Education, Volume 5, Issue 1, 30 May 2006, Pages 105–121, https://doi.org/10.1111/j.1467-9752.

L B Daniels; Some Comments on ‘Value in Education’ by Johanna Burgess1, Journal of Philosophy of Education, Volume 8, Issue 2, 30 May 2006, Pages 237–250, https.

Fārābī; Avicenna, 980-1037; Avempace, -1138 or 1139; logic; Islamic philosophy; history.

The papers in the 2010 “Clinical Ethics” number of the Journal of Medicine and Philosophy explore issues along La Frontera, the borders and boundaries of clinical ethics. The first three papers in this “Clinical Ethics” number of the Journal explore borders and boundaries drawn within clinical ethics, concerning the moral standing of complementary and alternative medicine, palliative sedation, and induced abortion and feticide. The fourth and fifth papers explore the borders and boundaries between research ethics and clinical ethics.

Within the professional practice of psychology the code of ethics characterizes what is morally right or wrong, by means of a set of principles, values, and standards of conduct. While there are numerous international mental health organizations that incorporate ethical guidelines such as the APA and EFPA; these codes still fall short in providing guidelines for psychologists working in non-western cultures, especially when there are no universally adopted and valid cross-cultural ethics codes. This paper explores various challenges psychologists in the (...) Arab region face when using a western code which does not reflect the values and traditions of their culture. A comparison of several ethical codes from different Arab countries is presented, with a focus on challenging areas of interest such as confidentiality, informed consent and multiple relationships. (shrink)

The paper illustrates how organic chemists dramatically altered their practices in the middle part of the twentieth century through the adoption of analytical instrumentation - such as ultraviolet and infrared absorption spectroscopy and nuclear magnetic resonance spectroscopy - through which the difficult process of structure determination for small molecules became routine. Changes in practice were manifested in two ways: in the use of these instruments in the development of 'rule-based' theories; and in an increased focus on synthesis, at the expense (...) of chemical analysis. These rule-based theories took the form of generalizations relating structure to chemical and physical properties, as measured by instrumentation. This 'Instrumental Revolution' in organic chemistry was two-fold: encompassing an embrace of new tools that provided unprecedented access to structures, and a new way of thinking about molecules and their reactivity in terms of shape and structure. These practices suggest the possibility of a change in the ontological status of chemical structures, brought about by the regular use of instruments. The career of Robert Burns Woodward (1917-1979) provides the central historical examples for the paper. Woodward was an organic chemist at Harvard from 1937 until the time of his death. In 1965, he won the Nobel Prize in Chemistry. (shrink)

It is well-recognized that uncertainty is an endemic feature and limitation of clinical judgment and practice that cannot be eliminated in many cases. Among the tasks of clinical ethics is the responsible management of uncertainties, first articulated in E. Haavi Morreim’s very nice concept of the "moral management of medical uncertainty." The papers in the 2012 Clinical Ethics issue of the Journal provide philosophically innovative and clinically applicable accounts of the varieties of uncertainty in clinical medicine and therefore in clinical (...) ethics: epistemic uncertainty, metaphysical uncertainty, and relational uncertainty. (shrink)

This paper introduces the 2011 number of the Journal on Clinical Ethics. Philosophical critical appraisal is essential for the success of philosophical analysis and argument in clinical ethics. To clear away conceptual underbrush, papers in this Clinical Ethics number of the Journal address genetic engineering, conscience-based objections to forms of health care, placebos, and preventing exploitation of patients to be recruited to become research subjects.

The five papers in the 2008 “Clinical Ethics” number of the journal address the conceptual and empirical foundations of clinical ethics. Three articles take up the concept of professionalism in medicine, exploring its possibilities and implications. The fourth article provides a distinctive, phenomenological account of the “placebo effect,” a vexing topic of surprising durability in the clinical setting. The final article, a systematic review of the qualitative literature on bedside rationing of resources, creates an empirical foundation for philosophical analysis and (...) argument of a distinctive kind. (shrink)

Central concepts and consensus views in clinical ethics are marked by instability. The papers in this number of the Journal take up two such central concepts, quality of life and moral status, and two such consensus views, that germ-line gene transfer should not be undertaken for the purposes of enhancement of human traits and that the ethical obligation of physicians to treat HIV infected patients rests on consent of the physician. One outcome of these philosophical investigations is that these two (...) concepts and consensus views are less stable than one might have thought. I explore the possibility of generalizing this outcome in a reflection on clinical ethics as the management of instability and incompleteness, including the instability and incompleteness of clinical ethics itself. In the course of this reflection I liken clinical ethics to abstract expressionism in mid-twentieth century Western art. (shrink)

The greatest contemporary challenge in the arena of cognitive neuroscience concerns the relation between consciousness and the brain. Over recent years the focus of work in this area has switched from the analysis of diverse spatial regions of the brain to that of the timing of neural events. It appears that two conditions are necessary in order for neural events to become correlated with conscious experience. First, the firing of assemblies of neurones must achieve a degree of coherence, and, second, (...) reflexive (i.e. top-down, or reentrant) neural pathways must be activated. It does not, of course, follow that such neural activity causes consciousness; it may be, for example, that the neural activity formats the brain to interact with consciousness. The latter possibility is suggested by analysis of mystical texts suggesting that coherence and reflexivity constitute the conditions for the influx of “spirit.” Kabbalistic sources, for example, describe a hierarchy of “brains” in the human and divine realms through which the principles of coherence and reflexivity operate. Whilst the ontological assumptions of such a scheme place it beyond the realm of psychology, parallels with the picture deriving from the contemporary cognitive neuroscience of consciousness are striking. (shrink)

First authoritative and comprehensive study in the field of Inkblot Personality Test, this book describes the historical roots of the three major projective inkblot measures: the Rorschach, the Holtzman Inkblot Technique (HIT) and the Somatic Inkblot Series (SIS). It presents the extensive psychometric background work accompanying the normative data and diagnostic indicators along with indices for selecting executives in a business organization. The book begins with a detailed history of Hermann Rorschach and his early experiments with inkblots in the diagnosis (...) of mentally ill patients. Special attention is given to the administration and scoring of the Rorschach, with the sections detailing the systems developed by Klopfer and Exner. The HIT and SIS are also reviewed in detail, emphasizing their psychometric qualities. (shrink)