After a brief review of pragmatic arguments against emotivism, the author of this monograph proceeds to outline and criticize two conflicting concepts of the morally right in Dewey's writings. A third interpretation, involving an "interaction of the factual and the normative" is advanced as more conformable to the spirit of instrumentalism.--A. D. P. M.

We report the results of a randomized trial to assess the impact of an innovative ethics curriculum on the knowledge and confidence of 85 medical house officers in a university hospital programme, as well as their responses to a simulated clinical case. Twenty-five per cent of the house officers received a lecture series, 25 per cent received lectures and case conferences, with an ethicist in attendance, and 50 per cent served as controls. A post-intervention questionnaire was administered. Knowledge scores did (...) not differ among the groups. Confidence regarding ethical issues was significantly greater in the aggregate intervention group compared to the control group. Confidence regarding procedural issues related to ethics was significantly higher for the EI group than for the controls. Responses to a simulated case showed that significantly fewer house officers in the EI group would intubate a patient for whom such therapy would be futile. We conclude that ethics education can have an impact on house officers' confidence and their responses to a simulated case, and that the EI was more effective than the LI. Such results have implications regarding the implementation of ethics education during residency. (shrink)

In 1885, during initial discussions of J. C. Maxwell's celebrated thermodynamic demon, Whiting (1) observed that the demon-like velocity selection of molecules can occur in a gravitationally bound gas. Recently, a gravitational Maxwell demon has been proposed which makes use of this observation [D. P. Sheehan, J. Glick, and J. D. Means, Found. Phys. 30, 1227 (2000)]. Here we report on numerical simulations that detail its microscopic phase space structure. Results verify the previously hypothesized mechanism of its paradoxical behavior. This (...) system appears to be the only example of a fully classical mechanical Maxwell demon that has not been resolved in favor of the second law of thermodynamics. (shrink)

In a recent article in this journal our unit was accused of a number of errors of judgment in applying covert video surveillance (CVS) to infants and children suspected of life-threatening abuse. The article implied, that on moving from the Royal Brompton Hospital in London to North Staffordshire Hospital, we failed to present our work to the Research Ethics Committee (REC). We did send our protocol to the REC though we did not consider that, after a total of 16 patients (...) had been documented as being the subject of life-threatening abuse, this was research. The REC in Staffordshire agreed with us. We were also accused of undertaking work that should be pursued by the Police. We agree with this. However, unlike the Metropolitan Police the Staffordshire Police would not undertake CVS. We fail to agree that 'working together' with parents is necessarily practical or safe when trying to protect children from life-threatening abuse of this kind. (shrink)

OBJECTIVES: To study the accuracy of reviewing ward notes (chart review) as a measure of the quality of care rendered to patients with "Do Not Resuscitate" (DNR) orders. DESIGN: We reviewed the charts of 19 consecutive, competent inpatients with DNR orders for evidence that the staff addressed a broad range of patient care needs called Concurrent Care Concerns (CCCs), such as withholding treatments other than resuscitation itself, and attention to patient comfort needs. We then interviewed the patient, consultant physician, house (...) officer, and primary nurse and compared the ward notes with the understandings of these staff members. SETTING: The medical service of an urban university medical centre. RESULTS: The average number of documented CCCs addressed per DNR order was 1.1. The ward notes generally agreed with the perceptions of patients, house officers, and nurses (% agreement with notes = 79%, 77%, and 82%; kappa = 0.43, 0.40, 0.50). Consultant physicians' understandings were poorly reflected in the ward notes (% agreement = 59%; kappa = 0.18). They overestimated attention to CCCs compared with the notes (P < 0.0001) and with other observers (P < 0.0001). CONCLUSION: Chart review for attention to CCCs accurately reflects the understandings of patients, house officers, and nurses, but consultant physicians report more attention to CCCs than is recorded in the ward notes or understood by other observers. Better communication regarding end-of-life care plans should be encouraged. (shrink)

We propose a model mechanism for the initiation and spatial positioning of teeth primordia in the alligator, Alligator mississippiensis. Detailed embryological studies by Westergaard and Ferguson have shown that jaw growth plays a crucial role in the developmental patterning of the tooth initiation process. Based on biological data we develop a dynamic patterning mechanism, which crucially includes domain growth. The mechanism can reproduce the spatial pattern development of the first seven teeth primordia in each half jaw of A. mississippiensis. The (...) results for the precise spatio-temporal sequence compare well with experiment. Simulation of the model also predicts that certain transplantations can alter the spatial sequence of teeth primordia initiation. (shrink)

This article seeks to shed light on the beliefs that influence nurses’ intention of respecting or not respecting an advance directive document, namely a living will or a durable power of attorney. Nurses’ beliefs were measured using a 44-statement questionnaire. The sample was made up of 306 nurses working either in a long-term care centre or in a hospital centre offering general and specialized care in the province of Québec. The results indicate that nurses have a strong intention of complying (...) with advance directives written by patients. The analysis also shows that four variables determine the strength of this intention: respect for autonomy; the location of the workplace; justice; and the dimension of relationships and emotions. Although these documents favour the expression of patients’ wishes, nurses should be aware that they do not systematically guarantee respect of a patient’s autonomy, nor do they replace a relationship based on trust between patients and health care professionals. (shrink)

In 1885, during initial discussions of J. C. Maxwell's celebrated thermodynamic demon, Whiting(1) observed that the demon-like velocity selection of molecules can occur in a gravitationally bound gas. Recently, a gravitational Maxwell demon has been proposed which makes use of this observation [D. P. Sheehan, J. Glick, and J. D. Means, Found. Phys. 30, 1227 (2000)]. Here we report on numerical simulations that detail its microscopic phase space structure. Results verify the previously hypothesized mechanism of its paradoxical behavior. This system (...) appears to be the only example of a fully classical mechanical Maxwell demon that has not been resolved in favor of the second law of thermodynamics. (shrink)

In his struggle to vindicate the religious enterprise from the charge that it is unfalsifiable and meaningless, McKinnon reduces both science and religion to distorted caricatures, ignores the centrality of the problems of evil, anguish, absurdity, and the egocentric predicament for religion, and asserts that religion and science are fundamentally one and the same. He builds his thesis on a distinction between "assertional," "self-instructional," and "ontological-linguistic" intentionality of utterances. By equivocating about whether these usages are logically independent, McKinnon holds that, (...) as "self-instructional," utterances are outside the positivist's arena. He presses the noteworthy point--that utterances sometimes are intended to report an existential stance--in such a way as to divert attention from the vast differences between religious and scientific methods and subject matter. Not content with leaving religious utterances restricted to mere reporting, McKinnon builds a case for bypassing positivistic attack under the other two usages by trading on a supposed incommensurability between particulars and universals. E.g., he holds that "God is love" must be indeterminate and unfalsifiable since both nouns are universals and since God is incomprehensible. And so it goes, a battle between straw men on a shifting field of honor for a prize of dubious worth. Notwithstanding, this is a thought provoking treatment of a difficult topic.--M. D. P. (shrink)

This collection of reprinted social philosophy broadly surveys and introduces problems and positions vis-à-vis the concept of right. Using the tools of ordinary language analysis, M. MacDonald evaluates the attempts of other writers to resolve the tensions between civil and moral responsibility. H. L. A. Hart argues that "... if there are any moral rights at all, it follows that there is at least one natural right." His laudatory deductive exercise and categorization of rights suggests no leads for answering the (...) hypothetical he poses. While MacDonald and Hart raise no gut issues, G. Vlastos gives a common sense analysis of the main stream of classical debate, couching his inquiry in terms of conflicts between collective and distributive justice. His article both includes the scope and surpasses the stopping points of the earlier selections. Through leading to a philosophical discussion of the workings of the denial of human rights within the segregationist position, R. Wasserstrom unmasks the practical stakes involved in what the others leave as an academic problem. H. Morris's witty analysis of a hypothetical "right to be punished" lays bare the fact that social institutions embody some concept of right, duty, and obligation. He leaves the reader with the unanswered but clearly indicated question of which concept of right does one want society to sanction. Also included are: J. Locke's The Second Treatise of Civil Government, Chapters two and five; J. Bentham's Anarchical Fallacies; The Virginia Declaration of Rights ; Declaration of the Rights of Man and of Citizens ; Universal Declaration of Human Rights ; and a portion of the Declaration of Independence of the U.S.A.--M. D. P. (shrink)

"Neuroscience and Philosophy" begins with an excerpt from "Philosophical Foundations of Neuroscience," in which Maxwell Bennett and Peter Hacker question the ...

Ormerod and Chronicle reported that optimal solutions to traveling salesperson problems were judged to be aesthetically more pleasing than poorer solutions and that solutions with more convex hull nodes were rated as better figures. To test these conclusions, solution regularity and the number of potential intersections were held constant, whereas solution optimality, the number of internal nodes, and the number of nearest neighbors in each solution were varied factorially. The results did not support the view that the convex hull is (...) an important determinant of figural attractiveness. Also, in contrast to the findings of Ormerod and Chronicle, there were consistent individual differences. Participants appeared to be divided as to whether the most attractive figure enclosed a given area within a perimeter of minimum or maximum length. It is concluded that future research in this area cannot afford to focus exclusively on group performance measures. (shrink)