The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)

In 2000, a simple, foundational thermodynamic paradox was proposed: a sealed blackbody cavity contains a diatomic gas and a radiometer whose apposing vane surfaces dissociate and recombine the gas to different degrees (A $_{2} \rightleftharpoons $ 2A). As a result of differing desorption rates for A and A $_{2}$ , there arise between the vane faces permanent pressure and temperature differences, either of which can be harnessed to perform work, in apparent conflict with the second law of thermodynamics. Here we (...) report on the first experimental realization of this paradox, involving the dissociation of low-pressure hydrogen gas on high-temperature refractory metals (tungsten and rhenium) under blackbody cavity conditions. The results, corroborated by other laboratory studies and supported by theory, confirm the paradoxical temperature difference and point to physics beyond the traditional understanding of the second law. (shrink)

Pleidooi voor een metafysische visie op hedendaagse sociale en economische problemen.

Analytical expressions for the matrices and an explicit algorithm for computing Clebsch-Gordan coupling coefficients are given forsu(4) in au(3)-coupled basis as an example of the construction for anysu(n) in au(n−1) basis. The results areinduced from the known results foru(3) by means of the vector-coherent-state (VCS) theory of induced representations. The important recent result that makes this possible is the discovery that a complete set of shift tensors for the finitedimensional representations of reductive Lie algebras can be induced, by VCS methods, (...) from those of suitably defined subalgebras. (shrink)

A combination of social forces has thrown marriage into question in westernised societies at the end of the millennium. This uncertainty creates space for new ways of thinking about marriage. In this context, we examine the idea of marriage as friendship. We trace its genealogy in the work of Mary Wollstonecraft, John Stuart Mill and Harriet Taylor and then subject it to critical scrutiny using some of Michel de Montaigne’s ideas. We ask how applicable the ideal of higher friendship is (...) to marriage and what might be gained and lost by a synthesis of marriage and friendship. Grounding the discussion in historical sources is valuable because the topic is so little explored in the contemporary philosophical literature. This approach also allows any enduring value in these historical texts to be elicited. (shrink)

Outcomes from cardiopulmonary resuscitation (CPR) remain distressingly poor. Overuse of CPR is attributable to unrealistic expectations, unintended consequences of existing policies and failure to honour patient refusal of CPR. We analyzed the CPR outcomes literature using the bioethical principles of beneficence, non-maleficence, autonomy and justice and developed a proposal for selective use of CPR. Beneficence supports use of CPR when most effective. Non-maleficence argues against performing CPR when the outcomes are harmful or usage inappropriate. Additionally, policies which usurp good clinical (...) judgment and moral responsibility, thereby contributing to inappropriate CPR usage, should be considered maleficent. Autonomy restricts CPR use when refused but cannot create a right to CPR. Justice requires that we define which medical interventions contribute sufficiently to health and happiness that they should be made universally available. This ordering is necessary whether one believes in the utilitarian standard or wishes medical care to be universally available on fairness grounds. Low-yield CPR fails justice criteria. Cardiopulmonary resuscitation should be performed when justified by the extensive outcomes literature; not performed when not desired by the patient or not indicated; and performed infrequently when relatively contraindicated. (shrink)

Multiple -conclusion logic extends formal logic by allowing arguments to have a set of conclusions instead of a single one, the truth lying somewhere among the conclusions if all the premises are true. The extension opens up interesting possibilities based on the symmetry between premises and conclusions, and can also be used to throw fresh light on the conventional logic and its limitations. This is a sustained study of the subject and is certain to stimulate further research. Part I reworks (...) the fundamental ideas of logic to take account of multiple conclusions, and investigates the connections between multiple - and single - conclusion calculi. Part II draws on graph theory to discuss the form and validity of arguments independently of particular logical systems. Part III contrasts the multiple - and the single - conclusion treatment of one and the same subject, using many-valued logic as the example; and Part IV shows how the methods of 'natural deduction' can be matched by direct proofs using multiple conclusions. (shrink)