This paper examines the concept of ‘openness with patients’ from the stand-point of the limitations of biomedical ethics. Initially we review contemporary critiques of bioethics and, in particular, of principlism; we relate how other; somewhat neglected, forms of medical ethics can yield useful information and provide moral guidance.The main section of the paper then shows how a bioethical approach to openness misses the social context in our example, the viewpoints of patients; we present some of the increasing wealth of research (...) evidence which points towards patients wanting more information and a greater degree of openness.Finally we put forward that a principlist’s objection to active encouragement of openness might be based on the risk of infringing upon the ‘right not to know’. We reject this by arguing how rights can be trumped. (shrink)

Este manuscrito apresenta um ponto de vista sobre o conhecimento da origem do cosmos. A ciência afirma que o Universo teve um começo com o tempo, mas também declara que nenhuma lei natural pode ser aplicada no tempo inicial. Considerando que se trata de algo exclusivo da ciência divina, sugere-se então a instrumentalidade da fé para se conhecer aquilo que de fato é relevante sobre o início da história.

Séculos de intenso trabalho no discurso da origem da vida levaram a ciência a nenhuma descoberta significativa. As teorias mais progressivas se estagnaram no problema central da origem da informação genética, inimaginavelmente distante de qualquer concepção humana. Aparentemente o Criador reservou para si o conhecimento absoluto deste extraordinário acontecimento. Mas há algo surpreendente nessa investigação que está ao alcance do homem.

Die demografische Entwicklung und der medizinische Fortschritt werden die Problematik der Ressourcenknappheit im deutschen Gesundheitswesen in Zukunft weiter verschärfen. Soll nicht nur kurzfristig akuten Sparzwängen ausgewichen werden, steht – wie in verschiedenen Ländern bereits geschehen – auch Deutschland auf Dauer eine Prioritätensetzung im Gesundheitswesen bevor. Diese sollte in möglichst transparenter Weise nach klaren Kriterien erfolgen. Eines der seit einiger Zeit häufig öffentlich zitierten Kriterien der Verteilung von Mitteln in der Gesundheitsversorgung ist die Eigenverantwortung von Patienten. Deren Berücksichtigung in der Allokation (...) von Ressourcen birgt allerdings zahlreiche Probleme. Der vorliegende Beitrag untersucht die gerechtigkeitstheoretischen Grundlagen und die praktischen Probleme bzw. die möglichen Konsequenzen von Eigenverantwortung als Verteilungskriterium im Gesundheitswesen. Auf der Grundlage eines alternativen gerechtigkeitstheoretischen Vorschlags werden drei Möglichkeiten skizziert, Eigenverantwortung von Patienten im deutschen Gesundheitswesen in gerechter Weise stärker zu betonen. (shrink)

The ability to reason independently from one's own goals or beliefs has long been recognised as a key characteristic of the development of formal operational thought. In this article we present the results of a study that examined the correlates of this ability in a group of 10-year-old children ( N = 61). Participants were presented with conditional and relational reasoning items, where the content was manipulated such that the conclusion to the arguments were either congruent, neutral, or incongruent with (...) beliefs, and either logically valid or logically invalid. Participants also received a measure of working memory capacity (the counting span task) and a measure of inhibitory control (the stop signal task). Indices of belief bias and logical reasoning on belief-based problems were predicted independently by both measures. In contrast logical reasoning on belief neutral problems was predicted by working memory alone. The findings suggest that executive functions play a key role in the development of children's ability to decontextualise their thinking. (shrink)

Sarah A. Mattice develops a comparative intervention in contemporary metaphilosophy. Drawing on resources from hermeneutics, cognitive linguistics, aesthetics, and Chinese philosophy, she explores how philosophical language is deeply intertwined with the definition and practice of the discipline.

The similarity of documents in a large database of published Fractals articles was examined for redundancy. Three different text matching techniques were used on publisheds to identify redundancy candidates, and predictions were verified by reading full text versions of the redundancy candidate articles. A small fraction of the total articles in the database was judged to be redundant. This was viewed as a lower limit, because it excluded cases where the concepts remained the same, but the text was altered substantially.Far (...) more pervasive than redundant publications were publications that did not violate the letter of redundancy but rather violated the spirit of redundancy. There appeared to be widespread publication maximization strategies. Studies that resulted in one comprehensive paper decades ago now result in multiple papers that focus on one major problem, but are differentiated by parameter ranges, or other stratifying variables. This ‘paper inflation’ is due in large part to the increasing use of metrics (publications, patents, citations, etc) to evaluate research performance, and the researchers’ motivation to maximize the metrics. (shrink)

This paper examines some of the possible legal implications of the production, marketing and use of expert systems. The relevance of a legally useful definition of expert systems, comprising systems designed for use both by laymen and professionals, is related to the distinctions inherent in the legal doctrine underlying provision of goods and provision of services. The liability of the sellers and users of, and contributors to, expert systems are examined in terms of professional malpractice as well as product liability. (...) A recurring theme indicates that legislators may be inclined to restrict possibilities of liability suits in order to avoid disincentives to the creation of expert systems. (shrink)

The use of placebo in clinical trials has been repeatedly challenged as being unacceptable from an ethical point of view. The present paper responds to this criticism by taking up the issue in the light of the pertinent provisions of the Helsinki Declaration. Examples from different therapeutic areas are given that highlight the importance of placebo in situations in which its use is acceptable according to the Declaration. Particular emphasis is given to the question of active control trials, which, under (...) conditions of low assay sensitivity, may become an ethically less acceptable approach than the use of a placebo control. (shrink)

Este artigo contém um estudo sobre a Ciência a partir do ponto de vista bíblico, por meio da fé na revelação divinamente inspirada. A Bíblia revela a origem e a plenitude da Ciência no ato da criação do Universo e a apresenta como uma dádiva especial de Deus aos homens. As Escrituras também demonstram que a Ciência genuína existe para glorificar a Deus, sendo a sua instrumentalidade uma forma excelente de comunicação divina.

The present article discusses the two stages that, according to the vinaya texts, precede a full ordination of a woman candidate within the samgha: the stages of novice and of probationer. In the context of the present-day discussions on the position of nuns within the samgha, and on the introduction of a nuns' ordination in lineages where today this is not fully accepted, the article focuses on the formal issues that in the Dharmaguptaka vinaya tradition precede the nuns' ordination and (...) thus prepare the basis on which the full ordination was traditionally built. (shrink)

The purpose of this article is to suggest that the fictionalist’s emotions toward religious discourse could be better supported than the current literature allows. By ‘fictionalist’ I mean those of whom interpret religious discourse as useful fiction. The threefold structure of the article will argue that: (1) the concept of aliefs has been falsely equated with the concept of imagining, (2) the fictionalist ought to adopt a hybrid theory of emotions rather than a cognitive appraisal and, (3) if (1) and (...) (2) are accepted, then key issues concerning the genuineness and appropriateness of emotions toward fictional entities can be overcome. I will conclude that something significant is at stake here, and that is whether or not the fictionalist’s emotions are deemed ‘real’ or not. Thus, to provide the best defence of the fictionalist’s emotions is to: (A) separate that which has been lumped together, that is: quasi emotions and alief-evoked emotions (B) argue for the hybrid account of emotions and, (C) defend the genuine and appropriate nature of fictional emotions. (shrink)

This book brings together contributors from the different member states of the European Union in order to understand the different degrees of subscription to the concept of Europe and the role education plays in such a process. This second edition includes the new countries which have become part of the union and also considers recent developments in policy and practice. Countries covered are: Austria; Belgium; Denmark; Finland; France; Germany; Greece; Ireland; Italy; Luxembourg; Netherlands; Portugal; Spain; Sweden and the UK. All (...) sectors of education are dealt with in each case and the central theme of the European dimension is examined throughout. (shrink)

A great variety of medical conditions are subject to the placebo effect. Although there is mounting evidence to suggest that the placebo effect is related to the expectation of clinical benefit, little is still known about the biochemical bases underlying placebo responses. Positron emission tomography studies have recently shown that the placebo effect in Parkinson’s disease, pain, and depression is related to the activation of the limbic circuitry. The observation that placebo administration induces the release of dopamine in the ventral (...) striatum of patients with Parkinson’s disease suggests a link between the placebo effect and reward mechanisms. In addition to Parkinson’s disease, the placebo-reward model may also apply to other disorders. However, the relative contribution of the different neurotransmitters and neuropeptides that are known to be involved in modulating the activity of the limbic system may be disease-specific. Thus, while the placebo-induced clinical benefit observed in Parkinson’s disease would mostly reflect the release of dopamine in the dorsal striatum, the activation of opioid and serotonin pathways could be particularly implicated in mediating placebo responses encountered in pain and depression, respectively. (shrink)

ABSTRACT -/- Ayurveda is science of living being with an aim to live healthy life and curing of ailments. Arogyata (healthy life) is root to achieve the purushartha chatushtaya which are dharma(religious rituals), artha, kama and moksha. Kama in society is taken in sexual lust but Vatsayan has described kama as the enjoyment of appropriate objects by the five senses of hear- ing, feeling, seeing, tasting, and smelling, assisted by the mind together with the soul. The ingre- dient in this (...) is a peculiar contact between the organ of sense and its object, and the consciousness of pleasure which arises from that contact is called Kama. A well organised, controlled form of kama comes under brahmacharya. Acharya Charaka has specified brahmacharya among three subpillars which assists in healthy living being. Brahmacharya leads to conservation of shukra dhatu which is essence of ahara. This shukra dhatu is responsible for bala, virya, yash, dhairya, preeti. Development of these qualities assists higher faculty buddhi or pragya not to indulge in pragyaparadh leading to correct decisionary power and patience. Healthy state of mind is achieved with this brahmacharya. Through this paper a review over various parameters of brah- macharya have been discussed and concluded. -/- Keywords: Kama, dhairya, pragyaparadh, health, shukra dhatu. (shrink)

This article starts off with a historical section showing that deep disagreements among notions of social and political justice are a characteristic feature of the history of political thought. Since no agreement or consensus on distributive justice is possible, the article argues that political philosophers should – instead of continuously proposing new normative theories of justice – focus on analyzing the reasons, significance, and consequences of such kinds of disagreements. The next two sections are analytical. The first sketches five possible (...) reasons for deep disagreements among notions of social and political justice. The second discusses the meta-ethical relevance of the lack of consensus on justice and rejects ethical realism and cognitivism based on the argument from deep disagreements. (shrink)

The fundamental principle holds a strong ground in Ayurveda. Every medical stream has its own science in which its matter is developed, evolved and explained. From creation of living to issues of health, disease and its treatment these fundamental principles are the root. These can be enumerated as Tridosha, Panchamahabhuta, Prakriti, Ojas, Dhatu, Mala, Agni, Manas, Atma etc. They are most unique and original approach to the material creation and it has all scope to incorporate the modern development in the (...) elemental physics. The aim of Ayurveda is to maintain the proper equilibrium of dosa, dhatus, and mala constituent in order to preserve health in a healthy person and cure a disease in a diseased person.The presence of cognition as well as the absence of cognition is an indication of the mind. In the presence of senses with senses object and soul the man does not perceive a thing in the absence of mind that is to say that senses are unable to grasp the object in the absence of Manas. The term Ojas has been used in Ayurveda for the factor which prevents decay and degeneratioif the body and provides strength and support against a disease. Concept of Agni which incorporates all activities and factors responsible for digestion and metabolism in the living organism as known today, knowledge to these fundamental principles is a key to health and diseases .Maintenances of health depend on good and sound knowledge of these. Detail will be given in full paper. Keywords: Ayurveda, health, dosa, Agni, mind. (shrink)

A few weeks ago I received a copy of the PHILOSOPHICAL STUDIES, containing a review of my book John Henry Newman, Our Way to Certitude, written by Fr. Boekraad. It was very unfavourable so that anybody reading it is sure to make up his mind never to buy the book.

abstract: In Kephalaia Gnostika, the third part of his great trilogy on the ascetic and contemplative life, the early Christian desert monk Evagrios of Pontus made a statement that resonates with the story told by the Buddha in the Aggañña Sutta. Evagrios declared that there had been a time when evil did not exist, and from this premise, he extrapolated that there will come a time when evil will not exist anymore. Both Evagrios and the Buddha, it seems, were essentially (...) optimistic in their teaching, convinced that despite being subject to a "fall," human beings have agency and can work toward establishing virtue in their lives and experiencing the fruits of this labor. In order to do this, a sophisticated understanding of how the mind works is key, and the two teachers, within the lineaments of the thought worlds of their respective backgrounds, explore what contemplation and meditation offer to this end. They also discuss other qualities that contribute to the development of a "gentle warrior," a character recognizable in both traditions and notable for the level to which they have erased subjectivity and their dedication to the achievement of good outcomes. Evidence can be found in both Buddhist and Christian writings of the recognition of correlations between the structure of the cosmos and spiritual or religious experience. (shrink)

Analytic study of the Advaita philosophy of Śaṅkarācārya and its schools.

Based on the Guest 1997 organizational outcome model, this explanatory study examined the effects of five dimensions of practices of HR. i.e. performance evaluation, recruitment & selection, compensation & reward, career opportunities within organization and training & development on proximal business outcomes. The study validates components of GUEST model by integrating between HRM dimensions and banking operations, thus strengthens the existing theoretical model of GUEST by improving the comprehensiveness as it provides analytical framework for studying HR. Exploratory factor analysis and (...) confirmatory factor analysis was utilized in the current study, and tested the study hypotheses by SEM to analyze the proposed conceptual model. It was found that all five chosen HR practices had significant influence on the quality of operations however for flexibility of operations, performance appraisals and career within organization have shown significant role for banking industry of the country, Pakistan. The study contributed to the construction and validation of structural. path and measurement models of SHRM practices and two selected operational competitive outcomes based on theoretical and empirical foundations, which will help progress the human resource management future researches and important implications for HR mangers, as very little work has been done on interdisciplinary framework of HR and OM specifically within context of South Asian banking Industry. (shrink)

This is the first book to take nursing ethics beyond stock 'moral concepts' to a critical examination of the fundamental assumptions underlying the very nature of nursing. It takes as its point of departure the difficulties nurses experience practising within the confines of a bioethical model of health and illness and a hierarchical, technocratic health care system. The contributors go on to deal openly and honestly with controversial issues faced by nurses, such as euthanasia and HIV.

A partir de algunos motivos presentes en Poesie in forma di rosa, La Divina Mimesis y, sobre todo, Petrolio, atenderemos algunos motivos de la propuesta estética de Pasolini en relación con la crítica de lo político. Lo que inicialmente parece una crítica o semiología de la sociedad y lo político se revela, con el tiempo, como un problema artístico en el cual el arte es en sí político y lo político es en sí artístico. Este asunto no es más que (...) el de la forma tal y como aparece en las mencionadas obras del poeta. (shrink)

Ageing populations and rising rates of chronic disease globally have shifted key elements of disease management to ideas of integrated care and self‐management. The associated policies and programmes often focus on intervention and support beyond the sites of the hospital and clinic. These shifts have significantly impacted the delivery and practice of nursing for both nurses and the clients with whom they work. This article argues that Foucault's comments on space, place and heterotopia (1986) are useful in exploring these changes (...) from a philosophical perspective, to draw out the complexity of these programmes and add texture to discussions on the ways these shifts to localisation and the dominant discourses of self‐management and responsibility have reconfigured nursing practices. The theoretical discussion is augmented with illustrations from an Australian integrated health care programme. (shrink)

Bei der „terminalen Sedierung“ wird ein unheilbar kranker und schwer leidender Patient für den Rest seines Lebens in ein tiefes Koma versetzt. Das hierzu verwendete Morphin bzw. Midazolam kann lebensverkürzend wirken. Ist dies also eine Maßnahme, die das Leben des Patienten beendet, auf seinen Wunsch hin oder nicht? Gewöhnlich wird diese Frage mit nein beantwortet, wenn die lebensverkürzende Wirkung nur vorhersehbar, aber nicht beabsichtigt ist. Allerdings ist der Zugang der Menschen auch zu ihren eigenen Intentionen fallibel, so dass sogar ihre (...) Selbstangaben in komplexen Fällen nicht sehr zuverlässig sind. Wenn ein Arzt sagt, dass er „beabsichtigt“, das Leben eines Patienten zu verkürzen, meint er damit möglicherweise nur, dass dieses vorhersehbare Ergebnis ein erwünschtes ist. Diese Art der Einschätzung kann nicht als solche moralisch diskreditiert werden, weil sie bei anderen allgemein akzeptierten Entscheidungen unvermeidlich ist, z. B. von einer „vergeblichen“ Behandlung Abstand zu nehmen. Legitimerweise können wir von einem Fachmann erwarten, dass er begründet handelt. Deshalb sollte unsere Klassifikation von ärztlichem Handeln als „terminale Sedierung“ oder „Beendigung des Lebens des Patienten“ nicht von den Intentionen des Arztes abhängen, sondern von den in dieser speziellen Krankheitsphase bei diesem speziellen Patienten verwendeten Dosierungen. (shrink)

The contemporary debate centering round the circumference of feminist discourse has of late been very potent in addressing the issues of certain prejudiced notions in our existing patriarchal structure. This paper is an attempt to show the ongoing paradox existing in the world of feminism which has thoroughly critiqued the patriarchal culture and has naturalized sexual identities, thereby glorifying man’s supremacy and dominion. The patriarchal culture lionized the ideals of brevity, courageousness, and intellect and thought of these as the only (...) special possessions of man in society. The qualities of being submissive, kind and caring in nature is considered to be “ideal” and exclusive qualities of a woman. Even though these qualities are “ideal” to women, they are discarded from being considered as universal in nature and are thought of as insignificant in the mainstream societal structure. These qualities are treated as inferior, and exclusively womanly and hence cannot make their stand in the conventional patriarchal social order. For this reason a dilemmatic situation arises here. My effort is to show that this dilemma cannot be exposed in the sense of gender specific human qualities. (shrink)