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)

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)

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.

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)

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.

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 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)

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)

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)

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

Biography of Ibn Rushd... Averroes, old heathen, If only you had been right, if Intellect Itself were absolute law, sufficient grace. Our lives could be a myth of captivity. Which we might enter: an unpeopled region.

Sterelny’s Thought in a Hostile World ([ 2003 ]) presents a complex, systematically structured theory of the evolution of cognition centered on a concept of decoupled representation. Taking Godfrey-Smith’s ([ 1996 ]) analysis of the evolution of behavioral flexibility as a framework, the theory describes increasingly complex grades of representation beginning with simple detection and culminating with decoupled representation, said to be belief-like, and it characterizes selection forces that drive evolutionary transformations in these forms of representation. Sterelny’s ultimate explanatory target (...) is the evolution of human agency. This paper develops a detailed analysis of the main cognitive aspects. It is argued that some of the major claims are not correct: decoupled representation as defined doesn’t capture belief-like representation, and, properly understood, decoupled representation turns out to be ubiquitous among multicellular animals. However, some of the key ideas are right, or along the right lines, and suggestions are made for modifying and expanding the conceptual framework. (shrink)

A relatively high incidence of unsatisfactory review decisions is widely recognised and acknowledged as ‘the peer review problem’. Factors contributing to this problem are identified and examined. Specific examples of unreasonable rejection are considered. It is concluded that weaknesses of the ‘peer review’ system are significant and that they are well known or readily recognisable but that necessary counter-measures are not always enforced. Careful management is necessary to discount hollow opinion or error in review comment. Review and referee functions should (...) be quite separate. (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)

The present article aims to explain Kamala??la’s understanding of the nature of insight, specifically considering it as the ‘discernment of reality’ -- a technical term identified with insight in the author’s well known Bh?van?krama? texts. I approach my analysis of bh?ta-pratyavek?? from three different angles. I begin by providing a rationale for its translation. This is followed by an account of Kamala??la’s reading of key passages in the La?k?vat?ra S?tra describing the process to which the term refers. Here the aim (...) is to illustrate Kamala??la’s understanding of bh?ta-pratyavek?? as it is actually experienced in meditation. The final section examines bh?ta-pratyavek?? in relation to other important technical terminology employed in the course of making arguments against his historical rival in debate, the Ch’an monk Mo ho yen. By providing these three different perspectives on the same process it is my hope that both scholars and practitioners will be able to more fully comprehend and benefit from the instructions provided by the ancient master Kamala??la. (shrink)

Résumé Le cadran solaire analemmatique est présenté pour la première fois par un mathématicien français, appelé Vaulezard, dans un petit fascicule publié en 1640. Suit un deuxième ouvrage, plus complet, en 1644. Dernier venu, ce cadran attire l'attention d'importants savants tels que Foster et Lalande. Parfait dès le départ, il a néanmoins la singulière particularité d'inspirer diverses tentatives d'amélioration, plutôt infructueuses, et d'être à l'origine de quelques variétés de cadrans analemmatiques qui, elles, connaissent un franc succès. Nous apportons la preuve (...) trigonométrique et, pour la première fois semble‐t‐il, la preuve géométrique de sa validité astronomique en suivant fidèlement la méthode de construction indiquée par Vaulezard. Nous effectuons, en outre, un survol aussi exhaustif que possible des différents modèles dérivés de ce cadran ainsi que de la littérature les concernant. Summary The analemmatic sundial was briefly presented for the first time in 1640 by the French mathematician Vaulezard and was described in more detail by him in 1644. The analemmatic dial is the last genuine sundial to be invented and it has attracted the attention of some important scholars such as Foster and Lalande. Although perfect from the very beginning, it had the unusual particularity of inspiring several unfortunate attempts at its improvement as well as being at the origin of a few other types of analemmatic dials, which met with a certain success. We provide here the trigonometric proof and for the first time, the geometric proof of its astronomical validity by closely following the construction method of Vaulezard. We also make a comprehensive survey of the different kinds of analemmatic sundials and of their literature. (shrink)

Transformation in the discipline of Social Sciences is a global phenomenon but in the post-colonial societies it means two things. First, far reaching societal changes resulting into the emergence of new fields in Social Sciences fulfilling new conditions and requirements of society. Second, the growing need and relevance of Social Sciences research so as to address issues which cause serious societal changes. Marginalization of Social Sciences and social scientists in case of Pakistan is not a new phenomenon. There cannot be (...) any time line which can be given for modernizing Social Sciences in Pakistan which can meet the criteria and standards of 21st century. Yet, those who teach and do research in different subjects of Social Sciences must come forward and play a leadership role in this regard. This would require a paradigm shift in the arena of admitting students and appointing faculty so that the best stuff both at the student and faculty level is motivated to join the subjects of Social Sciences in order to ensure quality control and standard which seem to have deteriorated in the last four decades is restored. By attracting the best talent in the subjects of Social Sciences one can expect positive transformation in the state and societal patterns of Pakistan. (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)

ABSTRACT Many people now believe that human reproductive cloning – once sufficiently safe and effective – should be permitted on the grounds that it will allow the otherwise infertile to have children that are biologically closely related to them. However, though it is widely believed that the possession of a close genetic link to our children is morally significant and valuable, we argue that such a view is erroneous. Moreover, the claim that the genetic link is valuable is pernicious; it (...) tends to give rise to highly undesirable consequences, and therefore should be combated rather than pandered to. The emphasis on the genetic is unwarranted and unfortunate; rather than giving us moral reason to support reproductive cloning in the case of infertility, the fact that cloning requests are likely to be motivated by the genetic argument gives us reason to oppose its availability. (shrink)

McTaggart's ideas on the unreality of time as expressed in "The Nature of Existence" have retained great interest for many years for scholars, academics and other philosophers. In this essay, there is a brief discussion which mentions some of the high points of this philosophical interest, and goes on to apply his ideas to modern physics and neuroscience. It does not discuss McTaggart's C and D series, but does emphasise how the use of derived versions of both his A and (...) B series can be of great virtue in discussing both the abstract physics of time, and the present and future importance of McTaggart's ideas to the subject of time. Indeed an experiment using human volunteers and dynamic systems modelling which was carried out is described, which illustrates this fact. The Many Bubble Interpretation, which also derives from McTaggart's ideas, is discussed and various examples of its use and effectiveness are referred to. The Schrodinger Cat paradox is essentially resolved in principle, the quantum Zeno effect interpretable, Kwiat's recent result referred to, and the newly discovered reverse Stickgold effect described. (shrink)

The “hypervigilance, escape, struggle, tonic immobility” evolutionarily hardwired acute peritraumatic response sequence is important for clinicians to understand. Our commentary supplements the useful article on human tonic immobility (TI) by Marx, Forsyth, Gallup, Fusé and Lexington (2008). A hallmark sign of TI is peritraumatic tachycardia, which others have documented as a major risk factor for subsequent posttraumatic stress disorder (PTSD). TI is evolutionarily highly conserved (uniform across species) and underscores the need for DSM-V planners to consider the inclusion of evolution (...) theory in the reconceptualization of anxiety and PTSD. We discuss the relevance of evolution theory to the DSM-V reconceptualization of acute dissociativeconversion symptoms and of epidemic sociogenic disorder(epidemic “hysteria”). Both are especially in need of attention in light of the increasing threat of terrorism against civilians. We provide other pertinent examples. Finally, evolution theory is not ideology driven (and makes testable predictions regarding etiology in “both directions”). For instance, it predicted the unexpected finding that some disorders conceptualized in DSM-IV-TR as innate phobias are conditioned responses and thus better conceptualized as mild forms of PTSD. Evolution theory may offer a conceptual framework in DSM-V both for treatment and for research on psychopathology. (shrink)

The paper concentrates on the most pressing question of Indian philosophy: what is the exact connotation of a word or what sort of entity helps us to identify the meaning of a word? The paper focuses on the clash between Realism (Nyāya) and Apoha vāda (Buddhist) regarding the debate whether the meaning of a word is particular/universal or both. The paper asserts that though Naiyāyikas and Mīmāṁsakas challenged against Buddhist Apoha vāda, yet they realized that to establish an opinion in (...) support of a word that conceptually denotes a negative meaning first would be a very difficult task. (shrink)

A pesquisa sobre o dogma mariano mostra que, no seu desenvolvimento, a experiência, mas, sobretudo, a fé vivida, precedeu as proclamações dogmáticas oficiais, de modo que é importante que o dogma mantenha contato com a fé viva da Igreja, pois é nesse contato, que aquilo que está ainda implícito se torne sempre mais explícito sem que haja mudança no seu conteúdo formal, porque não se trata de adição de verdades, e sim de clarificação da verdade. Esse estudo mostra também a (...) contribuição da psicologia das profundezas na compreensão da relação entre experiência e dogma. (shrink)