Hip fractures are common and serious injuries in the geriatric population. Obtaining informed consent for surgery in geriatric patients can be difficult due to the high prevalence of comorbid cognitive impairment. Given that virtually all patients with hip fractures eventually undergo surgery, and given that delays in surgery are associated with increased mortality, we argue that there are select instances in which it may be ethically permissible, and indeed clinically preferable, to initiate surgical treatment in cognitively impaired patients under the (...) doctrine of presumed consent. In this paper, we examine the boundaries of the license granted by presumed consent and use the example of geriatric hip fracture to build an ethical framework for understanding the doctrine of presumed consent. The license to act under presumed consent requires three factors: patient incapacity, clinical urgency and clarity on the correct course of action. All three can apply to geriatric hip fracture. The typical patient frequently lacks capacity. Delays in initiating surgical treatment are associated with markedly increased mortality rates. Last, there appears to be consensus that surgery is the preferred treatment. Nonetheless, because there is a window of safe delay during which treating physicians can stabilize the patient, address reversible causes of cognitive impairment and identify surrogate decision makers, presumed consent should be invoked only as a method of last resort. A medical situation need not be characterized by risk of imminent and certain death for presumed consent to be relevant. Rather, there are two distinct windows that must be considered: the time interval in which action may be delayed without danger, and the time interval needed to obtain a better form of consent. Presumed consent is appropriate only when the latter exceeds the former. (shrink)

This study asks after the fate of sophistry in the Eleatic Stranger's investigation of the best of the six regimes governed by law, and outlines as far as possible the role of the rhetor under the supervision of the true statesman, as well as the function and effects of myth on the citizens of the best regime. In short, I argue that Socrates' competitors do, in a qualified manner, still have a place in such a polis precisely where the work (...) of gathering intelligence finds its civic limit. (shrink)

This article takes up the question of how to facilitate substantive inclusion in deeply divided societies. Turning to deliberative democracy and consociationalism, we find that there is a surprising amount of overlap between the two potentially contradictory models of inclusion. We consider the deliberative potential of consociational institutions that not only address majority and minority relations, but that also find ways to include minorities within minorities. To this end, we examine the institutions that make up a consociation and recommend a (...) two-stage approach to deliberation that facilitates the articulation of public reasons in political decision-making. We argue that extending broad inclusion in an initial stage of deliberations where people do not have to adhere to the criterion of public reason avoids pre-emptive exclusions, while introducing this criterion in a second, decision-making stage of deliberations retains the benefits of deliberative democracy. This two-stage approach addresses the democratic concerns in consociational democracy vis-à-vis minority groups and in deliberative democracy vis-à-vis marginalized groups (that is, minorities within minorities). We argue that adopting this two-stage approach will deepen the level of inclusion found within consociational democracies and widen the applicable scope for deliberative democracy, which is often thought most amenable to small-scale decision-making. (shrink)

In a recent response to Persson & Savulescu’s Unfit for the Future, Nicholas Agar argues that moral bioenhancement is dangerous. His grounds for this are that normal moral judgement should be privileged because it involves a balance of moral subcapacities; moral bioenhancement, Agar argues, involves the enhancement of only particular moral subcapacities, and thus upsets the balance inherent in normal moral judgement. Mistaken moral judgements, he says, are likely to result. I argue that Agar’s argument fails for two reasons. Firstly, (...) having strength in a particular moral subcapacity does not necessarily entail a worsening of moral judgement; it can involve strength in a particular aspect of morality. Secondly, normal moral judgement is not sufficiently likely to be correct to be the standard by which moral judgements are measured. (shrink)

An affectionate and thoughtful look at the history of county fairs and their tradition and persistence today reveals the county fair as an important institution that helped define America as a nation of free-thinking, self-reliant, and ...

The 18th century figure, Joseph de Maistre, has long been regarded as characterising the Counter-Enlightenment, but his intellectual relationship to 18th-century philosophy remains unexplored. This is a comprehensive assessment of his response to the Enlightenment.

Long known solely as fascism s precursor, Joseph de Maistre (1753-1821) re-emerges in this volume as a versatile thinker with a colossally diverse posterity whose continuing relevance in Europe is ensured by his theorization of the ...

Joseph de Maistre's reputation as a writer is legendary. His style, unique and alive, moulded the French language anew. It sabotaged his attempts at anonymous publication and earned him, through the centuries, the praises of enemies and admirers. Yet the relationship between Maistre's thought and writing remains ill-known. This collection is the first to examine how Maistre's ideas - including his denunciation of the written word - intersected with his writing practices and personas. The essays disclose an author formed by (...) duty and affectionate relationships, by the conventions of public combat, by an intense sense of history, and by the imperatives of Revolution."--Series page. (shrink)

Philosophers sometimes give arguments that presuppose the following principle: two theories can fail to be empirically equivalent on the sole basis that they present different “thick” metaphysical pictures of the world. Recently, a version of this principle has been invoked to respond to the argument that composite objects are dispensable to our best scientific theories. This response claims that our empirical evidence distinguishes between ordinary and composite-free theories, and it empirically favors the ordinary ones. In this paper, I ask whether (...) this response to the dispensability argument is tenable. I claim that it is not. This is because it presupposes an indefensible thesis about when two empirical consequences are distinct or the same. My argument provides some insight into what our empirical consequences are, and I conclude that empirical evidence is radically metaphysically neutral. This gives us some insight into the significant content of our scientific theories—the content that a scientific realist is committed to—and I show how this insight relates to questions about theoretical equivalence more broadly. (shrink)

Although often neglected, this work is crucial for an understanding of Maistre's epistemology, which formed the philosophical basis for his critique of modern science as well as for his criticisms of other aspects of Enlightenment thought. Given Maistre's stature in the history of conservative thought, his critique of Bacon remains significant for what it tells us about Maistre's own thought, for what it reveals about attitudes toward science in his time, and for its relevance for issues that remain under debate (...) today. (shrink)

DNA repetitions may provoke heterochromatinization. We explore here a model in which multiple cis‐acting sequences that display no silencing activity on their own (protosilencers) may cooperate to establish and maintain a heterochromatin domain efficiently. Protosilencers, first defined in budding yeast, have now been found in a wide range of genomes where they appear to stabilize and to extend the propagation of heterochromatin domains. Strikingly, isolated or moderately repeated protosilencers can also be found in promoters where they participate in transcriptional activation (...) and have insulation functions. This suggests that the proper juxtaposition of a threshold number of protosilencers converts them from neutral or transactivating elements into ones that nucleate heterochromatin. Interactions might be transient or permanent, and are likely to occur over distances by looping. This model provides a conceptual framework for as varied phenomena as telomere‐driven silencing in Drosophila, X inactivation in mammals, and rDNA silencing in S. cerevisiae. It may also account for the silencing that occurs when multiple copies of a transgene are inserted in tandem. BioEssays 24:828–835, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

To assess ethics pedagogy in science and engineering, we developed a new tool called the Engineering and Science Issues Test. ESIT measures moral judgment in a manner similar to the Defining Issues Test, second edition, but is built around technical dilemmas in science and engineering. We used a quasi-experimental approach with pre- and post-tests, and we compared the results to those of a control group with no overt ethics instruction. Our findings are that several stand-alone classes showed a significant improvement (...) compared to the control group when the metric includes multiple stages of moral development. We also found that the written test had a higher response rate and sensitivity to pedagogy than the electronic version. We do not find significant differences on pre- test scores with respect to age, education level, gender or political leanings, but we do on whether subjects were native English speakers. We did not find significant differences on pre- test scores based on whether subjects had previous ethics instruction; this could suggest a lack of a long-term effect from the instruction. (shrink)

This case study examines a teaching candidate's completion of a major assessment project, including his approach to lesson planning and assessment design, the creation of rubrics, and the crafting of narratives to analyze his students’ work. Qualitative data analysis suggests that this beginning teacher, who excelled in planning and teaching for historical thinking, needed additional support in honing his skills with respect to discipline-based assessment. In his analysis of students’ work and his reflection on the assessments, the teaching candidate retreated (...) to generalist stances that made no references to thinking historically. The teaching candidate demonstrated an ability to design discipline-based assessments and an inability to use a discipline-based framework to assess and describe his students’ work. (shrink)

Extreme narcissistic organizations are unable to behave ethically because they lack a moral identity. While such organizations are not necessarily unethical intentionally, they become self-obsessed and use a sense of entitlement, self-aggrandizement, denial, and rationalizations to justify anything they do. Extreme narcissistic organizations might develop formal ethics programs, but such programs will have little effect on behavior.

To assess ethics pedagogy in science and engineering, we developed a new tool called the Engineering and Science Issues Test (ESIT). ESIT measures moral judgment in a manner similar to the Defining Issues Test, second edition, but is built around technical dilemmas in science and engineering. We used a quasi-experimental approach with pre- and post-tests, and we compared the results to those of a control group with no overt ethics instruction. Our findings are that several (but not all) stand-alone classes (...) showed a significant improvement compared to the control group when the metric includes multiple stages of moral development. We also found that the written test had a higher response rate and sensitivity to pedagogy than the electronic version. We do not find significant differences on pre-test scores with respect to age, education level, gender or political leanings, but we do on whether subjects were native English speakers. We did not find significant differences on pre-test scores based on whether subjects had previous ethics instruction; this could suggest a lack of a long-term effect from the instruction. (shrink)

Initial moves to develop a new generation of commercial supersonic transports to succeed Concorde are already under way. Aircraft manufacturers promise a plane that will withstand both economic and environmental scrutiny. Yet, the crash of an Air France Concorde at Paris in July 2000 has caused further doubts about the viability of SSTs. This study revisits the previous debate surrounding Concorde to explore the potential for current initiatives to overcome the public’s anxiety of further environmental degradation. This article seeks, therefore, (...) to examine the role that environmental issues and campaign groups played in the development of the first generation of SSTs, concentrating on the influence of global environmental arguments on political decision making. Debate surrounding the global environmental impact of SSTs foreshadows later attention to human impact at the planetary scale. It provides the first illustration of the often complex links between attempted protection of the global environment and political and public perceptions of national vested interests. (shrink)

Evaluates trade-offs and uncertainties inherent in achieving sustainable energy, analyzes the major energy technologies, and provides a framework for assessing policy options.

Keeping Kids Safe, Healthy, and Smart is for all adults who interact with kids—whether they be parents, teachers, or other caregivers—and provides specific suggestions for keeping children safe from hidden and open dangers wherever they spend time. Major threats and hidden dangers to children in our country are examined, including threats in school; threats in cyberspace , and a wide range of other threats such as self-mutilation, accidents, abuse, drugs, and mental illness.

À partir de la métaphore de « corps familial », l’auteur propose quelques hypothèses invitant à « faire travailler » ensemble les concepts de la thérapie familiale et les théories de l’adolescence. Le pubertaire impliquerait une sorte d’autonomie des organes génitaux, une fragmentation, phénomènes mis en parallèle avec les risques liés à l’autonomisation d’un membre de la famille au moment de son adolescence. L’adolescence est ainsi entendue comme une épreuve pour le sujet et pour le corps familial, nécessitant un travail (...) de liaison… Est particulièrement abordé ici le vécu parental de perte. (shrink)