Hastings Center Report, Volume 52, Issue 2, Page 10-14, March‐April 2022.

The debate over futility is driven, in part, by physicians' desire to recover some measure of decision-making authority from their patients. The standard approach begins by noting that certain interventions are futile for certain patients and then asserts that doctors have no obligation to provide futile treatment. The concept of futility is a complex one, and many commentators find it useful to distinguish ‘physiological futility’ from ‘qualitative futility’. The assertion that physicians can decide to withhold physiologically futile treatment generates little (...) controversy. The claim that they can withhold qualitatively futile treatment runs afoul of standard objections to medical paternalism. There is reason to believe that the conceptual distinction will not be maintained in clinical practice. This paper contends that the scientific data which would support a physician's unilateral decision to withhold physiologically futile treatment also provide support for an institutional policy restricting access to the treatment. The data the doctor uses to take decision-making power out of the hands of the patient can be used by the administrator to take power out of the hands of the doctor. While this loss of power is unproblematic, there is reason to believe that the ambiguity in the term ‘futility’ will allow a much greater loss of physicians' power. Keywords: futility, physician authority CiteULike Connotea Del.icio.us What's this? (shrink)

This paper compares the ethical decisions and attitudes of business students and practitioners. Recent unpublished data from a national study of over 1600 students are contrasted with information reported previously. Students are found consistently to make less ethical choices than practitioners, and there is some indication that students are making less ethical choices in the 1980s than in the 1960s. In addition, both students and practitioners agree that buyers should beware, view the role of business more narrowly, and find fewer (...) incentives to behave ethically over time. Codes of ethics appear to be less influential than the individual''s strong personal value system and one''s superiors behaving ethically; support for codes is declining. The paper concludes with observations about the limitations and possibilities for survey research in this area drawing on other studies that used the same instrument utilized for this paper. Some implications for future research are suggested. (shrink)

A reprint, with new Introduction, of the Harper Torch edition of 1970. The famous introductory lectures collected in this volume represent the distillation of Hegel’s mature views on the three most important activities of spirit, and have the further advantage, shared by his lectures in general, of being more comprehensible than those works of his published during his lifetime. A new Introduction, Select Bibliography, Analytical Table of Contents, and the restoration in the section headings of the outline of Hegel’s lectures (...) make this new edition particularly useful and welcome. (shrink)

One of the most serious theoretical obstacles to contemporary spacetime substantivalism is Earman and Norton's hole argument. We argue that applying the bundle theory of substance to spacetime points allows spacetime substantivalists to escape the conclusion of this argument. Some philosophers have claimed that the bundle theory cannot be applied to substantival spacetime in this way due to problems in individuating spacetime points in symmetrical spacetimes. We demonstrate that it is possible to overcome these difficulties if spatiotemporal properties are viewed (...) as tropes rather than universals. (shrink)

The liver was used widely in early studies of polarised transport but has been largely overlooked in recent years, mostly because of the development of epithelial cell lines which provide more tractable experimental systems. The majority of membrane proteins and lipids reach the hepatocyte apical membrane by transcytosis and it remains unclear whether there is a direct route for apical targeting, although the pathways present have yet to be fully characterised. The recent development of systems that allow hepatocyte transport processes (...) to be studied in culture and the observation that transcytosis can be significantly stimulated under physiological conditions suggest that hepatocytes have a role to play in future studies of polarised transport. This review discusses the known features of polarised membrane traffic in hepatocytes and contrasts them with the characteristics of vesicular transport in other epithelial cell types. (shrink)

This book examines transaction cost economics, the influential theoretical perspective on organizations and industry that was the subject of Oliver Williamson's seminal book,Markets and Hierarchies. Written by leading economists, sociologists, and political scientists, the essays collected here reflect the fruitful intellectual exchange that is occurring across the major social science disciplines. They examine transaction cost economics' general conceptual orientation, its specific theoretical propositions, its applications to policy, and its use in systematic empirical research. The chapters include classic texts, broad review (...) essays, reflective commentaries, and several new contributions to a wide range of topics, including organizations, regulations and law, institutions, strategic management, game theory, entrepreneurship, innovation, finance, and technical information. The book begins with an overview of theory and research on transaction cost economics, highlighting the specific accomplishments of scholars working within the perspective and emphasizing the enormous influence that transaction cost reasoning exerts on the social sciences. The following section covers conceptual uses for the transaction cost framework and major theoretical or methodological elements within it, such as bounded rationality. While advancing some interesting theoretical propositions, these chapters are in fact more ambitious: each examines a specific field, area, or research program and attempts to fashion a new way of thinking about research questions. In the section on industrial applications, contributors study the application of transaction cost theory to a range of problems in utilities, telecommunications, laser printing, and early international trade. The book closes with four microanalytical chapters that delve into the structures and behaviors of specific aspects of firms and organizations: boards of directors, equity structures, employment models, human resource policies and practices, technology strategies, and innovation events. Firms, Markets, and Hierarchies collects excellent social science work on transaction cost economics, taking stock of its status, charting its future development, and fostering its renewal and evolution. (shrink)

Nietzsche's harsh attacks on modernity suggest a problem: if the modern age is so diseased, can we overcome it and move on to something higher? Or is the disease too severe? I examine the question by studying Nietzsche's view of spiritual health. Spiritual illness, even in the highest man, is nothing unusual or necessarily debilitating. Even the strongest have been infected since the earliest days of civilization. Indeed, infection with slave morality and bad conscience are requirements for spiritual elevation. And (...) the disease serves life by giving the strong something to struggle against, as well as making possible the spiritual greatness required to revalue all values. The higher man, then, is a mixture of health and disease. The revaluation of values is extraordinarily dangerous, but not impossible. Key Words: great politics • Nietzsche's revaluation of all values • On the Genealogy of Morals • spiritual health. (shrink)

Albert Einstein insists that his epistemology made his discovery of relativity possible. He believed it was his understanding of the relationship of experience and reason that allowed him to reconsider certain “truths” of physics. Specifically, he believed that reality and thought were independent but related, and that conceptual systems are independent of but conditioned by experience. Failure to understand the relation between experience and reason had, Einstein believed, limited progress in science. His understanding of the relation, on the other hand, (...) enabled him to formulate relativity theory and therefore provides one example of the relevance of philosophy to scientific inquiry. When Albert Einstein discussed his discoveries in physics, particularly the theory of relativity, he often began with an explanation of his epistemology and referred to thinkers like Hume and Kant. Einstein may have been a physicist, but he had definite ideas about how we know and regarded epistemological theories as crucial to science, especially to physics. Indeed, he placed such importance on the question of how we know that the discussion of his work in his “Autobiographical Notes” begins with the question, “What, precisely, is ‘thinking?'” (1951, 7). The correct answer to this philosophical question, he believed, makes progress in science possible. The present article focuses on the relationship of the two elements, experience and reason, in Einstein's epistemology. Einstein himself frequently concentrates on what he characterizes as “the eternal antithesis between the two inseparable components of our knowledge, the empirical and the rational” (1934b, 271) in his papers and lectures on physics, for he regards them as independent in origin but related in scientific truth. His insistence that experience and reason do not determine one another yet must be related proved, for him, to be a necessary but not sufficient condition for the formulation of relativity theory and for scientific progress in general. The discussion of the relationship has four parts. First, experience and reason are explained; included in this explanation are Einstein's reasons for maintaining that the two are independent. The second section discusses the connection between the two that produces truth and knowledge. The third section follows with discussion of the way that Einstein believes reason can be both conditioned by and independent of experience. Finally, the significance of this understanding of the relation for relativity theory is examined. (shrink)

Nurse researchers are increasingly adopting qualitative methodologies for research practice and theory development. These approaches to research are, in many cases, more appropriate for die field of nursing inquiry than the previously dominant techno‐rational methods. However, there remains the issue of adapting methodologies developed in other academic disciplines to the nursing research context. This paper draws upon my own experience with interpretive research to raise questions about the issue of nursing research within a social science research framework. The paper argues (...) that by integrating the characteristics of nursing practice with the characteristics of research practice, the researcher can develop a ‘nursing lens’, an approach to qualitative research that brings an added dimension to social science methodologies in the nursing research context. Attention is drawn to the unique nature of the nurse‐patient relationship, and the ways in which this aspect of nursing practice can enhance nursing research. Examples are given from interview transcripts to support this position. (shrink)

The Post-Information Age will see the merger of humans and their technologies, perhaps creating an entirely new species.

John Amos Comenius was a revolutionary leader in both the church and the academy in 17th century Europe. Born and raised in Moravia and firmly grounded in the doctrine of the United Church of the Brethren, Comenius rose from obscurity in what is now the Czech Republic to become recognized around Europe and beyond as an innovative and transformational leader. He contributed to efforts such as advocating for universal education, authoring classroom textbooks, shepherding local churches and his entire denomination, and (...) working for unity and peace among Christians across Europe. Though for many decades after his death he seemed to be lost to time, there has been a resurgence of scholarly interest in the ideas and methods of Comenius. His life and work can serve as a source of encouragement and inspiration to church and educational leaders today. (shrink)