The objective of this paper is to outline challenges associated with the inclusion of welfare issues in breeding goals for farm animals and to review the currently available methodologies and discuss their potential advantages and limitations to address these challenges. The methodology for weighing production traits with respect to cost efficiency and market prices are well developed and implemented in animal breeding goals. However, these methods are inadequate in terms of assessing proper values of traits with social and ethical values (...) such as animal welfare, because such values are unlikely to be readily available from the product prices and costs in the market. Defining breeding goals that take animal welfare and ethical concerns into account, therefore, requires new approaches. In this paper we suggest a framework and an approach for defining breeding goals, including animal welfare. The definition of breeding goals including values related to animal welfare requires a multidisciplinary approach with a combination of different methods such as profit equations, stated preference techniques, and selection index theory. In addition, a participatory approach involving different stakeholders such as breeding organizations, food authorities, farmers, and animal welfare organizations should be applied. We conclude that even though these methods provide the necessary tools for considering welfare issues in the breeding goal, the practical application of these methods is yet to be achieved. (shrink)

Background Euthanasia is a topic of intense ethical debate and it is illegal in most countries at present, including Sri Lanka. The aim of this descriptive cross-sectional study of medical students and practicing doctors was to explore the acceptance of euthanasia and physician assisted suicide, and factors influencing this opinion. Methods A customised online questionnaire which explored opinions on euthanasia was administered to first and final year medical undergraduates in University of Colombo and practicing doctors with more than 5 years (...) of work experience at The National Hospital of Sri Lanka. Attitudes on euthanasia and PAS were also assessed with the attitudes towards euthanasia Scale, which is a 10-item questionnaire. Results A total of 425 individuals responded, which included 143 first-year medical undergraduates, 141 final-year medical undergraduates and 141 practicing doctors. More participants favoured legalizing euthanasia than those directly opposing it, but a significant proportion remained undecided. The mean scores of ATE questionnaire from the whole sample were generally unfavourable towards euthanasia/PAS. Accepting euthanasia as an option for oneself was the strongest predictor of favouring euthanasia/PAS or supporting its legalization. Conclusion In this cross-sectional survey, more respondents supported legalisation of euthanasia in Sri Lanka than those openly opposing it. Yet, a significant minority that responded as “undecided” for legalisation, were more likely to have unfavourable ATE. (shrink)

Using a fictional but representative general practice consultation, involving the diagnosis of irritable bowel syndrome in a patient who is anxious for some relief from the discomfort his condition entails, this paper argues that when both a drug fails to out-perform placebo and the condition in question is a functional illness with no demonstrable underlying pathology, then the action of the drug is not only no better than placebo, and it is also no different from it either. The paper also (...) argues that, in the circumstances of the consultation described, it is striking that current governance deems it ethical for a practitioner to prescribe either a drug or a placebo, both of which appear to rely for their effectiveness on a measure of concealment on the part of the doctor, yet deems it unethical for a practitioner openly to prescribe a harmless and enjoyable substance which is likely to be no less effective than either drug or placebo and is also likely to be better-tolerated and cheaper than the drug. (shrink)

Apresentam-se os resultados clínicos principais de uma primeira investigação efectuada a familiares de doentes sob tratamento paliativo no domicílio da área de Lisboa, com o instrumento de medida da satisfação SERVQUAL Modificado. Dos 58 familiares/doentes que responderam ao questionário apenas uma minona estava insatisfeita (uma classe de 5 indivíduos mostra-se francamente insatisfeita), uma classe de 15 estava moderadamente satisfeita, havendo 38 individuos fortemente satisfeitos com a qualidade e prontidäo dos serviços prestados. Porém urna percentagem elevada de doentes, segundo a opinião (...) retrospectiva dos cuidadores, faleceu com sintomatologia agravada, nomeadamente dores (60%), obstipação (67%) e depressão/ansiedade (43%). Discute-se a consistência e validade do questionáno SERVQUAL Modificado, contextualizam-se os resultados no que é o standard da prática da MCP e integram-se na promoção da dignidade humana no fim da vida. We present the main clinical findings of research on palliative home care, carried out among relatives of patients in the Lisbon area. An adapted version of SERVQUAL was used. Of a total of 58 carers surveyed only a small number (5) was unsatisfied 15 were only moderately satisfied. 38 family carers were strongly satisfied with the services. Yet, a high percentage of patients, as viewed in retrospect by their relatives died with some aggravated symptoms: 60% with more pain, 67% constipation, and 43% anxiety/depression. We discuss the consistency and validity of this adapted SERVQUAL tool and the main results are contextualized beanng in mind the standard practice of palliative medicine and the pursuit of human dignity in death. (shrink)

Apresentamos um resumo do desenvolvimento e do contexto institucional do Projecto Humanização dos Cuidados Paliativos em Contexto Domiciliário, aprovado e financiado pela Fundação Calouste Gulbenkian. Utilizam-se largamente os próprios documentos que o justificaram e os relatórios oficiais para dar uma imagem vivida, realista e técnica das dificuldades da profissionalização e reforma dos Cuidados Paliativos, mesmo quando integrada em acções de formação num serviço de um Centro de Tratamento Compreensivo do Cancro. We put forward a synopsis of the development and institutional (...) context of the Project Humanização dos Cuidados Paliativos em Contexto Domiciliário, approved and financed by the Calouste Gulbenkian Foundation. The groundwork documents are widely used as well as official reports so as to convey a lively, realistic and technical image arising from professionalizing and reforming Palliative Medicine even when it is based on in-service training programmes in an Comprehensive Cancer Center. (shrink)

Background Informed consent confers upon participants the right to decline or accept participation in a study in equal measure. Consent declines can be used as a potential metric to assess the adequacy of the informed consent process. Limited literature is available on the reporting of consent declines in Clinical Research. We evaluated randomized controlled trials published in three high-impact factor journals for consent declines to assess the extent of exertion of autonomy by research participants. Methods CONSORT flow charts in RCTs (...) published in New England Journal of Medicine, The Lancet and Journal of the American Medical Association between 2012 and 2015 were evaluated. The total and per journal proportion of RCTs reporting consent declines was calculated. Percentage of consent declines was also compared based on number of centers and type of setting. Between-groups analysis was done using Chi Square, Chi Square for trend and a Crude odds ratio [95% C.I] were calculated. Results Only 3.7% of the published articles were RCTs. Of the 1103 RCTs, only 532 reported consent declines. JAMA had the highest RCTs reporting consent declines, the Lancet [129,150/781,924, 16.5%] had the most participants declining consent. Difference was significant using Chi square for linear trend [ p < 0.00001]. Consent decline rate was higher in developed countries relative to developing countries [cOR: 2.27, p < 0.000001] and in single centric versus multicentric studies [cOR : 3.63, p < 0.0000001]. Conclusion Both authors and journal editors need to ensure better reporting of consent declines. (shrink)

In the early nineties of the previous century, leaf languages were introduced as a means for the uniform characterization of many complexity classes, mainly in the range between P and PSPACE . It was shown that the separability of two complexity classes can be reduced to a combinatorial property of the corresponding defining leaf languages. In the present paper, it is shown that every separation obtained in this way holds for every generic oracle in the sense of Blum and Impagliazzo. (...) We obtain several consequences of this result, regarding, e. g., universal oracles, simultaneous separations and type-2 complexity. (shrink)

This little volume is a critical introduction to the phenomenological scene through discussion of the ideas of some of its more prominent exponents and an extensive analysis of the thought of its founder. About two thirds of the book is devoted to Husserl. It traces the evolution of Husserl's philosophy from an early interest in the psychological presuppositions of number, to the phenomenological analysis of acts of meaning, and finally to his unsuccessful attempt to construct a comprehensive system embracing the (...) presuppositions of knowledge in general. Previous acquaintance with Husserl's work is not necessary as Pivcevic gives critical expositions of the main theses of Husserl's Philosophy of Arithmetic, Logical Investigations, Ideas for a Pure Phenomenology and Phenomenological Philosophy, and The Crisis of European Sciences and Phenomenological Philosophy. He is careful to establish particular philosophic problems through reference to the views of other philosophers, and on different issues the position of Husserl is compared and contrasted to those of Frege, Brentano, Russell, Descartes, the positivists, the classical Empiricists and Kant. The presentation of Sartre's views includes brief discussions of European romanticism, Hegel, and Marx. Besides Sartre, Scheler and Heidegger are discussed to illustrate differing applications of the phenomenological method. The final chapter is a brief critique of the limitations of this method: the problem of "other egos," the marked tendency to anti-rationalism, and the failure to achieve its aim of a presupposition-less philosophy. Pivcevic is not totally sympathetic with the phenomenologists, which is perhaps what makes possible this critical exposition of their views. But at times one wishes his clear prose would follow a philosopher's thought further into its more obscure dimensions. His criticisms are often the standard, uninspired objections to what are generally accepted as unjustified excesses of existentialist thought. Nevertheless, this is an excellent introduction to phenomenology and especially valuable for its exposition of the thought of Edmund Husserl.--M. S. H. (shrink)

An edition of the letters of Erasmus, regarded as one of the greatest humanist writers. All 12 volumes of this work have been reissued, complete with their scholarly apparatus of commentary and notes, as well as plates.

An edition of the letters of Erasmus, regarded as one of the greatest humanist writers. All 12 volumes of this work have been reissued, complete with their scholarly apparatus of commentary and notes, as well as plates.

An edition of the letters of Erasmus, regarded as one of the greatest humanist writers. All 12 volumes of this work have been reissued, complete with their scholarly apparatus of commentary and notes, as well as plates.

An edition of the letters of Erasmus, regarded as one of the greatest humanist writers. All 12 volumes of this work have been reissued, complete with their scholarly apparatus of commentary and notes, as well as plates.

In terms of intervening in embodied experience, medical treatment is wonder-full in its ambition and its metaphysical presumption; yet, wonder’s role in clinical medicine has received little philosophical attention. In this paper, I propose, to doctors and others in routine clinical life, the value of an openness to wonder and to the sense of wonder. Key to this is the identity of the central ethical challenges facing most clinicians, which is not the high-tech drama of the popular conceptions of medical (...) ethics but, rather, the routine of patients’ undramatic but unremitting demands for the clinician’s time and respectful attention. Wonder (conceived as an intense and transfiguring attentiveness) is a ubiquitous ethical source, an alternative to the more familiar respect for rational autonomy, a source of renewal galvanizing diagnostic imagination, and a timely recalling of the embodied agency of both patient and clinician. (shrink)

The notion of patients’ duties has received periodic scholarly attention but remains overwhelmed by attention to the duties of healthcare professionals. In a previous paper the author argued that patients in publicly funded healthcare systems have a duty to participate in clinical research, arising from their debt to previous patients. Here the author proposes a greatly extended range of patients’ duties grounding their moral force distinctively in the interests of contemporary and future patients, since medical treatment offered to one patient (...) is always liable to be an opportunity cost in terms of medical treatment needed by other patients. This generates both negative and positive duties. Ten duties—enjoining obligations ranging from participation in healthcare schemes to promoting one’s own earliest recovery from illness—are proposed. The characteristics of these duties, including their basis, moral force, extent and enforceability, are considered. They are tested against a range of objections—principled, societal, epistemological and practical—and found to survive. Finally, the paper suggests that these duties could be thought to reinforce a regrettably adversarial characteristic, shared with rights-based approaches, and that a preferable alternative might be sought through the notion of a “virtuous patient” contributing to a problem-solving partnership with the clinician. However, in defining and giving content to that partnership, there is a clear role for most, if not all, of the proposed duties; their value thus extends beyond the adversarial context in which they might first be thought to arise. (shrink)

An edition of the letters of Erasmus, regarded as one of the greatest humanist writers. All 12 volumes of this work have been reissued, complete with their scholarly apparatus of commentary and notes, as well as plates.

An edition of the letters of Erasmus, regarded as one of the greatest humanist writers. All 12 volumes of this work have been reissued, complete with their scholarly apparatus of commentary and notes, as well as plates.

Required reading for anyone who believes in the equality of the sexes. A long awaited, highly acclaimed new translation of Simone De Beauvoir's landmark work.

Löwe and von Hartel have drawn attention to the striking similarity between R's contents and those of a lost manuscript bequeathed by Philippe d' Harcourt to the library at Bee. This manuscript is described in a twelfth-century catalogue as follows:7 ‘in alio Seneca de naturalibus questionibus et Adelermus Batensis [Adhelardus Bathonensis Becker), Proba vates, Aurea Capra, et liber Hildeberti Turonensis archiepiscopi de dissensione interioris et exterioris hominis, et sermones eius et uita ipsius.’.