Considering that getting along in civil society is based on the expectation that people will do what they say they will do, i.e., essentially live up to their explicit or implicit promises, it is amazing that so little scientific attention has been given to the act of promising. A great deal of research has been done on the moral development of children, for example, but not on the child’s ability to make and keep a promise, one of the highest moral (...) achievements. What makes it possible developmentally, cognitively, and emotionally to make a promise in the first place? And on the other hand, what compels one to keep a promise when there seems to be no personal advantage in doing so, and even when harm can be predicted? How do we know when a promise is offered seriously to be taken at face value, and how do we understand that another is only a polite gesture, not to be taken seriously? In _Promises, Oaths, and Vows: On the Psychology of Promising_, Herbert Schlesinger addresses these questions, drawing on the literature of moral development in children; the psychotherapy of a patient who regularly broke promises that were unnecessary in the first place; those who were regarded as "promising youngsters" who did not fulfill their "promise"; and those who feared making a promise, a commitment, or a threat out of fear that, once made, the utterance would take on a life of its own and could never be taken back. Furthermore, he illustrates his conclusions by examining the widespread use of promising in classical literature, such as Greek drama and the plays of Shakespeare, as well as the motivating and reifying power of the promise in Western religious traditions. With a style honed over the penning of two previous books, Schlesinger once again produces a work grounded in a firm analytic sensibility, but which also retains the wit and candor of the seasoned analyst. His seminal investigation of this all but neglected topic in the clinical literature is as timely as it is scholarly, and – with the title firmly in mind – _Promises, Oaths, and Vows_ is assured to be a worthy addition to any clinician’s library and a provoking investigation into Nietzsche’s notion of man as "the animal who makes promises.". (shrink)

What sets off the termination of analysis and psychodynamic therapy from the variety of endings that enter into all human relationships? So asks Herbert J. Schlesinger in _Endings and Beginnings: On Terminating Psychotherapy and Psychoanalysis_, a work of remarkable clarity, conceptual rigor, and ingratiating readability. Schlesinger situates termination - which he understands, variously, as a phase of treatment, a treatment process, and a state of mind - within the family of "beginnings and endings" that permeate one another throughout the (...) course of therapy. For Schlesinger, therapeutic endings cannot be aligned with the final phase of treatment; ending-phase phenomena are ongoing accompaniments of therapeutic work. They occur whenever patients achieve some portion of their treatment goals and supervene when therapy stagnates. Small wonder that an assessment of the patient's relationship to time and capacity to end therapy are key aspects of diagnostic evaluation. By linking beginning and ending phases not to the chronology of treatment but to the patient’s experience of it, Schlesinger brings revivifying insight to a host of psychodynamic concepts. Nor does he shy away from a trenchant critique of the instrumental “medical model” of psychiatric and psychotherapeutic training, which militates against the therapeutic exploration of treatment endings. Schlesinger's exemplification of how to begin treatment from the point of view of ending; his sensitive delineation of the mid-treatment "ending" crises characteristic of "vulnerable patients"; his richly woven case vignettes illustrating various "ending" contingencies and permutations - these inquiries are gems of pragmatic clinical wisdom. _Endings and Beginnings_ distills lessons learned over the course of a half century of practicing, teaching, and supervising psychotherapy and psychoanalysis and is a gift to the profession. (shrink)

In this paper certain basic assumptions about causation will be made explicit and then an attempt will be made to show, on the basis of those assumptions, that causation must be supplemented by an extra-causal operation of a selective nature. It is hoped that our assumptions will have in their own right a certain general acceptability, but since assumptions or “postulate sets”, whether antecedently acceptable or not are usually chosen for the purpose of proving something already deemed desirable, a word (...) should be said as to why it was thought desirable to argue for selectivity. (shrink)

Here is a simple, clear, useful proof that quantum mechanics contradicts Einstein, Podolsky, and Rosen's local realistic assumptions. It is a variant of the powerful argument first worked out by Daniel Mordechai Greenberger, Michael A. Horne, and Anton Zeilinger. This version uses the eigenstates of two orthogonal spin components for three spin-1/2 particles. No operator or matrix algebra is necessary. A novel discussion of the background and history serves to introduce this proof and to place it in the context of (...) Danny's work. (shrink)

Health care in France falls almost exclusively under theresponsibility of the Social Security department, which coversalmost all the expenditures related to health care,whether hospitalization or medication is concerned.For severe diseases or surgery the coverage is likelyto reach as much as 100%. The medical expendituresfor several severe diseases, such as cancer, myocardialinfarction, or neurodegenerative diseases are 100% coveredfor a period of time as long as three months. For some procedures, full coverage may be achieved by usinga subscription to private health care (...) insurance.Access to cover by the state has recently been openedto anyone living in France, after passage of a special law. There is still a lack of intensive care and hospice beds, given the rapidly increasing number of elderly who cannot be maintainedat home. There is a tendency to reduce the number ofbeds in private and public hospitals due to thegreat number of such institutions and the generalconcern that a low volume of procedures, associatedwith inexperienced health care professionals, is likelyto increase morbidity and mortality as well as publichealth care expenditure. Patients are still free tochoose doctors and hospitals (whether privateor public), provided that beds are available and thatspecific procedures can be carried out in thevicinity. So far no waiting list is needed, exceptfor specific procedures performed by a few specialists of high repute. Health care expenses are increasingcontinuously, which results in a very expensive systemin France. (shrink)

This book addresses one of the most urgent questions in American society today, one that is currently in the spotlight and hotly debated on all sides: Who shall rule the schools--parents or educators? _School Choice or Best Systems: What Improves Education?_ presents an overview of research and practical applications of innovative--even radical--school reforms being implemented across the United States. These fall along a continuum ranging from "parental choice" to "best systems." At the one extreme are schools of choice, which allow (...) parents to choose and even govern schools for their children. These include charter schools, traditional private and parochial schools, schools that are privately governed but publicly funded through vouchers, and those that are funded by private scholarships provided by both corporations and wealthy individuals. At the other extreme are centralized state or district systems, based on reform initiatives and new systems of education that have been developed in response to views of citizens and legislators that schools can do much better. These schools, which specify uniform goals, policies, and programs for each school, are highly innovative systems based on research or representing advanced thinking about "what works," and have attracted wide interest. Important questions related to schools of choice and best systems are addressed: How can we choose among schools of choice and best systems? Among the various approaches within each of these alternatives? How can we understand their guiding principles and operational practices? What results do they produce? How can we evaluate their claims? In choosing among the alternatives, how should issues of student achievement, accountability, costs, feasibility, and equity be factored in? This volume brings together leading researchers and education leaders who have carried out the latest studies and advances in the field, providing a forum for them to set forth the arguments and evidence that will be most helpful in making choices for tomorrow's schools. It does not provide a single "right" answer--values and preferences differ across parents, schools, districts, and states. However, there are benefits for all from seeing the rigorous research, challenging thinking, and alternate points of view this volume presents. (shrink)

Rice is the most important crop species on earth, providing staple food for 70% of the world's human population. Over the past four decades, successes in classical breeding, fertilization, pest control, irrigation and expansion of arable land have massively increased global rice production, enabling crop scientists and farmers to stave off anticipated famines. If current projections for human population growth are correct, however, present rice yields will be insufficient within a few years. Rice yields will have to increase by an (...) estimated 60% in the next 30 years, or global food security will be in danger. The classical methods of previous green revolutions alone will probably not be able to meet this challenge, without being coupled to recombinant DNA technology. Here, we focus on the promise of these modern technologies in the area of nitrogen acquisition in rice, recognizing that nitrogen deficiency compromises the realization of rice yield potential in the field more than any other single factor. We summarize rice‐specific advances in four key areas of research: (1) nitrogen fixation, (2) primary nitrogen acquisition, (3) manipulations of internal nitrogen metabolism, and (4) interactions between nitrogen and photosynthesis. We develop a model for future plant breeding possibilities, pointing out the importance of coming to terms with the complex interactions among the physiological components under manipulation, in the context of ensuring proper targeting of intellectual and financial resources in this crucial area of research. BioEssays 26:683–692, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

The participation of vulnerable patients in clinical research poses apparent ethical dilemmas. Depending on the nature of the vulnerability, their participation may challenge the ethical principles of autonomy, non-maleficence, or justice. On the other hand, non-participation may preclude the building of a knowledge base that is a prerequisite for defining the optimal clinical management of vulnerable patients. Such clinical uncertainty may also incur substantial economic costs. We present the participation of pre-menopausal women with atrial fibrillation in trials of novel oral (...) anticoagulant drugs as a case study. Due to their non-participation in pivotal trials, it is uncertain whether for them, the risks that are associated with these drugs are outweighed by the advantages compared with conventional treatment. We addressed the question whether research of this new class of drugs in this subgroup would be appropriate from both, an ethical as well an economic perspective. We used the method of specifying norms as a wider framework to resolve the apparent ethical dilemma, while incorporating the question whether research of oral anticoagulants in premenopausal women with atrial fibrillation can be justified on economic grounds. For the latter, the results of a value-of-information analysis were used. Further clinical research on NOACs in premenopausal women with atrial fibrillation can be justified on both, ethical and economic grounds. Addressing apparent ethical dilemmas by invoking a method such as specifying norms can improve the quality of public practical reasoning. As such, the method should also prove valuable to committees that have formally been granted the authority to review trial protocols and proposals for scientific research. (shrink)