BackgroundObtaining informed consent for intravenous thrombolysis in acute ischemic stroke can be challenging, and little is known about if and how the informed consent procedure is performed by neurologists in clinical practice. This study examines the procedure of informed consent for intravenous thrombolysis in acute ischemic stroke in high-volume stroke centers in the Netherlands.MethodsIn four high volume stroke centers, neurology residents and attending neurologists received an online questionnaire concerning informed consent for thrombolysis with tissue-type plasminogen activator (tPA). The respondents were (...) asked to report their usual informed consent practice for tPA treatment and their considerations on whether informed consent should be obtained.ResultsFrom the 203 invited clinicians, 50% (n = 101) completed the questionnaire. One-third of the neurology residents (n = 21) and 21% of the neurologists (n = 8) reported that they always obtain informed consent for tPA treatment. If a patient is not capable of providing informed consent, 30% of the residents (n = 19) reported that they start tPA treatment without informed consent. In these circumstances, 53% of the neurologists (n = 20) reported that the resident under their supervision would start tPA treatment without informed consent. Most neurologists (n = 21; 55%) and neurology residents (n = 45; 72%) obtained informed consent within one minute. None of the respondents used more than five minutes for informed consent. Important themes regarding obtaining informed consent for treatment were patients’ capacity, and medical, ethical and legal considerations.ConclusionThe current practice of informed consent for thrombolysis in acute ischemic stroke varies among neurologists and neurology residents. If informed consent is obtained, most clinicians stated to obtain informed consent within one minute. In the future, a shortened information provision process may be applied, making a shift from informed consent to informed refusal, while still considering the patient’s capacity, stroke severity, and possible treatment delays. (shrink)

Yarkoni's analysis clearly articulates a number of concerns limiting the generalizability and explanatory power of psychological findings, many of which are compounded in infancy research. ManyBabies addresses these concerns via a radically collaborative, large-scale and open approach to research that is grounded in theory-building, committed to diversification, and focused on understanding sources of variation.

Signs of mankind's solidarity, by J. R. Nelson.--Mankind, Israel and the nations in the Hebraic heritage, by M. Greenberg.--Christian insights from biblical sources, by C. Maurer.--Muhammad and all men, by D. Rahbar.--The impact of New World discovery upon European thought of man, by E. J. Burrus.--The effects of colonialism upon the Asian understanding of man, by J. G. Arapura.--Religious pluralism and the quest for human community, by S. J. Samartha.--From Confucian gentleman to the new Chinese 'political' man, by D. A. (...) Robinson.--The scientific revolution and the unity of man, by B. Towers.--Language and communication, by E. A. Nida.--Man and the son of man, by J. Moltmann.--The potentiality of conciliarity: communion, conscience, council, by W. B. Blakemore.--Oneness must mean wholeness, by J. R. Nelson. (shrink)

Einheit der Kirche und Einheit der Menschheit, by W. Pannenberg.--Die Menschheit, Israel und die Nationen in hebräischer Überlieferung, by M. Greenberg.--Die Einheit der Menschheit in biblischer Sicht, by C. Maurer.--Einheit und Entfremdung im Islam, by H. Askari.--Die Entdeckung Amerikas und das europäische Menschenbild, by L. González Rodríguez.--Der Einfluss des Kolonialismus auf das asiatische Verständnis vom Menschen, by J. G. Arapura.--Religiöser Pluralismus und die Suche nach menschlicher Gemeinschaft, by S. J. Samartha.--Vom konfuzianischen Edelmann zum neuen chinesischen "politischen Menschen", by D. A. (...) Robinson.--Die Revolution der Wissenschaft und die Einheit der Menschheit, by B. Towers.--Sprache und Kommunikation, by E. A. Nida.--Die Theologie der Tradition als Grundlage der Einheit, by N. A. Nissiotis. (shrink)

The anticipated social capabilities of robots may allow them to serve in authority roles as part of human-machine teams. To date, it is unclear if, and to what extent, human team members will comply with requests from their robotic teammates, and how such compliance compares to requests from human teammates. This research examined how the human-likeness and physical embodiment of a robot affect compliance to a robot's request to perseverate utilizing a novel task paradigm. Across a set of two studies, (...) participants performed a visual search task while receiving ambiguous performance feedback. Compliance was evaluated when the participant requested to stop the task and the coach urged the participant to keep practicing multiple times. In the first study, the coach was either physically co-located with the participant or located remotely via a live-video. Coach type varied in human-likeness and included either a real human, a Nao robot, or a modified Roomba robot. The second study expanded on the first by including a Baxter robot as a coach and replicated the findings in a different sample population with a strict chain of command culture. Results from both studies showed that participants comply with the requests of a robot for up to 11 min. Compliance is less than to a human and embodiment and human-likeness on had weak effects on compliance. (shrink)

Background One of the objectives of medicine is to relieve patients' suffering. As a consequence, it is important to understand patients' perspectives of suffering and their ability to cope. However, there is poor insight into what determines their suffering and their ability to bear it. Purpose To explore the constituent elements of suffering of patients who explicitly request euthanasia or physician-assisted suicide (EAS) and to better understand unbearable suffering from the patients' perspective. Patients and methods A qualitative study using in-depth (...) face-to-face interviews was conducted with 31 patients who had requested EAS. The grounded theory approach was used to analyse the data. Results Medical, psycho-emotional, socio-environmental and existential themes contributed to suffering. Especially fatigue, pain, decline, negative feelings, loss of self, fear of future suffering, dependency, loss of autonomy, being worn out, being a burden, loneliness, loss of all that makes life worth living, hopelessness, pointlessness and being tired of living were constituent elements of unbearable suffering. Only patients with a psychiatric (co)diagnosis suffered unbearably all the time. Conclusions Unbearable suffering is the outcome of an intensive process that originates in the symptoms of illness and/or ageing. According to patients, hopelessness is an essential element of unbearable suffering. Medical and social elements may cause suffering, but especially when accompanied by psycho-emotional and existential problems suffering will become ‘unbearable’. Personality characteristics and biographical aspects greatly influence the burden of suffering. Unbearable suffering can only be understood in the continuum of the patients' perspectives of the past, the present and expectations of the future. (shrink)

In early 2020, a number of countries developed and published intensive care triage guidelines for the pandemic. Several of those guidelines, especially in the UK, encouraged the explicit assessment...

In this third and last paper on inner models we consider some of the inherent limitations of the method of using inner models of the type defined in 1.2 for the proof of consistency results for the particular system of set theory under consideration. Roughly speaking this limitation may be described by saying that practically no further consistency results can be obtained by the construction of models satisfying the conditions of theorem 1.5, i.e., conditions 1.31, 1.32, 1.33, 1.51, viz.:This applies (...) in particular to the ‘complete models’ defined in 1.4. Before going on to a precise statement of these limitations we shall consider now the theorem on which they depend. This is concerned with a particular type of complete model examples of which we call “proper complete models”; they are those complete models which are essentially interior to the universe, those whose classes are sets of the universe constituting a class thereof, i.e., those for which the following proposition is true:The main theorem of this paper is that the statement that there are no models of this kind can be expressed formally in the same way as the axioms A, B, C and furthermore it can be proved that if the axiom system A, B, C is consistent then so is the system consisting of axioms A, B, C, plus this new hypothesis that there exist no proper complete models. When combined with the axiom ‘V = L’ introduced by Gödel in this new hypothesis yields a system in which any normal complete model which exists has for its universal class V, the universal class of the original system. (shrink)

In his discussion of the ethics of suicide Plato alludes to more than one traditional injunction against it:indicates a fairly general acceptance of its wickedness. Cebes has heard the Pythagorean Philolaus, among others, saying that suicide was immoral, but has gathered no satisfactory explanation as to why this should be so. One reason, impressive, but, Socrates admits, difficult is to be found.

Imagine that we are considering whether our healthcare system (or insurer) should fund treatment or procedure X. One factor that may be cited is that of so-called ‘medical necessity’. The claim would be that treatment X should be eligible for funding if it is medically necessary, but ineligible if this does not apply. Similarly, (and relevant to the debates in this special issue), if considering whether a particular treatment should be ethically and/or legally permitted, we may wish to distinguish between (...) cases where the treatment is medically necessary, and those were it is not. But what do we mean by this concept? Here I will propose and briefly defend one plausible and practical definition. (shrink)

C W Evers, J C Walker; Knowledge, Partitioned Sets and Extensionality: a refutation of the forms of knowledge thesis, Journal of Philosophy of Education, Volume.

It is the purpose of this paper to carry out a partial syntactical analysis of imperatives. Imperatives form a large body of linguistic expressions, appearing, e.g. in mathematical proofs be a continuous function!”), laws, moral injunctions, instruction, etc. For analytical purposes we distinguish between two forms of imperatives, the fiat and the directive. By a directive we mean an imperative which includes an indication of the agent who is to carry it out. For example, “Henry, don't forget to stop at (...) the grocery!” is a directive. By a fiat we mean an imperative which includes no reference to an agent who is to carry it out. For example, “Let there be light!” is a fiat. This is a distinction made in terms of meaning. If, however, proper symbolic devices were introduced for the formalization of imperatives, it could be made in a syntactical manner. Thus we could distinguish between imperatives which possess a certain operator—the directive operator formed by putting a name within square brackets—as “[Henry]!”, and imperatives which do not possess this operator, e.g. “Let it be the case that Henry does not forget to stop at the grocery!” In the following we pay attention only to fiats. This, of course, involves a great limitation of subject matter and excludes topics of great interest. (shrink)

Williamson claims that we are cognitive homeless, and for most aspects of our cognitive life it is not the case that if we are in the mental state S we know or are in a position to know that we are in said mental state. In this paper, I critically examine Williamson’s argument, some common misconceptions, and provide a different understanding of the way we relate to our own mental states that shows how we are not always in a condition (...) of cognitive homelessness. (shrink)

C W Evers, J C Walker; Pyrotechnics Defended: a reply to Jim Mackenzie, Journal of Philosophy of Education, Volume 21, Issue 1, 30 May 2006, Pages 139–142, http.

In defining physical (i.e. causal dynamic) units to which conscious experience is to be ascribed, integrated information theory (IIT) raises three notable requirements: (1) that a unit to which consciousness is ascribed must be defined, or circumscribed, by some intrinsic aspect or property, where intrinsic implies existing 'for itself' or 'from its point of view'; (2) that the intrinsic aspect that defines the unit to which consciousness is ascribed must be dynamic (i.e. involve causal power) rather than purely structural or (...) kinematic; (3) that this dynamic aspect must involve the integration of elements of information in such a way that semantic values of elements are interdependent, allowing rich meaning. It will be argued that, although these requirements are all well-motivated, IIT falls short on them within a testable natural science framework. Concerns raised about the three requirements all point towards one central problem: that the concept of 'integrated information' does not involve any specific causal relation. Although IIT starts from strictly causal premises, the final analysis appears to invoke two incompatible accounts of the same events, with 'integration' having no causal relational basis. It will also be argued that the way IIT attempts to provide a testable theory of dynamic units to which consciousness is ascribed mustcausal reason inherent in any means of testing, be at best redundant for in the human case and, as a general principle, untenable. (shrink)

In 1926, Mally presented the first formal system of deontic logic. His system had several consequences which Mally regarded as surprising but defensible. It also, however, has the consequence that A is obligatory if and only if A is the case, which is unacceptable from the point of view of any reasonable deontic logic. We describe Mally's system and discuss how it might reasonably be repaired.