As a patient approaches death, family members often are asked about their loved one’s preferences regarding treatment at the end of life. Advance care directives may provide information for families and surrogate decision makers; however, less than one-third of Americans have completed such documents. As the U.S. population continues to age, many surrogate decision makers likely will rely on other means to discern or interpret a loved one’s preferences. While many surrogates indicate that they have some knowledge of their loved (...) one’s preferences, how surrogates obtain such knowledge is not well understood. Additionally, although research indicates that the emotional burden of end-of-life decision making is diminished when surrogates have knowledge that a loved one’s preferences are honored, it remains unclear how surrogates come to know these preferences were carried out. The current study examined the ways that next of kin knew veterans’ end-of-life preferences, and their ways of knowing whether those preferences were honored in Veteran Affairs Medical Center inpatient settings. (shrink)

Kurrâ’ya nispet edilen aynı kelimelerdeki edâ farklılıklarının tartışmalara sebep olmasından ötürü kıraat ihtilafı olan kelimelerde ihticâc yapılmasına gereksinim duyulmuştur. Delil getirmek manasında kullanılan ihticâc kavramı, kıraat ihtilafları için söz konusu olduğunda ise kıraat ihtilaflarının sıhhat zemininin ortaya konması kastedilmektedir. Ayrıca 2. asrın sonlarında kıraat tevcîhlerinin yapıldığı müstakil eserler ortaya çıkmakla birlikte kıraat alan yazınına ait genel telifatlarda da kıraat ihticâclarının yapıldığı görülmektedir. Kıraat müelliflerinden biri olan İbnu’l-Cezerî de Neşru’l-ḳırââti’l-‘aşr adlı eserinde zaman zaman kıraat ihticâcına yer vermektedir. Mezkûr eserdeki kıraat ihticâcları (...) hakkında tespit edilebildiği kadarıyla yapılmış tek bir çalışma bulunmaktadır. Fakat bu çalışmada, kıraatten ve bunun dışındaki disiplinlerden yeterince istifade edilmediği belirlenmiştir. Ayrıca selef ulemasının Neşru’l-ḳırââti’l-‘aşr adlı esere ihticâc konusunda etkisi özelinde bir çalışmaya da rastlanmamıştır. Buradan hareketle elinizdeki bu çalışmada, İbnu’l-Ce-zerî’nin kıraat ihticâcına dair uygulamaları Neşru’l-ḳırââti’l-‘aşr adlı eser özelinde incelenmiş, me‘âni’l-Kur’ân ve me‘âni’l-kıraat literatürlerinin ortaya çıktıkları dönem dikkate alınarak h. 2.-4. asırlarda kaleme alınan bu literatürlere ait eserlerin İbnu’l-Cezerî’ye ait kıraat tevcîhlerine etkisinin olup olmadığı araştırılmıştır. Çalışmanın neticesinde İbnu’l-Cezerî’nin yaptığı kıraat tevcîhlerinden ele alınanların bir kısmına, söz konusu üç asırda kaleme alınan me‘âni’l-Kur’ân ve me‘âni’l-kıraat telifatında ekseriyetle yer verilmediği saptanmıştır. İbnu’l-Cezerî’nin ise kıraat ihtilafının olmadığı yerlerde dahi ilgili edâ için ihticâc yaptığı müşahede edilmiştir. Buna ilaveten İbnu’l-Cezerî’nin Neşr’de yaptığı ihticâc uygulamalarının me‘âni’l-Kur’ân ve me‘âni’l-kıraat telifatında yapılan ihticâc işlemleriyle benzeştiği görülmüştür. Yine Neşr’in tevcîh eseri olmaması hasebiyle de İbnu’l-Cezerî tarafından yapılan ihticâcların ihtiyaç merkezli olarak kendini gösterdiği belirlenmiştir. (shrink)

Social media applications such as Twitter, YouTube and Facebook have attained huge popularity, with more than three billion people and organizations predicted to have a social networking account by 2015. Social media offers a rapid avenue of communication with the public and has potential benefits for communicable disease control and surveillance. However, its application in everyday public health practice raises a number of important issues around confidentiality and autonomy. We report here a case from local level health protection where the (...) friend of an individual with meningococcal septicaemia used a social networking site to notify potential contacts. (shrink)

This article explores the enduring mysteries of consciousness and the afterlife, two enigmatic topics that have fascinated humanity for ages. Despite extensive scientific efforts, the existence of an afterlife remains unproven, and understanding consciousness remains a significant challenge. The research introduces innovative hypotheses through simple thought experiments with empirical evidence and robust theoretical foundations. It delves into the complexities of consciousness, its relationship with the brain, and the need for interdisciplinary approaches including philosophy. Boldly contemplating the probability of a continuous (...) consciousness after death, the study argues that existing evidence strongly supports this idea. Beyond theoretical implications, it envisions practical outcomes, suggesting that insights into these mysteries could enhance human well-being and contribute to a more harmonious world. In summary, this article embarks on a quest to shed light on age-old questions about consciousness and the high probability of the afterlife. Through fresh methodologies, it aims to provide new perspectives that could reshape our understanding of existence and inspire intellectuals to positive individual and societal advancements including peace, happiness, health, and intelligence. -/- . (shrink)

This article explores egg freezing experiences of women in Turkey. Since 2014, it has been legal in Turkey to use egg freezing technology for ageing women, while it was previously allowed only for disease-related purposes. In cooperation with a private fertility clinic in Istanbul, the authors conducted 21 interviews with older, single women who held either professional or managerial positions and who were undergoing or had undergone the procedure. Drawing on a qualitative analysis of these interviews, the authors explore the (...) social context in which women postpone motherhood and decide to freeze their eggs. The study also looks at the women’s emotional responses to ageing that were triggered by the experience of egg freezing and their narratives of empowerment as a result of the procedure. (shrink)

Spinoza has been appropriated as a philosophical forefather of deep ecology. I identify what I take to be the relevant components of Spinoza ’s metaphysics, which, at face value, appear to be harmonious with deep ecology’s commitments. However, there are central aspects of his moral philosophy which do not appear to be “environmentally friendly,” in particular the sentiments expressed in the Ethics IV35C1 and IV37S1. I describe environmental ethics’ treatment of these passages and then indicate what I take to be (...) a more satisfactory route toward “ecologizing Spinoza.”. (shrink)

Electrical membrane fluctuations are treated as due to sequences of ion pulses passing through the membrane. A mathematical procedure is developed which permits calculation of the power spectra for sequences in which the pulses can have Poisson or non-Poisson interval distributions and may or may not have coupled pulse parameters. It is shown that there probably exist specific sequences which are intimately related to membrane 1/f and burst noise. In particular, emphasis is placed upon sequences with non-Poisson interval distributions and (...) their implications for membrane structure. A variety of experiments is suggested which will help to distinguish among the alternatives presented. (shrink)

L'auteur accepte la position d'auteurs comme Germain Grisez et John Finnis selon laquelle l'immoralité de l'homosexualité est connectée en quelque manière au dualisme esprit-corps de la recherche du plaisir. Il s'efforce pourtant, par une analyse de ce que Platon et Aristote disent au sujet du plaisir dans le Philebus et l'Ethique de Nichomaque, de décrire le genre - ou, plutôt, les genres - de dualisme dont il s'agit. Le résultat, pense-t-il, est une analyse qui évite la position insoutenable selon laquelle (...) le plaisir n'est en aucune manière à être poursuivi pour lui-même. Il est d'accord avec Aristote et Thomas d'Aquin que le plaisir est «une sorte de fin», qui reçoit son intelligibilité complète seulement lorsqu'elle accompagne des pratiques humaines pleinement intelligibles de façon isomorphique. (shrink)

Here, I discuss how natural biological evolution might have selected human origin and the psychology of the better mind-brain. However, all humans are closely related; why do we make crimes, war, hate, and jealousy their primary reasons and overcoming methodologies? How can they gain their best happiness? What kind of philosophy apply to annalize this big question and convince humankind to evolve their mind? How we could achieve our optimum potential happiness by developing hidden intelligence to make the world a (...) happier place to live in. (shrink)

There are a number of problematic features within the current treatment of time in physical theories, including the “timelessness” of the Universe as encapsulated by the Wheeler–DeWitt equation. This paper considers one particular investigation into resolving this issue; a conditional probability interpretation that was first proposed by Page and Wooters. Those authors addressed the apparent timelessness by subdividing a faux Universe into two entangled parts, “the clock” and “the remainder of the Universe”, and then synchronizing the effective dynamics of the (...) two subsystems by way of conditional probabilities. The current treatment focuses on the possibility of using a realistic clock system; namely, a coherent-state description of a damped harmonic oscillator. This clock proves to be consistent with the conditional probability interpretation; in particular, a standard evolution operator is identified with the position of the clock playing the role of time for the rest of the Universe. Restrictions on the damping factor are determined and, perhaps contrary to expectations, the optimal choice of clock is not necessarily one of minimal damping. (shrink)

Background and objectives: Definitions of medical futility, offered by healthcare professionals, bioethicists and other experts, have been rigorously debated by many investigators, but the perceptions of patients of futility have been explored only by a few. Patients were allowed to discuss their concerns about end-of-life care, so that their ideas about treatment futility or utility could be extrapolated by us.Methods: In this cross-sectional study, in-depth, semistructured interviews were conducted with 30 elderly people who were receiving outpatient care in a large, (...) urban Veterans Affairs medical centre in the US. Each of their healthcare providers was also interviewed. Participants were asked to consider four terms commonly used in advance directive forms and to discuss what these terms meant to them. Audiotapes of the open-ended interviews were transcribed and responses were coded and categorised by constant comparison, a commonly used qualitative method.Results: The following four factors were taken into account by the participants when discussing end-of-life interventions and outcomes: expected quality of life; emotional and financial costs of treatment; likelihood of treatment success; and expected effect on longevity.Conclusions: Although the terms “utility” or “futility” were not generally used by the participants, segments of speech indicating their perceptions of these terms were identified. Treatment was not always discussed in the same way by patients and providers, but seemed to reflect the same four concerns. Therefore, it may be fruitful for providers to focus on these concerns when discussing end-of-life treatment options with their patients. (shrink)

In spite of a continuing long and rich history of caring for patients, many nurses have not been satisfied with their work. One cause among others for this dissatisfaction is that nurses often do not care for one another. The philosophy of a Buddhist Sangha, or community, is similar to the philosophy of western communitarian ethics. Both philosophies emphasize the importance of people working together harmoniously towards a common good. In this article, unsatisfactory nurse-nurse relationships have been considered and a (...) model for communitarian nursing practice has been suggested based on a Buddhist Sangha. (shrink)

Patrick Lee, professeur de philosophie à l'Université franciscaine de Steubenville, vient de publié un livre excellent sur la question de l'avortement : Abortion and Unborn Human Life . L'A. en présente le contenu et en commente l'actualité ainsi que la pertinence.

Background Professional autonomy, which directly affects the quality of professional nursing in patient care, and cognitive flexibility, which is an important factor for adaptation to change and developing nursing roles, are important concepts for nursing. Research objectives This research was carried out to determine the effect of cognitive flexibility on attitudes towards professional autonomy in nurses. Research design This was a descriptive study. Participants and research context The research was conducted with 415 nurses working in a city hospital of a (...) province, meeting the inclusion criteria and agreeing to participate in the study. A questionnaire form, The Cognitive Flexibility Inventory (CFI), and the Attitude Toward Professional Autonomy Scale for Nurses (APASN) were used to collect data. Ethical considerations Ethical approval was obtained from the university ethics committee before starting the study. Institutional permission was obtained from the city hospital where the study was conducted. Electronic informed consent was obtained from the nurses included in the study. Findings In the study, the mean CFI score was 80.62 ± 11.55 and the mean APASN score was 70.42 ± 18.79. There was a weak positive correlation (r = 0.270; p < 0.05) between CFI and APASN scores. Moreover, the effect of the CFI mean score on the APASN mean score was found to be statistically significant (β = 0.278; p < 0.001). Furthermore, CFI explains 7.7% of APASN. Conclusion In the study, nurses’ attitudes towards professional autonomy and cognitive flexibility scores were found to be at a good level. Cognitive flexibility has a positive effect on attitudes towards professional autonomy. Interventional studies that will increase the level of cognitive flexibility are recommended in the development of nurses' attitudes towards professional autonomy. (shrink)

Study of the Advaita and the philosophy of Immanuel Kant, 1724-1804, German philosopher.