Background: The intentions of clinicians are widely considered to be relevant to the ethical assessment of their actions. A better understanding of the psychological factors that influence the ascription of intentions in clinical practice is important for improving the self-understanding of clinical decision-making and, ultimately, the ethics of clinical care. Drawing on empirical research on intentionality that has been done in other contexts, this is the first study to test whether the “asymmetric effect” of intention ascription is exhibited by respondents (...) when presented with clinical decision-making scenarios. Objective: To assess how individuals attribute intentions to clinical actors in clinical decision-making scenarios. Methods: A total of 149 first and second year medical students was randomly assigned to two groups. Subjects in each group read two scenarios and submitted anonymous responses to questions regarding each scenario. Results: The asymmetric effect was strongly exhibited by the responses given to scenario 2, but it was not exhibited by the responses given to scenario 1. Conclusion: The present study provided evidence for the view that people’s ascription of intentions to others is influenced by their previous evaluative judgement of the conduct in question. (shrink)

This new edition brings Farquharson's authoritative 1944 translation up to date and includes a helpful introduction and notes for the student and general reader. Rutherford includes a selection of letters from Marcus to his tutor Fronto--most of which date from his earlier years--that offer personal detail and help to fill out the somber portrait of the emperor that is found in the Meditations.

Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations warrant (...) research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care. We used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted. The CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy. By using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations. (shrink)

Silence has gained a prominent role in the field of psychotherapy because of its potential to facilitate a plethora of therapeutically beneficial processes within patients’ inner dynamics. This study examined the phenomenon from a conversation analytical perspective in order to investigate how silence emerges as an interactional accomplishment and how it attains interactional meaning by the speakers’ adjacent turns. We restricted our attention to one particular sequential context in which a patient’s turn comes to a point of possible completion and (...) receives a continuer by the therapist upon which a substantial silence follows. The data collection consisted of 74 instances of such post-continuer silences. The analysis revealed that silence can retroactively become part of a topic closure sequence, can become shaped as an intra-topic silence, and can be explicitly characterized as an activity in itself that is relevant for the therapy in process. Only in this last case, the absence of talk is actually treated as disruptive to the ongoing talk. Although silence is often seen as a therapeutic instrument that can be implemented intentionally and purposefully, our analysis demonstrated how it is co-constructed by speakers and indexically obtains meaning by adjacent turns of talk. In the ensuing turns, silence indeed shows to facilitate access to the patient’s subjective experience at unconscious levels. (shrink)

Historians of the Roman Empire have been nearly unanimous in giving the ill-fated Caesar whom Hadrian designated as his successor the cognomen Verus ascribed to him by Spartianus.2 Following the same biographer Annalists have given the names Aurelius and Annius to his father and grandfather. Noris in his Epistola Consularis3 maintained against Pagi that the original names of this prince were Lucius Ceionius Commodus, that neither he nor any of his family bore the names Aurelius, Annius, or Verus ascribed to (...) them in the Historia Augusta, but that the name Verus has been mistakenly reflected upon him from his more famous son L. Verus Augustus the colleague of M. Aurelius Antoninus. De Tillemont4 rejected Noris’ opinion on purely literary grounds, saying, ‘il est bien difficile de croire qu'un auteur ait esté assez ignorant et assez malheureux pour nommer toujours un prince, mesme en faisant exprès son histoire, d'un nom qu'il n'a jamais eu.’ By consequence the mistake, if mistake it be, is become inveterate and is repeated5 down to our own day. Klebs6 alone rejects the jiame, and the error is not corrected in Dr. Bury's edition of Gibbon. (shrink)

In biological electron transport the spin, and thus the magnetic property of electrons, is neglected. Furthermore, no attention is paid to the fact that the great majority of biologically important molecules are chiral, and during excitation a magnetic moment is induced in them. It is shown, both theoretically and experimentally, that the magnetic moment of the electron and the magnetic transition moment of the optically active molecules may interact. The main consequences of such an interaction are a higher probability of (...) the occurrence of optically active molecules in triplet states, and the polarization of transported electrons. (shrink)

I desire to invite the attention of students of Plato and of Greek mathematics to a solution of a passage which has long been a field of controversy for critics. For brevity's sake I shall take for granted an acquaintance with the two solutions which at present dispute the field, and further adopt certain positions which previous enquirers have established beyond reasonable doubt.

Throughout his life, John Tyler Bonner contributed to major transformations in the fields of developmental and evolutionary biology. He pondered the evolution of complexity and the significance of randomness in evolution, and was instrumental in the formation of evolutionary developmental biology. His contributions were vast, ranging from highly technical scientific articles to numerous books written for a broad audience. This historical vignette gathers reflections by several prominent researchers on the greatness of John Bonner and the implications of his work.

This is the first of four papers to be published in Research Ethics Review in 2009 that address methodological issues of relevance to research ethics committees. These will be practical papers, intended to assist ethics committee members to determine whether a research method is both ethically justified and likely to lead to high quality research. This paper prepares the way for the series through a consideration of the relationship between research ethics and methodology.

To investigate the current status of hospital clinical ethics committees (CEC) and how they have evolved in Canada over the past 20 years, this paper presents an overview of the findings from a 2008 survey and compares these findings with two previous Canadian surveys conducted in 1989 and 1984. All Canadian hospitals over 100 beds, of which at least some were acute care, were surveyed to determine the structure of CEC, how they function, the perceived achievements of these committees and (...) opinions about areas with which CEC should be involved. The percentage of hospitals with CEC in our sample was found to be 85% compared with 58% and 18% in 1989 and 1984, respectively. The wide variation in the size of committees and the composition of their membership has continued. Meetings of CEC have become more regularised and formalised over time. CEC continue to be predominately advisory in their nature, and by 2008 there was a shift in the priority of the activities of CEC to meeting ethics education needs and providing counselling and support with less emphasis on advising about policy and procedures. More research is needed on how best to define what the scope of activities of CEC should be in order to meet the needs of hospitals in Canada and elsewhere. More research also is needed on the actual outcomes to patients, families, health professionals and organisations from the work of these committees in order to support the considerable time committee members devote to this endeavour. (shrink)

In this paper we study the variety of order Hilbert algebras, which is the equivalent algebraic semantics of the order implicational calculus of Bull.

Causation is at once familiar and mysterious. Neither common sense nor extensive philosophical debate has led us to anything like agreement on the correct analysis of the concept of causation, or an account of the metaphysical nature of the causal relation. Causation: A User's Guide cuts a clear path through this confusing but vital landscape. L. A. Paul and Ned Hall guide the reader through the most important philosophical treatments of causation, negotiating the terrain by taking a set of examples (...) as landmarks. They clarify the central themes of the debate about causation, and cover questions about causation involving omissions or absences, preemption and other species of redundant causation, and the possibility that causation is not transitive. Along the way, Paul and Hall examine several contemporary proposals for analyzing the nature of causation and assess their merits and overall methodological cogency.The book is designed to be of value both to trained specialists and those coming to the problem of causation for the first time. It provides the reader with a broad and sophisticated view of the metaphysics of the causal relation. (shrink)