The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views the body as a machine and medical professionals as technicians whose job is to repair that machine. The purpose of this paper is to advocate for an alternative philosophy of medicine based on the concept of healing relationships between clinicians and patients. This is accomplished first by exploring the ethical and philosophical work of Pellegrino and Thomasma and then by connecting (...) Martin Buber's philosophical work on the nature of relationships to an empirically derived model of the medical healing relationship. The Healing Relationship Model was developed by the authors through qualitative analysis of interviews of physicians and patients. Clinician-patient healing relationships are a special form of what Buber calls I-Thou relationships, characterized by dialog and mutuality, but a mutuality limited by the inherent asymmetry of the clinician-patient relationship. The Healing Relationship Model identifies three processes necessary for such relationships to develop and be sustained: Valuing, Appreciating Power and Abiding. We explore in detail how these processes, as well as other components of the model resonate with Buber's concepts of I-Thou and I-It relationships. The resulting combined conceptual model illuminates the wholeness underlying the dual roles of clinicians as healers and providers of technical biomedicine. On the basis of our analysis, we argue that health care should be focused on healing, with I-Thou relationships at its core. (shrink)

Most metazoan organisms have evolved a mildly acidified and calcium diminished sorting hub in the early secretory pathway commonly referred to as the Endoplasmic Reticulum‐Golgi intermediate compartment (ERGIC). These membranous vesicular‐tubular clusters are found tightly juxtaposed to ER subdomains that are competent for the production of COPII‐coated transport carriers. In contrast to many unicellular systems, metazoan COPII carriers largely transit just a few hundred nanometers to the ERGIC, prior to COPI‐dependent transport on to the cis‐Golgi. The mechanisms underlying formation and (...) maintenance of ERGIC membranes are poorly defined. However, recent evidence suggests an important role for Trk‐fused gene (TFG) in regulating the integrity of the ER/ERGIC interface. Moreover, in the absence of cytoskeletal elements to scaffold tracks on which COPII carriers might move, TFG appears to promote anterograde cargo transport by locally tethering COPII carriers adjacent to ERGIC membranes. This action, regulated in part by the intrinsically disordered domain of TFG, provides sufficient time for COPII coat disassembly prior to heterotypic membrane fusion and cargo delivery to the ERGIC. -/- . (shrink)

Objective: To develop an approach for seeking informed consent to examine tissues retained from a previous study of sudden infant death syndrome as part of a study on asthma, and to document responses and participation rate.Design: Pilot open-ended approach to 10 volunteer SIDS parents, followed by staged approach to seek consent from the target SIDS families for the asthma study.Participants: Parents of SIDS infants known to SIDS and Kids Victoria and parents of SIDS infants from the 1991–2 SIDS in Victoria (...) case–control study.Main outcomes: Qualitative responses of the piloted parents and study parents, and participation rates.Results: The pilot group responses were used to refine the written material to be provided. Of the 72 families for which contact details were available, 45 gave verbal consent for contact by the Victorian Institute of Forensic Medicine regarding the asthma study, three refused and 24 did not respond to two letters. Thirty-three completed consent forms, all positive for participation in the asthma study, giving a positive response rate of 73% .Conclusions: The use of postmortem tissue for research is acceptable to the next of kin when an approach is sensitive to their concerns and needs and is made by experienced counsellors from a familiar organisation. Despite the painful memories evoked by the approach of the research group, the acceptance rate among those who could be contacted was high. (shrink)

These essays use particular issues, thinkers and texts to engage the question of God in early Christianity.

An interdisciplinary course was designed as an introduction to the applications of, and the socio-economic issues associated with, biotechnology. College students enrolled in the course were surveyed prior to the first formal lecture, and again upon completion of the course. Assessment was made of the impact of the educational materials on the attitudes and perceptions of the students toward the applications of biotechnology to agriculture. Data were collected for the first three semesters in which the course was offered. Answers to (...) survey questions were analyzed on a before and after basis. It was found that students were very accepting of biotechnology prior to taking the course, despite a generally low level of exposure to this type of technology. The course was effective in increasing the knowledge base of the students, but not as effective in allaying their perceptions of risks associated with biotechnology. (shrink)

It is always possible to construct a real function f, given random quantities X and Y with continuous distribution functions F and G, respectively, in such a way that f(X) and f(Y), also random quantities, have both the same distribution function, say H. This result of De Finetti introduces an alternative way to somehow describe the `opinion' of a group of experts about a continuous random quantity by the construction of Fields of coincidence of opinions (FCO). A Field of coincidence (...) of opinions is a finite union of intervals where the opinions of the experts coincide with respect to that quantity of interest. We speculate on (dis)advantages of Fields of Opinion compared to usual `probability' measures of a group and on their relation with a continuous version of the well-known Allais' paradox. (shrink)

The discussion among philosophers and experimental scientists on the pages of Problems of Philosophy [Voprosy filosofii] about the substance of and relations between the fundamental and applied sciences [1] persuades me that this remains a topical issue despite the very deep crisis that followed the breakup of the USSR in all spheres of society, including science, throughout the post-Soviet region. Most likely, it is precisely the crisis phenomena in society that impel its thinking part to answer the questions: What has (...) happened to us? Where are we now? Where do we go from here and by which paths? What is the role of science in changing the situation? And inasmuch as science and philosophy are the supreme creations of the human mind, called upon to reflect by specific means what is taking place in society, these questions have been at the center of philosophers' and scientists' attention. (shrink)

The new thinking is making itself known in the posing and resolution of problems of man as an extremely important philosophical problem. The old philosophical question of the relationship between freedom and necessity in their dialectical interconnection once again occupies center stage.

A new proof of the impossibility of reconciling realism and locality in quantum mechanics is given. Unlike proofs based on Bell's inequality, the present work makes minimal and transparent use of probability theory and proceeds by demonstrating a Kochen-Specker type of paradox based on the value assignments to the spin components of two spatially separated spin-1 systems in the singlet state of their total spin. An essential part of the argument is to distinguish carefully two commonly confused types of contextuality; (...) we call them ontological and environmental contextuality. These in turn are associated with two quite distinct senses of nonlocality. We indicate the relevance of our treatment to other related discussions in recent literature on the philosophy of quantum mechanics. (shrink)

An extension of the hypothetical experiment of Szilard, which involved the action of a one-molecule gas in an isolated isothermal system, is developed to illustrate how irreversibility may arise out of Brownian motion. As this development requires a consideration of nonmolecular components such as wheels and pistons, the thought-experiment is remodeled in molecular terms and appears to function as a perpetuum mobile.

An attempt to reveal the linguistic and cultural potential of education in the process of learning Russian as a means of communication, of cognition of the linguistic picture of the world and the phenomenon of culture is made in the article. The stages of development of linguocultural concept of teaching Russian language in the Republic of Bashkortostan are presented. New approaches to teaching Russian language are considered. The author shows that in the process of education, elementary literacy of students should (...) be achieved while they are dealing with communicative and socially important tasks contributing to the development and formation of students as linguistic personalities. The author concludes that the actual task of the modern school, which is a successful preparation for the unified state examination, should also be achieved not by increased training before the exam, but provided by the total system of education aimed at the formation of personality with a wide range of language capabilities: a cultural person, well-speaking, correct writing, able to understand and interpret the text, to express their thoughts and feelings in their own texts. Such training involves the ascent of a language personality from basic literacy to formed linguistic, communicative and cultural competences. Theoretical basis and methodological support of the concept are presented in the list of publications. (shrink)

The ethical pre-condition of randomised controlled trials is, at present, the presence of equipoise. This refers to an opinion of the investigator that there is uncertainty as to the merits of the treatments being compared. It is argued that since the decision to enrol is the potential subject’s, the investigator’s opinion is not ethically relevant. It is proposed instead that equipoise be patient-centred, and that a trial is in equipoise for a patient when enrolling gives them the same chance of (...) a good outcome as not enrolling. It is shown that trial enrolment is normally easily the best strategy for achieving a good outcome, and that trials currently thought to be unethical may be in patient-centred equipoise. This is so for three reasons: (1) patients in trials receive superior care, (2) trial enrolment minimises the risk of being a victim of a therapeutic disaster and (3) health professionals make mistakes, and a 50% chance of receiving the worse treatment until a trial reports is always better than any chance of receiving the worse treatment indefinitely. It is concluded that so long as the standard of professional conduct is the furtherance of patients’ objective interests randomised controlled trials are ethical. (shrink)