Advance care planning allows patients to articulate preferences for their medical treatment, lifestyle, and surrogate decision-makers in order to anticipate and mitigate their potential loss of decision-making capacity. Written advance directives are often emphasized in this regard. While these directives contain important information, there are several barriers to consider: veracity and accuracy of surrogate decision-makers in making choices consistent with the substituted judgement standard, state-to-state variability in regulations, literacy issues, lack of access to legal resources, lack of understanding of medical (...) options, and cultural disparities. Given these issues, it is vital to increase the use of patient and healthcare provider conversations as an advance care planning tool and to increase integration of such discourse into advance care planning policy as adjuncts and complements to written advance directives. This paper reviews current legislation about written advance directives and dissects how documentation of spoken interactions might be integrated and considered. We discuss specific institutional policy changes required to facilitate implementation. Finally, we explore the ethical issues surrounding the increased usage and recognition of clinician–patient conversations in advance care planning. (shrink)

This study invited curates and training incumbents attending a 3-day residential programme to function as a hermeneutical community engaging conversation between the Lucan post-resurrection narrative concerning the Road to Emmaus and the learning relationship in which they were engaged. Building on the SIFT approach to biblical hermeneutics the participants were invited to work in type-alike groups, structured first on the basis of the perceiving process and second on the basis of the judging process. This approach facilitated rich and varied insights (...) into the Emmaus Road narrative and into the theme of learning relationships. (shrink)

A readable, well illustrated, and often entertaining book surveying the main issues in the controversy over "time-dilation" and the "clock paradox" in Einstein's theory of relativity.

Despite growing advances in medical technologies, health status inequalities continue to increase across the globe. Developing countries have been faced with declining expenditures in health and social services, increasing burdens posed by both communicable and non-communicable diseases, and economic systems poorly geared to fostering sustainable development for the poorest and most marginalized. Under such circumstances, the challenges facing health practitioners in countries in transition are complex and diverse, and require the balancing of many conflicting imperatives. This is particularly so in (...) relation to the development of public health policy, where equity, redress of past inequalities, and the god of social justice may seemingly be pitted against macroeconomic adjustments required for national economic development in an increasingly globalized economic order.For example, pressures to deregulate as part of a market-oriented development philosophy will increase the risks from occupational hazards in populations desperate for paid employment. (shrink)

Intended both for undergraduate students and for general readers, this introduction to the philosophy of science uses case studies, anecdotes and personal comment to portray many heroes and villains from the field of science through the ages.

Inspired by Kant, Merleau-Ponty and Sellars, I illustrate and identify certain kinds of unity which are typical (if not universal) features of our conscious experience, and argue that Kant was right to claim that such unities are produced by unconscious processes of synthesis:A perceptual experience of succession is not reducible to a succession of perceptual experiences.The experience of perceiving one object as having several features is not reducible to a conjunction of perceptual experiences of those features.A cross-modal perceptual experience is (...) not reducible to a conjunction of single-modality perceptual experiences.Incoming perceptual information is synthesized into a single scene---a representation of the world as perceived from a spatia-temporal point of view.Any two of the simultaneous features of the experience of a subject S can be thought of together by S.Many of the experiences of a subject S can be thought of by S at a later time as part of his or her history of experience.These can be summarized in the general principle:An experience of a complex is not a complex of experiences.This is consistent with Sellars’ principle that:A sense-impression of a complex is a complex of impressionsbecause the latter applies at the sub-personal, unconceptualized level, and the former at the conscious level of conceptualized experiences. (shrink)

Symposium of Oakeshott on religion, science and politics.

This essay critically engages Dreyfus's widely read interpretation of Heidegger's Being and Time . It argues that Dreyfus's reading is rooted in two primary claims or interpretative principles. The first - the Cartesianism thesis - indicates that Heidegger's objective in Being and Time is to overturn Cartesianism. The second - the hermeneutics of suspicion thesis - claims that Division II is supposed to suspect and throw into question the results of the Division I analysis. These theses contribute to the view (...) that there are two conflicting accounts of inauthenticity that threaten the coherence of Heidegger's notion of authenticity. This view concerning authenticity is mistaken, as are the two theses that support it. The first thesis is incorrect because Heidegger's explicit aim is to investigate the question of the meaning of being not to overturn Cartesianism. The second is incorrect because the analyses of Division I describe the structures of everyday human existence in preparation for a closer examination in Division II of what makes them possible. Division II does not undercut Division I; it carries the analysis deeper. Authenticity, then, is not a negation of everydayness; it is a deepening of the self-understanding expressed in everydayness. (shrink)

The pioneering ideas of Glenn D. Paige for a paradigm shift from killing to nonkilling are highlighted. The relevance of anthropology for this paradigm is advanced. The accumulating scientific evidence proves that nonviolent and peaceful societies not only exist, but are actually the norm throughout human prehistory and history. This scientific fact is elucidated through a historical inventory of the most important documentation. Ethnographic cases are summarized of the Semai as a nonviolent society, the transition from killing to nonkilling of (...) the Waorani, and the critiques of the representation of the Yanomami as a killing society. Several of the most important cross-cultural studies are discussed. The assertions of some of the most vocal opponents to this paradigm are refuted. The systemic cultural and ideological bias privileging violence and war over nonviolence and peace is documented. (shrink)

To know is to cognize, to cognize is to be a culturally bounded, rationality-bounded and environmentally located agent. Knowledge and cognition are thus dual aspects of human sociality. If social epistemology has the formation, acquisition, mediation, transmission and dissemination of knowledge in complex communities of knowers as its subject matter, then its third party character is essentially stigmergic. In its most generic formulation, stigmergy is the phenomenon of indirect communication mediated by modifications of the environment. Extending this notion one might (...) conceive of social stigmergy as the extra-cranial analog of an artifcial neural network providing epistemic structure. This paper recommends a stigmergic framework for social epistemology to account for the supposed tension between individual action, wants and beliefs and the social corpora. We also propose that the so-called "extended mind" thesis offers the requisite stigmergic cognitive analog to stigmergic knowledge. Stigmergy as a theory of interaction within complex systems theory is illustrated through an example that runs on a particle swarm optimization algorithm. (shrink)

U.S. journalists must walk a fine line when reporting on hate speech. Journalists have a vested interest in standing up for the First Amendment, which gives them the freedom to do their work. Howev...

This brief article introduces a symposium discussing the extended mind thesis and its suggestive relation to religious thought. Essays by Mark Rowlands, Lynne Rudder Baker, Teed Rockwell, Joel Krueger, Leonard Angel, and Matthew Day present a variety of perspectives.

The massive growth in global health research in past decades has posed many challenges for its effective ethical oversight, not least of which is how best to provide effective protection of research participants. The extent of the HIV epidemic in sub-Saharan Africa in particular makes research into prevention technologies for HIV, including HIV vaccine research, a global priority. However, the need for vaccine research must be considered in conjunction with the individual's right to informed consent, which is based on the (...) principle of respect for autonomy. One of the primary human rights violations likely to occur in the context of HIV vaccine research is that potential research participants may not fully understand what participation in research studies entails. People who elect to enrol in HIV vaccine trials are required to understand both the potential negative effects of participation (eg, discrimination) as well as complex scientific concepts such as randomisation and prophylaxis in order to be ethically enrolled. In this study, two vignettes are presented to illustrate two core issues in conducting phase III HIV vaccine trials in low-income countries—namely, (1) from the perspective of participants, the extent to which understanding is a prerequisite for consenting to participate in a trial, and (2) from the perspective of trial investigators, whether it is appropriate to persuade eligible people to enrol in a trial, even though their initial reaction is to decline to participate. These vignettes are used to analyse these issues through the prisms of research ethics and human rights in order to identify helpful synergies. It is argued that the human rights perspective provides a helpful lens on ethical issues. (shrink)

It has been suggested recently that Heidegger’s philosophy entails a linguistic idealism because it is committed to the thesis that meaning determines reference. I argue that a careful consideration of the relationship between meaning and signification in Heidegger’s work does not support the strong sense of determination required by this thesis. By examining Heidegger’s development of Husserl’s phenomenology, I show that discourse involves a logic that articulates meaning into significations. Further analysis of Heidegger’s phenomenological method at work shows that while (...) meaning serves as a condition of possibility of signification in the sense that all possibilities for a term’s signification are latent in the meaning of that term, meaning under-determines signification and hence reference. Key Words: discourse • language • linguistic idealism • logic • meaning • phenomenology • signification. (shrink)

The Early Heidegger’s Philosophy of Life: Facticity, Being and Language offers an interpretation of Heidegger’s concept of facticity as it is articulated in connection with the ideas of life and language in the lecture courses from 1919225. The book argues that facticity is both the source of vitality for theory and a source of deception and falsehood and therefore cannot be viewed in either positive or negative terms exclusively, but must instead be viewed as ambiguous. This essay argues that this (...) basic thesis is correct and is supported by drawing a distinction between everydayness and inauthenticity. It is also argued that the analysis of language the book offers can be useful in clearing up misunderstandings of Heidegger’s concept of discourse in Being and Time. (shrink)