Background: Sharing information with relatives of elderly patients in primary care and in hospital has to fit into the complex set of obligations, justifications and pressures concerning the provision of information, and the results of some studies point to the need for further empirical studies exploring issues of patient autonomy, privacy and informed consent in the day-to-day care of older people.Objectives: To know the frequency with which “capable” patients over 65 years of age receive information when admitted to hospital, the (...) information offered to the families concerned, the person who gives consent for medical intervention, and the degree of satisfaction with the information received and the healthcare provided.Method: A descriptive questionnaire given to 200 patients and 200 relatives during the patients’ stay in hospital.Results: Only 5% of patients confirmed that they had been asked whether information could be given to their relatives. A significantly higher proportion of relatives received information on the successive stages of the care offered than did patients themselves. As the age of the patients increased, so the number who were given information, understood the information and were asked for their consent for complementary tests decreased. The degree of satisfaction with the information offered was high for both patients and relatives , despite the irregularities observed.Conclusions: The capacity of elderly patients to participate in the decision-making process is frequently doubted simply because they have reached a certain age and it is thought that relatives should act as their representatives. In Spain, the opinion of the family and doctors appears to play a larger role in making decisions than does the concept of patient autonomy. (shrink)

Cet article propose une vue d’ensemble de la doctrine des Intermédiaires mathématiques (τὰ μεταξύ) qu’Aristote attribue à Platon dans sa Métaphysique, des objections qu’Aristote lui adresse et des questions philosophiques qu’elle soulève. Suivant Aristote, Platon avance que les vérités de la géométrie et de l’arithmétique ne peuvent pas porter sur des objets perceptibles ni sur des Formes, mais doivent porter sur une troisième classe d’entités intermédiaires entre les deux. Je soutiens que la critique d’Aristote la plus efficace de cette doctrine (...) montre que les raisons avancées en faveur de l’existence des Intermédiaires par les Platoniciens ne sont pas concluantes, mais ne peut pas montrer qu’ils n’existent pas. En m’appuyant sur quelques remarques de David Ross sur la démarche d’Aristote, je soutiens également que, s’il est vrai que le fait que toute science est caractérisée par des propositions de la forme « Tout F est G » n’implique pas qu’elle porte sur des entités intermédiaires, il peut y avoir des raisons pour accepter leur existence eu égard à une science mathématique en particulier, à savoir la géométrie. (shrink)

Le volume offre huit articles sur le scepticisme pyrrhonien. Les essais, de la plume de M. Bonazzi, T. O’Keefe, J. Warren, F. Grgić, H. Thorsrud, S. Marchand, D. E. Machuca et O. Bueno, sont tous en anglais. Précédés d’une préface, d’une notice sur les auteurs et d’une brève introduction, ils sont suivis d’index des noms propres, des passages et des sujets. Chaque contribution est munie d’une bibliographie. Les deux premiers articles sont consacrés à la section des Esquisses Pyrrhoniennes (PH...

Je remercie Stéphane Marchand : ses objections me fournissent l’occasion d’éclaircir certains points capitaux de mon livre et de mon interprétation de Sextus Empiricus. Scepticisme et langage veut affronter la question de savoir si le sceptique pyrrhonien décrit par Sextus peut maîtriser une langue. Après avoir identifié le pyrrhonien à un sceptique radical, un individu dépourvu de croyances, je m’efforce de lui assurer la possibilité de parler en proposant plusieurs façons d’expliquer son co...

ch. 1. Ontologii︠a︡ razuma -- ch. 2. Gnoseologii︠a︡ razuma.

Gennaro Chtjerchia, Dynamics of meaning: anaphora, presupposition, and the the of grammar. Chicago and London: The University of Chicago Press, 1995.xv+ 270 pp, £59.95, £31.95 G. Pr...

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social (...) sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed. (shrink)

Objective: The field of clinical ethics is relatively new and expanding. Best practices in clinical ethics against which one can benchmark performance have not been clearly articulated. The first step in developing benchmarks of clinical ethics services is to identify and understand current practices.Design and setting: Using a retrospective case study approach, the structure, activities, and resources of nine clinical ethics services in a large metropolitan centre are described, compared, and contrasted.Results: The data yielded a unique and detailed account of (...) the nature and scope of clinical ethics services across a spectrum of facilities. General themes emerged in four areas—variability, visibility, accountability, and complexity. There was a high degree of variability in the structures, activities, and resources across the clinical ethics services. Increasing visibility was identified as a significant challenge within organisations and externally. Although each service had a formal system for maintaining accountability and measuring performance, differences in the type, frequency, and content of reporting impacted service delivery. One of the most salient findings was the complexity inherent in the provision of clinical ethics services, which requires of clinical ethicists a broad and varied skill set and knowledge base. Benchmarks including the average number of consults/ethicist per year and the hospital beds/ethicist ratio are presented.Conclusion: The findings will be of interest to clinical ethicists locally, nationally, and internationally as they provide a preliminary framework from which further benchmarking measures and best practices in clinical ethics can be identified, developed, and evaluated. (shrink)

The British National Institute for Health and Clinical Excellence has recently released new guidelines for the diagnosis, treatment and prevention of the psychiatric category antisocial personality disorder. Evident in these recommendations is a broader ambiguity regarding the ontology of ASPD. Although, perhaps, a mundane feature of much of medicine, in this case, ontological uncertainty has significant ethical implications as a product of the profound consequences for an individual categorised with this disorder. This paper argues that in refraining from emphasising uncertainty, (...) NICE risks reifying a controversial category. This is particularly problematical given that the guidelines recommend the identification of individuals “at risk” of raising antisocial children. Although this paper does not argue that NICE is “wrong” in any of its recommendations, more emphasis should have been placed on discussions of the ethical implications of diagnosis and treatment, especially given the multiple uncertainties associated with ASPD. It is proposed that these important issues be examined in more detail in revisions of existing NICE recommendations, and be included in upcoming guidance. This paper thus raises key questions regarding the place and role of ethics within the current and future remit of NICE. (shrink)

LIFE offers various amusements, and anyone these days who can choose among them will come late to the study of hiatus in Greek prose. Germany in the 1880s, so it seems, was less fortunate, and few greater excitements were known to young or old than the hunt for hiatus; but now that we no longer strait-waistcoat our classical authors and the austerity of those times is discredited, few collectors of hiatus are to be found, and there are people even in (...) Germany who have never identified a single specimen. Yet there is nothing to be said for underrating an author' stylistic pretensions, still less for encouraging others to do the same; and the textual critic, whose path is slippery enough at the best of times, can ill afford to dispense with footholds. There has been no broad study of hiatus in Greek prose since 1841, when Benseler in a long and original book De hiatu in oratoribus et historicis Graecis went through the text of 27 authors and attempted to determine their practice. (shrink)

In a brief article under the present title, Adam Parry raised a simple but profound question: were there certain things that the inherited vocabulary of oral poets did not allow them to sayF; The mere raising of this question, whatever his answer, is enough to make the article one of the more important contributions to Homeric studies in the last fifty years. As it happens, his answer was affirmative, and it has not been contested. Contested it will now be.

The editorial in the September 1982 issue of this journal and many articles before and since have addressed the problem of informed consent. Is it possible? Is it a useful concept? Is there anything new to be said about it? In this article the basic rationale of the rule (patient autonomy) is explained and the extent of the rule explored. Various exceptions have been offered by the law and an attempt is made to catalogue the chief of these. A number (...) of specially vulnerable groups are then identified, the most important, and vexed, being children. How can informed consent be secured in the case of young patients? Finally, a few problems are mentioned in an attempt to get this subject back to reality. The appeal to the principle primum non nocere may be medical paternalism in disguise. Informed consent is the competing principle that reminds us of the primacy of human autonomy. A pointer is given to the future: even the use of sound recordings to explain medical procedures and to activate informed consent so that it may become a reality and not just a lawyer's myth, should be considered. (shrink)

No speech in Attic tragedy has made a stronger impression on later generations than Medea's farewell to her children. Four changes of mind and two displays of maternal affection lay bare the depths of a tortured soul; ‘there, in a short space, arelove and hatred, firmness and hesitation, fierce joy and unfathomable sorrow’.

Statius' Silvae owe their preservation to a copy made in Switzerland for Poggio in 1417 by a local scribe. This copy, brought to light by G. Loewe in 1879, was recognized for what it was by A.C. Clark and A. Klotz twenty years later, and since then its descendants have had at best historical interest. To extract much of that from them an editor must endeavour to survey all the extant material, and A. Marastoni in the recent Teubner edition claims (...) to have done just that: ‘omnes manuscriptos libros veteresque editiones iterum contuli’ he says at the opening of his preface, and the reviewers echo his words. (shrink)

When did Livy write his history? How many books had it, and what did the lost ones cover? Such answers as can be given to these questions come almost entirely from the one extant summary, the Periochae. The manuscripts of the Periochae disagree, however, on a matter of considerable interest: out of a hundred or so, only three, supported by a lost fourth, have been cited as adding to the title Ex libro CXXI the subtitle qui editus post excessum Augusti (...) dicitur. When the latest editor, P. Jal in the Collection Budé , declares himself unconvinced of its authenticity , he leaves the reader to decide whether authenticity means truth, authorial origin, or presence in the archetype; but whatever it means, seeds of suspicion have been sown. (shrink)

The imbalance between supply of organs for transplantation and demand for them is widening. Although the current international drive to re-establish procurement via non-heart beating organ donation/donor is founded therefore on necessity, the process may constitute a desirable outcome for patient and family when progression to brain stem death does not occur and conventional organ retrieval from the beating heart donor is thereby prevented. The literature accounts of this practice, however, raise concerns that risk jeopardising professional and public confidence in (...) the broader transplant programme. This article focuses on these clinical, ethical, and legal issues in the context of other approaches aimed at increasing donor numbers. The feasibility of introducing such an initiative will hinge on the ability to reassure patients, families, attendant staff, professional bodies, the wider public, law enforcement agencies, and the media that practitioners are working within explicit guidelines which are both ethically and legally defensible. (shrink)

These H, British Library Harl. 647, was written in Lorraine but crossed before AD 1000 to England, where it later belonged to St. Augustine's Canterbury; Cicero's verses in minuscule occupy the foot of each page, and the rest is given over to the appropriate illustration, painted only at the extremities and filled out to the requisite shape with scholia from Hyginus in small capitals. D, Dresden Dc 183, left France not before 1573; illustrations and scholia occur only in a preceding (...) work, the scholia Sangermanensia. (shrink)

Citizens today are increasingly expected to be knowledgeable about and prepared to engage with biomedical knowledge. In this article, I wish to reframe this ‘public understanding of science’ project, and place fresh emphasis on public understandings of research: an engagement with the everyday laboratory practices of biomedicine and its associated ethics, rather than with specific scientific facts. This is not based on an assumption that non-scientists are ‘ignorant’ and are thus unable to ‘appropriately’ use or debate science; rather, it is (...) underpinned by an empirically-grounded observation that some individuals may be unfamiliar with certain specificities of particular modes of research and ethical frameworks, and, as a consequence, have their autonomy compromised when invited to participate in biomedical investigations. Drawing on the perspectives of participants in my own sociological research on the social and ethical dimensions of neuroscience, I argue that public understanding of biomedical research and its ethics should be developed both at the community level and within the research moment itself in order to enhance autonomy and promote more socially robust science. Public bioethics will have to play a key role in such an endeavour, and indeed will contribute in important ways to the opening up of new spaces of symmetrical engagement between bioethicists, scientists and wider publics—and hence to the democratisation of the bioethical enterprise. (shrink)

LIFE offers various amusements, and anyone these days who can choose among them will come late to the study of hiatus in Greek prose. Germany in the 1880s, so it seems, was less fortunate, and few greater excitements were known to young or old than the hunt for hiatus; but now that we no longer strait-waistcoat our classical authors and the austerity of those times is discredited, few collectors of hiatus are to be found, and there are people even in (...) Germany who have never identified a single specimen.Yet there is nothing to be said for underrating an author' stylistic pretensions, still less for encouraging others to do the same; and the textual critic, whose path is slippery enough at the best of times, can ill afford to dispense with footholds.There has been no broad study of hiatus in Greek prose since 1841, when Benseler in a long and original book De hiatu in oratoribus et historicis Graecis went through the text of 27 authors and attempted to determine their practice. (shrink)

Statius' Silvae owe their preservation to a copy made in Switzerland for Poggio in 1417 by a local scribe. This copy, brought to light by G. Loewe in 1879, was recognized for what it was by A.C. Clark and A. Klotz twenty years later, and since then its descendants have had at best historical interest. To extract much of that from them an editor must endeavour to survey all the extant material, and A. Marastoni in the recent Teubner edition claims (...) to have done just that: ‘omnes manuscriptos libros veteresque editiones iterum contuli’ he says at the opening of his preface, and the reviewers echo his words. (shrink)

This article identifies two trends in Dooyeweerd’s conception of ‘cosmic time’, and elaborates their consequences for the philosophy of history. The first trend, connecting time to modal diversity and the order of the modal aspects, prevails in Dooyeweerd’s analysis. The application of the second trend, emphasizing that in each relation frame the temporal order governs subject-subject relations and subjectobject relations, sheds a new light on the interpretation of history conceived of as development of the culture and civilization of mankind. The (...) distinction of faith and religion and the position of the aspect of faith in the order of the modal aspects play important parts in this discussion, in particular with respect to the possibility of transcending time. (shrink)

Heliodorus has been edited twice in the last thirty years, by Colonna and by Rattenbury and Lumb . Colonna's text is erratic, but in another respect his work on Heliodorus has been productive: he has put it beyond doubt that Book 9 of Aethiopica was written after the third siege of Nisibis, which took place in A.D. 350 . There is no point in repeating Colonna's arguments here; they merit mention because no one has taken any notice of them.

Heliodorus has been edited twice in the last thirty years, by Colonna and by Rattenbury and Lumb.Colonna's text is erratic, but in another respect his work on Heliodorus has been productive: he has put it beyond doubt that Book 9 ofAethiopicawas written after the third siege of Nisibis, which took place in A.D. 350. There is no point in repeating Colonna's arguments here; they merit mention because no one has taken any notice of them.

These H, British Library Harl. 647, was written in Lorraine but crossed before AD 1000 to England, where it later belonged to St. Augustine's Canterbury; Cicero's verses in minuscule occupy the foot of each page, and the rest is given over to the appropriate illustration, painted only at the extremities and filled out to the requisite shape with scholia from Hyginus in small capitals. D, Dresden Dc 183, left France not before 1573; illustrations and scholia occur only in a preceding (...) work, the scholia Sangermanensia. (shrink)

At the law side of the creation, the Philosophy of the Cosmonomic Idea distinguishes between natural laws, values and norms. Natural laws are coercive both for human beings and for any other subject or object. Like natural laws, values or normative principles belong to the creation, being universal and invariable. Both people and associations are subject to values, which they can obey or disobey. Values characterize the relation frames following the natural ones. Norms are man-made realizations of values, historically and (...) culturally different. Philosophical ethics investigates the normativity of human acts. This paper argues that ethics cannot be related to a single relation frame and that the designation ‘ethical’ or ‘moral’ modal aspect is a misnomer. (shrink)

Thomas Marshall, who became Rector of Lincoln College in 1672 and died in 1685, left to the Bodleian his collection of books and manuscripts. Two lists of the manuscripts appear in Edward Bernard's Catalogi librorum manuscriptorum Angliae et Hiberniae , i . 272–3, 373–4, but both omit what is now called MS. Marshall 140, which F. Madan in the Summary Catalogue describes as follows.

Thomas Marshall, who became Rector of Lincoln College in 1672 and died in 1685, left to the Bodleian his collection of books and manuscripts. Two lists of the manuscripts appear in Edward Bernard's Catalogi librorum manuscriptorum Angliae et Hiberniae, i. 272–3, 373–4, but both omit what is now called MS. Marshall 140, which F. Madan in the Summary Catalogue describes as follows.