If all dependent expressions were adjacent some variety of immediate constituent analysis would suffice for grammar, but syntactic and semantic mismatches are characteristic of natural language; indeed this is a, or the, central problem in grammar. Logical categorial grammar reduces grammar to logic: an expression is well-formed if and only if an associated sequent is a theorem of a categorial logic. The paradigmatic categorial logic is the Lambek calculus, but being a logic of concatenation the Lambek calculus can only capture (...) discontinuous dependencies when they are peripheral. In this paper we present the displacement calculus, which is a logic of intercalation as well as concatenation and which subsumes the Lambek calculus. On the empirical side, we apply the new calculus to discontinuous idioms, quantification, VP ellipsis, medial extraction, pied-piping, appositive relativisation, parentheticals, gapping, comparative subdeletion, cross-serial dependencies, reflexivization, anaphora, dative alternation, and particle shift. On the technical side, we prove that the calculus enjoys Cut-elimination. (shrink)

BackgroundDespite consensus about the importance of implementing shared decision-making (SDM) in clinical practice, this ideal is inconsistently enacted today. Evidence shows that SDM practices differ in the degree of involvement of patients or family members, or in the amount of medical information disclosed to patients in order to “share” meaningfully in treatment decisions. Little is known on which representations and moral justifications physicians hold when realizing SDM. This study explored physicians’ experiences of SDM in the management of paediatric patients with (...) prolonged disorders of consciousness (PDOC). Specifically, we focused on physicians’ SDM approaches, representations, and ethical justifications for engaging in SDM.MethodsWe used a qualitative approach to explore the SDM experiences of 13 ICU physicians, paediatricians, and neurologists based in Switzerland who have been or were involved in the care of paediatric patients living with PDOC. A semi-structured interview format was used and interviews were audio-recorded and transcribed. Data were analysed through thematic analysis.ResultsWe found that participants followed three main decision-making approaches: the “brakes” approach, characterized by maximized family’s decisional freedom, though conditional to physician’s judgment regarding the medical appropriateness of a treatment; the “orchestra director” approach, characterized by a multi-step decision-making process led by the main physician aimed at eliciting the voices of the care team members and of the family; and the “sunbeams” approach, characterized by a process oriented to reach consensus with family members through dialogue, where the virtues of the physician are key to guide the process. We also found that participants differed in the moral justifications sustaining each approach, citing the duty to respect parental autonomy, to invest in an ethics of care, and to employ physicians’ virtues to guide the decision-making process.ConclusionOur results show that physicians come to perform SDM in different ways, with several representations, and distinct ethical justifications. SDM training among health care providers should clarify the ductility of SDM and the several ethical motivations underpinning it, rather than insisting on the principle of respect for patient’s autonomy as its only moral foundation. (shrink)