Spain is one of the most advanced European countries in terms of the legislative and administrative development of ADs. Article 11 of Law 41/2002, concerning Patient Autonomy, regulates ‘advance directives’ and has prompted various Autonomous Regions to develop legislation in this area. Nevertheless, whilst the variety of legislations in different territories presents advantages, the disparity of criteria also presents problems.Despite significant legislative development, only 23,000 Spanish citizens have filled in an AD. Clearly, AD use is confined to a minority. Several (...) surveys, however, show that the Spanish population views these documents in a positive light. Thus, we must analyse this discrepancy between attitude and practice. A similar situation exists amongst health professionals. Whilst they generally feel that the use of ADs is positive and necessary, they are frequently unwilling to employ them.Bioethical literature and research on ADs has significantly increased in Spain over the last six years. It is likely that this trend will continue in the foreseeable future; but more resources and effort are required if ADs are to become consolidated. (shrink)

This paper evaluates the content of the syllabi of postgraduate courses on public health ethics within accredited schools and programs of public health in the United States in order to gain an awareness of the topics addressed within these courses. Methods: Data was gathered via the analysis of syllabi of courses on PHE. In 2012, information was requested by e-mail from the 48 schools and 86 PH programs accredited by the U.S. Council on Education for Public Health for 2012. The (...) “Epidemiology and PHE Syllabi” project of the University of Miami also was consulted. A table of topics was drawn up in order to carry out content analysis of the documents. Results: Data was obtained from 25 schools and 36 accredited programs ; 36 syllabi were gathered and 75 different topics were found. Of these, 38 topics were addressed in six or more syllabi and can be grouped as follows: foundations of PHE; autonomy and its limits; infectious disease control; justice; research ethics; health education and promotion; environmental and occupational health; screening; genetics; privacy and confidentiality; and community-based practice and vulnerable populations. Conclusions: The analyzed syllabi show high variability in curricular content. The debate with regard to whether a core curriculum on PHE should be established is ongoing. The results of this work might be of interest for schools and programs of PH in other countries or regions of the world in order to develop or ameliorate their own PHE syllabi. (shrink)

Objective: To measure the stability of life-sustaining treatment preferences amongst older people and analyse the factors that influence stability. Design: Longitudinal cohort study. Setting: Primary care centres, Granada (Spain). Eighty-five persons age 65 years or older. Participants filled out a questionnaire with six contexts of illness (LSPQ-e). They had to decide whether or not to receive treatment. Participants completed the questionnaire at baseline and 18 months later. Results: 86 percent of the patients did not change preferences. Sex, age, marital status, (...) hospitalisation, and self-perception of health and pain did not affect preferences. Morbidity and the death of a relative did. Conclusion: Stability of preferences of older persons in relation to end-of-life decisions seems to be more probable than instability. Some factors, such as the death of a relative or the increase in morbidity, can change preferences. These findings have implications for advance directives (ADs) and advance care planning. (shrink)

The accuracy of proxies when they interpret advance directives or apply substituted decision-making criteria has been called into question. It therefore became important to know if the Andalusian Advance Directive Form (AADF) can help to increase the accuracy of proxies' predictions. The aim of this research was to compare the effect of the AADF on the accuracy of proxies' predictions about patients' preferences with that gained from informative and deliberative sessions about end-of-life decision making. A total of 171 pairs of (...) patients and their proxies were randomized to three groups. The control group's answers to the Life Sustaining Preferences Questionnaire (LSPQ) were compared with their proxies' answers to the same questionnaire. In one intervention group, the patients had already completed the AADF and given it to their proxies, who used it to guide their own answers to the LSPQ. In the second intervention (discussion) group, both patients and proxies attended two educative sessions guided by trained nurses and later filled in the LSPQ. Comparisons of accuracy and other variables showed a strong association with the discussion group. The findings show that promoting communication between patients and their proxies improves the accuracy of proxies' predictions much more than isolated use of the AADF form. (shrink)

The aim of this study is to assess the knowledge, attitudes and experiences of Spanish nurses in relation to euthanasia and physician-assisted suicide. In an online questionnaire completed by 390 nurses from Andalusia, 59.1% adequately identified a euthanasia situation and 64.1% a situation involving physician-assisted suicide. Around 69% were aware that both practices were illegal in Spain, while 21.4% had received requests for euthanasia and a further 7.8% for assisted suicide. A total of 22.6% believed that cases of euthanasia had (...) occurred in Spain and 11.4% believed the same for assisted suicide. There was greater support (70%) for legalisation of euthanasia than for assisted suicide (65%), combined with a greater predisposition towards carrying out euthanasia (54%), if it were to be legalised, than participating in assisted suicide (47.3%). Nurses in Andalusia should be offered more education about issues pertaining to the end of life, and extensive research into this area should be undertaken. (shrink)

This study compares the balance of newspaper and television news coverage about migration in two countries that were differently affected by the so-called “refugee crisis” in 2015 in terms of the geopolitical involvement and numbers of migrants being admitted. Based on a broad consensus among political elites, Germany left its borders open and received about one million migrants mainly from Syria during 2015. In contrast, the conservative British government was heavily attacked by oppositional parties for closing Britain’s borders and, thus, (...) restricting immigration. These different initial situations led to remarkable differences between the news coverage in both countries. In line with news value theory, German media outlets reported much more on migration than did their British counterparts. In line with indexing theory, German news coverage consonantly reflected the consensual view of German political elites, while British news media reported along their general editorial lines. (shrink)

Cancer is a singular cellular state, the emergence of which destabilises the homeostasis reached through the evolution to multicellularity. We present the idea that the onset of the cellular disobedience to the metazoan functional and structural architecture, known as the cancer phenotype, is triggered by changes in the cell's external environment that occur with ageing: what ensues is a breach of the social contract of multicellular life characteristic of metazoans. By integrating old ideas with new evidence, we propose that with (...) ageing the environmental information that maintains a multicellular organisation is eroded, rewiring internal processes of the cell, and resulting in an internal shift towards an ancestral condition resulting in the pseudo‐multicellular cancer phenotype. Once that phenotype emerges, a new local social contract is built, different from the homeostatic one, leading to tumour formation and the foundation of a novel local ecosystem. (shrink)

Principles of procreative beneficence (PPBs) hold that parents have good reasons to select the child with the best life prospects. Sparrow (2010) claims that PPBs imply that we should select only female children, unlesswe attach normative significance to “normal” human capacities. We argue that this claim fails on both empirical and logical grounds. Empirically, Sparrow’s argument for greater female wellbeing rests on a selective reading of the evidence and the incorrect assumption that an advantage for females would persist even when (...) a serious gender imbalance is obtained. Logically, PPBs cite only pro tanto reasons and allow that the good of an individual child could be outweighed by other morally relevant considerations, such as those which take collectively suboptimal outcomes into account. There is thus no need to attach value to the “normal.”. (shrink)

Human decisions are increasingly supported by decision support systems (DSS). Humans are required to remain “on the loop,” by monitoring and approving/rejecting machine recommendations. However, use of DSS can lead to overreliance on machines, reducing human oversight. This paper proposes “reflection machines” (RM) to increase meaningful human control. An RM provides a medical expert not with suggestions for a decision, but with questions that stimulate reflection about decisions. It can refer to data points or suggest counterarguments that are less compatible (...) with the planned decision. RMs think against the proposed decision in order to increase human resistance against automation complacency. Building on preliminary research, this paper will (1) make a case for deriving a set of design requirements for RMs from EU regulations, (2) suggest a way how RMs could support decision-making, (3) describe the possibility of how a prototype of an RM could apply to the medical domain of chronic low back pain, and (4) highlight the importance of exploring an RM’s functionality and the experiences of users working with it. (shrink)

Un tipo de prolepsis, utilizado frecuentemente en Argonáuticas, es el discurso-programa en el cual un personaje anticipa la narración posterior. De esta manera funciona el relato de Fineo como guía de navegación para los Argonautas. Con el ineludible modelo de los relatos de viajes de Odisea, esta narración interna guarda una relación especular con la obra que la contiene y conlleva una cuasi-identificación entre narrador interno y narrador principal. Este artículo tiene como objetivo el análisis de los niveles narrativos en (...) este relato, para mostrar el modo en que esa técnica anticipatoria funciona en el poema en un nivel metaliterario. One type of prolepsis, frequently used in the Argonautica, is the programmatic speech in which a character anticipates the subsequent story. In this manner works the story of Phineus as navigation guidance for the Argonauts. With the inevitable model of travel stories of Odyssey, this internal narrative keeps a mirror-relationship with the work that contains it and carries a quasi-identification between internal narrator and main narrator. This article aims to analyze the narrative levels in this story, to show how this anticipatory technique works in the poem on a metaliterary level. (shrink)

El presente artículo aborda las connotaciones y los fundamentos de la paráfrasis cum canere vellem en Serv. Ecl. 6. 3. El análisis del sentido del verbo volo en este contexto y la confrontación del pasaje con Serv. Ecl. 6. 5 revelan que Servio interpreta la frase cum canerem reges et proelia como referencia a un temprano empeño de Virgilio en componer poesía épica, del que pronto desistió. Esta interpretación está condicionada por la idea de que la secuencia cronológica Églogas - (...) Geórgicas - Eneida tiene un correlato jerárquico, idea que se funda en noticias biográficas y en la teoría de la tripertita varietas. This paper focuses on the connotations and grounds of the paraphrase cum canere vellem in Serv. Ecl. 6. 3. The analysis of the sense of verb volo within this context, as well as the confrontation between that passage and Serv. Ecl. 6. 5, show that Servius interprets the clause cum canerem reges et proelia as a reference to Virgil's early endeavor to compose an epic poem, from which he shortly desisted. This interpretation is conditioned by the idea that the chronological sequence Eclogues - Georgics - Aeneid has a hierarchical correlate, an idea which is founded on biographical information and the theory of tripertita varietas. (shrink)

Daniel Isaacson has advanced an epistemic notion of arithmetical truth according to which the latter is the set of truths that we grasp on the basis of our understanding of the structure of natural numbers alone. Isaacson’s thesis is then the claim that Peano Arithmetic (PA) is the theory of finite mathematics, in the sense that it proves all and only arithmetical truths thus understood. In this paper, we raise a challenge for the thesis and show how it can be (...) overcome. We introduce the concept of purity for theories of arithmetic: a theory of arithmetic is pure when it only proves arithmetical truths. Then, we argue that, under Isaacson’s thesis, some PA-provable truths—including transfinite induction claims for infinite ordinals and some consistency statements—are seemingly not arithmetical in Isaacson’s sense, and hence that Isaacson’s thesis might entail the impurity of PA. Nonetheless, we conjecture that the advocate of Isaacson’s thesis can avoid this undesirable consequence: the arithmetical nature, as understood by Isaacson, of all contentious PA-provable statements can be justified. As a case study, we explore how this is done for transfinite induction claims with infinite ordinals below ε0. To this end, we show that the PA-proof of such claims employs exclusively resources from finite mathematics, and that ordinals below ε0 are finitary objects despite being infinite. (shrink)

Simon Critchley's first book, The Ethics of Deconstruction, was originally published to great acclaim in 1992. This edition contains three new appendices and a new preface where Critchley reflects upon the origins, motivation and reception of The Ethics of Deconstruction.

A partir de una presentación general del concepto de especie aplicado a los humanos, este texto expone dos nociones generales sobre la naturaleza humana: la tipológica y la filogenética. Una vez expuestos los fundamentos de cada noción, se defiende una distinción entre naturaleza humana e identidad humana como dos aspectos que se han confundido respecto a este problema, pero que cumplen distintos roles en las explicaciones, por lo que se proponen como dos nociones complementarias. Así, la naturaleza humana estaría definida (...) en términos metafísicos y daría cuenta de la realidad biológica de los humanos desde un punto de vista filogenético, mientras que la identidad humana estaría definida en términos epistemológicos y daría cuenta de los conocimientos que tienen los humanos sobre ellos mismos, aludiendo a aspectos contingentes. (shrink)

This chapter contains sections titled: Introduction On Law and Morality Legal Rights and Legal Principles Law and Legal Systems Deontic Logic and Legal Philosophy Philosophical Doctrines in Latin America Conclusion References.

Gilles Deleuze’s engagements with mathematics, replete in his work, rely upon the construction of alternative lineages in the history of mathematics, which challenge some of the self imposed limits that regulate the canonical concepts of the discipline. For Deleuze, these challenges provide an opportunity to reconfigure particular philosophical problems – for example, the problem of individuation – and to develop new concepts in response to them. The highly original research presented in this book explores the mathematical construction of Deleuze’s philosophy, (...) as well as addressing the undervalued and often neglected question of the mathematical thinkers who influenced his work. -/- In the wake of Alain Badiou’s recent and seemingly devastating attack on the way the relation between mathematics and philosophy is configured in Deleuze’s work, Simon Duffy offers a robust defence of the structure of Deleuze’s philosophy and, in particular, the adequacy of the mathematical problems used in its construction. By reconciling Badiou and Deleuze’s seeming incompatible engagements with mathematics, Duffy succeeds in presenting a solid foundation for Deleuze’s philosophy, rebuffing the recent challenges against it. -/- Simon B. Duffy is a Senior Lecturer in Philosophy at Yale-NUS College, Singapore, and Honorary Research Associate in the Department of Philosophy at the University of Sydney, Australia. He is the author of The Logic of Expression: Quality, Quantity, and Intensity in Spinoza, Hegel and Deleuze (2006). (shrink)

To what degree can language be acquired from linguistic input alone? This question has vexed scholars for millennia and is still a major focus of debate in the cognitive science of language. The complexity of human language has hampered progress because studies of language–especially those involving computational modeling–have only been able to deal with small fragments of our linguistic skills. We suggest that the most recent generation of Large Language Models (LLMs) might finally provide the computational tools to determine empirically (...) how much of the human language ability can be acquired from linguistic experience. LLMs are sophisticated deep learning architectures trained on vast amounts of natural language data, enabling them to perform an impressive range of linguistic tasks. We argue that, despite their clear semantic and pragmatic limitations, LLMs have already demonstrated that human-like grammatical language can be acquired without the need for a built-in grammar. Thus, while there is still much to learn about how humans acquire and use language, LLMs provide full-fledged computational models for cognitive scientists to empirically evaluate just how far statistical learning might take us in explaining the full complexity of human language. (shrink)

Topics in Cognitive Science, Volume 14, Issue 3, Page 634-645, July 2022.

The relevance of Martin Heidegger’s thinking to Paul Celan’s poetry is well known. Between Celan and Heidegger proposes that, while the relation between them is undeniable, it is also marked by irreducible discord. Pablo Oyarzun begins with a deconstruction of Celan’s Todtnauberg, written after the poet visited Heidegger in his Schwarzwald cabin. The poem stands as a milestone, not only in the complex relationship between the two men but also in the state of poetry and philosophy in late modernity, (...) in the aftermath of the Holocaust. Discussion then turns to The Meridian, Celan’s acceptance speech for the prestigious Büchner Prize for German language literature. Other issues are insistently addressed—place, art, language, pain, existence, and the Heideggerian notion of dialogue—as Oyarzun revisits several essential poems from Celan’s oeuvre. A rare translation of Oyarzun’s work into English, Between Celan and Heidegger affirms the uniqueness of Celan’s poetry in confrontation both with Heidegger’s discourse on Dichtung (a poetic saying centered in the idea of gathering) and with Western philosophical notions of art, technē, mimesis, poiesis, language, and thinking more broadly. (shrink)

What kind of discourse is likely to build up constitutional norms? How do legal-philosophical insights get along with competing political claims? This book presents the main conclusions from the CITC (Congreso Internacional de Teoria Constitucional) in Cordoba, Argentina. While addressing the very foundations of Constitutional Law, leading scholars from Europe and America got together to debate legal and political issues which impinge upon institutional design and polity assessment, political representation and rights protection. Not to mention other vexing challenges such as (...) the proper latitude of judicial review, the threatening phenomena of untamed emergency powers and the current international dimension of supra-national state-building. Beyond governance and human rights discourse, the core content of this book is concentrated on shedding some light on which theoretical and/or political conditions could better stand and give shelter to civil obedience and constitutional patriotism. (shrink)

I intend to argue that good friendship sometimes requires epistemic irresponsibility. To put it another way, it is not always possible to be both a good friend and a diligent believer.

1.Los bienes invisibles -- 2. Tareas del espíritu.

El presente artículo pretende invitar al estudio del impacto que tuvo _El Evangelio en Triumpho_ de Olavide sobre el pensamiento decimonónico. Con ese fin propone, en primer lugar, leerlo captando en sus rasgos esenciales el valor alegórico de sus personajes en sus relaciones. A continuación, señala qué aspectos de esa lectura habrían influido de manera más marcada en las obras de Maistre y Saint-Simon, con las que abarca las dos tendencias post-revolucionarias de entender la historia, catecóntica y quiliástica. Finalmente, presenta (...) la unidad milenarista de la obra de Olavide, ajena a aquellas interpretaciones precisamente por su ortodoxia, apuntando, como lectura alternativa a la francesa, la que sugiere Dostoyevski en _El Gran Inquisidor_. (shrink)

Un atlas zoopolítico es lo que pretende tener aquí lugar. Un atlas en el sentido en que cada pequeño tratado de los cincuenta y dos que configuran el libro se presenta en la forma de un retrato donde el pensamiento, entre sus pensadores, se aplica en el esfuerzo de hacerse cargo de la presencia animal sin renunciar a la diferencia humana, y en que, entre todos ellos, se delinea en todas sus valoraciones posibles esta nueva presencia del animal entre nosotros. (...) Retrato con animal. Prefacio. Pablo Perera Velamazán es escritor, además de filósofo e historiador del arte. Esta triple condición –y alguna otra (profesor, traductor)- le han permitido entrar en el círculo de los que escriben siempre de los que no saben y le ha impedido, también formar parte de ninguna empresa concreta, salvo la del precipicio del pensamiento en la singularidad que se resiste a los nombres. Allí suelen estar acompañado de niños y animales, de ángeles como muñecos, pero allí también se pueden encontrar a cualquiera. Buen compañero de viaje de invierno. (shrink)

It is shown that the Hilbert-Bernays-Quine principle of identity of indiscernibles applies uniformly to all the contentious cases of symmetries in physics, including permutation symmetry in classical and quantum mechanics. It follows that there is no special problem with the notion of objecthood in physics. Leibniz's principle of sufficient reason is considered as well; this too applies uniformly. But given the new principle of identity, it no longer implies that space, or atoms, are unreal.

In considering the debate about the meaning of ‘disease’, the positions are generally presented as falling into two categories: naturalist, e.g., Boorse, and normativist, e.g., Engelhardt and many others. This division is too coarse, and obscures much of what is going on in this debate. I therefore propose that accounts of the meaning of ‘disease’ be assessed according to Hare’s (1997) taxonomy of evaluative terms. Such an analysis will allow us to better understand both individual positions and their inter-relationships. Most (...) importantly, it will show that it is unlikely that there is a single unique disease-concept at issue. Rather, different authors are, for the most part, considering different concepts. (shrink)

This is a collective work of philosophy of science on a topic, even though it could already be considered a classic, of great academic actuality in the field: change and incommensurability in science. The contributors are researchers from Spain, Argentina, Mexico, Brazil and Colombia.

La lectio divina es un ejercicio ascético y espiritual usado por la comunicad cristiana en las asambleas litúrgicas. Desde los Padres del Desierto su práctica nunca se ha extinguido como ejercicio espiritual. Ahora parece haber vuelto con fuerza como ejercicio de lectura de la Palabra de Dios. La primera parte del artículo recrea los datos históricos fundamentales, la segunda explica su validez para los cristianos y las comunidades de nuestro tiempo.

In this paper we investigate a semantics for first-order logic originally proposed by R. van Rooij to account for the idea that vague predicates are tolerant, that is, for the principle that if x is P, then y should be P whenever y is similar enough to x. The semantics, which makes use of indifference relations to model similarity, rests on the interaction of three notions of truth: the classical notion, and two dual notions simultaneously defined in terms of it, (...) which we call tolerant truth and strict truth. We characterize the space of consequence relations definable in terms of those and discuss the kind of solution this gives to the sorites paradox. We discuss some applications of the framework to the pragmatics and psycholinguistics of vague predicates, in particular regarding judgments about borderline cases. (shrink)