Presents a plethora of approaches to developing human potential in areas not conventionally addressed. Organized in two parts, this international collection of essays provides viable educational alternatives to those currently holding sway in an era of high-stakes accountability.
BackgroundThere is evidence that direct journal endorsement of reporting guidelines can lead to important improvements in the quality and reliability of the published research. However, over the last 20 years, there has been a proliferation of reporting guidelines for different study designs, making it impractical for a journal to explicitly endorse them all. The objective of this study was to investigate whether a decision tree tool made available during the submission process facilitates author identification of the relevant reporting guideline.MethodsThis was (...) a prospective 14-week before–after study across four speciality medical research journals. During the submission process, authors were prompted to follow the relevant reporting guideline from the EQUATOR Network and asked to confirm that they followed the guideline. After 7 weeks, this prompt was updated to include a direct link to the decision-tree tool and an additional prompt for those authors who stated that ‘no guidelines were applicable’. For each article submitted, the authors’ response, what guideline they followed and what reporting guideline they should have followed were recorded.ResultsOverall, 590 manuscripts were included in this analysis—300 in the before cohort and 290 in the after. There were relevant reporting guidelines for 75% of manuscripts in each group; STROBE was the most commonly applicable reporting guideline, relevant for 35% and 37% of manuscripts, respectively. Use of the tool was associated with an 8.4% improvement in the number of authors correctly identifying the relevant reporting guideline for their study, a 14% reduction in the number of authors incorrectly stating that there were no relevant reporting guidelines, and a 1.7% reduction in authors choosing a guideline. However, the ‘after’ cohort also saw a significant increase in the number of authors stating that there were relevant reporting guidelines for their study, but not specifying which.ConclusionThis study suggests that use of a decision-tree tool during submission of a manuscript is associated with improved author identification of the relevant reporting guidelines for their study type; however, the majority of authors still failed to correctly identify the relevant guidelines. (shrink)
We outline some ways in which motor neglect (the underutilization of a limb despite adequate strength) and hysterical paralysis (failure to move a limb despite no relevant structural damage or disease) may throw light on the pathophysiology of catatonia. We also comment on the manifold inadequacies of distinguishing too firmly between symptoms of “neurologic origin” and of “psychiatric origin.”.
Wynn's claims are, in principle, entirely reasonable; although, as always, the devil is in the details. With respect to Wynn's discussion of the cultural evolution of artifactual symmetry, we provide a few more arguments for the utility of mirror symmetry and extend the enquiry into the tacit and explicit processing of natural and artifactual symmetry.
… the supreme end, the happiness of all mankind. The law concerning punishment is a Categorical Imperative; and woe to him who rummages around in the winding paths of a theory of happiness, looking for some advantage to be gained by releasing the criminal from punishment or by reducing the amount of it.
I had a strange dream, or half-waking vision, not long ago. I found myself at the top of a mountain in the mist, feeling very pleased with myself, not just for having climbed the mountain, but for having achieved my life's ambition, to find a way of answering moral questions rationally. But as I was preening myself on this achievement, the mist began to clear, and I saw that I was surrounded on the mountain top by the graves of all (...) those other philosophers, great and small, who had had the same ambition, and thought they had achieved it. And I have come to see, reflecting on my dream, that, ever since, the hard-working philosophical worms have been nibbling away at their systems and showing that the achievement was an illusion. True, their skeletons, indigestible to worms, remained, and were surprisingly similar to one another. But I was led to think again about what one can, and what one cannot, achieve in this direction. (shrink)
We use Homer and Sun Tzu as a background to better understand and reformulate confrontation, anger and violence in medicine, contrasting an unproductive ‘love of war’ with a productive ‘art of war’ or ‘art of strategy’. At first glance, it is a paradox that the healing art is not pacific, but riddled with militaristic language and practices. On closer inspection, we find good reasons for this cultural paradox yet regret its presence. Drawing on insights from Homer's The Iliad and The (...) Odyssey, we argue for better understanding of confrontation, anger, bullying, intimidation and violence in medicine in order to change the culture. For example, equating medicine with war is not a given condition of medicine but a convenient metaphor with historical origins and a historical trajectory. Other, non-martial metaphors, such as medicine as collaboration, may be more appropriate in an age of team-based care. Taking lessons from Homer, we suggest three key ways in which cold-hearted confrontation and anger in medicine can be transformed into productive, warm-hearted engagement: the transformation of angry impulse into reflection, moral courage and empathy. Thinking with Homer can offer an aesthetically and morally charged alternative to the current body of literature on topics, such as anger in doctors, and how this may be ‘managed’, without recourse to an instrumental economy where emotions are viewed as commodities, and emotional responses can be ‘trained’ through communication skills courses. (shrink)
R. M. Hare, one of the most influential moral philosophers of the twentieth century, presents a definitive summary of his fundamental views on ethics, incorporating a critical taxonomy of rival ethical theories. Sorting Out Ethics is a characteristically lucid and lively guide to the subject and Hare's place in it.
Logic ought to guide our thinking. It is better, more rational, more intelligent to think logically than to think illogically. Illogical thought leads to bad judgment and error. In any case, if logic had no role to play as a guide to thought, why should we bother with it? The somewhat naïve opinions of the previous paragraph are subject to attack from many sides. It may be objected that an activity does not count as thinking at all unless it is (...) at least minimally logical, so logic is constitutive of thought rather than a guide to it. Or it may be objected that whereas logic describes a system of timeless relations between propositions, thinking is a dynamic process involving revisions, and so could not use a merely static guide. Or again the objection may be that there is no such thing as logic, only a whole variety of different logics, not all of which could possibly be good guides. (shrink)
Wittgenstein's Tractatus contains a wide range of profound insights into the nature of logic and language – insights which will survive the particular theories of the Tractatus and seem to me to mark definitive and unassailable landmarks in our understanding of some of the deepest questions of philosophy. And yet alongside these insights there is a theory of the nature of the relation between language and reality which appears both to be impossible to work out in detail in a way (...) which is completely satisfactory, and to be bizarre and incredible. I am referring to the so-called logical atomism of the Tractatus. The main outlines of this theory at least are clear and familiar: there are elementary propositions which gain their sense from being models of possible states of affairs; such propositions are configurations of names of simple objects, signifying that those simples are analogously configured; every proposition has its sense through being analysable as a truth-functional compound of elementary propositions, thus deriving its sense from the sense of the elementary propositions when this view is taken in conjunction with the idea that the sense of a proposition is completely specified by specifying its truth-conditions. In this way the Tractatus incorporates in its working out a philosophical system analogous to the classical philosophical systems of Leibniz or Spinoza which are regarded by many people, in a sense rightly, as the prehistoric monsters of philosophy which are not to be studied as living organisms, but studied as the curiosities of human thought. And we may here agree that in the end we must simply reject a philosophy which incorporates such features as its postulation of simple eternal objects, or of a possibility of an analysis of a proposition which was presented as a pre-condition for the propositions that we ordinarily utter to make sense, and yet the specific form of which we are unaware of, and so on. (shrink)
Sainsbury and Tye present a new theory, 'originalism', which provides natural, simple solutions to puzzles about thought that have troubled philosophers for centuries. They argue that concepts are to be individuated by their origin, rather than epistemically or semantically. Although thought is special, no special mystery attaches to its nature.
In Russell's Problems of Philosophy, acquaintance is the basis of thought and also the basis of empirical knowledge. Thought is based on acquaintance, in that a thinker has to be acquainted with the basic constituents of his thoughts. Empirical knowledge is based on acquaintance, in that acquaintance is involved in perception, and perception is the ultimate source of all empirical knowledge.
Gordon's emphasizes that the process of prosecution is crucial to the idea of crime. One who commits a public wrong is properly called to public account for it, and the criminal trial constitutes such a public calling to account. The state is the proper prosecutor of crimes: since a crime is ‘our’ wrong, rather than only the victim's wrong, it is appropriate that we should prosecute it, collectively. The case is not simply V the victim, or P the plaintiff, against (...) D the defendant. It is brought, as the Americans properly have it, by ‘the People’, or by ‘the Commonwealth’, against the defendant. This is a useful way in which to think about crimes and criminalisation. This chapter tries to develop this conception of public wrongs a little further, which also involves complicating it more than a little. It works from a version of liberal communitarianism that rejects the metaphysical version of the individualist's ‘unencumbered self’; but the account sketched here should be compatible with all but the most radically individualist kinds of liberal theory. (shrink)
The dead donor rule governs procuring life-prolonging organs. They should be taken only from deceased donors. Miller and Truog have proposed abandoning the rule when patients have decided to forgo life-sustaining treatment and have consented to procurement. Organs could then be procured from living patients, thus killing them by organ procurement. This proposal warrants careful examination. They convincingly argue that current brain or circulatory death pronouncement misidentifies the biologically dead. After arguing convincingly that physicians already cause death by withdrawing treatment, (...) they claim no bright-line differences preclude organ removal from the living. The argument fails for those who accept the double effect doctrine or other grounds for distinguishing forgoing life support from active, intentional killing. If the goal is determining irreversible loss of somatic function, they correctly label current death pronouncement a “legal fiction.” Recognizing a second, public policy meaning of the term death provides grounds for maintaining the DDR without jeopardizing procurement. (shrink)
My assigned task is to lay out the shape of my father's life and faith. This is daunting, but it is also a privilege because I loved him and admired him, and his life has been central in shaping my own. I am speaking also on behalf of my mother, my three sisters, Bridget, Louise and Ellie, and our children, Catherine and Andrew, Sam and Anisa, Hannah and Matty.
Organization theory and business ethics are essentially the positive and normative sides of the very same coin, reflecting on how human cooperative activities are organized and how they ought to be organized respectively. It is therefore unfortunate that—due to the relatively impermeable manmade boundaries segregating the corresponding scholarly communities into separate schools and departments, professional associations, and scientific journals—the potential symbiosis between the two fields has not yet fully materialized. In this essay we make a modest attempt at establishing further (...) connectivity by surveying the terrain covered by the two disciplines jointly, as if the boundaries between them did not matter. We commence by providing a concise overview of the organization theory discipline for interested non-specialists from the field of business ethics. Next, we proceed to point out four research themes commonly investigated by members of both communities, and also a variety of organization-theoretical perspectives on each. In the final part of this essay we explore what organization theory has to offer business ethics, and what the boundaries of that potential contribution are. We warn skeptical readers in advance that the spirit and tone of our essay is most definitely upbeat, as we are convinced that the potential for symbiosis between the two fields is vast and inspiring, even though it has only been unleashed partially and incidentally thus far. (shrink)
Empathy is thought a desirable quality in doctors as a key component of communication skills and professionalism. It is therefore thought desirable to teach it to medical students. Yet empathy is a quality whose essence is difficult to capture but easy to enact. We problematise empathy in an era where empathy has been literalised and instrumentalised, including its measurement. Even if we could agree a universally acceptable definition of empathy, engendering it in the student requires a more subtle approach than (...) seems the case currently. We therefore examine this modern concept and compare it with others such as pity and compassion, using the medium of Homer’s Iliad. Two famous scenes from the Iliad elicit pity in the characters and the audience. Pity and compassion are, however, given a complexity within the narrative that often seems lacking in modern ways of conceptualising and teaching empathy. (shrink)
The current definition of death used for donation after cardiac death relies on a determination of the irreversible cessation of the cardiac function. Although this criterion can be compatible with transplantation of most organs, it is not compatible with heart transplantation since heart transplants by definition involve the resuscitation of the supposedly "irreversibly" stopped heart. Subsequently, the definition of "irreversible" has been altered so as to permit heart transplantation in some circumstances, but this is unsatisfactory. There are three available strategies (...) for solving this "irreversibility problem": altering the definition of death so as to rely on circulatory irreversibility, rather than cardiac; defining death strictly on the basis of brain death (either whole-brain or more pragmatically some higher brain criteria); or redefining death in traditional terms and simultaneously legalizing some limited instances of medical killing to procure viable hearts. The first two strategies are the most ethically justifiable and practical. (shrink)
This paper examines the perceived ethical values of Malaysian managers. It is based on the opinions of 15 hypothetical ethical/unethical business situations from the 81 managers who agreed to participate in the survey. The findings of this study showed that these Malaysian managers have high ethical values. However 53% of the respondents believed that the ethical standards of today are lower than that of 15 years ago. Apparently, this is related to the existence of many unethical business practices prevalent in (...) the modern business world. The behavior of one's immediate superior is the most important factor in influencing managers to commit unethical practices. The results also indicate only a slight variation among the managers in terms of perceived ethical values by virtue of job position, job specialization, type of business activity or the size of the business organization. (shrink)
Scientific authority and physician authority are both challenged by Thomas Kuhn's concept of incommensurability. If competing “paradigms” or “world views” cannot rationally be compared, we have no means to judge the truth of any particular view. However, the notion of local or partial incommensurability might provide a framework for understanding the implications of contemporary philosophy of science for medicine. We distinguish four steps in the process of translating medical science into clinical decisions: the doing of the science, the appropriation of (...) the scientific findings by the clinician, the transfer of the findings from the clinician to the patient, and the choice of a treatment regimen. Incommensurability can play a role in each stage. There is at least some theory- and value-ladenness in science that is dependent on the world view of those who construct the scientific theories. Clinicians who must use the results of scientific research will inevitably interpret the research from the standpoint of their own world view. There may be further incommensurability when these data are communicated to the patient. Finally, clinician and patient values must come into play in any decision about choice of treatment. No stage of medical research or practice is value-free. This position does not imply relativism; some scientific accounts are better than others. However, the challenge of the incommensurabilists shows that further analysis is needed to establish how particular accounts are better or worse. (shrink)
The dynamics of populations of self-replicating, hierarchically structured individuals, exposedto accidents which destroy their sub-units, is analyzed mathematically, specifically with regardto the roles of redundancy and sexual repair. The following points emerge from this analysis:0 A population of individuals with redundant sub-structure has no intrinsic steady-statepoint; it tends to either zero or infinity depending on a critical accident rate α c . Increased redundancy renders populations less accident prone initially, but populationdecline is steeper if a is greater than a fixed (...) value α d . Periodic, sexual repair at system-specific intervals prevents continuous decline and stabilizesthe population insofar as it will now oscillate between two fixed population levels. The stabilizing sexual interval increases with increased complexity provided this is accom-panied by appropriate levels of redundancy. The model closely simulates the dynamics of heterosis effects. Repair fitness is a population fitness: the chance of an individual being repaired is a functionof the statistical make-up of the population as a whole at that particular period. Populationsliving at α > α c either engage in sexual repair at the appropriate time or they die out. The mathematical properties of the model illustrate mechanisms which possibly played arole in the evolution of a mortal soma in relation to sexual reproduction. (shrink)
Are fictional characters such as Sherlock Holmes real? What can fiction tell us about the nature of truth and reality? In this excellent introduction to the problem of fictionalism R. M. Sainsbury covers the following key topics: what is fiction? realism about fictional objects, including the arguments that fictional objects are real but non-existent; real but non-factual; real but non-concrete the relationship between fictional characters and non-actual worlds fictional entities as abstract artefacts fiction and intentionality and the problem of irrealism (...) fictionalism about possible worlds moral fictionalism. R. M. Sainsbury makes extensive use of examples from fiction, such as Sherlock Holmes, Anna Karenina and Madame Bovary and examines the work of philosophers who have made significant contributions to the topic, including Meinong, David Lewis, and Bas Van Fraassen. Additional features include chapter summaries, annotated further reading and a glossary of technical terms, making _Fiction and Fictionalism_ ideal for those coming to the issue for the first time. (shrink)
I offer no apology for presenting a simple paper about what is essentially a simple subject: the objectivity of moral judgments. Most of the complications are introduced by those who do not grasp the distinctions I shall be making. I am afraid that they include the majority of moral philosophers at the present time. These complications can be unravelled; but not in a short paper. I have tried to do it in my other writings.
R.M. Hare is one of the most widely discussed of today's moral philosophers. In this volume he has collected a number of essays, including one which is previously unpublished, which fill in the theoretical background of his thought. Each essay is self-contained, but together they give a connected picture of his views on such questions as the objectivity and rationality of moral thinking, the issue between the ethical realists and their opponents, the place in our moral thought of appeals to (...) common convictions, and how to tell whether a feature of a situation is morally relevant. (shrink)