Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

We discuss five kinds of representations of rationales and provide a formal account of how they can alter disputation. The formal model of disputation is derived from recent work in argument. The five kinds of rationales are compilation rationales, which can be represented without assuming domain-knowledge (such as utilities) beyond that normally required for argument. The principal thesis is that such rationales can be analyzed in a framework of argument not too different from what AI already has. The result is (...) a formal understanding of rationales, a partial taxonomy, and a foundation for computer programs that represent and reason with rationales.The five kinds of rationales are as follows: (c)ompression and (s)pecialization, which yield rules, and (d)isputation, which yields a decision. These are modeled as potentially changing the focus of the dispute. Then there are (f)it, a rationale for rules, and (r)esolution, a rationale for decisions. These cannot be modeled as simply; they force disputation to a meta-level, at least temporarily. (shrink)

The 1973 archeological discovery of important documents of classical thought known as the Huang-Lao Boshu coupled with advancements in contemporary jurisprudence make possible a reassessment of the philosophies of pre-Qin and early Han China. This study attempts to elucidate the importance of the Huang-Lao school within the intellectual tradition of China through a comparison of the Boshu's philosophical position, particularly its understanding of the relation between law and morality, with the respective views of major thinkers of the period--Confucius, Han Fei, (...) Lao Zi, Zhuang Zi, and to a lesser extent, Shen Dao, Shen Buhai and the authors of the Guan Zi and He Guan Zi. So doing reveals Huang-Lao to be a unique and sophisticated social and political philosophy which, until its expulsion from court by Emperor Wu and subsequent adoption by Daoist religion, served as the ideological foundation for the post-Qin reforms of the early Han. (shrink)

Many physicists regard the flow of time as an illusion. There is an upper level flow of time, the phenomenon of past/present/future; and there is a lower level flow of time which is really a flow of events. Perceptual completion accounts for the lower level flow of time in a few ways: apparent movement; amodal completion; and dynamic change as exemplified by a newly described modal completion that we called happening. It acts like an illusory percept connecting discrete stimuli in (...) all sensory modalities. The past/present/future distinction cannot exist unless an object is perceived to be the same now as it is then. This cognition requires object persistence. Experiments with object persistence suggest the circumstances when that, too, is an illusory percept. The illusory percepts of object persistence and perceptual completion can account for the entire flow of time. Our findings and conclusions are congruent with a few time theories and cosmologies that suggest that the flow of time is an illusion. (shrink)

Interactive technology assessment (iTA) provides an answer to the ethical problem of normative bias in evaluation research. This normative bias develops when relevant perspectives on the evaluand (the thing being evaluated) are neglected. In iTA this bias is overcome by incorporating different perspectives into the assessment. As a consequence, justification of decisions based on the assessment is provided by stakeholders having achieved agreement. In this article, agreement is identified with wide reflective equilibrium to show that it indeed has the potential (...) of justifying decisions. We work out several conditions for this agreement to be achievable and just. (shrink)

I propose that neural cognition is supported by non-neural storage of a 3-D model of local space, used in the planning of movements. Information is stored in wave-like excitations which couple to neurons in the thalamus, with the wave-vectors of excitations representing spatial positions. This hybrid of neural and non-neural cognition may have fitness advantages over any purely neural mechanism -- in information capacity, geometric accuracy, and fast selective retrieval. The wave excitations may be sustained on a Bose-condensed state of (...) some excitation in the brain, by a mechanism like those investigated by Frohlich, Umezawa, Vitiello and others. These states, being frictionless, can store information indefinitely at low energy levels, insulated from thermal noise, so are an ideal substrate for memory. If a Bose-condensed state is a 3-D representation of local reality, it may be the basis of phenomenal consciousness . The resulting theory of consciousness is highly constrained, and agrees well with the main properties of conscious experience. In this account, consciousness arises from a very simple state of matter, rather than from complexity; and it evolved to meet one of the strongest selection pressures on the brain. (shrink)

Type theory is a fast-evolving field at the crossroads of logic, computer science and mathematics. This gentle step-by-step introduction is ideal for graduate students and researchers who need to understand the ins and outs of the mathematical machinery, the role of logical rules therein, the essential contribution of definitions and the decisive nature of well-structured proofs. The authors begin with untyped lambda calculus and proceed to several fundamental type systems culminating in the well-known and powerful Calculus of Constructions. The book (...) also covers the essence of proof checking and proof development, and the use of dependent type theory to formalize mathematics. The only prerequisites are a good knowledge of undergraduate algebra and analysis. Carefully chosen examples illustrate the theory throughout. Each chapter ends with a summary of the content, some historical context, suggestions for further reading and a selection of exercises to help readers familiarize themselves with the material. (shrink)

Athenaeus preserves an intriguing description by the otherwise unknown writerMoschion of a giant grain-ship, the Syracusia, built by Hiero II of Syracuse in thelater third century B.C.1 The account is extremely circumstantial. Besides a fulldescription of the ship's layout, Moschion gives such details as the name of thearchitect, the size of the construction-force, the construction time, details of the launching arrangements devised byArchimedes, and even the procedure for judging crimes committed on board.

The Covid-19 pandemic has resulted in disruption of work and other social activities of so many people. Some were forced to stay at home and many decided to stay at home for fear of being infected with the virus. This phenomenon brought different reactions and even mental stress to many people. However, there were people who turned this kind of tragedy into creative work. This paper discusses the experiences and insights of known plant lovers in Digos City, Davao del Sur (...) Philippines. Digos City is one of the heavily affected places during the series of earthquakes that jolted Davao del Sur last year. While people are still recovering, COVID-19 added an additional burden to the residents. In this paper, we argue that their decision to focus on gardening was not only to fight boredom and to divert their attention during lockdown but this was their way of maintaining their well-being by participating in the on-going work of creation and recreation and to rise from the tragedy. We further argue that it might be good that this creative work will go beyond home gardening and beyond pots and slowly extend to creative work for environmental protection and preservation through more active engagements into reforestation activities. (shrink)

Error is protean, ubiquitous and crucial in scientific process. In this paper it is argued that understanding scientific process requires what is currently absent: an adaptable, context-sensitive functional role for error in science that naturally harnesses error identification and avoidance to positive, success-driven, science. This paper develops a new account of scientific process of this sort, error and success driving Self-Directed Anticipative Learning (SDAL) cycling, using a recent re-analysis of ape-language research as test example. The example shows the limitations of (...) other accounts of error, in particular Mayo’s (Error and the growth of experimental knowledge, 1996) error-statistical approach, and SDAL cycling shows how they can be fruitfully contextualised. (shrink)

Ventricular Fibrillation is responsible for a majority of sudden cardiac death, but little is known about how ventricular tachycardia (VT) degenerates into ventricular fibrillation. Several clinical studies focused only on preventing VT with a class III antiarrhythmic drug resulted in many deaths. Our simulations investigate the interactions between an antiarrhythmic drug likely to suppress a VT and a Figure 8 reentry. A parameter AAR is introduced to increase the action potential duration and therefore simulate various Class III drugs. Simulations are (...) ran under several conditions (phases of the reentry, values of AAR, durations). They show that a VT can be suppressed whatever the phase of the reentry but it strongly depends on the duration of the effect. It confirms that a drug which can suppress a reentry can also worsen it. It also shows a great variety of activation patterns and thus the complexity of antiarrhythmic drugs effects. Simulations also demonstrate that suppressing VT is an increasing function of AAR. (shrink)