Nearly $2 trillion is spent annually in the U.S. treating chronic illness — yet accessibility to quality health care services in rural communities for the chronically ill and dying remains problematic. Unique barriers present special challenges to a meaningful discussion of and subsequent strategies for addressing these issues in the context of increasingly scarce resources.

The Institute of Medicine reporting on the quality of health care in America recommends six aims for achieving the health care system we could have. Together with the Institute for Healthcare Improvement Triple Aim initiative, a framework has emerged to challenge providers, educators, and policymakers to remake the health care system according to specific objectives: to provide care that is safe, effective, patient-centered, timely, efficient, and equitable to more people at a price we can afford. Complicating this mission of better (...) prevention and better care at a lower cost is a daunting demographic: January of 2011 marked the month and year that the first of the baby boomers turned 65. The U.S. Census Bureau in May 2010 projected the number of Americans of this age and over to reach 88 million by 2050, more than double the current figure of 40.2 million. Parekh and Barton forecast in stark detail what it will be like to address these burgeoning numbers of older Americans with comorbidities, including the fact that over 20% of the population currently experiences at least two chronic medical conditions. (shrink)

Richard M Weaver, a thinker and writer celebrated for his unsparing diagnoses and realistic remedies for the ills of our age, is known largely through a few of his works that remain in print. This new collection of Weaver's shorter writings, assembled by Ted J Smith III, Weaver's leading biographer, presents many long-out-of-print and never-before-published works that give new range and depth to Weaver's sweeping thought. Included are eleven previously unpublished essays and speeches that were left in near-final form (...) at the time of Weaver's death in 1963. In all, there are some one hundred and twenty-six essays, speeches, book reviews, and editorials. (shrink)

In this volume, fourteen scholars, many of them contemporaries of Professor Frank, engage with his legacy with important and seminal works which take some of ...

Our intention here is to present the essential character of classical, sunnī kalām within a strictly formal perspective and to set out its basic aspects. It was conceived by the mutakallimīn as a rational, conceptual, and critical science and, although kalām differed in a number of basic concepts and constructs and in its analytic system, the topical organisation of the major compendia parallels that of metaphysics as understood in the contemporary Aristotelian tradition. The debates between kalām and falsafa need to (...) be examined within this context. Kalām, however, is theological in the strict sense of the term and it is as such that its problematic and its procedures are primarily to be understood. Thus seen, the object of kalām is to rationalise the cognitive content presented to Believers in the symbolic language of the koranic revelation. It has, then, four principal tasks, sc, to conceptualise, to order, to explain, and where possible to justify the primary doctrines of the community whose belief is held to be normative. Within this framework the differences that characterise the major schools as such and the various tendencies of individual masters within each school may readily be brought to light. On se propose ici de présenter, d'un point de vue strictement formel, la nature du kālam classique sunnite et d'identifier ses caractéristiques principales. II avait été conçu par les mutakallimin comme une science rationelle, conceptuelle et critique. L'organisation des matières dans ses traités reprend celle de la métaphysique dans la tradition aristotélicienne de l'époque, bien que le kalām s'en distingue par plusieurs de ses structures et concepts fondamentaux, ainsi que par son système analytique. C'est dans ce contexte qu'il faut considérer les debats qui s'instaurèrent entre kalām et falsafa. Le kalām, cependant, est d'ordre strictement théologique et c'est principalement dans ce cadre qu'il faut comprendre sa problématique et ses procédures. Le kalām a pour fonction de rationaliser le contenu cognitif offert aux croyants dans le langage symbolique de la révélation coranique. Il en résulte quatre tâches principales; il s'agit de conceptualiser, ordonner, expliquer et, dans le mesure du possible, justifier les doctrines principales reconnues par la communauté faisant référence en matière de croyance. Dans ce cadre, il sera possible de mettre en lumière les différences entre les principales écoles, ainsi que les tendances qui distinguent certains de leurs grands maîtres respectifs. (shrink)

The present study seeks to lay out the most basic elements of the ontology of classical Aš‘arite theology. In several cases this requires a careful examination of the traditional and the formal lexicography of certain key expressions. The topics primarily treated are: how they understood “Being/ existence” and “being/existent” and essential natures; the systematic exploitation of the equivocities of certain expressions within a general context in which other than words there are no universals proves to be elegant as well as (...) insightful; the basic categories of primary entities: independant beings and nonindependant beings, created and uncreated, the equivocity of “being/existent” as predicated of contingent entities on the one hand and of God and His attributes on the other, and certain problems that arise because of the rigid application of the system's underlying analytic principles. Nous essayons ici de presenter les éléments fondamentaux de l'ontologie de l'aš‘arisme classique. Pour quelques expressions, il a fallu examiner la lexicographie et ordinaire et technique pour bien comprendre leur emploi et leur signification. Les sujets examinés sont: le sens de “Etre/existence” et de “être/existant” et le concept de réalité essentielle; l'emploi nuancé des équivocités de quelques expressions dans un contexte où les seuls universaux sont des mots, emploi qui se révèle philosophiquement élégant; les catégories fondamentales des êtres: êtres indépendants et êtres non-indépendants, soit créés soit incréés, l'équivocité de “être/existant” dit des êtres contingents d'une part, de Dieu et ses attributs d'autre part, et enfin quelques difficultiés qui résultent de l'application rigide des principes analytiques du système. (shrink)

Richard M. Gale Richard Gale was an American philosopher known for defending the A-theory of time against the B-theory. The A-theory implies, for example, that tensed predicates are not reducible to tenseless predicates. Gale also argued against the claim that negative truths are reducible to positive ones. He created a new modal version of … Continue reading Gale, Richard M. →.

R. M. Adams’s essay, “Must God Create the Best?” can be interpreted as offering a theodicy for God’s creating morally less perfect beings than he could have created. By creating these morally less perfect beings, God is bestowing grace upon them, which is an unmerited or undeserved benefit. He does so, however, in advance of the free moral misdeeds that render them undeserving. This requires that God have middle knowledge, pace Adams’s version of the Free Will Theodicy, of what would (...) result from his actualization of possible free persons. It is argued that God’s possession of such middle knowledge negates the freedom of created beings, since God completely determines every action of every created person. And since they are not free, they cannot qualify as morally unmeritorious or undeserving. And, with that, Adams’s theodicy of grace-in-advance collapses. (shrink)

Ethics and the Clinical Encounter explores the moral dimensions of clinical medicine and the phenomenon of illness, to determine what ethics must be in order to be fully responsive to clinical encounters. Written in a lively and conversational style with minimal technical terminology, and enhanced by actual experience or real clinical situations, this volume lays out a clinical ethics methodology both in practical and theoretical terms.Here's what the experts had to say: Professor Zaner has provided us with a remarkably lucid (...) and trenchant discussion of the interface of philosophy and the field of medicine. He brings into play an extraordinary range of historial knowledge, extensive observations based on firsthand experience with medical practices, and an acute sense of philosophical argumentation. This is a work that will be an exemplary and indispensable text in the philosophy of medicine for years to come. -- Calvin Schrag... it is a highly original contribution usable in a number of fields.... It really has no competition.... The genius of Zaner's approach is to ground ethics from the 'bottom up' and to direct us to the concrete particulars of therapeutic encounters wherein lie moral and ethical matters... meaty, challenging, and ultimately rewarding.... -- Paul R. DokeckiRichard M. Zaner founded the Center for Clinical and Research Ethics at Vanderbilt University Medical Center. Having established Vanderbilt's first Hospital Ethics Committee, he served as co-chair of VUMC's Ethics Committee since its inception in 1990. Zaner has published five original books, edited ten, and translated four more, and has published more than 100 sections of books and professional journals. (shrink)

Early in the first volume of his Ideen zu einer reinen Phiinomeno logie und phiinomenologischen Philosophie, Edmund Husserl stated concisely the significance and scope of the problem with which this present study is concerned. When we reflect on how it is that consciousness, which is itself absolute in relation to the world, can yet take on the character of transcendence, how it can become mundanized, We see straightaway that it can do that only by means of a certain participation in (...) transcendence in the first, originary sense, which is manifestly the transcendence of material Nature. Only by means of the experiential relation to the animate organism does consciousness become really human and animal (tierischen), and only thereby does it achieve a place in the space and in the time of Nature. l Consciousness can become "worldly" only by being embodied within the world as part of it. In so far as the world is material Nature, consciousness must partake of the transcendence of material Nature. That is to say, its transcendence is manifestly an embodiment in a material, corporeal body. Consciousness, thus, takes on the characteristic of being "here and now" (ecceity) by means of experiential (or, more accurately, its intentive) relation to that corporeal being which embodies it. Accordingly, that there is a world for consciousness is a conse quence in the first instance of its embodiment by 2 that corporeal body which is for it its own animate organism. (shrink)

Early in the first volume of his Ideen zu einer reinen Phiinomeno logie und phiinomenologischen Philosophie, Edmund Husserl stated concisely the significance and scope of the problem with which this present study is concerned. When we reflect on how it is that consciousness, which is itself absolute in relation to the world, can yet take on the character of transcendence, how it can become mundanized, We see straightaway that it can do that only by means of a certain participation in (...) transcendence in the first, originary sense, which is manifestly the transcendence of material Nature. Only by means of the experiential relation to the animate organism does consciousness become really human and animal (tierischen), and only thereby does it achieve a place in the space and in the time of Nature. l Consciousness can become "worldly" only by being embodied within the world as part of it. In so far as the world is material Nature, consciousness must partake of the transcendence of material Nature. That is to say, its transcendence is manifestly an embodiment in a material, corporeal body. Consciousness, thus, takes on the characteristic of being "here and now" (ecceity) by means of experiential (or, more accurately, its intentive) relation to that corporeal being which embodies it. Accordingly, that there is a world for consciousness is a conse quence in the first instance of its embodiment by 2 that corporeal body which is for it its own animate organism. (shrink)

This honest, forthright, and beautifully-written book introduces readers to the human variations on medical topics spoken of in abstract in the daily news--euthanasia, assisted suicide, abortion, "extreme procedures", genetic testing, experimental surgeries--and to the people who must agonize over those decisions regarding themselves and their loved ones.

This paper is devoted to an examination of the discovery, characterization, and analysis of the functions of microRNAs, which also serves as a vehicle for demonstrating the importance of exploratory experimentation in current (post-genomic) molecular biology. The material on microRNAs is important in its own right: it provides important insight into the extreme complexity of regulatory networks involving components made of DNA, RNA, and protein. These networks play a central role in regulating development of multicellular organisms and illustrate the importance (...) of epigenetic as well as genetic systems in evolution and development. The examination of these matters yields principled arguments for the historicity of the functions of key biological molecules and for the indispensability of exploratory experimentation in contemporary molecular biology as well as some insight into the complex interplay between exploratory experimentation and hypothesis-driven science. This latter result is not only important for philosophy of science, but also of practical importance for the evaluation of grant proposals, although the elaboration of this latter claim must be left for another occasion. (shrink)

Tested the 2-process theory of detection, search, and attention presented by the current authors in a series of experiments. The studies demonstrate the qualitative difference between 2 modes of information processing: automatic detection and controlled search; trace the course of the learning of automatic detection, of categories, and of automatic-attention responses; and show the dependence of automatic detection on attending responses and demonstrate how such responses interrupt controlled processing and interfere with the focusing of attention. The learning of categories is (...) shown to improve controlled search performance. A general framework for human information processing is proposed. The framework emphasizes the roles of automatic and controlled processing. The theory is compared to and contrasted with extant models of search and attention. (shrink)

There has been in recent years a plethora of defences of theism from analytical philosophers: Richard Gale's important book is a critical response to these writings. New versions of cosmological, ontological, and religious experience arguments are critically evaluated, along with pragmatic arguments to justify faith on the grounds of its prudential or moral benefits. In considering arguments for and against the existence of God, Gale is able to clarify many important philosophical concepts including exploration, time, free will, personhood, actuality, (...) and the objectivity of experience. (shrink)

R. M. Adams’s essay, “Must God Create the Best?” can be interpreted as offering a theodicy for God’s creating morally less perfect beings than he could have created. By creating these morally less perfect beings, God is bestowing grace upon them, which is an unmerited or undeserved benefit. He does so, however, in advance of the free moral misdeeds that render them undeserving. This requires that God have middle knowledge, pace Adams’s version of the Free Will Theodicy, of what would (...) result from his actualization of possible free persons. It is argued that God’s possession of such middle knowledge negates the freedom of created beings, since God completely determines every action of every created person. And since they are not free, they cannot qualify as morally unmeritorious or undeserving. And, with that, Adams’s theodicy of grace-in-advance collapses. (shrink)

In what sense does time exist? Is it an objective feature of the external world? Or is its real nature dependent on the way man experiences it? Has modern science brought us closer to the answer to St. Augustine's exasperated outcry, 'What, then, is time?'? Ever since Aristotle, thinkers have been struggling with this most confounding and elusive of philosophical questions. How long does the present moment last? Can we make statements about the future that are clearly true or clearly (...) false? And if so, must we be fatalists? This volume presents twenty-three discussions of the problem of time. A section on classical and modern attempts at definition is followed by four groups of essays drawn largely from contemporary philosophy, each preface with an introduction by the editor. First, in a chapter entitled 'The Static versus the Dynamic Temporal', four philosophers advance solutions to McTaggart's famous proof of time's unreality. In the next two sections, the discussion turns to the meaning of the 'open future' and to the much-debated nature of 'human time'. Finally, modern science and philosophy tackle Zeno's celebrated paradoxes. The essays by Adolf Grnbaum, Nicholas Rescher, and William Barrett are published for the first time in this volume. (shrink)

In what sense does time exist? Is it an objective feature of the external world? Or is its real nature dependent on the way man experiences it? Has modern science brought us closer to the answer to St. Augustine's exasperated outcry, 'What, then, is time?' ? Ever since Aristotle, thinkers have been struggling with this most confounding and elusive of philosophical questions. How long does the present moment last? Can we make statements about the future that are clearly true or (...) clearly false? And if so, must we be fatalists? This volume presents twenty-three discussions of the problem of time. A section on classical and modern attempts at definition is followed by four groups of essays drawn largely from contemporary philosophy, each preface with an introduction by the editor. First, in a chapter entitled 'The Static versus the Dynamic Temporal', four philosophers advance solutions to McTaggart's famous proof of time's unreality. In the next two sections, the discussion turns to the meaning of the 'open future' and to the much-debated nature of 'human time'. Finally, modern science and philosophy tackle Zeno's celebrated paradoxes. The essays by Adolf Grnbaum, Nicholas Rescher, and William Barrett are published for the first time in this volume. (shrink)

This article reviews the historical and current controversies about the nature of clinical ethics consultation, as a way to focus on the place and responsibility of ethics consultants within the context of clinical conversation — interpreted as a form of dialogue. These matters are approached through a particularly compelling instance of the controversy that involves several major figures in the field. The analysis serves to highlight very significant questions of the nature and constraints of clinical situations, and the moral responsibility (...) and legal accountability that are especially important for clinical ethics consultants. (shrink)

Originally published in 1948, at the height of post–World War II optimism and confidence in collective security, _Ideas Have Consequences_ uses “words hard as cannonballs” to present an unsparing diagnosis of the ills of the modern age. Widely read and debated at the time of its first publication,the book is now seen asone of the foundational texts of the modern conservative movement. In its pages, Richard M. Weaver argues that the decline of Western civilization resulted from the rising acceptance (...) of relativism over absolute reality. In spite of increased knowledge, this retreat from the realist intellectual tradition has weakened the Western capacity to reason, with catastrophic consequences for social order and individual rights. But Weaver also offers a realistic remedy. These difficulties are the product not of necessity, but of intelligent choice. And, today, as decades ago, the remedy lies in the renewed acceptance of absolute reality and the recognition that ideas—like actions—have consequences. This expanded edition of the classic work contains a foreword by _New Criterion _editor Roger Kimball that offers insight into the rich intellectual and historical contexts of Weaver and his work and an afterword by Ted J. Smith III that relates the remarkable story of the book’s writing and publication. (shrink)

__ The Blackwell Guide to Metaphysics__ is a definitive introduction to the core areas of metaphysics. It brings together sixteen internationally respected philosophers that demonstrate how metaphysics is done as they examine topics including causation, temporality, ontology, personal identity, idealism, and realism.

This book inquires into the swarm of ontological, epistemological, and ethical questions provoked by psychedelic experience in the context of global ecological crisis. Richard M. Doyle is professor of English and science, technology, and society at Pennsylvania State University. He is the author of On Beyond Living and Wetwares.

According to the biopsychosocial model, developed by the late Dr. George Engel, how physicians approach patients and the problems they present is very much ...