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)
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)
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 defenses of theism from analytical philosophers such as Plantinga, Swinburne, and Alston. 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. A special feature of the book is the discussion of the atheological argument that attempts to deduce a contradiction from (...) the theist's way of conceiving of God's nature. 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)
In what has become a classic work, Richard M. Weaver unsparingly diagnoses the ills of our age and offers a realistic remedy. He asserts that the world is intelligible, and that man is free. The catastrophes of our age are the product not of necessity but of unintelligent choice. A cure, he submits, is possible. It lies in the right use of man's reason, in the renewed acceptance of an absolute reality, and in the recognition that ideas—like actions—have consequences.
Philosophers of science turned to historical case studies in part in response to Thomas Kuhn's insistence that such studies can transform the philosophy of science. In this issue Joseph Pitt argues that the power of case studies to instruct us about scientific methodology and epistemology depends on prior philosophical commitments, without which case studies are not philosophically useful. Here I reply to Pitt, demonstrating that case studies, properly deployed, illustrate styles of scientific work and modes of argumentation that are not (...) well handled by currently standard philosophical analyses. I illustrate these claims with exemplary findings from case studies dealing with exploratory experimentation and with interdisciplinary cooperation across sciences to yield multiple independent means of access to theoretical entities. The latter cases provide examples of ways that scientists support claims about theoretical entities that are not available in work performed within a single discipline. They also illustrate means of correcting systematic biases that stem from the commitments of each discipline taken separately. These findings illustrate the transformative power of case study methods, allow us to escape from the horns of Pitt's "dilemma of case studies," and vindicate some of the post-Kuhn uses to which case studies have been put. (shrink)
We will give a new cosmological argument for the existence of a being who, although not proved to be the absolutely perfect God of the great Medieval theists, also is capable of playing the role in the lives of working theists of a being that is a suitable object of worship, adoration, love, respect, and obedience. Unlike the absolutely perfect God, the God whose necessary existence is established by our argument will not be shown to essentially have the divine perfections (...) of omnipotence, omniscience, omnibenevolence, and sovereignty. Furthermore, it is not even shown that he is contingently omnipotent and omniscient, just powerful and intelligent enough to be the supernatural designer-creator of the exceedingly complex and wondrous cosmos that in fact.. (shrink)
Four prominent views of the nature and methods of clinical ethics (especially in consultation forums) are reviewed; each is then submitted to a criticism intended to show both weaknesses and strengths. It is argued that clinical ethics needs to be responsive to the specific complexities of clinical situations. For this, the need for an expanded notion of practical reason within unique situations is emphasized, one whose aim is to facilitate decision-making on the part of those directly responsible for them and (...) consonant with their own respective moral frameworks and conceptions of what is most worthwhile. Keywords: Casuistry, clinical ethics, consultation, decision-making, dialogue, facilitator, practical reason, relationships CiteULike Connotea Del.icio.us What's this? (shrink)
Fiction has been of concern to both the aesthetician and the ontologist. The former is concerned with the criteria or standards by which we judge the aesthetic worth of a fictional work, the latter with whether our ontology must be enlarged to include possible or imaginary worlds in which are housed the characters and incidents referred to and depicted in such works. This is a paper on the ontology of fiction. It will attempt to answer these ontological questions concerning truth (...) and reference in fiction by clarifying the use of language. Our paradigm case of the fictive use of language will be one in which the story-teller orally relates the fictional story in the presence of his audience, rather than one in which he inscribes his story so that it may be read at a later date. The value of considering the use of language in a face-to-face situation is that it brings before us in their full explicitness all of the different facets of a speech act, many of which often lie dormant in non-face-to-face uses and therefore are hard to discover from a consideration of such uses. (shrink)
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)
: Stem cell research that requires the destruction of human embryos is incompatible with Catholic moral principles, and with any ethic that gives serious weight to the moral status of the human embryo. Moreover, because there are promising and morally acceptable alternative approaches to the repair and regeneration of human tissues, and because treatments that rely on destruction of human embryos would be morally offensive to many patients, embryonic stem cell research may play a far less significant role in medical (...) progress than proponents believe. (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)
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)
History of science, it has been argued, has benefited philosophers of science primarily by forcing them into greater contact with "real science." In this paper I argue that additional major benefits arise from the importance of specifically historical considerations within philosophy of science. Loci for specifically historical investigations include: (1) making and evaluating rational reconstructions of particular theories and explanations, (2) estimating the degree of support earned by particular theories and theoretical claims, and (3) evaluating proposed philosophical norms for the (...) evaluation of the degree of support for theories and the worth of explanations. More generally, I argue that theories develop and change structure with time, that (like biological species) they are historical entities. Accordingly, both the identification and the evaluation of theories are essentially historical in character. (shrink)
In this study we have examined the reception of Mendelism in France from 1900 to 1940, and the place of some of the extra-Mendelian traditions of research that contributed to the development of genetics in France after World War II.