Futile medical interventions have virtually no chance of success. Doctors might perform such procedures because of pressure from families or patients. The doctor might also have an ulterior motive of gain or prefer to do it rather than take time to communicate with the patient about a poor prognosis. Established ways to communicate bad news to patients are not always used by managing physicians with time constraints. The SPIKES protocol method is outlined to assist in sensitive communication where further intervention (...) is futile. This review primarily explores various aspects of medical futility. It also explores strategies for effectively communicating with patients and their families regarding futility interventions. A side-effect of futile interventions is burnout in doctors and other health practitioners (HPs). The complex relationship between futility and burnout is described. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"The Fittest Man in the Kingdom":Thomas Reid and the Glasgow Chair of Moral PhilosophyPaul Wood (bio)Paul Wood Paul Wood is at the Department of History, University of Victoria, PO Box 3045, MS 7381, Victoria BC V8W 3P4 Canada. email: [email protected] August 1996Revised January 1997Notes. An earlier version of this paper was delivered at a plenary session of the 23rd International Hume Conference held at the University of Nottingham. For (...) comments and/or references, the author wishes to thank Roger Emerson, Carol Gibson-Wood, Knud Haakonssen, Ian Simpson Ross, Stephen Snobelen, M. A. Stewart, and the anonymous Hume Studies referees. For permission to cite and quote from manuscripts, he is grateful to the Keeper of the Manuscripts of Scotland as well as to the Librarians of Aberdeen University Library, Edinburgh University Library, Glasgow University Archives and Business Records Centre, Glasgow University Library (Department of Special Collections), the Mitchell Library Glasgow, and Dr. Williams' Library.1. Although little information survives regarding Law's teaching, we do know that he discussed Pufendorf in his classes; see Christine Mary King [Shepherd], "Philosophy and Science in the Arts Curriculum of the Scottish Universities in the Seventeenth Century," (Unpublished Ph.D. Dissertation, University of Edinburgh, 1974), 177. Carmichael's edition of Pufendorf first appeared in Glasgow in 1718, and a second edition was published in Edinburgh in 1724 while Hume was still a student there.2. The surviving correspondence between the two men from this period is to be found in The Letters of David Hume, ed. J.Y.T. Greig, 2 vols. (Oxford: Clarendon Press, 1932), I 32-35; 36-40; 45-48 (hereafter abbreviated as HL).3. The first detailed discussion of the 1745 election appeared in the introduction to David Hume, A Letter from a Gentleman to His Friend in Edinburgh, edited by Ernest C. Mossner and John V. Price (Edinburgh: Edinburgh University Press, 1967). This account has recently been challenged in Roger L. Emerson, "The 'Affair' at Edinburgh and the 'Project' at Glasgow: The Politics of Hume's Attempts to become a Professor," in Hume and Hume's Connexions, edited by M. A. Stewart and John P. Wright (Edinburgh: Edinburgh University Press, 1994), 1-22; and M. A. Stewart, The Kirk and the Infidel (Lancaster: Lancaster University Publications Office, 1995). For historically sensitive contextual analysis of Hume's philosophical relations with Hutcheson, see inter alia James Moore, "Hume and Hutcheson," in Stewart and Wright, 23-57, and M. A. Stewart, Warmth in the Cause of Virtue (Edinburgh: Edinburgh University Press, forthcoming).4. In January 1752, "Mr. Smith read an Account of some of Mr. David Hume's Essays on Commerce" to the Society, and Hume was elected a member in 1753; see Notices and Documents Illustrative of the Literary History of Glasgow, During the Greater Part of Last Century, edited by W. J. Duncan (Glasgow: T. D. Morison, 1886), 132-133. Hume's failed candidacy is discussed in Emerson, "The 'Affair' at Edinburgh," 14-16, and Ian Simpson Ross, The Life of Adam Smith (Oxford: Clarendon Press, 1995), 112-113. Smith's Glasgow colleague from 1751 to 1755, William Cullen, was also sympathetic to Hume's philosophy, as was John Millar, who was elected Professor of Law in 1761. On Cullen and Hume see J.R.R. Christie, "Ether and the Science of Chemistry: 1740-1790," in Conceptions of Ether: Studies in the History of Ether Theories 1740-1900, edited by G. N. Cantor and M.J.S. Hodge (Cambridge: Cambridge University Press, 1981), 90-96.5. David Hume to William Strahan, 26 October 1775, HL II 301.6. See, for example, The Works of Thomas Reid, D.D., edited by Sir William Hamilton, 4th ed. (Edinburgh: Maclachlan and Stewart, 1854), 30n; James McCosh, The Scottish Philosophy, Biographical, Expository, Critical, from Hutcheson to Hamilton (London: Macmillan, 1875), 36; James Veitch, "Philosophy in the Scottish Universities," Mind 2 (1877): 207-234 (209).7. John Rae, Life of Adam Smith (London and New York: Macmillan, 1895); William Robert Scott, Francis Hutcheson: His Life, Teaching and Position in the History of Philosophy (Cambridge: Cambridge University Press, 1900); idem., Adam Smith as Student and Professor (Glasgow: Jackson... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Jean Wyatt THE CELEBRATION OF EROS: GREEK CONCEPTS OF LOVE AND BEAUTY IN TO THE LIGHTHOUSE A voracious reader all her life, Virginia Woolf stored up patterns and images which she naturally wove into the fabric of her novels.1 Integrating literature of the past into her own works was also an affirmation of her belief that "everything comes over again a little differently," as Eleanor says in The Years. (...) Acutely aware of the prevailing fluidity of human life, Virginia Woolf sought a counterbalance in the principle of eternal recurrence. The whole chain of human history forms a "gigantic pattern, momentarily perceptible." It becomes perceptible when elemental forces in human life coincide with the forms of individuals, "making them symbolical, making them representative."3 In Mrs. Ramsay, Virginia Woolf combines a personal portrait of her mother with an evocation of eternal life forces in the "symbolical outline" (p. Ill) of Aphrodite, goddess of love, beauty and marriage, that Mrs. Ramsay irradiates. Events, too, can be "symbolical, and therefore perhaps permanent," in the words of Bernard in The Waves, when they reflect the continuity of human experience. The dinner party in To the Lighthouse contains ritual elements, reminders that it is one in a series of communal feasts. The search for truth in the midst of human pleasures, by means of human love, recalls one such banquet in particular, the Symposium.'' The central concerns of the Symposium are those of To the Lighthouse: striving for knowledge through love; the desire to create that beauty arouses; the paradox of the eternal in the midst of the transitory. The figures and patterns of Greek literature were part of Virginia Woolf's mental formation. She began learning Greek at King's College in 1897, at the age of fifteen.6 For the next few years, Greek was her chief refuge from a stifling Victorian society. From 10:00 a.m. to 1:00 p.m. every day she read Greek: Homer, Aeschylus, Euripides, all of Sophocles, Plato. Twice a week she met for Greek lessons, first 160 Jean WyATT161 with Clara Pater, then with Janet Case. Her letters speak of Greek as "the greatest of comforts to me" (April, 1900), "my daily bread, and a keen delight to me" (June, 1900); it "has so much attraction for me... that I don't want to do anything else" (February, 1905).8 A diary entry from 1924 shows how Greek "worked its way" into her life. Upon meeting a herd of cattle, "I waved my stick and stood at bay; and thought of Homer.... some mimic battle. Grizzle grew more and more insolent and excited and skirmished about yapping. Ajax? That Greek, for all my ignorance, has worked its way into me." Seeing Grizzle as Ajax is not different in kind from transforming Mrs. Ramsay into Aphrodite, Mr. Carmichael into Poseidon. Greek was in the forefront of Virginia Woolf's mind in 1924 because she had been reading Greek steadily since 1922 in preparation for the article "On Not Knowing Greek." "The amount of reading... that went into the production of that essay... was remarkable," comments Quentin Bell. She published the essay in 1925, the year she began To the Lighthouse. "On Not Knowing Greek" shows that Virginia Woolf knew the Symposium well: she discusses it for four pages, not with the analytical lens of a literary critic, but with loving familiarity. She first read the Symposium when she was about sixteen, but her intimacy with it suggests that she must have read it more than once. At the center of the Symposium is Diotima's doctrine: man has to work through a series of human loves to arrive at the eternal. Lily pursues a similar quest for knowledge through love. She loves Mrs. Ramsay, but, unable to satisfy her love on a personal level, casts about for a way of reaching "the spirit in her, the essential thing" (p. 76). She finally finds a way of loving that takes her to the essence of things when, ten years after Mrs. Ramsay's death, she sees and loves a Mrs. Ramsay who transcends the individual to become the form of love and beauty. To understand the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"The Fittest Man in the Kingdom":Thomas Reid and the Glasgow Chair of Moral PhilosophyPaul Wood (bio)Paul Wood Paul Wood is at the Department of History, University of Victoria, PO Box 3045, MS 7381, Victoria BC V8W 3P4 Canada. email: [email protected] August 1996Revised January 1997Notes. An earlier version of this paper was delivered at a plenary session of the 23rd International Hume Conference held at the University of Nottingham. For (...) comments and/or references, the author wishes to thank Roger Emerson, Carol Gibson-Wood, Knud Haakonssen, Ian Simpson Ross, Stephen Snobelen, M. A. Stewart, and the anonymous Hume Studies referees. For permission to cite and quote from manuscripts, he is grateful to the Keeper of the Manuscripts of Scotland as well as to the Librarians of Aberdeen University Library, Edinburgh University Library, Glasgow University Archives and Business Records Centre, Glasgow University Library (Department of Special Collections), the Mitchell Library Glasgow, and Dr. Williams' Library.1. Although little information survives regarding Law's teaching, we do know that he discussed Pufendorf in his classes; see Christine Mary King [Shepherd], "Philosophy and Science in the Arts Curriculum of the Scottish Universities in the Seventeenth Century," (Unpublished Ph.D. Dissertation, University of Edinburgh, 1974), 177. Carmichael's edition of Pufendorf first appeared in Glasgow in 1718, and a second edition was published in Edinburgh in 1724 while Hume was still a student there.2. The surviving correspondence between the two men from this period is to be found in The Letters of David Hume, ed. J.Y.T. Greig, 2 vols. (Oxford: Clarendon Press, 1932), I 32-35; 36-40; 45-48 (hereafter abbreviated as HL).3. The first detailed discussion of the 1745 election appeared in the introduction to David Hume, A Letter from a Gentleman to His Friend in Edinburgh, edited by Ernest C. Mossner and John V. Price (Edinburgh: Edinburgh University Press, 1967). This account has recently been challenged in Roger L. Emerson, "The 'Affair' at Edinburgh and the 'Project' at Glasgow: The Politics of Hume's Attempts to become a Professor," in Hume and Hume's Connexions, edited by M. A. Stewart and John P. Wright (Edinburgh: Edinburgh University Press, 1994), 1-22; and M. A. Stewart, The Kirk and the Infidel (Lancaster: Lancaster University Publications Office, 1995). For historically sensitive contextual analysis of Hume's philosophical relations with Hutcheson, see inter alia James Moore, "Hume and Hutcheson," in Stewart and Wright, 23-57, and M. A. Stewart, Warmth in the Cause of Virtue (Edinburgh: Edinburgh University Press, forthcoming).4. In January 1752, "Mr. Smith read an Account of some of Mr. David Hume's Essays on Commerce" to the Society, and Hume was elected a member in 1753; see Notices and Documents Illustrative of the Literary History of Glasgow, During the Greater Part of Last Century, edited by W. J. Duncan (Glasgow: T. D. Morison, 1886), 132-133. Hume's failed candidacy is discussed in Emerson, "The 'Affair' at Edinburgh," 14-16, and Ian Simpson Ross, The Life of Adam Smith (Oxford: Clarendon Press, 1995), 112-113. Smith's Glasgow colleague from 1751 to 1755, William Cullen, was also sympathetic to Hume's philosophy, as was John Millar, who was elected Professor of Law in 1761. On Cullen and Hume see J.R.R. Christie, "Ether and the Science of Chemistry: 1740-1790," in Conceptions of Ether: Studies in the History of Ether Theories 1740-1900, edited by G. N. Cantor and M.J.S. Hodge (Cambridge: Cambridge University Press, 1981), 90-96.5. David Hume to William Strahan, 26 October 1775, HL II 301.6. See, for example, The Works of Thomas Reid, D.D., edited by Sir William Hamilton, 4th ed. (Edinburgh: Maclachlan and Stewart, 1854), 30n; James McCosh, The Scottish Philosophy, Biographical, Expository, Critical, from Hutcheson to Hamilton (London: Macmillan, 1875), 36; James Veitch, "Philosophy in the Scottish Universities," Mind 2 (1877): 207-234 (209).7. John Rae, Life of Adam Smith (London and New York: Macmillan, 1895); William Robert Scott, Francis Hutcheson: His Life, Teaching and Position in the History of Philosophy (Cambridge: Cambridge University Press, 1900); idem., Adam Smith as Student and Professor (Glasgow: Jackson... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Virgil and the ModernsMichael L. HallVirgil and the Moderns, by Theodore Ziolkowski; xv & 274 pp. Princeton: Princeton University Press, 1993, $35.00.Theodore Ziolkowski’s Virgil and the Moderns is a wonderful book. Everyone interested in modern literature and the western cultural heritage should read it. Ziolkowski does much more than tell us about Virgil and his influence on modern authors and readers; he traces the Latin poet’s appeal from (...) the nineteenth century forward, focusing on different national trends and responses to the Roman past. His book is a veritable education in modern literature and cultural history.In the introductory chapter Ziolkowski situates Virgil in the twentieth century, with references to the Virgilian epigraph on the title page of Freud’s The Interpretation of Dreams (1900) and the Virgilian motto to the first volume of Toynbee’s A Study of History (1934). Ziolkowski concentrates attention, in fact, on the appeal to Roman history in many early twentieth-century historians, and he explores the various European and American reactions to the bimillennial celebrations in 1930 of Virgil’s birth. Like the Bible, the Roman past seems to speak directly to a great variety of points of view: “Roman history, properly comprehended in its broad outlines, is and remains the best teacher not only for today, but indeed for all times”; thus opined the author of Mein Kampf.Ziolkowski’s second chapter, “The Ideological Lives,” begins by observing that “every biography is ideological” and quoting Duane Reed Stuart’s comment that “Every age has tended to fashion a Virgil after its own image.” Ziolkowski tests this proposition against the many “modern” biographies of Virgil that appeared in the nineteenth and twentieth centuries, especially during the bimillennial celebrations. In Italy he finds Virgil described as “a Latin nationalist with conservative messages for the present on government and agriculture”; in France he discovers “a protofascist emerging from the bohemian life of the rive gauche of ancient Rome”; in Germany he encounters “an agrarian anima naturaliter christiana destined to become Father of the West in opposition to the rise of Nazism”; and in Latin America he sees that Virgil has become “an apostle of peace among the pagans with the providential mission to serve the generations as a pedagogue for Christ.”In the five chapters that follow, Ziolkowski shows that these various versions of Virgil’s life and influence resulted in a similar diversity of literary manifestations. In Europe, each country found a Virgil suited to its own preoccupations and prejudices. A rich and indeed overwhelming curriculum in modern literature could be constructed from the authors and texts Ziolkowski discusses in these brief surveys of works influenced by Virgil’s poetry. But although he is a deft literary critic, Ziolkowski goes further, to trace biographical and cultural influences. We discover, for example, that Gide was obsessed with the Eclogues, that it was the Georgics that Mr. Carmichael “liked to lie awake a little reading” in Woolf’s To the Lighthouse, and that Joe Paterno’s first and most enduring hero [End Page 175] was Virgil’s Aeneas, “to whom he was introduced by his high school Latin teacher at Brooklyn Prep.”I confess that my favorite parts of the book were the chapters on Virgil in Britain and the “New World.” I thought I was a pretty good student of the classics and of British and American literature, but I am ashamed to admit how much I learned from Ziolkowski’s discussions of Virgil’s influence on Virginia Woolf, T. S. Eliot, and Cyril Connolly, on Willa Cather and Robert Frost, on Archibald MacLeish, Allen Tate, and Robert Lowell. Ziolkowski is a treasure, and he has given us a rare treat in this very thoughtful study of the way our cultural inheritance is passed on and reaffirmed. As he himself remarks in the book’s final sentences on the ties that bind us to Virgil and our common past: “This reaffirmation, attained at the cost of great spiritual engagement by our intellectual predecessors, we neglect today at our peril.”Michael L. HallAlexandria, VirginiaCopyright © 1995 The Johns Hopkins University Press... (shrink)

The standard approach to protecting privacy in healthcare aims to control access to personal information. We cannot regain control of information after it has been shared, so we must restrict access from the start. This ‘control’ conception of privacy conflicts with data-intensive initiatives like precision medicine and learning health systems, as they require patients to give up significant control of their information. Without adequate alternatives to the control-based approach, such data-intensive programmes appear to require a loss of privacy. This paper (...) argues that the control view of privacy is shortsighted and overlooks important ways to protect health information even when widely shared. To prepare for a world where we no longer control our data, we must pursue three alternative strategies: obfuscate health data, penalise the misuse of health data and improve transparency around who shares our data and for what purposes. Prioritising these strategies is necessary when health data are widely shared both within and outside of the health system. (shrink)

T H McLaughlin; Parental Rights and the Religious Upbringing of Children, Journal of Philosophy of Education, Volume 18, Issue 1, 30 May 2006, Pages 75–83, http.

Bioethical issues remain front-page news, with debate continuing to rage over issues including genetic modification, animal cloning, and "designer babies." With public opinion often driven by media speculation, how can we ensure that informed decisions regarding key bioethical issues are made in a reasoned, objective way? Ideal for students new to the subject, Bioethics: An Introduction for the Biosciences offers a balanced, objective introduction to the field. With a focus on developing powers of reasoning and judgment, the book presents different (...) perspectives on common themes in an impartial way, thereby fostering debate and discussion. The opening section, "The Ethical Groundwork," introduces students to the nature of bioethics and ethical theory. The book goes on to cover a broad range of bioethical issues relating to people, animals, and food, before concluding with an overview of bioethics in practice. Features: * The broadest, most balanced textbook on bioethics available, offering students just the right mix of science and philosophy as well as a clear, objective introduction to the subject * Presents different perspectives on common themes in order to encourage students to question, evaluate, and form their own opinions * Incorporates many useful pedagogical tools including self-assessment questions, topics for discussion, and exercises * Includes references for further reading and useful web sites * A companion website offers resources for both students and instructors. (shrink)

J. T. Ismael's monograph is an ambitious contribution to metaphysics and the philosophy of language and mind. She tackles a philosophical question whose origin goes back to Descartes: What am I? The self is not a mere thing among things--but if so, what is it, and what is its relationship to the world?

The Greek mathematician Diophantos of Alexandria lived during the third century CE. Apart from his age, very little else is known about his life. Even the exact form of his name is uncertain, and only a few incomplete manuscripts of his greatest work, Arithmetica, have survived. In this impressive scholarly investigation, first published in 1885, Thomas Little Heath meticulously presents what can be gleaned from Greek, Latin and Arabic sources, and guides the reader through the algebraist's idiosyncratic style of mathematics, (...) discussing his notation and originality. This was the first thorough survey of Diophantos' work to appear in English. Also reissued in this series are Heath's two-volume History of Greek Mathematics, his treatment of Greek astronomy through the work of Aristarchus of Samos, and his edition in modern notation of the Treatise on Conic Sections by Apollonius of Perga. (shrink)

T. M. Rudavsky tells the story of the development of Jewish philosophy from the 10th century to Spinoza in the 17th, as part of a dialogue with medieval Christian and Islamic thought. She gives a broad historical survey of major figures and schools within the medieval Jewish tradition, focusing on the tensions between Judaism and rational thought.

An interpretation is offered of thrasymachus' account of the nature of justice and just action in book I of the 'republic' which is internally consistent throughout on all important points. Just action is not defined in terms of its practical consequences, As many commentators assume, But rather in terms of its logical consequences 'vis-A-Vis' just agents. When one man acts justly towards another, The performance of the just act renders the just agent vulnerable to unfair or unjust exploitation by those (...) with whom he deals. The "strong man", In thrasymachus' sense, Would thus never be a just man. It is argued that socrates addresses himself to this position, But that, While the textual thrasymachus is silenced, Socrates' best arguments are, In fact, Inadequate to refute thrasymachus. (shrink)

In this paper I want to suggest that, while the argued philosophical distinction between logic, epistemolgoy and ontology is one of the many achievements of Aristotle, his predecessor Parmenides was in fact already operating with a theory of knowledge and an elementary propositional logic that are of abiding philosophical interest. As part of the thesis I shall be obliged to reject a number of interpretations of particular passages in his poem, including one or two currently fashionable ones. Since so much (...) turns on points of translation, I note for purposes of comparison what seem to be significant alternatives to my own in any particular instance. The line numbers are those of the DK text. (shrink)

Beginning with a review of Michael Pollan's latest book about the renaissance of research into the use of psychedelics to treat addiction, depression, and end-of-life anxiety, this essay considers wisdom and insight that might be gained by examining the psychedelic practices of primitive people. Pollan finds that almost all who begin using psychedelics to treat the ill eventually come to the conclusion that they should be made available for the broader purpose of 'the betterment of well people'. By considering both (...) scientific and spiritual perspectives on these compounds, the book offers insight into the toxicity not only of our mental environment, but at the same time our relationship to fellow humanity and Mother Nature. However, Pollan does not consider what is perhaps the greatest source of wisdom regarding the pharmacological potential of psychedelics: primitive societies who have long incorporated these compounds into their ways of being. By casting anthropological accounts of primitive psychedelic practices against those of contemporary research, this essay seeks to deepen enquiry into the pathologies of modern personhood as they bear upon the ecological crisis, together with the potential value of entheogens for understanding and responding to these problems. (shrink)

This paper argues that the Food and Drug Administration’s (FDA) policy for health and wellness apps is ethically problematic. Currently, the FDA does not regulate health and wellness apps that are not intended for medical use. As a result of this hands‐off policy, preventing harm to consumers is left primarily to developers and app marketplaces. We argue that the FDA’s duties to prevent harm and maintain accountability to the American public require that they play a much stronger role. We also (...) discuss concerns about efficiency and fostering innovation, and argue that while they should help shape FDA regulation of health and wellness apps, they do not justify complete absence of FDA involvement. -/- . (shrink)

Human development is a matter of complex interactions between nutritional regimes, genes, educational regimes and other diverse developmental resources. I argue that there is no ethically salient difference between the contributions made to development by genes and the contributions made by these other resources. Since we think nutrition and schooling should be included in the calculus of distributive justice, we should include at least some genes in this calculus too. What is more, under the right circumstances genetic engineering may become (...) a useful tool for the distribution of developmental resources. This said, attention to the parity of genetic and environmental causation can also help to articulate the legitimate suspicions many groups have of genetic engineering. (shrink)

Portion of the ancient Hindu epic, on fundamentals of the Vedanta school in Hindu philosophy.