Purpose: Physicians are often reluctant to discuss “Do Not Resuscitate” orders with patients. Although perceived self-efficacy is a known prerequisite for behavioural change, little is understood about the confidence of physicians regarding DNR discussions.Subjects and methods: A survey of 217 internal medicine attendings and 132 housestaff at two teaching hospitals about their attitudes and confidence regarding DNR discussions.Results: Participants were significantly less confident about their ability to discuss DNR orders than to discuss consent for medical procedures , and this was (...) true for both attendings and housestaff . In a multivariate logistic model of confidence regarding DNR discussions, women were less confident than men ; house officers were less confident than attendings , those who were less confident of their ability to discuss medical procedures were less confident discussing DNR , and those who found talking to patients about DNR orders very difficult reported less confidence than those who did not .Conclusion: We conclude that physicians’ confidence regarding DNR discussions is low compared with their confidence regarding other medical discussions and that confidence varies by sex and perceived difficulty of the task. Efforts to improve DNR discussions should explore the need to tailor educational interventions to fit these characteristics. (shrink)

The advent of the Web is one of the defining technological events of the twentieth century, yet its impact on the fundamental questions of philosophy has not yet been explored, much less systematized. The Web, as today implemented on the foundations of the Internet, is broadly construed as the space of all items of interest identified by URIs. Originally a space of linked hypertext documents, today the Web is rapidly evolving as a universal platform for data and computation. Even swifter (...) is the Web‐driven transformation of many previously unquestioned philosophical concepts of privacy, belief, intelligence, cognition, and even embodiment in surprising ways. The ensuing essays in this collection hope to explore the philosophical foundation of the World Wide Web and open the debate on whether or not the changes caused by the Web to technology and society warrant the creation of a philosophy of the Web. (shrink)

_Talking Politics_ is a philosophical examination of some of the basic concepts of political discourse. Its primary focus is on the _ordinary_; on what is said by politicians, in newspapers and by people in pubs, rather than on the works of political theorists. This is a work _of_, but not _on_ political theory. _Talking Politics_ is: * Invaluable as a source of reference for students, and contains a detailed index * Arranged thematically, around topics such as `Nation'. Each entry has (...) copious cross-references and suggestions for further reading A. W. Sparkes is uniquely qualified to write such a book, combining some thirty years' teaching as a philosopher with wide experience of, and a life-long fascination with, politics. His attitude is that of a critical, but uncynical, observer. (shrink)

Anton Wilhelm Rudolph Amo (1703–c. 1759 ce), philosopher and physician, was born at Axim, Ghana, and died at Fort Chama, Ghana. When he was four years old, the Dutch West Indies Company's preacher in Ghana sent him to Holland to be baptized and educated in the Bible for future service in Ghana. However, the Company headquarters, undesirous of any interference with its lucrative trade in slaves, turned little Amo over to the German Duke Anton Ulric‐Wolfenbuttel.

Software piracy is a damaging and important moral issue, which is widely believed to be unchecked in particular areas of the globe. This cross-cultural study examines differences in morality and behavior toward software piracy in Singapore versus the United States, and reviews the cultural histories of Asia versus the United States to explore why these differences occur. The paper is based upon pilot data collected in the U.S. and Singapore, using a tradeoff analysis methodology and analysis. The data reveal some (...) fascinating interactions between the level of ethical transgression and the rewards or consequences which they produce. (shrink)

The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self-administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non-identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed to (...) photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non-identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital-owned camera to personal camera/personal camera-phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non-identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera-phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of privacy and confidentiality in medical practice. (shrink)

DISCOURSE; EXPRESSION (i) 'Discourse' is a word with a variety of meanings. One of the more useful is as an omnibus word covering both thought and talk. ...

Dans plusieurs passages, Épicure mentionne des durées infraperceptibles saisies par la raison, ce qui conduit à envisager un atomisme du temps, c’est-à-dire l’existence de durées indivisibles ou quanta de temps. Cette hypothèse, nulle part explicite chez Épicure et Lucrèce, a été évoquée par quelques doxographes. L’objet de cet article est de l’étayer et de la préciser, en lisant les textes épicuriens sur le temps à la lumière des trois grandes objections antiatomistes de la Physique. Notre analyse conclut que l’atomisme du (...) temps permet de répondre aux objections d’Aristote, mais doit être limité au seul niveau des atomes, par opposition à celui des agrégats. Il permet alors en effet de justifier l’isotachie des atomes, de rendre concevable la communauté de structure de la grandeur, du mouvement et du temps, et de garantir le caractère fini de la vitesse atomique. Deux lignes argumentatives se superposent : une conception proprement atomiste du mouvement et une reprise des termes de la physique aristotélicienne destinée à mieux en réfuter les objections. (shrink)

There remains the problem of accounting for the appeal of transcendental idealism. Transcendental idealists themselves may say that there is nothing wrong with the doctrine, but only with the attempt to express it, the point being that it is inexpressibly true: but I argue that this does not extricate them from the trap of self‐stultification. An importantly different proposal, which I derive from the earlier work of Wittgenstein, is this: while we cannot coherently state that transcendental idealism is true we (...) are shown that transcendental idealism is true, where ‘A is shown that x’ is defined as ‘ A has ineffable knowledge, and when an attempt is made to put that knowledge into words, the result is: x.’ I try to indicate how, provided we can make sense of and, this proposal has the threefold merit of: avoiding self‐stultification; being compatible with the incoherence of transcendental idealism; and providing an account of transcendental idealism's appeal. (shrink)

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) has for decades been a locus of dispute between ardent defenders of its scientific validity and vociferous critics who charge that it covertly cloaks disputed moral and political judgments in scientific language. This essay explores Alasdair MacIntyre's tripartite typology of moral reasoning—"encyclopedia," "genealogy," and "tradition"—as an analytic lens for appreciation and critique of these debates. The DSM opens itself to corrosive neo-Nietzschean "genealogical" critique, such an analysis holds, only (...) insofar as it is interpreted as a presumptively objective and context-independent encyclopedia free of the contingencies of its originating communities. A MacIntyrean tradition-constituted understanding of the DSM, on the other hand, helpfully allows psychiatric nosology to be understood both as "scientific" and, simultaneously, as inextricable from the political and moral interests—and therefore the moral successes and moral failures—of the psychiatric guild from which it arises. (shrink)

The paper begins with a defence of a new definition of privacy as the absence of undocumented personal knowledge. In the middle section, I criticise alternative accounts of privacy. Finally, I show how my definition can be worked into contemporary American Law.

With this work, the author terminates his trilogy on nationally prominent philosophers in Germany, France, and the United States, respectively. In all three works a deliberate attempt is made to counter the current trend towards linguistic analysis and deal with philosophy in its classical meaning as a body of general truths about the universe as a whole, which the author believes leads to some important consequences of present day relevance. The style of the work, to say the least, is unusual (...) in that it is cast in the form of a series of letters, fourteen in number, of a father to his daughter. Since he admits there are no German, French, or American "philosophies," properly speaking, each letter deals with a particular North American philosopher, beginning with Jonathan Edwards, Benjamin Franklin, and Thomas Paine in Revolutionary days, continuing with Ralph Waldo Emerson, William James, Charles Sanders Peirce, Josiah Royce, John Dewey, and George Herbert Mead as 19th century representatives, and Whitehead, Santayana, and Carnap for the first half of the twentieth. The work concludes with Hans Kelsen and Marcuse, who like Carnap, came to the United States as the result of Hitler’s antisemitism. The tenor of the work lays stress on problems of cultural and political life and, thereby, on the ties of this sort that bind the United States and Europe. The work reads well, and although its tone is more biographical than philosophical, more expository than critical, it could well serve as supplementary reading for a seminar on American philosophy.—A.B.W. (shrink)

Le passage de la Lettre à Hérodote consacré au temps (Hrdt. 72-73) est particulièrement obscur. Épicure y affirme explicitement que le mot temps ne renvoie à aucune préconception (prolepse), en tout cas pas au sens habituel qu’a ce terme pour lui, puisqu’il n’existe aucun contenu commun à toutes nos expériences du temps ; et cependant le mot temps n’est pas vide. Cet article vise à résoudre ce paradoxe. Il éclaircit la nature de la perception du temps épicurien et tente de (...) reconstituer le processus cognitif qui la sous-tend. La perception du temps est idiosyncrasique, car elle porte sur une entité de troisième degré : le temps est en effet, selon la formule attribuée à Épicure par Démétrius Lacon, un « accident d’accidents ». Sa perception implique une combinaison d’intuition et de déduction, d’analogie et d’épilogisme, en deçà de la formation d’une préconception – dont nous expliquons l’impossibilité. Elle concerne toujours les durées en tant que nous les rapportons les unes aux autres, selon un « libre jeu » de l’épilogisme et de l’analogie qui ne donne pas lieu à une préconception, mais rend possible de nommer le temps. (shrink)

Several decades of behavioral research have established that variations in socioeconomic status are related to differences in cognitive performance. Neuroimaging and psychophysiological techniques have recently emerged as a method of choice to better understand the neurobiological processes underlying this phenomenon. Here we present a systematic review of a particular sub-domain of this field. Specifically, we used the PICOS approach to review studies investigating potential relationships between SES and scalp event-related brain potentials. This review found evidence that SES is related to (...) amplitude variations in a diverse range of ERPs: P1, N1, N2, Error-Related Negativities, N400, auditory evoked potentials, negative difference waves, P3 and slow waves. These ERPs include early, mid-latency and late potentials that reflect a broad range of cognitive processes. In this review, all SES effects on ERPs appeared to reflect an impairment or a less efficient form of task-related neural activity for low-SES compared to high-SES individuals. Overall, these results confirm that a wide variety of distinct neural processes with different functional meanings are sensitive to SES differences. The findings of this review also suggest that the relationship between SES and some ERP components may depend on the developmental stage of study participants. Results are further discussed in terms of the current limitations of this field and future avenues of research. (shrink)